What Parents Need to Know About ADHD

According to the Ministry of Health, 5 to 8% of people in the world have Attention Deficit Hyperactivity Disorder and According to the Brazilian Association of Attention Deficit – ABDA, the number of ADHD cases varies between 5% and 8% worldwide . It is estimated that 70% of children with the disorder have another comorbidity and at least 10% have three or more comorbidities.

We spoke with Neuropediatrician Rafael Engel specialist in Neurosciences Rafael Engel to clarify some questions about ADHD.

What is ADHD?

A: ADHD is a neurodevelopmental disorder in which several symptoms of inattention and hyperactivity/impulsivity, present before the age of 12 and in two or more environments, bring about evident social and academic/professional impairments.

– What are the symptoms of ADHD?

A: The core symptoms of ADHD are inattention and hyperactivity/impulsivity. Inattention is seen as frequent wandering, lack of persistence, difficulty maintaining focus and disorganization, despite the individual having a good understanding of what is being asked, nor being challenged. Hyperactivity refers to excessive motor activity when not appropriate (eg, a child who runs around in any environment, or an extremely restless adult who exhausts others with his agitation). Impulsivity refers to social intrusiveness (eg, interrupting others excessively), or rash actions that often put the person at risk (eg, crossing a street without looking), or making important decisions without considerations of long-term consequences (eg, taking a job without adequate information).

– What are the causes of ADHD?

A: The causes and risk factors for ADHD are unknown, but numerous studies have demonstrated the neurobiological basis (ie, genetic and biochemical factors) of the disorder. It is believed that the intensity of the manifestations is a combination mainly of genetics with some environmental factors, such as exposure to toxins during pregnancy (mainly tobacco), prematurity and low birth weight (which, in fact, are risk factors for any disorder of neurodevelopment).

– How is ADHD diagnosed?

A: The diagnosis of ADHD is clinical, that is, it does not depend on any test, and is only performed by specialized doctors (neuropediatricians and psychiatrists). In Brazil, we usually use the criteria described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), organized by the American Academy of Psychiatry, to standardize the diagnosis.

– Is there a cure for ADHD?

A: As with any disorder, ADHD is not a disease, so it is not a cure. It does not cure the disorder. The treatment aims to help the patient to develop tools and strategies to deal with their characteristics so as not to be harmed by them anymore and, with that, to improve their quality of life.

– What are the treatment options for ADHD?

R: Long-term treatment is primarily based on therapeutic and educational interventions (eg Psychology, Pedagogy, among others), aimed at the individual and their family members. It is also based on social changes and adaptations that comply with current inclusion legislation. In the short term, there are some medications available that help alleviate symptoms, but that need to be evaluated and indicated on a case-by-case basis. Some studies are evaluating the benefit of other interventions, such as energy manipulative practices, but still without precise scientific indication.

– What are the effects of ADHD on academic life?

R: The criteria for thinking about the diagnosis of ADHD involve academic impairment, which is not due to an intelligence problem, but because the symptoms of inattention and hyperactivity/impulsivity make it difficult to concentrate in classes, plan, organize and performing tasks and meeting school deadlines (which is what we call executive function). In schoolchildren, adolescents, and even young adults, academic impairment may be hidden by an excessive effort by the environment (ie, caregivers, teachers, etc.) to control symptoms and not let work and deadlines be lost.

– Does ADHD affect only children or also adults?

A: ADHD starts in childhood, but the damage can be noticed even in adult life. The diagnosis is suspected, for example, in individuals who frequently change jobs, cannot remain in relationships or commit minor traffic violations due to carelessness or inattention.

– What are the possible complications associated with ADHD?

R: In addition to the obvious damage to social relationships and academic/professional performance, there are complications mainly associated with the lack of adequate diagnosis and treatment. In addition to the risk of accidents and dropping out of school, there is a greater propensity to develop other disorders (such as anxiety, depression, drug and alcohol abuse) and a greater risk of suicide. That is why it is so important to know about the disorder and to refer it, even in childhood, for evaluation, but also that adults seek, or are referred by their family members, adequate help.

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