The Blog

ADHD: Myth or Reality

Dr Wariyar talked about many aspects of ADHD - including of course - the core symptoms. Inattention - difficulty in giving attention to detail - not appearing to listen - difficulty in completing a task - not following through on instructions.

I recently organised a talk on Attention Deficit and Hyper-Activity Disorder (ADHD) delivered by Dr Sethu Wariyar - a Consultant Neurodevelopmental Paediatrician. It was in Surrey and the advertising was sent out to a few local schools. The first person - a youth worker - booked a space within minutes. In the end over a dozen schools booked places - one school wanted 18 seats. This was a talk taking place on a Friday afternoon at 4.30pm - the end of the week and not usually a popular time to hold anything.

We nearly reached capacity in the small hall- such was the level of interest. Those that came were teachers, parents and youth workers in the main. There is clearly a desire - or a need - to find out more about ADHD - the talk was titled 'ADHD, Myth or Reality'

Dr Wariyar talked about many aspects of ADHD - including of course - the core symptoms. Inattention - difficulty in giving attention to detail - not appearing to listen - difficulty in completing a task - not following through on instructions. Then hyperactivity - fidgeting running about - unduly noisy - often leaving their seat in classroom situations. Impulsivity also features - blurting out answers, doesn't wait to take a turn and talks a lot. There was a lot of recognition from the audience as he listed the behaviours

So does ADHD exist or is it a modern invention? Dr Wariyar gave examples from history and culture of ADHD - from books by Heinrich Hoffmann in 1846: the story of 'Fidgety Phil' and the story of 'Johnny Head in the Air' - these fictional characters both exhibiting symptoms of ADHD.

In 1775, Melchior Adam Weikard, a German physician, described ADHD like behaviours. ADHD is not a modern invention.

Dr Wariyar suggested that possible causes range from genetic inheritance; environmental factors, brain injury and neurochemical influence. He gave lots of evidence for each of these causes from brain scans to twin and adoption studies.

He went onto say that assessments for a child lasts up to 6 months: that symptoms present before the age of 12 years and symptoms must be present in two settings (home and school) to achieve a proper assessment.

Some parents exhibit symptoms of ADHD and this does not help them to engage with people who might help them and their children. It is possible that both parents might exhibit symptoms.

Dr Wariyar explained that ADHD doesn't come alone - that it often comes along with symptoms of Developmental Coordination Disorder or reading or learning disorders.

So what does this all mean for individuals and wider society? Quite a lot it seems - those with ADHD feature in high numbers of those losing their jobs: attempting suicide, substance abuse and teen pregnancy and sufferers getting into trouble with the police.

Studies in the USA have put the cost of ADHD in children at around $42.5 billion! We can expect that the cost to the UK is high. A website run by the ADHD Institute puts the estimated cost of ADHD in the UK at £670 million per annum.

Early intervention is key - to help relationship with parents - to help bring better outcomes at school to help develop better peer relationships and to help with self-esteem.

Dr Wariyar does believe in using medications as an option and several parents in the audience said that their children had done well on medication. I am sure that there is a debate about medication but these parents supported it's use. There was a discussion about 'zombie children' whose behaviour changes after going onto medication. He made the point that this new behaviour is actually the true nature of their children minus the symptoms of ADHD. Again some parents said their children were doing better at school after going on the medication.

I personally have seen a change for the better in a young teenager with mild autism and ADD - after medication. He does seem to be more settled now. Of course the debate will continue around this topic.

So what was his advice for managing such children? For inattention 'Get their eyes' - give positive feedback - short, reinforced instructions - backed by pictorial timetables for the day ahead. Plenty of visual cues - on cards for instance. For hyperactivity: acknowledge child's need to move - build in movement during the day - whole class activities; jogging in place. Introduce physical activity at the beginning and end of the day.

Can a child with ADHD succeed in life? Of course - one of the most successful Olympians of all time - the swimmer Michael Phelps was diagnosed with ADHD at the age of nine. Perhaps we can also measure many types of success at a lower level than being an Olympic legend - but I think it makes the point.