Has your child’s teacher raised some concerns about your child’s performance at school?
Perhaps friends or family members have commented negatively regarding aspects of your child’s behaviour.
Maybe you have a niggling worry that something may not be quite right with your child.
Is your child having trouble concentrating at school?
I often see children whose parents or teachers are concerned their child may have a behavioural or learning problem. People often jump to assumptions and frequently raise the possibility of diagnoses such as Attention Deficiency Hyperactivity Disorder (ADHD).
It is so important a thorough assessment is carried out to determine if your child does in fact have areas they are struggling with and, from there, determine how best to help them.
Applying a label or diagnosis is not always necessary and should be sought only to help guide intervention for you child if necessary.
Having a diagnosis of ADHD does not always mean your child requires medication – there are many other things that can be done to help.
Read on to learn more and please arrange an appointment if you have concerns.
What is ADHD?
ADHD is a medical condition. It is not caused by poor parenting. ADHD currently affects 1 in 20 children under the age of 12 in Australia and is more common in boys than girls.
Children with ADHD might be overly active, they may have difficulty focussing and may often act impulsively. Others may present with difficulties in learning and expressing feelings.
In ADHD these behaviours are more extreme than what would be expected for a particular age group and have a significant impact on the life of the child with ADHD and their family.
There are 3 subtypes of ADHD:
Inattentive – difficulty with concentration, attention and memory
Hyperactive / impulsive – hyperactive behaviour and impulsivity.
Combined – this is a combination of the 2 types of ADHD described above.
What causes ADHD?
So far we don’t fully understand exactly what causes ADHD. We do know some children are genetically susceptible and certain things in their life may increase their risk of developing ADHD. Things that may increase the risk of ADHD are:
prematurity or low birth weight at delivery
Maternal smoking / substance abuse
Advanced maternal age
Antenatal infections
Exposure to toxins such as lead
There is no evidence to link food intolerances to ADHD however it has been commonly observed that certain food additives can exacerbate some of the behavioural issues seen.
How can ADHD be Diagnosed? Formal diagnosis of ADHD is a complicated process that is carried out by a developmental paediatrician, paediatric psychiatrist or clinical psychologist.
Experienced GP’s however can carry out an initial assessment to see if further specialist assessment is warranted. This would involve talking to you at length about your concerns and your childs history as well as conducting a thorough health and development check up. Your GP may also ask you to complete a questionnaire and have your child’s teacher do the same.
What features should I look for?
Consider whether the problem behaviour in your child seems more significant than other children in the same age group - the areas of concern must have a significant impact on the child’s social or academic functioning and be out of context for what would be expected.
Consider how long the symptoms have been an issue - these would need to be present for at least 6 months before a diagnosis of ADHD would be made.
Consider if the issues are seen across various settings – i.e school and home. Many children have difficult behaviour at home but are doing well in the school environment – in most cases this would not be consistent with ADHD.
Consider the age of your child - ADHD is generally only diagnosed in children over the age of 5 years and when symptoms have been present before 12 years of age. Diagnosing ADHD in older children is more complicated.
There are other diagnoses which may be similar to ADHD in their presentation such as:
normal childhood behaviour
Oppositional Defiant Disorder or Conduct Disorder
Intellectual disability
Physical conditions – hearing loss, visual impairment, thyroid disorders, absence seizures
Anxiety / Depression
Sleep apnoea
Psychosocial issues at school (peer relationships, bullying etc)
What treatment options are available?
The good news is there are many options available to help your child with ADHD and in most cases many of these would be trialled before medication is considered.
There are children with ADHD who benefit from medication however this should not be the first step taken.
There are many different people who can help you and your child to decrease the impact of ADHD on their life. These may include your GP, teacher and guidance officer at school, psychologists, Occupational Therapists, Speech Therapists and Physiotherapist.
Some things that need to be considered are:
Making sure your child is getting enough sleep
Making sure your child’s diet is adequate
Making sure there are no underlying medical issues such as constipation or iron deficiency
Working on parenting strategies to help in the family environment
Working on different approaches within the classroom to help your child’s learning.
What should I do now? If you have concerns about your child after reading this, I encourage you to make an appointment with a GP who has some experience in this area and work through your concerns.
Making an official diagnosis is not imperative however it can help with access to the various services discussed as well as facilitating extra help for your child within the classroom.
Having a diagnosis can also help you to manage expectations and understand your child's behaviour making it easier for you to help them.
References: Brisbane Health Pathways
Raising Children Network