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ADHD

ADHD is an internationally-recognised condition. It is the subject of an enormous amount of scientific research. However, despite this, fears and/or prejudices about ADHD and its treatment remain.

ADHD is a complex neurobiological disorder. Researchers consider that people with ADHD have a few structures in the brain that are smaller and that their neurotransmitters – the chemical messengers of the brain – do not work properly. It usually gives rise to significant problems with concentration, hyperactivity and/or impulsivity that impact adversely on education and home/social life.

ADHD occurs in approximately 5% of children worldwide.

In practice, there are two distinctly different types of ADHD – those with hyperactivity and impulsivity and those who are predominantly inattentive.

40-50% of children with ADHD have at least one parent with the condition and 30% have a sibling with it.

Children with ADHD usually behave about a third less than their chronological age with a 2-4 year lag in age appropriate developmental skills – they know what to do but don’t always do what they know. Most children with ADHD have a few activities where their impairments are absent. The impairments unfold as they get older.

Ratio of males to females diagnosed with ADHD is about 5:1. Males are often more aggressive and oppositional. Females more often have the inattentive form of ADHD and are currently significantly under-diagnosed.

Individuals with ADHD are not alike – symptoms can be mild, moderate, severe or combined with other conditions. This means adults will see variability in skills and maturity levels in these students.

ADHD often occurs with other conditions – two thirds of individuals with ADHD have at least one other co-existing condition, such as Oppositional Defiant Disorder (ODD), dyslexia, depression and anxiety.

Children with ADHD are not “problem children” but children with a genuine problem. They have a medical condition that is difficult for them and difficult for you. They stand out as different from peers and siblings at all stages of development.

Individuals with ADHD are slower to learn self management skills, like problem-solving, anger management, conflict resolution, self advocacy and monitoring their own behaviour. Research and reality tells us that they often experience a significant developmental delay and are not ready for the same level of independence and responsibility as their peers, needing parents/teachers support for longer. Their skills deficits are real and not due to laziness or lack of motivation.

Individuals with ADHD usually have many talents and gifts. The challenge is to help them develop their potential.

Early identification and effective treatment, after comprehensive multi-professional assessment, which may include appropriate medication, allows an individual to achieve their potential and have an improved quality of life.

An individual’s confidentiality should always be respected – special arrangements for medication should not be common knowledge to the class.

The child with ADHD on medication will not become an angel overnight – there will still be problems in some situations.

It is often in group situations and at unstructured times that things go wrong for an individual with ADHD.

The threat of punishment has little effect on the child with ADHD because of poor appreciation of cause and effect and consequences of actions.

Try not to assume that an individual with ADHD will behave well because of getting a treat or reward.

Rather than being given a “label”, an individual with an appropriate diagnosis of ADHD should then have the best chance of receiving the most appropriate interventions and supports to help him achieve to his potential and have an improved quality of life.

Try to be conscious of the hypersensitivity of an individual with ADHD – they often over-react to apparently minor  triggers – to the observer – and easily becomes overwhelmed by stress and pressure.

Try to accommodate skills difficulties; acknowledge and note vulnerabilities.

Sufferers have difficulty monitoring situations and themselves at the same time and adjusting their action to the setting. They have problems with managing frustration/modulating emotion which takes over and causes over reaction to frustration, hurts, wants and worries. They are often unaware of how they come across to others or unable to interpret emotions in themselves and others.

A comprehensive specialist assessment of an individual is indicated if reasonable strategies, including educational strategies, alone have been unsuccessful in improving the difficulties to establish whether or not there is a diagnosis of ADHD and/or related conditions.

Medication may be advised in combination with educational, behavioural and other individually-determined strategies to help the child. The aim of medication is to normalise the brain’s deficient neurochemistry and should be seen as providing a “window of opportunity” to treat the core ADHD symptoms of inattentiveness, hyperactivity and impulsiveness.

Significant improvement in core symptoms is possible in up to 95% of children carefully managed for ADHD. Side effects – if they occur – are usually mild and transient under careful management. There is also usually a subsequent flow-on effect to many of the other difficulties – ie self esteem, social skills. A child with associated specific learning difficulties will generally cope much better when able to concentrate; a child who is impulsive or fidgety in class can become aware of the consequences of his/her actions or words. Hence, the child with ADHD is able to proceed through schooling more appropriately to potential and thus to have a more positive outcome in adulthood. There is also less disruption in the classroom setting.

ADHD is a hidden disability. The diagnosis is not an excuse – rather an explanation. Symptoms of ADHD present lifelong challenges. Untreated and misunderstood, it damages a childhood and blights a future and can lead to family dysfunction. Treated, its many gifts can outweigh its challenges.

A good understanding of the facts and reality of ADHD – rather than reliance on myth and misinformation – enables teachers to have realistic expectations so they are better able to help and support the child and family.

Progression of Untreated ADHD

Useful Links:
NICE Guidelines – www.nice.org.uk

Useful Resources:
ADHD – A Mother’s Story
ADHD – An Overview
ADHD – A Brother’s Story
ADHD – Understanding Children’s Needs

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