Attention-deficit
hyperactivity disorder and hyperkinetic disorder: for
parents and teachers
By
the Royal College of Psychiatrists
About this factsheet
This is one in a series of factsheets for parents,
teachers and young people entitled Mental Health
and Growing Up. The aims of these factsheets
are to provide practical, up-to-date information
about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children
and young people. This factsheet looks at
attention-deficit hyperactivity disorder (ADHD) and
hyperkinetic disorder, the signs to look for and
where to get help.
Introduction
What are attention-deficit hyperactivity
disorder and hyperkinetic disorder?
Many children, especially under-fives, are
inattentive and restless. This does not necessarily
mean they are suffering from ADHD or hyperkinetic
disorder (see
Factsheet 1 on the restless and excitable
child).
The terms `attention deficit', `attention-deficit
hyperactivity disorder', `hyperkinetic disorder' and
`hyperactivity' are used by professionals to
describe the problems of children who are overactive
and have difficulty concentrating.
The terms attention deficit disorder (ADD) or
attention-deficit hyperactivity disorder (ADHD) are
used in the USA. The official term in the UK is
hyperkinetic disorder. These differences in
terminology can sometimes cause confusion. In both
instances, these children usually have problems with
attention control and overactivity.
What are the signs?
Children with ADHD/hyperkinetic disorder:
- are restless, fidgety and overactive
- continuously chatter and interrupt people
- are easily distracted and do not finish things
- are inattentive and cannot concentrate on tasks
- are impulsive, suddenly doing things without
thinking first
- have difficulty waiting their turn in
games, in conversation or in a queue.
This type of behaviour is common in most children.
It becomes a problem when these characteristics are
exaggerated, compared to other children of the same
age, and when the behaviour affects the child's
social and school life. Often the signs will have
been obvious since the child was a toddler.
What causes ADHD/hyperkinetic disorder?
We do not know exactly what causes these disorders,
but genetic factors seem to play a part. The
disorders can run in families, with boys more often
affected than girls.
Where can I get help?
There is no simple test for ADHD/hyperkinetic
disorder. Making a full diagnosis requires an
experienced specialist assessment, usually done by a
child psychiatrist or specialist paediatrician. The
diagnosis is made by recognising patterns of
behaviour, observing the child and obtaining reports
of their behaviour at home and at school.
Your general practitioner will be able to offer you
advice and support and will usually refer you to a
specialist. A child and adolescent psychiatrist will
undertake a thorough assessment and offer treatment.
Some clinical psychologists and paediatricians also
have special experience and skills in managing this
problem.
Effective treatment will include advice and support
for the parents.
A full specialist assessment
This will enable your child's needs to be clearly
identified.
Psychological management
You should expect:
- a full explanation of the condition to you and
your child;
- advice about on how to manage difficult
behaviour;
- communication between the child's
specialist and teachers, who will offer you advice
on structured activities and reward systems for
positive behaviour that may help. Special support
and teaching may also be needed;
- help for difficulties that have developed as a
result of ADHD/hyperkinetic disorder, including low
self-esteem, difficulty with friendships, temper
tantrums and aggression.
Stimulant medication
Some medications such as methylphenidate or
dexamphetamine may reduce hyperactivity and improve
concentration (see Factsheet 6 on stimulant
medication). Medication produces a short-lived
improvement after each dose, but is not a permanent
cure. It creates a period when the child can learn
and practise new skills. Children often say that
medication helps them to get on with people, to
think more clearly, to understand things better and
to feel more in control of themselves. Not all
affected children need medication. Those who do
always need psychological and educational support as
well.
Changing diet and avoiding additives
There is a small body of evidence about the effect
of diet on some children. A few may be sensitive to
certain foods. If parents notice that specific foods
worsen hyperactivity, these may be avoided. It is
best to discuss this with the specialist.
Do children grow out of it?
Children who receive specialist treatment tailored
to their needs may benefit considerably. Some
problems with restlessness, attention and lack of
control might continue into adult life. However,
with help, most hyperactive children will have
settled down by the time they reach their mid-teens.
They will have been able to catch up with their
learning, improve their school performance and make
friends.
References
- Carr, A. (ed.) (2000) 'What Works with
Children and Adolescents?' - A Critical Review of
Psychological Interventions with Children,
Adolescents and their Families. London:
Brunner-Routledge.
- National Institute for Clinical Excellence
(2000) 'Guidance on Methylphenidate' (Ritalin/Equasym)
- for Attention Deficit Hyperactivity Disorder
(ADHD).
www.nice.org.uk
- Rutter, M. & Taylor, E. (eds) (2002) 'Child
and Adolescent Psychiatry' (4th edn). London:
Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (2001)
'Finding the Evidence' - A Gateway to the Literature
in Child and Adolescent Mental Health (2nd edn).
London: Gaskell.
Sources of further information
- ADD Information and Support Services (ADDISS)
(Registered Charity 1070827): The ADDISS Resource
Centre, 10 Station Road, London NW7 2JU. tel: ; fax: ; e-mail:
[email protected]; website:
www.addiss.co.uk
- The YoungMinds Parents' Information Service
provides information and advice on child mental
health issues. 102-108 Clerkenwell Road, London EC1M
5SA; Parents' Information Service: 0800 018 2138;
www.youngminds.org.uk
- The Mental Health and Growing Up
series contains 36 factsheets on a range of common
mental health problems. To order the pack, contact
Book Sales at the Royal College of Psychiatrists, 17
Belgrave Square, London SW1X 8PG; tel: , ext. 146; fax: ; e-mail:
[email protected], or you can download
them from this website.
-
ADD Resources website offers 100 free and
carefully chosen articles helpful to adults with
ADD/ADHD and to parents of children with ADD/ADHD,
links to other ADHD-related websites, and more.
© [2006] Royal College of Psychiatrists. This
factsheet may be downloaded, printed out, photocopied
and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no
profit is gained from its use. Permission to reproduce
it in any other way must be obtained from the
Head of
Publications. The College does not allow reposting
of its factsheets on other sites, but allows them to be
linked to directly.
