I’ve had ADHD since I was little. I’m now in my late 50s.
I can’t recall exactly when I first realised that there was something different going on with me – but I was an adult before the light dawned.
Well known, but not known about
Most people who work with troubled kids will have heard about ADHD.
In my experience, though, many don’t know much beyond the very basics, In fact, lots of people I speak to have a view of ADHD limited to kids with an unusual degree physical hyperactivity. The fidgety kids who can’t sit still – ‘Oh, he’s the one with ADHD.’
We need a broader sense of what ADHD is and of how it affects children’s functioning, if we’re to really help them push through and do better.
DISCLAIMER: what follows is an aggregation of my reading – I am not a doctor.
If you need help yourself or for someone else, please consult a doctor.
In a nutshell:
So, here’s my very brief, non-medical, summary of what it is:
ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder that commonly affects children but can persist into adulthood. It is characterized by persistent patterns of inattention, hyperactivity, and impulsivity, which can significantly impact an individual’s daily functioning and quality of life.
Here are some key summary points about ADHD:
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- Definition: ADHD is a neurodevelopmental disorder which causes children to experience abnormal levels of inattention, hyperactivity, and impulsivity.
- Prevalence: It is one of the most common childhood neurodevelopment disorders. It is thought to affect around 5-10% of children. Symptoms normally appear in early childhood, but they very often persist into the teenage years and beyond, into adulthood.
- Inattention: Sustaining attention is perhaps the most prevalent symptom of ADHD. This shows itself in distractibility (i.e. difficulty paying attention), forgetfulness (e.g. losing things, not keeping appointments), struggling to follow instructions and difficulties with task-completion.
- Hyperactivity: Perhaps the most well-known symptom, hyperactivity manifests as excessive physical agitation, such as fidgeting, restlessness, and having trouble sitting still. People with ADHD may struggle to engage in quiet activities and seem to be ‘on the go’ all the time I’ve heard it described as feeling like having a dynamo inside.
- Impulsivity: Impulsivity refers to acting without thought for potential consequences – act first, think…whenever! Individuals with ADHD may also cut across conversations and interrupt people, and/or struggle with self-control (e.g. saying ill-thought-through and/or inappropriate things, buying things they can’t really afford, acting rashly or taking risks, etc.).
Subtypes:
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- Subtypes: ADHD can be classified into 3 subtypes:
- predominantly inattentive presentation,
- predominantly hyperactive-impulsive presentation, or
- combined presentation (inattention, hyperactivity, and impulsivity).
- Subtypes: ADHD can be classified into 3 subtypes:
Diagnosis – Symptoms – Causes:
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- Diagnosis: Diagnosis is typically made through a comprehensive assessment by a psychiatrist, sometimes in partnership with a psychologist, who follow a diagnostic manual – either DSM-V (North American) or ICD-11 (World Health Organisation).
- Symptoms: These must be present for at least 6 months, start before the age of 12, be outside of what’s normal for age & intellectual functioning, be present in multiple different settings and have a notable negative impact on everyday life (e.g. school, work, social relationships).
- Causes: This is the focus of great debate and much ongoing research! But the truth of it is likely to be some combination of genetic, environmental, and neurological factors, possibly differing from person to person. Differences in brain structure, different function and neurotransmitter imbalances, may also contribute to the condition.
‘Scientists have not yet identified the specific causes of ADHD. While there is growing evidence that genetics contribute to ADHD and several genes have been linked to the disorder, no specific gene or gene combination has been identified as the cause of the disorder. However, it is important to note that relatives of individuals with ADHD are often also affected. There is evidence of anatomical differences in the brains of children with ADHD in comparison to other children without the condition.’ (American Psychiatric Association)
Comorbidities – Treatment
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- Comorbidities: ADHD often coexists with other conditions like learning disabilities, autistic spectrum disorders, anxiety disorders, depression, and oppositional defiant disorder. These comorbidities can further complicate diagnosis and treatment.
- Treatment: Treatment for ADHD typically involves a combination of approaches, including (but not limited to) coaching, behavioural interventions/strategies and medication. The regimen for each person is unique and requires regular review, particularly where medications are a feature.
Final Thoughts…
As we can see from this, ADHD is a lot more than being a ‘fidgety kid.’ It’s a complex condition that has real & troublesome impacts on everyday life. It needs looking at carefully by quaified people so children (and adults – like me!) can get the help they need.
What do you think?…
Please let me know your thoughts… Leave a comment below.
