Many moons ago, when I started my career with children, ADHD and ASD were two words we rarely heard. In fact, when I started my career in early years 24 years ago, most frequently, children were just described as ‘fidgety’ ‘having ants in their pants’ or in worst cases, described as being ‘naughty’.
Whilst we have learnt a lot about neurodiversity over the years, frequently, in my work as a therapist and coach, I come into contact with multiple children who have sat under the radar for ADHD who should have been diagnosed.
The frequent feedback that parents and/or children have received:
- They wont meet thresholds
- The school can manage it
- The child is not affected
- The child is fine at school
- That parents are worrying about nothing
This article is not to tar all settings with the same brush, there are many who are well informed and trained. However, since the pandemic, I have seen an exodus of children who have had symptoms for a long period of time and they have been missed.
Why does this happen though?
Often, this is on the basis of the understanding, training and knowledge of ADHD being out of date. Historically, ADHD was a condition associated with ‘naughty school boys’. The hyperactivity trait of ADHD is the aspect most well-known. However, it is extremely out of date and why so many young people, both male and female fall under the radar and lose out on the help that they both need and deserve.
In the UK, a research survey of 10,438 children between the ages of 5 and 15 years found that 3.62% of boys and 0.85% of girls had ADHD [Journal of Attention Disorders]. Global prevalence is considered to be between 2 and 7% with an average of 5%.
However, less girls are referred for diagnosis than boys, so how accurate are these statistics? See my previous article here.
What are the symptoms?
ADHD has many symptoms, but, as we have noted, hyperactivity and ‘ants in their pants’ is often the one that is most recognised.ADHD (Attention Deficit Hyperactivity Disorder) is a disorder which is categorised into two parts:
- Inattention (concentration and focus)
- Hyperactivity and impulsivity
Symptoms can include:
- Difficulty with impulse control
- Easily distracted
- Difficulty sitting still
- Interrupting others
- Talking excessively
- Difficulty organising tasks
- Trouble focussing
- Missing details
- Difficulty with time management / poor sense of time
- Moving between tasks
- Seeking pleasure or excitement
- Angry outbursts
- Sensory overload
- Emotional dysregulation
- Zoning out
- Short attention span
- Frequently daydreaming
- Difficulty following instructions
- Frequently losing things
- Sleep issues
- Becoming hyperfixated or hyperfocussed on things that they enjoy
- Complaining that everyday tasks are ‘boring’
- Difficulty managing money
- Excessive impulse buys
- Difficulty in social relationships
- Frustration if things do not go their way
- Low self-esteem
- Negative self-image
- Negative body image
- Wanting to always do ‘exciting things’
- Binge eating / eating large quantities of sugar and carbohydrates
- Being hypersexual
- Melt downs
- Becoming burnt out
In fact, no two children will present with ADHD in the same way.
However, the lack of deep understanding of ADHD often means that children are dismissed as not caring, or not being bothered. When, in reality, their amazing brains are not being motivated and supported in the ways that help them. This can lead to huge quantities of frustration for both child and parent.
Many children will be identified with ADHD by the age of 7. However, where traits are associated with inattention and impulsivity, often young people will not be recognised until they are over the age of 14, and there are now many adults being assessed. Often, having spent many years feeling that something, was ‘wrong’ with them.
Do we need a diagnosis?
This is only personal opinion, but from my perspective, young people having a diagnosis is a benefit, in terms of both their personal understanding of their identity, but also in regards to accessing support, interventions, access requirements in exams and support for transitions to college or university, as well as the workplace. For some children, medication can support their needs.
Diagnosis in current timelines, through CAMHS can take 2-3 years, and therefore the earlier this is identified, the better for the child, as whilst children may manage well through primary and junior school, the gaps can become greater in Secondary school.
How can we support children?
- Be their ally – listen and identify the challenges that they are having and utilise neurodiverse communities and ADHD support groups to explore this in more depth. Often, I find that parents had a feeling that their child had ADHD way before it is identified in school.
- Speak with your SENCO – speak with your school SENCO and ask about their observations. You may wish to follow this up in writing to identify an action plan. Schools may wish to observe and collect information and if you can offer insight into your observations this can support the process.
- Seek a second opinion – you can explore issues with a therapist, to identify if symptoms respond to intervention and strategies, and explore whether there may be symptoms which are attributed to other conditions. Learning skills and strategies is beneficial in all cases.
- Contact your early help team – the early help team can often offer signposting and guidance.
- Learn regulation strategies – supporting children to identify regulation strategies to use in areas where they may struggle with impulse control and emotional reactions can give them confidence and raise self-esteem.
- Develop a strong routine – Children with ADHD need strong routines, boundaries and sleep routines.
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