ADHD in a nutshell

 

Attention Deficit Disorder with Hyperactivity refers to a disorder where the individual is unable to regulate his or her own behaviour. There are a number of features which are common to this disorder which make learning and normal behaviour extremely difficult. It is a condition which impacts the child, family and teachers. Typically these children will experience negative reactions towards them, which in turn affects their self-image. It is also a condition which is far more common in boys than in girls and certainly runs in families.

 

Over the years I have encountered children with this disorder and listened to the parents describe with sadness what their child has had to experience as a result. Imagine a scene such as this: A little boy attends a local nursery school. His mother arranges a wonderful party for his 5th birthday. She books out a party farm and sends invitations to school for the teacher to hand out to the whole class. It is supposed to be a happy event. Instead the mom is told by the teacher that many of the children who received the invitations cried. On the day of the party, the cake is ready, games arranged and balloons pumped but only a trickle of children arrive. The mother is devastated for her little boy.

 

At a meeting with the teacher the mother is informed that her son’s behaviour makes the other children scared. He is prone to bullying, often loses his temper and breaks toys or flings puzzle pieces. He is also disruptive in the classroom and is just not a likable child. After some discussion it is decided that the child needs to be investigated for ADHD. A couple of months later the same little boy is very happy at school. He has made friends and his ability to concentrate and interact normally with his classmates has improved tremendously. It sounds like the ending to a fairy-tale but often these stories are due to interventions which address ADHD in children.

Let’s take a look at this disorder, how to recognise it and what can be done to ensure that we help prevent the awful effects of a bad self-image, poor academic achievement and unmanageable behaviour.

 

 

As described in our little story, parents and teachers may experience a child who:

 

  • Has a temper
  • Is disruptive
  • Is easily distracted so tasks are often not completed
  • Talks a lot
  • Acts without thinking and often does things other children wouldn’t attempt
  • Has an endless supply of energy
  • Struggles with socialising

 

These findings would translate into the 4 major features of ADHD. The doctor would assess:

 

 

  • In ability to concentrate (Inattention)
  • Impulsivity (Acting without thought)
  • Distractibility
  • Hyperactivity

There are very specific questionnaires which the parent and teachers would complete in order to give the doctor a good sense of the features to decide if your child fits the picture. Along with the questionnaires, the doctor should conduct a neurodevelopmental assessment to ensure that your child has attained all the expected milestones related to his or her age. This assessment will also help the doctor rule out any other causes for the behaviour of the child. Conditions such as epilepsy or anxiety disorders may be among the other causes for a child with behavioural or concentration problems.

 

Parents question why their child has ADHD?

 

To be honest scientists don’t know the exact cause of ADHD. What they do know about the condition is that:

  1. It happens because of an imbalance in the neurotransmitters in the brain. These are the chemical messengers. This imbalance may be due to a traumatic birth, prematurity or even illness at the time of birth.
  2. Certain genetic factors may affect the brain development during pregnancy.
  3. It is hereditary. Very often a parent or another close family member will identify with the features and nod in agreement when the behaviours are described.

 

What happens after diagnosis?

 

It is never easy for parents to accept that their child has a disorder but coming to terms with it is extremely important if your child is going to get the best support.

The main component of treatment is medication. Medication for ADHD has really received a bad rap over the years but all the research points to the need for medication in order to normalise the neurotransmitters in the brain.

It is interesting that the medication used is often a stimulant. Parents often find this strange because it is hard to believe that such a busy child needs anymore stimulation. What the medication does however is to bring the brain back into balance. There are various options for treating ADHD depending on the features present so your doctor will guide you as to the best medication for your child.

Some children may experience side effects from the medication and these need to be monitored closely. The most common are headaches, sore tummies and poor appetite. These symptoms usually disappear after a week or two so it may just mean pushing through the symptoms and helping your child cope.

Over and above the medication your doctor may recommend additional interventions like behaviour modification (a form of psychology), remedial assistance or a dietician, depending on the findings.

For the parents it may also be helpful to get support because parenting a child with ADHD is tough. Finding methods that support the child but allow the parents to have their own needs met is something I believe is very important for a healthy outcome for the whole family.

 

Parents ask if there are alternatives to medication?

 

Diet– A lot of parents report that their children react to certain foods. The truth is that children without ADHD are also reported to be affected by certain foods. This is why a lot of schools have changed their tuckshop menus. If this is the case for your child then there isn’t any harm in eliminating these foods from the diet. There isn’t however scientific evidence to support that food causes ADHD. Certainly a healthy diet free from excessive preservatives and colourants is vital to normal brain development and functioning for all children. The diet does become extremely important if the child isn’t eating a balanced diet or if the medication makes your child loose his or her appetite. Under these circumstances I strongly advise getting a dietician involved to ensure that your child gets good nutritional support.  This may include the addition of vitamins and essential fatty acids to support your child.

Homeopathic remedies: I had a very interesting conversation with a homeopath about homeopathic medications. He was concerned that a lot of homeopathic medications or those sold as such have not all been put through the same level of testing. As a highly qualified homeopath he was confident about the products he uses for various ailments but could not say the same about all homeopathic products. With this in mind a parent must be careful of what they administer to a child as we don’t have all the scientific data necessary to support all of these products. For those parents who find it makes a difference and they are confident in the skills of their homeopath then there shouldn’t be a reason why the homeopathic medication isn’t used in conjunction with the conventional medication.

 

Conclusion

 

ADHD is a complexed disorder because it is very often coupled with other difficulties like a learning disability or an emotional disorder. Thankfully the disorder has been investigated for more than 100 years which means that there is a lot of evidence to support current treatment and people living with the disorder are increasingly understood and given the tools to cope. Not all children will grow out of the disorder and will carry a lot of the symptoms into their adult life. The positive side of early diagnosis and intervention is that the adults who were identified and treated as children grow up with a healthy self-image, experienced success at school and know how to manage their symptoms. In the end they can go on to fulfill their full potential and that is the kind of ending we are all looking for in the life stories of our children.

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