What is ADHD?
According to CDC
ADHD is described as: "one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active."
ADHD is not a disease or a disorder with a specific cause, but a label for a broad set of symptoms. It also does not hinder a person’s intelligence, but can coincide with learning difficulties.
- ADHD combined type – if the child meets the criteria for both inattention and hyperactivity-impulsivity for the past six months
- ADHD predominantly inattentive type – if the child meets the criteria for inattention, but not the criteria for hyperactivity-impulsivity, for the past six months
- ADHD predominantly hyperactive-impulsive type – if the child meets the criteria for hyperactivity-impulsivity, but not the criteria for inattention, in the past six months.
It is important to know that although all children struggle with paying attention, only some have ADHD, and those that do experience a severe hindrance of their everyday life by their symptoms.
Who can assess my child and how is a child diagnosed with ADHD?
If you’re concerned about your child’s behaviour, your GP is a good place to start. Your GP might refer your child to a pediatrician, a psychologist or a child psychiatrist for a diagnosis of attention deficit hyperactivity disorder (ADHD) or other conditions.
There isn’t one standard test—diagnoses are made by observing symptoms in most areas of a child’s life and looking at a variety of sources of information.
The diagnosis process might include most, if not all, of the following:
- an interview with you and other primary carers of your child
- an interview with your child
- behaviour checklists that you and/or your child’s carers and teachers fill out
- discussions with your child’s teachers or carers
Your child might also have other tests, including:
- developmental, learning, educational or IQ checks
- language, speech and movement checks
- general health checks
- vision and hearing tests.
A commonly used assessment tool is the Standardized DSM-5
criteria which may be used by your paediatrician to assess ADHD. It looks to determine if symptoms are excessive, long-term, and pervasive. Criteria includes at least 6 symptoms occurring in multiple areas of a child’s life under the age of twelve.
A child with symptoms of inattention will, on a regular basis:
- not give close attention to details, or make seemingly careless mistakes in school work or other activities
- have difficulty sustaining attention in tasks or play activities
- not seem to listen when spoken to directly
- not follow through on instructions
- not finish school work, chores or other duties (but not because they are being wilful or do not understand instructions)
- have difficulty organising tasks and activities
- avoid, dislike or be unwilling to do tasks that need continuing mental effort (such as school work or homework)
- lose things needed for tasks or activities (such as toys, school assignments, pencils, books or tools)
- be easily distracted
- be forgetful in daily activities.
Why is it important to get an assessment?
To be able to start treatment, a child needs to be assessed. Treatments could include medication, psychotherapies like behavior therapy, and/or counselling for children and parents. Early intervention is the key to supporting children with ADHD.
ADHD can be also be caused by many different underlying factors, such as brain injury, PTSD and abuse, and ADHD can also be co-morbid with other issues like ODD, learning difficulties, mood disorders, and ASD. So, a diagnoses of ADHD can uncover these other underlying issues which would be important to identify and treat.
For as common as ADHD is, there can be a significant lack of awareness and support among the greater community. Often parents lament how they feel alone with their struggle and confused on how to support their child.
We asked some parents to share with us the concerns and struggles they have experienced in parenting a child with ADHD, here is what some of them said:
"..We had tried various psychologists/ASD assessment centres for our daughter and told she was "just difficult". When we finally got a diagnosis of ADHD/ODD and learning problems, we were sort of left to it – told there was no funding for ADHD. School was great and organized, with a one-on-one weekly tutor for her, but at their own expense and effort. It would have been fabulous to have received a website/booklet/list with the following:
- Clear guidelines to what does/doesn't receive any funding
- How to approach school and understand what you might push for in terms of what your kid needs Peer (other parents) reviewed lists of social courses/OTs, learning/education, psychs/speechies/docs for sensory/eating issues/inclusive, and specialised camps/school holiday programs.
- Facebook support groups, especially localised ones
- Core reading recommendations
Based on these concerns, MyCareSpace reached out to parents of children with ADHD to get some of their suggestions and we came up with a few of our own ideas.
Find these below:
What to do next after an ADHD Diagnosis?
Managing your child's ADHD is as much about managing your child as it is about managing your own support structures, informing yourself, understanding your options and accessing any funding which may be available
There are a number of ways to help reduce your child's ADHD symptoms. These include:
- medication – ADHD medications are most commonly stimulant medications. They can reduce hyperactivity and impulsivity and improve a child's ability to focus, work, and learn
- psychotherapies such as behaviour therapy and cognitive behaviour therapy
- counselling – for your child and other family members.
The program for managing ADHD needs to be tailored to the individual child. Some therapies are more useful for controlling anger, while others are better for treating impulsivity.
