Understanding ADHD: a consultant paediatrician’s guide
ADHD, or attention deficit hyperactivity disorder, is a common neurodevelopmental condition that affects children, adolescents, and adults. Individuals with ADHD may experience persistent difficulties with attention, hyperactivity, or impulsivity, which can affect everyday life.
In this guide, consultant neurodevelopmental paediatrician Dr Hema Palanyiaya explains the key aspects of ADHD, including its symptoms, causes, diagnosis, and treatment options.
What is ADHD?
ADHD is more than being “easily distracted” or “overly energetic.” It is a recognised neurodevelopmental disorder that affects the brain’s executive functions—the skills required for planning, focus, and impulse control. Challenges often impact education, work, and social interactions.
ADHD typically begins in childhood. While some individuals experience a reduction in symptoms with age, many continue to experience difficulties into adulthood. ADHD is divided into three main types:
- Predominantly inattentive: difficulty sustaining attention, following instructions, and organising tasks.
- Predominantly hyperactive-impulsive: excessive movement, restlessness, and impulsive decision-making.
- Combined presentation: symptoms of both inattention and hyperactivity-impulsivity are present.
Recognising the signs and symptoms
Symptoms of ADHD are grouped into three core areas:
Inattention
- Difficulty sustaining attention on tasks or instructions.
- Frequently losing items or forgetting routines.
- Being easily distracted by external stimuli.
Hyperactivity
- Fidgeting, tapping, or leaving seats frequently.
- Difficulty engaging in quiet activities.
- Feeling constantly “on the go”.
Impulsivity
- Interrupting conversations or activities.
- Making hasty decisions without considering consequences.
- Difficulty waiting turns.
Symptoms should be observed over at least six months, as occasional lapses in attention or energy are common in all children.
Causes and risk factors
The exact cause of ADHD is not fully understood, but it involves a combination of genetic, neurological, and environmental factors. A family history of ADHD increases the likelihood. Brain regions responsible for attention and impulse control often show structural and functional differences in individuals with ADHD. Additional risk factors include premature birth, low birth weight, and prenatal exposure to toxins.
Diagnosis and assessment
A formal diagnosis should be made by a qualified healthcare professional. The assessment typically includes:
- Comprehensive medical and developmental history.
- Behavioural observations and assessments.
- Feedback from parents, teachers, or carers.
- Standardised questionnaires and rating scales.
Early diagnosis enables timely interventions, improving long-term outcomes for children and adults with ADHD.
Treatment and management
ADHD is best managed with a combination of approaches:
- Behavioural therapies: support for developing coping strategies and routines
- Educational interventions: tailored classroom support to improve learning outcomes
- Medication: stimulant and non-stimulant medications can regulate attention and behaviour under professional supervision
- Lifestyle adjustments: regular exercise, consistent sleep routines, and structured daily schedules
Treatment should be individualised, considering age, symptom severity, and personal circumstances.
Living with ADHD
With appropriate support, individuals with ADHD can thrive. Awareness, early intervention, and understanding from family, educators, and peers are essential. Many people with ADHD also demonstrate creativity, problem-solving abilities, and high energy that can be positive assets in daily life.
ADHD is a complex but manageable condition. Recognising its signs, understanding the causes, and accessing timely treatment can empower individuals and families.