Could my child have ADHD?

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, got wrapped in the paper roll , and who, within minutes found their way behind my chair and tried to get into the drawers -  While their parents tried to have a conversation without being interrupted!

Children with ADHD have a brain that is wired slightly differently, showing 3 main characteristics; 1, typically being more impulsive, not thinking first and interrupting often; 2, they have a short attention span for their age, finding it hard to concentrate as well as having  difficulties listening and following instructions; 3, they may be 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!

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, complete chores or manage homework. They are easily distracted in class and at home. Their teachers, parents and family might find them exasperating as they seem to be lazy, and can come across as thoughtless. What’s more, when it comes to school, they may be capable at times, yet frequently do not complete their work and getbehind.    To compound the problem, at school they are usually the last to get started,  and as a result are slow in finishing work which is often disorganised.

ADHD is due to brain immaturity 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 different remembered facts to write an essay may be particularly difficult. While finding the “right answer” from a puzzle, choosing from answers that are in front of them such as multiple-choice questionnaires can be easier.

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 demanding task.  They are master procrastinators, frequently only starting work at the last possible moment. 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 or their Play Station!!  This is common in ADHD, because video screens provide constant ever-changing immediate stimulation which is addictive for the ADHD brain. Such children then find it especially hard to change their focus of attention when they are asked to. This is typically the case on video games, because nothing is more engaging if you are distractible and ever hungry for new stimulation. This is because   video games hit them with a new sound or visual image every second or so - perfect brain food if you have ADHD!

But 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, even taking drugs et cetera. 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 interested in, they will then thrive and show their strengths.