Understanging ADHD
Over the last 20 years there has been a dramatic growth in the number of children and young people referred to Child & Adolescent Mental Health Services (CAMHS) and Paediatric Services for inattentive and hyperactive behaviour. This increased referral rate clearly reflects the escalating numbers of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Recently in Scotland there was concern expressed by some MSP’s that too many children were being diagnosed with ADHD and that there was over prescribing of medication to treat this disorder.
Given the above concerns, in 2006 Quality Improvement Scotland (QIS) was commissioned to clarify the number of school aged children with ADHD being diagnosed and treated. All 14 Health Boards in Scotland were asked how many children they were treating for ADHD and they were invited to randomly submit 60 anonymous case files which would be systematically audited against recommendations made by Scottish Intercollegiate Guidelines Network (SIGN 52, 2001).
For more information on the results from the above audit and on guidelines click: QIS and SIGN 52 (ADHD)
The results produced by QIS have clearly demonstrated that the vast majority of school aged children who have ADHD are not being identified nor are they accessing services. The consequences of this are huge. There is good evidence to show that ADHD is highly costly to the individual, their family and society as a whole.
Problems of inattention, hyperactivity and impulsivity presenting in early childhood, can predict significant problems in middle childhood. Moreover, there is good evidence that for many given an ADHD diagnosis in childhood symptoms will persist into adulthood. I often have the impression that many unaffected people consider ADHD as a problem that can be attributed to poor parenting, too many E numbers in the diet or violent console games. I would put this group into the bracket I call “Non-believers”. This group can range from passive in their views of ADHD to having extreme views about the disorder.
Sometimes, even those who do believe ADHD exists will still often consider it to be a problem that begins when you are 5 years of age and ends when you are 16 years of age; or it starts at 9 am and finishes when the bell rings at the end of the school day. For most people affected by ADHD, the problems it causes are there constantly and results in significant impairment in most aspects of their lives.
ADHD children and young people experience significantly more difficulties in maintaining relationships in their family and with their peer group. Low self-esteem is a major concern at this important developmental stage and may account in part for the 25-45% who will go on to develop oppositional defiant disorder (ODD). In terms of comorbid conditions (conditions that can coexist with ADHD), I have at this stage mentioned but a few. However, I will cover more in other parts of the site..
Is ADHD Real?
Over the years, ADHD has in many instances received a bad press. It is regarded by some as a made up, manufactured “label” that parents are happy to attribute to their children because they cannot control their unruly behaviour. This assertion is inaccurate and stems from a lack of knowledge on the subject from those who make it. In 2002, leading clinicians and researchers in ADHD from across the globe were so concerned about the inaccurate reporting of ADHD and the misleading data that was being made public that they wrote the International Consensus Statement on ADHD. The purpose of this paper was to help dispel the many myths around ADHD and to reinforce that this is a credible disorder for which there is a wealth of scientific evidence to support its validity.
To read an excerpt on the International Consensus Statement on ADHD, see Russell Barkley’s web site by clicking on the following link. Professor Barkley’s website is also an excellent resource for further information on ADHD: International Consensus State on ADHD
ADHD IS REAL!