What is attention deficit hyperactivity disorder ADHD?Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and it can continue through adolescence and into adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behaviour, and hyperactivity (over-activity).
ADHD has three subtypes:
‘Predominantly inattentive’. The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.
Combined hyperactive-impulsive and inattentive. Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
Most children have the combined type of ADHD.
Can schools exclude my child who has ADHD for his behaviour?Your child should only be excluded if they have committed a serious disciplinary offence or if their presence at school threatens the welfare or education of other pupils.
Your child can also be excluded for behaviour outside school, if the head teacher feels there’s a clear link between the behaviour and maintaining discipline in the school – e.g. if they are accused of a serious criminal offence. By law, schools must demonstrate they have followed the guidance around exclusions, unless they can show good reason why they didn’t. It is always useful to identify if your child’s school has a good understanding of the needs of children and young people with ADHD especially relating to their policy on exclusion. ‘The National Institute for Clinical Excellence’ (NICE) guidance suggests that The Department for Children, Schools and Families should consider providing more education to trainee teachers about ADHD by working with the Training and Development Agency for Schools and relevant health service organisations to produce training programmes and guidance for supporting children with ADHD.
The Advisory Centre for Education (ACE) and the Department for Children, Schools and Families can provide you with information relating to exclusions.
The Department for Children, Schools and Family website.
ADHD is not an excuse for challenging or poor behaviour. It does offer however, an explanation why some children struggle in some aspects of home and school life. Many schools now employ ‘brain friendly’ styles of teaching and learning, including the implementation of the ‘Social and emotional aspects of learning’ (SEALS) initiative.
Increasingly educationalists recognise that the genetic imperative in the developing child is relationship driven – and therefore, positive nurturing relationships with parents, siblings, peers and teachers all contribute the emotional development that underpins ‘intellectual development’. Happy children are better learners and grow in confidence and the emotional resilience needed to navigate their way through childhood into adulthood.
Does having ADHD mean my child will have a learning problem or difficulty too?Not necessarily, the characteristics of ADHD can often mean that children may struggle with areas of concentration, inattention and impulsivity within the classroom, which in turn, can impact on them accessing their learning and education. ADHD is not an indicator of a child’s level of intelligence.
It is often the lack of ability to ‘complete’ set work or tasks which can be assessed, in order for the teacher to discern their level of knowledge. Although schools aim is to meet the needs of all children or young people in their care, they often can’t or don’t because of their lack of understanding around specific mental health disorders such as ADHD.
Will my child ever stop having ADHD? Will they grow out of it?ADHD is a lifelong condition. There is a lessening of ADHD symptoms over time, particularly the signs of hyperactivity, which are much less common in most adolescents. Some research suggests that as many as 60% of young people with ADHD will have persistent impulsive behaviours and lack of focus and inattention in adulthood. Without early intervention, and teaching parents, children and professionals how to manage their ADHD, there is an increased risk of school failure, mental health difficulties and problems accessing further education or employment.
Is ADHD genetic?Scientists believe they have identified the first clear evidence of a genetic link to attention- deficit hyperactivity disorder (ADHD). This genetic link predisposes a child to ADHD – however, nurturing and environmental factors such as a positive home environment, good parenting, good quality teaching and access to positive personal development activities, will determine the severity of the child’s ADHD characteristics.
There is a great deal of myth and ignorance about ADHD. Many people associate ADHD with poor parenting or poor dietary habits, but the latest research in the Lancet medical journal suggests that it is actually a genetic condition. Researchers at Cardiff University studied the genes of 366 children with ADHD, as well as 1,000 healthy youngsters and found that children with ADHD were more likely to have duplications of small segments of their DNA, or to have sections that were missing.
Lead researcher Professor Anita Thapar, from Cardiff University School of Medicine, said that the findings may help to overcome the stigma associated with ADHD, stating: ‘Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children,’ Previous research has shown that siblings of a child with ADHD are between four and five times more likely to have ADHD themselves. There is also evidence that many parents of children with ADHD had undiagnosed ADHD themselves. It is important to know that some of the most successful and intelligent people, such as Albert Einstein, Mozart and Leonardo de Vinci successfully managed their ADHD.
Is ADHD a real disability?ADHD is a long term condition which does impact on the day to day living of those with affected by the condition at home, within education and society as a whole. In the UK: The Disability Discrimination Act 1995 Chapter 50 Section 1 Sub-section 1 states:
“Subject to the provisions of Schedule 1, a person has a disability for the purposes of this Act if he has a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities.”
ADHD affects some more than others. It is the decision of the clinician who diagnoses who discerns to what extent ADHD is a ‘disability’ as defined under law.
Is it safe to give my child stimulant medication?We have mentioned that ADHD characteristics are more evident in some children than others. Some children are not proscribed medication by their Doctor. Many children benefit enormously from ADHD medication. Ultimately the decision to medicate is taken by the paediatrician and the parents. Side affects can vary from child to child. There have been a series of studies looking at the long term effects of stimulant medication for ADHD. A study undertaken by Russell A. Barkley, PhD*, Mariellen Fischer, PhD, Lori Smallish, MA and Kenneth Fletcher, PhD* from Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, along with 11 previous studies, have found no compelling evidence that stimulant treatment of children with attention- deficit/hyperactivity disorder leads to an increased risk for substance experimentation, use, dependence, or abuse in adulthood.
Multi modal interventions such as physical exercise, good teaching, good parent skill building programmes, giving support with planning, organisation and structure to reduce anxiety, will all help build the resilience in the child’s developing brain and nervous system. However, the availability of post diagnostic support services and the lack of understanding about childhood mental health in schools often means that medication is the only ‘choice’ available.
Do I have to give my child medication even though his Community Paediatrician has prescribed it for them?If your community paediatrician has prescribed medication for your child, this will be because they have decided on medication as part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and interventions (NICE: ADHD Management of children, young people and adults, September 2008) However if you have concerns relating to your child taking medication for their ADHD, you should speak to your community paediatrician to discuss your concerns.
Do schools have to be trained on understanding ADHD in order to support my child?Just as it is important for families to access training programmes to improve their personal knowledge, skills and confidence in managing their child or young persons ADHD, it is important for teachers and those supporting children in schools, to also have the required knowledge and skills to help them to care for and better manage children with ADHD characteristics in the classroom and the playground. Helping children and young people to enjoy learning and fully access their education is paramount for the successful educational outcomes for pupils living with ADHD. However, since many children and young people with ADHD are not enrolled on the Special Education Needs register within schools, teachers and support staff most likely will not be specialised in ADHD and may know very little about the condition.
Schools may benefit from a whole school approach to understanding and managing ADHD and the learning difficulties and mental health issues associated with it. It would be preferable for all SENCO’S (Special Educational Needs coordinators) to access training on how to successfully manage ADHD within the learning environment, in order to support both staff and children and raise levels of achievement and academic attainment. However, there appears to be no compulsory or legal requirement for schools to access training on ADHD, although, it is good practice for schools to keep up to date with all the learning needs and practices surrounding ‘Special Educational Needs’ and disability. Many schools are very successful at meeting the needs of children with additional needs.
Where can I get further information?Below a list of research, together with web site addresses which may be helpful to you in understanding ADHD.