Attention deficit hyperactivity disorder (ADHD) is a disorder that appears in early childhood. It makes it difficult for individuals to restrain their spontaneous responses—responses that can involve everything from movement to speech to attentiveness.
The specific causes of are not known. But a number of factors like genetics, diet and social and physical environments may contribute to, or increase it. Environmental factors include alcohol and tobacco smoke exposure during pregnancy and exposure to lead in very early life. Complications during pregnancy and birth—including premature birth, infections during pregnancy, at birth, and in early childhood are also linked to an increased risk of developing ADHD.
The signs and symptoms typically appear before the age of seven. There are basically three important symptoms – Poor concentration, hyperactivity and impulsivity. Only if a child shows all three symptoms in different environments like school and home, and are unable to control their behaviour are they considered for the diagnosis. ADHD can affect adults too. Adults with ADHD have difficulty following directions, remembering information, concentrating, organizing tasks or completing work within time limits. If these difficulties are not dealt with appropriately, they can cause associated behavioural, emotional, social, vocational and academic problems.
Treatment usually involves both medication and therapy. Behavioural therapy involves adjusting the environment to promote more successful social interactions. Social skills training can help a child learn behaviours that will help them develop and maintain social relationships. Education and support for the parents can be an integral part of treating ADHD in children.
- Combined Type (Inattentive/Hyperactive/Impulsive)
- Hyperactive Type
- Impulsive Type
- Inattentive Type
Read in detail about various types of ADHD in children
Scientists and researchers are yet to ascertain the exact reason of what causes ADHD, though at the moment it is believed that it is an outcome of a combination of certain factors that leads to the existence of this disorder. There are a lot of studies underway trying to establish a cause and effect link for ADHD, some of the common causes that’s supposed to give rise to this disorder are:
Research is indicative of the fact that ADHD can run in families and can be inherited from parents. Also a study published in Jama Psychiatry in 2007 stated that children born with a particular type of gene had thinner brain tissues present in the areas related to attention. However, this wasn’t a permanent condition and as the child grew up the brain developed to a normal level of thickness thus reducing the ADHD symptoms too. Going by the evolutionary theories that propose the hunter VS farmer theory, states that hyperactivity may be an adaptive behaviour in pre-modern humans and that those with ADHD retain some of the older “hunter” characteristics associated with early pre-agricultural human society. According to this theory, individuals with ADHD may be more adept at searching and seeking and less adept at staying put and managing complex tasks over time. A study published in Nature Genetics in 2011 pointed out that ADHD may or may not be inherited. Some mutations that may occur spontaneously might give rise to the condition.
Studies have seen that alcohol and smoking during pregnancy can lead to ADHD in children. Also complications during pregnancy like premature birth, infections during pregnancy or at birth, brain injury during early childhood can lead to ADHD. Lead exposure during early infancy is also considered to be a probable cause.
Artificial food colours
Though a direct link has not been established but there is enough indication that shows artificial colours used in food preparations can aggravate the symptoms of ADHD. A study published in Pediatrics in 2012 stated that avoiding artificial flavours, additive and colour in foods of children who suffer from ADHD experience fewer symptoms.
On the onset the symptoms, ADHD appear to be very normal aspect of a child’s behaviour. Most of these behaviours disappear as the child grows. ‘A parent should be wary if the symptoms of attention deficit, hyperactivity and impulsiveness prolongs for at least six months at a stretch in every situation, like in the playground, home or the school. But if your notice that these symptoms are seen only suppose in the school and your baby is calm and composed at home or during play then it might not be a case of ADHD,’ says Dr Deshpande. The symptoms can range from mild, moderate to severe. Children suffering from ADHD often:
- Are in constant motion.
- Squirm and fidget.
- Do not seem to listen.
- Have difficulty playing quietly.
- Often talk excessively.
- Interrupt or intrude others.
- Are easily distracted.
- Do not finish tasks.
