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   This information was extracted from a series of factsheets from the Royal College of Psychiatrists for parents and young people. 

What are attention-deficit hyperactivity disorder and hyperkinetic disorder?

Many children, especially under-fives, are inattentive and restless. This does not necessarily mean they are suffering from ADHD or hyperkinetic disorder. The terms `attention deficit', `attention-deficit hyperactivity disorder', `hyperkinetic disorder' and `hyperactivity' are used by professionals to describe the problems of children who are overactive and have difficulty concentrating.


The terms attention deficit disorder (ADD) or attention-deficit hyperactivity disorder (ADHD) are used in the USA. The official term in the UK is hyperkinetic disorder. 

What are the signs?

Children with ADHD/hyperkinetic disorder:

This type of behaviour is common in most children. It becomes a problem when these characteristics are exaggerated, compared to other children of the same age, and when the behaviour affects the child's social and school life. Often the signs will have been obvious since the child was a toddler.

What causes ADHD/hyperkinetic disorder?

We do not know exactly what causes these disorders, but genetic factors seem to play a part. The disorders can run in families, with boys more often affected than girls.

Where can I get help?

There is no simple test for ADHD/hyperkinetic disorder. Making a full diagnosis requires an experienced specialist assessment, usually done by a child psychiatrist. The diagnosis is made by recognising patterns of behaviour, observing the child and obtaining reports of their behaviour at home and at school.

Your general practitioner will be able to offer you advice and support and will usually refer you to a specialist. A child and adolescent psychiatrist will undertake a thorough assessment and offer treatment. Some clinical psychologists and paediatricians also have special experience and skills in managing this problem. Effective treatment will include advice and support for the parents.


Stimulant medication

Some medications such as methylphenidate may reduce hyperactivity and improve concentration (see Factsheet on stimulant medication). Medication produces a short-lived improvement after each dose, but is not a permanent cure. It creates a period when the child can learn and practise new skills. Children often say that medication helps them to get on with people, to think more clearly, to understand things better and to feel more in control of themselves. Not all affected children need medication. Those who do often need educational support as well.

Changing diet and avoiding additives

There is a small body of evidence about the effect of diet on some children. A few may be sensitive to certain foods. If parents notice that specific foods worsen hyperactivity, these may be avoided. It is best to discuss this with a dietician.

Do children grow out of it?

Children who receive specialist treatment tailored to their needs may benefit considerably. Some problems with restlessness, attention and lack of control might continue into adult life. However, with help, most hyperactive children will have settled down by the time they reach their mid-teens. They will have been able to catch up with their learning, improve their school performance and make friends.



This factsheet is from a series of factsheets from the Royal College of Psychiatrists.

What are stimulant medications?

They are medications that affect the action of certain chemicals in the brain. In adults, they have the effect of making people more alert, active and awake. This is why they are called stimulants. In children, they can increase attention and reduce hyperactivity, and are used as one part of the treatment for hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD).

Medication should be prescribed only after your child has been fully assessed by a specialist. Stimulant medications may be worth trying if your child has serious difficulties with:

They may have big problems:

How stimulant medication works

Stimulants seem to affect parts of the brain that allow us to control how we pay attention and organise our behaviour.

What are its effects?

The child's behaviour becomes calmer, more focused and less impulsive. However, medication does not work for everyone. It is also important that the child has adequate help with learning in the classroom, and with controlling behaviour.

Why does medication help?

Stimulant medication creates a `window of opportunity' when children can be focused and concentrate better. They can therefore learn better at school. Some children say that when they are taking the medication, they can think more clearly, and find it easier to understand requests from parents and teachers. School work becomes more interesting and enjoyable, and they make more friends.


Parents and teachers can do a lot to help a child to make these changes. Your understanding and support (practical and emotional) are crucial. Practical and effective ways of helping a child to improve behaviour include:


Which stimulant medications are used?

The stimulant medication most commonly used in the UK is methylphenidate. When it works, the effect begins within 30 - 60 minutes. The exact amount of each dose needs to be carefully monitored and adjusted by a specialist. There are also long-acting forms that last up to 12 hours.


What are the side-effects?

As with any effective treatment, there might be side-effects, such as reduced appetite and staying awake later than usual. Side-effects are less likely if the dose is increased gradually when the tablets are started. Some parents worry about addiction, but there is no good evidence to suggest that this is a problem.


The most common side-effects are:

Because of the effect on appetite, the child's height and weight should be measured regularly. Giving medication with meals may help.


Less common side-effects to look out for include:

How long should the medication continue?

Medication may need to be continued for several years. Some children will be able to stop completely as teenagers, others may be able to stop even sooner. Some may still need medication as adults. There are no known harmful effects from using these medications over several years.

Treatment will be monitored by a specialist and will be reviewed regularly. Medication may need to be adjusted. Physical health checks and repeat prescriptions may be provided by your general practitioner.

Non-stimulant medication

If stimulants don't work, your specialist may suggest one of a number of alternatives, such as atomoxetine (Straterra).




What drugs do and don’t do on their own 

Taken from the book ‘Parenting the ADD child. Can’t do? Won’t do?’, by David Pentecost and Jessica Kingsley


Likely to change substantially:

abilities and traits

Likely to change to some extent

Unlikely to change much:

Learned behaviour


Poor concentration


Unstructured behaviour


Ability to pay attention


Ability to listen


Ability to play constructively


Ability to focus on tasks


Ability to listen to what you are saying


Ability to follow through tasks









Frustration Outbursts






Severe aggression and spitefulness




Verbal abuse


‘chip on the shoulder’


Anti-social behaviour


Temper tantrums




About courses for parents (NICE guidance for parents and carers, 2008) 

The aim of the course is to equip parents with the necessary skills so that they can help to improve their child’s behaviour. 

A course is about 8–12 sessions and usually takes place in a group with other parents. The course will help parents to understand their own and their child’s feelings and behaviour. It is a chance to meet other people in a similar situation, help one another and share experiences. There will be activities and ‘homework’ so that anything new can be practised at home. 

Ask your GP for local parenting skill workshops / groups, as resources vary locally. Parenting courses with support with behaviour management can be found at the Early |nterventions Hubs (Oxfordshire),  or try Triple P parenting, Webster Stratton Parenting courses within your county council.




 Consider the following:

   The most effective classrooms include:



   Setting up a classroom

   Display your classroom rules


  Cut down and ‘chunk’ work

  Time and tests

    Allot extra time to complete tests and homework. They shouldn’t be penalised for attention lapses or their difficulty sustaining       extra effort during complex learning tasks.


  Make use of technology

  Hands on


In any case, contact has occurred and you have caught the child’s


   Verbalisation and Cueing


  Improving attention in the classroom


  Establishing control and focus of attention


  Activities to promote the transfer of attention

  Increase tolerance by either:-