Attention deficit disorders (ADD and ADHD) can be categorised into two types of behavioural problems; inattentiveness and hyperactivity/ impulsiveness.
Most people with ADHD have problems that fall into both these categories, but this isn’t always the case.
For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness. This form of ADHD is also known as attention deficit disorder (ADD).
ADD can sometimes go unnoticed because the symptoms may be less obvious.
These conditions were once thought to occur only in children, but it is now recognized as continuing into adulthood in many people. In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.
What Are The Symptoms Of Attention Deficit Disorders?
Attention Deficit Disorder symptoms may fall into three categories: predominantly hyperactive, predominantly inattentive, and combined type. Inattentive Attention Deficit symptoms are still sometimes misunderstood and misdiagnosed by medical professionals who may mistake them for mood disorders, anxiety, or another related condition. Inattentive ADHD is also more common in girls and women than it is in boys and men.
Children with ADHD may be:
- Inattentive, but not hyperactive or impulsive.
- Hyperactive and impulsive, but able to pay attention.
- Inattentive, hyperactive, and impulsive (the most common form of ADHD).
Children who only have inattentive symptoms of ADHD are often overlooked, since they’re not disruptive. However, the symptoms of inattention have consequences: getting in trouble with parents and teachers for not following directions, underperforming in school or quarrelling with other children because of “not playing by the rules”, for example.
- Disorganization and problems prioritizing.
- Poor time management skills.
- Problems focusing on a task.
- Trouble multitasking.
- Excessive activity or restlessness.
- Poor planning.
- Low frustration tolerance
What Are The Causes Of Attention Deficit Disorders?
The exact cause of attention deficit hyperactivity disorder (ADHD) isn’t fully understood, although a combination of factors is thought to be responsible.
Attention Deficit states are developmental disorders; it’s believed that it can’t develop in adults without it first appearing during childhood.
Attention Deficit tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition.
Research shows that both parents and siblings of a child with ADD/ADHD are four to five times more likely to have ADD/ADHD themselves.
However, the way Attention Deficit states are inherited is likely to be complex and isn’t thought to be related to a single genetic fault.
Brain function and structure
Research has identified a number of possible differences in the brains of people with ADDs compared to those who don’t have the condition, although the exact significance of these differences is not clear.
For example, studies involving brain scans have suggested that certain areas of the brain may be smaller in people with Attention Deficit states, whereas other areas may be larger.
Research has also shown that the brain may take an average of two to three years longer to mature in children with ADD/ADHD, compared to children who don’t have the condition.
Other studies have suggested that people with Attention Deficit conditions may have an imbalance in the level of neurotransmitters in the brain, or that these chemicals may not work properly.
Other possible causes
Various other causes have also been suggested as playing a role in the development of ADD/ADHD, including:
- being born prematurely (before the 37th week of pregnancy)
- having a low birthweight
- brain damage either in the womb or in the first few years of life
- maternal use of alcohol, smoking or drugs
- exposure to high levels of toxic lead at a young age
However, the evidence for many of these factors is inconclusive, and more research is needed to determine if they contribute to Attention Deficit conditions.
It’s known that symptoms of ADHD often persist from childhood into a person’s teenage years, and then into adulthood.
By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives.
In order to be appropriately diagnosed, signs and symptoms must start before the age of 7 and are primarily characterized by inattention, distractibility, and impulsiveness.
What Is The Treatment For Attention Deficit Disorders?
Treatment for attention deficit disorders can help relieve the symptoms and make the condition much less of a problem in day-to-day life.
ADHD can be treated using medication or therapy, but a combination of both is often best, along with some other approaches. Treatment is usually arranged by a specialist, such as a paediatrician or psychiatrist, although the condition may be monitored by your GP.
There are five types of medication licensed for the treatment of Attention Deficit:
These medications aren’t a permanent cure for ADHD, but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.
Some medications need to be taken every day, but some can be taken just on school or work days. Treatment breaks are occasionally recommended, to assess whether the medication is still needed.
In the UK, all of these medications are licensed for use in children and teenagers. Atomoxetine is also licensed for use in adults who had symptoms of Attention Deficit as children.
If you are not diagnosed with Attention Deficit until adulthood, we can discuss which medications and therapies are suitable for you, and involve your GP in your ongoing care.
If you or your child is prescribed one of these medications, you’ll probably be given small doses at first, which may then be gradually increased. You or your child will need to have regular check-ups, to ensure the treatment is working effectively and to check for signs of any side effects or problems.
Your specialist will discuss how long you should take your treatment but, in many cases, treatment is continued for as long as it is helping.
Methylphenidate is the most commonly used medication for Attention Deficit. It belongs to a group of medicines called stimulants that work by increasing activity in the brain, particularly in areas that play a part in controlling attention and behaviour.
Methylphenidate can be used by teenagers and children with ADHD over the age of six. Although methylphenidate isn’t licensed for use in adults, it may be taken under close supervision from your GP and specialist.
The medication can be taken as either immediate-release tablets (small doses taken two to three times a day), or as modified-release tablets (taken once a day in the morning, and they release the dose throughout the day).