Children who only have inattentive symptoms of ADHD are often overlooked, since they’re not disruptive. But, the symptoms of inattention have consequences: like unable to follow directions; underperforming in school; or clashing with other kids over not playing by the rules.
Also remember some behaviours can appear to be ADHD-related, but are not. Some causes of ADHD-like behaviour are:
- Major life events or traumatic experiences (e.g. a recent move, death of a loved one, bullying, divorce).
- Medical disorders affecting brain function like neurological conditions, epilepsy, and sleep disorders.
- Psychological disorders including anxiety, depression, and bipolar disorder.
- Behavioural disorders such as conduct disorder and oppositional defiant disorder.
- Learning disabilities or problems with reading, writing, motor skills, or language.
There is no single test to diagnose ADHD; however a series of assessments and other information gathering by the doctor can help one come to the conclusion and accurate diagnosis of the condition.
The questions addressed during a counseling session with the pediatrician while diagnosing the condition are -
- How severe are the symptoms? The symptoms must have a negative impact on the child’s life.
- When did the symptoms start? How early the symptoms appeared?
- How long have the symptoms been bothering the child? Symptoms must have been going on for at least 6 months before ADHD can be diagnosed.
- When and where do the symptoms appear? The symptoms of ADHD must be present in multiple settings, such as at home and school. If the symptoms only appear in one environment, it is unlikely that ADHD is to blame.
Though it is imperative to seek treatment for ADHD but one should know that there aren’t any cures for the same. ADHD is treated with help of medications, various types of psychotherapy, education and training, or by using a combination of treatments.
Medications: Stimulants such as methylphenidate and amphetamines are the most common type of medication used for treating ADHD. The main aim of prescribing medications is to keep the symptoms like hyperactivity and impulsiveness under control. Medications can improve their ability to focus, work, and learn and also may improve physical coordination.
‘But remember there is no cure for the condition, while the medications are prescribed, it might keep the symptoms in check and improve concentration. There isn’t a cure for ADHD yet,’ says Dr Deshpande. But with medications there are also chances of developing certain side effects like decreased appetite, sleep problems, irritability, mild stomach aches and headaches. With a lower dose of the medications usually such minor side effects disappear.
Behavioural Treatments: Behavioural treatment for children with ADHD involves adjusting to the environment to promote more successful social interactions. Such adjustments include creating more structure, encouraging routines, and clearly stating expectations of the child with ADHD.
While a child might have to live and deal with the condition there is a lot parents can do to help streamline the child’s behaviour pattern
Practice effective parenting: One common mistake that parents make with children suffering from ADHD is inconsistent parenting. ‘Behaviour as we see it is a combination of nature vs nurture. Some children are inherently overactive while others aren’t. Good parenting skills are required to deal with such children. However, it must be made clear that bad parenting can’t cause ADHD,’ says Dr Deshpande. But if a child with the condition isn’t handled carefully the symptoms might worsen. Parents need to set boundaries and limits for all children.
Limit use of gadgets and electronic instruments: Early and excessive exposure to electronic media like mobile phones, televisions and computers can be detrimental for your child. Many, many studies show that these devices have a negative impact on a child’s communication and socialisation skills. Television and other electronic media provide passive stimulation which stifles creativity. ‘It’s believed that the brain of a young child gets used to this passive stimulation from an electronic device and they find that normal life doesn’t match up in the excitement stakes. This is when they start acting up to create a situation which is more exciting. This is why I tell all parents that TV shouldn’t be used as a substitute for a babysitter or a parent,’ says Dr Deshpande.
Help your child be organized: To make sure your baby follows rules and is organized keep things at fixed places and encourage the habit of doing the same. Keep a fixed routine from waking up to getting back to bed constant to help your baby deal with everyday niggles. This has to include homework, outdoor play and indoor activities.
Practice an activity together: Many therapists believe that parental involvement in a positive way can help correct a lot of behaviours in children including symptoms of ADHD. Practise an activity with your child that could help him cultivate the habit of focus and also relive stress to some extent. This can help to deal with the symptoms of ADHD effectively.