Understanding ADHD

First published on Tuesday 13 September 2016 Last modified on Wednesday 16 December 2020

As parents, we've all heard about ADHD, perhaps you know a child who has it or have read reports in the newspaper about the effects of food or fish oils.

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The truth is that ADHD is a very real condition that affects thousands of UK children and their families. Here's everything you need to know about this neurological disorder ...

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What is ADHD?

ADHD stands for Attention Deficit Hyperactivity Disorder - a chronic medical condition that produces chemical imbalances in the part of the brain that handles concentration, attention and impulses. A child with ADHD is likely to be restless, exhibit regular mood swings, general hyperactivity and poor co-ordination, whilst finding social situations particularly difficult to deal with. Many people mistakenly put this down to 'poor parenting' or the child being 'naughty' or 'difficult to deal with' but in most circumstances, the condition is entirely inherent which means the child and the parents have little control over it, especially if ADHD is yet to be diagnosed.

There are generally three types of ADHD conditions:-

Inattentive:

shows an inability to pay attention to details or a tendency to make careless errors in schoolwork or other activities
difficulty with sustained attention in tasks or play activities
apparent listening problems & difficulty following instructions
problems with getting organised & easily distracted
dislike of tasks that require mental effort
forgetfulness in daily activities

Hyperactive-impulsive:

fidgeting, squirming & general restlessness
difficulty remaining seated, excessive movement & running
difficulty playing quietly and talks excessively
often blurts out answers before hearing the full question and interrupts conversations
finds it difficult to wait their turn

There is also a combined type which includes a combination of all of the above symptoms and is very common in young children.

Symptoms often start to disperse as a child grows up, but up to half of ADHD children will continue to display symptoms way until their adult years. The real problems occur when a child with ADHD is undiagnosed. This can result in:

poor performance at school
difficulty at maintaining healthy relationships which can lead to social exclusion
difficulties finding a job (and keeping it ...)
mental health problems

What causes ADHD?

ADHD is not caused by bad parenting, a poor diet (though this can certainly worsen symptoms), vaccinations or lots of sugar. The condition actually has biological links and is thought - though it's not not 100% confirmed - to be mostly genetic. Other causes are smoking during pregnancy which is believed to trigger ADHD in children later on, whilst premature deliveries, low birth weights and injuries to the brain at birth are also potential causes.

There's even been speculation that too much television can contribute to ADHD symptoms as it prevents children from developing proper focus and attention skills. Though this has never been proved, it is wise to keep tabs on how much screen time they have, perhaps limiting it to 1 or 2 hours per day and ensuring it's combined with lots of other activities such as painting, role play games and time outdoors.

My lad is nearly 16 and has ADHD. He is more or less controlled with his meds now and we only have the odd moments and occasionally in the morning until his meds kick in. Looking back I sometimes wonder how I coped over the yrs...

My son is 9 and has ADHD. He is on Concerta XL which works well once it has got in his system but that means that first thing in the morning and then after 6pm is difficult. He can be really vile to me, not physical now he's medicated but very verbal and knows when I'm tired or stressed. It makes me so mad I could scream sometimes. I spend so much of my time just having superficial friendships with people who say they'll help or 'you know where I am if you need me', but in reality they run a mile. I've stopped asking for help - it's always one sided.

Is there a link between the condition and what we eat?

For many years, parents and professionals have cited many links between the development of ADHD and a child's diet. It has long been believed that what we choose to put into our child's bodies can contribute to the chemical imbalance that produces ADHD but as research builds, experts are citing it as a more serious neurological condition that is most likely to have genetic origins.

That's not to say diet doesn't count. If your child has an underlying allergy or nutritional deficiency, this could certainly worsen their symptoms, which is why it's essential to get a full medical check done by your GP. Hyperactivity (a classic symptom of ADHD) is triggered by sugar and other stimulants so it's best to cut these out and swap them for healthier snacks and drinks. It's not difficult to eat well and with a little planning in advance, you can ensure the whole family enjoys a diet rich in brain-boosting vitamins and minerals.

Kate S ...
"I got help early on and took a very close look at what my son ate. There are colourings and artificial flavourings in all sorts of foods that made him flare up so I did find changing his diet helped. He is also now on medication which is slowly making a difference."

Sue P ...
"ADHD children have very sensitive biochemistry's, and avoiding artificial flavourings, colourings etc and by reducing overall toxic load from whatever source, and keeping blood sugar levels even can make a big difference. In general, the younger the child, the easier it is to implement changes, particularly dietary ones, so at under 5 you have more of an advantage than if say your child was 15."

Fish oils

Fish oils contain essential fatty acids that can boost the neuronal membranes of the brain and have a beneficial effect on children suffering from ADHD. In particular, the EPA (eicosapentaenoic acid) and DHA (dihomogamma linolenic acid) present in fish oils can be especially helpful to children suffering from ADHD as they tend to be deficient in both of these fatty acids.

A 30 week trial carried out by the University of South Australia found that children with ADHD who were given regular fish oil supplements could concentrate better and were less restless than those who didn't take the supplements, in fact their condition improved continuously until the trial finished at 30 weeks. Another 6 month study found that children who took fish oils overcame many of the problems associated with ADHD, dyslexia and dyspraxia (a disorder of the brain which affects co-ordination and movement) and were seen to be:

more perceptive
more confident with increased self-esteem
calmer with tasks
less disruptive
improved memory
better reading, writing and listening skills

You can start by giving your child a daily supplement of fish oils and boost their intake further by incorporating plenty of Omega-enriched foods into their daily diet. We have plenty of tasty fish recipes that will boost the entire family's intake of those essential fatty acids.

