Does your child have trouble staying in one place? Let's learn about ADHD (Attention-Deficit/Hyperactivity Disorder)!

Is your little one always in one place? Struggling, running, jumping... Are you tired of not paying attention to what is being said? These may be signs of something deeper than we think. That is a condition called ADHD (Attention-Deficit/Hyperactivity Disorder) . ADHD is not just a lack of attention, it is a more complex, brain-related problem. Because of this, they have a little trouble paying attention to certain things, staying in one place, and controlling their thoughts at once. But, the amazing thing is, when they are doing something they love, they can even `hyperfocus` on it!

ADHD symptoms usually begin between the ages of 3 and 6. Sometimes, it can be present even as adults. Some people even recognize this condition after they are older. Although there is no complete cure for ADHD, don't worry, these symptoms can be well controlled with things like medications and behavioral therapies.

Millions of children around the world have ADHD. This condition is common in our country as well. If your child is diagnosed with ADHD, knowing the exact facts about it, as well as talking to other parents of children with ADHD, will be very helpful for you and your child to support them. Don't be fooled by myths.

Are there types of ADHD? What are they?

Yes, doctors talk about four main types when diagnosing ADHD in children and adults:

• Inattentive ADHD: This type is characterized by difficulty paying attention, completing tasks, and keeping things organized. In this type, the symptoms of fidgeting and restlessness are less common, if at all. These individuals are often seen as "dreamers" in the classroom or at home.

• Hyperactive-impulsive ADHD: These people have a hard time sitting still or being quiet. They have a lot of energy and are very talkative. They jump in when others are talking, and they do things without thinking. However, these people may not have obvious attention problems.

• Combined presentation: This is the most common type of ADHD. This is what most people think of when they hear the word ADHD. It combines the previously mentioned inattention and hyperactivity/impulsivity symptoms.

• Unspecified presentation: This type of ADHD is severe enough to interfere with daily life, but does not quite fit the official criteria for the previous types. Doctors then call it 'Unspecified ADHD'.

Also, depending on how much these symptoms affect your daily life, doctors classify it as mild, moderate, and severe .

What are the symptoms of ADHD?

ADHD symptoms fall into two main categories:

1. Inattention symptoms: These symptoms affect your ability to focus on a task and complete it from start to finish. You may procrastinate on tasks that require your attention. You may seem to be distracted even when someone is talking, and you may lose things frequently.

2. Hyperactivity/impulsivity symptoms: These symptoms affect the ability to sit still, stay in one place comfortably, and may have difficulty waiting one's turn or thinking before speaking.

There are about nine symptoms in each of these categories. They are described below. But the important thing is that these are normal behaviors that many children show from time to time. Not every child who does these things occasionally has ADHD. Doctors use very careful criteria to diagnose ADHD.

Attention-related symptoms (in children):

See if your child does things like this:

• Avoids tasks that require a lot of attention (e.g., homework, schoolwork).
• Doesn't pay enough attention to details, or appears to make careless mistakes .
• I often forget things I need to do.
• It's easy to get distracted by things going on around you, and sometimes by your own thoughts.
• Difficulty keeping things organized (e.g., how toys are arranged in the room, how things are arranged in the school bag, how the steps of a project are arranged).
• Difficulty paying attention to what you are doing (e.g., listening to a lecture, reading a long text).
• Loses things they need (e.g., school supplies, pencils, glasses).
• Even when someone is speaking directly, it seems like their mind is somewhere else, or they are in a dream world .
• Even if a task starts easily, it is not finished because the mind is distracted by something else (this can affect doing household chores and finishing them).

Symptoms related to fidgeting/impulsive activity (in children):

Look at these features too:

• Makes small movements with hands or legs, fidgets (especially when eating, doing housework, or sitting in a chair).
• Sit down and get up when you need to.
• It's very difficult to play quietly or do anything else.
• It's hard to wait until your turn comes.
• Interferes with what others are doing (e.g., jumps on other children while they are playing, takes someone's toy without permission).
• Jumping, climbing, running , or feeling restless when you want to stay in one place.
• It always seems to be "on the move" or "like a motor."
• They speak before their turn, or they finish other people's sentences.
• Talking more than expected.

