Liam is a 6 yr old boy from Melbourne whose mother is worried that he shows attention deficit
hyperactivity disorder. He can not keep still at home for the last 2 months. He can not sit on a chair and he moves constantly,
touching different objects and furniture in the room.
His mother ( Jennifer ) tries to control him but it works only for a few seconds. His mother is worried about ADHD.
Her friends brought this issue to her attention. ADHD is Attention deficit hyperactivity disorder.
Liam's friend is diagnosed with ADHD recently. Jennifer is not sure what implications it may have on
Liam's future.
ADHD symptoms:
ADHD is the most common developmental disorder of the nervous system in childhood. Its prevalence is 3-5%. Genetic factors play an important role in ADHD. Most children with ADHD have one or two parents with ADHD.
ADHD is twice more common in boys than girls. Its exact cause is unknown. 2 main features are poor impulse control and limited continuous attention to tasks. In younger children, physical hyperactivity can be noticed as well.
It may involve other medical conditions like anxiety, learning disorder, autism spectrum disorder, and tics.
Risk factors for ADHD:
Family history, prematurity, very low birth weight, drinking alcohol during pregnancy,...
Obviously drinking alcohol or other contacts with toxins during pregnancy is preventable.
Family history which is one or two parents with a history of ADHD plays an important role.
Environmental deprivation in infancy was recorded as a risk factor. for effects of deprivation on childhood please click here.
For detailed criteria of ADHD according to DSM-5 please click here.
About two-thirds of children with ADHD have the combined presentation (inattention and hyperactivity-impulsive features). the predominantly inattentive subgroup often presents later with difficulties in school performance.
Jennifer informed me that making an ADHD diagnosis is a complex issue and needs further investigation and assessment. Jennifer reports that Liam's pregnancy was uneventful, with normal vaginal delivery with no complications. He was not premature (term infant). Liam had proper care and attention from Jennifer and her partner. Growth chart checks show no delay in Liam's growth or development.
Immunization is up to date.
His hearing and eyesight were tested before going to school recently.
Liam is very intelligent and his school performance has been satisfactory until 2 months ago. His teacher does not report any hyperactivity or difficulty with him at school. He has at least 9 hours of sleep per night. Jennifer is sure that Liam's diet is diverse with sufficient nutrients and he is not a fussy eater. Liam does not show any nutritional deficiency symptoms.
Jennifer recently separated from her partner (Liam's father) who moved to Brisbane. It happens quickly and Liam has difficulty coping with the new situations at home. Liam asks about his father frequently.
Jennifer informed that Liam does not meet ADHD criteria but due to anxiety/adjustment difficulty needs further assessment with a multidisciplinary team ( GP, Paediatrician, Practice nurse, and Child psychologist). Liam had a psychological evaluation and detailed assessment including ADHD tests by a pediatrician. It came back as adjustment disorder and stress due to his parent's separation. His psycho-educational assessment does not show any learning difficulties or inattention to tasks at hand. Jennifer is happy to take Liam to counsel to help him to cope with the separation of his parents.
Please comment below if you have any experience with ADHD.