ADHD

What is Attention Deficit/Hyperactivity Disorder?

Attention deficit hyperactivity disorder (ADHD) is characterised by persistent inattention and/or hyperactivity and impulsivity that greatly interfere with a child's development and functioning. It is maintained over time and persists into adolescence and adulthood.

The child with ADHD can be:

• Inattentive without being hyperactive or impulsive
• Hyperactive and impulsive but able to pay attention
• Inattentive, hyperactive and impulsive (the most common form of ADHD)

The causes

Over the last decade, scientists have learned a lot about the course of the disorder and are able to recognise and diagnose it early.
Researchers have not identified a single cause responsible for its occurrence, but multiple risk factors.
These include genetic and physiological factors that play a decisive role, but also influences from environmental and temperamental characteristics.

Symptoms of inattention

Inattention manifests itself behaviourally with:

• difficulty in maintaining attention
• ease of distraction
• difficulty in organising, carrying out and completing assigned tasks
• Loss of homework, books and other objects
• Difficulty remembering things
• Difficulty following directions or instructions
• Ease of boredom

Hyperactivity symptoms

This refers to excessive motor activation resulting in:

• carrying out several activities simultaneously
• difficulty in sitting
• stamping your feet
• drumming with hands
• restlessness and agitation
• loquacity

Symptoms of impulsiveness

Impulsivity is a manifestation of the self-control problems found in children with ADHD. Impulsive behaviour can be:

• difficulty in respecting speaking turns
• invading the space of others
• making unnecessary remarks
• ask excessively personal questions.
• Interrupting and joining games
• difficulty controlling emotions

 

How can we help you?

Currently, a multimodal type of treatment is proposed for ADHD, involving a combination of behavioural modification therapies, pharmacological therapies and psycho-educational interventions.

Cognitive behavioural therapy (CBT) is indicated as the treatment of first choice for this disorder as it aims to:

• to improve the management of impulsiveness
• to implement self-control and emotional management
• to enhance attentional skills
• to foster the development of social skills

In addition to the work directly with the patient, it is necessary to emphasise the importance of the involvement of parents and teachers in the age of development:

• parent training
• teacher training

PHARMACOLOGICAL THERAPY: Pharmacological intervention is sometimes combined with TCC. In particular, it appears that stimulant drugs are the most effective in the management of ADHD symptoms. At present, however, their long-term effects have not yet been determined and therefore constant and regular monitoring of side effects is recommended.
Finally, it should be considered that the pharmacological response is subjective and that the use of these substances gives more favourable results when combined with TCC.

OTHER INTERVENTIONS: Recent research has shown that regular aerobic exercise is an effective adjunctive treatment when combined with stimulant medication. In particular, it appears to bring about an immediate improvement in executive functions (including attention, inhibitory control and planning, among other cognitive domains).

Moreover, although some studies conducted in the last decade suggested that dietary variations could be helpful in regulating ADHD symptoms, the American Academy of Pediatrics as of 2019, due to insufficient evidence, recommends against dietary changes.