ADHD (Attention Deficit Hyperactivity Disorder) in children

What is ADHD?

School-aged children who have behaviour and learning problems may show signs of hyperactivity and/or inattention. If these problems are severe enough, they may be diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). The disorder impairs social and academic functioning and is often noticed in children who are failing to learn at school.

ADHD has received a lot of attention; discussion and debate amongst parents, teachers and the wider community in Australia because of the apparent recent increase in the diagnosis of the condition. Controversy has arisen over the use of medication, such as Ritalin, to control symptoms and help manage behavioural and learning problems in children.

What are the key symptoms?

There are two main criteria used to make a diagnosis: attention symptoms and hyperactivity symptoms.

The key features associated with symptoms of inattention include:

• failing to give close attention to details and difficulty sustaining attention in tasks or play
• not listening when spoken to
• not following through on instructions and failure to finish tasks
• difficulty organising tasks and activities
• avoiding, disliking or being reluctant to engage in tasks that require sustained mental effort
• losing things necessary for tasks or activities
• easily distracted

The key features associated with symptoms of hyperactivity (sometimes known as hyperactivity-impulsivity) include:

• fidgeting with hands or feet, squirming in seat
• leaving seat when remaining sitting is expected
• running about or climbing excessively
• difficulty playing or engaging in leisure activities and often ‘on the go’
• talking excessively and blurting out answers before a question is completed
• interrupting others

To fulfil a diagnosis of ADHD, each symptom must persist for six months or more.

While ADHD is recognised as a disorder that is distinct from other childhood disorders, it frequently overlaps with other conditions such as Conduct Disorder. This can make diagnosis difficult. Also, many of the symptoms of ADHD are shared by other disorders.

How is ADHD assessed/diagnosed?

Usually a medical professional such as a paediatrician or child psychiatrist, conducts the initial assessment or diagnosis of ADHD. It is also common for psychologists to be involved. Psychologists focus mainly on how the disorder affects behaviour and learning, and what can be done to improve this.

There are various ways to measure ADHD. Psychologists use rating scales, questionnaires and other tests for collecting information from the children themselves, their parents/caregivers and their teachers. Children are observed at home and school.

How is ADHD treated?

Treatments can include medication, training for parents/caregivers/teachers, and tailored behaviour management programs for children. Medication is generally used in more severe cases to help focus the child’s attention. Psychological treatments generally aim to develop skills for successful behaviour at school.

Medication
Typically, the most commonly prescribed medication is a stimulant such as dexamphetamine and methylphenidate (Ritalin). The high level of prescribing of these medications has caused some community concern.

Psychological treatment
Psychologists commonly provide the following treatments:

• parent/caregiver education about the nature of the disorder and training in behaviour management techniques
• teacher education about the nature of the disorder as well as training in behaviour management techniques and appropriate learning interventions
• counselling and psychological treatment of the child, including education and advice, and skills training to improve concentration. Addressing issues of self-esteem, anxiety and peer relationships is also a crucial element of counselling.

Medication should generally not be regarded as sufficient on its own for treatment of ADHD. Even children with severe ADHD should have access to long-term behavioural programs, as should their families and school. Close collaboration and consultation between professionals involved with children with ADHD can ensure medical and psychological interventions are coordinated, to maximise the benefits and outcomes for each child.

Who can help?

It is important that children who may have ADHD are able to access treatment promptly. The APS Psychologist Referral Service can help you find an APS Psychologist with experience in treating and managing ADHD.