ADD & ADHD....WHAT ARE THEY-Synopsis 

 

Attention Deficit Disorder ( ADD) , Attention Deficit Hyperactivity Disorder ( ADHD), often the names ADD and ADHD are used to mean the same thing. as part of a group of behaviour problems where children have more difficulty with concentrating on what they are doing (problems with attention) than other children of their age.

 

What causes ADHD?

There is not yet a clear explanation for ADHD, however there are some theories to suggest that: 

• There is a problem with how the front part of the brain functions. This causes the child's brain to deal with information and feelings in a different way from other children.

• Genetic factor, ADD tends to run in families.

• Some foods (such as sugar and food colourings) seem to trigger more 'out of control' behaviour.

• Sleep apnoea, research findings  has shown that about 30% of children who have ADD or ADHD have some sleep apnoea.

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Signs and symptoms

Your child may have ADHD if he or she is having difficulties both at school and at home and has had at least six of the behaviours listed below in either of the following groups.

Remember that for younger children these are part of normal everyday behaviour.

Children who are distressed or unhappy for other reasons, or who have other learning problems can also show these behaviours.

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Inattention

The child often:

• Misses details or makes careless mistakes in school-work or other activities

• Has trouble organising tasks and activities

• Loses things needed for tasks or activities, eg. toys, school assignments, pencils, books

• Has trouble sticking to tasks or play activities

• Does not seem to listen when spoken to directly

• Doesn't follow through instructions that he is able to understand, and does not finish tasks (eg. at school or chores at home)

• Tries to get out of doing things that require a lot of thinking and concentrating (these are hard work and tiring)

• Is easily distracted

• Is forgetful in daily activities.

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Hyperactivity/Impulsivity

The child often:

• Fidgets with hands or feet, or squirms in his/her seat

• Leaves his/her seat in the classroom when he/she should be seated

• Runs about or climbs excessively (more than most other children)

• Has trouble playing quietly

• Is continually 'on the go'

• Talks 'all the time'

• Blurts out answers before the questions have been completed

• Has difficulty awaiting his/her turn

• Butts into conversations or games

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AND​

1. The behaviour pattern is different from most other children of about the same age

2. The behaviours happen in more than one place, for example at home and school

3. The behaviour has lasted for more than 6 months

4. The behaviour pattern started before age 7 years, the child does not have other major health or development problems, and

5. The behaviour is causing the child problems with school work, friends and daily living.

 

The last thing listed here is very important - the behaviour pattern must be interfering with the child's ability to get on with his life, to learn or to fit in with his world.
(Adapted from the 'Diagnostic and Statistical Manual of Mental Disorders, DSM-IV')

 

Other problems that can occur with ADD/ADHD

It is common for children with ADD/ADHD to have other problems.

• Many will not do well at school, and may have specific learning problems.

• Many children who are diagnosed with ADD/ADHD will have behaviour problems such as conduct disorders, anxiety disorders, mood disorders and motor coordination problems (be clumsy).

• In secondary school, a teenager needs to be better organised, and be able to concentrate for longer times compared to younger children. Although his behaviour may be better than when he was young, his problems with learning may be greater.

 

Treatment

Specialist Team will carry out thorough assessment to reach the accurate diagnosis and to identify the child's needs, and to provide the appropriate treatment program, The assessment normally include:

• Assessment of the child's development, behaviour, and how well the child manages at school

• Psychology assessments to work out how the child manages different tasks, including learning

• Thinking about what is happening for the child at home and how your discipline works for the child.

• Assessment of the child's school and friendships

• A family assessment - ADD/ADHD runs in families, but stress within the family can trigger behaviour problems in children, so thinking about other people in the  family is important. 

• Checking that your  child can see clearly and has normal hearing

• Checking to see if there are other reasons to explain your child's behaviour, such as sleep apnoea, illness or medicines.

 

Assessment should involve parents, teachers, psychologists, doctors and possibly others, depending on your child's needs.

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• It is also important that other problems which often come with ADD/ADHD, such as specific learning problems, and difficulties with movements (coordination) are fully checked and a plan is made to help your child manage them if they are present.

• The management of ADD/ADHD is not simple. It involves many people - it is important to share difficulties and successes, especially with teachers.

• To really help your child all the other areas such as behaviour and learning also need attention.

• ADD/ADHD is only one of many possible explanations for inattentive, distractible or hyperactive behaviour in children

 

What is the long-term outlook?

ADHD was traditionally viewed as a disorder of childhood that individuals grow out of. However, it has been reported that many children with ADHD continue to exhibit significant difficulties as adults. By adulthood, the classic hyperactivity of childhood may have eased; however, the effects of ADHD on social and academic functioning and self-esteem can become cumulative. For example, adults with ADHD have more marital difficulties, more employment difficulties and more driving violations. Untreated ADHD is associated with higher rates of alcohol and drug use in adulthood.

Early intervention is key

 

Dr. Akeel. A.Abdul Wahab

Fellow & Member of The Royal College of Psychiatrists (UK)

FRCPsych. (UK), MRCPsych. (UK), Board NeuroPsych. (London University ,UK), Dip.Psych. (London University, UK), MB.ChB.(Basra University , Iraq )

Formerly Senior Consultant Psychiatrist  & Clinical professor

References:

American Psychiatric Association. 'Diagnostic and Statistical Manual of Mental Disorders, DSM-IV'  

Royal Australasian College of Physicians Australian Guidelines on ADHD 2016 

Mental health public Awareness /ADD/ADHD/AAW  Jan 2022 Copyright