An introduction to ADHD

 

ADHD. It’s a label most people have heard of, and most people have an opinion on. There are lots of questions people have and many myths surrounding ADHD, which can lead to so many questions: Does ADHD really exist? Should kids be put on medication? Won’t medication lead to teenagers who take drugs? Can other supplements help? Is ADHD caused by a bad diet? What non-medication based treatments are available? Is it something people can grow out of? Does ‘screen time’ make ADHD worse? Isn’t it just due to bad parenting? Aren’t people with ADHD just lazy or dumb? Hasn’t ADHD been “made up” by medical professionals? How can someone have ADHD if they’re not hyperactive? And many more! While this blog post will not attempt to address all of these questions, it has been written to provide a basic introduction to ADHD and make it more clear just what ADHD is.

So what does ADHD stand for?

Attention Deficit Hyperactivity Disorder

The main components in ADHD – as suggested by its title – are difficulties with attention and hyperactivity. One might assume that both of these elements need to be present for a diagnosis of ADHD to be given; however this is not the case. There are in fact three types of ADHD: the hyperactive/impulsive type, the inattentive type, and the combined type.

The hyperactive/impulsive type of ADHD might be seen in a child who is very fidgety, is frequently out of their seat during class, talks excessively, fails to wait their turn, and has difficulty inhibiting certain behaviour (stopping themselves from doing or not doing something) e.g. calling out or touching objects. There is a common description of these children as though they are “driven by a motor” – meaning that they just don’t stop!

A child with inattentive ADHD – often referred to as ADD – may have trouble following instructions, fail to pay attention to details, be easily distracted, appear not to be listening, is forgetful, loses things, and has trouble organising their materials. They may be described as a “daydreamer” or “in their own world” a lot of the time.

These two descriptions paint two very different pictures, so it’s no wonder there can be confusion over what ADHD is!

Finally, the combined type of ADHD is – as its name also suggests – a combination of both the hyperactive/impulsive and inattentive symptoms described.

It is important to recognise that everyone may have times that they demonstrate some – or even many – of these symptoms, However, in ADHD there must be many of these symptoms occurring for at least 6 months and these symptoms must be interfering with day-to-day tasks such as social and academic/work activities. The symptoms need to be present in two or more settings, for example at home and at school. If symptoms were only interfering in one setting – home but not school, or vice versa – there is likely to be some other cause for such behaviour.

ADHD is not something that can be diagnosed in a quick 5-minute visit. While some of the symptoms can be observed in that time, further information needs to be gathered to determine whether the child does have ADHD. For example, I might see children who are unable to sit still in my office and touch lots of the things I have in there – but this alone does not determine whether they have ADHD or not. Further information would need to be gathered through interviews with the child, their parent, teachers, taking a thorough history of the child’s development and current functioning, and gathering information using questionnaires and standardised testing so that the child’s behaviour can be compared to other children of the same age.

For some parents, the diagnosis of ADHD may be something they view as a negative for their child, however this need not be the case. Treatment can be very effective – both medication and behavioural – and having a great team on board to support both the parents and the child means that the child has the best hope for a positive outcome. I have met many adults and children with ADHD and just like people without ADHD, they have a broad range of interests and strengths, and their individual personalities mean that their ADHD is not what shines, but rather who they really are as a person.

 

By Erin Patten

MPsych (Educational & Developmental)

Registered Psychologist @ Alpha Psychology and The Resilience Centre

 

R U OK?

Today is National R U OK Day. The message is simple – ask those around you: “Are you OK?”

R U OK Day encourages people to ask those around them – friends, family, colleagues – R U OK? Relationships are crucial to who we are, and just those three little words could mean so much to someone who is struggling. People each other all the time, but how much do we really listen? In such a busy world, it can be hard to find the time. But by making the time, you can help people to feel cared about, and know that they are not alone.

As humans, we tend to work in ‘problem solving mode’ for a good portion of the time. Feeling hungry? Grab a snack or make a meal. Need a new hairdresser? Ask around to see if anyone you know has a good one. Can’t find your car keys? Ask your spouse to help you look for them. But when it comes to our emotions, humans are pretty complicated beings. Sometimes people aren’t able to explain why they are feeling a certain way and a common response can be to try and ‘fix’ the problem. While sometimes this can lead to a positive, empowering response in the person, at other times it can leave them feeling as though they haven’t been heard. Sometimes if someone is having a hard time the best thing you can do is to listen – allow them to feel heard and let them know you are there for them. And of course, if they need to speak to a professional then encourage or help them to do that.

