ADHD in Children

Children can be hyperactive, impulsive, and inattentive. Children can run around playing, climb on things to seek adventure, and seem to never stop talking about their exciting day. They can interrupt often, blurt out their great ideas, and seem impatient waiting for their turn. They can also be disorganized, lose things, get distracted, and seem like they are not listening to anything they are told. These behaviours are common and may even be some of the things most loved about some children.  However, these behaviours can also be problematic and raise concerns if they occur beyond what is expected for their age and if they result in negative consequences during their daily lives, like their school performance or friendships.  In these cases, these behaviours may be indicative of something more going on, such as an underlying disorder. 

Attention-Deficit/Hyperactivity Disorder, or ADHD, is a neurodevelopmental disorder that involves more than usual levels of inattention, impulsivity, and hyperactivity that interfere with school, social, and home functioning (APA, 2013). It is one of the most commonly diagnosed neurodevelopmental disorders in Canada, affecting approximately 5% of children worldwide (CADDAC, 2021). It is highly heritable, and symptoms emerge in childhood and tend to last a lifetime. In fact, more than 75% of children diagnosed with ADHD continue to experience significant symptoms into adulthood, although they might change over time (CDC, 2020). Children with ADHD are at risk for other challenges and many also have co-occurring disorders like learning disabilities or disruptive behavioural disorders; however, there are treatments available and KIDTHINK can help. 

 

Diagnosis, Symptoms, and Subtypes

Professionals use the Diagnostic Manual of Mental Disorders -5th Edition (DSM-5) to diagnose ADHD and it lists three types of ADHD presentations, relying on three core symptoms (inattention, hyperactivity, and impulsivity): 

  • Predominantly Inattentive Presentation (e.g., individuals who fail to give close attention to details, have difficulty sustaining attention, have difficulty with organization, lose things, are forgetful, and are easily distracted). 
  • Predominantly Hyperactive-Impulsive Presentation (e.g., individuals who fidget often, talk excessively, have difficulty remaining seated, interrupt others, blurt out answers, and have difficulty waiting their turn). 
  • Combined Presentation (e.g., individuals who present with both inattentive and hyperactive-impulsive presentations). 

The subtype of diagnosis depends on the number of symptoms present in the individual. Some children may only show inattentive symptoms, and some may only show hyperactive-impulsive symptoms, but the majority show both. For a diagnosis, symptoms of ADHD must arise in early childhood (prior to the age of 12) but can change presentation throughout their development.  Symptoms must be present for at least 6 months, be more than what is expected for their age, and be present in more than one setting, such as home and school (APA, 2013).

There is no single test or tool to diagnose ADHD, and diagnosing it is a comprehensive process which generally takes several steps. It typically involves ruling out other problems that have similar symptoms (e.g., hearing problems, sleep difficulties, learning disabilities, trauma or anxiety), gathering a thorough history of the child from multiple sources, and completing a clinical evaluation of the child’s social, academic, cognitive, emotional, and developmental functioning.  

 

What is the difference between ADHD and ADD?

The labels ADHD and ADD (Attention-Deficit Disorder) are confusing because the name of the disorder has changed over time. Prior to the DSM-5, older editions of the manual used the term ADD, but now ADD is called ADHD, regardless of whether symptoms of hyperactivity and impulsivity are present. Despite the official change of labels, many professionals and individuals still choose to use both terms, perhaps out of habit, or to describe children who have ADHD but are not hyperactive and impulsive. Currently, children who are inattentive but not hyperactive or impulsive will receive a diagnosis of ADHD (APA, 2013). 

 

What is the treatment for ADHD?

While there is no cure for ADHD, it is often referred to as the most treatable mental health condition (CADDAC, 2021). The right treatments can help reduce symptoms and improve functioning by supporting you and your child. Treatment for ADHD should be multifaceted and standard treatments for ADHD include medical, educational, behavioural, and psychological components. Depending on your child’s needs, age and severity of symptoms, their treatment plan may include parent skills training and counselling, medication, behavioural training, cognitive behavioural therapy, social skills training, psychotherapy, family therapy, classroom intervention, and psychoeducation (CHADD, 2021).

 

Does my child need treatment?

Symptoms of ADHD commonly interfere with children’s school, social, and home functioning. Children with ADHD may have more difficulties with academics, friendships, extra-curricular activities, and family relationships. For example, they may lose friends because they are constantly interrupting and in other’s faces, or they may get kicked off the sports team because they struggle following rules. They may also display more behavioural challenges such as defiance, tantrums, and arguing than peers their same age. When left untreated, children with ADHD are at greater risk for several issues, including learning difficulties, school dropout, additional mental health disorders, lower self-esteem, and substance abuse. The good news is that with proper diagnosis, treatment and support, children with ADHD can be successful and happy, and live meaningful lives (CADDAC, 2021). 

 

What do I do if I think my child has ADHD?

If you think your child has ADHD, a common first step is to take your child to a pediatrician to rule out other possible medical causes that have symptoms similar to ADHD. For example, a child with hearing problems may present as a child who does not follow through on tasks, does not follow directions, and interrupts or intrudes on others. Once medical problems are ruled out, a common second step is for the child to undergo a clinical evaluation, like a psychological assessment, that will include a careful and thorough history and evaluation of the child’s academic, social, emotional, and developmental functioning through questionnaires and standardized tests. Clinical psychologists typically complete these assessments and will diagnosis if ADHD and/or other disorders are present. ADHD is also commonly diagnosed by psychiatrists. 

 

How can KIDTHINK help?

KIDTHINK clinical psychologists can help you decide if your child would benefit from an assessment to determine whether ADHD or other underlying problems are present. If your child has a diagnosis of ADHD, KIDTHINK professionals, including mental health clinicians, outreach clinicians, and clinical psychologists will determine and implement appropriate intervention supports for your child. KIDTHINK also has a psychiatrist available to provide diagnostic consultation and prescribe medication.

 

Written by Megan Hebert, Ph.D., C. Psych. 

Clinical Psychologist 

MORE COMMON THAN YOU THINK  

  • 1 in 7 children suffers from mental illness in Manitoba (Chartier et al., 2016).  
  • 70% of mental health problems have their onset in childhood or adolescence (Government of Canada, 2006).  

 

There Is Hope The good news is that mental illness can be treated effectively. There are things that can be done to prevent mental illness and its impact and help improve the lives of children experiencing mental health concerns. Early intervention is best.  

 

How KIDTHINK Can Help   

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Centre for ADHD Awareness, Canada. (2021). Understanding ADHD. Retrieved from https://caddac.ca/adhd/understanding-adhd/in-general/facts-stats-myths/#

Centers for Disease Control and Prevention. (2021). Attention-Deficit/Hyperactivity Disorder (ADHD). Retrieved from https://www.cdc.gov/ncbddd/adhd/facts.html