How to help a child with ADHD?

Mental health issues in adults usually starts before the age of 18. There are significant number of psychiatric health disorders in children. ADHD is considered as second most common psychiatric disorder of childhood. About one third of children are described by their parents as overactive and 5 to 20% of school children are also described by teachers being hyperactive. ADHD is the term that is most commonly used and comes from DSM 5 criteria where symptoms need to be present from main categories of inattention, hyperactivity and impulsivity.

What causes ADHD?

ADHD can be caused by both genetic and non-genetic factors however there is much evidence which suggests that abnormalities of neurotransmission in the prefrontal cortex and subcortical structures. Neurodevelopmental impairment or delay are usually found in children with hyperkinetic disorder. This can be due to birth complications and it can also occur as consequence of severe traumatic brain injury. 

Neuroimaging studies have shown reduction in the volume and cortical thickness in certain areas of the brain, especially the grey matter of the basal ganglia.

Genetic studies suggest heritability about 70 to 80% in twins. Biological parents of children with ADHD are more likely to have the same or related disorder. This proves that there is a very strong genetic basis as cause of ADHD.

What are the symptoms of ADHD?

The main symptoms of ADHD are inattention, hyperactivity, and impulsivity. Children with ADHD are usually impulsive, reckless and more prone to accidents. 

They might develop learning difficulties because of poor attention and difficulty in performing tasks. Mood fluctuations, low self-esteem and depression are commonly seen in children with ADHD.

As the child grow older the hyperactivity part usually subsides,however there can be persistent attention. 

How to treat ADHD?

Parental training for ADHD is commonly utilised, although it does not have a strong evidence base. It is usually group based and it focuses on making unwanted behaviour for the child explicit, clarifying family rules and anticipating potentially difficult times of the day such as transition times. Interventions to help children with ADHD in the classroom, including advice for teachers, can provide some positive effects.

Psychoeducation of parents and teachers is extremely essential to help the child with ADHD. These practices combined with stimulant medications can give very good results. Behavioural interventions often include parent, child and social based elements and seem to be most effective in combination with medicines,

Very few children with ADHD may get benefit from free fatty acid supplements. Medicines can improve all the three core symptoms inattention, overactivity and impulsivity and should be tried if there is severe restlessness and attention deficit and their parent training and psychological approaches have not proved effective.

Stimulant drugs like methylphenidate can be prescribed in short or long-acting preparations. The side effects of these medicines include irritability, depression, insomnia and poor appetite. The noradrenaline reuptake inhibitor, atomoxetine, has also been licensed for the treatment of ADHD.