So make the effort, take the time, and ask away. You may be surprised at what you hear. And while you may not feel as though you can do anything, that simple act of asking, caring, and listening can mean a lot.

It could be the most important question you ask someone today – or any other day: R U OK?

 https://www.ruokday.com

If you or someone you know needs support, see your local GP or phone Lifeline on 13 11 44. If it is an emergency, phone 000 or go to your nearest hospital.

“But surely there’s nothing to worry about?” Anxiety in children and how to tackle it

By Erin Patten
MPsych (Educational & Developmental)
Registered Psychologist @ Alpha Psychology and The Resilience Centre

I have had parents bring their anxious child to see me and say “but what does a child have to be worried about?” And the kids tell me – plenty! While their parents may not necessarily see the child’s fears as something to be scared of or worry about, the fear is real nonetheless to the child and giving them effective strategies to face their fear is really important.

Anxiety is a normal emotion that we all experience at times – and sometimes this can actually serve to keep us safe in a threatening situation. Think about our ancestors: did we evolve from people who were scared of bears and wolves and ran away – or did something else to keep themselves safe – when they saw them coming, or those who saw them coming and did nothing? (I’ll give you a hint: the second group of people got eaten by the bears and wolves!) However, in some children the degree of anxiety they experience in particular situations far outweighs the threat and means they can actually miss out on important childhood experiences such as trying new activities, making friends, or going to new places.

There are several different types of anxiety that may present in children including:

  • Separation Anxiety: These children have difficulty separating from their parent/caregiver, and often worry that something bad will happen while they are apart.
  • Social Anxiety: These children worry a lot about what other people think of them. They may have difficulty mixing in social situations and subsequently find it hard to make friends.
  • Specific Phobias: These children are scared of one particular thing or situation, for example dogs, the dark, thunderstorms, spiders . . . and the list of possibilities goes on.
  • Obsessive Compulsive Disorder: These children repeat the same behaviour over and over again, fearing that something bad will happen if they don’t do it.
  • Generalised Anxiety: These children worry about many different things, and may find it hard to try new things, seek constant reassurance, and often complain of physical symptoms such as a sore tummy or headache.

There are several things that parents can do in order to help their child with their particular fears or worries. As a parent, we all want to protect and reassure our children. However, for children with anxiety doing this too much can actually serve to increase their fears of the particular situation. If you are constantly protecting your child from the situations or things they are scared of or worried about, this only serves to affirm the message that they are not able to cope. Anxious children need to be encouraged to experience situations for themselves in order to attain the sense that, “I can do it!”

Validating your child’s fears is important, but be sure not to reassure them too much. For example, it is helpful to say, “I understand you are feeling worried about . . .” but focusing too much on the anxious behaviour only serves to reinforce it and means your child is less likely to overcome their fears.

It is important as a parent to expose your child to the things or situations that they are afraid of in order to help them reduce their fears. If you allow your child to avoid the thing they are fearful of this will reinforce the fear. Breaking fears down into more manageable steps is a helpful way to approach the anxiety. This is referred to as the ‘stepladder approach’, and this page http://raisingchildren.net.au/articles/anxiety_stepladder_approach.html
has some great examples of stepladders. It is great if you are able to decide on the different steps with your child, and doing this means that they will feel more of a sense of control over what is happening. They may need to practice each stage of the stepladder several times before they feel confident to move on to the next step. Rewards can be incorporated into this process along the way too to encourage your child. It is important to remember that rewards do not necessarily have to be ‘stuff’: one of my favourite ways of rewarding my children is by doing a special activity with them (and it’s fun for me, too!).

Allowing your child to make mistakes is something that many parents find difficult. But this can be important in terms of helping your child to work out how to solve problems on their own. Although tempting, it is better not to jump in when you can see your child struggling. It gives them time to try a different strategy rather than reinforcing to them that you don’t think they can do it.

When you are tackling your child’s anxiety, staying calm and patient can be quite a challenge at times, but it is important to maintain this as much as possible. And of course, it’s a good opportunity to model your own emotional regulation strategies to your child! If at any stage you need help or support through the process, working with a psychologist is a great way to work through your child’s (or your own!) anxieties.

Erin Patten is a Registered Psychologist at Alpha Psychology and The Resilience Centre. You can find out more about Erin here.

If you would like to make an appointment with Erin, please call (02) 9869 0377.