Your questions answered: Part three | ADHD in children: What to look for and what to do next

Dr Heidi Phillips, and Charlotte Jarvis, Practice Manager at Oxford ADHD & Autism Centre recently presented on the key signs of ADHD in children, how it can present differently depending on age and gender, and what steps parents and carers can take if they have concerns.

Within the session, they covered:

• Common signs of ADHD in children and how they may show up differently in boys and girls

• How ADHD can affect learning, friendships, and emotions

• When to seek professional advice and what the assessment process involves

• Practical strategies to support your child at home and at school

After the presentation, Dr Heidi covered a wide range of questions, and this post is the third in a series covering the most frequently asked questions. If you have not yet had an opportunity to watch the webinar, you can access the replay.

Questions answered in this post

• How do I know if it's ADHD or autism?

• Are there any clear distinguishing signs of autism, particularly thinking about girls?

• I am not sure if I should consider medication for my child if they are diagnosed with ADHD?

• If a child struggles with worries and anxiety, is that a sign of ADHD?

It comes down to the diagnostic criteria. For ADHD, we are looking for predominantly inattentive, predominantly hyperactive-impulsive, or a combination of both.

For autism, we are looking at social communication differences and repetitive restrictive behaviours. It might be things like repetitive body-focused behaviours, such as stimming, collections, fascinations, or real special interests. Those special interests might not be trains, they might be makeup, for example.

I had a beautiful assessment recently where I started with the young person, in this case a girl. What concerns do you have? What are your difficulties? Not what mum thinks your difficulties are.

This young lady said, “I hate going to school. I'm really struggling with school. And it's not just the work, it's the friends.” Her main impairing difficulty was friendships.

When we unpicked that, she felt like she was the zebra in a field of horses. She did not know how to get in, how to make those social overtures, and always felt like she was being left out.

So social communication differences are features of autism, not ADHD. The criteria for ADHD are inattention, hyperactivity, and impulsivity, not social communication differences.

Good question. As a mum of four children, I absolutely relate to that question.

Medication can be transformative, and medication is one of the tools in your toolbox. I have read some research that shows if you start a child on medication, those executive function pathways can help get rewired. The changes with focus and attention that you manage to achieve with medication can then be long lasting and might not be something they need to continue throughout life. That same research does not apply to adults. Starting an adult on ADHD medication does not have the same long-lasting effect. It works while they take it and stops working when they do not.

Firstly, it does not have to be now. You have the diagnosis; you have the assessment. Nobody can take that away from you. It depends on what you want to do with it. You can hold it and live with it and learn from it and think about it.

If you decide to go for medication, a good clinician will talk you through the pros, the cons, how it works and what it does. Remember, it's called a medication trial for a reason. We are going to try it; we are going to suck it and see. If it works, great. If it does not, stop it. You are not changing your child. If the medication does not work, okay, the medication does not work. We can mix and match and try others.

I think the more I have gone along this journey, I have recognised that anxiety and depression are physiological responses to stresses. So why is a child anxious?

If a parent is noticing their child struggling or seeing signs like that, do not do what I did. Do not invalidate. Do not say, “oh, do not be silly, darling, you are fabulous,” or “they are all just jealous,” or “there is nothing to be anxious about.” Listen to what your child's telling you. Validate their concerns and, depending on their age, try to understand what the anxieties are related to, what their concerns are, and how they hope you can help.

You do not necessarily want to go guns blazing into school. Ask what they want. I tend to share my concerns, like “I'm worried because...”, and then try and get my children to talk about their concerns. Together, work through, “what do you want this to look like?” and “how can we work together to come to a solution?”

I think my job as a mum is to try and help my children to understand and embrace who they are rather than feeling they need to be someone else. If your child is struggling, try and notice what they are struggling with, then work through that and see if you can come up with some solutions together.