Attention Deficit Hyperactivity Disorder

What is attention deficit hyperactivity disorder (ADHD)?

ADHD is a neurodevelopmental condition which usually first appears in childhood and is more common in boys. Children usually are at least five years old before they are diagnosed with ADHD. It can appear in different ways, usually as one of three basic types: predominantly hyperactive, inattentive, or combined. Inattentive girls present later, hence the sex difference is minimal in adulthood.

A child with ADHD may have trouble in these areas:

• Being inattentive, such as difficulty concentrating or finishing tasks
• Impulsivity, such as butting into conversations or being accident prone
• Overactivity, such as constant fidgeting and always being on the go
• Problems with executive functioning, which results in difficulties with planning and organisation
• Sleep difficulty and mood dysregulation.

ADHD often exists in tandem with other problems, such as learning problems (50 per cent of those with ADHD), oppositional defiant disorder (20-35 per cent), autism (10-20 per cent), depression (10 per cent), anxiety (20-30 per cent), and conduct disorder (10-20 per cent), and may lead to problems in social situations, cause behavioural and learning issues at school, and result in sleep difficulties.

However, developmental paediatrician and Telethon Kids researcher Professor Desiree Silva – who has written a guide to ADHD and is also Co-Director of the ORIGINS Project – says that while children with ADHD often encounter negative experiences daily, many become very resilient with appropriate support from those around them, including families, teachers, and the education system.

“In the past children with ADHD have simply been considered naughty and the condition has wrongly been blamed on poor parenting, however we now know that this is a complex neurodevelopmental disorder and that children with ADHD have a different brain structure and immature neural development compared with other children,” Professor Silva says.

How is ADHD treated?  

Combining stimulant medication with other therapies, including counselling and behavioural strategies, is generally the most successful treatment. Speech pathology, support from a psychologist, occupational therapy, ADHD coach, healthy diet, regular exercise, neurofeedback and education support can also assist.

Not all children with ADHD require medication – about a third of children will grow out of the condition without ever having needed it – however Professor Silva says that for those with moderate to severe symptoms, medication is a safe treatment which can lead to significant improvements in symptoms and better functioning.

Risk factors

ADHD is estimated to affect one in 14 children in Australia. The exact cause of ADHD is not known but Professor Silva says genes appear to be the largest factor in determining who develops it. Research suggests up to 70 per cent of ADHD is inherited, with 30-40 per cent related to environmental factors that affect wiring in the brain, including early infections and prematurity.

Professor Silva says that, combined with other treatments and a healthy lifestyle which includes exercise and contact with nature, a healthy diet (one that includes omega-3 fatty acids and avoids food additives, refined sugars, processed foods and saturated fat) may help to reduce symptoms.

Maternal smoking and drinking during pregnancy have also been identified as risk factors. A study found that mothers of children with ADHD were significantly more likely to be younger, smoked in pregnancy, and were more likely to have given birth slightly earlier.

More studies are needed to better understand the genetic and environmental risk factors of ADHD.

*If you're concerned about your child’s behaviour, your GP can refer your child to a paediatrician, psychologist or psychiatrist so they can be assessed for ADHD.