What is

ATTENTION DEFICIT/HYPERACTIVE DISORDER ?

Attention-deficit/ hyperactivity disorder (ADHD for short) is one of the more common neurological developmental disorder that affects children, adolescents, and adults. Children afflicted with ADHD are inattentive, quick tempered, impulsive and quite restless to the point that they find it almost impossible to sit still. As per reports almost one-third of children are described by their parents as overactive, and 5-20% of school children are described by teachers, these reports describe a spectrum of behavior ranging from normal high spirits to a severe persistent disorder. It is important to point out here that Attention Deficits Hyperactivity Disorder (ADHD) denotes the functionally impairing persistent end of the spectrum.   Early intervention in ADHD can help a child achieve age appropriate goals and assimilate better in school and society. Indeed with the right therapies children can learn to target this hyperactivity into excellence in sports and inattentiveness can be converted to hyperfocus and extreme skill at certain activities

As per reports as many as 11 percent of children in India at the primary level and 5 percent children worldwide have one form or another of ADHD. 

ADHD symptoms

Common symptoms of ADHD include:

  • Lack of attention
  • Mood swings and easy to anger
  • Impulsiveness and low tolerance level
  • Difficulty in time-management
  • Disorganization
  • Hyperactivity
  • Fidgeting
  • Stress-related problems

ADHD Rates by Age

Most ADHD cases are found in children. While hyperactivity, impulsiveness, and inability to focus are all normal traits for children, children with ADHD suffer more extreme symptoms. Generally speaking, about one-third of children diagnosed with ADHD carry their diagnosis into adulthood.

The following are statistics on ADHD pertaining to age:

  • The median age of diagnosis in children is 6 years old. This means that 50% of children diagnosed with ADHD were diagnosed by the age of 6.
  • The median age of severe diagnosis in children is 4 years old. This means that 50% of children diagnosed with severe ADHD were diagnosed by the age of 4.
  • In 2001 to 2004, 8.7% of adolescents (teens aged 13 to 18) were diagnosed with ADHD.
  • In 2001 to 2003, about 4% of adults had ADHD.
  • In a 2013 study, children aged 12 to 17 made up the largest percentage of ADHD diagnoses (11.8%). Children aged 6 to 11 made up 9.5%, and children aged 4 to 5 made up 2.7%.

ADHD Rates by Gender

There are definitive differences in the rate of ADHD cases between men and women.

A deeper look shows that:

  • ADHD affects three times as many males as females.
  • In one study, 12.9% of boys were diagnosed with ADHD, while 5.6% of girls were diagnosed.

ADHD & Co-Occurring Diagnoses

ADHD can occur alongside other disorders like depression, anxiety, or autism. Co-occurring disorders can be either symptoms of a larger disorder or the results of societal, cultural, or other expectations.

Whether co-occurring diagnoses are a symptom of ADHD or just a related issue, research shows that:2,3

  • According to a 2016 parent study, 5 in 10 children with ADHD had a behavior problem. In that same study, 3 in 10 had anxiety.
  • The CDC states that depression and autism spectrum disorder can also affect those diagnosed with ADHD.
  • Another 2016 study found that 2 out of 3 children had at least one other co-occurring disorder. 1 in 6 children with ADHD suffered from depression while 1 in 7 children with ADHD had autism spectrum disorder.

Types

There are three different types of ADHD, depending on which types of symptoms are strongest in the individual:

  • Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
  • Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
  • Combined Presentation: Symptoms of the above two types are equally present in the person.

Because symptoms can change over time, the presentation may change over time as well.

Children with the disorder are often reckless and prone to accidents. They may have learning difficulties, which results in part from poor attention and lack of persistence with tasks. Many develop minor forms of antisocial behavior as the condition continues, particularly disobedience, temper tantrums, and aggression. These children are socially inhibited and can cause disruption both at home and in the classroom. They can be susceptible to bullying and can be easily influenced by ‘silly’ things. Mood fluctuates, but low self-esteem and depressive mood are common.

Restlessness, overactivity, and related symptoms often start before school age. sometimes the child overactive as a baby, but more often significant problems begin when the child starts to walk; they are constantly on the move, interfering with objects and exhausting their parents. But with a timely diagnosis and the right treatment plan, these children can go on to turn their lives around for the better!

WHAT CAUSES ADHD

Attention Deficits Hyperactivity Disorder (ADHD) is suspected to occur due to both heritable and non-heritable factors. Several studies are under way in an effort to find better ways to manage and reduce the chances of a person having ADHD. The precise cause and risk factors for ADHD remain unknown, but current research shows that genetics plays an important role.

