Child Psychiatry - ADHD
Symptoms and Diagnosis
ADHD is a fairly common disorder among schoolchildren. On average, in a classroom of 30 students, there would be one or two ADHD patients, with a high likelihood of them being male. Children with ADHD exhibit different characteristics at different stages of growth. Parents and teachers should pay close attention and consider consulting a professional for advice if they notice similar situations in their children.
How ADHD Symptoms Change as a Child Grows: Recognizing the Signs at Different Stages
ADHD is a fairly common disorder among school-aged children. According to various research studies, approximately 3% to 7% of school-aged children have ADHD, with a male-to-female ratio ranging from 4:1 to 9:1. This means that in a classroom of 30 students, there are likely to be one or two ADHD patients, with a high probability of them being male.
Children with ADHD exhibit different characteristics at different stages of growth. Parents and teachers should pay close attention and consider consulting a professional for advice if they notice similar situations in their children.
In children under six years old, the brain is still rapidly developing. Moreover, the learning environment for preschoolers often involves playing and physical activities, so doctors are generally not in a hurry to diagnose ADHD. However, if preschool children exhibit the following characteristics, their chances of developing ADHD later in life may be higher than their peers:
They can only sit quietly and play for about three minutes before moving on to another activity.
They seem to not be listening when adults talk to them.
They lack a sense of danger and don't seem to care even after multiple accidents or falls.
As children enter elementary school, they are expected to sit quietly and pay attention in class, with the curriculum being more complex than in preschool. At this stage, ADHD symptoms may become more apparent due to the change in environment. Children with ADHD are generally more unruly and disruptive than their peers. They are easily distracted and forgetful, and can usually concentrate on activities for less than 10 minutes.
As adolescents grow, they face an increasing number of challenges. However, teenagers with ADHD often have poorer executive functioning compared to their peers. They lack focus and planning when performing tasks, often act impulsively, and lack careful consideration. Their ability to concentrate typically lasts less than 30 minutes.
Adult ADHD patients are a continuation of their teenage selves. They tend to be careless, lack patience, and may frequently cause accidents. Due to the long-term effects of their symptoms, not all ADHD patients can reach their full potential.
The Impact of Untreated ADHD on Life: Dispelling the Myth of Outgrowing the Disorder
Many parents tend to avoid addressing their child's problems, either because they believe that ADHD medications may harm the brain or that their child's issues will gradually disappear as they grow up. These misconceptions have negatively affected many children.
According to research, only about half of ADHD patients experience a gradual reduction of symptoms as they grow older. The other half may experience varying degrees of symptom reduction, but 15% of patients show no improvement at all after reaching adulthood. The more severe a child's ADHD symptoms are during their childhood, the lower the chances of improvement as they grow up.
Without proper treatment, ADHD patients tend to have poorer academic performance compared to their peers when they grow up. They experience higher rates of unemployment, and even if they find a job, it may not be something they are good at or enjoy. They are more impulsive and reckless than others, making them more prone to traffic accidents.
In addition to these challenges, their impulsiveness and lack of planning can lead to marital problems if they find a partner in adulthood. Adult ADHD patients often struggle with consistent parenting methods when interacting with their own children, indirectly causing difficulties in parent-child relationships.
Understanding the Symptoms of ADHD: Attention Deficit and Hyperactivity
ADHD, or Attention Deficit Hyperactivity Disorder, is characterized by two main groups of symptoms: attention deficit and impulsivity with hyperactivity. Although ADHD symptoms may vary at different stages of a child's development, there are commonalities that persist across all age groups.
Attention Deficit Symptoms:
Children with ADHD often struggle with attention to detail, making careless mistakes in their homework, household chores, or playtime activities. They have difficulty maintaining focus on tasks, and their ability to concentrate is significantly lower than that of their peers. They tend to avoid or dislike tasks that require sustained attention and may even exhibit avoidance behavior.
At school, these children may appear to not hear what their teachers are saying and struggle to follow instructions from teachers or parents. They may be unable to complete assignments according to instructions. As they grow older, they may also struggle with tasks that require planning and organization skills.
Easily distracted, these children are often disrupted by sounds or events around them and may stop their tasks abruptly. They are extremely forgetful, losing track of everyday details and frequently misplacing important items such as wallets, stationery, or glasses.
Hyperactivity and Impulsivity:
During class or other situations that require sitting still, children with ADHD often leave their seats or move around and climb without permission. Even when seated, they may fidget constantly, unable to remain still. They find it difficult to stay quiet during activities and always seem to be on the go.
These children tend to talk more than their peers and often interrupt others, making it difficult for them to wait their turn in conversations or while waiting in line. They also struggle with patience, such as when answering questions or waiting in queues.
The Causes of ADHD: Genetic Factors and the Importance of Environmental Influences
ADHD, or Attention Deficit Hyperactivity Disorder, has a high heritability. Research shows that up to 76% of the variance in ADHD is attributable to genetic factors. In other words, if a parent has ADHD, their children are more likely to develop the disorder as well. Conversely, if a child is diagnosed with ADHD, there is a chance that their parents may have undiagnosed ADHD.
Children with ADHD have brains that develop differently from their peers. Studies have found that their cerebral cortex matures more slowly than that of typically developing children. Additionally, they have abnormal catecholamine secretion, leading to dysfunction in the prefrontal-striatal circuits in the brain, which affects memory, behavior, and emotional control.
It is worth noting that most ADHD medications work by stimulating catecholamine secretion, helping patients regain focus and control over their behavior and emotions.
However, environmental factors also play a significant role in the severity of ADHD symptoms. Research indicates that children from lower socioeconomic backgrounds, those who experience prolonged neglect, or those raised in non-family environments (such as group homes) may exhibit more severe ADHD symptoms and experience greater challenges in their daily lives and learning.
Comorbidity in ADHD: An Overview of Common Co-occurring Disorders
Children with ADHD (Attention Deficit Hyperactivity Disorder) may also experience other health conditions, making diagnosis and treatment more complex. In fact, individuals with ADHD are at higher risk for developing additional psychological disorders, and caregivers and healthcare providers must remain vigilant.
Oppositional Defiant Disorder (ODD)
Many children with ADHD are also diagnosed with ODD. Due to the symptoms of ADHD, these children may often face punishment from an early age. Educators and parents may find them difficult to manage, leading to a hostile attitude towards authority figures and the development of oppositional behavior.
Autistic Spectrum Disorder (ASD)
There is a significant connection between ADHD and ASD. Among children with ASD, up to 60% meet the diagnostic criteria for ADHD. However, only about one in eight children with ADHD also have ASD. This relationship is largely linked to genetics.
Tourette's Syndrome symptoms can range from mild to severe, and up to 50% of individuals with Tourette's also have ADHD. The exact cause of this comorbidity is unclear, but some studies suggest that both conditions are related to the dopamine neural circuits in the brain (cortico-basal-thalamic loop).
Research indicates that up to 23% of individuals with ADHD also have bipolar disorder. These patients typically struggle with both inattention and hyperactivity symptoms. Overlapping symptoms between ADHD and bipolar disorder can make diagnosis challenging, but studies show that most patients with "BAD ADHD" truly have both conditions.
Children and adolescents with ADHD are five times more likely to develop depressive disorders than the general population. Depression is often diagnosed several years after the onset of ADHD symptoms, and many believe that the stress and frustration caused by ADHD contribute to the development of depressive symptoms.
Children with ADHD often struggle with attention and short-term memory problems, which can directly impact their phonological awareness and reduce their reading abilities.