Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is when a child, young person or adult has difficulty with paying attention, is sometimes much more energetic than others, and is unable to control certain emotional or behavioural impulses. ADHD is the most commonly cooccurring condition with Tourette Syndrome (TS).
Most children with ADHD are diagnosed between the ages of 6–12 years – in girls often later, and as with TS, the condition is more common in boys.
ADHD is caused by the movement and ‘braking’ systems in a child’s brain maturing more slowly. As with TS, not every child with ADHD will carry their symptoms through to adulthood; around 50% of adults will continue to experience ongoing symptoms.
Symptoms usually start in early childhood and although most toddlers and children are restless and excitable, children with ADHD are always ‘on the go’, find it challenging to focus their attention and don’t always understand social rules. The key thing to remember is that someone with ADHD is not behaving badly on purpose. The area in their brain which is responsible for self-control takes longer to mature than in children who don’t have ADHD.
Symptoms can range from mild to challenging, and some symptoms may even be specific to certain environments (e.g. home and not school).
Typical examples of how ADHD symptoms might show up in everyday life:
• Difficulty sitting still – such as mealtimes or during a classroom lesson
• Constant fidgeting, moving, talking, making noises as this actually helps them concentrate
• Low patience threshold – hard to wait in a queue or listen attentively to another person
• May interrupt others or say and do things without thinking through the consequences – which is not the same as intentional inappropriate behaviour.
Here are behaviours you might observe in school:
Inattentive symptoms of ADHD:
• Makes careless mistakes in schoolwork, overlooks details
• Is easily distracted or side-tracked
• Has difficulty following instructions
• Doesn’t seem to be listening when spoken to directly
• Has trouble organizing tasks and possessions
• Often fails to finish work in school or chores in the classroom
• Often avoids or resists tasks that require sustained mental effort, including doing homework
• Often loses homework assignments, books, jackets, backpacks, sports equipment
Hyperactive or impulsive symptoms of ADHD:
• Often fidgets or squirms
• Has trouble staying in his seat
• Runs and climbs where it’s inappropriate
• Has trouble playing quietly
• Is extremely impatient, can’t wait for his turn
• Always seems to be “on the go” or “driven by a motor”
• Talks excessively
• Blurts out answers before a question is completed
• Interrupts or intrudes on others conversations, activities, possessions
Caring for a child with attention deficit hyperactivity disorder (ADHD) can be draining.
The impulsive, fearless and chaotic behaviours typical of ADHD can make everyday activities exhausting and stressful.
Ways to cope
Although it can be difficult at times, it's important to remember that a child with ADHD cannot help their behaviour. People with ADHD find it difficult to suppress impulses, which means they do not stop to consider a situation, or the consequences, before they act.
If you're looking after a child with ADHD, you may find the below advice helpful.
Plan the day
Plan the day so your child knows what to expect. Set routines can make a difference to how a child with ADHD copes with everyday life.
For example, if your child has to get ready for school, break it down into structured steps, so they know exactly what they need to do.
Set clear boundaries
Make sure everyone knows what behaviour is expected and reinforce positive behaviour with immediate praise or rewards. Be clear, using enforceable consequences, such as taking away a privilege, if boundaries are overstepped and follow these through consistently.
Give specific praise. Instead of saying a general: "Thanks for doing that," you could say: "You washed the dishes really well. Thank you."
This will make it clear to your child that you're pleased and why.
If you're asking your child to do something, give brief instructions and be specific. Instead of asking: "Can you tidy your bedroom?" say: "Please put your toys into the box and put the books back onto the shelf."
This makes it clearer what your child needs to do and creates opportunities for praise when they get it right.
Repeat the request, if you ask them to “put on your shoes” follow through with “what did I ask you to do” by repeating the request it shows that the information has been retained.
Set up your own incentive scheme using a points or star chart, so good behaviour can earn a privilege. For example, behaving well on a shopping trip will earn your child time on the computer or some sort of game.
Involve your child in it and allow them to help decide what the privileges will be.
These charts need regular changes or they become boring.
Targets should be:
• immediate – for example, daily
• intermediate – for example, weekly
• long-term – for example, three-monthly
Try to focus on just one or two behaviours at a time.
Watch for warning signs. If your child looks like they're becoming frustrated, overstimulated and about to lose self-control, intervene.
Distract your child, if possible, by taking them away from the situation. This may calm them down.
Keep social situations short and sweet. Invite friends to play, but keep playtimes short so your child doesn't lose self-control. Don't aim to do this when your child is feeling tired or hungry, such as after a day at school.
Make sure your child gets lots of physical activity during the day. Walking, skipping and playing sport can help your child wear themselves out and improve their quality of sleep.
Make sure they're not doing anything too strenuous or exciting near to bedtime.
Keep an eye on what your child eats. If your child is hyperactive after eating certain foods, which may contain additives or caffeine, keep a diary of these and discuss them with your GP.
Stick to a routine. Make sure your child goes to bed at the same time each night and gets up at the same time in the morning.
Avoid overstimulating activities in the hours before bedtime, such as computer games or watching TV.
Sleep problems and ADHD can be a vicious circle. ADHD can lead to sleep problems, which in turn can make symptoms worse.
Many children with ADHD will repeatedly get up after being put to bed and have interrupted sleep patterns. Trying a sleep-friendly routine can help your child and make bedtime less of a battleground.
Help at school
Children with ADHD often have problems with their behaviour at school, and the condition can negatively affect a child's academic progress.
Speak to your child's teachers or their school's special educational needs co-ordinator (SENCO) about any extra support your child may need.
Adults with ADHD
If you're an adult living with ADHD, you may find the following advice useful:
• if you find it hard to stay organised, then make lists, keep diaries, stick up reminders and set aside some time to plan what you need to do
• let off steam by exercising regularly
• find ways to help you relax, such as listening to music or learning relaxation techniques
• if you have a job, speak to your employer about your condition, and discuss anything they can do to help you work better
• talk to your doctor about your suitability to drive, as you'll need to tell the Driver and Vehicle Licensing Agency (DVLA) if your ADHD affects your driving
• contact or join a local or national support group – these organisations can put you in touch with other people in a similar situation, and can be a good source of support, information and advice
follow the above link for information on assessment and diagnosis. In Hull the waiting list for assessment is currently around two years.