ADHD in children

According to The National Institute for Health and Care Excellence (NICE), ADHD has an estimated prevalence of five percent in children, with a ratio of 2-5:1 between boys and girls. This may be because the condition has been shown to present differently between the genders. What do we mean by this? Typically, boys are more likely to show externalised symptoms, such as disruptive behaviour and aggression, while girls are more likely to present with internalised symptoms such as poor self-esteem and inattention or distraction, which can be more difficult to recognise and, as a result, may not prompt the parent to seek a diagnosis for their child.

As mentioned, symptoms of ADHD can sometimes be conflated with bad behaviour. The condition can cause a child to be disruptive in class, talk over others, display aggression and appear as if they are not listening. However, there is usually a difference between the way in which the behaviour is conducted by a child who has ADHD versus one who doesn’t. Bad behaviour is usually intermittent and sometimes provoked, and may only need addressing once in order to correct. ADHD causes these behaviours to be repeated without provocation, and they are unlikely to be treated through a simple one-time correction.

Some children can learn coping methods to hide their symptoms. This can make it more difficult to spot signs of ADHD.

There is a genetic element to ADHD, as it often runs in families. If a child’s biological parents or the child’s siblings have ADHD, then they are more likely to have it too. However, genetic inheritance of ADHD is thought to be complex, and it is not the case that a child will definitely get it if their parents do.

Some research suggests that there are differences in the structure of the brains of those with ADHD in comparison to those who don’t have the condition, strengthening the argument that the condition is present from birth, rather than developed later in childhood.

There is no evidence that factors such as poor parenting, sugar consumption or vaccines have any correlation with ADHD in children.

There are three different types of ADHD. The type that your child has will depend on which symptoms they exhibit.

ADHD can be categorised into three subtypes:

1. Inattentive type: Easily distracted, quick to become bored, struggles with focus and organisation, and may appear to be daydreaming.
2. Hyperactive-impulsive type: Fidgets, talks excessively, disrupts other children, struggles to be quiet or patient, and may exhibit impulsive behaviour.
3. Combination type: Displays a combination of symptoms from both inattentive and hyperactive-impulsive types.

These traits are usually noticeable before the age of six. Some children will exhibit traits from only one type, but the most common type of ADHD is combination type.

Aside from the typical signs of ADHD – a short attention span, hyperactivity and impulsivity – children with this condition may exhibit additional mental, emotional, and physical symptoms.

Some examples include:

• Making absent-minded mistakes in schoolwork or chores
• Forgetting tasks and becoming distracted easily
• Losing their possessions or forgetting to bring important items when leaving the home
• Appearing like they are not listening to instructions
• Having difficulty organising or prioritising tasks
• Being unable to sit still or be quiet
• Having trouble waiting their turn
• Having little or no sense of risk

These symptoms can make everyday life challenging for children with ADHD, and it can be frustrating and worrying for parents who are unaware of their child’s condition.

Following diagnosis, we offer a range of interventions. These include:

• Psychoeducation – a combination of cognitive behavioural therapy (CBT), group therapy and education. This is prescribed with the aim of equipping the patient and family with greater knowledge about ADHD and its treatment, enabling them to work closely with our consultants for a better outcome.
• Behaviour management – this effective treatment can improve a child’s self-control and self-esteem.
• Parenting advice – effective parenting is an important part of ADHD treatment. The way in which parents respond to and handle symptoms of ADHD can greatly impact a child’s chances of improvement. This part of ADHD treatment equips you with the tools needed to help improve your child’s quality of life.
• Individual work – by working closely with your child, we can help them recognise and manage their behaviours.
• Medication – the choice of treatment will, of course, depend on each child’s particular circumstances, but we would usually start with psychological treatments before going on to medication. The most common medications for the treatment of ADHD are methylphenidate, lisdexamfetamine, dexamfetamine, atomoxetine and guanfacine.

We will work with you to create a plan that may include one or more of these therapies. The treatment that your child receives will depend on comorbidity (whether any other conditions are already present or diagnosed) and the severity of their case.

Greater awareness of ADHD means that more children than ever are getting the diagnoses and treatments they need. However, it can sometimes be difficult for parents to determine whether their child’s behaviour is a result of ADHD symptoms, or just poor behaviour.

If you are unsure whether your child should undergo an ADHD assessment, it is important to observe your child daily and make note of their behaviours. In addition, talk with their teachers or other care providers to understand more about how your child behaves with others and in situations outside the home. If their behaviour seems unusual to you, your next step may be to seek a medical opinion. You can call us with any questions on 020 7580 4224.

You should be aware that certain symptoms of ADHD can cross over with those of other conditions.

The London Psychiatry Centre and our multidisciplinary CAMHS team has been committed to providing world-class care to children with ADHD since 2011. Our consultants offer years of specialised experience to our patients, as well as expertise that spans a wide array of mental health conditions, ensuring accurate diagnoses and personalised treatment plans.

Not only that, but we prioritise sensitivity and discretion, and provide a safe and comfortable clinical environment for children and their families at our Central London centre.

After your child has been diagnosed, our consultants will formulate a personalised treatment plan that may include one or more of the following therapies: cognitive behavioural therapy (CBT), psychoeducation, behaviour management, parenting advice, individual work, or medication.

We would usually start with psychological treatments before going on to medication, however, your consultant will recommend the most suitable treatment plan for your child based on their investigations.

Every case of ADHD is different. The cost of treatment depends on the severity of the case, as well as the presence of any comorbid conditions, therefore we can only provide an idea of costs once an assessment has taken place. For a general overview of our fees, please visit our fees page.