Factsheet 5: Attention-deficit hyperactivity disorder and
hyperkinetic disorder: for parents and teachers
About this factsheet
This is one in a series of factsheets for parents, teachers
and young people entitled Mental Health and Growing Up.
The aims of these factsheets are to provide practical, up-to-date
information about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children and young
people. This factsheet looks at attention-deficit hyperactivity
disorder (ADHD) and hyperkinetic disorder, the signs to look for
and where to get help.
Introduction
What are attention-deficit hyperactivity disorder and
hyperkinetic disorder?
Many children, especially under-fives, are inattentive and
restless. This does not necessarily mean they are suffering from
ADHD or hyperkinetic disorder (see
Factsheet
1 on the restless and excitable child).
The terms `attention deficit', `attention-deficit
hyperactivity disorder', `hyperkinetic disorder' and
`hyperactivity' are used by professionals to describe the problems
of children who are overactive and have difficulty
concentrating.
The terms attention deficit disorder (ADD) or
attention-deficit hyperactivity disorder (ADHD) are used in the
USA. The official term in the UK is hyperkinetic disorder. These
differences in terminology can sometimes cause confusion. In both
instances, these children usually have problems with attention
control and overactivity.
What are the signs?
Children with ADHD/hyperkinetic disorder:
- are restless, fidgety and overactive
- continuously chatter and interrupt people
- are easily distracted and do not finish things
- are inattentive and cannot concentrate on tasks
- are impulsive, suddenly doing things without thinking
first
- have difficulty waiting their turn in games, in conversation or
in a queue.
This type of behaviour is common in most children. It becomes
a problem when these characteristics are exaggerated, compared to
other children of the same age, and when the behaviour affects the
child's social and school life. Often the signs will have been
obvious since the child was a toddler.
What causes ADHD/hyperkinetic disorder?
We do not know exactly what causes these disorders, but
genetic factors seem to play a part. The disorders can run in
families, with boys more often affected than girls.
Where can I get help?
There is no simple test for ADHD/hyperkinetic disorder. Making
a full diagnosis requires an experienced specialist assessment,
usually done by a child psychiatrist or specialist paediatrician.
The diagnosis is made by recognising patterns of behaviour,
observing the child and obtaining reports of their behaviour at
home and at school.
Your general practitioner will be able to offer you advice and
support and will usually refer you to a specialist. A child and
adolescent psychiatrist will undertake a thorough assessment and
offer treatment. Some clinical psychologists and paediatricians
also have special experience and skills in managing this
problem.
Effective treatment will include advice and support for the
parents.
A full specialist assessment
This will enable your child's needs to be clearly
identified.
Psychological management
You should expect:
- a full explanation of the condition to you and your child;
- advice about on how to manage difficult behaviour;
- communication between the child's specialist and teachers, who
will offer you advice on structured activities and reward systems
for positive behaviour that may help. Special support and teaching
may also be needed;
- help for difficulties that have developed as a result of
ADHD/hyperkinetic disorder, including low self-esteem, difficulty
with friendships, temper tantrums and aggression.
Stimulant medication
Some medications such as methylphenidate or dexamphetamine may
reduce hyperactivity and improve concentration (see Factsheet 6 on
stimulant medication). Medication produces a short-lived
improvement after each dose, but is not a permanent cure. It
creates a period when the child can learn and practise new skills.
Children often say that medication helps them to get on with
people, to think more clearly, to understand things better and to
feel more in control of themselves. Not all affected children need
medication. Those who do always need psychological and educational
support as well.
Changing diet and avoiding additives
There is a small body of evidence about the effect of diet on some
children. A few may be sensitive to certain foods. If parents
notice that specific foods worsen hyperactivity, these may be
avoided. It is best to discuss this with the specialist.
Do children grow out of it?
Children who receive specialist treatment tailored to their needs
may benefit considerably. Some problems with restlessness,
attention and lack of control might continue into adult life.
However, with help, most hyperactive children will have settled
down by the time they reach their mid-teens. They will have been
able to catch up with their learning, improve their school
performance and make friends.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- National Institute for Clinical Excellence (2000) 'Guidance
on Methylphenidate' (Ritalin/Equasym) - for Attention Deficit
Hyperactivity Disorder (ADHD). www.nice.org.uk
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (4th edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (2001) 'Finding the
Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
Provides information and resources about Attention Deficit
Hyperactivity Disorder to anyone who needs assistance.
- Young
Minds Parents Helpline for any adult concerned about
the emotions and behaviour of a child or young person. They offer
information and professional advice, via telephone and email -
contact 0800 018 2138 or parents@youngminds.org.uk
- The Mental Health and Growing Up series contains 36
factsheets on a range of common mental health problems. To order
the pack, contact Book Sales at the Royal College of Psychiatrists,
17 Belgrave Square, London SW1X 8PG; tel: 020 7235 2351, ext. 146;
fax: 020 7245 1231; e-mail: booksales@rcpsych.ac.uk, or
you can download them from this website.
- ADD Resources
website offers 100 free and carefully chosen articles helpful to
adults with ADD/ADHD and to parents of children with ADD/ADHD,
links to other ADHD-related websites, and more.
© [2006]
Revised March 2009.
Royal College of Psychiatrists. This factsheet may be
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Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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