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Attention deficit hyperactivity disorder (ADHD) in children
Published by Bupa's health information team, May 2009.
This factsheet is for parents of children who have attention deficit hyperactivity disorder (ADHD), or for people who would like information about it.
ADHD is a disorder that has a harmful effect on a child's learning, behaviour and development. Children with ADHD have very short attention spans and may be easily distracted, overactive and restless.
ADHD is also known as hyperkinetic disorder (the official UK term) and attention deficit disorder (ADD). These different names can be confusing but are all used to describe the problems of children who are unable to concentrate and are overactive.
It's estimated that ADHD may affect up to one in 20 school-age children. ADHD is at least four times more common in boys than girls. Children are usually diagnosed around the age of 7, but symptoms continue into adolescence and adulthood.
If you think your child may have ADHD, it's important that you get a diagnosis and start treatment as soon as possible so that his/her symptoms don't get worse and his/her development isn't too badly affected.
Symptoms of ADHD
There are a range of symptoms or behaviours that are associated with ADHD. Many of these behaviours are also seen in children who don't have ADHD. These are only a problem if they affect your child's social and school life.
The following table lists a number of common ADHD symptoms.
Making careless mistakes in schoolwork
Not listening to or following instructions properly
Running or climbing when and where they shouldn’t
Unable to wait for their turn or in queues
Not finishing things – being distracted easily
Unable to stay sitting down or to play quietly
Answering questions before they have been fully asked
Losing and forgetting things
Children with ADHD may have mostly hyperactive or impulsive symptoms, mostly inattention symptoms or a combination of these.
Other symptoms common in children with ADHD include:
aggressiveness and poor discipline - disruptive behaviour
fearlessness and reckless behaviour
ADHD won't make your child less intelligent but it may interfere with his/her ability to learn.
If your child has ADHD, it may become more noticeable or get worse when he/she starts school. Your child's learning may be slowed down by a lack of attention and concentration. If your child is hyperactive and aggressive he/she may have difficulty getting on with other children. If your child is dreamy and inattentive but not disruptive, his/her condition may go unnoticed.
Complications of ADHD
If your child has ADHD, he/she may find it more difficult to communicate and interact with other children and adults. Problems with speech development are also common.
As your child gets older, he/she may become involved in antisocial conduct (such as rowdy or threatening behaviour) and may be unaware of how his/her actions affect others.
Causes of ADHD
The exact cause of ADHD isn't known, but there are likely to be a number of factors involved.
Research suggests that people with ADHD may have differences in the parts of their brains that deal with controlling impulses and focusing attention.
Your child may be more likely to have ADHD if he/she:
has a family history of ADHD
had a low birthweight
was exposed to cigarettes, alcohol or drugs (such as cocaine) in the womb
Your child's behavioural and emotional symptoms may be made worse if he/she also has other problems (such as an anxiety disorder). A stressful home environment, for example because of a divorce or separation, may also contribute. There is also evidence to suggest that there may be a link between television viewing in preschool children and development of ADHD behaviours.
Diagnosis of ADHD
If you're concerned that your child may have ADHD, visit your GP. Your GP will ask you about your child's symptoms and examine him/her. Your GP may also ask you about your child's medical history.
If your GP thinks that your child may have ADHD, he/she may refer your child to one of the following specialists for diagnosis and treatment.
A child psychiatrist (a doctor who specialises in children's mental health).
A child psychologist (a health professional who specialises in children's behaviour).
A specialist paediatrician (a doctor who specialises in children's illnesses).
There are no specific tests for ADHD. Your child will be observed and reports of his/her behaviour will be studied. You and other people who spend time with your child (such as carers or teachers) may be asked to fill in a questionnaire about your child's behaviour.
ADHD is usually diagnosed if many symptoms are present and occur in more than one setting (such as home and school) and other mental or physical conditions (such as obsessive compulsive disorder or deafness) have been ruled out.
Treatment of ADHD
It's thought that the most effective way to treat ADHD is to use a combination of different approaches. The exact types of treatment used will depend on the specific requirements of your child - the symptoms he/she has and how he/she responds to each type of treatment. It's important to remember that your child may have to try a number of different treatments before a successful combination is found.
