Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a condition affecting people’s behaviour. People with ADHD are often restless, may have trouble concentrating or sitting still, have a short attention span and may act on impulse. It generally happens in children and teens and may continue into adulthood.

The symptoms of ADHD are usually noticed at an early age and become more noticeable when the circumstances of children change (eg. when they start school). Sometimes when ADHD remains undiagnosed in childhood, it may be diagnosed at a later stage as an adult. Approximately 2-7% of children are globally affected by ADHD. India has a higher ADHD prevalence (11.32%) in children compared to the global estimate.

What are the symptoms of ADHD?

Symptoms in children are grouped into three types:
Month Savings
Readily distracted Fidgets, or bounces while sitting
Difficulty following directions Doesn’t play quietly
Does not listen or pay attention Constantly in motion with activities such as running or climbing on things (restlessness).
Careless mistakes Excessive talking
Forgets daily activities Always ‘on the move’
Problems with daily tasks Trouble waiting for turns
Doesn’t like activities that require sitting still Interrupts others and often blurts answers first

The third type are combined symptoms that involves signs of both other types.

Symptoms in Adults:

Changes in symptoms of ADHD may be seen as the person gets older. These include:

  • Often being late or forgetting things
  • Anxiety
  • Low self-esteem
  • Anger issues
  • Impulsiveness
  • Substance misuse or addiction
  • Disorganized and poor planning
  • Procrastination
  • Easily frustrated and often bored
  • Mood swings
  • Depression
  • Relationship problems

What are the causes of ADHD?

Causes of ADHD aren’t very well-proven. Certain factors may lead to ADHD:

  • ADHD tends to run in families (genetic)
  • Certain imbalance of brain chemicals
  • Certain areas of the brain controlling attention are less active in children with ADHD as compared to those without ADHD(Brain changes).

ADHD is not caused by excess consumption of sugar or by watching too much TV, stressful home life, poor schools, or food allergies.

How is ADHD diagnosed?

Diagnosing ADHD is difficult, especially in children as not one single test concludes ADHD. ADHD is diagnosed in children and teens post discussion of symptoms at length. This includes discussion with the child, parents, and teachers and also by observing the child’s behaviours. Certain physical tests and noting family history, parent’s history may be conducted along with an evaluation of the child’s intelligence, aptitude, personality traits, or processing skills. A scan called the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System, measuring theta and beta brain waves may be recommended to find the ratio of theta/beta, which is higher in children as compared to adults.

What are the treatment options for ADHD?

Multimodal treatment approach is the best way manage ADHD. Multimodal treatment involves using medication, therapy together to improve the symptoms of ADHD.

Medications of ADHD:

Stimulants such as amphetamine are most commonly prescribed medications for treating ADHD as they may help controlling the hyperactive, impulsive behaviour while improving attention span.

The use is controversial, and the doctor is the best person to advise on the treatment. People older than 6 may take nonstimulant medications such as atomoxetine, clonidine and guanfacine. Antidepressants such as drugs called SSRIs may be prescribed by doctors in some cases, but they may cause side effects. Talking to the doctor about benefits and risk before starting the medication is important.

Therapy in ADHD:

  • Special education to help a child-learning at school. Structure and routine can help with ADHD children.
  • Behavioural modification: Replacing bad behaviours with good ones and letting your child know your expectation in terms of behaviours. The rules for children should be simple and clear. Good behaviour should be rewarded as it keeps their impulses in check.
  • Psychotherapy (counselling) helps with ADHD in terms of learning better ways to handle emotions and frustration and helps in improving their self-esteem. Parental or family counselling may also help the child to be better understood.
  • Social skills training: Teaches behaviours, such as taking turns and sharing.

Educating parents about managing the disorder and knowing about it more is another important part of ADHD treatment. It includes the parenting skills to help a child manage their behaviour; it helps if the family members are also a part of it.

Tips for parents to help in managing routines and behaviour of kids with ADHD:

  • Sticking to a clear schedule and routine.
  • Instructions are simple and specific (“Brush your teeth. Now, get dressed.”) instead of general (“Get ready for school.”).
  • Complete focus on your child while talking to them.
  • Make an example of yourself – calm, focused behavior, discipline
  • Reward good behaviour.
  • Boosting the child’s self-esteem. Since the child is usually heaped with directions, corrections, they have a low opinion of themselves.
  • Encouraging the child’s special strengths, particularly in sports and extra activities.
  • Keeping close contact with the child’s doctor, teachers, and therapists.
    Joining a support group to learn from other parents who have been through the same problems.

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