Attention deficit hyperactivity disorder, or ADHD, is when the child has problems with attention span. The Child & Adolescent Mental Wellness Service, Department of Psychological Medicine, KK Women's & Children's Hospital [KKH] explains.
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ADHD: Causes and risk factors
There is evidence that alcohol or drug use and smoking during pregnancy may affect the unborn child, raising the risk of attention deficit hyperactivity disorder [ADHD]. In addition, prematurely born or low-birth-weight babies and children with a head injury are at greater risk of developing ADHD.
Certain psychological and social factors like poor socio-economic background and severe early deprivation are also risk factors for ADHD.
Research studies have identified some changes in brain development in ADHD patients, such as lower concentrations of a brain chemical called dopamine.
ADHD treatment
ADHD treatment involves managing the symptoms with medication, occupational therapy, and behaviour strategies.
- Medication: Stimulants boosting certain brain chemicals can help reduce hyperactivity and improve attention in moderate and severe ADHD cases.
- Occupational therapy: This may improve attention and concentration and help the child to filter external distractions and achieve better motor coordination.
- Behaviour strategies: Parents and teachers can use strategies, e.g. reward charts, to help promote good behaviour.
“Parenting skills training programmes can help parents learn ways to better manage their child’s ADHD symptoms,” says says Dr Vicknesan Jeyan Marimuttu, Consultant, Child and Adolescent Mental Wellness Service, KK Women's and Children's Hospital [KKH], a member of the SingHealth group.
Dr Marimuttu also stresses the importance for parents, caregivers, and educators to have a good understanding of ADHD.
“Children with ADHD may also benefit from specific educational support, anger management as well as social and problem-solving skills training,” he adds.
A key aspect of ADHD treatment is loving support both at home and at school. This can help ADHD children better manage their symptoms and build their self-esteem.
Does ADHD increase a child’s risk of developing other health conditions?
Currently, evidence indicates that a child with ADHD is not at risk of developing other physical health conditions. However, there is a high association with learning problems, mood and anxiety symptoms, and conduct disorders.
ADHD children are prone to accidents due to their hyperactive and impulsive behavior. They need to be taught to follow safety rules.
Undiagnosed and untreated ADHD has been associated with poor academic achievement in children. In adults, it has been associated with a higher rate of divorce, substance and alcohol misuse, difficulties at the work place and higher rates of contact with the criminal justice system, underscoring the importance of proper diagnosis and treatment at an early stage.
Ref: R14
References:
About ADHD. Children and Adults with Attention-Deficit/Hyperactivity Disorder website. Available at: //www.chadd.org/Understanding-ADHD/About-ADHD.aspx. Accessed October 4, 2017.
Attention deficit hyperactivity disorder [ADHD]. National Institute of Mental Health website. Available at: //www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml. Updated 2016. Accessed October 4, 2017.
Stern T, Rosenbaum J, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, PA: Mosby Elsevier; 2008.
Understanding ADHD: Information for parents. Healthy Children—American Academy of Pediatrics website. Available at: //www.healthychildren.org/English/health-issues/conditions/adhd/Pages/Understanding-ADHD.aspx. Updated January 9, 2017. Accessed October 4, 2017.
What is ADHD? Kids Health—Nemours Foundation website. Available at: //kidshealth.org/en/parents/adhd.html. Updated July 2014. Accessed October 4, 2017.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors [may act without thinking about what the result will be], or be overly active.
Signs and Symptoms
It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.
A child with ADHD might:
- daydream a lot
- forget or lose things a lot
- squirm or fidget
- talk too much
- make careless mistakes or take unnecessary risks
- have a hard time resisting temptation
- have trouble taking turns
- have difficulty getting along with others
Learn more about signs and symptoms
Types
There are three different ways ADHD presents itself, depending on which types of symptoms are strongest in the individual:
- Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
- Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long [e.g., for a meal or while doing homework]. Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
- Combined Presentation: Symptoms of the above two types are equally present in the person.
Because symptoms can change over time, the presentation may change over time as well.
Learn about symptoms of ADHD, how ADHD is diagnosed, and treatment recommendations including behavior therapy, medication, and school support.
Causes of ADHD
Scientists are studying cause[s] and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause[s] and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies link genetic factors with ADHD.1
In addition to genetics, scientists are studying other possible causes and risk factors including:
- Brain injury
- Exposure to environmental risks [e.g., lead] during pregnancy or at a young age
- Alcohol and tobacco use during pregnancy
- Premature delivery
- Low birth weight
Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.
Diagnosis
Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.
Learn more about the criteria for diagnosing ADHD
Treatments
In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children [4-5 years of age] with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.
Learn more about treatments
Managing Symptoms: Staying Healthy
Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:
- Developing healthy eating habits such as eating plenty of fruits, vegetables, and whole grains and choosing lean protein sources
- Participating in daily physical activity based on age
- Limiting the amount of daily screen time from TVs, computers, phones, and other electronics
- Getting the recommended amount of sleep each night based on age
Get Help!
If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency [for children under 3] or public school [for children 3 and older].
The Centers for Disease Control and Prevention [CDC] funds the National Resource Center on ADHD, a program of CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center [1-866-200-8098] with trained staff to answer questions about ADHD.
For more information on services for children with special needs, visit the Center for Parent Information and Resources. To find the Parent Center near you, you can visit this website.
ADHD in Adults
ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. The symptoms can cause difficulty at work, at home, or with relationships. Symptoms may look different at older ages, for example, hyperactivity may appear as extreme restlessness. Symptoms can become more severe when the demands of adulthood increase. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health.
More Information
- National Resource Center on ADHD
- National Institute of Mental Health [NIMH]
Reference
- Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., . . . Wang, Y. [2021]. The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews. doi:10.1016/j.neubiorev.2021.01.022