October is ADHD awareness month. Here, our paediatrician, Dr Lexi Frydenberg, sheds light on what ADHD is and is not.
Are you worried that your child can not sit still? Can not focus on a task for more than a few minutes? Is impulsive and can’t control their emotions? Daydreams all the time? These are the common concerns that parents raise with paediatricians on a very regular basis and often ask the question: Does my child have ADHD?
It is a normal part of a toddler and young children’s behaviour and development to have a limited attention span, jump from activity to activity and have difficulties regulating their emotions. As children grow older and mature, these will improve with time and still occur occasionally.
Only a few of these children will be diagnosed with ADHD. In children with ADHD, these challenges often happen and significantly affect the child and family’s daily life.
What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a long-term Neurodevelopmental disorder that starts in childhood.
ADHD Symptoms
The three main signs and symptoms of ADHD are:
Inattention
Hyperactivity
Impulsivity
Further ADHD signs include
Inattention: trouble concentrating, focusing, remembering instructions and trouble finishing tasks - easily distracted
Hyperactivity - finds it hard to sit still, fidgety, restless, always “on the go.”
Impulsivity - difficulty controlling emotions, acting or saying things without thinking, interrupting other people's conversations or games, and taking risks.
ADHD Types
ADHD Combined type
A person with ADHD combined with possess difficulties with attention, hyperactivity/impulsivity
ADHD Inattentive type
Previously referred to as ADD. A person with Inattentive ADHD will have difficulties with attention, concentration and focus
ADHD Hyperactive/Impulsive type
A person with hyperactive/impulsive ADHD will struggle with hyperactivity/impulsivity.
What causes ADHD?
The exact cause of ADHD is not known. It is a neurodevelopment disorder
ADHD tends to run in families (so there is most likely a genetic component)
It is NOT caused by poor parenting or something you did wrong in pregnancy etc.
What age is ADHD diagnosed?
A diagnosis of ADHD should only be considered when the symptoms above are causing problems for your child +/- family
Usually, children must be at least five years old to be assessed for ADHD
By definition, the symptoms of ADHD must begin before age 12, but ADHD may not be diagnosed until the teenage years or adulthood
ADHD is most commonly diagnosed in children when issues arise at school, socially or at home. ⠀
How to diagnose ADHD
ADHD is a clinical diagnosis, meaning there is NO SPECIFIC TEST to make a diagnosis
A diagnosis of ADHD can only be made by a trained, experienced health professional. Usually, Paediatrician and Psychologist
Diagnosing ADHD is not easy because ADHD can overlap with other conditions
Diagnosis is based on a set of clinical criteria and how many of the features of inattention and hyperactivity/impulsivity the child has across two settings (both home and school)
The symptoms need to be there for > 6 months
The diagnosis will include gathering information from both home and school - this is usually done by standardised questionnaires/behaviour checklists
Other health professionals who know your child (e.g. Speech path, OT) may also share very useful information
Your child may also need other assessments e.g., learning assessments, cognitive (IQ) assessments, speech and language, vision and hearing assessments, general health check
A paediatrician will review your child and try and look at "the whole picture". This is to look for other possible causes and contributors to your child’s issues as well as other conditions that often occur in children with ADHD (e.g. learning difficulties, sleep issues, anxiety)
How to help a child with ADHD?
There are so many things that can be done to help you understand your child as well as to help your child. There are thousands of books written about this. I have added a reference to a book I recommend below that talks about behavioural and school management as well as the role of medication. This is the general approach I take when managing a child
with ADHD
General measures for parents dealing with ADHD
I can’t emphasise enough how important these are.
POSITIVE PARENTING STRATEGIES
SLEEP - quality and quantity
NUTRITION - broad, healthy diet - rules out nutritional deficiencies
SCREEN USAGE
MENTAL HEALTH ISSUES- manage co-existing issues if present
Specific management of ADHD symptoms
Classroom strategies
Home/parenting strategies
School support/ Individual learning plan
Psychological, behavioural management/support
Occupational Therapy support
Medication - Stimulant medication is most effective if you decide to try medication once other management options are explored and in place
Fish oils - may have some benefits
These Information sheets have some excellent tips on how to support your
child both at home and school if features of ADHD are present.
The information sheets include strategies for school and homework, and self-esteem.
- Social Skills
- Communication between home and school
- Strategies for home
Top tips for parents
- Try to understand your child and how their brain may be “wired”
differently than yours
- Find their strengths and focus on these, often
- Positive Parenting Strategies
- Praise appropriate behaviours/reinforcement
- Use clear instructions
- Behavioural contracts
- Consistency
- Stick to a routine where possible
- Build up your child’s confidence and social skills
- Help plan your child’s learning and learning environment - work with the
school
There is so much we could discuss about ADHD; we know many people hold strong and different beliefs about ADHD. It is a controversial topic and just a brief overview from our Paediatrician Expert Dr Lexi Frydenberg's perspective.
Explore our range of informative masterclasses to elevate your parenting skills with valuable insights and knowledge.
Below are some resources you may find helpful.
RESOURCES:
Royal Children’s Hospital:
https://www.rch.org.au/kidsinfo/fact_sheets/Attention_deficit_hyperactivity_disorder_
ADHD/
https://www.rch.org.au/kidsinfo/fact_sheets/ADHD_ways_to_help_children_at_schoo
l_and_home/
RCH Kids Health Info Podcast episode- Does my child have ADHD?
https://www.rch.org.au/kidsinfo/Podcast/
Raising Childrens Network
https://raisingchildren.net.au/school-age/development/adhd/adhd
Book Recommendation:
https://uwap.uwa.edu.au/products/adhd-go-to-guide-facts-and-strategies-for-parents-
and-teachers-1
Disclaimer: The information in this article is provided for educational purposes only and is not intended to substitute advice provided by your doctor or other healthcare professionals. The author of this information has made a considerable effort to ensure the information is in-line with current guidelines, codes and accepted clinical evidence at time of writing, is up-to-date at time of publication and relevant to Australian readers. The opinions and thoughts expressed in this article reflects the view of the author only and not the broader medical profession or her places of work. The author accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in this information. We recommend you always consult a qualified health practitioner for individualised advice.
Comments