ADHD in children

Your child's nursery or school teacher may have noticed certain behaviors, or you and your family may have concerns about home life. You should book an appointment with your pediatrician.

Your pediatrician will listen to your concerns and ask for examples, and they will consider if any other medical conditions could be causing or adding to certain behaviors. It's important to consider where certain behaviors are occurring, and where they may be symptom-free – at school, home, their grandparent's home, sports clubs – and whether there were any significant events that precipitated these behaviors.

If your pediatrician considers ADHD a possibility, they can conduct tests or refer you to a child psychiatrist. There is no one test that points to ADHD, but a detailed assessment, including interviews with the child, parents, teachers, and anyone else involved, will help them reach a conclusion.

Diagnosis follows strict criteria:

• 6 or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness
• Symptoms have been ongoing for at least six months
• Symptoms started before 12 years old
• Behaviors are present in at least two settings – like at home and at school
• Symptoms are having an impact on their social and educational progress
• There's no explanation or diagnosis that fits better with their behaviors than ADHD, like another mental health disorder, and symptoms are not part of a developmental disorder

Medication and therapy are offered to help with ADHD, and providing both together usually gives the best outcome. The aim is to relieve symptoms and make behaviors easier to manage and live with. There isn’t a cure, as such, but medications may help patients to concentrate for longer periods, thereby improving learning. It can also reduce impulses and bring a calmer feeling overall. Methylphenidate (brand name Ritalin) is the most commonly used of these medications.

Children may experience side effects such as headaches, stomach upset, feeling less hungry, or changes to their mood. They will be started on a low dose and closely observed for any intolerable side effects before increasing the dose if needed.

ADHD is often considered a lifelong condition, although your child may improve as they get older. Medications are offered for as long as they’re needed, but your child’s specialist may consider reducing or stopping at various points to check if they are still necessary.

Behavioral therapy may be offered where children learn or strengthen positive behaviors and eliminate unwanted and problematic behaviors. It will involve parents and teachers working together to provide support, strategies, and boundaries.

Students with ADHD are eligible for an Individual Accommodation Plan under Section 504 of the Individuals with Disabilities Education Act (IDEA), known as a 504 Plan. This means your child is entitled to appropriate support to help them thrive socially and educationally. This may include reasonable adjustments to their school day, such as regular rest breaks, extra time for exams, and a seating plan to minimize distractions and disruptions.

Information and resources for families can be found from the American Academy of Child and Adolescent Psychiatry or the Attention Deficit Disorder Association.

Children and Adults with Attention Deficit/Hyperactivity (CHADD) is a non-profit organization offering local social support in some communities. You may also be able to find other local support groups of parents who are facing similar challenges with a child with ADHD.

The first thing is to keep your child informed and supported, as the condition and society’s response to their behaviors can leave them feeling confused, isolated, anxious, and low in confidence. They may be getting in trouble at school or have difficulty managing their emotions or maintaining friendships. Give them space to talk about how they are feeling and explain how the behavior strategies and medication will help them.

A consistent routine for school days and weekends can help – regular mealtimes, bedtimes, and homework time can help to keep distractions to a minimum and not overload them with work. Reward systems will reinforce good behavior, and outlining boundaries will help discourage bad behavior, although this is easier said than done.