ADHD

MAY I HAVE YOUR ATTENTION?

We all know a child who just never seems to run out of steam and most normal, healthy children have a lot of energy and are constantly active. While it is perfectly normal for a child to be full of playful energy the term ‘hyperactive’ seems to be used a lot more frequently recently.

Some young children seem to have a short attention span and suffer from volatile moods. They will often disrupt classes at school or get into fights. The question is how do you distinguish between a naughty child who perhaps just wants a bit of attention and one who has the symptoms of an ever-increasing syndrome known as Attention Deficit Hyperactivity Disorder (ADHD)? The answer is that it is very difficult and complex.

De Faye’s chemists pharmacist, Richard Lyness, takes us through some of the symptoms and treatments of ADHD.

SO WHAT IS ADHD?

To understand what happens in ADHD it is useful to know how the brain controls our behaviour under normal circumstances. It enables us to react to what we see, hear and feel in the world around us and there are millions of nerve cells that send messages between our brain and body. The part of the brain that collects all this information and helps us decide what to do in any given situation is called the control centre.

Doctors think that the problems that occur in ADHD are linked to this control centre of the brain with studies suggesting that it may work more slowly in children with ADHD. An imbalance of brain chemicals is also seen in children with the condition, especially one called dopamine. Children with ADHD appear to have low levels of dopamine which means that the control centre of their brain cannot deal with and react to information in the way it should do.

This inability to process information means that a child with ADHD may feel overwhelmed with a flood of noise and images. They cannot decide what is important and so they get confused and find it impossible to complete relatively simple tasks or see any activity through to the end.

The truth is that nobody knows exactly what causes ADHD but it is thought that it is a combination of inherited genetic factors and elements from the environment.

RISK FACTORS FOR ADHD

1. FAMILY HISTORY – there is a tendency for ADHD to be passed on through families.
2. SMOKING DURING PREGNANCY – mothers of children with ADHD are more likely to have smoked during their pregnancy with one study estimating that smoking while pregnant increased the risk of having a child with ADHD by around a third.
3. LOW BIRTH WEIGHT – for every 4 or 5 new babies weighing less than 1.5kg (around 3 pounds 4 ounces) one will go on to develop ADHD. This compares with less than 1 in 10 children of normal birth weight who develop the condition.

HOW COMMON IS ADHD?

Awareness of ADHD is on the increase so more children seem to be being diagnosed but it is not necessarily a new problem. Parents are now more likely to seek medical advice if their child has behavioural problems and schools are now much more vigilant about warning signs and symptoms.

It is estimated that up to 5% of school age children have ADHD; that’s about 367,000 children which means that in a class of 30 children one or two pupils will have the condition. About 5 times more boys than girls are diagnosed with ADHD but this may be down to the way that boys express their difficulties as they are more likely to be overactive and difficult to manage than girls with similar problems.

HOW IS ADHD DIAGNOSED AND WHAT ARE THE SYMPTOMS?

This can be a challenging area as it must be remembered that no diagnosis can be perfect; all children are different and will express their problems in different ways. There is no simple physical test (e.g.) a blood test to check for ADHD and a doctor has to use certain criteria to try and draw the line between normal childhood exuberance and an attention disorder. In addition other factors such as language or hearing difficulties, dyslexia or a major disruption in a child’s life all need to be considered.

The 3 signs of ADHD are:
1. NOT PAYING ATTENTION
2. BEING OVERACTIVE
3. ACTING WITHOUT THINKING (IMPULSIVE BEHAVIOUR)

A child can have symptoms of all three of these signs but for a firm diagnosis to be made a child must have SIX or more symptoms of NOT PAYING ATTENTION
AND SIX or more symptoms of BEING OVERACTIVE and IMPULSIVE THINKING.

The types of symptoms that will be seen include things such as:
• Paying no attention to detail and making careless mistakes in school work
• Unable to concentrate on one game or task for too long
• Often seem not to listen when spoken to
• Easily distracted and often forgetful
• Often fidget or squirm when sitting down or keep getting up and running around
• Talk too much and often blurt out answers before a question is finished
• Have difficulty waiting their turn and often interrupt others.

If you have just read this list and think that sounds like my child there is no need to panic!
Doctors will want to check that they have been behaving like this FOR AT LEAST SIX MONTHS and some of the symptoms started BEFORE THE CHILD REACHED THE AGE OF SEVEN. One of the most important things is that your child’s behaviour must be causing problems IN AT LEAST TWO PLACES, most commonly at home and in school.

