AD/HD – An Overview

AD/HD is a condition in which there is developmentally inappropriate attention and/or hyperactivity and/or impulsive difficulties that are so pervasive and persistent as to significantly interfere with a child’s daily life.  It is more common in boys than girls and affects between 3-5% of the school age population. 

The core AD/HD symptoms are:

Excessive distractibility or inattentiveness – trouble paying attention, being easily distracted, not remaining focused, procrastinating and not listening.

Impulsiveness – all children are impulsive to some extent, however, the impulsiveness with AD/HD excessive and causes ongoing difficulties with physical or verbal impulsiveness.  Such children speak without thinking of the consequences of their words, call out in class or interrupt their parents’ phone conversations.  They also do not see the consequences of their physical actions and will run on the road or do other things impulsively rather than maliciously/

Hyperactivity – is the other core AD/HD symptom.  This frequently lessens with time but nevertheless in many children it is persistent and severe.  Such children are always on the go, cannot sit still at mealtimes, are fidgety and restless in the classroom and are often very rough in their physical play.

As your Consultant will discuss, these are the core AD/HD symptoms.  Some children have all of them, some are just inattentive and have never been impulsive or hyperactive, and some are more hyperactive/impulsive and less inattentive.  There is a wide range of ways in which a child with AD/HD comes to the attention of his parents or teachers as having difficulties.  Nevertheless, for a diagnosis of AD/HD to be made there must be excessive problems with one or other of the core AD/HD symptoms.

Having been through an initial diagnostic assessment as to whether or not a child has AD/HD the Consultant will have evaluated whether or not there are also complications of your child’s AD/HD.  Frequent complications include Oppositional Defiant Disorder (being excessively like a teenager in behaviour, even from a very young age), having Conduct Disorder or antisocial behaviour, being anxious, depressed or obsessive, having tics, features of an autistic spectrum difficulty, or excessive moodswings, specific learning difficulties such as dyslexia or speech and language or coordination problems.  Not all children with AD/HD have these complications but many children have one or other, and sometimes a number of these difficulties.

Other problems that frequently occur with AD/HD and are more problematic the longer the AD/HD goes untreated, are problems such as low self-esteem, socialising difficulties, demotivation, hypersensitivity or relative academic underachievement.

Long term studies show that about 70% of children with AD/HD will continue to exhibit features into adulthood.  They also show that children who receive adequate treatment for AD/HD tend to have fewer problems at school with peers, with substance abuse or with overall behavioural and educational difficulties.  Whilst the problems experienced by people with AD/HD vary enormously, at the very least they significantly underachieve in a wide range of areas if their condition is not adequately managed.

It is very important that as parents you and your child become empowered in the management of your child’s condition.  This means that you must become well informed on the condition, able to make management decisions within parameters that will be spelled out for you by your Consultant, and able to act as your child’s advocate so that all members of the team, including the school and the physician, are able to work together in your child’s best interests.

There are a wide range of books available, some of which are detailed below.  There are also a number of websites mentioned below from which you may obtain further information. It is important, however, to note that on the internet there are also a number of websites with fallacious and misleading information. The websites listed below are generally those where factual and informed information is available.

Many parents also feel somewhat helpless and confused in the initial weeks following a diagnostic assessment.  There has been a great deal of misinformation in the media about the condition and it is important that you obtain factual information.  There are now clear international guidelines on the existence and management of AD/HD.  In the UK the guidance from the National Institute of Clinical Excellence 2000 is particularly informative and can be accessed via the website below.  European guidelines on the management of AD/HD have now been published and there are guidelines from the American Academy of Pediatrics.  These will help reassure you that the approaches taken by your Consultant are very much in keeping with international opinion on the management of this condition and are based on research and clinical practice which enables your child to be helped to the fullest.