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We are a small group based in the Brighton and Hove area of Sussex, UK, though we aim not to exclude anybody, anywhere, from accessing the information we have available.
We would like to ensure that all those that live with, work with or teach those with AD/HD have access to information that is current, to enable to the best possible outcomes for all those concerned.
What is Attention Deficit Disorder? Attention
Deficit /Hyperactivity Disorder (AD/HD) refers to a cluster of behaviours that
cause a child to underachieve at school and under-behave at home for the
standard of parenting. It is not
a 'new fad', but a clearly recognisable medical condition identified in 1902
by an English doctor called George Stills. It comes from a difference in the
fine tuning of the normal brain, the underlying problem thought to be a
deficit in the neurotransmitters, and this has been shown using the latest
scan techniques (PECT scans). It is
strongly hereditary - so many families have a parent or close relative who has
similar problems. If one identical twin has AD/HD there is over a 90% chance
the other will have the condition. If
one sibling has AD/HD there is about a 30% chance another child will be
affected. (The chances may be increased if both parents have AD/HD). The
opinion varies on the number it affects altogether, ranging from 2% to 10% of
the population. It continues throughout the school years with about 60% still
having serious difficulties in adulthood - it is now known to be a life-long
condition, managed well by some.
Hyperactivity for example, can sometimes diminish as a person matures. But the
outcomes of AD/HD cannot be
accurately predicted. The
hallmarks of AD/HD are inattention, easy distractibility and impulsivity with
or without hyperactivity, causing educational and behavioural
difficulties. Sufferers without
hyperactivity can be distant, dreamy and 'spaced out' whilst some remain
restless and fidgety. 60% of
children with AD/HD will have other co-existing conditions. Some examples are,
dyslexia, language difficulties, obsessive/compulsive disorder, substance
abuse, depression, tics, and oppositional defiant disorder.
How
will I know if my child has AD/HD? AD/HD affects people in different ways and they vary
in the number of the behaviours and the relative severity of each. The disorder can often be evident in the very young
with many parents remembering their AD/HD child as a baby with some or all of
the following characteristics: Extreme
foetal Excessive
crying Poor
sleeping pattern Over-active
toddler Frequent
extreme temper tantrums Poor
adaptability Fussy
feeder Developmental
delays i.e: Slow
language development Slow
toilet training Poor
co-ordination Poor
social skills Fearless
and unpredictable Accident
prone Poor
sense of personal safety Needs
constant watching However,
other AD/HD children may have been ‘good’ babies and toddlers and shown no
developmental concern, but symptoms will always occur before the age of seven.
Problems will often develop once the child has started school with their socially unacceptable behaviour and impulsivity causing great difficulties and disruption in the classroom. Often
they are known by all but liked by few! The dreamy inattentive types may create no disruption but will achieve little work, and will often seem as though they are simply not paying attention.
Is there a link to AD/HD and learning difficulties? Not
necessarily (but
just as with any other individual), ability to ‘learn’ and
IQ will vary among those with AD/HD. Untreated AD/HD, however, will always
seriously affect a persons ability to achieve to their full potential.
Criteria The
following is the medical criteria (list of symptoms) used for diagnosing AD/HD
called the DSM-IV 1994. Symptoms should be noted in at least two settings
(e.g.. home and school) and must cause significant difficulties with social,
educational or occupational functioning. INATTENTION 6 or more of the following symptoms of inattention
for at least 6 months: 1. Often
fails to give close attention to details or makes mistakes in schoolwork, work
or other activities. 2. Often
has difficulty sustaining attention in tasks or play activities. 3. Often
does not seem to listen when spoken to directly. 4. Often
does not follow through on instructions and fails to finish schoolwork, chores
or duties in the workplace (not due to oppositional behaviour or failure to
understand instructions). 5. Often
has difficulty organising tasks and activities. 6. Often
avoids, dislikes or is reluctant to engage in tasks that require sustained
mental effort (such as schoolwork or homework). 7. Often
loses things necessary for tasks or activities (e.g. toys, school assignments,
pencils, books, tools ). 8. Is
often easily distracted by extraneous stimuli. 9. Is
forgetful in daily activities. HYPERACTIVITY
/ IMPULSIVITY 6 or more of the following symptoms of Hyperactivity
and impulsivity for at least 6 months: 1. Often
fidgets with hands or feet or squirms in seat. 2. Often
leaves seat in classroom or in other situations in which remaining seated is
expected. 3. Often
runs about or climbs excessively in situation in which it is inappropriate (In
adults or adolescents this may be limited to feelings of restlessness).
