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Attention deficit hyperactivity disorder (ADHD) is a condition which has three different groups of symptoms:
It is thought that that around three to five per cent of children at school in the UK show signs of ADHD. But the most serious form (sometimes also known as Hyperkinetic Disorder) only affects about one to 1.5 per cent. Of course, many children and young people have difficulty concentrating or are restless and excitable. If it’s quite mild and does not impact on your life, it is not considered a disorder.
What causes ADHD?ADHD can result from several causes and often involves a ‘family predisposition’. That means that a child or young person with ADHD is likely to have a relative who had the same difficulties when they were young. It can also be linked to differences in brain development resulting from being born too early or too small, or being exposed to toxins in the womb through a pregnant mother smoking or drinking excess alcohol. Conditions such as epilepsy, autism and Tourette’s syndrome are commonly associated with ADHD. Some studies also show a small contribution from certain food additives in a child’s diet. But there are also other medical conditions that can cause poor concentration such as epilepsy, hearing problems, reading difficulties (dyslexia) or sleeping problems and these have to be considered before diagnosing ADHD. What are the signs and symptoms of ADHD?The main signs or symptoms of ADHD are:
ADHD can make you say or do things without thinking about it first. You might also talk a lot but find it hard to listen when it’s not your turn. As you get older you may find that you get frustrated easily and often get into trouble. You might have problems finishing things you’ve started, and not do your school work or homework properly. The problems are first seen in quite young children. But the signs of the condition are usually more obvious to other people than to the person with ADHD. As they get older they begin to realise that their concentration is poor and that they are unusually restless and impatient compared with their friends. Most young people with ADHD have other difficulties as well. These can include:
These are not actually part of ADHD but are very commonly associated with it. How is ADHD normally diagnosed and treated?There is no single test for ADHD (like a blood test or scan). So it can take a while to get all the information needed together to give you a diagnosis. Usually your family doctor (GP) or your school will refer you to a child psychiatrist or paediatrician for assessment. They’ll ask a lot of questions about you, how you have grown up and how you are getting on at school, for example. You may find you have to see other experts such as a psychologist or specialist nurse as well as a doctor. It’s also normal for the team to ask your school for information. Not all children will be offered the same treatment for ADHD. The best approach is often a mixture of treatments, which will change as they get older: Preschool children usually just need behaviour management programmes. Children in school will have medication as well as a behaviour management programme. Special arrangements will be needed to help with school work. Teenagers may be offered counselling along with medication. Their behaviour management programme will focus more on organisation and planning skills. There will normally also need to be special arrangements to help learning in school. Adults will be given medication and continue with behavioural modification programmes. Many people who are referred for specialist assessment will be offered medicines. The most common of these are stimulant drugs. These medications can help with attention problems, hyperactivity and impulsiveness but they don't get rid of ADHD permanently. This means you have to keep taking them, sometimes only on schooldays, for months or years, but not forever. You won’t become addicted to them. It is important to get the right dose to make sure that the side-effects, such as having a poor appetite or finding it difficult to fall asleep, are not troublesome. Medication can help you to think more clearly, understand schoolwork better and feel calmer and more in control of yourself. This means you can take proper advantage of any other help you are getting at home and at school. You may find that you don’t feel any different when you take the medicine but people around you notice that you are doing much better. Don’t stop your medicine yourself – your doctor will stop it from time-to-time to check whether you still really need it. When to ask for medical helpGenerally speaking, the earlier in the school years ADHD is picked up, the better. The more help you get, right from the start, the more likely you are to go on to lead a positive and successful life. The longer problems go on at home and school then the more difficult things can become. What’s going to help?Having structure in your life can really help you to feel in control. This means doing things on a regular, predictable basis, planning ahead and having regular timetables and routines. Having a set time for homework can be useful as well as breaking tasks up into chunks so they don’t take so long that your concentration fades. Educational psychologists can also help you with aspects of your schoolwork by recommending the best ways of teaching you to your teachers. Sometimes counselling can help you find better ways of organising yourself or understanding how what you might be doing is upsetting other people. Looking forwardMany children grow out of this condition, with treatment though about half will continue to have some of the difficulties in their twenties. These tend to be around getting organised, keeping focused or concentrating on things that other people want you to do. For more help and informationVisit the national UK Attention Deficit Hyperactivity Disorder Information and Support Service (ADDISS). ADDERS provides information and practical help, mainly for parents. You can call the Psychiatric Drug Helpline on 020 7919 2999. YoungMinds is a national charity committed to improving the mental health of all babies, children and young people. Youth Access has information on youth counselling. Click here to choose a different journal Last reviewed by Great Ormond Street Hospital: 24 July 2008 Return to A-Z of mental health homepage >
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