Last updated on Feb 24th, 2021 at 05:02 pm
While there are no reliable local prevalence rates, internationally, attention deficit hyperactivity disorder (ADHD) affects around one to three children in every 100 children.
What is ADHD?
ADHD is a chronic neurobehavioural condition that affects millions of children and often continues into adulthood. Almost all kids have times when their attention or behaviour deviates, but children with ADHD have behavioural problems that occur so frequently and severely that it can affect their schoolwork and relationships.
A comprehensive assessment is needed before ADHD can be diagnosed in children. “ADHD may be diagnosed far too frequently in children who have other symptoms that can be caused by poor nutrition, an iron deficiency, insufficient sleep, exposure to trauma, poor routines or a diet of foods that are unbalanced, stimulating and non-nutritive,” says Dr Anusha Lachman, a child psychiatrist at Stellenbosch University’s faculty of Medicine and Health Sciences.
She adds that children are often medicated in situations where there are specific learning problems or issues with poor discipline, because people are under the misperception that the child has ADHD.
What test is used to diagnose ADHD?
ADHD cannot be diagnosed with only one test. The diagnosis is based on a clinical assessment supported by standardised tools that can assist your child’s doctor to make the diagnosis.
To be diagnosed with ADHD, according to the Diagnostic and Statistical Manual (DSM-5) Manual of Mental Disorders, a child must have shown:
- Some specific symptoms of inattention, hyperactivity or impulsivity for a period of six months in various environments, such as in school, at home or on the playground.
You can’t diagnose ADHD if there is only one symptom present in one area (for example at school and not at home). “ADHD doesn’t suddenly present after years of effective functioning. There must be a history of poor functioning or impaired functioning as a result of inattention, distractibility or impulsivity,” says Dr Lachman.
What causes ADHD?
- Research has shown there is no single cause for ADHD, but children with a family history or genetic predisposition are at a higher risk.
- ADHD is also influenced by environmental and emotional risk factors like maternal smoking, or alcohol use, anxiety and mental illness during pregnancy.
ADHD can be successfully managed, but it’s equally important to ensure that the right diagnosis is made. There have been numerous studies to investigate the effectiveness and safety of different treatments, but only three have been proven to be effective for ADHD:
- Dr Lachman says ADHD medication is both necessary and effective, but it should only be prescribed if the diagnosis is correct and the behaviour manifests in more than one environment. A 2013 study in the American Journal of Psychiatry reviewed the non-pharmacological treatment for ADHD and concluded that supplements like multivitamins, vitamin elixirs, omega oils and free fatty acids may be additional rather than substitutional treatments for ADHD. Evidence for restrictive or elimination diets as “core” treatment for ADHD is limited. Dr Lachman warns that alternative natural products should be tried with the utmost of care and under supervision of your child’s medical health practitioner.
- Behaviour modification. This may include cognitive training and more structured routines.
- The combination of the two.