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Attention Deficit Hyperactivity Disorder (ADHD)

September 08, 2021

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Team Mindsum

About the author: This article is written by our team of researchers and writers. Our content is published after careful review and approval by the editorial board.

Team Mindsum

About the Editor: Our team of researchers and writers edited this article. Our content is published after careful review and approval by the editorial board.

What is Attention Deficit Hyperactivity Disorder (ADHD)?
Symptoms of ADHD in young children
Causes of ADHD in children
Treating ADHD
What types of professionals are involved?
The journey of treating ADHD
How to support someone with ADHD
How can I support my child with ADHD?
Useful resources

What is Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that influences the way the brain develops and functions affecting behaviour. It is one of the most common disorders that affects children, where around 1 in 20 have ADHD.

Symptoms can first appear during childhood and go on to exist in teenage years and adulthood as well. People with ADHD tend to be more restless and impulsive and have difficulties concentrating can lead to experiences with mental health problems such as anxiety, depression, sleep problems and more.

There are three types of ADHD: hyperactive-impulsive type, inattentive type and the combined type.

The inattentive type refers to having challenges with tasks and activities that consist of focus, organisation and sustaining attention. Individuals diagnosed with the inattentive type are usually less disruptive and active than those with the hyperactive-impulsive type. Formerly, it was known as Attention Deficit Disorder (ADD).

The hyperactive-impulsive type refers to having symptoms of hyperactiveness and impulsiveness. More specifically, hyperactivity looks at signs of excessive movements and energy. Meanwhile, impulsivity refers to the tendency to act without giving thought or reflecting on the consequences.

The combined type is when a patient doesn’t particularly fall into either inattentive or hyperactive-impulsive type. Rather they display symptoms from both categories combined. For an individual to be diagnosed with the combined type they must display at least six symptoms from the inattentive ADHD symptoms and six hyperactive-impulsive ADHD symptoms. According to the National Institute of Mental Health, most children usually are diagnosed with the combined type of ADHD with it being more common in boys than girls.

It can be easy for children and young people with ADHD to feel out of control and misunderstood. Others who may not understand can think that they are acting out on purpose. This can make them feel sad and alone and can affect their self-esteem. It is important to support children and young people with ADHD in managing the disorder and preventing problems with their mental health.

Symptoms of ADHD in children

‍The symptoms of ADHD usually start before the age of 12 years. These symptoms cause problems in different situations, such as school and home. The child or young person will experience issues with making friends, performing well in school and completing tasks by themselves. Based on the type of ADHD, there are different symptoms that you may notice.

The inattentive type symptoms can include:

Failing to pay attention
Careless mistakes
Difficulty maintaining concentration while doing tasks
The mind seems to be elsewhere during conversations
Can rarely follow instructions and finish tasks
Difficulty with organising tasks
Dislikes tasks that need mental effort
Often forget their belongings

The hyperactive and impulsive type symptoms can include:

‍Constant fidgeting
Leaving seat when remaining still is required (e.g. at school)
Running around and climbing in situations where it is not appropriate (e.g. during class time)
Difficulty staying calm and quiet during activities
Always on the go and can be difficult to keep up with
Talks a lot
Blurting out the answer before someone finishes the question
Has a hard time waiting for their turn
Often interrupts others

Comorbidity

There is a high level of association of ADHD with developmental and learning problems as well as with a variety of mental health disorders. ADHD often occurs alongside other neurodevelopmental disorders in children.

50% of people with ADHD also are diagnosed with other conditions, which most commonly include: depression, anxiety, obsessive-compulsive disorder (OCD), oppositional defiant disorder (ODD), learning and language disabilities, motor and executive function difficulties, Tic disorders and other neurological problems. Some of these are prompted by the coping of ADHD. The causes of ADHD comorbidity range from genetics to environmental factors. There are three categories of ADHD comorbidity as well:

Cortical wiring problems (caused by structural abnormalities in the cerebral cortex) – learning disabilities, language disabilities, fine and gross motor difficulties
Struggling with regulations of emotions – depression, anxiety disorders (panic attacks), anger-control problems, obsessive-compulsive disorder (OCD), bipolar disorder.
Tic disorders – twitches in muscles including motor tics (eye blinking / head jerking / repeated gestures), oral tics (blurting out words) and Tourette’s syndrome

“ Sophia is a 10-year-old girl. Since starting school Sophia has found it hard to pay attention in class. The teachers report that Sophia’s mind always seems to be elsewhere. She feels embarrassed every time it is her turn to read in class, but she just can’t seem to focus long enough to do it. Her mother realises that Sophia forgets things quite a lot and misplaces her belongings. Sophia has started to feel sad and irritable on most days. She finds it hard to keep friends, as it is really difficult for her to keep up. Sophia’s parents decided that it was time to speak to a mental health expert for some support.”

