The following is a brief introduction to ADHD. You can find out more via our useful links page.
What is ADHD?
Attention Deficit Hyperactivity Disorder is a neuro-developmental disorder which affects the executive functioning of the brain. Executive functioning is like the management system of the brain – it helps us to plan, juggle or organise different tasks, remember things, prioritise what to think about or what to do, pay attention, manage frustration and regulate our emotions. Executive functioning also helps us to use information and experiences from the past to solve current problems. All of these things can be affected in ADHD.
If you are new to ADHD, we recommend watching the 28 minute primer video to the right by Dr Thomas Brown.
Most estimates around the world suggest that around 1 to 2 in every 100 children have significant levels of ADHD, but many more than this have milder problems. In 2012, the Services Over Scotland report on ADHD showed that around 0.6% of the under 18 population (1 in every 167 children) in Scotland is being treated for ADHD. The latest data for 2016/17 shows that this is now closer to 1%.
ADHD rarely comes on its own, and people with ADHD are more likely than others to have other difficulties including mental health problems like anxiety and depression, behavioural problems like oppositional defiant disorder (ODD) , specific learning difficulties like dyslexia, and autistic spectrum disorder. These additional problems can make being a parent to a young person with ADHD complex and challenging.
How is ADHD diagnosed?
In the UK, ADHD can only be diagnosed by a specialist doctor - a consultant psychiatrist or paediatrician. If you think your child may have ADHD, your first port of call should be your GP. They should rule out other things which can lead to similar problems such as difficulties with sleep, hearing and vision. They may then refer your child to one of the psychiatrists within the Children and Adolescent Mental Health Service (CAMHS) teams based around the city.
Unfortunately, there’s no simple test for ADHD like a blood test or a brain scan. To make a diagnosis, the specialist will ask lots of questions and take a thorough history. They may use standardised questionnaires for both parents and teachers to fill in independently, and they may visit your child's school to observe them in the classroom. The diagnosis process can take some weeks or months, as it’s really important to get it right.
The official list of symptoms which doctors use to diagnose ADHD are based on two internationally recognised classifications of diseases - the American Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD10), produced by the World Health Organisation (W.H.O.). Although there are some slight differences in the definitions, the two guidelines agree on a number of things:
The core symptoms of ADHD are:
inattention (difficulty in concentrating, short term memory difficulties)
hyperactivity (disorganised, excessive levels of activity)
impulsive behaviour (acting without thinking)
Of course all children display these characteristics to some extent, but in ADHD the levels are above and beyond what you would expect given the age of the child.
In order to meet diagnostic criteria it is essential that symptoms:
have started before the age of 12 years (many children and adults are diagnosed older than this, but the signs will have been there since early childhood.)
have lasted for at least six months
are present in more than one setting, e.g. home, school and social situations
have caused significant ‘functional impairment’ (i.e. problems)
can’t be better explained by other conditions (e.g. pervasive developmental disorder, schizophrenia, severe sleep problems, depression or anxiety) - the assessing doctor will want to rule out these other problems first.
More details of the diagnostic criteria for ADHD are given on the ADDISS website.
You can also read a discussion of the difference between the old diagnostic criteria in the DSM IVth edition and the new criteria in the DSM Vth edition, which was published in 2013, here.
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