Attention Deficit Hyperactivity Disorder (ADHD) for Child and Adolescent

Overview

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-developmental disorder that begins from an early age, usually before seven years old.

It is a condition associated with brain functioning or development and describes a group of behavioural difficulties marked by inattention, hyperactivity and impulsivity. These difficulties can be observed in early childhood and are consistent across different situations, e.g. at home, in school and in social settings.

Causes

Risk Factors

Many factors are thought to contribute to ADHD, including genetic factors, injuries, toxins and infections.
A family history of ADHD increases the likelihood of your child having symptoms of ADHD.
Experts agree that ADHD is not caused by poor parenting.

Signs & Symptoms

There are two main groups of symptoms: inattentive; and hyperactive-impulsive. A child or adolescent with ADHD may show symptoms from predominantly one group or the other or combine symptoms from both groups.

Symptoms of inattentive include:

Not listening to what is being said.
Making careless mistakes in schoolwork or activities.
Frequently shifting from one activity to another.
Forgetfulness, losing items frequently.
Being messy and disorganised.
Avoids or dislikes tasks that require sustained mental effort.
Easily distracted by surroundings.

Symptoms of hyperactive-impulsive include:

Fidgeting or squirming.
Talking excessively.
Having difficulty remaining seated.
Frequently interrupting conversations or activities of others.
Blurting out answers before questions have been completed.
Having difficulty waiting for their turn in games or activities.
Having difficulty playing or engaging in leisure activities quietly.

It is worth noting when these behaviours:

Become severe and persistent over time.
Become pervasive and occur consistently all the time, whether it is at home or in school.
Impair their ability to make friends, get along with others or perform their tasks in such an instance, the child may be suffering from ADHD.

Detection & Treatment

Treatment of children or adolescents with ADHD involves a combination of different approaches:

Behavioural methods

Use of a rewards system or behaviour contract that focuses on a few problem behaviours at a time.
Skills-based training for the family or individual (e.g. social skills training, anger management training) to help the child and family cope better in various situations.

Appropriate school-based interventions

School-based interventions by teachers may include:

Seating the child or adolescent at the front of the classroom.
Rewarding or praising the child or adolescent for work done or effort made.
Teaching organizational skills to help children or adolescents with inattention track their progress and pick up time-management and note-taking skills.

Medication may be prescribed to help reduce symptoms of ADHD. Talk to your child's doctor if you have any queries or concerns about medication.

Care Management

Support and education of parents

Parents should keep themselves as informed as possible about the disorder and work closely with the school and professional staff in supporting the child.
It is important for parents to cope with their own emotions and not be reactive or negative towards the child. Modeling and providing specific instructions about appropriate behaviour are more effective than giving the child a longlist of 'do-nots'.

Support groups and parent training are helpful for providing techniques for behaviour management.
You can also help your child by being patient, understanding and supportive.
Be encouraging and empathize with his or her challenges.
Celebrate all small successes and be positive.
Parents often find themselves feeling stressed from caring for their children who have ADHD. It is vital that they find support from other family members and the school. Parents can work with teachers and school counsellors to assess the child and discuss how to best support them.
Parents can also directly reach out to a psychiatrist or IMH's multidisciplinary community mental health team REACH (Response, Early Intervention and Assessment in Community Health) to explore treatment and management strategies for any queries or concerns about medication.

Additional Resources

NHG_Attention Deficit Hyperactivity Disorder for Child and Adolescent.pdf

Specialties & Services

Neurology

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