Attention deficit hyperactivity disorder (ADHD) in children

Published by Bupa's Health Information Team, April 2011.

This factsheet is for parents of children who have attention deficit hyperactivity disorder (ADHD), or for people who would like information about it.

ADHD is a disorder that can affect children’s learning, behaviour and development. Children with ADHD have short attention spans and may be easily distracted, overactive and restless.

About ADHD

ADHD is also known as attention deficit disorder or hyperkinetic disorder. These different names can be confusing but are all used to describe the problems of children who can’t concentrate and are overactive.

ADHD is more common in boys than in girls – it affects around one in 25 boys and one in 100 girls in the UK. Children are usually diagnosed between the ages of three and seven, but symptoms continue into adolescence and adulthood and sometimes may only be diagnosed in later life.

If you think your child may have ADHD, it’s important to talk to your GP and start treatment as soon as possible. 

Symptoms of ADHD

There are a range of symptoms or behaviours that are associated with ADHD. Many of these behaviours are also seen in children who don’t have ADHD. These are only a problem if they are exaggerated compared to children of the same age and they affect your child’s social and school life.

The following table lists a number of common ADHD symptoms.

Children with ADHD may have mostly hyperactive or impulsive symptoms, mostly inattention symptoms or a combination of these.

Other symptoms common in children with ADHD include:

• aggressiveness and poor discipline – disruptive behaviour
• vocal or motor tics
• fearlessness and reckless behaviour
• irritability
• difficulty interacting with peers
• sleep problems

ADHD won’t make your child less intelligent but it may interfere with his or her learning.

If your child has ADHD, you may first notice it or it may get worse when he or she starts school. Your child may be slower to learn things than other children because he or she can’t pay attention and concentrate. If your child is hyperactive and aggressive he or she may have difficulty getting on with other children. If your child is dreamy and inattentive but not disruptive, you and your child’s teacher may not notice his or her condition.

Complications of ADHD

If your child has ADHD, he or she may find it difficult to communicate and interact with other children and adults. Your child may also have problems with speech development.

As your child gets older, there is an increased risk that he or she may become involved in antisocial conduct, such as rowdy behaviour, and may be unaware of how these actions affect others.

Causes of ADHD

The exact cause of ADHD isn't known, there are probably a number of factors involved.

Compared to people of the same age, people with ADHD may show differences in the parts of their brains that deal with controlling impulses and focusing attention.

Your child may be more likely to have ADHD if he/she:

• has a family history of ADHD
• had a low birthweight
• was exposed to cigarettes, alcohol or drugs (such as cocaine) in the womb

Your child's behavioural and emotional symptoms may be made worse if he or she also has other problems, such as an anxiety disorder. A stressful home environment, for example because of a divorce or separation, may also be linked with ADHD, but it's hard to know whether this might be a cause or a result of the condition.

Diagnosis of ADHD

If you think that your child may have ADHD, visit your GP. He or she will ask you about your child’s symptoms and examine your child. Your GP may also ask you about your child’s medical history.

If your GP thinks that your child may have ADHD, he or she will refer your child to one of the following specialists:

• a child psychiatrist (a doctor who specialises in children’s mental health)
• a specialist in your local Child and Adolescent Mental Health Services
• a specialist paediatrician (a doctor who specialises in children’s illnesses)

There are no specific tests for ADHD. The specialist will observe your child and look at reports of his or her behaviour. You and other people who spend time with your child, such as carers or teachers, may be asked to fill in a questionnaire about your child’s behaviour.

ADHD is usually diagnosed if you child has symptoms that affect both school and social life (present in more than one setting).

Treatment of ADHD

The most effective way to treat ADHD is to use a combination of different treatments.

The exact treatments used will depend on what your child needs and how he or she responds. Your child may need to try several treatments before finding one that works.

Self-help

Diet
A healthy diet is always important. In some children, ADHD symptoms can be improved by cutting down on certain ingredients such as food additives. You should speak to your child’s doctor or a dietitian before making any changes to your child’s diet.

Managing behaviour at home
You can help your child by providing a structured environment with clear rules of acceptable behaviour. Your child’s specialist can help you learn how to manage his or her specific behaviours. You could also attend classes and support groups where parents with similar experience can share their knowledge and experience.

School
Talk to your child’s teacher about his or her condition. A structured and orderly classroom without too many distractions and small group or individual teaching may help your child to focus.

If your child is diagnosed with ADHD, his or her school may offer extra help with reading, spelling, maths, organisational skills, speech therapy, physical education therapy and counselling. An educational psychologist will usually assess your child’s needs and check on his or her progress.

Medicines

Your child’s specialist may offer medicines to manage the symptoms of ADHD. Your child will often need to continue treatment into adolescence and may need to continue as an adult. The specialist will identify a suitable medicine and dosage, and after this your child’s GP may take over his or her care. Medicines aren’t usually recommended for children under the age of six.

The type of medicine prescribed for your child will depend on:

• his or her symptoms
• whether he or she has any other medical conditions
• how he or she responds to the medicine
• whether he or she gets any side-effects

Medicines that are often prescribed for children with ADHD include methylphenidate (eg Ritalin and Concerta XL), atomexetine and dexamfetamine. Like most medicines it is important that you’re aware of possible side-effects, including insomnia, headaches, irritability, loss of appetite and weight loss. Always ask your child’s doctor for advice and read the patient information leaflet that comes with your child’s medicine.

It’s not clearly understood how these medicines work. However, it’s thought that they work by changing the levels of certain chemicals in the brain. They can help to reduce hyperactivity and impulsiveness and increase attention span, helping your child to concentrate at school.

Talking therapy

Talking therapies such as psychological and behavioural therapy can also help. The therapy is designed to help your child learn to focus their attention and reduce impulsive behaviour. Therapy may be offered to your child or your whole family.

Living with ADHD

Caring for a child with ADHD can be difficult and the effects on family life can be dramatic. National support groups are available for the families of children with ADHD, and your GP may be able to put you in touch with a local group. Through one of these, you can meet other families in the same situation and get support and advice on behaviour management for your child.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.