Attention deficit hyperactivity disorder, or ADHD, is characterised as children finding it hard to focus on a task or play without getting distracted. They may also act on impulse and make mistakes, they may be forgetful, and they can appear restless or fidgety. This condition is often picked up in children between 3 and 7 years old, but a diagnosis can be made in older children or even adults. It's much more commonly diagnosed in boys, and around 75,000 children are on ADHD medication in the UK, which is the equivalent of a medium-sized town. It can be a tough time for parents and teachers, especially before any diagnosis is made, as behaviours can be disruptive in the classroom and in family life, and your child may be finding it difficult to meet the expectations laid on them, which can feel quite isolating.
Your child’s nursery or school teacher may have noticed certain behaviours or you and your family may have concerns about home life. You should book an appointment with your GP, who cannot directly diagnose ADHD but can refer you on. Your GP will listen to your concerns and ask for examples, and they will consider if any other medical conditions could be causing or adding to certain behaviours. It’s important to consider where certain behaviours are occurring, and where they may be symptom-free – at school, home, their grandparents, sports clubs – and whether there were any significant events that started these behaviours. If your GP considers ADHD is a possibility, they can refer for a specialist opinion to either a paediatrician or child psychiatrist. There is no one test that points to ADHD, but a detailed assessment including interviews with your child, parents, teachers and anyone else involved, will help them reach a conclusion. Diagnosis follows strict criteria – your child has: · 6 or more symptoms of inattentiveness, or 6 or more symptoms of hyperactivity and impulsiveness · Symptoms have been ongoing for at least 6 months · Symptoms started before 12 years old · Behaviours are present in at least two settings – like at home and at school · Symptoms are having an impact on their social and educational progress · There's no explanation or diagnosis that fits better with their behaviours than ADHD, like another mental health disorder, and symptoms are not part of a developmental disorder
Medication and therapy are offered to help with ADHD, and providing both together usually gives the best outcome. The aim is to relieve symptoms and make behaviours easier to manage and live with. There isn’t a cure, as such, but medications may help patients to concentrate for longer periods, thereby improving learning. It can also reduce impulses and bring a calmer feeling overall. Methylphenidate (brand name Ritalin) is the most commonly used of these medications. Children may experience side effects such as headaches, stomach upset, feeling less hungry, or changes to their mood. They will be started on a low dose and closely observed for any intolerable side effects, before increasing the dose, if needed. ADHD is often considered a lifelong condition, although your child may improve as they get older. Medications are offered for as long as they’re needed, but your child’s specialist may consider reducing or stopping at various points, to check they are still necessary. Behavioural therapy may be offered where children learn or strengthen positive behaviours and eliminate unwanted and problem behaviours. It will involve parents and teachers working together to provide support, strategies and boundaries.
ADHD is classed as a special education need (SEN), which means your child is entitled to appropriate support to help them thrive socially and educationally. This may include reasonable adjustments to their school day, such as regular rest breaks, extra time for exams, and a seating plan to minimise distractions and disruptions. The Independent Parental Special Education Advice charity offers free, independent advice on the legal rights of children with SEN and disabilities in school. ADDISS (The National Attention Deficit Disorder and Information and Support Service ) is a national UK ADHD charity and has lots of information on its website and in its bookstore. YoungMinds is a national charity looking after mental health of young people, and has practical tips on the challenges of ADHD. You may be able to find a local support group of parents who are facing similar challenges with a child with ADHD.
The first thing is to keep your child informed and on side, as the condition and society’s response to their behaviours can leave them feeling confused, isolated, anxious and low in confidence. They may be getting in trouble at school or have difficulty managing their emotions or maintaining friendships. Give them space to talk about how they are feeling, and explain how the behaviour strategies and medication will help them. A consistent routine for school days and weekends can help – regular mealtimes, bedtimes and homework time, can help to keep distractions to a minimum and not overload them with work. Reward systems will reinforce good behaviour and outlining boundaries will help discourage bad behaviour. Although easier said than done.