Is a Hyperactive Child Always Diagnosed with ADHD? Understanding Attention Deficit/Hyperactivity Disorder

Children naturally have energy and love to run and play, but in the field of child psychiatry, there are specific criteria for evaluating their behavior. ADHD, commonly known as attention deficit/hyperactivity disorder, affects approximately 5 to 10% of children and adolescents in Hong Kong, with a male-to-female ratio of around 4:1. It's understandable that many parents question whether their child's energetic behavior is simply typical for their age or if it indicates a genuine case of ADHD.

What’s ADHD?

ADHD is a neurodevelopmental condition characterized by three main behavioral symptoms: inattention, hyperactivity, and impulsivity. Individuals with ADHD often exhibit signs such as being easily distracted, having difficulty concentrating, impatience, forgetfulness, restlessness, dislike for waiting in line, interrupting others, and academic underachievement. These symptoms typically manifest before the age of 12 and persist for at least six months or more. The symptoms may be observed in at least two different settings, such as home, school, or social interactions, and can significantly impact academic performance, social relationships, and future employment prospects.

Can ADHD tendencies in the fetus be detected during pregnancy?

The exact cause of ADHD is still unknown, but many studies suggest an association with imbalances in neurotransmitters like dopamine in the brain. Genetic inheritance, chromosomal disorders, and adverse environmental factors can also play a role. For instance, premature birth, head trauma during infancy, rare conditions like Fragile X syndrome or tuberous sclerosis, maternal substance abuse or alcohol consumption during pregnancy, and exposure to severe environmental toxins can increase the likelihood of a child developing ADHD. However, currently, there are no prenatal genetic tests available to determine the risk of ADHD in the fetus.

Is it just hyperactivity or does the child really have ADHD?

Diagnosing ADHD cannot be done through blood tests or imaging. To determine whether a child truly has ADHD, it is generally necessary to consult a pediatrician, psychiatrist, or psychologist for a clinical diagnosis. They will carefully observe the child's behavior for the presence of the three main behavioral symptoms or developmental abnormalities associated with ADHD. Additional assessments, such as children's daily attention tests or questionnaires, may be used as evaluation tools to confirm the diagnosis. Moreover, the diagnosis of ADHD is typically made at the age of 5 or older, as there are many uncertainties when diagnosing younger children. However, before the age of 5, parents can pay attention to their child's physiological and personality development for any ADHD-related traits. These may include delayed motor, language, or cognitive development, restlessness, difficulty staying calm, and frequent interruption of others' speech or activities. Parents can also choose to have regular monitoring and follow-up with a pediatrician during this period.

How can parents support children with ADHD?

Gentle and positive responses from parents are the best medicine for children with ADHD. Given that ADHD children often experience insecurity, stubbornness, sensitivity, anxiety, and defiant behavior, parents should provide ample encouragement to establish a stable attachment with their child, strengthening the bond. Most importantly, it is crucial to teach children that crying or misbehaving isn't the solution. Instead, they should be encouraged to express their needs verbally, fostering a foundation of mutual respect between parent and child.

Should children with ADHD receive treatment?

Many parents mistakenly believe that ADHD in children is simply a result of incomplete physical or brain development and will naturally improve over time. However, the reality is that around 90% of ADHD cases involve issues with attention deficit. While impulsive symptoms may diminish as the brain's vestibular system matures, attention deficit problems cannot improve without treatment! Attention deficit not only affects a child's classroom and learning performance but can also persist into adolescence and even adulthood, impacting various aspects of life such as social interactions, work, and marriage. Therefore, when a child is diagnosed with ADHD, it is crucial for parents to initiate treatment to avoid missing the golden opportunity for intervention and prevent potential repercussions on their quality of life and values.

The treatment approach for ADHD aims to improve attention, reduce impulsive behaviors, and enhance emotional regulation. For young ADHD patients, behavioral therapy is often employed. This may involve setting simple goals together, allowing them to experience recognition and a sense of accomplishment upon achieving these goals. Gradually, this helps cultivate a sense of responsibility and initiative. For school-aged ADHD patients, the treatment approach may involve a combination of long-acting or short-acting medications, depending on the severity of the condition. These medications can help reduce impulsivity, hyperactivity, and enhance their ability to concentrate in the classroom. It is important for parents to maintain open communication with the school, actively discussing their child's performance and behavior, as this information can assist doctors in adjusting the treatment plan.

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