Attention deficit/hyperactivity disorder (ADHD) is among the most common neurobehavioral disorders presenting for treatment in children and adolescents. ADHD is often chronic with prominent symptoms and impairment spanning into adulthood. ADHD is often associated with co-occurring disorders including disruptive, mood, anxiety, and substance abuse. The diagnosis of ADHD is clinically established by review of symptoms and impairment. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry and neuropsychological data. Consideration of all aspects of an individual s life needs to be considered in the diagnosis and treatment of ADHD. 

Multimodal treatment includes educational, family, and individual support. Psychotherapy alone and in combination with medication is helpful for ADHD and comorbid problems. Pharmacotherapy including stimulants, noradrenergic agents, alpha agonists, and antidepressants plays a fundamental role in the long-term management of ADHD across the lifespan. 

The management of ADHD includes consideration of two major areas: non-pharmacological (educational remediation, individual and family psychotherapy) and pharmacotherapy. 

I personally support Psychotherapy. Specialized educational planning based on the child s difficulties is necessary in a majority of cases. Since learning disorders co-occur in one-third of ADHD youth, ADHD individuals should be screened and appropriate individualised educational plans developed. Educational adjustments should be considered in individuals with ADHD with difficulties in behavioral or academic performance. Increased structure, predictable routine, learning aids, resource room time, and checked homework are among typical educational considerations in these individuals. Similar modifications in the home environment should be undertaken to optimize the ability to complete homework. For youth, frequent parental communication with the school about the child s progress is essential. 

Symptoms in children and teenagers 

The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school. The main signs of each behavioural problem are detailed below:

Inattentiveness: having a short attention span and being easily distracted making careless mistakes   for example, in schoolwork appearing forgetful or losing things being unable to stick at tasks that are tedious or time-consuming appearing to be unable to listen to or carry out instructions constantly changing activity or task having difficulty organising tasks 
Hyperactivity and impulsiveness: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger 
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline. 

Related conditions in children and teenagers 

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as: 

anxiety disorder   which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness 
oppositional defiant disorder (ODD)   this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers 
conduct disorder   this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals 
depression 
sleep problems   finding it difficult to get to sleep at night, and having irregular sleeping patterns 
autistic spectrum disorder (ASD)   this affects social interaction, communication, interests and behaviour 
epilepsy   a condition that affects the brain and causes repeated fits or seizures 
Tourette s syndrome   a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics 
learning difficulties   such as dyslexia Symptoms in adults In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD. 
ADHD is a developmental disorder; it's believed that it can't develop in adults without it first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into a person's teenage years, and then adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood. By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives. The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms. 

Some specialists have suggested the following list of symptoms associated with ADHD in adults: 

carelessness and lack of attention to detail 
continually starting new tasks before finishing old ones 
poor organisational skills 
inability to focus or prioritise 
continually losing or misplacing things 
forgetfulness 
restlessness and edginess 
difficulty keeping quiet and speaking out of turn 
blurting out responses and often interrupting others 
mood swings, irritability and a quick temper 
inability to deal with stress 
extreme impatience 
taking risks in activities, often with little or no regard for personal safety or the safety of others   for example, driving dangerously 
Additional problems in adults with ADHD As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include: 

personality disorders   conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others 
bipolar disorder   a condition that affects your moods, which can swing from one extreme to another 
obsessive-compulsive disorder (OCD)   a condition that causes obsessive thoughts and compulsive behaviour 
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job. If you notice any of the above in your child or yourself , it is worth making the effort and spending some time and money to have your child and or yourself assessed on a priority basis as ADHD causes neural changes in the brain. 

Attention Deficit Hyperactivity Disorder (ADHD) - A Guide!

What is ADHD?

ADHD refers to attention-deficit hyperactivity disorder, which is a brain-related condition found among preschoolers, children, teenagers and in many cases extends well into adulthood. These individuals have significant impairment in academics as well as social situations and interpersonal relations. The child has difficulty sustaining attention, phases of hyper activeness and cannot control his/her impulses which make their day to day life at school and home difficult.

ADHD Symptoms

The symptoms of this disorder among children can be categorized under three headings.

