Attention-Deficit/Hyperactivity Disorder in Children and Youth

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Author: Canadian Mental Health Association, BC Division

 

There are times when children just can't seem to concentrate. This isn't a huge problem for most kids—they can regain their focus and get back on task fairly easily. But it's a serious problem for others.

Attention-deficit/hyperactivity disorder (ADHD) is a real illness that makes it difficult for children to sit still, concentrate, and complete their work correctly and on time. Of course, it’s normal for children to want to run around or play loudly on occasion, and no one would expect a young child to sit quietly for a long time. But with ADHD, these behaviours occur frequently and interfere a lot with the child’s life.

What is it?

ADHD is a mental illness that affects the way a child behaves or acts. Symptoms of ADHD start before a child is 12 years old. Some symptoms may not be obvious or start to cause problems until the child is older as expectations at home and school increase and tasks become more complicated.

If your child is living with this illness, they might have a hard time paying attention to what’s going on around them. Or they might make careless mistakes at school or struggle to organize things. These examples fall into the inattention category of symptoms. Your child may also find it impossible to sit still. They may fidget often or look very restless. Your child might also have a hard time waiting in line or waiting for their turn. They may shout out answers at school or jump into games at home when it isn’t their turn. These examples fall into the hyperactivity and impulsivity category of symptoms.

There are different types of ADHD based on the group of symptoms that causes the most problems, though most children have at least some symptoms from all of the groups. A child who experiences a lot of symptoms from the inattentive group will look differently than a child who experiences a lot symptoms from the hyperactivity and impulsivity group. The stereotype of ADHD as a child who can't sit still isn't very accurate.

ADHD symptoms such as impulsivity or failing to follow instructions are not the same as oppositional or hostile behaviours meant to cause harm or disrespect others. ADHD also isn't the same as struggling to understand what is required, like when a child doesn't complete a school assignment because they don't understand the questions.

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Could my child have ADHD?

  • My child has a hard time following instructions

  • My child often loses things like toys or homework

  • My child is easily distracted, even when they're doing something fun

  • My child can't seem to sit still

  • My child has a hard time playing quietly

  • My child often seems impatient

  • My child often interrupts people or blurts out answers when they shouldn't

  • My child often misses details and makes careless mistakes

It's normal for any child to sometimes get distracted, restless or disorganized. But if you feel that many of the above concerns apply to your child and they've been happening often for a long time and causing a lot of problems, talk to your doctor or other health care provider.

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Who does it affect?

ADHD affects about 2.5% of school-age children in Canada. It's usually diagnosed during elementary school years because it's normal for younger children to have a lot of energy and less ability to pay attention.

  • Family members—ADHD seems to run in families, so a child is more likely to have ADHD if a close biological relative has it

  • Other mental illnesses—About half of children diagnosed with ADHD also have another behavior disorder. They may also experience a mood disorder or anxiety disorder. ADHD may also be associated with learning problems or communication problems. In a few cases, ADHD may occur with Tourette’s Disorder

Different illnesses and medical conditions can look like ADHD. Some of these include learning disabilities, vision or hearing problems, fetal alcohol syndrome, and mental illnesses like bipolar disorder. That's why it's so important for a doctor to rule out other problems before they diagnose a child with ADHD.

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What causes ADHD?

Like other mental illnesses, ADHD is likely caused or influenced by many different things. A few examples include your genes, the environment you live in, and your life experiences. We do know that researchers haven't found a concrete link between ADHD and factors like parenting style or watching TV. ADHD also seems to happen more often in children of women who smoked cigarettes while they were pregnant.

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What can I do about it?

When a child is diagnosed with ADHD, the child and their family members should take steps to learn about ADHD. Doing so can help the entire family understand the illness and learn strategies to help your child thrive.

A combination of counselling, changes at home, changes at school and medication help children living with ADHD. Counselling, changes at home and changes at school may be the best first-line treatments and supports for mild to moderate ADHD symptoms. Medication may be needed if symptoms are severe or don’t improve with other treatments or supports.

Counselling

The most common type of counselling for children living with ADHD is training to help them engage in positive behaviours. This is called behaviour skills training. It also helps children make positive choices that help them reach their goals, and it helps them work well with the people around them.