Generally, the range of non-medication therapies used for ADHD can include:
- Behaviour modification
- Cognitive therapy
- Anger management
- Social training
- Family counselling
If you would like to further investigate some of these therapies and how they work or might help, refer to the VicBetterHealth .Therapy can be the best support available, not just for the child but also for parents and the whole family. Many don’t consider therapy for adults, but these services can be particularly helpful. Many parents have struggled with undiagnosed ADHD their whole lives, and many have struggled with mental illness after taking care of their undiagnosed child for years.
According to VicBetterHEalth
, stimulant medications have been used as ADHD medications for over 50 years. They can reduce hyperactivity and impulsivity and improve a child's ability to focus, work, and learn. However there are many types to consider with different side effects and benefits. The stimulants available in Australia are methylphenidate and dexamphetamine. Both have similar actions and side effects. Another more recent type of medication is called atomoxetine (Strattera).
Take your time to work with your doctor so you and your child so you can make an informed decision on which, if any, medication to give is best. Do your research, talk to other parents, get a second opinion as embarking on pathway of medicating your child can be an emotional and physical roller coaster.
The symptoms of ADHD can make it difficult for a child to succeed in school. Additionally children with ADHD are usually not in special education and their teachers may not be familiar with the disorder. A diagnoses can give you a justified reason for why your child should receive special attention.
Consider seeing a counselor or advocating service, as they can inform you on your child's rights at school and what you are entitled to ask a school to do for a child. Then meet with/bring ADHD printouts to parents and principals to discuss your child’s difficulties and how they can personally address them. Another useful reference is the article we shared on navigating the school system when you have a special needs child.
ADHD tutoring can cover a number of aspects that your child and family struggle with. A tutor can help them 'catch up' what they have missed during class whilst they were bouncing from foot to foot or staring out the window.
A tutor can help them prepare for class so that they have a little confidence under their belt to start.
Most importantly a tutor can help with homework and take the stick waving away from you, the parent.
Find out more about ADHD Tutoring
Become familiar with the Department of Human Services and Centrelink, which is the government agency which controls any funding you may be entitled to. Based on feedback from parents with a child with an ADHD diagnosis alone, it is much more difficult to qualify for a carers payment or allowance. it is however possible but a child with ADHD may sometimes have a dual diagnosis with ASD or ODD or GDD which again based on parent feedback, seems to make it easier to qualify for any Centrelink funding.
Familiarise yourself with the criteria for the carers allowance or carer supplement
as a parent of a child with ADHD. To be eligible both
the carer and person needs to be a permanent resident of Australia
. There are strict eligibility criteria and entitlement is based on a points system not on diagnosis alone
. It appears that there is inconsistency on how successful people are in receiving the funding. The allowance is not income or asset tested.
Here are some comments and advice from parents who have successfully received funding:
"Centrelink approves the Carers payment on a point basis not a diagnosis. You need to make sure that whatever professional you get to fill in the form knows exactly how difficult your day can be. Whoever fills in the form pretty much determines whether or not you will get the payment."
"Make sure the specialist completing their part of the form does so well and includes extra information in writing regarding therapy, medication costs and the everyday impact on life."
Another parent said:
"I just made sure my doctor listed everything in the comments section like
- Speech delays
- Angry issues
- Separation issues
My list of issues was pretty extensive and covered absolutely everything even down to not eating and can't do self care things on her own ect the more details I reckon the better '
Further funding may be accessible for some of the medication which is prescribed. Stimulants are available in Australia on the government Pharmaceutical Benefits Scheme (PBS), and the cost is the usual prescription fee or health care card holder fee.
Any health related costs may be covered by Medicare however under the NDIS, ADHD does not qualify as a disability and people with ADHD will not be regarded as eligible for the NDIS funding.
An advocating service, especially if you have an older child that doesn’t qualify for early funding, can also help you determine what government supports you can claim.
Consider accessing Ability Links
to help build stronger circles of community based supports for yourself and your child. As a carer, a valuable government website offering different types of support can be accessed at the Carers Gateway
As a parent, you set the foundation for your child’s development. Work on positive parenting techniques, and consider taking parent skills training workshops that teach how to encourage positive behaviours in children. Work on managing parental stress. Date nights and joining local or online support groups are wonderful way to do this.
When caring for a child with ADHD, keep things simple and consistent. Establish consistent routines, give them few instructions at a time, have them repeat instructions, stay calm, praise good behavior, and be clear with unaccepted behavior. Limit their television time and computer time, and make sure you have their undivided attention when talking to them.
Supportive Facebook Groups
There are several ADHD support groups on Facebook but many of the Facebook groups are closed so you will need to request joining them. We suggest you search using the tag, ADHD and select one in your city or local area. Some of the larger ADHD Facebook groups include:
Here are some Australian ADHD groups that are evidence-based
Sources used in this article:
If you are looking for therapists specialising with ADHD we suggest you type 'ADHD' on mycarespace or 'cognitive therapy'
This article was written by Nicole Gamerov for MyCareSpace with the objective of making information on the topic more accessible. If you have concerns about your child you should consult your health professional.