ADHD or ADD (Attention Deficit Disorder) is a condition that appears in early childhood and is defined by a cluster of behaviours causing a child to be inattentive, impulsive or hyperactive.

ADHD can make it difficult for children to inhibit or moderate their responses to stimulus, leading to spontaneous and unfiltered behaviours affecting speech, movement and attentiveness.

If untreated, the condition can lead to delays in a child's learning, development and social relationships. ADHD symptoms are classified as one of three groups; inattentive, hyperactive or impulsive.

PROBLEMS ASSOCIATED WITH THIS CONDITION

ADHD is often identified and diagnosed in early childhood, when many children experience phases of being particularly impulsive, inattentive or hyperactive. However, this can be part of normal development and does not necessarily indicate ADHD. Below are some of the most common signs of the condition that we would recommend warrant further investigation. As the condition is generally diagnosed within the 3 key areas of inattention, hyperactivity and impulsivity, we have listed the possible symptoms within these categories:

Inattention: this is where a child with ADD or ADHD finds it difficult to focus and pay attention to anything that they are not immediately engaged in. They often 'tune out' and their attention will drift.

• Little attention to detail or instruction
• Rushes activities and frequently makes mistakes
• Easily distracted
• Difficulty following instructions
• Poor memory for recent conversations, instructions or events
• Difficulty getting organised to leave the house, preparing for school or getting dressed
• Frequently loses items such as clothes, school equipment or toys

Hyperactivity: this is the most common associated symptom of ADHD and children with the condition are often 'on the go'. Even when they are sitting or standing still, children with ADHD will often have a leg tapping, arm shaking or fingers drumming.

• Fidget frequently and have difficulty sitting still
• Struggle to remain seated in a classroom or at the meal table
• Talk excessively
• Overly energetic or always �on the go�
• Find it difficult to relax or play quietly

Impulsivity: this can be one of the most socially challenging symptoms of ADHD causing an inability to moderate their physical and verbal responses.

• Often struggle with taking turns and sharing
• Will regularly shout out in class, talk over people or interrupt others
• Difficulty controlling emotions such as sadness or anger and may be prone to angry outbursts

HOW CAN THESE DIFFICULTIES IMPACT ON FUNCTION?

Occupational therapists will observe your child and analyse how some of the difficulties that they are experiencing directly affect the function of the child within both the home and school environment. Some examples of how ADHD impacts function are below:

Home:

• Struggles to follow instruction
• Doesn't like sharing or taking turns
• Finds it hard to concentrate on homework
• Can be too rough with siblings
• Difficulty sleeping

School:

• Doesn't listen in class
• Easily distracted
• Talks over teacher/ other children
• Doesn't follow rules
• Can't sit still
• Struggles to concentrate
• Finds accurate movements in P.E difficult
• Can be involved in many incidents on the playground

OCCUPATIONAL THERAPY TREATMENT AVAILABLE

Our team of expert paediatric occupational therapists are skilled at working with children with ADHD/ADD. We recognise that the condition affects each young person and family differently and therefore aim to provide a consultative approach to help them manage everyday life.

Management strategies for home or school may be:

• Sleep training strategies - to reduce night time activity and waking
• Social stories - to help teach the child how to act in certain situations such as initiating social communication with class mates
• Sensory processing - to identify what the difficulties are and their impact on daily life, then provide strategies and treatment as needed. Sensory processing for children with ADHD is a very successful treatment method and can assist a child to remain focused for increased periods of time
• Visual cues - to support routines, we look at breaking the tasks down into small, achievable activities to help the child remain focused and develop independence
• Routines - providing ideas to give routine and structure to manage daily life and cope with changes when they occur.
• Physical skills -to develop strength and coordination, enabling a child to participate in activities with their peers.
• Educating school or nursery staff - on how to help a child with ADHD engage with the curriculum within their own parameters.

Occupational therapists are experts at analysing how a condition is impacting upon a person's ability to perform occupations. A child with ADHD has many difficulties surrounding concentration, memory and multi-tasking. The occupational therapist has a multitude of options and therapy treatments aimed at improving the difficulties associated with ADHD. Some of which are listed below:

• Adaptive equipment such as ear defenders or a concentration board
• Concentration and memory improvement therapy
• Gross motor activity training
• One on one treatment
• Group therapy regarding ground rules and waiting their turn

SPEECH THERAPY TREATMENT AVAILABLE

The speech and language therapists will carry out an initial assessment which will evaluate and identify the type and severity of the difficulties the individual is experiencing in their speech, language and communication. Following an initial assessment and discussion with the individual and their parents / carers, the speech and language therapist will implement an individualised treatment plan which will be tailored to the specific needs and abilities of the individual with ADHD.

The speech and language therapist can use a variety of interventions which will be dependent on the specific needs and abilities of the individual. Intervention will delivered using a behavioural approach with positive reinforcement and structure for the individual. Speech and language therapists will work closely with educational staff to ensure the individual is reaching their full potential in achieving their academic goals.

Speech and language therapists will also work closely with educational staff and the individual's family members, providing them with support, strategies and techniques which will improve and develop the individual's speech, language and communication skills. Speech and language therapy aims to maximise the individual's communication to their highest potential in their home and educational environments.

Speech and language therapy is extremely beneficial for individuals with ADHD who have speech, language and communication difficulties. By improving and supporting an individual's communication it will also benefit the individual in their academic achievement and social skills.