In some children, ADHD symptoms can be improved by cutting down on certain ingredients (such as sugar, caffeine and food additives), or giving extra vitamins, minerals or omega-3 fatty acids. It's been found that children with ADHD often have lower levels of these essential nutrients than children who don't have ADHD. You should always speak to your child's doctor or a dietitian before making any changes to your child's diet.
Managing behaviour at home
You can help your child by providing a structured environment with clear rules of acceptable behaviour. Your child's specialist can help you learn how to manage his/her specific behaviours. You could also attend classes and support groups where parents can share their knowledge and experience.
Talk to your child's teacher about his/her condition. A structured and orderly classroom without too many distractions and small group or individual teaching may help your child to focus better in school.
If your child is diagnosed with ADHD, his/her school may offer extra help with reading, spelling, maths, organisational skills, speech therapy, physical education therapy and counselling. An educational psychologist will usually assess your child's needs and check on his/her progress.
Your child's specialist doctor may prescribe medicines when diagnosing the disorder. He/she will identify a suitable medicine and dosage, and following this your child's care will usually be transferred to his/her GP.
The type of medicine prescribed for your child will depend on:
whether he/she has any other medical conditions
how he/she responds to the medicine
whether he/she gets any side-effects
Medicines that are often prescribed for children with ADHD include methylphenidate (eg Concerta XL), atomexetine and dexamfetamine. These medicines work by changing the levels of certain chemicals in the brain that have been found to be unbalanced in children with ADHD. They can help to reduce hyperactivity and impulsiveness, and can increase the attention span of children with ADHD, helping them to concentrate better at school.
Like all drugs, these medicines can sometimes have side-effects, including insomnia, headaches, irritability and weight loss.
Always ask your child's doctor for advice and read the patient information leaflet that comes with your child's medicine.
Talking therapies such as psychological and behavioural therapy can also help children with ADHD. The therapy is designed to help your child learn to cope with his/her condition and reduce impulsive behaviour. Therapy may be offered to your child or your whole family. Talk to your GP or child's psychiatrist about what is best for you and your child.
Living with ADHD
Caring for a child with ADHD can be difficult and the effects on family life can be dramatic. National support groups are available for the families of children with ADHD, and your GP may be able to put you in touch with a local group. Through one of these, you can meet other families in the same situation and get support and advice on behaviour management for your child.
- Royal College of Psychiatrists
020 7235 2351
- National Attention Deficit Disorder Information and Support Service (ADDISS)
020 8952 2800
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007:899
- Factsheet 5: Attention-deficit hyperactivity disorder and hyperkinetic disorder. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed 17 June 2008
- Methylphenidate, atomoxetine and dexamfetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
- Attention deficit and hyperkinetic disorders in children and young people. Scottish Intercollegiate Guidelines Network (SIGN), 2001. www.sign.ac.uk
- Background information on ADHD. ADDISS. www.addiss.co.uk, accessed 20 June 2008
- Attention deficit hyperactivity disorder (ADHD). Mental Health Foundation. www.mentalhealth.org.uk, accessed 17 June 2008
- Attention deficit hyperactivity disorder (ADHD). DirectGov. www.direct.gov.uk, accessed 20 June 2008
- Understanding and recognising ADHD. ADDISS. www.addiss.co.uk, accessed 20 June 2008
- ADDISS common questions. ADDISS. www.addiss.co.uk, accessed 20 June 2008
- Nutt DJ, Fone K, Asherson P et al. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology. J Psychopharm 2007; 21:10-41. http://jop.sagepub.com
- Curtis LT, Patel K. Nutritional and environmental approaches to preventing and treating autism and attention deficit hyperactivity disorder (ADHD): a review. J Altern Complement Med 2008; 14:79-85
- Diet, behaviour and learning in children. British Dietetic Association (BDA). www.bda.uk.com, 2007
- Education. ADHD Aberdeen & Northeast. www.adhd-aberdeen.org.uk, accessed 23 June 2008
- Special educational needs code of practice. Department for Education and Skills. www.standards.dfes.gov.uk, 2001
- Joint Formulary Committee, British National Formulary 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008: 215-217
- Miller CJ, Marks DJ, Miller SR et al. Brief report: Television viewing and risk for attention problems in preschool children. J Pediatr Psychol 2007; 32:448-452. http://jpepsy.oxfordjournals.org
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: May 2009