What are the causes of ADHD?

ADHD is genetic . This means that your child is born with genetic changes that cause certain changes in brain development. We call this 'neurodivergence.' Simply put, their brains are wired a little differently. Often, these genetic changes that cause ADHD run in families. Children with ADHD may have biological parents or siblings who have the condition.

Researchers are still figuring out how ADHD affects the brain. What we know so far is that when your child has ADHD, the frontal lobe of their brain is affected, making it harder for them to use 'directed attention' . 'Directed attention' is the ability to focus on something that we're not particularly interested in. Think about it, things like listening to the teacher at school or doing homework.

We use this 'directed attention' to plan, multitask, and solve problems. This is called 'executive functions' . When there are other things around us that interest us, it takes a lot of energy to use 'directed attention'.

If your child has ADHD, it takes more energy than the average person to focus on the things they really need to do. This means that after coming home from school exhausted, your child may be reluctant to do tasks that would normally seem easy, like hanging up their coat or packing their bag, because they don't have the focus they need to do those 'basic' tasks.

On the other hand, your child is better at using 'automatic attention' than children with a typical brain ('neurotypical'). This is the attention we use to focus on something that interests us. This gives us what is called 'hyperfocus' , the ability to do one thing for hours at a time. Your child may use this 'hyperfocus' to become very good at a hobby or sport, or to achieve certain goals.

What are the risk factors for ADHD?

Experts believe that some people have genes that predispose them to ADHD. That is, those genes make it more likely that the person will develop ADHD. But then, certain environmental factors come into play and cause ADHD to develop.

Environmental risk factors include:

• Exposure to certain toxins during the fetal stage. For example, exposure to toxins such as tobacco, alcohol use, or lead during pregnancy.
• Low birth weight (the lower the weight, the higher the risk).
• Premature birth.

What are the possible complications of ADHD?

ADHD can affect the way your child thinks about themselves and interacts with the world around them. Without proper treatment , your child may experience the following:

• Having low self-esteem .
• Low school grades and inability to reach their full potential.
• Having difficulty in social situations (mostly due to being teased by peers or not wanting to hang out with them).
• Increased risk of substance use disorders in adulthood.
• Frequent accidents and injuries .
• Difficulty obtaining and maintaining employment in adulthood.

How do doctors diagnose ADHD?

Doctors diagnose ADHD based on the presence or absence of certain symptoms. They use criteria from the internationally accepted guide , the DSM-5-TR .

To diagnose your child with ADHD, all of the following must be met:

• Your child must have at least six symptoms from one category (inattention or hyperactivity/impulsivity). Or, at least six symptoms from each category (a total of twelve or more).
• Symptoms must have started before the age of 12 .
• Symptoms must be present in at least two places (e.g., at home and at school).
• The symptoms should interfere with the child's daily activities and friendships .
• Another medical condition should not be the cause of these symptoms.

There is no lab test (like a blood or urine test) that can diagnose ADHD. Instead, doctors do an 'ADHD assessment' . This involves talking to you, your child, and other people (like friends, family members, teachers) to learn more about your child's behavior.

Diagnosis occurs in three steps:

1. Identifying behavioral patterns related to attention and activity.

2. Make sure there are no other causes for these behaviors (such as depression or anxiety ).

3. Check for other co-occurring conditions.

Children with ADHD often have other mental health conditions as well. For example:

• Anxiety
• Depression
• Oppositional defiant disorder

They may also have other neurodevelopmental disorders, such as autism or a learning disability . Your child's doctor may recommend additional evaluations to identify or rule out these other conditions.

What should I know about ADHD treatment?

ADHD treatments fall into two main categories: behavioral interventions (which teach practical skills) and medications (pharmacotherapy) . The treatment plan will vary depending on the person's age and personal needs.

If your child has ADHD, their doctor may recommend one or more of these things:

• Parent training: Therapists teach you how to build on your child's strengths and help them improve the behaviors that are causing them problems. For example, you learn to create a routine for your child, encourage positive behaviors, and respond to negative behaviors. This is very important .
• Social skills groups: Your child may benefit from social skills training groups. These groups meet for one or two hours a week, usually for 6-12 weeks. Your child will learn new skills to interact with peers under supervision.
• Medication (`Pharmacotherapy`): ADHD medications improve your child's ability to use 'focused attention.' This can improve symptoms and, more importantly, their quality of life and relationships. Doctors monitor your child to see how the medication is working and if the child has any side effects. They may change the type and dosage of medication as needed.

