There is a normal spectrum amongst children and adults in their level of activity throughout the day and night, and their ability to concentrate on a single task for an extended period.
Attention deficit hyperactivity disorder (ADHD) is at the extreme end of “hyperactivity” and inability to concentrate (“attention deficit“). It affects the person’s ability to carry out everyday tasks, develop normal skills and perform well in school.
Features should be consistent across various settings. When a child displays these features only at school but is calm and well behaved at home, this is suggestive of an environmental problem rather than an underlying diagnosis.
Features
All the features of ADHD can be part of a normal spectrum of childhood behaviour. When many of these features are present and it is adversely affecting the child, ADHD can be considered:
- Very short attention span
- Quickly moving from one activity to another
- Quickly losing interest in a task and not being able to persist with challenging tasks
- Constantly moving or fidgeting
- Impulsive behaviour
- Disruptive or rule breaking
Management
A detailed assessment should be carried out by a specialist in childhood behavioural problems before a diagnosis is made. Management should be coordinated by a specialist in ADHD. Parental and child education is essential. This includes education about parental strategies to manage the child.
Establishing a healthy diet and exercise can offer significant improvement in symptoms. Keeping a food diary may suggest a link between certain foods, such as food colourings, and behaviour. Elimination of these triggers should be done with the assistance of a dietician
Medication is an option after conservative management has failed or in severe cases. This should be coordinated by a specialist. Contrary to what you might think, they are central nervous system stimulants. Examples are:
- Methylphenidate (“Ritalin“)
- Dexamfetamine
- Atomoxetine
Last updated January 2020