ADHD children at school

According to the UK's National Institute for Health and Clinical Excellence, around 5% of our school children are suffering from ADHD and around half of those also have a learning difficulty such as dyslexia or problems with handwriting. Although ADHD isn't categorised as a learning difficulty itself, it interferes with concentration and performance which can make it even more difficult for a child to perform well. It also seems that boys are more susceptible to the condition - perhaps up to three times more likely to develop ADHD than girls.

The condition largely affects their progress at school as inattention and difficulty focusing on specific tasks can prevent them from excelling with their peers, meaning they are often placed in separate special needs classes where they can get the right kind of tutoring at an appropriate speed for them. Maintaining a close relationship with the school and teachers can be highly beneficial for parents with ADHD children and by openly discussing their progress, you'll be helping to ensure their needs are continuously met. A few minor details can make all the difference to a child with ADHD and you can help by ensuring the following:-

Check where they are sat in the classroom and ask them to be moved if you feel they need to be closer to the teacher/away from any distraction.
Always look out for positive behaviour and ask the teacher to ensure they praise your child whenever they perform well.
Ask for tasks to be broken down to a level that your child understands. If the teacher hasn't got time to do that, perhaps you can do it together with your child when they get home?
Teach basic study skills such as underlining/highlighting, note taking, reading out loud and asking for help when they don't understand something.
Keep on top of the curriculum and if possible, ask for a programme of work up front so you know the topics/exercises your child will be expected to learn.
Boost their self-esteem by praising good work and ensuring teachers provide feedback in private rather than in front of other children.

You can also contact the Independent Panel for Special Education Advice for further information

I fought for a specialist teacher for my son as he has ADHD and is also autistic. Our Consultant was very supportive and came to meetings and outlined essentially how ADHD affected him at school.
Children have the right to a good education so it's worth making all the right changes you need to ensure they get it.

Diagnosing ADHD

If you have a hunch your child may have ADHD, it's best to visit your GP as soon as possible to get an assessment arranged. By realising the condition at an early stage, you can ensure your child gets all of the help, guidance and support they need to maximise their potential through their developing years. It's also important that everyone who comes into contact with them understands the reasoning behind their behaviour and can respond/handle it in the most appropriate way - if your child is surrounded by caring, understanding and supportive people, they are likely to feel more confident, happier and develop well socially and emotionally.

Your GP will conduct a medical examination, ask you about your child (and families) medical history and check their vision and hearing to rule out any other potential causes. If they are satisfied there could be a link to ADHD, they will organise for a child therapist, paediatrician or psychiatrist to observe your child over a period of time in at least two or three different social situations (e.g. at home, at school, with friends). They will base their observations on a variety of criteria and questions which will eventually lead them to conclude a diagnosis. Here's a couple of stories from Sarah K and Naomi W:

My daughter wasn't necessarily naughty but she would talk non stop and couldn't sit down to do anything for more than 5 minutes, At school she would rather chat and fiddle than do her work which wasn't good as she needs extra help for dyslexia. When she was naughty it would be in the evening and she would get so hyper and threaten to harm herself and be totally horrible to me and her sister. The paediatrician gave me a prescription for 10mg of ritalin which was later put to 20mg and I noticed the difference the same day she started it as the medication isn't a drug that takes a while to get into the system. It works through the day when they are given it and then its out of their system by bedtime meaning if they don't have it the next day they will go back to normal. Since being on it for the last 2 months I don't think she has been told of at school once she is actually sitting down and concentrating and enjoying what she is doing, she even started telling me what she was doing at school. Overall, she is just calmer and more attentive and less angry which makes her feel better in herself.

After screaming and shouting at the doctor for 6 months, Lucas (3) was finally diagnosed with autism and ADHD 6 months ago. He was never an easy baby and I always knew something wasn't right, so when I got that diagnosis I was relieved more than anything, as I knew something could now be done!

Treating ADHD

ADHD can't be cured but with the right diagnosis and treatment, it can be successfully managed. As with most illnesses, their are various levels of severity and where one child might suffer with continuous ADHD from morning to evening, another might exhibit symptoms only at certain times of the day, perhaps when they're feeling tired, irritable or angry about something. The level of your child's ADHD will have a direct effect on the course of treatment which could include one or more of the following:-

Diet overhaul: You will be advised to cut out all foods with artificial additives, cut out caffeine (usually found in fizzy drinks and chocolate) and other general food nasties like added sugar, colourings and preservatives. Many parents also report dietary supplements having an effect.

Exercise: Activity can boost a child's feel good factor, help them burn off excess energy and boost their concentration levels in the classroom.

Psychological support: Behavioural therapies can help your child understand more about their actions and how they might be able to better their behaviour. You may also be offered family therapies which will provide plenty of support and advice for you as parents and decipher the best ways of dealing with the condition. Behavioural therapies will attempt to create some sort of routine to make your child feel more grounded and able. This could include anything from reorganising your home and setting up a list of clear rules and directions to a rewards system for good behaviour or reaching new goals at school.

Medical therapies: ADHD treatments can help reduce levels of hyperactivity and increase a child's ability to concentrate. The medication used for ADHD sufferers are called 'psychostimulants' or 'non-stimulants' and work by helping children to focus their thoughts and ignore distractions. Approved for children aged 6+, they are thought to be around 70-80% effective and are used to treat both moderate and severe ADHD. As with all drugs, there is a risk of side effects so make sure you are well aware of these before you start administering them to your child (your doctor may suggest changing medication or adjusting the amount of times your child takes it if side effects become a concern).

Educational support: Ensuring your child has access to understanding teachers is paramount to their learning progression. Their educational needs and standard of learning will be closely looked at and the appropriate measurements taken to ensure a steady and comfortable progress in all areas of their education. This could mean additional teaching support, the support of a special needs teacher or after school tutor specialising in ADHD children.