ADHD appears to have its root in a minor dysfunction of the brain, which research suggests may be metabolic in nature as PET scans indicate persons suffering this problem use less glucose in the area of the brain dealing with concentration, when working on a task. This dysfunction affects the brain's information filtering systems and creates overload. ADHD has been likened to a fast moving kaleidoscope in which sounds, images and thoughts are constantly shifting. There is a sense of being quickly bored with something, yet feeling completely helpless to keep the mind on task. Sufferers are easily distracted by irrelevant sights or sounds, which then fix there attention to the exclusion of all other stimuli. This may result in apparent rudeness when they 'ignore' someone speaking to them - they genuinely have not heard a word being said to them. Children are unable to sit still, concentrate on a single task, plan ahead and are frequently unaware of their surroundings.
Between 3-5% of UK children suffer from ADHD to some extent, and around 1% have severe symptoms. There are around 2.5 times more boys than girls suffering ADHD, and many of these boys have at least one other mental disorder, some of which are quite major, eg., Oppositional Defiance Disorder, (ODD), and Conduct Disorder, (CD). If these are present then the help of a specialist psychiatrist is required.
ADHD is not down to poor parenting, but it is a fact that more children with ADHD do come from broken or dysfunctional families. The cause for this is unclear but it is possible that genetics play a part as many of the parents show ADHD behaviours but have never been diagnosed as such. Around 60% of child sufferers continue to have the symptoms into adulthood.
Diagnosing ADHD
As there is no single cause of ADHD there is no single test for it, its not like a broken bone - take an X-ray and decide to splint, plaster to operate on the injury. The most common way that ADHD is diagnosed is by using symptoms - which fall into three main categories: inattention, hyperactivity and impulsiveness.
Inattention
The child may have a hard time keeping the mind on one thing for more than a few minutes, especially if the task is something new or requires lots of concentration. However they may be able to apply effortless, automatic attention to something that they enjoy. (This can lead to the child being labelled as 'lazy' or 'naughty' as they can concentrate when they want to. In effect they are accused of being in control of the symptoms of ADHD!).
These children have poor short term memory so forget to write their homework down, so do not do it, and when reproached over it really cannot even remember it being set. Essays and coursework are an almost impossible task for any ADHD sufferer.
Hyperactivity
The person is in constant motion, sitting still is very difficult, and if forced to do so will fidget, and be constantly moving their hands and feet, or tapping a pen on the desk. They frequently move around the classroom and talk constantly - often flitting from one subject to another, on just one topic relentlessly. Children may start one task and soon tire and go on to another and another, never completing anything started. (Caution. Many two to three year olds are very busy little people learning about the world around them, they are into everything, and soon move onto something else. This is normal and not ADHD).
Impulsiveness
Many ADHD sufferers seem to be unable to think before they react, as a result they blurt out inappropriate comments, or lash out and hit someone who may have accidentally knocked them or have their favourite toy. They are impatient when waiting may try to go out of turn when playing games - and argue about it.
We all, on occasion, have ADHD-like symptoms but this does not make us sufferers. The criteria that is most widely used for diagnosing ADHD is the DSM, (Diagnostic and Statistical Manual of Mental Disorders). The basis of diagnosis is that;- the behaviours must start early in life, (before the age of seven); be continuous for at least six months; the symptoms must be frequent and severe compared to the norm for children of the same age; and they must impact in a debilitating way on at least two areas of life, eg., school, home, social settings, or at work in the case of adults.
This would mean that a child who appears hyperactive at school and nowhere else would not be considered as having ADHD. Other explanations for the behaviour at school would have to be looked into.
DSM Criteria
Inattention
Easily distracted by irrelevant sights and sounds,
Fails to pay attention to detail, makes careless mistakes,
Rarely follows instructions carefully or completely,
Losing or forgetting things like books, pens, homework, passing on messages.
Hyperactivity and Impulsiveness
Feeling restless, fidgety, constantly moving hands and feet, tapping, wriggling in seat,
Unable to remain seated or be quiet in situations where this is required,
Blurting out inappropriate remarks in social situations,
Blurting out answers to questions before the question is complete,
Have difficulty waiting in queues or for a turn in a game,
May hit out at others on the slightest pretext.
Other symptoms that may present
Difficulty in sharing things like toys and games,
Insatiability - constantly talks about the same topic,
Social clumsiness,
Physical clumsiness,
Large fluctuations in performance over time or topics,
Large fluctuations in moods,
Extreme sensitivity to criticism,
Very low self-esteem,
Interrupt other children's games by butting in,
Engage in physically dangerous activities without considering the consequences, eg. running across a road without looking, or jumping off a high wall or climbing frame
ADHD is very complex and may turn out to be an 'umbrella' term for a whole collection of related disorders. it is also important to recognise that other disorders may give rise to some of the same symptoms. Tourette’s Syndrome can cause inappropriate outbursts, Petite Mal can appear as if a child is not paying attention to what is being said to them, anxiety and depression can cause aberrant behaviour patterns as can coming from an unsafe home environment , e.g. where a child is being physically or mentally abused.
Standard medicines for ADHD are Ritalin, Dexedrine and Cylert. These have an 'instant' positive effect on symptoms but do not offer a cure, and should only be considered as a short term treatment. They are backed up with Cognitive-Behavioural Therapy and various other support structures. I do not use prescription drugs, only natural products in treatment plans which are unique to every individual. In general terms my treatment plans include dietary changes, lifestyle changes, supplements and Cognitive-Behavioural Therapy. Parental/family and school/work support is key to this form of therapy. I will probably recommend blood tests for allergies or intolerances to foods or additives. It is very uncommon for allergies or intolerances to be the cause of ADHD but I believe that if someone has a predisposition to ADHD then foods and especially additives can have a profound impact on the severity of the symptoms suffered. The removal of these from the diet may have a dramatic effect on the reduction of the symptoms and the quality of the ADHD suffer, their family and people at school or work.
What happens during a consultation?
The first consultation is a fact finding mission. A detailed personal and family profile will be made, DSM criteria will be applied along with other diagnostic procedures. If blood tests are require then I will have to wait for the results before working out a treatment plan. If blood tests are not required I will tailor an individual treatment plan for the next session. No treatment plan is given at the end of the initial session - I need time to construct it properly for the individual.
Treatment starts on the second session, how many sessions will be required is totally dependent on the person being treated and their response to therapy.
(As with all natural therapies the response of individuals varies greatly from 'total cure' through various stages in the reduction of symptoms, to the little or no effect. I cannot say where you or your child will fall on this spectrum.)
Therapist - Richard Wain
Wednesday and Saturday mornings and Thursday evening. |
