Attention Deficit Hyperactivity Disorder (ADHD)
September 08, 2021
- What is Attention Deficit Hyperactivity Disorder (ADHD)?
- Symptoms of ADHD in young children
- Comorbidity with other mental health disorders
- 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 parents support their 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
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 really 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
- 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.
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.
Cognitive behavioural therapy (CBT) is a type of talk 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 be helpful in reducing 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.
A specialist can prescribe medication to treat ADHD, but treatment that also includes therapy is usually best. Within the UK, there are 5 types of medication that are licensed for treating ADHD. This includes:
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
It is advisable for children and young people with ADHD to eat a healthy diet and exercise regularly. Exercise may also help your child sleep better at night, which makes the symptoms less severe the following day. Having an early bedtime will also help your child get enough sleep. It is important to organise your child’s daily activities. This can be done using timetables, checklists and a consistent routine. An organised routine will be helpful for your child to complete tasks, remember things and be more successful in coping with everyday life.
What types of professionals are involved?
There are different professionals that may or may not be involved throughout the treatment process of ADHD. These might include counsellors, psychotherapists, educational psychologists, doctors, psychiatrists, and social workers. These 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.
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 own schools. Here at Mindsum, we have counsellors who are available to provide support.
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.
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.
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 to cope better with ADHD.
These are professionals who are also trained in medicine. However, they specialised in the field of psychiatry. They are able to provide consultation and medication for a wide range of mental disorders such as anxiety, depression, schizophrenia, psychosis, bipolar affective disorder and so on.
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.
This is an important phase, where the counsellor or psychotherapist 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.
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 counsellor or psychotherapist 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.
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 really 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.
The counsellor or psychotherapist will eventually prepare the child, young person and parents for the end of therapy. This is a very important phase because it is vital for the child or young person 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.
There might be an agreement with the counsellor or psychotherapist 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.
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.
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
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.
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
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.
Encourage them to stay physically active
Doing physical activities such as exercise might help your loved one to release excessive energy. Exercise can help them to focus their attention and energy in a healthy way. You could invite them out for any type of exercise that will get them moving (e.g. a walk, jog, group exercise class).
These activities will also help to release ‘feel good’ chemicals in the brain, which can fight off other problems, such as depression or anxiety.
Look after yourself too
It is extremely important for you 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?
Parent/guardian training programmes
This a specialised programme that helps parents to improve their parenting skills, as a way to reduce the symptoms of ADHD. There is a lot of research that supports parent training as an effective treatment for ADHD.
The idea behind it is that parents hold the key to stopping certain symptoms from continuing. This is because parents are the ones responsible for the environment at home, setting boundaries, ensuring discipline and giving appropriate love and affection.
The parents/guardians will learn more about ADHD and develop good strategies to help their child with ADHD. For example, they might be encouraged to make changes to their communication, the way they interact with their child and the home environment.
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. Due to the fact that 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. Alongside medication, behaviour management therapy enforces positive reinforcement and negative consequences for behaviour, teaching the child about acceptable behaviours. 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)
For more information about ADHD on the NHS website.
You can have a chat with our AI bot to get free support 24x7. The bot can also offers a range of resources, such as videos, podcasts and articles.
The ADHD Foundation offers a variety of helpful resources for parents and young people.
This national centre for children and families offers helpful resources including podcasts for parents and carers on ADHD.
For more information and access to resources for young people the YoungMinds website.
'How NOT to Murder your ADHD Kid: Instead Learn How To Be Your Child's Own ADHD Coach' by Sarah Templeton.
To read more information on ADHD and the treatments involved, you can go to the ADDIS information services website.
The British Association for Counselling Professions (BACP) has a useful document on different aspects of therapy.
To read general information about helping someone with a mental health problem on the MIND website.
‘ADHD Is Our Superpower’ by Soli Lazarus. You can purchase this through Mindsum to receive a discount.