1.Hyperactivity which includes

- Fidgets often
- Restlessness
- Inability to stay at one place runs around and tries to climb things
- Trouble playing quietly
- Excessive talking

2. Inattention, which can be divided into symptoms like

- Getting easily distracted
- Tendency to loose things
- Daydreaming
- Facing problems related to organizing things
- Not listening carefully
- Forgetting about daily activities, carelessness

3. Impulsiveness

- Interrupts others as they speak and talks out of turn
- Answers questions without listening to what has been asked
- Not being able to wait for their turn to come

Prevalence :

10-12% of school children before puberty are affected by one or more types of ADHD. ADHD especially hyperactivity is more prevalent in boys than in girls, with the ratio up to 9:1. Inattention and poor concentration are more commonly seen amongst girls. The rate of ADHD in parents and sibling of children with ADHD is 5-10 times higher than in the general population.

ADHD Causes

The probable causes of ADHD among children are,

1. Neurodevelopmental changes - Poorly developed activity of the brain particularly in the areas that control attention and concentration cause ADHD. This causes an imbalance in the neurotransmitters or the chemicals important for brain functioning and development.

2. Genetic Factors - genetic studies show that ADHD is largely hereditary in nature with a heritability of 75% approximately.



What are the Causes and Symptoms of ADHD?

Children generally tend to be fairly over active and have lesser attention spans. However, when this tends to get into their performance at school and in general with getting along with other children it may be a sign of ADD or attention deficit disorder. Let's look at some of the common symptoms of this disorder.

Symptoms of ADD

1. Problems in staying focused: One of the very basic symptom is that children will often be very inattentive even during classes and will be easily distracted by small things.

2. Problems in trying to remember things or difficulty in following instructions: Children with attention deficit disorder tend to have issues with remembering things and if given tasks, being unable to complete as they can't remember instructions properly.

3. Issues with organizing, planning and trying to finish tasks: Due to the lack of attention, kids have problems retaining information and cannot plan or finish tasks given to them on a daily basis.

4. Easily bored or loses interest: Even if a child with ADD starts with something they like, interest may wane off quickly. Thus it is difficult to make them stick to a specific work schedule which may require regular practice.

5. Lack of attention to details and making careless mistakes: This is another trait of children with attention deficit disorder. They may be able to complete a task, but it will be fraught with mistakes as they wouldn't have much attention to detail.

6. Has a tendency to not listen when someone is speaking to them: This is also very common and is usually tied to being easily distracted and thus will drift off or not listen to when someone is speaking to them.

Some Myths about ADD

a. All kids with ADD are hyperactive
b. They will eventually grow out of it
c. Medication is the only option to treat ADD
d. ADD is not really a disorder and kids need to be trained better

Most of these are half truths and the extent of the problems varies from child to child. Only proper counseling will be able to diagnose the extent of the problem and what needs to be done.

How to spot ADD in Children

ADD can be spotted in children aged below 7 years via certain symptoms. Apart from the ones mentioned above, children generally tend be abrasive towards others and can make embarrassing comments quite often. They also change tasks very quickly without completing any of them. Any distraction would force them to change their track. It is best to go to a child specialist to get your child checked out for possible symptoms.

Symptoms and Myths About Attention Deficit Disorder (ADD) and How to Spot Them in Children

Concentration problems and trouble in focusing on one task at a time can be termed as Attention Deficit Hyperactivity Disorder or ADHD, in rare and severe cases. While most of the cases are identified in one's childhood, it has been seen that many cases persist into adulthood while still others go completely undiagnosed. This mental health disorder comes with a number of symptoms and management methods. Read on to know more.

Symptoms: While many patients suffering from this disorder may not display any obvious symptoms at a young age as children are supposed to be brimming with energy, the symptoms for adult ADHD, start to show up in a more obvious fashion. Wavering concentration and low levels of focus along with disorganised living with impulsiveness are the first signs of adult ADHD. Such adults also have trouble when it comes to finishing one task at a time, or even focusing on a task for a prolonged period of time. Bouts of impatience and excessive activity can also show up as symptoms, while restlessness is a quality that most of these patients seem to possess.

Diagnosis: The diagnosis of this condition is slightly difficult because most adults may complain of some or the other symptoms related to this condition at some point in their lives. Anxiety and mood swing related symptoms can help in diagnosing the condition in a better manner. If the condition ends up disrupting your normal life, work, socialising and behaviour in general, then you may want to see a doctor regarding the same, so that proper diagnosis may take place.

Causes: While genetic predisposition is said to be the foremost cause of this condition, especially when it continues well into adulthood, there are various environmental factors that may also have a significant bearing on the onset of the condition. Exposure as a child increases the risk of falling prey to this condition. Also, when there are problems with the central nervous system during the developing years, the patient may start to develop symptoms connected with this disorder later on.

