ADHD in Children and Teenagers

ADHD in Children and Teenagers

What is ADHD?

ADHD stands for Attention-Deficit/Hyperactivity Disorder. It is a neurodevelopmental disorder that affects both children and adults, characterized by a persistent pattern of inattention, impulsivity, and/or hyperactivity that significantly impairs daily functioning and quality of life.
The symptoms of ADHD can vary in severity and presentation, but generally fall into two main categories: inattention and hyperactivity/impulsivity. Inattentive symptoms may include difficulty paying attention to details, making careless mistakes, trouble organizing and completing tasks, forgetfulness, and being easily distracted. Hyperactivity/impulsivity symptoms may include fidgeting, restlessness, excessive talking, difficulty waiting their turn, interrupting others, and impulsive decision-making.

What causes ADHD?

The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood, but is believed to be a complex interplay of genetic, neurological, environmental, and developmental factors.
Genetics: Studies have shown that children with a family history of ADHD are more likely to have ADHD themselves.
Brain chemistry: There may be differences in the brain structure and functioning of individuals with ADHD. Neurotransmitters, which are chemicals that help transmit signals between brain cells, may also be involved. People with ADHD may have lower levels of neurotransmitters such as dopamine and norepinephrine in parts of the brain which govern attention, focus, and impulse control.

Environmental factors: Certain environmental factors may contribute to the development of ADHD. These include exposure to environmental toxins during pregnancy such as lead or environmental pollutants. Other risk factors include prenatal complications or maternal smoking during pregnancy.

Developmental factors: Premature birth and low birth weight has also been shown to be associated with an increased risk of ADHD.
ADHD is not caused by parenting practices, sugar intake, or a lack of discipline. These are myths and misconceptions which have been debunked by scientific research. ADHD is a medically recognised neurodevelopmental disorder that requires understanding, support, and appropriate interventions.

Impact of ADHD in School

ADHD can have significant impact on a child’s school life:
1. Academic performance: Children and teenagers with ADHD may struggle to pay attention in class, organize and complete assignments, and follow instructions. They have difficulty staying focused, staying on task, and managing their time effectively. This can lead to academic underachievement. ADHD  also affects working memory, which is crucial for reading, comprehension and problem-solving.
2. Conduct problems: ADHD is associated with impulsivity which may manifest as difficulty adhering to rules, interrupting others, or disruptive behaviour in the classroom. Not being able to self-regulate emotions or impulses can lead to conduct problems and strain relationships with teachers and peers.
3. Lower self-esteem and motivation: Children and teenagers with ADHD may have lower self-esteem and motivation due to academic difficulties and conduct problems in school. They may become frustrated, discouraged, and develop a negative perception of their abilities. This perpetuates a cycle of academic struggles and limit the chances of academic success.
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How Do Psychiatrists and Psychologist Assess ADHD?

Psychiatrists and psychologists use a variety of methods to assess ADHD in children and teenagers.
1. Clinical interviews: We will spend around an hour speaking to the child and parents to gather information about the child’s medical history, developmental history, and current symptoms. We use established diagnostic criteria, such as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) to assess for ADHD symptoms.
2. Rating scales: Rating scales and questionnaires are used to assess the severity and frequency of ADHD symptoms. These may be completed by the individual, parents and/or teachers. An example is the Connor’s Rating Scales.
3. Behavioural observations: The individual’s behaviour in different settings is observed to assess for ADHD-related behaviours, such as inattention, hyperactivity, and impulsivity.
4. School reports: We gather information from collateral sources, such as school reports, previous assessments, and relevant medical records, to get a more comprehensive understanding of the individual’s symptoms and functioning.

How can a Psychiatrist or Psychologist help a child with ADHD?

1. Assessment and Diagnosis: Psychiatrists and psychologists can conduct comprehensive assessments to determine if a child meets the criteria for diagnosis of ADHD.
2. Medication Management: Psychiatrists are medically qualified to prescribe medication for ADHD, such as methylphenidate (common brands are Ritalin, Medikinet and Concerta) or non-stimulant medications (e.g., Atomoxetine). Medication is safe and effective in reducing the symptoms of  inattention, impulsivity, and hyperactivity. Psychiatrists can monitor the child’s response to medication, adjust dosages as needed, and provide ongoing supervision to optimize the benefits and minimize potential side effects.
3. Therapy and counselling: Therapy and coaching can help the child develop strategies to manage ADHD symptoms, improve organizational and time-management skills, and enhance self-regulation abilities. Social skills training can help to improve social interactions and relationships.
4. Behavioural and Family-based Interventions: Our family therapist can guide parents in implementing home-based strategies and behaviour management plans and teach parents effective strategies for managing challenging behaviours associated with ADHD.
5. Academic Support: We can advocate for the child and get in touch with the school to implement special accommodations to support the child’s learning needs and optimise the chance of academic success. These may include classroom management strategies, cognitive strategies, time extension for major examinations and to allow the child to take exams in a less distracting, more conducive setting.
ADHD in Children and Teenagers

Is Ritalin safe for ADHD?

Methylphenidate, commonly known as Ritalin, is a central nervous system stimulant commonly used for ADHD treatment. It is safe and effective when used as prescribed and under the supervision of a psychiatrist. However, like all medications, there are potential side effects.
The safety of methylphenidate for children with ADHD has been extensively studied. It is generally safe and well-tolerated when used as prescribed. Possible side effects include a reduced appetite, insomnia, nervousness, and increased heart rate or blood pressure. These side effects are usually temporary and often improve over time or with adjustments to the medication dosage. Children with pre-existing medical conditions such as heart problems, high blood pressure, or a history of seizures or tics, will require special consideration and monitoring. The child’s response to the medication will be closely monitored at regular intervals.
The decision to take medication for ADHD is made on a case-by-case basis, taking into consideration the child’s specific needs, medical history, and the potential benefits and risks of medication. Regular monitoring and adherence to the prescribed instructions are essential to ensure the safe and effective use of methylphenidate.

Seek Help Today

The treatment approach for each child may vary depending on their profile, needs and circumstances. Collaborative and multidisciplinary care involving the child, family, teachers, and mental health professionals is crucial to helping children with ADHD thrive and reach their full potential.

If you observe that your child is very inattentive, careless, lacks focus, hyperactive or impulsive, contact us to arrange for an initial consultation at a time of your convenience. Early assessment and interventions usually lead to better outcomes (academic, emotional and social), but it is never too late to find out more and get the support that your child needs.

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