Children with Attention Deficit Hyperactivity Disorder (ADHD) are often labelled as 'naughty children'. But this isn't the case. ADHD is a real developmental delay in the ability to be focused and affects 1-5% of school-aged children in the UK, and that's probably a conservative estimate.
Research using specialised brain scanning techniques confirms that in children with ADHD the frontal part of the brain takes longer to mature. This area has the role of controlling concentration, planning and organisational skills.
For some children and young people with ADHD, the inability to focus can also be associated with a tendency to be constantly on the go (restlessness), to be fidgety (over-activity) and to do things without thinking (impulsivity).
A frequent example I come across is the child who shouts at a teacher as they might with a friend due to impulsivity or failing to stop and think about what they should say in different situations. Another example is the child who sees something they like it and takes it without thinking only to realise their mistake later.
These difficulties can severely impact on the ability of children with ADHD and related conditions to get through a normal day of activities at home and school. From the child's perspective, the most troubling symptom is often that they can find it hard to make or keep friends.
There is a range of treatment options for ADHD. When children are young or if their symptoms are relatively mild, there are lots of things that parents can do to help. For example, encouraging children to do puzzle and memory games that help them to concentrate better, making sure their child has a good diet and reinforcing positive behaviour. If children are older or if their symptoms are moderate to severe then medication may be helpful.
Of course, treatment decisions completely depend on the child and should be decided by the parents/ carers, child and psychiatrist on a case by case basis.
Many of the families I see are concerned about the safety of medication. High-quality studies show that medications prescribed for ADHD are generally safe. As with all drugs there may be side effects, for example a few children may develop a mildly increased blood pressure or will have a reduced appetite. But with careful monitoring and adjustments these will always be kept to a minimum. And the doctor will ask you about whether you or your family has any history of cardiac problems.
The aim of medication is not to reduce your child's spark or energy but to enable them to focus and fulfil their potential. And it has been found to be helpful in terms of improving focus in the classroom and as it can also reduce impulsivity your child may appear as less aggressive.
Another common worry amongst parents is that children might end up on medication forever. But a high proportion of children grow out of the need for medication and a yearly 'drug holiday' is the best, and easiest, way of working out whether such intervention is still helpful and necessary.
In a podcast for the Anna Freud National Centre for Children and Families, I spoke with Minesh, a father whose 10 year old son Dillon showed impulsive behaviour at school and who was diagnosed with ADHD at the age of 7. His story highlights some of the common challenges families face. Minesh said:
"[Dillon] was a very bright child, very talkative, very social, but when he started school we saw some problems around concentration, [... teachers] telling us he wasn't concentrating or focusing. He's the youngest in his year. His birthday's in August, so we put it down to that.
Minesh got an appointment at a Child and Adolescent Mental Health Service (CAMHS) where the option of medicating Dillon was brought up. The family initially had serious concerns about using medication but decided it was the right option after discussions with a psychiatrist.
"Our main goal was to get Dillon through school. That was the main concern for us. To be honest with you, most parents will have a problem medicating their children, but we've been medicating [Dillon] for a year now [... and ] from a learning perspective; focusing and concentrating at school, it's working".
If you think your child may have ADHD it would be useful to find out what other people (such as relatives, nursery and school teachers) who know him or her have observed.
Depending on where you live and your child's age, the people who can advise you about treatment options include health visitors or school nurses, the head teacher or a special needs coordinator or General Practitioner. You may also be able to self-refer to your local CAMHS service and should ask the service or the professionals mentioned if this is possible.