ADHD Diagnosis and Treatment

Types of ADHD

The three main types are:

• ADHD combined type: When a child exhibits both inattentive and hyperactive-impulsive symptoms for at least 6 months.
• ADHD predominantly inattentive type: When a child has met the standards for inattention but does not display significant hyperactive-impulsive behaviour over the last six months.
• ADHD predominantly hyperactive-impulsive type: When a child primarily shows hyperactive-impulsive traits without meeting the criteria for inattentiveness during the last 6 months.

Signs and Symptoms

Kids with ADHD constantly exhibit inattentiveness, impulsivity, and/or restlessness. These traits appear in multiple environments, such as home and school, and across different activities, including academics and social interactions. The behaviours exceed what is typical for their age and significantly impact their day-to-day lives.

To be diagnosed with ADHD, symptoms must:

• Begin before the age of 12.
• Be present in at least two settings or more, like school and home.
• Persist for a minimum of six months.
• Disrupt or diminish social, academic, or occupational performance.
• Not be better explained by a different mental health condition.

Causes

Although the exact aetiology of ADHD is still unknown, the dominant view defines it as a neurodevelopmental condition. Numerous elements that impact brain development might be implicated, such as:

• Genetics: Research suggests that certain genetic variants may be at play.
• Environmental factors: Exposures during pregnancy and throughout life may contribute.
• Life experiences: Early attachment issues, such as a lack of proper bonding with a parent or caregiver or traumatic life experiences connected to attachment, may lead to increased inattentiveness and hyperactivity.

Diagnosis

Most children undergo periods of disruptive or restless behaviour, but there is a clear distinction between ADHD and general misbehaviour. Kids without ADHD can sit still, wait for their turn, or focus when their needs are met despite having bad behaviours of hunger, tiredness, or lack of routine. However, those with ADHD often struggle with these actions regardless of their best efforts.

There is no single test for diagnosing ADHD. If a teacher or doctor suspects ADHD, a referral to a specialist is usually necessary for assessment. Depending on the child's age and local healthcare resources, this specialist may be a paediatrician, child psychiatrist, adolescent mental health professional, or adult psychiatrist.

Usually, the evaluation consists of the following:

• Conversations with the child's caregiver.
• A medical assessment.
• Teacher or school staff reports.
• Close observations of the youngster carrying out certain activities.
• Extra evaluations carried out by nurses or other medical specialists.

The assessment aims to:

• Confirm whether ADHD is present.
• Rule out other possible explanations, such as hearing impairments, epilepsy, or thyroid issues.
• Identify coexisting conditions, such as low self-esteem, anxiety, or learning difficulties.

For an accurate ADHD diagnosis, symptoms of inattentiveness and/or hyperactivity-impulsivity must:

• Have persisted for at least six months.
• Be severe enough to interfere with daily life.
• Be different from developmental expectations for the child's age.
• Have begun before age 7.
• Be present in multiple settings, such as home and school.

Additionally, other potential causes—such as anxiety or depression—must be ruled out before confirming the diagnosis.

Treatment and Management

The treatment approach usually depends on the child's age and the severity of their condition. A team of professionals trained in ADHD should be involved in managing care.

Non-medication treatments:

For children with mild to moderate ADHD, the initial step typically involves referral to a parent training program. This does not imply poor parenting—but rather, children with ADHD require different strategies and guidance compared to others.

In some cases, children may also participate in group therapy focused on behaviour improvement, while family therapy can provide additional support. Parent programs often include:

• Developing strategies to manage and reduce challenging behaviour.
• Learning more effective communication techniques.
• Gaining a deeper understanding of the child's feelings and actions.

Medications:

For more severe cases of ADHD or when behavioural treatments are insufficient, medication is often recommended.

ADHD medications have been widely used for several years and have shown effective results. They are generally not prescribed for children below 6 and should only be administered under the observation of an expert in childhood behavioural conditions.

The most commonly prescribed medications include:

• Methylphenidate (Ritalin®) – The first-line treatment in most cases.
• Atomoxetine – An alternative to methylphenidate.
• Dexamfetamine or lisdexamfetamine – Used when other medications are ineffective.
• Guanfacine – Recommended when other options are unsuitable or do not work.

Conclusion

Attention-deficit/hyperactivity disorder (ADHD) is a lifelong condition that impacts individuals of all ages. While it affects attention and behaviour, it can be managed with therapy and medication. Behavioural interventions, along with support from family, friends, and teachers, play a crucial role in helping children cope. If you suspect your child has ADHD, consult their physician right away for guidance on diagnosis and treatment options.

For more information or if you have any concerns about symptoms, please contact us today.