Dexamfetamine is also a stimulant medication, which works in a similar way to methylphenidate by stimulating areas of the brain that play a part in controlling attention and behaviour.
Dexamfetamine can be used by teenagers and children with Attention Deficit over the age of three. Although it’s not licensed for use in adults, it may be taken under close supervision from your GP and specialist.
Dexamfetamine is usually taken as a tablet once or twice a day, although an oral solution is also available.
Lisdexamfetamine is a similar medication to dexamfetamine, and works in the same way.
It can be used by children with ADHD over the age of six if treatment with methylphenidate hasn’t helped. You may continue to take it into adulthood if your doctor thinks you’re benefitting from treatment.
Lisdexamfetamine comes in capsule form, which you or your child usually take once a day.
Atomoxetine works differently to other Attention Deficit medications.
It’s known as a selective noradrenaline reuptake inhibitor (SNRI), which means it increases the amount of a chemical in the brain called noradrenaline. This chemical passes messages between brain cells, and increasing the amount can aid concentration and help control impulses.
Atomoxetine can be used by teenagers and children over the age of six. It’s also licensed for use in adults if symptoms of Attention Deficit are confirmed.
Atomoxetine comes in capsule form, which you or your child usually take once or twice a day.
Atomoxetine has also been linked to some more serious side effects that it’s important to look out for, including suicidal thoughts and liver damage. If either you or your child begin to feel depressed or suicidal while taking this medication, speak to your doctor.
Guanfacine acts on part of the brain to improve attention and it also reduces blood pressure.
It’s used for Attention Deficit states in teenagers and children if other medicines are unsuitable or ineffective.
Guanfacine is usually taken as a tablet once a day, in the morning or evening.
As well as taking medication, different therapies can be useful in treating Attention Deficit in children, teenagers and adults. Therapy is also effective in treating additional problems, such as conduct or anxiety disorders, that may appear with Attention Deficit problems.
Some of the therapies that may be used are outlined below:
Psychoeducation means that you or your child will be encouraged to discuss Attention Deficit and how it affects you. It can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.
This approach – like parent education and socialskills training, is normally only applicable to children with a diagnosed Attention Deficit state.
Behaviour therapy provides support for carers of children with Attention Deficit, and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards to encourage your child to try to control their Attention Deficit.
If your child has Attention Deficit, you can identify types of behaviour you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour, and removal of a privilege for poor behaviour.
For teachers, behaviour management involves learning how to plan and structure activities, and to praise and encourage children for even very small amounts of progress.
Parent training and education programmes
If your child has Attention Deficit specially tailored parent training and education programmes can help you learn specific ways of talking to your child, and playing and working with them to improve their attention and behaviour.
These programmes are usually arranged in groups of around 10-12 parents. A programme usually consists of 10-16 meetings, which each last up to two hours. They aim to teach parents and carers about behaviour management while increasing confidence in your ability to help your child and improve your relationship.
Social skills training
Social skills training involves your child taking part in role play situations, and aims to teach them how to behave in social situations by learning how their behaviour affects others.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave. A CBT therapist would try to change how an adult or a child feels about a situation, which would in turn potentially change their behaviour.
CBT can be carried out with a therapist individually or in a group.
Other possible treatments
There are other ways of treating Attention Deficit that some people with the condition find helpful, such as cutting out certain foods and taking supplements. However, there’s no strong evidence that these work, and they shouldn’t be attempted without medical advice.
People with Attention Deficit should eat a healthy, balanced diet. Don’t cut out foods before seeking medical advice.
Some people may notice a link between types of food and worsening ADHD symptoms. For example, sugar, food colourings/additives and caffeine are often blamed for aggravating hyperactivity. Some people believe they have intolerances to wheat or dairy products, which may add to their symptoms.
If this is the case, keep a diary of what you eat and drink, and what behaviour this causes. You can discuss this with a specialist dietitian at the Healthcare On Demand clinic .
Some studies have suggested that supplements of omega-3 and omega-6 fatty acids may be beneficial in people with Attention Deficit, although the evidence supporting this is very limited.
It’s advisable to talk to your GP before using any supplements, because some substances can react with medication unpredictably or make it less effective.
You should also remember that some supplements shouldn’t be taken long term, as they can reach dangerous levels in your body.
Tips for parents
- Be sure that your GP or specialist helps you understand the difference between Attention Deficit and other problems your child may have.
- Think about who else needs to know about your child’s Attention Deficit, such as their school or nursery.
- Find out the side effects of any medication your child takes and what you need to look out for.
- Getting to know people at local support groups can stop you feeling isolated and unable to cope.
- For information on local support groups, contact Attention Deficit Disorder Information and Support Service (ADDISS) or call 020 8952 2800.
Assessments for Attention Deficit Disorders (both screening and full diagnostic assessments) are in line with the current guidelines from the National Institute of Health and Care Excellentce (NICE).
Click HERE to review these national guidelines.
Learn more about the ADHD/ADD Assessment Services that we offer by selecting the appropriate offering below.