The goal of ADHD treatment is to improve symptoms as the child goes about their daily lives. For younger children (ages 4 and 5) , doctors recommend parent training before prescribing medication. For older children, teenagers, and adults, the best treatment is usually a combination of behavioral interventions and medication.

There is currently no evidence that traditional 'talk therapy' or 'play therapy' directly helps with ADHD symptoms. However, your child's doctor may recommend such treatments for other co-occurring conditions (such as anxiety).

How can I help my child at home?

Parenting training teaches you effective techniques that you can use every day. Doctors can also give you advice tailored to your child's specific needs. In general, here are some things you can do to help your child. (These are not a substitute for treatment, including medication, recommended by your doctor.)

• Organize the things your child needs every day. Everything should have a place, and everything should be in its place. This includes clothes, bags, and school supplies. A checklist can help keep things organized.
• Get into a routine. Follow the same routine every day from the time you wake up in the morning to the time you go to bed at night. This routine should include time for homework and play. Consistency is very important for children with ADHD.
• Use a calendar or planner where your child can see it. Create a place to write down important reminders, responsibilities, and events. These tools can be especially helpful for young children and young adults who struggle with time management .
• "Catch the child when he's doing something good." Pointing out positive behaviors teaches the child what they should do. When parents only focus on inappropriate behaviors, those behaviors increase. Punishing a child only teaches them what they shouldn't do.
• Discipline effectively. Create a consistent system for rewarding appropriate behavior. Respond to bad behavior with alternative methods, such as giving a ``time out'' or taking away privileges.
• Choose a place to do your homework. Create a quiet, clutter-free, and distraction-free area to do your homework.
• Set a timer. Set a time frame for homework. If your child doesn't finish it, take a short break and set a new time to finish it.
• Praise effort and completion. Instead of showing your child unfinished work, reward them for the work they complete.

Is ADHD a disability?

Yes, in some countries, for example, the Americans with Disabilities Act (ADA) considers ADHD a developmental disability. This condition can affect your child's daily activities, including learning at school. Therefore, your child may need additional support at school, such as ``special education`` and/or ``modified instruction.`` Talk to your child's doctor and school about this.

When should I see a doctor?

If you think your child has ADHD, talk to their pediatrician . They can diagnose ADHD (or rule it out) and make sure your child gets any necessary treatment. Be sure to take your child for regular medical checkups (`well-checks`) . This is so their pediatrician can monitor their development and provide other necessary care.

If you think you may have ADHD symptoms (adults can have ADHD too!), talk to a doctor. They can walk you through the steps to get a diagnosis as an adult. They can also check for other conditions that have similar symptoms.

How long does ADHD last?

ADHD doesn't go away; it's a lifelong condition. But it doesn't have to be a life-threatening condition. You can't 'get rid' of it, but with treatment, your symptoms can be managed well. Thanks to effective treatments, some people no longer have any problems with ADHD symptoms as they enter adulthood. But for others, the symptoms still affect their daily lives. Doctors tailor treatment to each individual's needs.

ADHD is not a brain disorder or defect. It affects everyone a little differently.

So, even if you have the same condition, your child may have a different experience. Their symptoms may be milder or more severe than yours. And their symptoms (just like yours) may change over time.

If you think your child has ADHD, or if they have been diagnosed with it, you probably have a lot of questions. Remember, this condition is very common , and doctors are constantly learning more about it. Your child's doctors can answer your questions and help you understand how to best support your child.

Finally, things to remember

ADHD is not something to be afraid of. It is a subtle change in how the brain works. With proper diagnosis, treatment, and loving support, even a child with ADHD can live a successful, happy life. If you have any concerns about your child, it is never too late to seek medical advice. Remember, you are not alone , and there are many people who can help you on this journey. Recognize your child's strengths and support them with love and patience.

` ADHD, attention deficit hyperactivity disorder, child mental health, behavioral problems, neurodivergence