Other kinds of counselling might also be helpful. Counselling may include the child, their parents and the entire family. Common types of counselling include:

  • Cognitive-behavioural therapy (CBT). It has been adapted to help children understand and challenge the thoughts behind their urges

  • Parenting skills training. It teaches parents how to cope with their child’s ADHD symptoms and how to guide a child living with ADHD. This may include learning how to predict problem situations, solve problems, enforce rules and give constructive feedback

  • Family counselling and support. This helps all family members, including siblings, learn how to cope with disruptive behaviour and encourage positive behaviour

Changes at home

Changes at home can help a child cope with ADHD symptoms. Helpful changes may include:

  • Maintaining a consistent daily schedule, including a regular bedtime

  • Using lists, charts, schedules or notes to help your child remember important tasks or information

  • Making sure your child is getting exercise

  • Helping your child try structured social activities. Sports, dance or community volunteer work may help improve social skills, demonstrate the child’s strengths and boost self-esteem

Your mental health clinician can suggest changes at home to help your child’s specific problems.

Changes at school

Your child's school may provide changes to classroom activities and learning material. For example, the school may allow your child to move their desk to a quieter, less distracting area. These small changes help many children living with ADHD. But if your child still struggles, the school may make bigger changes, like providing different kinds of learning materials. It's best if parents and schools work together to help a child living with ADHD.

Medication

There are two different types of ADHD medication: stimulant and non-stimulant medication. It may seem odd to treat a hyperactive child with a stimulant, but they are very effective for children who have been properly diagnosed with ADHD. There is also a non-stimulant medication for ADHD. However, the kind of medication your child is prescribed will depend on many factors, such as the type of ADHD and any other medical or mental health problems.

Medication can help manage ADHD symptoms and improve your child's quality of life, but it won't solve all behaviour problems or social skills problems. That's why it's important to include counselling and changes at home or school in the treatment plan.

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Where do I go from here?

In addition to talking to your family doctor or another health care provider, check out the resources below for more information about attention-deficit/hyperactivity disorder:

Institute of Families: FamilySmart
Visit www.familysmart.ca or call 1-855-887-8004 (toll-free in BC) or 604-878-3400 (in Greater Vancouver) for information and resources that support families and young people who experience a mental illness.

Kelty Mental Health Resource Centre
Contact Kelty Mental Health at www.keltymentalhealth.ca or 1-800-665-1822 (toll-free in BC) or 604-875-2084 (in Greater Vancouver) for information, referrals and support for children, youth and their families in all areas of mental health and addictions.

BC Partners for Mental Health and Substance Use Information
Visit www.heretohelp.bc.ca for the Managing Mental Illness series of info sheets, which is full of information, tips and self-tests to help you understand mental illnesses. The website also has many publications for family members, including parents of younger children.

Centre for ADHD Awareness, Canada
Visit www.caddac.ca for information and resources, tips for working with your doctor and child’s school, information for educators, parenting strategies, support groups, and more.

HealthLink BC
Call 811 or visit www.healthlinkbc.ca to access free, non-emergency health information for anyone in your family, including mental health information. You can also speak to a registered nurse about symptoms you’re worried about, or talk with a pharmacist about medication questions.

Foundry
Foundry is a one-stop office for youth ages 12–24 seeking mental and physical health services, supports, or information. Foundry locations are available around the province. Visit www.foundrybc.ca for more information and local contact information.

Confident Parents: Thriving Kids
This phone-based positive parenting skills program supports parents of children ages 3–12 who experience mild to moderate behaviour problems. Parents learn different skills to cope with challenges and improve behaviours with the support of a coach. Confident Parents: Thriving Kids is a program of the Canadian Mental Health Association, BC Division. It’s free for BC parents with a doctor's referral. For more information, visit www.confidentparents.ca.

 

If you are in distress, need information on local services, or you just need to talk with someone, call 310-6789 (no area code) 24 hours a day to connect to a BC distress line, without a wait or busy signal.

 

 
About the author

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The Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing a mental illness through public education, community-based research, advocacy, and direct services. Visit www.cmha.bc.ca.

 
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