Facts and Figures

• ADHD should be a diagnosis of exclusion, to discount any alternative explanations for the behavioural disturbance. There are many reasons a child may be overactive, impulsive or have difficulties remaining on task. There is a wide range in the activity level of children, and in what is regarded as acceptable in a given family, social setting and culture.

• There is a lot of disagreement about how many children have ADD or ADHD. Some studies suggest that about 2% of primary school-aged children have ADD, while others have suggested that almost 18% have ADD. Most estimates are between 5% and 10%. Boys are at least 4 times more likely to be diagnosed with ADD/ADHD than girls.

• The exact cause of ADHD is unknown, but suspected contributing factors may include: neurophysiology – including differences in brain anatomy, electrical activity and metabolism; genetics – some research suggests possible gene mutations may be present; drugs; lead; lack of early attachment; childhood post-traumatic stress disorder.

• Despite more than 30 years of research, there is currently no clear explanation why ADHD affects some children. Recently it has been found that there may be differences in the way the brain works in relation to concentration and self-regulation. Research shows that chemicals in the brain, called neurotransmitters, also seem to play a significant role. This aspect of ADHD may be genetic. Food sensitivities have been shown to play a role in less than 5% of children with ADHD.

• ADHD cannot be cured but good management helps. There is no firm evidence that children grow out of ADHD. Left untreated, ADHD may cause significant problems at home, at school and in making and keeping friends.

• To be diagnosed with ADHD as an adult, the symptoms must be present from childhood.

• As children mature into adulthood, some develop strategies to better cope with their symptoms. Many children, however, will carry symptoms of ADHD through to adulthood and if untreated, these result in significant impairment in their ability to study, work and manage their lives.

• ADHD can only be diagnosed by a qualified health professional. A full history and evaluation is carried out and symptoms are checked against a set of diagnostic criteria. A range of tests to exclude other causes of symptoms, e.g. hearing and sight, should be carried out before ADHD is diagnosed. It is vital that an accurate diagnosis is made so the most effective treatment and support can be provided.

• The most effective treatment of ADHD involves a range of interventions referred to as the 'multimodal' approach: family support; educational support; medication; counselling/behavioural management; occupational therapy; speech and language therapy.

• A person with ADHD may have difficulty maintaining relationships or holding down a job. If their condition was undiagnosed and untreated in childhood, their academic record may be poor. A lifetime of grappling with this behavioural disorder often means the person has low self-esteem. In many cases, a person with ADHD turns to drugs or alcohol in an attempt to cope with their feelings of frustration and failure.

• Medications used in the treatment of ADHD include: stimulants (most commonly methylphenidates e.g. Ritalin, Concerta; dexamphetamines e.g. Adderall; and pemocatecholamines, mainly dopamine blockers); antidepressants; and antihypertensives.

• When medication isn't working for an individual with ADHD, or when a parent decides not to medicate, the next best option is behavioural therapy. In fact, most experts recommend that parents and teachers use these techniques even if a child with ADHD is taking medication.
Some studies show that you may be able to lower your child's medication dosage if behavioural therapy is working well.

• The neurotherapy treatment developed for ADHD (also called neurofeedback) involves patients viewing a computer screen, which displays their brainwave activity obtained via EEG sensors on their scalp. Using the visual and auditory feedback provided by the computer, patients learn to reduce slow (theta) brainwaves and increase fast (beta) brainwaves.

• Numerous studies have demonstrated that the behaviour of some children improves when they avoid certain foods. Those children may react to any of a variety of different foods, and those concerned about diet and ADHD hypothesise a toxic or allergic effect by some foods. The most commonly targeted foods are milk, wheat, dyes, preservatives, sugars and caffeine. These diet elements are believed to cause, or at least contribute to, ADHD symptoms.

• The use of ADHD drugs has rocketed in the past decade. Prescriptions for dexamphetamine jumped from 96,000 a year to 232,000 in the 10 years to 2004-05.

• ADHD is now the most commonly diagnosed psychiatric condition among school-age children. In 2000, a federal government report surveyed 4000 people in Australia and found that 11% of parents thought their child had ADHD.

• In September 2005 an analysis of more than 2200 studies into 16 drugs, including Ritalin and dexamphetamine, found there was no solid evidence about the long-term effect of ADHD drugs.