Treatment: Stimulants and other medication like anti-depressants, nonstimulant amphetamine are also used for treating this condition along with therapy and psychological counselling for better organisation in life.

ADHD in Adults

The tendency for the development of Attention Deficit Hyperactivity Disorder, which is more popularly known as ADHD, during the months of pregnancy is growing with each passing day. The main reason behind this is the increased exposure to the digital devices. This disorder is characterized by some specific characteristics, the most common ones being the inability to concentrate on anything and being hyperactive at all times of the day. People tend to show impulsive actions in all cases. 

But the good news is that the researchers have come up with some possible solutions to ADHD during pregnancy with the help of which it can be prevented-

Curb the intake of sugars: One of the main steps that you can take towards preventing the development of ADHD during your pregnancy is going on a low sugar diet. Several types of research have proved that when the mother has a high sugar diet, it directly correlates to the development of ADHD. The reason behind this is quite simple. It is because there is a particular gene in the human body called the IGF2 and this gene is responsible for the development of the brain. But when there is a high amount of sugar in the diet, the IGF2 levels are compromised which ultimately leads to the development of ADHD. So, don t take too much of processed proteins and stick to a healthy diet. If necessary, approach a dietician who can give you a proper diet chart to follow.
Get the proper probiotics for yourself: Probiotics have a major role in many of the health conditions and one of them is the development of ADHD in pregnancy. Adding the necessary probiotics to a pregnant woman is not only good for her overall health but also enhances the growth and development of the fetus. Not only does the application of the right probiotics prevents the chances of development of ADHD in newborns, but it also reduces the risk of development of conditions like autism, bipolar disorder, mood disorders, and even schizophrenia.
Keep your cell phones away from you: All forms of digital devices create a heavy impact on the fetus leading to ADHD in many cases. Mobile phones are no doubt an important part of your lifestyle but you can keep them away from yourself when they are not needed, especially, keep them away from your pockets.
Drink filtered water: Unfiltered water contains many chemicals and other unhygienic substances. You should refrain from consuming unfiltered water especially in your months of pregnancy.
In the months of pregnancy, when your body is vulnerable to the outside factors that are harmful, you must stay extra vigilant and take all the precautions necessary to ensure that your child does not develop ADHD. Maintain your diet and don t skip your checkups.

How To Prevent ADHD During Pregnancy?

If you have noticed your child to be restless and anxious all the time, it might look cute as the child is highly energetic, but it could be a cause for concern at the same time. It is not normal and the child could be having ADHD that is attention deficit hyperactivity disorder. As the name suggests, it is a disorder with deficiency of attention and in which the child is always hyperactive.

ADHD is a disorder in which the symptoms usually show up before the age of seven. It is characterized by a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness. The impact of these symptoms is felt extensively where his overall self-esteem is affected, be it at home, preschool or school, academics or extracurricular activities and in interpersonal relationships.

The most common symptoms, which are almost diagnostic of ADHD are:
1. Inability to hold attention: The child's attention span is very short and it is very difficult to keep them engaged on one particular thing.
2. Increased restlessness: The child would be extremely restless and gets distracted easily.
3. Fidgeting: The child would be seen constantly fidgeting with his fingers.

The following are the less common ones:
1. Learning disability is rare, but can happen. However, the good news is that it does not affect the child's intelligence.
2. Sleep disorders
3. Difficulty in following directions
4. Poor executive functioning skills
5. Disorganization, which can lead to poor motor coordination and impaired movements
6. ADHD kids tend to forget things very easily and need help with coordinating movements
7. The child suffering from ADHD could easily tire and/or feel lethargic with very low energy levels. This can lead to the child procrastinating things and not wanting to do things on priority basis
8. These children also have difficulties with fine motor and cognitive skills and so there is delay in their overall participation in games.

While these are the pressing symptoms of ADHD, occupational therapy can play a significant role in managing the child in the following ways. As a first step, the caregiver should have a detailed discussion with the school staff and any other people with whom the child interacts significantly. This will help identify areas that need support from an Occupational Therapy, which are the following:

1. Support with gross and/or fine motor skills
2. Support with improving handwriting
3. Support with engaging in playing sports and games
4. Support in engaging in social activities
5. Improving sensory processing difficulties
6. Improving visual perception
7. Support in adapting to the environment
8. Teaching strategies to participate in various social and academic activities

So, while an ADHD child is definitely a cause for concern, proper support from family can help manage the condition.

Symptoms of ADHD

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