Introduction
As a doctor, sitting in my consulting room I could often spot children who appear to have ADHD within a few minutes. Full of energy and curiosity, they would be the ones who climbed on the couch and got wrapped in the paper roll, while their parents tried to have a conversation with me!
Children with ADHD have a brain that is wired slightly differently, showing three main characteristics: [1] typically being more impulsive, not thinking first and interrupting often; [2] having a short attention span for their age, finding it hard to concentrate as well as having difficulties listening and following instructions; and [3] being hyperactive, seldom sitting still and bouncing around full of energy.
These little scenarios will likely be played out at home, at school, and even in the playground. Such children are not being deliberately naughty or rude, but they do have a slightly different engine!
However, there are also many other children with ADHD who don’t fit the typical disruptive picture. These children may appear calm and relatively well behaved, but if you look more closely, they are easily distracted, less organised and more forgetful while inclined to daydream. This group is known as ‘Inattentive type ADHD’. These children don’t fit the popular stereotype and do not usually present with challenging behaviours. Instead, these children often get overlooked, especially if they are girls.
Sadly, these children all too often get missed at school – they make careless mistakes, don’t seem to listen when spoken to, or to follow instructions and manage homework.
Why does ADHD occur?
...and what does in mean in practice?
ADHD is due to brain difference in these children’s prefrontal lobes, which means that their ability to sustain concentration and draw down information from the upper brain is impaired; for them it is like working through treacle to get something “from brain to page”.
Often their ability to process material is greatly reduced, and synthesising material from different parts of their memory is especially hard. For example recalling various facts to write an essay may be particularly difficult.
Being a parent or teacher of a child with ADHD can be incredibly frustrating: sometimes these children can pull the rabbit out of the bag, other times they can’t get underway, particularly with a demanding task. This is because their brain works differently - being under stimulated, they only really get going when the pressure is on. As a result, homework can often take 3 times longer than for other children in their class.
To compound this, they may have ‘time blindness’ when they are engaged in an interesting task and don’t realise hours are passing. Consequently parents say that their child can’t possibly have ADHD as he can spend HOURS concentrating on a videogame!
Strengths and opportunities
Children (and adults) with ADHD also have wonderful attributes too!
They are often fun, energetic, live in the moment, are creative and full of plans, as well as being great at thinking outside the box and coming up with original and inspired ideas. In later life, they can do well. But it’s a challenge for them to be stuck in a boring class for 6 or 8 hours a day!
So the task is to support them through school, avoiding 3 poor outcomes: firstly, that they feel bad about themselves and feel they are stupid; secondly, that because of this they fall in with a lazy “bad” crowd, particularly in as teenagers, who don’t like school and maybe on the verge of dropping out, misbehaving, and so on. Thirdly, they may underachieve in exams, so end up not doing themselves justice, and get placed in a lower set than their intelligence justifies, underachieving in GCSEs and A-levels, and not achieving their potential. The good news is that if they go to work, university or do an apprenticeship on something they are truly interested in, they will then thrive and show their strengths.
So, might my child have ADHD?
ADHD occurs in about 6% of boys and 3% of girls. A child may be on the ADHD spectrum, having some traits of ADHD without having the "full diagnosis".
For a diagnosis it is important to note that the symptoms of inattentiveness, impulsiveness, and moving around much more than children of their age (“hyperactivity”) should be present both at home and school. Being like this just home is not enough and could be due to other factors such as anxiety; and if it is just a school, it could be due to specific learning difficulties such as dyslexia.
Also it is important to recognise that it might not occur on its own, but might be part of a “neurodiverse” picture that includes some autistic features such as rigidity about changes to routine, inability to understand other people’s points of view, and impaired turn taking in conversation. And some children are very anxious, so you will know that they are sensitive, worriers, and nervous, which can also make them have difficulty in concentration when they feel this way. While other children may just present with challenging, oppositional and defiant behaviour but can concentrate fine on most things and anything they are interested in -they are more likely to have so-called “conduct problems”.
The assessment is best done by a child and adolescent mental health professional, but knowing the criteria for a diagnosis is useful. So here are some things to look out for; The three main characteristics are INATTENTIVENESS (difficulty concentrating and focusing), IMPULSIVENESS, and HYPERACTIVITY.
To meet criteria to get a diagnosis of ADHD it has to be getting in the way of their daily life, relationships at home, with friends, at school and with hobbies. And that this is over a period of 6 months.
Although there are some similarities, every child is different, so it's important to tailor these strategies to your child's individual needs. Try to remind yourself that they are not trying to be difficult! Be patient and try to provide the unconditional love and support that will help you and your child along the way.
Recruit help and try to look after yourself too. In addition to the detailed tips provided in the full article, and other information in the Parenting Matters programme itself, here are some quick tips to get you started.
- Provide a Healthy Mediterranean Style diet for your child: This has been shown to be the healthiest way of eating, offering a balanced diet rich in whole grains, fruits, vegetables, peas, beans and lentils (you can gradually slip these into familiar dishes) as well as nuts, seeds plenty of protein (required for growth and energy) and healthy fats. Getting the right nutrients for the brain is particularly important for these children. Avoiding inflammatory ultra processed foods, and lots of sweet and refined carbohydrates, as well as swapping for a more anti-inflammatory Mediterranean style diet can help reduce ADHD symptoms. It is now well established that an improved diet can have an impact on the brain.
- Encourage Physical Activity: This can relax your child and help them to learn to pay attention to the game or task, especially if its an activity they enjoy. Regular physical activity can help channel excess energy. Engaging in sports, outdoor play, or even simple exercises can improve focus, reduce hyperactivity, and promote overall well-being. Let them go for a runaround every hour or so, even if it is only for 10 minutes, and especially after school.
- Collaborate with Teachers and Professionals: Maintain open communication with your child's teachers and seek their support. Work with any professionals, such as therapists, counsellors or other professionals, who can provide additional strategies and guidance. Learn as much as you can about ADHD to better understand your child's challenges and strengths. Share this knowledge with your child, teachers, and other caregivers to increase understanding and support. Some teachers will be well clued up about ADHD, others not so much and may just think it is due to a character deficit!
- Practice Mindfulness and Relaxation Techniques: You can do this with your child from a young age. Teach your child simple relaxation techniques, such as deep breathing or mindfulness exercises, to manage stress, improve self-regulation, and increase focus. Teach your child to trace their finger running it from the base of your thumb up and over each finger to the base of the little finger to help them settle. Or count backwards to 6.
So, might my child have ADHD?
ADHD is pretty common, occurring in about 6% of boys and 3% of girls. And a child may be on the ADHD spectrum, having some traits of ADHD without having the "full diagnosis".
Find more out about ADHD diagnoses
Inattentiveness - Impulsiveness
What exactly is hyperactivity?
How can we help your family?