Causes of ADHD

The specific cause of ADHD is not known. It is likely due to a combination of genetic and environmental factors as well as differences in the way the brain works. These are some factors to consider:

Runs in families
Problems at birth (e.g. low birth weight, preterm delivery)
Problems during pregnancy (e.g. smoking, alcohol consumption.
Lead exposure at a young age
Brain injury
Epilepsy
Iron deficiency

ADHD is diagnosed more often in boys than in girls. This is because boys tend to present with more disruptive symptoms and girls with more inattentive symptoms.

Treating ADHD

‍When treating ADHD, there are psychosocial types of therapy that are involved. This means that the therapy aims to focus on the child or young person and the influence of others around them.

Under five years old

Alike to conduct disorders, a parent training programme is usually the first route of therapy. The parents/guardians will learn to adapt their parenting skills in a way that helps the child or young person to manage their behaviour. The child might be invited to some sessions together with their parents, where they will get to practice these new skills and get feedback from the professional.

Over five years old

Professionals may also offer a parent training programme for guardians of the child, which can have a positive impact on the behaviours of children that have ADHD.

Cognitive behavioural therapy (CBT) is another type of therapy that focuses on the link between thoughts, feelings and behaviours. With CBT, children and young people learn the skills to reduce symptoms of ADHD and manage mental health problems. According to research, CBT can help reduce behavioural problems linked with ADHD.

The idea behind this is that some of the symptoms of ADHD can cause problems in the child or young person’s life such as poor social skills, concentration and self-control. Therefore, by learning the skills that will improve these areas, the symptoms of ADHD will be reduced.

The therapist will help the child or young person to talk about difficult feelings, as they also learn skills such as social skills, problem-solving and listening skills. This will help the child to develop helpful strategies to cope with ADHD and mental health problems.

M‍edication

A specialist can prescribe medication to treat ADHD, but treatment that also includes therapy is usually best. Within the UK, 5 types of medication are licensed for treating ADHD. This includes:

Methylphenidate
Dexamfetamine
Lisdexamfetamine
Atomoxetine
Guanfacine

Medication is not a cure for ADHD, but it can help your child to feel calmer and more able to concentrate in their everyday life. Please note that for children under five a second specialist opinion needs to be sought from an ADHD service before prescribing medication.

‍Children and young people with ADHD should eat a healthy diet and exercise regularly as both can alleviate symptoms of ADHD.

What types of professionals are involved?

‍‍Different professionals may or may not be involved throughout the treatment process of ADHD. The terms might be confusing, but the main difference is in the training that each of these professionals has received.

In the UK, there is not much of a distinction made between counsellor and psychotherapist. Both of these professionals provide therapy. However, there are some slight differences between these two professional terms. These are outlined below.

Counsellors‍

Counselling is focused on helping people with what they need right now. Compared to psychotherapists, counsellors tend to have shorter training. There may be school-based counsellors available that children and young people can approach at their schools. Here at Mindsum, we have counsellors who are available to provide support.

Psychotherapists‍

Psychotherapy training tends to be longer. Psychotherapists can also give counselling but their approach to talk therapy is more in-depth, exploring the history and causes of certain behaviours and emotional issues. The psychotherapist will help the child in this specialised way. Here at Mindsum, we have psychotherapists who are available to provide support.

Cognitive Behavioural Therapists

These are therapists who have been trained in Cognitive Behavioural Therapy using this model to form an idea of a patient’s mental health difficulties and to treat them. When working with children with ADHD the therapists would have been trained to make adaptations to the CBT model and therapy itself to best suit the child’s needs.

Educational psychologist

Psychologists trained in the area of child development and learning might be involved in the treatment process of ADHD. They will help to support and improve the child’s learning experience so that they can be successful at school.

Doctors

These are professionals who are trained in medicine. This will likely be the family GP, who might find it necessary to prescribe certain medications that might help the child or young person cope better with ADHD.

Psychiatrist

These are professionals who are also trained in medicine. However, they specialised in the field of psychiatry. They can provide consultation and medication for a wide range of mental disorders such as anxiety, depression, and schizophrenia.

Social workers

Workers trained in working with vulnerable individuals and the community might also be involved with the child or young person. They can provide or make arrangements for support. They may also work with law enforcement and other sectors to ensure that the child is safe from harm.

The journey of treating ADHD

‍The journey of recovery from ADHD can look different for each child or young person. Depending on the child’s age and severity of symptoms, the treatment might include therapy and/or parent training programmes. An example journey through cognitive behavioural therapy is discussed below.

Assessment

This is an important phase, where the therapist will get a feel of what is going on with the child or young person. The therapist will also identify important background information. They will ask some questions, which will help to know what type of treatment will be most helpful.

