Effective management and treatment for ADHD

Posted on 1 March 2020

Experts say that effective management and treatment for ADHD depends on the correct diagnosis – and that early diagnosis is key.

According to updated research cited in the 2017 SA Pharmaceutical Journal, Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed chronic childhood disorders in South Africa.

As Dr Marieta Voges, a paediatrician at Mediclinic Vereeniging, explains, many people assume that ADHD presents as an overly energetic, disruptive seven-year-old boy who loves to jump off dangerously high things. “However, there are three different types of ADHD and only a percentage of children with ADHD fit the hyperactive subtype,” she explains.

 

The three different types of ADHD

Hyperactivity/impulsivity: The main symptoms are hyperactivity and impulsivity. Hyperactivity means to be abnormally active while impulsivity means acting with little thought about the consequences of your actions. “Symptoms may include talking excessively, fidgeting, interruptive behaviour and difficulty awaiting his/her turn,” says Dr Voges.

Inattentive type: Here the child has a reduced ability to focus their attention and struggles to process information. “These children don’t display signs of hyperactivity and are often referred to as dreamers,” says Dr Voges. They are easily distracted, forgetful, make careless mistakes and seem not to pay attention.

Combined type: This is when the child’s symptoms don’t fit one of the other categories but the symptoms overlap.

 

Naturally forgetful, fidgety, bored or excitable children are sometimes misdiagnosed with ADHD. “Additionally, other medical conditions (such as autism, bipolar disorder, hypoglycaemia and hearing problems) may mimic the signs of ADHD,” says Dr Voges. Your child should be assessed by a psychologist, paediatrician and occupational therapist or GP before an official ADHD diagnosis is made.

There are many treatment options for this condition, including tailor-made behaviour modification, medication and changes to diet. But as Dr Voges cautions, whether a child is treated with behavioural therapy or a course of medication, these measures are only effective if they are surrounded by a supportive and invested team.

This multidisciplinary team should comprise doctors, teachers, parents, family members and friends. “Teachers need to be prepared to give that child special attention, and parents must do their bit at home as well,” says Dr Hannelie Potgieter, a paediatrician at Mediclinic Potchefstroom. “Then there are educational psychologists and occupational therapists – all of these are specialists in their own way, and they all play a vital role.”

A good paediatrician is at the core of that team.

“What we find works best is when we focus on changing behaviour, as opposed to simply medicating,” says Dr Potgieter. “And that needs to start very early in a child’s life – the sooner the better.”

“No matter how closely a child meets the clinical standards required for us to diagnose them with ADHD, we never begin treatment before the age of five,” she says. “That’s because there is always a chance that these behaviours are in fact age-appropriate, and just a part of their growing up.”

Therapy is also a priority in the early years after diagnosis. “Between the ages of five and seven, we generally steer clear of medication and focus on trying to adjust behaviour, through occupational and psychological therapy.”

 

Further reading:

Is ADHD a learning disability?

Adult ADHD: Your questions answered