ADHD: Assessment and Treatment

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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects around one in twenty young people. Young people with ADHD may find certain parts of daily life more difficult than others, particularly those that relate to concentration, impulsivity, and activity. While ADHD can make life hard to manage – and may sometimes feel overwhelming – there is plenty of support out there to help young people cope with difficult symptoms, learn useful skills, and enjoy a fulfilling, productive life.

What Is Attention Deficit Hyperactivity Disorder?

Attention deficit hyperactivity disorder affects the way a young person’s brain develops and works. It’s characterised by symptoms of inattention and hyperactivity (also called hyperactivity-impulsivity). The way these symptoms manifest looks different in each individual and may depend on a young person’s age and gender.

While many people with ADHD experience symptoms from both categories, this isn’t true for everyone. Around 2 or 3 in 10 people with ADHD may experience symptoms of inattention but not hyperactivity (also known as attention deficit disorder or ADD).

Symptoms of inattention include:

  • difficulty sustaining attention
  • difficulty organising
  • difficulty paying attention to details or frequently making careless mistakes
  • often not listening when spoken to directly
  • not following through on instructions and not completing tasks
  • reluctance to engage in tasks that require sustained mental effort over a long time
  • losing things necessary for tasks and activities
  • being easily distracted
  • forgetfulness in everyday activities

Symptoms of hyperactivity include:

  • fidgeting
  • finding it hard to stay seated
  • restlessness
  • finding it hard to play quietly
  • talking excessively
  • interrupting others when they are speaking
  • difficulty waiting for their turn

Usually, ADHD symptoms arise during early childhood, but they may continue into the teenage and adult years. Symptoms often reduce and change in character as a young person grows up – adult ADHD symptoms tend to be more subtle and related to inattentiveness rather than hyperactivity.

ADHD is neither a mental health condition nor a learning disability, although it can make having a mental illness more likely. Many young people with ADHD find that they also experience certain “superpowers”, such as incredible creativity, hyperfocus, and abundant energy. With the right support, young people can learn to manage difficult symptoms while appreciating the positive ones.

Read more: What Is ADHD Inattentive Type?

Exploring the Sub-Types of ADHD

Three sub-types of ADHD reflect the clusters of symptoms experienced by a young person. These are:

  • Predominantly Inattentive Presentation, where a person experiences symptoms of inattention, but few or no symptoms of hyperactivity
  • Predominantly Hyperactive-Impulsive Presentation, where a person experiences symptoms of hyperactivity but with few or no symptoms of inattention
  • Combined Type, where a person experiences both groups of symptoms

Diagnosing ADHD

A mental health professional with expertise in neurodevelopmental disorders (usually a psychologist, psychiatrist, or social worker) can diagnose ADHD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an ADHD diagnosis requires that:

  • at least 6 symptoms of inattention and/or hyperactivity have been present for more than 6 months, to an extent that is disruptive to a young person’s life and inappropriate to their developmental level (adolescents over the age of 17 need to show only 5 symptoms)
  • several symptoms were present before the age of 12
  • several symptoms are present in two or more settings (e.g. school and work)
  • symptoms significantly affect a young person’s life, interfering with their ability to navigate school, social, or work environments

The diagnosis process involves a comprehensive assessment using various techniques to gain a deep, broad insight into a young person’s thoughts and behavioural patterns. This may include:

  • Medical History – A licensed medic will offer a detailed history of a young person’s medical conditions, including previous diagnoses and treatment for ADHD or other mental and physical health conditions
  • Behavioural Assessment – Behavioural assessments involve a series of interviews with a young person, their family, or others that know them (for example, school teachers). They may use a variety of standardised scales and questionnaires to evaluate a young person’s symptoms depending on their age and other factors. These may include the Adult ADHD Self-Report Scale, Connors’ Parent Rating Scale and the Behaviour Assessment System for Children.
  • Physical Assessment – A physical assessment looks for any physical health conditions that may explain the symptoms a young person experiences.
  • Differential Diagnosis – A mental health professional will consider what other diagnosis may co-occur with ADHD or otherwise explain a young person’s symptoms, ruling out other options until it’s clear what condition(s) is the most likely cause. They may consider mental health conditions or other developmental disorders such as autism. In particular, the mood swings, irritability, and low-self image associated with adult ADHD may overlap with symptoms of bipolar disorder or borderline personality disorder.
  • Socio-Economic Factors – Mental health professionals will also consider cultural, socio-economic, and other environmental factors that may affect the way symptoms manifest.

