with thanks to Dr Monika Bajaj, neurodevelopmental paediatrician practising privately in east London.
ADHD is a chronic life long disorder of self-regulation with symptoms persisting in >70-80% adolescents and >50% adults.
It is real disorder with real long-term risks, just to quote a few impacts….
- Up to 30% of children may have depression and up to half of girls with ADHD may attempt self-harm
- Children with untreated ADHD are >5 times more likely to participate in fights and underachieve at school
- Adults with ADHD are 9 times more likely to end up in prison, more likely to experience financial problems and being fired from a job.
- Adults with ADHD have a higher mortality compared to those without mainly due to causes such as driving accidents, substance abuse, obesity and co-morbid problems (Dalsgaard et al. Lancet 2015, May;385(9983):2190-6)
- Organisational skills problems (time management, memory, late and unfinished homework and projects)
- Erratic work and academic performance
- Family/marital problems
- Poor sleep and other household routines
- Difficulty managing finances, impulsive shopping
- Compulsive addictions – sex, gambling, video gaming, exercise, eating
- Frequent accidents secondary to recklessness
- Speeding tickets, car and motorbike accidents
- First degree relatives with ADHD
- Low self-esteem, chronic under-achievement
ADHD is usually diagnosed after the age of 6 years to allow for the child to mature. Almost all children have times when their behaviour seems unacceptable and age inappropriate. However, when behaviours happen many times a week or daily, ADHD ought to be looked for. NICE guidance allows children to be treated after the age of 5 years and medication makes a huge and quick difference along with psychoeducation and behavioural management.
Resources: The Canadian ADHD Resource Alliance (www.caddra.ca is an excellent resource for professionals with free downloads).
US guidelines have recently changed to allow treatment of some 4 year olds with debilitating features of ADHD (https://www.healthychildren.org/English/news/Pages/Practice -Guideline-for-the-Diagnosis-Evaluation-and-Treatment-of- ADHD.aspx)
UK support group: https://www.borntobeadhd.co.uk/