Comment: Reviewing social care and ADHD
Nikos Myttas
pp 3-3
There has been a steady increase of looked-after children (LAC) in the care system over the past years: 28,220 children were taken into care during the year ending 31 March 2012 compared with 27,500 children the year before, an increase of 3%. Those most affected are in the ten- to 15-year-old bracket, bringing the total of LAC to 67,050. The death of Baby P in 2007, after months of abuse, is thought to have contributed towards a more cautious and proactive approach in the social work profession. How well have these children been comprehensively assessed regarding their physical, mental, cognitive and social development prior to being moved out of their parents’ care? The answer is invariably ‘not very well’ and a number of reasons can be cited for these multiple failings: lack of resources, poor or absent training, lack of expertise, personal and professional bias, organisational barriers and interprofessional rivalry.
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Adult ADHD and intellectual disability: diagnosis and therapy
Marios Adamou, Marian Quinn and Mandy Graham
pp 4-5
As recently as the 1980s, it was believed that people with intellectual disability (ID) did not have the cognitive capacity to experience mental health problems and that behavioural disturbances were attributable to ID. Thankfully, the literature caught up with clinical experience and it is now accepted that people with such disability do experience the same mental ill-health as those without it and that they are probably more vulnerable. Epidemiological studies estimating the coexistence of attention deficit hyperactivity disorder (ADHD) in this population were mired with difficulties as they required valid and reliable measurements of both the learning disability and ADHD, which were not always available. As a result, rather unhelpfully, the rate of coexistence was initially calculated to be 10–92%.
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ADHD and children in care
David Bramble
pp 6-9
Currently, there are approximately 67,000 infants, children and young people in the lookedafter care (LAC) system in England, of whom 75% are in foster care and 12% reside in children’s homes, secure units, residential schools, hostels and other specialist placements; the rest reside with their parents but under a statutory care order. Nearly two-thirds of those in care are placed there because of parental abuse or neglect. Epidemiological evidence has revealed that rates of attention deficit hyperactiviy disorder (ADHD), autism and a range of other common neurodisabilities are significantly higher in these children and adolescents compared with rates in the general population. The presence of a neurodisability contributes significantly to the difficulties of these children and, if undetected, may add considerably to the already high rates of emotional, behavioural and formal mental health problems also encountered in this group. Furthermore, such neurodisabilities may contribute to the difficulties in both placing affected children and managing them while in care.
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ADDISS Conference 2013 – Hearts and Minds
Deepak Kansagra, Karen Walkden and Leon Rozewicz
pp 10-11
The 11th International ADDISS (Attention Deficit Disorder Information and Support Service) Conference took place in Liverpool in October 2013. As usual, the event brought together professionals, families and individuals with an interest in attention deficit hyperactivity disorder (ADHD). There is always a buzz at ADDISS conferences and this one was no exception. Alongside the serious talks and practical tips, there was also a lot of fun. You get a real sense of community when you have a group of people facing similar challenges. Many adults with ADHD came along for the first time and there was a lot of positive feedback about the ‘community’ feel of the event. The talent show enabled us to look at the lighter side of life, especially with all those people in their onesies! The conference, held at the historic Adelphi Hotel, started on Thursday 10 October and finished on Saturday 12 October. The conference hall was full with ADHD service users, doctors, teachers, partners and carers. It was a great space for networking and meeting attendees.
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Abstract watch: Diagnosis classification and ADHD associations
Nigel Humphrey
pp 12-12
In this issue, we highlight ADHD diagnoses and associations. A systematic review by Curtin et al looks at the link between eating disorders and ADHD. Merwood et al explore the possible genetic nature of emotional lability. The final two abstracts look into the diagnostics and treatment of ADHD: a case for neuro-imaging as a diagnostic tool and a change in the diagnostic classification and possible distinction between sluggish cognitive tempo and the inattentive form of ADHD.
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ADHD and driving: advice for adolescents
Nwanneka N Sargant and Fiona Finlay
pp 13-15
Motor vehicle accidents are the leading cause of death among teenagers in the UK, accounting for 30% of male and 17% of female deaths. Statistically, teenage motorists are ten times more likely to be killed or seriously injured while driving than motorists in their 40s. According to the US National Highway Traffic Safety Administration and the National Center for Statistics and Analysis, in 2008, hand-held mobile phone use, impairment due to alcohol, speeding and failure to use a seatbelt were features in more than 80% of fatal crashes among 16- to 24-year-olds. Factors increasing the vulnerability of young drivers include inattention, impulsivity, immature judgement, thrill-seeking tendencies and impaired executive function skills. Attention deficit hyperactivity disorder (ADHD) is defined as a ‘persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and is more severe than is typically observed in individuals at a comparable level of development’.
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ADHD and sleep difficulties: a common problem
Allan Hvolby
pp 16-18
Attention deficit hyperactivity disorder (ADHD) is the most common problem presented to child and adolescent mental health services (CAMHS) and occurs in 4–6% of schoolage children. The core symptoms of ADHD – inattention, hyperactivity and impulsiveness – are often associated with difficulties in regulating behaviour; these are strikingly similar to the difficulties caused by disrupted sleep and sleep deprivation. Sleep problems in children have, therefore, often been associated with ADHD. Sleep–wake disorders have even been included in the diagnostic criteria for ADHD in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and are often included in ADHD rating scales; for example, Conners’ Rating Scale for parents. It has been theorised that sleep deprivation in children with ADHD could be the result of a primary sleep disorder, or that it could be related to dysregulation of arousal mechanisms, as implicated in the aetiology of ADHD.
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Resources: AFRB
pp 19-19
ADHD–ASC–DYSLEXIA Family Resources Belgium (AFRB) is a non-profit organisation staffed entirely by volunteers who provide support, resources and training for families, teachers and therapists affected by ADHD, ASC and dyslexia and other LDs.
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