In addition to genetics, scientists are studying other possible causes and risk factors including:

  • Brain Injury
  • Exposure to environmental risks (e.g. lead) during pregnancy or at a young age
  • Alcohol and tobacco use during pregnancy
  • Premature delivery
  • Low birth weight

Research has disproved several common myths including the fact that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. All these factors may contribute to the severity of the symptoms, especially in certain people. But it cannot be said with surety that they are the main causes of ADHD.

Important note to parents: As a precaution, parents should request pediatricians to conduct routine developmental tests to check if the child has met developmental and language milestones. 

Screening at home for

aDHD

Parents are the first ones to notice when something is wrong, they can spot warning signs that a Pediatrician may miss in a ten minute visit. An early diagnosis of ADHD combined with the right therapies can substantially help the child. However, early diagnosis is only possible if parents are made aware of the warning signs of ADHD, if caught in infancy treatments can take advantage of the remarkable plasticity of the young brain and reverse a lot of the issues that arise.

Children afflicted with Attention Deficits Hyperactivity Disorder (ADHD) display many of the following symptoms:

  1. Inattention:
  • Fail to finish the things started
  • Shift from one uncompleted activity to another
  • Do not seems to listen
  • Are easily distracted by external stimuli
  • Often lose things
  1. Hyperactivity:
  • Are fidgety
  • Find it difficult to sit in one place for long
  • Prefer to always keep moving
  • Talk excessively
  • Interfere in other people’s activities 
  1. Impulsivity:
  • Act before thinking on the spur of the moment
  • Find it difficult in waiting for their turn at work or play

If you or your Paediatrician has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or a developmental Paediatrician.

 

GETTING A FORMAL DIAGNOSIS

Child Psychologist

Diagnosing ADHD is a complicated process as there are no medical tests, such as blood tests, which can be used to diagnose it. It can ony be diagnosed through direct observation by the right medical personnel.

Specialist Medical personnel that diagnose ADHD include Child Psychologists/Psychiatrists, Child Neurologists and Developmental Pediatricians.

Pediatrician

ADHD is diagnosed by a child mental health specialist who is trained to evaluate and diagnose. The DSM-5 criteria that professionals rely on to diagnose ADHD seeks to fulfill the following requirements. 

  1. Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
    • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
    • Often has trouble holding attention on tasks or play activities.
    • Often does not seem to listen when spoken to directly.
    • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
    • Often has trouble organizing tasks and activities.
    • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
    • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
    • Is often easily distracted
    • Is often forgetful in daily activities.
  2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
    • Often fidgets with or taps hands or feet, or squirms in seat.
    • Often leaves seat in situations when remaining seated is expected.
    • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
    • Often unable to play or take part in leisure activities quietly.
    • Is often “on the go” acting as if “driven by a motor”.
    • Often talks excessively.
    • Often blurts out an answer before a question has been completed.
    • Often has trouble waiting their turn.
    • Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
  • Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
  • The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

TREATING ADHD

Generally, ADHD is treated with a combination of behavior therapy and medication. Training for parents is highly recommended as the first line of treatment. Nearly 70% of children with ADHD are taking medication for their symptoms.

Being healthy is important for all children and can be especially important for children with ADHD. In addition to therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:

  • Developing healthy eating habits such as eating plenty of fruits, vegetables, and whole grains and choosing lean protein sources
  • Participating in daily physical activity based on age
  • Limiting the amount of daily screen time from TVs, computers, phones, and other electronics
  • Getting the recommended amount of sleep each night based on age

 

Every child or adult with autism has unique strengths and challenges and so each autism intervention or treatment plan should be tailored to address their specific needs. The treatment plan includes therapies that can broadly be classified into the following three groups.

 

Special Education
Special
Education
Occupational Therapy
Occupational
Therapy
ABA based Behavioural Therapy

WE CAN HELP

We, at EduPlay Therapy offer a supportive and interactive environment for young minds to learn and grow. We offer Special Education, Occupational Therapy, ABA Based Behaviour Therapy and Speech Therapy for specially abled children with conditions such as ADHD, Autism Spectrum Disorder, Down syndrome and Cerebral Palsy. We also provide parent training sessions to ensure that every parent can be an active participant in their child’s recovery. To know more about our services click here.

ADHD MYTHS

Many parents believe that ADHD is a problem of school-aged children. But, in fact, the symptoms of ADHD, and the diagnosis can be made as early as 3 years of age.

All children want to succeed and get praised for their good behaviour. However, a child that finds it nearly impossible to stay focused in class, or to complete a lengthy task such as writing a long essay, may try to save face by acting as though he does not want to do it or is too lazy to finish. This behavior may look like laziness or lack of motivation, but it stems from real difficulty in functioning.

ADHD is not a result of poor discipline—although behaviors that stem from ADHD can challenge otherwise effective parenting styles