Attention deficit hyperactivity disorder - What is it?
In this section
Many parents worry at times about how their children behave. Often, disruptive behaviour is simply part of growing up. But in some children, it is caused by a medical condition called attention deficit hyperactivity disorder (or ADHD for short).
Children with ADHD find it hard to concentrate, are overactive and act without thinking. If your child has ADHD, it's important to get treatment. Otherwise, ADHD may affect how your child develops, and create problems at home and at school.
But with the right treatment, your child's behaviour can improve dramatically.
Key points for parents whose child has ADHD
- ADHD is a medical condition. Children with the disorder find it hard to pay attention, are overactive and act without thinking.
- Not all children with behaviour problems have ADHD. Their behaviour may just be a phase or part of some other problem.
- The symptoms of ADHD tend to get better as children get older.
- Treatments for ADHD include drugs and talking treatments.
- Treatments can't cure ADHD, but they can help your child develop and learn normally.
You may hear ADHD called different things. Doctors used to call it attention deficit disorder or ADD. Children could have ADD on its own or with hyperactivity (being overactive). In 1987, this term was replaced with ADHD. But some doctors still use the old name.
You may also hear ADHD called hyperkinetic disorder, or HKD for short. The term HKD is usually used when your child's symptoms are severe and your child has all three signs of ADHD: inattention, overactivity and impulsiveness. Doctors sometimes call this combined type ADHD.[1]
If your child has ADHD, bear in mind that it's nobody's fault. Nothing you or your child has done has caused the condition.
You may feel as if your child is behaving badly on purpose. But being strict with a child who has ADHD is unlikely to make things better.
Many parents of children with ADHD offer this advice: "Don't try to cope with your child's problems on your own".
Our brain and our behaviour
To understand what happens in ADHD, it's useful to know something about normal behaviour. Our brain controls how we behave.
- Our brain enables us to react to what we see, hear and feel in the world around us.
- Millions of nerve cells send messages between our brain and our body.
- Chemicals called neurotransmitters help the messages travel from one nerve cell to another.
- For our brain to work properly and tell us how to behave, we need to have just the right amount of these neurotransmitters.
The front part of the brain is called the frontal lobe. It sits just behind the forehead and is the brain's control centre. It collects information from other parts of the brain and helps decide how we react to this information.What goes wrong in ADHD
Doctors aren't sure exactly what goes wrong in ADHD. But they think that the behaviour problems are linked to the way that the front part of the brain works.
- Studies suggest that this part of the brain works more slowly in children with ADHD than in other children.[2]
- Children with ADHD may have an imbalance in the neurotransmitters in the front part of the brain. Some doctors believe they don't have enough of a neurotransmitter called dopamine. Children with ADHD may also lack the neurotransmitter noradrenaline.
- Without enough dopamine or noradrenaline, the front part of the brain can't deal with and react to information in the way that it should.[2]
- This is why some drug treatments for ADHD aim to increase the amount of dopamine or noradrenaline in the brain. (See What treatments work for ADHD?)
How it feels to be a child with ADHD
A child with ADHD is unable to process information in the same way as other children. This means that for a child with ADHD:
- The outside world rushes in with a flood of noise and images
- The child cannot decide what's important and gets confused.
This is why the child finds it impossible to organise daily tasks and to see activities through to the finish.
For instance, a child without ADHD can sit happily in a room playing with a toy while the television is on, two adults talk and a car honks in the background. A child with ADHD will probably find this impossible. This child's brain can't deal with all the different sights and sounds and decide which is important. The child gets confused and can't concentrate.
Unfortunately, there are no tests that show whether the front part of a child's brain is working normally. So doctors have to rely on what children, parents and teachers say in order to diagnose ADHD.
Why does my child have ADHD?
ADHD is nobody's fault. Nothing you or your child has done has caused it. Too much television, too much sugar or poor schools do not cause ADHD.[4]
The truth is, nobody knows exactly what causes ADHD. It is probably caused by a combination of many things.
Many parents wonder if ADHD could be linked to what their child eats. There isn't enough good research to be certain whether changing your child's diet can improve the symptoms of ADHD. But there is some evidence that children with ADHD may not be eating enough essential fatty acids.[1] Essential fatty acids are found in foods such as meat, fish and eggs. There is also some evidence that, for a small number of children, ADHD may be linked to an allergy to food additives, such as artificial colours and preservatives.[2] To learn more, see Vitamin and mineral supplements, and special diets.
Although researchers don't know what causes ADHD, they have found certain risk factors for the condition. Risk factors are things that may make it more likely that a child will get ADHD. But, so far, there is no solid evidence that these things actually cause ADHD. We know only that they seem to happen more often in children who have the condition. To learn more, see Risk factors for ADHD.
References
- Scottish Intercollegiate Guidelines Network. Attention deficit and hyperkinetic disorders in children and young people. Scottish Intercollegiate Guidelines Network clinical guideline 52. 2001. Available at: http://www.sign.ac.uk (accessed 18 April 2006).
- Bradley JD, Golden CJ. Biological contributions to the presentation and understanding of attention-deficit/hyperactivity disorder: a review. Clinical Psychology Review. 2001; 21: 907-929.
- Mercugliano M. What is attention-deficit/hyperactivity disorder? Pediatric Clinics of North America. 1999; 46: 831-843.
- Hill P, Taylor E. An auditable protocol for treating attention deficit/hyperactivity disorder. Archives of Disease in Childhood. 2001; 84: 404-409.
Glossary
- dopamine
- Dopamine is a chemical that affects the nerve cells in the brain and other parts of the body.
- noradrenaline
- Noradrenaline is a neurotransmitter, which is a chemical that helps to send information between nerve cells. It is similar to adrenaline. Your body produces adrenaline when you're in stressful situations, which increases your blood pressure and heart rate.
- allergy
- If you have an allergy to something (such as pollen or a medicine), your body always overreacts to it. The reaction happens because your (your body's system for fighting infection) is too sensitive to it.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
