Parents 'need lessons about ADHD'

Parents need lessons in how to cope with their children's unruly behaviour, new guidelines on attention deficit hyperactivity disorder (ADHD) say.

The National Institute for Health and Clinical Excellence (NICE) says drugs such as Ritalin should be avoided - and must not be given to the under-fives.

Teachers would also benefit from training to recognise and help children with this condition, it adds.

Any primary school class is likely to have a child with ADHD, experts say.

Most of the estimated 365,000 children in Britain with ADHD receive no treatment at all.

There is an over-reliance on medicines

Dr Tim Kendall, a consultant psychiatrist from Sheffield who helped write the guidelines

But of those who do, most - about 37,000 - are prescribed stimulants like Ritalin (methylphenidate).

Children with ADHD have extreme difficulty sitting still, learning or concentrating.

At school they may find it hard to keep friends and suffer from bullying because of their behaviour. Looking after affected children can be exhausting for parents.

Parenting classes

The guidelines, which cover England, Wales and Northern Ireland, say parent training and education programmes should be offered as a first-line treatment for ADHD, both for pre-school and school age children.

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The programmes teach parents how to create a structured home environment, encourage attentiveness and concentration, and manage misbehaviour better.

Drugs remain a first option for children over five and young people with severe ADHD, say the guidelines, but only as part of a comprehensive treatment plan that includes psychological and behavioural interventions.

Dr Tim Kendall, a consultant psychiatrist from Sheffield who is joint director of the National Collaborating Centre for Mental Health and helped draw up the guidelines, said: "There is an over-reliance on medicines. ADHD symptoms
Easily distracted
Restlessness
Difficulty remaining seated when required
Difficulty awaiting turn in group situations
Difficulty following instructions
Difficulty in playing quietly
Often shift from one incomplete activity to another
Often interrupts others
Often engages in physically dangerous activities without considering the consequences

"Quite commonly, people tend to revert to offering methylphenidate or atomoxetene. When they do that it's not always because there's a good balance of risk and benefits. It's because the child has got what appears to be ADHD and that's what's available.

"Its easier to prescribe a drug when other options like parent training programmes are not available."

Dr Kendall said it was important to diagnose ADHD correctly, rather than label all bad behaviour as ADHD. The symptoms of ADHD persist in all settings - both at school and at home - and cause real impairment.

Andrea Bilbow, chief executive of the ADHD charity ADDISS, welcomed the NICE recommendations but questioned how helpful the parent training programmes would be to parents.

"Parenting programmes are extremely important, but they need to be specific for ADHD.

"The ones that NICE are recommending were designed for the parents of children with conduct disorder, which is completely different from ADHD," she said.

The Scottish InterCollegiate Guidelines Network (SIGN) is rewriting its guidelines on ADHD diagnosis and treatment and will take the NICE guidelines into consideration.

Their new guidance will come out in the first half of 2009. (from BBC News)

Good about time something more was offered
Our school do not know how to cope with this ,i have looked after my grandson for nearly two years now because he is not allowed to go to school
the school do not know how to cope with this
it is not fair on other children who have to have a child like this in thier class,but most of all it is not fair on the child who has ADHA
we need a programme for parents and for teachers and carers how to deal with it all
it is hard work for all ,and for the child it is very distressing as they try to under stand why these things happen.
unless you have a child with this you will not understand half of what they go through.
i hear so many say it the parents fault or the child is just naughty ,or its what they eat or drink ,these factor are competly wrong
A child with ADHA is born like this ,you can see from an very early age how different they are .even as babies they act diferent and the sleep pattern is so much more dificult and so id their eating habits and general behaviour