ADHD

How Can You Best Support Your Child With Attention Deficit Hyperactivity Disorder?

I know first-hand how challenging it can be living with ADHD. I didn't realise I had it myself until I was well into my 20s. A number of my family members have this condition and so do both my sons, aged 24 and 12. ADHD interests me both personally and professionally.  As an integrative therapist, I work holistically to support both adults and children who have the condition.

ADHD is one of the most common neurodevelopment disorders of childhood. Lancet and NICE data reveal that an estimated 2.6 million people in the UK have ADHD, 708,000 of which are children. This figure is debatable as there are many adults and children who go undiagnosed. Further research in a survey of 10,438 children between the ages of 5 and 15 years found that 3.62% of boys and 0.85% of girls have ADHD. Why is there such a disparity in gender split? (roughly 4:1 boys: girls). Do girls mask better and go undiagnosed or misdiagnosed? When untreated, symptoms can intensify during the teenage years because of hormones. This is a lifelong condition but changes in estrogen can affect the intensity and presentation of ADHD symptoms at different stages of life, such as in puberty. I don't see significant differences in the symptoms between boys and girls but I do quite often see these symptoms presented in very different behaviours. Possibly because of the structural and functional differences between the male and female brain.

Neuroscience And The ADHD Brain

ADHD is a complex neurological condition. The ADHD brain produces low levels of a neurotransmitter called Norepinephrine which is linked hand-in-hand with dopamine. Dopamine helps control the brain’s reward and pleasure centre. The ADHD brain has impaired activity in four functional regions of the brain. The Frontal Cortex is where we control high-level functions such as attention and organisation. The Limbic System is located deeper in the brain and regulates our emotions and attention. A deficiency in the Basal Ganglia can result in intention and impulsivity. The Reticular Activating System is a relay that has many pathways to entering and leaving the brain and a deficiency can cause inattention and hyperactivity as well as impulsivity.

What Causes ADHD?

There is no one specific cause of ADHD. It is considered to be a result of an often complex interplay between genetic and environmental factors – with genetic factors being responsible for 70%-80% of the probability. This condition is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviours, may act without thinking about what the result will be, or present with being overly active.

Does your child struggle with sleep or staying asleep? The ADHD brain is hypersensitive to external stimuli. This is particularly true at bedtime, when racing thoughts, ticking clocks, tempting screens, and even thirst may keep your child awake far too late. It may seem that they need less sleep than other children but they often need more. Having ADHD can be exhausting and places demands on the brain and the central nervous system. There is a direct link between quality sleep and behaviour in children, affecting how they feel about their day, about themselves and the world around them.

Does your child find it hard to concentrate at school? Are they easily distracted or uncomfortable with sitting still? Does your child struggle to retain information or have difficulty listening or following instructions? This can make activities such as getting ready for school challenging.

There are many symptoms associated with ADHD and because symptoms can change over time, how a child presents going into teens and adulthood with ADHD may change over time as well.

Typical Symptoms

Difficulty holding attention on tasks or play activities

Difficulty listening when spoken to directly

Difficulty with following through on instructions

Demand avoidance - often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time -

Often loses things necessary for tasks and activities

Forgetful

Un-organised

Often fidgets or taps

Often “on the go” acting as if “driven by a motor”.

May talk excessively

Blirt out inappropriately (No filter)

Impulsivity

I tend to see girls as being less externally hyperactive and impulsive than boys but their internal hyperactivity is very apparent in the form of overthinking anxious and intrusive thoughts.

Hyper-fixation is not unique to individuals with ADHD. But almost every child with attention deficit hyperactivity disorder knows what it feels like to become so engrossed in something — a book, gaming — that they block out the world around them for hours at a time. With self-awareness, hyperfocus can be transferred to serve as a positive in lots of ways, ie. seeing through projects with immense attention to detail.

Treatment

Treatment plans are dependent on a child's specific circumstance and options, used individually or together, these often include counselling, social skills, family therapy, school-based interventions, and parent or carer ADHD education about the condition. If your child has ADHD it’s useful to understand how they may behave and what they need from you.

Medication

There are medications available for children with ADHD on prescription and this is always based on the recommendation from your child's consultant and is a personal choice for parents if they choose to go this route. If regular sleep quality is a problem too your child may also be offered Melatonin on prescription. Melatonin is a hormone that we all naturally produce that makes us feel sleepy but children with neurodevelopment disorders seem to have difficulty producing this hormone and poor sleep regularly presents as a symptom for children with ADHD.   

Working With Your Child Holistically

I work with children holistically.  As an integrative therapist, I use various therapeutic models and regard their well-being as a whole rather than just treating their symptoms. This approach I have found gets long-term results.

You can expect your child to work with me on mindfulness techniques, narrative and mindset, tools for managing anxiety, focus and behaviour, self-esteem, confidence and healthy boundaries. Your child's treatment plan will cover recommendations for nutrition and supplements, exercise, sleep hygiene and possibly intervention with your child's school.

Session time is 50 minutes weekly for the first 6 sessions and every session we also explore feelings, emotions and worries. On the 5th session we will discuss if your child needs further sessions and if this is the case, the next set of sessions will take place bi-weekly.

A typical session includes:

gathering information about patterns of behaviour

identifying how important needs are being met

revealing strengths and resources

agreeing on clear goals for the session and a strategy for change

using a range of therapeutic tools 

I usually teach new skills in the session and rehearse these with your child - and even teach you how to use these and other skills at home. This ensures that positive changes are deepened between sessions.

Living with ADHD can feel isolating as a child. With the right support though and gaining a better understanding of who they are, children with this condition can thrive. Overcoming in fact many challenges day to day that previously may have seemed overwhelming.

I often see a sixth sense in the children I work with who present with ADHD. A sensitivity that gives them a unique way of seeing right into the heart of others.

ADHD may play a part in who our children are, but it's worth remembering that this is not all of who they are. Hyper-focus, resilience, creativity, incredible conversational skills, spontaneity, and abundant energy are all very wonderful attributes if channelled positively.

www.louiseaspnall.co.uk