ADHD explained for worried parents
Ask any parent on a particularly long day, and they’ll tell you that their child can put the Energizer Bunny to shame. Sometimes just watching a child dash around the playground or go from game to game with their friends is enough to make anyone utterly exhausted. But what if your child’s activity is even more non-stop? What if they fidget constantly? What if they can never stay focused on a project? The answer may be found within your child’s brain.
Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder, and it is the most common psychiatric disorder found in children. According to the Centre for ADHD/ADD Advocacy Canada (CADDAC), about 5%-12% of children are diagnosed, or 1-3 children in every classroom. Even though it has been studied for centuries, with such common occurrences today, awareness of ADHD is rising and the stigma surrounding the disorder is disappearing. But there is still a lot of confusion over what ADHD really means.
Originally separate disorders, Attention Deficit Disorder (ADD) and its hyperactive cousin ADHD were unified in the fourth edition of the Diagnostic Statistical Manual (DSM), known as the psychiatrist’s bible on mental disorders, released in 2000. However, even though the term ADD no longer exists, the two are still often confused and used interchangeably.
Instead, the singular term ADHD now encompasses three subtypes: primarily inattentive ADHD, primarily hyperactive-impulsive ADHD, and combined ADHD (a combination of the two). Combined ADHD is the most common subtype, and hyperactive-impulsive ADHD is so rarely diagnosed there is debate about whether it exists at all.
How do I know if my child has ADHD?
There are three core symptoms to ADHD: inattention (or difficulty in regulating attention), hyperactivity, and impulsivity. If that sounds like your child, don’t start panicking. All children seem to have endless supplies of energy, so it’s important for parents not to jump to conclusions and assume that their son or daughter has ADHD.
The DSM also outlined a list of diagnostic criteria to determine if a child has ADHD, and if so, what type.
For the symptom of inattention, nine associated behaviours are described:
- failing to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
- difficulty sustaining attention in tasks or play activities
- not seeming to listen when spoken to directly
- not following through on instructions and failing to finish school work, chores, or duties in the workplace (not due to oppositional behaviour or failure to understand instructions)
- difficulty organizing tasks and activities
- avoiding, disliking, or being reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
- losing things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
- easily distracted by extraneous stimuli
- forgetful in daily activities
For the symptoms of hyperactivity and impulsivity, the following behaviours are described:
- fidgeting with hands or feet or squirms in seat
- leaving their seat in classroom or in other situations in which remaining seated is expected
- running about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
- difficulty playing or engaging in leisure activities quietly
- ‘on the go’ or often acts as if ‘driven by a motor’
- talking excessively
- blurting out answers before questions have been completed
- difficulty awaiting turn
- interrupting or intruding on others (e.g., butts into conversations or games)
Judging from the last 6 months of behaviour, if a child meets 6 out of the 9 criteria for the symptom of inattention, they could have primarily inattentive ADHD. If they meet 6 out of the 9 criteria for hyperactivity and impulsivity, they could have primarily hyperactive ADHD. If they meet both criteria, they could be diagnosed with combined ADHD.
CADDAC also lists some red flags to watch for, which can be found here http://www.caddac.ca/cms/page.php?142.
Also, it’s important to note that ADHD is caused by genetic and biological factors, and is about as hereditary as height. If there is a history of ADHD in your family, it is especially critical to keep an eye out for these symptoms.
Heidi Bernhardt, the National Director of CADDAC, suggests going to your family doctor if a parent suspects their child has ADHD. After an initial assessment, an ADHD specialist can give a final diagnosis. Following the diagnosis, Bernhardt strongly recommends getting a private psycho-educational assessment performed because ADHD is a mental disorder that is rarely found alone. An assessment will target all mental problems in order to come up with the best treatment plan possible.
However, Bernhardt says an assessment can cost from $1500-$2000, and is not covered by the federal government in Canada. Some school systems can provide psycho-educational assessments for children diagnosed with ADHD, but waitlists are very long and the child’s report ultimately belongs to the school system. Bernhardt highly recommends a private assessment if a family can afford it.