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“You can’t underestimate how important it is to feel understood and have a sense of belonging — it’s like finding your tribe.”

ADHD stands for Attention Deficit Hyperactivity Disorder — it’s a neurobiological condition affecting 5.9% – 7.1% of children and adolescents, and at least 5% of adults (Willcutt, 2012). It’s defined in the DSM-5 as a Neurodevelopmental Disorder (APA, 2013).

The condition is characterised by a consistent pattern of developmentally inappropriate levels of inattention, impulsivity, and hyperactivity. These characteristics often interfere with functions or development, and commonly present as difficulty sitting still, paying attention, or controlling impulsive behaviour. For some, ADHD is pervasive and persistent to the point of interfering with everyday life in home, academic, social, and work environments.

Even if not diagnosed in childhood, ADHD symptoms will have been present from this period.

  • 800,000 People in Australia are affected
  • 75% Children diagnosed continue to experience symptoms into adulthood
  • 2-3:1 Ratio of males:females affected
  • $20 billion Social and economic cost

ADHD subtypes

ADHD may be considered mild, moderate, or severe depending on the number of symptoms and the extent of functional, social, or occupational impairment. Diagnosis will fall into one of three subtypes — defining it for each person is a crucial step in the diagnosis process, and helps form an appropriate treatment plan.

 

References

(2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Arlington, VA: American Psychiatric Publishing.

Willcutt, E. G. (2012). The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review. Neurotherapeutics, 9(3), 490–499. http://doi.org/10.1007/s13311-012-0135-8

Primarily Inattentive (PI)

Inattention manifests behaviourally as wandering off task, lacking persistence, having difficulty sustaining focus, or being disorganised. In recognising this subtype, thesecharacteristics are not due to defiance or lack of comprehension.

Primarily Hyperactive Impulsive (HI)

Hyperactivity refers to excessive motor activity at an inappropriate time, such as excessive fidgeting, tapping, or talkativeness. Impulsivity refers to hasty actions that occur in the moment without forethought, and have high potential for harm to the individual. Impulsiveness may also reflect a desire for immediate rewards or an inability to delay gratification. Impulsive behaviours may again manifest in social intrusiveness such as interrupting others or making decisions without adequate consideration of the consequences.

Combined Type (CT)

Individuals with this subtype experience PI and HI symptoms.

Delve deeper into ADHD with answers to some of the biggest questions.

I heard that ADHD is a Neurodevelopmental Disorder. What is that?

“Neurodevelopmental Disorder” is an umbrella-term for conditions that affect the growth or development of the brain or central nervous system. A condition like this usually manifests early in child’s development before the child enters primary school. The disorder is characterised by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.

Is ADHD a learning disorder?

The short answer is, “no”. However, ADHD includes impairment in one or more processes related to perceiving, thinking, remembering, or learning, so it may be more useful to view ADHD as a learning disorder. In doing so, it is important to acknowledge that it differs from currently recognised reading or non-verbal learning disorders.

Is everybody with ADHD hyperactive?

No, there is more than one subtype of ADHD. Those diagnosed with Predominantly Inattentive Subtype have no symptoms of hyperactivity.

Where does ADHD come from?

Research shows that ADHD tends to run in families, so there are likely to be genetic influences. Children who have ADHD usually have at least one close relative who has ADHD, and at least a third of fathers who had ADHD in their youth have children with ADHD. Even more convincing of a possible genetic link is that when one twin of an identical twin pair has the disorder, the other is likely to have it too.

Is it possible to “grow out” of ADHD?

ADHD symptoms evolve over time (for example, hyperactivity and fidgeting commonly decrease with age), but the condition is rarely outgrown. In fact, many people are not diagnosed until adulthood. However, in many cases, with support, treatment, and management strategies, ADHD can be effectively navigated to the point where the condition appears to be outgrown.

What is involved in the diagnosis of ADHD?

There is no simple “test” for ADHD. The diagnosis of ADHD is a clinical diagnosis made using well-tested diagnostic interview methods. Diagnosis is based on history, the description of symptoms, observable behaviours in at least two separate settings (school, work, and home), and the exclusion of other conditions that may mimic ADHD.

Diagnosis should include input from parents, teachers, and others who may be interacting with the child or adult. The process will also consider conditions which may accompany ADHD, and the additional impacts this will have on the person. For example, depression, anxiety, learning difficulties, developmental status, oppositional defiant disorder and conduct disorder.

