Paediatric Neurodiveristy: ADHD
ADHD stands for Attention Deficit Hyperactivity Disorder. This condition is characterised by poor concentration or inattention, where children frequently shift from one activity to another. Many children also experience hyperactivity. ADHD is estimated to affect approximately 5% of all children.
Dr Sara Watkin, Consultant Paediatrician and Neonatologist at Optimal Healthcare in Cayman, provides paediatric neurodiversity care, including support and guidance for managing ASD (Autism Spectrum Disorder) and ADHD in children. This is backed by her own personal experience too.
In this article, we want to offer an overview of the care provided for children with ADHD at Optimal Healthcare in Cayman, including how Dr Watkin diagnoses a child with ADHD as well as information on follow-ups & support after the initial consultation.
General Diagnosis Criteria for ADHD in Children
To diagnose ADHD in children, symptoms must have started before the age of 12. Dr Watkin does mention parents often express concerns about their child’s behaviour as early as age four, but formal diagnosis typically begins around ages five or six.
It is crucial that an ADHD diagnosis is based on symptoms occurring in more than one environment. For example, a child must exhibit the same challenges at school as they do at home. A diagnosis cannot be based solely on symptoms observed in one setting.
ADHD Consultations – Dr Watkin’s Approach
Dr Watkin’s approach to assessing a child with ADHD involves an initial consultation, where she takes a comprehensive history, starting from birth. This includes a detailed family history, as ADHD is known to have a genetic component.
During this consultation, she also explores other possible conditions, such as Autism Spectrum Disorder (ASD), dyslexia, or dysgraphia, which can sometimes present with similar symptoms.
Additionally, she considers other contributing factors, such as sleep disturbances. For instance, some children diagnosed with ADHD have shown significant behavioural improvements after having their adenoids removed. Therefore, taking a thorough history is essential for an accurate diagnosis.
Managing ADHD in Children: What to Expect at Follow-up Appointments
Diagnosing ADHD is relatively straightforward. Simple questionnaires, completed by both parents and teachers, use a structured scoring system to assess symptoms. For a diagnosis, it must be demonstrated that the child’s symptoms occur in at least two different environments and that they impact the child’s performance, particularly in the classroom. These questionnaires can be administered by a paediatrician and do not necessarily require a specialist.
If the results indicate ADHD, the next step is exploring support options. For younger children, this typically involves parent training to help manage symptoms effectively.
Some interventions include:
- Vitamins and Supplements: Omega-3 has been shown to benefit children with ADHD. Certain herbal remedies may also help.
- Dietary Adjustments: Eliminating artificial food colourings (food dyes) from a child’s diet may reduce symptoms.
- Sleeping Habits: Ensuring that the child gets sufficient sleep can have a positive impact on their behaviour.
As children grow older and schoolwork becomes more demanding, medication may be considered as a supportive measure. Follow-ups with Dr Watkin focus on the child’s progress and evolving needs. If a child who previously managed well begins to struggle in middle school – losing books, forgetting homework, or having difficulty transitioning between classrooms – intervention may be necessary.
Collaboration with schools is essential to ensure that children with ADHD receive appropriate accommodations, such as exam adjustments.
Ongoing follow-up appointments help monitor for any additional symptoms as the child matures. Behavioural and psychological training, including cognitive behavioural therapy or social skills training, can further support the child in managing their ADHD effectively.
The ultimate goal is to equip children with the tools and support they need to thrive and reach their full potential.
Video Resources
We also have a video series featuring Dr Watkin describing her approach to ADHD consultations, diagnosing children with ADHD, and more information for parents and guardians in Cayman. These videos are split into three parts and are available to watch here.
