ADHD is a term that has come into common parlance in recent years and more people are being diagnosed with it as children, and even as adults. However, there is still a lot of misinformation in the public domain about the condition and a lot of stereotypical views of who suffers from it and what they are like. In October, ADHD Awareness Month seeks to raise awareness of the condition with the general public, members of the education and healthcare professionals, and to inform everyone of the truth about the condition and what can be done to support people who have it.
What is ADHD?
ADHD stands for Attention Deficit Hyperactivity Disorder and is a mental health condition that is defined by analysing a person’s behaviour. People with ADHD present with a persistent pattern of inattention and/or hyperactivity or impulsivity that affects their day-to-day functioning and/or their development. In an early years setting, it is often difficult to tell the difference between the challenges of youthful enthusiasm and curiosity, and the symptoms of ADHD.
For a diagnosis of ADHD to be made, there should be six of more symptoms of inattention for children up to the age of 16 years and symptoms need to be present over at least a 6-month period and be inappropriate for the person’s developmental age. A diagnosis can only be given by a qualified medical practitioner, and the list of symptoms that people can have includes:
- Not seeming to listen when spoken to directly
- Being often easily distracted
- Difficultly holding attention on tasks or play activities
- Often failing to give close attention to details
- Making careless mistakes in schoolwork, chores, or duties in the workplace and/or gets side-tracked easily)
- Has difficulty organising tasks and activities
- A reluctance to do tasks that require mental effort over a long period of time
- Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones)
In adults, and adolescents aged over 16, only 5 symptoms are needed for a diagnosis although the symptoms may present differently as people get older. In adults, hyperactivity may present as excessive restlessness or over activity. To help identify adults with ADHD, there is a WHO screening survey that adults can take as a first step on the diagnosis ladder.
One of the myths surrounding ADHD is that everyone has to present with some form or hyper-activity, and whilst many people do, this is not always the case. Indeed, people can present with different symptoms at different times. As people mature, they may be better able to cope with day-to-day activities although they may feel a constant ‘inner restlessness’ or have attention spans that are behind those of unaffected individuals.
The NHS website reports that approximately 60% – 80% of children with ADHD also have at least one other condition (e.g. social communication disorder, or difficulties with language, reading (dyslexia) or motor (dyspraxia) functions). Children also tend to not do so well on executive function tests such as those testing organisation or social functions.
How common is ADHD?
There have been several studies of the incidence and prevalence of ADHD in the UK with slightly varying data, however the ADHD website, https://adhduk.co.uk/ reports rates from NICE and The Lancet as:
- Childhood incidence rate of 5%
- Adult incidence rate of 3-4%
Those rates would give an estimate of around 785,000 children and 1.8 million adults; a total of 2.6 million people in the UK with ADHD.
What causes ADHD?
ADHD does not have a single, identified cause but is thought to be a result of complex interactions between genetic factors and environmental ones, with genetic factors being responsible for 70%-80% of the probability of having ADHD. However, there is no one gene which causes ADHD.
What is important to remember when dealing with children or indeed adults with ADHD, is that it is not something that they can always control easily and it is not them ‘being naughty’ or difficult. In the same way that many non-ADHD people would struggle to run around a football pitch for 20 minutes non-stop, many people with ADHD find sitting still almost impossible. However. many of our educational institutions place this restriction on children many times throughout the day. Think of storytime, lunchtime and other times in your setting when children are required to “sit still and listen”. When a sufferer of ADHD finds it difficult and has to move around, they are often branded as ‘disruptive’ or ‘difficult’ when it is not their fault.
There are several treatments and therapies that people with ADHD may find useful although as yet, there is no ‘cure’. Most people find a combination of therapies can help them manage including:
- Behavioural therapy and cognitive behavioural therapy (CBT)
- Social skills training
- Interpersonal psychotherapy (IPT)
- School-based interventions
- Training for parents and carers
- Speech and language therapy (SALT)
- Occupational therapy (OT)
- Medication such as methylphenidate (Ritalin®) or (Strattera)
How to help support people with ADHD
As previously mentioned, young children in early years settings may often appear to have short attention spans and lot of energy due to their developmental age, and spotting symptoms in these children is not always easy, so the first step in helping people with ADHD is to always be mindful of the condition before judging children’s behaviour. Things that can be done to help children include:
- Limiting distractions by sitting children in spaces where there are less things to distract them and where they can more easily focus on the things you want them to
- Allowing frequent movement breaks
- Making instructions clear and concise
- Breaking tasks or instructions into small steps
- Giving positive feedback to encourage the behaviour you want
Children with ADHD may also have an Individual Education Plan (IEP) or ultimately an Emotional Health Care Plan (EHCP) which may specify individual interventions that the child needs. These should be read carefully by the SENCo and implemented within the setting. Talking positively to other children in the classroom about diversity and special needs can also help those affected to feel more accepted.
Like all special needs, one of the main ways that settings can support families of children with ADHD is to offer understanding and knowledge about the condition, and ensure that your staff are well trained in how to deal with children with ADHD so that they are not chastised or labelled as ‘naughty’, when the behaviour they present with, is no fault of their own and they cannot help it. Patience and understanding will go a long way with families who are only just learning how to cope themselves.