How Can You Treat ADHD?

Without effective support, ADHD can have a huge effect on a young person’s life, preventing them from reaching their full potential and enjoying daily life. It may affect their relationships with others and lead to misunderstandings and frustration. The good news is that there are several treatment methods proven to help young people manage ADHD so they can successfully navigate symptoms and live life to its full.

Treatment for ADHD usually involves a combination of medication and therapy tailored to suit each young person’s needs. Their treatment plan may include the following:

  • ADHD Medication – There are five types of listed ADHD medications that may help a young person manage ADHD symptoms: methylphenidate (Ritalin), lisdexamfetamine, dexamfetamine, atomoxetine, and guanfacine. ADHD medications work by changing the balance of neurotransmitters (brain chemicals) in the brain and central nervous system, improving important functions like concentration and focus. While ADHD medications are not a permanent ‘cure’ for the disorder, they may help a young person to focus, stay calm, and develop new skills.
  • Behavioural Therapy – Behavioural therapies, such as cognitive-behavioural therapy – can help a young person learn the skills they need to manage difficult or disruptive symptoms. As well as individual therapy, behavioural therapy can involve parent training and behavioural modification to help you maintain supportive and nurturing relationships with your child.
  • Occupational Therapy – Occupational therapy can help younger children with ADHD to improve certain functional skills, such as organisation, time management, and fine motor skills. It helps children develop the skills they require to complete tasks and other activities of daily living, overcoming the limitations of the disorder.
  • Cognitive Behaviour Therapy – Cognitive behavioural therapy is a type of psychotherapy that focuses on the interaction between a person’s thoughts and behaviours. CBT works in real-time, helping young people to identify negative patterns and turn them into more positive ones. Research has shown the effectiveness of CBT among adolescents, helping to reduce the severity of symptoms over time.
  • Parenting Interventions – Parenting interventions offer support to parents and other family members, helping you to build positive relationships with your child that make it easier for them to manage symptoms of ADHD. These interventions, such as parent-child interaction therapy and behavioural parent training, teach caregivers effective parenting skills, improving family functioning and your child’s self-esteem.

Self-Help and Mutual Care

Aside from treatment, there are lots of other things a young person can do to help them manage their ADHD. It can help them to speak to their friends and others around them so they know how to support them. As a parent, it’s important to have open conversations with your child to discover how you can help them navigate daily life.

They may also benefit from:

  • taking regular exercise to improve their mood and cope with excess energy
  • taking regular breaks when they have to concentrate for a long time so they do not become overwhelmed

Transformative Treatment Experiences at The Wave Clinic

The Wave Clinic offers transformative treatment programs for young people, helping them to overcome the challenges of daily life and build positive futures. Our programs combine exceptional clinical care with education, interpersonal development, and a gap year experience, providing young people with the skills and inspiration they need to live life to its full. Our team draws on experts from around the world who specialise in adult mental health, ensuring each young person receives the very best care available.

At The Wave, we understand that managing developmental disorders and mental health issues requires a caring, supportive environment that promotes whole-person growth. Situated in Malaysia, our clinic offers a community that motivates young people to rediscover themselves and their love of life. During their stay, young people have the opportunity to try out new activities, change paths, and plan a future where they can realise their true selves.

If your child is living with ADHD or another disorder, don’t hesitate to contact us today. We’re ready to answer any questions you may have and explore the next steps.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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