Therapy sessions

These sessions will take place at a time and regularity that suits the child or young person and their parents. An important aspect of the session is the relationship the therapist will build with the child or young person. This will create a safe space to encourage them to talk and be open with the therapist. Sessions might include different activities such as discussing, role-playing, games, and feedback.

Homework

This can be an important part of treatment, especially when having CBT. This is because ADHD affects everyday situations in the child or young person’s life. So, homework tasks will help the child or young person to develop a sense of achievement and mastery over their difficulties.

Progress and setbacks

When having treatment for ADHD, there will be progress and setbacks. Learning to improve self-control, behaviours and concentration can take a long time to change, so it is not realistic to expect progress without any setbacks. It is important to not get discouraged when setbacks happen. It is an opportunity for the child or young person, parents and the therapist to think about new ways to move forward.

Ending therapy

The therapist will eventually prepare the child, young person and parents for the end of therapy. This is a very important phase because the child or young person needs to become confident without relying too much on the professional. The end of therapy will take place once the child or young person has made a lot of progress. The child or young person will leave therapy with many skills that they can use without the help of the therapist.

Follow up

There might be an agreement with the therapist to have a follow-up meeting. This is to check how the child or young person is coping. If they are doing well, there will be no need for more support. But if they continue to have difficulties or any other issues, this will be an opportunity to have extra support.

How to support someone with ADHD?

It can be challenging when you have a loved one who struggles with ADHD, as it usually affects many areas of the person’s life. Fortunately, there are some things that you can do to help. These are discussed below.

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Understand ADHD

It is a good idea to read as much information about ADHD as you can. Understanding ADHD and what it means can help you to recognise the ways that your loved one is affected and the ways that you can help.
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Help them to feel supported

ADHD is a condition that can be misunderstood as a kind of deliberate misbehaviour. Therefore, people suffering from ADHD can easily feel as though they lack support. It is important to make sure that they feel supported. You can do this by:

Showing acceptance: Because of their challenges, they can feel like they are not good enough. Remind them that they are loved and valued no matter what.

Being patient: Be mindful about how you react to their behaviour. Avoid reacting whilst you feel frustrated. Take the time to think about responding in more a helpful way.

Separating the person from the disorder: This is very important. It is good to remember that the person is not the disorder. This will allow you to avoid feelings of frustration and resentment towards your loved one because it is not their fault. This means that your loved one can also be free from feelings of guilt.

Help them to find the right support

Encourage them to find support through a GP or therapist. If this involves your young child, you can contact these services. You might:

Help them to search for a therapist
Help them to book an appointment with a GP or therapist
Offer support when they attend appointments (e.g. waiting in the waiting room or attending some sessions if you need to)
Help them search for support groups or self-help resources
Encourage them to keep attending sessions and to not give up
Give them small reminders to do their homework assigned by the therapist

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Ask them what they need

They may or may not be able to tell you what they need, but it is always good to ask. They might let you know other ways that you can help them. This way you won’t have to figure it out on your own.

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Encourage them to have a routine

Having a routine can help your loved one to have more structure in their daily life. Following a schedule and having a plan can make tasks much easier to complete for a person with ADHD. You might help them to:

Make a timetable
Make a checklist
Use colour codes for their schedule
Use creative reminders (e.g. fridge magnets, sticky notes, phone reminders)
Schedule free time

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Point out their strengths

It is good to remind your loved one of the things they are good at. You can point out their strengths and talents, as a way to remind them of the positive things in their life. This will uplift them and help them to appreciate their own strengths, despite struggling with ADHD.

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Look after yourself too

You need to look after yourself. Whether you are a parent, family member or a friend, you will be in a better position to give help, as long as you are taking care of your own well-being too.

How can parents support their child with ADHD?

When caring for a child with ADHD, it is vital to keep in mind that normal household routines and parenting styles may not be as effective due to the type and severity of the child’s symptoms. Since the brains and behaviours of children with ADHD function differently and more impulsively than those of other children, parents need to be more accepting of alternative approaches and parenting styles.

Furthermore, the following tips may provide useful advice and tips:

Planning the day – children understand what to expect, easier to break down structure
Setting boundaries – behavioural management therapy (positive reinforcement and implementing consequences for respective behaviour)
Giving instructions – brief and particular, easy to understand what to do to get it right
Intervene early – If signs of frustration, or agitation occur distract the child to calm them
Encouraging healthy lifestyles - physical activity, healthy diet, bedtime routine
Organisational skills – assist children with checklists, and timetables to maintain organisation in their life
Praising child/incentives – acknowledging and reinforcing good behaviour
Educate other members of the family – avoid singling out child amongst siblings (labels)