ATTENTION DEFICIT HYPERACTIVE DISORDER (ADHD)

April 1, 2020
Health Care, Mental Care, Wellness

What is ADHD?

Attention Deficit Hyperactivity Disorder is a neurological disorder that is characterized by impulsivity, hyperactivity and attention difficulties. It begins in early childhood and can persist into adulthood

There are three major types of ADHD:

  • ADHD – combination type. This is the most common type of ADHD characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.
  • ADHD – Impulsive/hyperactive type. This is the least common type characterized by impulsive and hyperactive behaviors without inattention and distractibility.
  • ADHD – Inattentive type. This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity.

Symptoms of ADHD

Symptoms of ADHD differs from person to person, these are the symptoms that are commonly present:

  • Being easily distracted
  • Struggling with inhibitory control
  • Taking longer to complete tasks
  • Making simple errors
  • Making impulsive decisions
  • Avoiding tasks that are complicated
  • Difficulty focusing on two tasks simultaneously
  • Hyperactivity (in certain cases)
  • Focus intensely on things they love for long periods of time (hyperfocus)
  • Doesn’t follow directions or finish tasks
  • Doesn’t appear to be listening
  • Struggling to pay attention and makes careless mistakes
  • Forgets about daily activities
  • Has problems organizing daily tasks
  • Doesn’t like to do things that require sitting still
  • Often loses things
  • Tends to daydream and not be present at the moment

Diagnosis of ADHD

ADHD is the most commonly diagnosed behavior disorder in childhood. A Pediatric Psychiatrist, or a Pediatric Neurologist can give a diagnosis. A detailed history of the child’s behavior from parents and teachers, observations of the child’s behavior contribute in making the diagnosis of ADHD.
ADHD presents with a group of symptoms, diagnosis depends on evaluating results from several different sources, including physical, neurological, and psychological testing. Other tests may be used to rule out other developmental conditions like Autism.

What causes Attention Deficit Hyperactivity Disorder?

Research suggests that children usually struggle with attention skills because of weak underlying cognitive skills that improve over time as the brain develops – those brain functions responsible for how well we pay attention, learn, read and remember (EXECUTIVE FUNCTIONS). These Executive functions are severely affected in ADHD and there is poor self-regulation. Environmental factors like diet, sleep, stress, and a busy environment also plays a part or contributes to the worsening of symptoms.

  • ADHD is one of the most researched areas in child and adolescent mental health. However, the precise cause of the disorder is still unknown. Available evidence lean more on the genetic etiology of ADHD more than the environment and the environment is viewed more as a contributory factor other than a cause. It is a brain-based biological disorder based on the current studies of brain imaging.
  • Brain anatomy and function. A lower level of metabolism in the parts of the brain that control attention, impulse control and activity level may be associated with ADHD. Brain imaging studies have shown differences in brain structure and wiring between children with ADHD and their peers. The brain develops in a similar way in both groups but in children with ADHD, development of certain areas of the brain is often delayed (some studies suggest by about three years). Those delays are typically in the areas most involved in Executive Functions. Low levels of dopamine (a brain chemical), which is a neurotransmitter (‘messengers’ that send information between neurons) were found in children with ADHD.
  • Genes and heredity. ADHD frequently runs in families. A child with ADHD has a 1 in 4 chance of having a parent with ADHD. It’s also likely that another close family member, such as a sibling, will also have ADHD.
  • Significant head injuries may cause ADHD in some cases.
  • Prematurity increases the risk of developing ADHD.
  • Prenatal exposures, such as alcohol or nicotine from smoking, increase the risk of developing ADHD.
  • In very rare cases, toxins in the environment may lead to ADHD. For instance, lead in the body can affect child development and behavior.

Treatment and therapies

There is no cure for ADHD, however there are therapies and medications that are available to manage the symptoms.
Major components of treatment for children with ADHD include

  • Parental support
  • Behavioral training for both parents and child – to equip parents with the necessary skills to help manage behaviors and to equip the child with self-regulating skills and teach appropriate social behavior
  • Appropriate school placement and academic accommodations put in place to help child reach their potential
  • Medication with psycho-stimulants – These medications are used to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses.

Can ADHD be prevented?

There are no known preventative measures to reduce the incidence of ADHD in children at present. However, early diagnosis and intervention can have a positive impact on the severity of symptoms, decrease the interference of behavioral symptoms on home and school functioning, enhance the child’s growth and development, and improve the quality of life experienced by children with ADHD.

Quick facts on ADHD

  • Attention deficit hyperactivity disorder (ADHD) affects children and teens and can continue into adulthood.
  • Boys are 3 times more likely to receive an ADHD diagnosis than girls.
  • ADHD is the most commonly diagnosed mental disorder in children – this has also raised concerns of possible misdiagnosis.
  • It interferes with school and home life.
  • Symptoms typically first appear between 3 and 6 years, when a child begins to have problems paying attention, being ‘all over the place’ (hyperactivity) and struggling at school.
  • The average age of diagnosis is 7 years
  • Children with undiagnosed ADHD are more commonly mislabeled as ‘naughty’, ‘troublemakers’ or ‘problem children’.
  • ADHD affects all races. o Children living in poverty have an increased risk.
  • It is estimated that at least one learner in every South African classroom is affected by ADHD.
  • The past few years have seen a huge increase in the number of cases and diagnosis of ADHD across all races.
  • ADHD does not cause other development disorders but can occur in the context of other existing disorders like Autism Spectrum, Learning Disability, and Conduct Disorders, etc.
  • It is the most medicated childhood developmental disorder with up to 69% of children with the diagnosis on medication worldwide.

AFRICAN PERSPECTIVES

  • There is a dearth of knowledge and awareness in African communities concerning mental health and in children, this is coupled with denial and a belief that a child will outgrow the ‘bad behavior’.
  • A child with ADHD is viewed as being ‘a naughty’ or ‘a problem child’ and in some cases, they are punished for the ‘bad behavior’ in the hope that they will snap out of it.
  • In a South African study by Amod Z, Kern A, Seabi J and Vorster A ‘South African Foundation Phase Teachers’ Perceptions of ADHD at Private and Public Schools’. They found that teachers had knowledge of what ADHD is but did not have adequate training in helping learners.

Talent Adamson

Behaviour Therapist

BA (Health and Social Services) Applied Psychology, BA Hon (HSS) Psychological Counselling – (UNISA)

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