More information:
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- This is my FAVOURITE book on ADHD (I’ve read most of them!) – ADHD 2.0 by Ed Hallowell & John Ratey
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- ADDitude magazine/website – an absolute min of information, advice, blogs, resources, etc. Learn more here.
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- AdvanceADHD – brilliant ADHD coaching service for people with ADHD or those who care for them. Learn more here.
Pass it on…
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© Jonny Matthew 2023
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MY experiences though of parents seeking a ADHD diagnosis for their child is an unwillingness to explore trauma in their own childhood or that of their child? the tick list for trauma is almost identical to that of ADHD
We provide social prescribing service for Llanelli GP for those children who do not meet the threshold for CAMHS In the 234 children we have supported they all had witnessed or experienced trauma. What is significant that many of the parents who identified the traits in their child stemmed from their own childhood and children were mirroring the language and behaviours ? on the spectrum I full agree that there are children with ASD / ALN which can confuse the presenting and emerging issues? We measure before and post service and all well being scores increased significantly by accessing a secure attached adult in their lives as we work with the main care giver as well.
Hi Tracy, THANKS for commenting. Yes, there are lots of overlapping issues here, aren’t there? The trauma one is a classic, of course, and sometimes (often?) over-looked, I think. The attachment point is a good one too, as many kids can look like ADHD (particularly the hyperactivity bit) when they’re presenting with attachment insecurity – and discerning the difference or connection between trauma and attachment insecurity is a subtle call in itself. Untangling it all is an important part of the assessment process, isn’t it, but I think is over-looked, unfortunately. We need a lot more resources to ensure quick access to thorough assessments made by people who really know ADHD and are not distracted by the ICD-11 bit alone. Sounds like you guys are doing a great job there – more power to ya! Cheers, J.
Thanks for the information. It couldn’t have come at a better time.i am not on Facebook so would not have seen it otherwise. I think the work you do for troubled children is phenomenal. God bless you joan
Hi Joan, THANKS so much for commenting, I’m delighted the info was handy. It’s very much a summary & therefore a little clumsy, but it can be tricky to find a succinct summary all in one place – so that’s what I was shooting for! Apologies – I missed your comment when you first posted it & only saw it when I went in to approve the one below. Thanks again! Cheers, Jonny.
Hiya for many years as part of our local CAMHs we ran an integrated Education, and Health ADHD assessment service this helped us run a one stop shop where a family would meet all assessments on one evening and walk away with a “diagnosis” or not at the end of the session. For those with a diagnosis we offered first a 10 week Family Effectiveness Programme where the parents would follow work on low arousal parenting while the kids in a seperate room would follow a CBT based programme in the room next door using a lot of Psychology undergrads to allow 1:1 work. We eventually prescribedbonly following the FEP to about a third of those diagnosed the others had made sufficient progress measured by school and home measures to progress drug free. Of those on meds our intention was to follow up until teenage years and to wean off (The kids were mainly 7-9 years old ) meds before secondary. Sadly the resource required was hard to maintain so we ran it for about three years and then due to educational changes, my transfer into child forensic etc the service crumbled. Currently it is now a seperate and sadly lengthy process with services no longer integrated. Still good while it lasted and I think offers a good model if services become less shattered for the future.
great project shame it ended !
We do similar in fact we now work with the parent first for 4 sessions before even meeting the child! In those sessions we explore their attachments in their own childhood and explore any trauma they may have experienced. We look at transference as some parents seem to see ADHD in their child when actually its the child seeking out attention from the parent in whatever way they can act out! It can be alight bulb moment for the parent and thus the approach to parenting changes without the need for medication. When we work with the child it is then CBT focussed and self soothing strategies, we use the egg timers a lot from amazon!
Thanks Tracy – interesting point about transference & the impact of this on parents’ perceptions of the child’s behaviour and the propensity to label this as ADHD. I imagine you see that quite a lot. It’s also common for people to mistake insecure attachment behaviour for ADHD, isn’t it, particularly where the child is fidgety & ‘on the go’ a lot. So important to have accessible services to do thorough assessments for these familIes. You guys are doing great work!
Hi Clifton, This sounds like a really good system you guys had set up. Such a shame it couldn’t continue as it’s so hard for folks to get an integrated service that follows kids through to adulthood & offers a range of input for the family.
What are your thoughts on the criticism that a one stop approach can make for less thorough diagnosis? I don’t subscribe to this view personally, but I hear it sometimes. Thanks for commenting! Cheers, J.