TIPS FOR PARENTS WHO HAVE A CHILD WITH ADHD

It is important to emphasise that not all children with behavioural problem have ADHD as their bad behaviour may be simply a phase or a means of attention seeking. If your child is diagnosed with ADHD, however, it is vital to bear in mind that it is in no way a negative reflection on your parenting skills or you have done something wrong in some way. It can be tempting to feel that your child is acting badly on purpose or is trying to test you but being strict with a child with ADHD is unlikely to make things any better. There is a wealth of information and support available for parents of children with ADHD so you should never try to cope on your own

If you are worried about your child’s behaviour you should speak to your GP or to your child’s teacher. They can arrange for you to see a specialist who can assess your child although unfortunately waiting lists for such appointments can be frustratingly long. It is important, however, not to give up and many parents find it useful to talk to other parents who have been through the same thing. It can also help to keep a diary of your child’s behaviour.

It is a sad fact that life for a child with ADHD is rarely easy. They may be labelled troublesome or attention seeking and part of the problem is that a child with ADHD often has no idea how their behaviour affects others. They may want to make friends but have no idea how to do so as they have never picked up the basic rules of social behaviour that most children seem to learn naturally.

The bright side is that as awareness of the condition heightens a child’s outlook can improve dramatically with the right treatment and support.
About one third of children will completely grow out of ADHD but some will still need treatment throughout adolescence and into adulthood. Without treatment your child’s behaviour can have an effect on their learning and development so it is important to seek advice and make full use of the support network available.

TREATMENT OF ADHD

Treatments cannot cure ADHD but they can ease the symptoms to such an extent that your child can develop and learn normally and most children with ADHD do attend a main stream school. Most experts agree that the most effective approach is to use a variety of methods, tailored to the needs of the individual child.

Treatment usually consists of a stimulant type drug called methylphenidate (brand names include Ritalin, Equasym and Concerta XL). It works by stimulating the part of the brain that controls behaviour and regulates behaviour. It will help your child become less restless, better able to concentrate and more likely to think before acting.

Methylphenidate is even more effective if it is combined with behaviour therapy. This involves sessions with a trained therapist who counsels and supports both the chills and their family.

Other medication options include dexamfetamine (Dexedrine) which is another stimulant and Atomoxetine (Straterra) Straterra is a relatively new drug for ADHD and is not a stimulant but instead increases levels of brain chemicals so helping the brain process information more efficiently.

IS THERE A LINK BETWEEN DIET AND ADHD?

More often than not children with ADHD have one or more nutritional imbalances that, once corrected, can dramatically improve their focus, concentration and behaviour

Some general rules to follow include:

• AVOID ADDITIVES.  One British study found that the removal of additives such as tartrazine, sunset yellow and sodium benzoate from the diet led to significant improvements in ADHD symptoms.
• AVOID CAFFEINE. This is a stimulant so may make symptoms worse; avoid tea, coffee and fizzy drinks.
• AVOID ALL FORMS OF REFINED SUGAR. Sugar feeds the brain and fluctuations in the level can lead to dramatic changes in a child’s mood. Regular meals and healthy snacks of fruit or nuts are advised.
• AVOID FOODS MADE WITH NATURALLY OCCURRING SALICYLATES (an aspirin-like compound). These are found in foods such as ice cream, chewing gum and soft drinks as well as most fruit especially berries and dried fruit. Many children with ADHD appear to be sensitive to these compounds.
• CONSIDER FOOD ALLERGIES OR SENSITIVITIES.
• INCREASE INTAKE OF MAGNESIUM – good sources include nuts, seeds and leafy green vegetables or it can be obtained in supplement form from your pharmacist.
• INCREASE INTAKE OF OMEGA-3 ESSENTIAL FATTY ACIDS. These are commonly found in oily fish and are essential for the development and function of the brain. Children with ADHD tend to be deficient in these fats. An excellent supplement, EYE Q, is a special combination of fatty acids formulated in the right ratio for optimal brain function. This product is suitable even for very young children and has been shown to produce real benefits in concentration, learning ability, co-ordination and memory. Ask your pharmacist for more advice about the benefits of essential fatty acids in your child’s diet.

If you want to know more about ADHD or about the nutritional supplements you can buy from your pharmacist then please contact Richard on 01534 724701 and he will be happy to answer any queries you may have.