What is Attention Deficit Hyperactivity Disorder?

Attention Deficit Hyperactivity Disorder (ADHD) is a formal psychiatric diagnosis (used primarily in the USA) to describe ongoing disruptive behaviours which cannot be explained by any other diagnosis, and are not in keeping with age and ability equivalent peers.  The key criteria for diagnosis includes:

• inattention - poor concentration with significant inability to manage distractions

• hyperactivity – highly elevated levels of activity that are inappropriate for the circumstance, with inability of child to regulate own behaviour

• impulsivity – inability to think through and plan before acting.

These behaviours are usually evident in early childhood, and are more extreme than simple misbehaviour.

Some mental health professionals in the UK use the diagnosis of Hyperkinetic Disorder rather than ADHD, however media attention has ensured ADHD has gained greater public prominence. 

How common is ADHD?

It is estimated that about 1.7 per cent of the UK population, mostly children, have ADHD.  Boys are more likely to be affected.

What are the long-term consequences of ADHD?

Although people with ADHD can be very successful in life, without identification and proper treatment, ADHD may have very serious consequences, could include: under-achievement at school, depression, impaired social relationships, employment difficulties, and criminal behaviour

How is ADHD diagnosed?

ADHD requires a medical diagnosis by a doctor, usually a child or adolescent psychiatrist, a paediatrician or paediatric neurologist or a GP.  As there is no single diagnostic test for ADHD a range of information needs to be gathered, including: history of symptoms, medical history, past psychiatric history educational history, evaluation of the child's temperament/personality, family history, and social assessment.  Further, it is appropriate for other professionals such as psychologists, social workers, speech therapists, teachers and health visitors to contribute to the assessment of a child with possible ADHD.

For a diagnosis of ADHD a child would be expected to show the behavioural symptoms in more than one setting, e.g. at school as well as at home.

What are the best practice interventions for ADHD?

There is no one specific intervention for ADHD.  Rather, best practice indicates that a multidisciplinary therapeutic approach produces the most effective outcomes for children diagnosed with ADHD.  These include:

• Management of behaviour by care providers – creation of a daily routine, specific and age appropriate instructions, establishment of clear boundaries, implementation of natural and logical consequences

• Management of behaviour by education providers – structured environment, use of rewards, consistent application of boundaries, ability specific learning activities, educational support for learning problems

• Psychological intervention – skill based development including anxiety management, cognitive therapy, individual psychotherapy and social skills training

• Medical intervention – medications used are amphetamine-like stimulants (methylphenidate and dexamphetamine) which require ongoing medical follow-up.  In general, medication produces a short-lived improvement after each dose, but is not a permanent cure

• Diet – While research indicates that diet is not a significant factor in ADHD for most children, diet still requires attention to ensure healthy growth and development

What is the relationship between child abuse and ADHD?

Research indicates that children with many of the symptoms of ADHD are at greater risk of being abused than those children without these behaviours.

What can be done for abused children who are diagnosed as ADHD?

ADHD compounds the difficulties faced by children that have been abused.  Once in a place of safety, the child needs to develop a sense of security.  Due to poor attention and concentration skills compounded by learning and social deficits, such a crucial attainment will have to endure significantly more challenges than for a child who has not experienced abuse.

What can New Horizons offer abused children with a diagnosis of ADHD?

New Horizons has experienced residential childcare staff that are able to provide a nurturing yet contained environment that will provide the structure and support needed for a child to develop a sense of safety and trust.  With the ready availability of a multidisciplinary team, best practice interventions can be implemented.