Early detection and specialized treatment

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequent neurodevelopmental disorders in childhood and adolescence. It is estimated to affect a significant percentage of children and young people, and may have a relevant impact on their academic, emotional, and social development if it is not properly detected and addressed.

In our specialized mental health units at Centro Médico Teknon, the approach to ADHD is carried out from a multidisciplinary perspective, with the objective of offering each child and their family a rigorous diagnosis and personalized treatment based on scientific evidence and focused on the individual needs of each child and their family.

What is ADHD?

ADHD is a disorder of multifactorial origin in which genetic, neurobiological, and environmental factors are involved. It is characterized by a persistent pattern of:

Attention deficit:

• They have difficulties maintaining attention in school and social tasks.
• They hear, but they do not listen.
• They do not always follow orders and instructions.
• They have difficulties organizing and planning.
• Learning difficulties may commonly appear.

Hyperactivity:

• These are children who cannot stay still, both at home and at school.
• They get up from their seat, touch everything and cannot keep still.
• In childhood hyperactivity is more significant; later, in adolescence, it’s less evident, with an internal feeling of restlessness often predominating.

Impulsivity:

These are children and adolescents who often interrupt and give hasty answers. Impatient and not very reflective, they act without thinking. This can generate behavioural problems.

To speak of ADHD, the symptoms must significantly interfere in academic, social, or family life and must be present in different areas of the person's life.

Do these symptoms always indicate the presence of ADHD?

A very active or distracted child should not necessarily be a child with ADHD. Consultations are common for children under five years old who present significant non-hyperactive restlessness. They are lively children who require a lot of time and dedication, and on some occasions, they cannot be given the necessary attention they require for other reasons.

There are also children who may present symptoms of ADHD without having it, that is, caused by other causes: this is seen in the genetic alteration of Fragile X Syndrome, in foetal alcohol disorder due to alcohol intake during pregnancy, in phenylketonuria, in lead poisoning and, finally, also due to side effects of some medications such as bronchodilators and antiepileptics.

ADHD is not caused by inadequate education, by the diet received, or is not due to visual problems.

It is important to understand that ADHD is not related to lack of intelligence, laziness or poor education. It is a difficulty in key brain functions such as:

• Sustained attention
• Impulse control
• Planning and organization
• Time management
• Emotional regulation

Clinical presentations of ADHD

According to current diagnostic criteria, ADHD is classified into three presentations, according to the symptomatic predominance:

Inattentive ADHD

Attention difficulties predominate, such as for example:

• Frequent forgetfulness. They may often appear unnoticed, forget tasks or materials, lose objects, and show difficulties in planning.
• Disorganization and difficulties with time management.
• Difficulty finishing tasks and maintaining attention in academic tasks or everyday activities.
• Apparent "disconnection", difficulties following complete instructions.

In some cases, these children go more unnoticed because they do not present disruptive behaviours.

Hyperactive-impulsive ADHD

Predominated difficulties in:

• Constant motor restlessness
• Difficulty waiting turns, difficulty remained seated or still in situations that require it
• Frequent interruptions, answering before time
• Frequent errors due to hasty responses

In young children, motor hyperactivity predominates. In adolescence, this may decrease, but impulsivity (verbal or behavioural) may be maintained in some adolescents, potentially affecting their social relationships and academic performance.

Combined ADHD

Includes significant symptoms of both inattention and hyperactivity-impulsivity.

When to consult?

It is advisable to carry out a specialized assessment when:

• The symptoms persist over time
• They appear in different contexts (home, school…)
• They interfere with academic performance or family life
• They generate distress in the child or in their environment

For all these reasons, early detection and careful assessment by specialized professionals is crucial. Early identification allows an appropriate and individual intervention to begin, which significantly improves the prognosis and quality of life of the child or adolescent and their family environment.

We currently have treatments with solid scientific evidence and, in most cases, with adequate support and approach, evolution is favourable. Early intervention helps to manage symptoms much better.