How can you tell if your child’s behaviour is normal or might be a sign of a disorder?
Fifty years ago, the term ‘ADHD’ was unheard of. If children had a short attention span or couldn’t sit still or had tantrums, they were labelled ‘naughty’.
Now we know that ADHD is a very real disorder.
Attention deficit hyperactivity disorder (ADHD) is, according to the NHS, a ‘group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness’.
According to NHS statistics, two to five per cent of school age children may have ADHD. Most are diagnosed between six and 12 years old.
The problem lies in being able to distinguish between normal kids’ behaviour, such as getting bored or being unable to sit still, and the symptoms of ADHD.
Consultant psychiatrist Dr Louise Theodosiou believes ADHD is under-diagnosed.
‘We are still not seeing as many people diagnosed across the UK as we should be,’ she says. ‘For example, ADHD is under-diagnosed in girls.’
Dr Theodosiou says that there are many processes a child goes through before getting a diagnosis, which includes a full developmental history, information from education settings as well as standardised tests such as the QbCheck — a 20-minute computer test where patients respond to runs of shapes and colours on screen by clicking their mouse.
Sustained attention during the test means you can maintain focus, whereas poor focus equals impulsivity — one of the signs of ADHD.
Dr Theodosiou says that children with ADHD stand out.
‘The core symptoms are difficulty concentrating, impulsivity and being more active than other children,’ she says. ‘Even in a classroom of children all jumping around, a child with ADHD will be apparent.’
However, Dr Theodosiou says that some children are not diagnosed because the parents do not want to medicalise their children.
‘Some people don’t want a label,’ she says. ‘People have anxieties about seeing a mental health worker. Some worry about medication. But guidance now makes it clear you do not have to accept medication for your child if you don’t want to. Medication can be useful but they don’t have to take it.’
So why are some people diagnosed easily while others take years or are never diagnosed at all?
Dr Theodosiou says many girls are not diagnosed because ADHD does not manifest in the same way as it does with boys.
‘With boys often the hyperactivity will stand out, but with girls it is often talkativeness or inattention such as “being a daydreamer”.’
The trouble is that, if not diagnosed, people can find their symptoms later impact their adult life.
‘We are seeing more adults coming forward realising they may have ADHD,’ she says. ‘Some even come with their children and say “she or he is just like I was” before realising they too had the same symptoms as a child, but were never diagnosed.’
Dr Theodosiou says that one of the biggest benefits of getting a proper diagnosis of ADHD is that the ‘child or young person and their family know why they struggle with their attention, concentration and activity levels.’
She adds: ‘They can share this knowledge with schools and the wider social setting to ensure children are understood.’
She says that, although medication is useful, education is just as important: ‘NICE recommends that unless symptoms of ADHD are moderate to severe, children should be treated initially through parent education and healthcare working with the education system to ensure that teachers understand ADHD.
‘Even when symptoms of ADHD require medication, we would always recommend education for parents and teachers.’
Edited by Julie Cook
Signs of ADHD
• Not concentrating in class
• Patterns of impulsive behaviour
• Losing things many times, eg four coats in one winter
• Winding up younger siblings
• Not sitting still
• Being excluded by peers
• Accidents and lack of road safety
It took seven years to diagnose
I knew my son Oliver was different when he was a toddler. He had terrible tantrums. He was hyper, unable to sit still and hated noise like hand dryers.
If I ever spoke to people about Oliver they’d say: ‘Ah, he’s just a boy.’
But I knew it was more than that.
When he started school I felt sure a teacher or a member of the SENCO staff would notice, but no one said anything. By age seven he was worse. We had to leave the cinema halfway through because Oliver couldn’t focus. His tantrums became more extreme.
I spoke to his teacher. She said she’d not noticed anything different. I even approached the SENCO worker, but she told me he just had ‘Year Two boys syndrome’.
I had another child and soon realised Oliver was very different to my second. I wondered if we’d ever find out what was wrong.
Then finally, at the end of Year Three, his teacher said: ‘I can now see what you mean.’
Oliver was referred to a paediatrician. He was diagnosed with ADHD and given medication — seven years after I’d first raised concerns.
It took time to get his medication right but, once we did, he was able to focus on his school work and the tantrums stopped.
I am so glad Oliver finally got diagnosed. It’s changed our lives.
From Anna Jones, 35, of Chelmsford, Essex
‘Girls can’t get ADHD’
From an early age, my daughter Callie was defiant. She never napped and had bad tantrums.
People told me: ‘It’s the terrible twos.’
The health visitor and GP said she was ‘badly behaved’.
When she started school, she was disruptive.
I worried Callie had ADHD but her teacher said: ‘Girls don’t get it. She’s just naughty.’
Finally, when Callie was nine the school put me in touch with a home support worker who told me about ADDUP — a support and action group for families of children with ADHD.
I took Callie there and immediately a support worker said: ‘I think Callie has ADHD.’
I saw the GP and Callie was referred to a paediatrician. But he refused to diagnose Callie and sent us home.
I got a second paediatrician referral. Thankfully, this one diagnosed Callie with ADHD — more than eight years after I’d first noticed problems.
Now Callie is 11 but we still haven’t been given medication and she still has tantrums.
My husband and I separated due to the stress.
I hope more people become aware that ADHD can affect anyone. I can’t thank ADDUP enough for their support.
From Danielle Jellinek, 38, of Grays, Essex