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ADHD: About ADHD

What is it?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a pattern of developmentally inappropriate behaviours in the areas of inattention, impulsivity, or hyperactivity and is usually present before the age of 7 years. It is the most common mental health problem of childhood, affecting 3% to 5% of the population, and is more common in boys than in girls.

There are three sub-types:

  • predominantly inattentive
  • predominantly hyperactive/impulsive
  • combined

The behaviour of children with ADHD often includes other problems such as defiant and noncompliant behaviour toward adults, verbal and physical aggression towards peers and siblings, low self esteem (particularly in adolescents), and learning problems. Stress-related family problems often accompany ADHD.

What causes ADHD?

The cause of ADHD is unknown. Most professionals believe that the cause is based in the brain, but the exact nature of the cause is unclear,

Most children do not outgrow ADHD. It is a chronic, long-term impairment that requires long-term lifestyle changes in order to cope.

Making the Diagnosis

A collaborative process

Diagnosis is a collaborative process that is not based on a single visit to your doctor or psychologist.

There is no test for ADHD. To make a diagnosis, information regarding the child’s developmental history and behaviour must be gathered from parents and teachers, and from observations of the child in natural settings. Standardized rating scales and interviews are used to provide a comprehensive picture of the child’s difficulties before a clinical judgement is made.

The symptoms and criteria for a diagnosis of ADHD are taken from the Diagnostic and Statistical Manual of The American Psychiatric Association, known as the DSM-IV. The symptoms of inattention, hyperactivity or impulsivity must have persisted for at least six months and must be present to a degree that creates significant impairments in at least two different settings and are not consistent with the child’s developmental level.

What is just as important as the diagnosis is a good assessment of the problems that a child is having in daily life and determining things that can be done to improve them.

For more information: There are many good books for parents and young people available in your local library or bookstore.

What Can Be Done?

For most children with ADHD, a combination of behaviour management and medication provides the most effective treatment.

1. Behaviour management

Behaviour management is when parents and teachers are taught by psychologists and others how to work systematically with their children. It is the most widely recommended and effective, non-medical treatment for ADHD. Behaviour management should be used at home, at school, and with peers.

Behaviour management includes:

  • Establishing and consistently enforcing clear rules
  • Establishing specific daily goals for the child and carefully monitoring them
  • Giving clear and appropriate instructions
  • Using rewards (for example, points and praise) to encourage good behaviours
  • Using consistent, non-physical punishments (for example, time out) to discourage inappropriate behaviours

Look for: 1-2-3 Magic: Training Your Children To Do What You Want, by Thomas Phelan, 1995. This popular publication comes as a book or as a videotape. It may be available at your local bookstore or library, along with other helpful child management materials.

2. Medication

Medication can be an effective treatment for ADHD, especially when combined with a behaviour management program. It is usually prescribed by the family doctor, or a medical specialist such as a pediatrician or child psychiatrist. Medication can help to reduce ADHD symptoms, but does not cure the condition. Medication should never be relied upon as the only treatment for a child with ADHD.

A comprehensive, double blind, medication trial is usually conducted prior to the regular use of medication. This initially requires a process of questionnaires completed daily by parents and teachers, and later, ongoing monitoring by the doctor, the school and the parents.

3. What else?

Many treatments, although widely used, are not effective with ADHD. Traditional one to one therapy, play therapy, or counselling done in a therapist's office does not change the disorder, but can sometimes help to improve social skills, anger management or self-organization.

For further information and support, call:

Attention Deficit Association of Nova Scotia 869-1117.

This article was adapted from: Pelham, William E., (1999). Attention-Deficit/ Hyperactivity Disorder: Diagnosis, Nature, Etiology, and Treatment. State University of New York at Buffalo, NY 14260