Is ADHD caused by too much sugar or food colouring?

While it is common for children to display hyperactive tendencies following the consumption of high volumes of sugar, this is often fleeting, and different to ADHD. The current weight of evidence indicates that ADHD is not caused by too much sugar or food colourings in the diet.

What about general diet? Does that play a role in ADHD?

Although a small body of research suggests some children may benefit from nutritional interventions, delaying the implementation of well-established, effective interventions to engage in unproven methods is likely to be harmful for children.

There are no well-established nutritional interventions proven to be effective for assisting the majority of children with ADHD, especially in the long-term. In other words, it is thought that diet does not play a role in the cause or management of ADHD.

There is no doubt that some foods affect behaviour, but food allergens or intolerances are not ADHD. ADHD and food chemical intolerance may co-exist as two separate conditions, just as ADHD and Asthma may co-exist, and ADHD symptoms may be worsened by the other condition and vice versa.

Inattention criteria for diagnosing ADHD in children

A child with symptoms of inattention may, on a regular basis:

  • not give close attention to details, or make seemingly careless mistakes in school work or other activities
  • have difficulty sustaining attention in tasks or play activities
  • not seem to listen when spoken to directly
  • not follow through on instructions
  • not finish school work, chores or other duties (but not because they are being wilful or do not understand instructions)
  • have difficulty organising tasks and activities
  • avoid, dislike or be unwilling to do tasks that need continuing mental effort (such as school work or homework)
  • lose things needed for tasks or activities (such as toys, school assignments, pencils, books or tools)
  • be easily distracted
  • be forgetful in daily activities.

A child with six or more of these symptoms of inattention for at least six months (to a degree that interferes with their everyday life and is inconsistent with the usual developmental level of a child their age) may be diagnosed with the inattention aspect of ADHD.

Can ADHD WA prescribe medication to treat ADHD?

No. The prescribing of stimulant medicines is restricted to medical practitioners who are:

• authorised in writing by the Department of Health;
• practicing in Western Australia;
• in a category of approved specialist medical practitioner; and
• treating approved indications.

Medical practitioners approved to prescribe stimulant medication to treat ADHD include:

  • Paediatrician
  • Child and adolescent psychiatrist
  • Psychiatrist
  • Neurologist
  • Paediatric neurologist

With a shortage of ADHD treating specialists across WA, once you have booked your assessment with us, we recommend booking visiting your GP for a referral to an approved medical practitioner for 6-8 weeks after your assessment date. This allows time for you to receive your report and will help reduce a wait time to see a specialist once you receive the results of your neuropsychological assessment, should your assessment indicate ADHD.  Be sure to research and find an available specialist before visiting your GP for the referral.

Hyperactivity-impulsivity criteria for diagnosing ADHD in children

Hyperactivity-impulsivity criteria for diagnosing ADHD

  • A child with symptoms of hyperactivity may often:
  • fidget with their hands or feet or squirm in their seat
  • leave their seat in the classroom or in other situations in which remaining seated is expected
  • run about or climb excessively in inappropriate situations
  • have difficulty playing or taking part in leisure activities quietly
  • be ‘on the go’ or act as if ‘driven by a motor’
  • talk more than average.

A child with symptoms of impulsivity may often:

  • answer before questions have been completed
  • have difficulty waiting in turn
  • interrupt or intrude on others (for example, interrupting conversations or games).

A child with six or more of these symptoms for at least six months (to a degree that interferes with their everyday life and is inconsistent with the usual developmental level of a child their age) may be diagnosed with the hyperactivity-impulsivity aspect of ADHD.

Other criteria for diagnosing ADHD in children

Other criteria for diagnosing ADHD may include:

  • some hyperactive-impulsive or inattentive symptoms that caused impairment before the child reached the age of seven years
  • impairment from the symptoms in two or more settings, such as at school and at home
  • symptoms that cannot be explained by another disorder (such as mood disorder, anxiety disorder, trauma, dissociative disorder or a personality disorder).
Types of ADHD
  • ADHD combined type – if the child meets the criteria for both inattention and hyperactivity-impulsivity for the past six months
  • ADHD predominantly inattentive type – if the child meets the criteria for inattention, but not the criteria for hyperactivity-impulsivity, for the past six months
  • ADHD predominantly hyperactive-impulsive type – if the child meets the criteria for hyperactivity-impulsivity, but not the criteria for inattention, in the past six months.

Information from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/attention-deficit-hyperactivity-disorder-adhd

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