4. Often
has difficulty playing or engaging in leisure activities quietly. 5. Is
often 'on the go' or acts as if they are driven by a motor. 6. Often
talks excessively. 7. Often
blurts out answers before questions have been completed. 8. Often
has difficulty awaiting turn. 9. Often
interrupts or intrudes on others (e.g. butts into conversations or games).
When
is this normal and when is it AD/HD? There are many normal children who have some of these behaviours - sometimes. There is no clear cut line between a normally active, impulsive and
inattentive temperament, and true AD/HD. However, if these behaviours are excessive and are causing the child to
under function at school, to under behave at home, is perhaps creating a
stressful family life and the child remains lonely, distressed or angry, they
must be taken seriously. 'A problem is only a problem when
it causes a problem'
What
can I do if I think my child has AD/HD? You must become an 'educated consumer' - you must thoroughly understand
this disorder, so learn all you can about AD/HD. There are many excellent
books available on AD/HD and a support group may be able to supply fact sheets
that you can copy and pass on. Ask
the child's nursery/teacher/minder to write a report on your child's
difficulties, achievement levels and behaviour, and friends or family if they
are willing, to do the same. Keep a record at home of events and behaviour. If you still feel that this is indeed the problem, take along your
reports and resources to your GP or school doctor, explain your concerns and
discuss an appropriate referral. It is important to get a correct diagnosis by
a specialist who has a thorough knowledge of this disorder. We are far behind countries like America, Canada, Australia, and South
Africa. In the UK there are far less professionals working in the area of
AD/HD although things are improving all of the time. There are now many people
that will be prepared to listen and refer you on.
Be prepared to be patient, you may have to go on a waiting list for an
appointment. Much of the diagnosis will depend on your evidence so always take
it with you. Parents are now realising that much
can be done to help these children and are putting pressure on the
medical profession to 'catch up' and learn how to diagnose and treat AD/HD. Another good idea is to learn all you can about the education system. Most schools now produce detailed information sheets for parents about what it means to have a child with special educational needs. However, if you find a school that is unhelpful, contact your Local Education Authority (LEA) and ask for a copy of their Special Educational Needs policy. There is a great deal that can be done in school to help children with behavioural difficulties, with or without AD/HD. Some LEA's even have their own guidelines on AD/HD, so it is worth contacting them. The DfES - SEN website http://www.teachernet.gov.uk/wholeschool/sen/ has a whole host of information available for parents on special educational needs and it's well worth having a look at. There are many GP's, Health
Visitors, Special Needs Teachers and School Doctors that will be sympathetic
to your problems and may even be able to offer assistance in the field of
management and special coaching. But don't be too disheartened if coaching
fails. AD/HD often requires specific kinds of behaviour management, and
anybody that tells you that these children are just the same as any other
child with 'challenging behaviour' and "Simply needs good
discipline," is simply out of date.
What is the treatment?
After a careful and full
assessment of the disorder by a professional with a vast knowledge in this
field, managing AD/HD may involve some or all of the following: Behavioural strategies at home Educational strategies at school Boosting the child's self esteem Medication Limiting distractions, working to only short term goals, immediate reward
systems and implementing only immediate sanctions are all useful tools. Medication will help redress the balance in the brain, and it is
extremely well researched and proven. For many, once the correct dosage has
been administered, the benefits can be quite miraculous. More detailed
information on medication is available from a specialist or
support group. Parents must ensure that they learn all they can about the treatments
available. Well informed and knowledgeable parents produce the best possible
outcome for their children. Remember, untreated AD/HD is not without its hazards.
Focus on early treatment Time is against children with AD/HD! It is a real condition whose
importance is only recently becoming understood. When misdiagnosed and
mistreated, it can cause stress and long term damage to family relationships.
These children will under function at school and start to believe that they are
stupid or naughty. Perhaps they will be excluded from school, later getting
into trouble with the police? Maybe none of these will happen; perhaps they
simply end up a long way behind academically.
Eventually though, they will have little self-worth. The outcome for AD/HD sufferers does not have to be a completely bleak
one, many are very successful people with much drive and ambition. But the possibility should not be
ignored.
The percentage of children in care with AD/HD is high. We cannot see what
the future holds for any child, the future for a child with AD/HD is even more
cloudy. AD/HD is a real, neurological condition. It cannot be cured, but with appropriate treatment and understanding, we can maintain the enthusiasm to learn, protect self-esteem and aid better family relationships.
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