1. What is ADHD and how common is it?
Attention deficit hyperactivity disorder (ADHD) is a medical condition characterized by inattention, hyperactivity, and impulsivity. It often first appears in childhood and can continue into adulthood. ADHD affects approximately 8 to 10 percent of children aged 4 to 17 years, making it one of the most common childhood disorders. It occurs two to four times more frequently among males, particularly for hyperactivity and impulsivity symptoms.
2. What are the symptoms of ADHD?
ADHD symptoms can be categorized into three groups: hyperactivity, impulsivity, and inattention. Children with ADHD may experience one or more of these symptoms, which may change in frequency or pattern as they grow. Hyperactivity includes excessive fidgetiness, talking, difficulty remaining seated, and restlessness. Impulsivity involves difficulty waiting turns, blurting out answers, disruptive behavior, and intruding on others. Inattention encompasses forgetfulness, being easily distracted, disorganization, underachievement, and poor concentration.
3. What are the presentations of ADHD?
There are three presentations of ADHD:
- Predominantly inattentive presentation (previously known as attention deficit disorder)
- Predominantly hyperactive-impulsive presentation
- Combined presentation
The specific presentation is determined based on a child’s predominant symptoms and can change over time.
4. What causes ADHD?
ADHD is a neurobiological condition influenced by a child’s environment. Factors that may contribute to ADHD include:
- Lower brain activity in areas controlling attention and activity levels
- Genetic predisposition, as ADHD often runs in families
- Rare cases of environmental toxins (e.g., lead exposure) causing ADHD-like symptoms
- Significant head injuries leading to ADHD-like symptoms in some children
- Preterm birth increasing ADHD risk
- Prenatal substance exposures (e.g., alcohol or nicotine)
Please note that ADHD is not caused by excessive sugar intake, food additives, food colorings, allergies, or immunizations.
5. How is ADHD diagnosed?
ADHD diagnosis involves meeting specific criteria defined by the American Psychiatric Association. These criteria include symptoms being present in multiple settings, persisting for at least six months, appearing before the age of 12, impairing function in various activities, being excessive for the child’s developmental level, and not being better explained by other mental disorders.
6. How is ADHD treated?
While there’s no specific cure for ADHD, various treatments help manage the condition. Each child’s treatment plan should be tailored to their individual needs and may include:
- Long-term management plans with target outcomes, follow-up activities, and monitoring
- ADHD education for the child, parents, and other caregivers
- Collaboration between doctors, parents, teachers, and other healthcare professionals
- Parent training in behavioral management
- Behavioral school programs
7. Is long-term planning necessary for ADHD treatment?
Yes, long-term planning is often needed, as ADHD is a chronic condition similar to asthma or diabetes. This involves continuous management by families, schools, and other caregivers.
8. How important is education in ADHD treatment?
Educating everyone involved with your child is a crucial part of ADHD treatment. As a parent, learning about the condition through reading and discussions with experts can help you manage ADHD’s daily impact on your child and family. This knowledge will also enable your child to learn self-help strategies.
9. What conditions can coexist with ADHD?
Up to 50% of children with ADHD may also have other psychological and developmental disorders, such as learning disabilities, disruptive behavior disorders (oppositional defiant disorder and conduct disorder), anxiety, mood disorders (depression or bipolar disorder), and autism spectrum disorder.
10. When should caregivers seek help for their child?
If caregivers suspect their child has ADHD, they should first talk to the child’s teacher and/or school staff to determine if the child has behavioral difficulties in multiple settings. The next step is to consult with the child’s healthcare provider for evaluation and potential referral to a specialist, such as a developmental behavioral pediatrician or child psychiatrist.
MD, FRCPC, FAAP, Consultant Pediatrician