Attention Deficit Hyperactivity Disorder (ADHD)

What is ADHD?

ADHD stands for Attention Deficit Hyperactivity Disorder. ADHD is a life-long neurodevelopmental disorder which impacts upon an individual’s behaviour.

ADHD causes two key groups of symptoms:

Inattention

  • Short attention span, or ‘flitty attention,’ jumping from one activity to another.
  • Poor focus and concentration.
  • Forgetfulness and losing things.
  • Trouble initiating or starting tasks, and in remaining on task.
  • Poor planning and organisation skills.

Impulsivity and hyperactivity

  • Struggling to remain seated and still when this is expected.
  • Fidgetiness and/or agitation.
  • Excessive movement.
  • Excessive talking.
  • Difficulties with turn-taking and interrupting others.
  • Acting without thinking, making poor decisions.
  • Having little regard for danger.

Many people with ADHD have difficulties in both areas. However, there is a subtype of ADHD called ‘Inattentive Subtype’ whereby the primary symptoms are poor attention and focus, with hyperactivity being much less apparent. Research suggests that females are more likely to present with the inattentive subtype, but this is not always the case. Roughly 3 in 10 of those with ADHD are thought to have the inattentive subtype. In general, boys are much more likely to be diagnosed with ADHD than girls.

There are often other symptoms present for those with ADHD, including broader executive functioning difficulties such as poor planning and organisation skills, difficulties following instructions, and poor working memory. There may be poor decision-making skills resulting from impulsivity. Time management can be a challenge. Due to their symptoms, children often struggle in school and require additional support and adjustments to help them manage.

Symptoms of ADHD are generally apparent from early on in school-aged children, but a formal diagnosis cannot be made until six years old. Symptoms must be pervasive; that is, they are observable in all environments, such as at school and at home in the case of children.

What causes ADHD?

While the causes of ADHD are still not fully known, as with many neurodevelopmental conditions, it sometimes seems to run in families. If a parent has ADHD, their child is much more likely to have ADHD.

Other factors that increase the likelihood of having ADHD include being born prematurely, having a low birth weight, or suffering hypoxic injury during birth. Being prenatally exposed to alcohol, tobacco smoking and some other substances also substantially increase the likelihood of ADHD. The majority of children with FASD have secondary ADHD. Other forms of acquired or traumatic brain injury can also result in ADHD symptoms.

While ADHD is a lifelong condition, many adults report improvement in their symptoms compared to how they experienced them in childhood. However, the degree of improvement varies in different people, and according to the underlying cause of the ADHD. For example, if ADHD is part of a broader diagnostic profile rather than being a person’s sole diagnosis, this can mean symptoms are more persistent.

How is ADHD diagnosed?

ADHD should be diagnosed through compliant assessment.

At PCEA, our ADHD assessments are conducted by two clinical psychologists who have considerable experience in assessing and working with children and adults with neurodevelopmental conditions, including ADHD.

The assessment may include the following (this may vary depending on age at assessment):

  • Developmental history taken through consultation with parents/carers, or other family members.
  • Use of standardised tools specifically for assessing ADHD, such as the Diagnostic Interview for ADHD (DIVA) or Young DIVA, and QbCheck.
  • Cognitive Assessment.
  • Observation and/or consultation with a child’s school.

Most of the time, assessments are completed on the same day, although sometimes they may take place over two days, with at least two clinicians assessing the child or adult. If a school observation is required, this will be arranged separately, with parent or carer permission being sought first.

How is ADHD treated?

Of primary importance is the use of ADHD-friendly strategies to facilitate children and adults with ADHD to function at their best at home and at school. Medical management of ADHD symptoms is also highly effective for many individuals. The two main types of medicine for ADHD are stimulant and non-stimulant medications, both of which have different mechanisms to reduce symptoms of inattention, hyperactivity and impulsivity.

At PCEA, we do not prescribe medication following a diagnosis, as we are clinical psychologists rather than medical doctors. However, we can provide advice about where to go should a family or individual wish to discuss the possibility of medical management moving forward.

FASD

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ASD

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