What impact does ADHD have on a child's life?

Written in association with:

Paediatrician

Published: 15/12/2023
Edited by: Aoife Maguire

Attention Deficit Hyperactivity Disorder (ADHD) diagnoses in children have risen significantly over the past two decades. Early diagnosis and intervention are crucial for managing its impact on a child's life; but how can this be done?

Consultant paediatrician Dr Rashad Nawaz, who specialises in ADHD explains everything you need to know about childhood ADHD and its impact on a child’s life.

How early can ADHD be diagnosed in children?

ADHD can be diagnosed as early as preschool age, typically around 3 to 6 years old. However, accurate diagnosis can be challenging due to normal variations in behaviour at this stage. Diagnosis often becomes more reliable as the child enters primary school, around ages 6 to 12.

What are the signs of ADHD in children?

The core ADHD traits are inattention, hyperactivity and impulsivity although in reality it is a lot more complex than this. Signs of inattentiveness include forgetfulness, difficulty sustaining attention, and frequent careless mistakes. Hyperactivity may involve excessive fidgeting, talking excessively, or difficulty sitting still. However, hyperactivity may be ‘internal’ so a child may describe rushing and chaotic thinking. Impulsivity can be observed through hasty decision-making and interrupting others.

It is important to highlight that ADHD is more than just difficulties with inattention, impulsivity and hyperactivity. ADHD is strongly associated with difficulties with executive functions and emotional regulation and often with other neurodevelopmental traits or difficulties related to for example autism, dyslexia, dyspraxia, tics.

It is important to highlight that every child with ADHD is different and how they present may change over time including into adult life. It is also very important to remember that girls with ADHD may not present with the typical ADHD traits and more likely to mask their difficulties, as such often go under the radar till late teen years with anxiety and difficulties with mental health.

Is it normal for children to be hyperactive or have trouble focusing?

It is normal for children to display occasional hyperactivity or have trouble focusing, especially in certain situations. However, in ADHD, these behaviours are more severe, persistent, and disruptive to the child’s quality of life. ADHD goes beyond typical childhood energy and curiosity, significantly impacting a child's ability to function in various environments.

What is the impact of ADHD on a child's academic performance?

ADHD can significantly affect a child's academic performance. Challenges with focus and impulsivity may lead to difficulties in completing assignments, staying organised, and following instructions. As a result, academic achievements may suffer, and the child may experience frustration, lowered self-esteem, and social challenges. The longer the child has unrecognised or untreated ADHD the higher the risk of developing future mental health difficulties.

Can a child outgrow ADHD?

While some children may show improvement in symptoms over time, it is crucial to recognise that ADHD is a chronic lifespan condition. Many individuals continue to experience symptoms into adolescence and adulthood. Early intervention and appropriate management strategies can, however, significantly improve a child's ability to cope with ADHD-related challenges and improves their long-term mental health and life options.

Myths about ADHD

Common ones include ADHD is not a real medical condition; due to bad parenting; affects only boys or is less severe in girls; ADHD medication causes addiction; children outgrow it.

How is ADHD diagnosed?

This is based on collecting as much information as possible about the child’s life especially at home and school and to what extent inattention, hyperactivity and impulsivity is affecting the child. This involves using specialised behavioural questionnaires, interviewing parent and child, and QbTest. A QbTest is now an established and approved NHS tool that measures the three ADHD traits and helps with minimising age and gender bias and quicker diagnosis. It is important to remember that how ADHD presents in any one child can be complex especially if they have other difficulties or complex backgrounds and as such requires considerable expertise. ADHD assessment and diagnosis should never be just a tick box exercise. It should be thorough and holistic.

Read more about QbTest at https://www.qbtech.com/adhd-tests/qbtest/

What are the treatment options for ADHD in children?

It is important to note that medication is only one component of the support a young person with ADHD requires, and that medication is more likely to be effective if a multimodal psychoeducational approach is used. The focus is on encouraging symptom recognition, allow active participation in treatment, enhance adherence to treatment, both pharmacological and non-pharmacological and provide families with coping skills to manage their child’s ADHD and to minimise negative impact on quality of life for all.

Behavioural therapy: Parenting a child with ADHD can be very stressful and incredibly challenging with standard behavioural techniques. This includes parent training, where parents learn effective relationship-enhancing strategies to manage their child's behaviour. For some older children cognitive-behavioural therapy can help.

Medication: Stimulant medications, such as methylphenidate and amphetamines, are commonly prescribed to help manage symptoms. Non-stimulant medications, like guanfacine and atomoxetine, are also available.

Educational support: Classroom accommodations, such as extra time on tests or preferential seating, can help children with ADHD succeed academically.

Lifestyle modifications: Adequate sleep, a balanced diet, and regular physical activity contribute to overall well-being and can help manage ADHD symptoms.

Important Note:

It is important to stress that ADHD is a pattern of both strengths and challenges and the focus should not be just on what the child finds challenging but what they can do and do very well (strengths-based approach).