The exact cause of attention deficit hyperactivity disorder (ADHD) is not fully understood. If your child has ADHD, you may worry that it is somehow your fault, but there is no evidence that parenting technique, or family stresses, can trigger the condition. There are several possible causes of ADHD which are detailed below.

Genetics

ADHD tends to run in families and, in most cases, it is thought that inheriting the condition is the most likely cause. Research shows that both the parents and siblings of a child with ADHD are four to five times more likely to have ADHD themselves.

Brain function and anatomy

Although the exact cause of ADHD is still unclear, research shows that the way the brain works in people with ADHD differs from that of people who do not have the condition. It is thought that chemicals in the brain that carry messages, known as neurotransmitters, do not work properly in people with ADHD. Also, people with the condition seem to display less activity in the parts of their brains that control activity and attention.

Some research shows that the frontal lobes, which are the part of the brain that control decision making, do not work as they should in people with ADHD. Other research indicates that they may have imbalances in the levels of certain chemicals, such as noradrenaline and dopamine.

Exposure to toxins during pregnancy

Women who smoke when they are pregnant are more likely to have a child with ADHD. Drinking alcohol, and drug abuse, can also increase the risks of ADHD in an unborn child.

Being male

Boys are more commonly diagnosed with childhood ADHD than girls, and this trend continues into adulthood, as more men are diagnosed with the condition than women. Some research suggests that this could be due to the tendency for the diagnosis to pinpoint loud, disruptive behaviour, which is more noticeable and more common in males than in females. It could also be that ADHD is missed in girls because they tend to have the form of the condition that is defined by inattentiveness, that is ADHD mainly inattentive, or attention deficit disorder (ADD).

Excessive exposure to television

There have been several studies that have looked at the relationship between children watching an excessive amount of television at a very young age, and the development of ADHD in later childhood. There is not enough evidence to say that television is definitely a cause of ADHD, but allowing children between the ages of one and three to watch several hours of television a day could possibly contribute to attention problems and ADHD in later life.

Food intolerance

Food intolerance is not a direct cause of ADHD, but some studies have suggested that there may be a link between childhood ADHD and common food allergens, such as milk, wheat and nuts. However, there is no evidence that sugar causes symptoms of ADHD.

Other causes

Other possible causes of ADHD include being born prematurely, and having a low birth weight. It may also be linked to brain damage either in the womb or in the first few years of life. Also, having a hearing impairment may increase the risk of developing the condition

Diagnosing ADHD

There is no simple test to determine whether you or your child has attention deficit hyperactivity disorder (ADHD). If you think either you or your child may have ADHD, see your doctor who may refer you (or your child) to a specialist.

The specialist, who will usually be a psychiatrist (an expert in mental and emotional health) or a pediatrician (an expert in children’s health) can make an accurate diagnosis after a detailed assessment.

The assessment should include a physical examination, which will rule out other possible causes for the symptoms, and several tests that can determine your (or your child’s) short-term memory, concentration, and problem-solving skills. The assessment may also involve a series of interviews with you, or your child, and interviews or reports from other significant people, such as partners, parents and teachers.

Diagnosing ADHD in children and adolescents

Diagnosing ADHD in children depends on a set of strict criteria. The criteria for diagnosing ADHD is outlined below.

1. To be diagnosed with ADHD, your child must have six, or more, symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness. The type of ADHD your child will be diagnosed with will depend on the number of symptoms they have from each group. For example, if they have eight symptoms of hyperactivity and impulsiveness, and only three symptoms of inattentiveness, they will be diagnosed with ADHD mainly hyperactive-impulsive.
2. To be diagnosed with ADHD, your child must have been displaying symptoms continuously for at least six months.
3. To be diagnosed with ADHD, your child must have started to show symptoms before the age of seven.
4. To be diagnosed with ADHD, your child must have be showing symptoms in at least two different settings, for example, at home and at school. This is necessary to rule out the possibility that the behaviour is just a reaction to certain teachers, or parental control.
5. To be diagnosed with ADHD, your child must have symptoms that make their lives considerably more difficult, on a social, academic or occupational level.
6. To be diagnosed with ADHD, your child must have symptoms that are not just part of a developmental disorder, or difficult phase, and are not better accounted for by another condition.

Diagnosing ADHD in adults

Diagnosing ADHD in adults is more problematic than it is in children because there is no definitive list of symptoms that can be applied to an adult who potentially has the condition.

If you think you may have adult ADHD, you should see your doctor, who may refer you to a specialist. They will ask you about your present symptoms, but under the current diagnostic guidelines, a diagnosis of adult ADHD cannot be confirmed unless your symptoms have been present from childhood.

In order for your specialist to decide on your diagnosis, they may ask you about your childhood, and whether your symptoms were present then. If you find it difficult to remember, or you were not diagnosed with childhood ADHD at the time, your specialist may wish to see your old school records, or talk to your parents, teachers or anyone else who knew you well when you were a child. If your problems are recent, and did not occur regularly in the past, you are not considered as having adult ADHD.

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