Most people think of ADHD as a mental disorder when in reality it is a chronic neurobiological disorder characterised by a deficit at the level of the nervous system. One that brings on inattention, hyperactivity, emotional hyperreactivity and impulsivity. Biological and genetic factors may play a part in how it develops.
Attention deficit disorder with or without hyperactivity (ADHD) is a condition that has probably always existed. Even so, it was not until the start of the last century that it was clinically described for the first time. It was first known as hyperactive child syndrome (1968), then as attention deficit disorder with or without hyperactivity (1980) and as hyperactivity disorder with attention deficit, or THADA (1987). The terms now preferred are attention deficit with hyperactivity (DAAH), or attention deficit disorder with or without hyperactivity (ADHD).
Children with ADHD
Children with ADHD make a great deal of noise, need to touch everything and always have something in their hands to play with. They are unable to wait their turn. In the same way, they forget and lose their belongings all the time. Their mood shifts without anyone understanding why, and they react very sharply, even out of all proportion, to the events around them. These children are forever seeking reassurance of affection and go through great anxiety. They are often misunderstood, and even punished and rejected by school, family and social settings.
It is not all grey for these atypical children. They even hold lovely surprises in store, once you know how to help them. Very often, these children are marked by a kind of 'giftedness'.
Their imagination is fertile and their creativity vast. They take an interest in everything around them and throw themselves passionately into all sorts of projects. You can expect wonderfully rich exchanges with them. For that flourishing to happen, they need a setting suited to their specific needs: a calm atmosphere, fewer visual and sound stimuli, quiet, and so on.
Before the age of 5
ADHD is difficult to diagnose in the very young, although it may be suspected in a child who fidgets everywhere, in every direction, with no regard for the fact that they might hurt themselves.
Between 6 and 12
The child is in the thick of learning. Hyperactivity is easier to detect during this period. Parents who notice motor hyperactivity should consult their family doctor or paediatrician.
After 12
Motor hyperactivity fades and attention deficits along with impulsivity take over.
| Age group | What dominates |
|---|---|
| Before 5 | Difficult to diagnose; it may be suspected in a child who fidgets everywhere, in every direction, with no regard for the fact that they might hurt themselves. |
| Between 6 and 12 | Hyperactivity is easier to detect; parents who notice it should consult their family doctor or paediatrician. |
| After 12 | Motor hyperactivity fades; attention deficits and impulsivity take over. |
More frequent in boys
ADHD is above all more visible in boys than in girls, which is why they are more straightforward to diagnose.
How do you care for a child with ADHD?
Where there is a diagnosis, multimodal care is needed. To help your child overcome their difficulties, several forms of support should be combined:
- Putting in place school arrangements tailored to the child's specific needs.
- Psychoeducation for both parents and patients. Psychotherapy is therefore recommended, in the form of cognitive behavioural therapy and individual and/or family therapy. It is very important that parents receive support of their own so as to be able to help their child and adopt a positive attitude.
- Rehabilitation therapies (psychomotor therapy, cognitive remediation, speech and language therapy, and so on)
The introduction of drug treatment and psychostimulants, a method both controversial and effective.
Medication, a necessary evil?
Drug treatments, as we have said, spark debate. Here is what you need to know before deciding whether to treat your child.
Medication remains a choice
Before you even ask the question, know that putting your child on drug treatment is above all a personal choice. Many myths surround ADHD, including those about your child being lazy and disorganised. A great many factors come into play. So do not rush; think it through calmly.
Are you certain of the ADHD diagnosis?
The fact that your child is restless or hyperactive, or struggles to concentrate, does not mean they have ADHD. Have a thorough assessment carried out before considering any form of medication.
Find out about the various treatments available for ADHD
Beyond the medication route, other options exist, such as individual therapy, behavioural therapy or cognitive remediation.
What would medication actually do for your child?
Your child faces particular challenges. Find out what each medicine brings. How would it help resolve the problems the child is experiencing? Discuss it with their doctor and make sure you understand all the implications.
Drug interactions
Is your child taking other medicines? Talk to the doctor about it to avoid nasty surprises and drug interactions.
Are you able to keep track of the medication?
Finding the right medicine and settling on the right dose calls for rigour, discipline, patience and time. Are you ready to put your child through all of that?
Will your child be disciplined enough?
Your child will first have to be able to identify and understand the effects of the medicine, which is no small matter given how young they are. Do you think they are able to understand the dosage of their treatment? Can you count on them to take the medicine regularly? Do you need to put a schedule in place?
Side effects of medicines
Side effects are not uncommon. Ask your doctor so that you are able to spot them. In the case of ADHD, side effects vary with the very nature of the medicine: is your child on a stimulant treatment or a non-stimulant? Bear in mind that side effects are meant to disappear after a few days. If they persist, talk to your doctor about adjusting the dose or adjusting the medicine.
Are you considering breaks?
Do you want your child to be on treatment constantly, or are you considering giving them a little respite over the summer holidays, at weekends or on family trips? Some children may be entitled to this. For others, it is better not to stop. Once again, it is worth thinking it through calmly and discussing it with your family doctor. Do not hesitate to gather other people's experiences or to look at discussion forums online.
