Reviewed by Heather Cashell, LCSW
Like all mental disorders, the precise causes of attention deficit hyperactivity disorder (ADHD) are unknown. Therefore, parents should not feel guilty if they notice signs of this condition in their child or teenager. It is possible that many factors contributed to the case of a child or teen with ADHD – most of which may not have any connection with parenting or child-rearing methods.
Instead, parents should direct their energy towards getting the best treatment or help for their child. Professionals hope that a better understanding of the risk factors and causes can help in the search for effective treatment methods, and more studies are tracing events back to genetic causes instead of environmental elements. Some factors around the child may contribute to the symptoms and severity of ADHD.
ADHD is linked to different types of symptoms, which often include difficulty focusing on tasks or assignments for long periods, and for some people, a need to constantly be on the move. There are different characteristics for each determiner of ADHD. Although the characteristics are prevalent in many young children, they are more serious than others' traits within the same age group.
Research is ongoing regarding the cause of the characteristics. Recent studies have shown the link between ADHD and factors such as genetics, smoking during pregnancy, stress, premature stress, and low birth weight. For an ADHD diagnosis, patients below 17 years old need to exhibit these traits to a disruptive level. Teenagers and adults above the age of 17 years will show five traits if they have ADHD.
This article focuses on some of the risk factors and proven causes that may explain why people get ADHD,some do not, and potential treatment options.
Risk Factors Of ADHD
Some mental health disorders can be traced to genetics, and the same applies to attention deficit hyperactivity disorder (ADHD). Research has some information on the genetic aspects of the disorder. However, there is more to the possible causes of ADHD aside from the person's genes. Some of the risk factors that contribute to ADHD include:
ADHD can be passed through families or generations. Research has shown that having a parent or sibling diagnosed with ADHD can increase the chances of developing ADHD. For instance, a study published in 2016 by Neuropsychiatric Disease and Treatment discovered that in a group of 79 children with ADHD, 41.3% had mothers with ADHD, and 51% had fathers with ADHD.
Another 2017 study found that the siblings of those with ADHD had between 26 to 45.2% of developing ADHD, which is increased compared to those who do not have a sibling with ADHD. Another 2014 study of 59,514 twins discovered the hereditary aspects of ADHD – the possibilities of a genetic component for the disorder –88%.
No specific gene leads to ADHD and no particular test to determine one's risk of developing the condition. There is a chance that ADHD is linked to several genes and not just one. However, researchers have suggested that one specific gene, the DRD4 gene, may play a role in ADHD. The DRD4 gene affects the brain's dopamine receptors, affecting brain functions and mental disorders related to brain functions, including ADHD. However, the real impact that DRD4 plays in ADHD is yet undetermined.
What researchers have discovered are other rare genes that are linked to different areas of brain development. Although these are noteworthy reasons to encourage new research leads, these genes have only been present in a small number of ADHD cases and are not practical for any form of a diagnostic test.
Another element that makes the study of genetic links to ADHD so difficult is that ADHD often cooccurs with other mental health disorders such as tic disorders, depression, and anxiety, all of which may also have links to genetics.
Nutrition And Diet
Some aspects of a child's diet, including food additives and sugar, seem to have noticeable effects on their behavior. However, appearances are sometimes deceiving. The notion that sugar is one of the risk factors of attention deficit hyperactivity disorder does not have strong backing by research data. Although some older studies hypothesize a connection, recent studies do not reveal a connection between ADHD and sugar. Although there is still much deliberation on whether sugar can aggravate ADHD symptoms, many professionals now believe that the link is reliable enough to be conclusive. Just removing sugar from a child's diet will probably not make any difference to their ADHD behavior.
Some studies also suggest that a deficiency of omega-3 fatty acids is connected to ADHD symptoms. These fats are vital for brain development and function, and there is a lot of proof to suggest that a deficiency may be a factor in developmental disorders such as ADHD. Fish oil supplements seem to reduce ADHD symptoms in some patients and may even contribute to better school performance. Some professionals opine that food additives may aggravate ADHD symptoms.
There may be a relationship between ADHD and maternal smoking. However, women who are ADHD patients are more likely to smoke, which means a genetic explanation cannot be eliminated. Regardless, nicotine can result in hypoxia (low oxygen) in the womb.
In some children, a brain injury may also be the contributing factor for attention deficit hyperactivity disorder. This may be the consequence of exposure to toxins or physical injury, either during pregnancy or after birth. Experts believe head injuries can result in ADHD-like signs in patients, sometimes due to damage to the frontal lobe.
Studies have shown that brain chemicals known as neurotransmitters do not work similarly in children and adults with ADHD. There are also certain differences in the function of the nerve pathways. Some parts of the brain may be smaller or not so active in patients with ADHD than those without the disorder.
Other Risks To Note
Smoking during pregnancy: in a 2018 analysis of three million participants published in Pediatrics, researchers discovered that mothers who smoke during pregnancy are at a higher risk of giving birth to children with ADHD, and the risk increases as the mother smoke more – meaning heavy smokers are at higher risks of birthing a child with ADHD. According to the National Institute of Mental health, alcohol, and drug use during pregnancy can also contribute to the risk.
Premature both or low birth weight: Studies have shown that these two factors can contribute to the development of ADHD eventually in life. A 2017 study published in Pediatrics evaluated 1,787 participants and concluded a remarkable association between preterm birth and significant low birth weight and ADHD.
Exposure to lead: Lead has also been touted as a risk factor for ADHD. A child might be at potent risk if exposed to lead like from leaded gasoline exhaust or household paint. Although lead is no longer used in paints, there is a chance that children who live in older apartments may be exposed to toxic amounts of lead from unreplaced plumbing or old paint. In a systematic review published in 2018, 16 of 18 studies revealed a strong connection between ADHD and the blood lead level.
Childhood trauma: Nongenetic factors such as low family socioeconomic status or domestic violence may contribute to childhood ADHD.
There are different treatments available for ADHD, in addition to medication. One type of treatment may be effective for some patients, while others may respond well to a different treatment or combination therapies. Together with the physician, patients can get a treatment plan that is designed to meet their needs.
For many patients, medication is important for ADHD management. Mental health professionals believe it is the most practical treatment for children with ADHD. Medication is effective for about 80 percent of the patients using it if the type and dosage are carefully designed. However, medications may not be suitable for all patients. There are two major types of drugs for ADHD – stimulants, and non-stimulants. They function differently in the brain to manage the major symptoms of ADHD.
For some patients, ADHD medication may have unwanted side effects. These are often temporary and will disappear after a few days. If not, the doctor will probably recommend using another medication to know if it will work differently and effectively. Or, they might recommend switching from a stimulant to a non-stimulant, or vice versa.
It is somewhat common for patients with ADHD to also have other disorders like depression or anxiety. For such patients, the doctor may recommend some additional medication or behavioral therapy.
Therapies For ADHD
It can be beneficial for families affected by ADHD to work with a mental health professional. The therapy chosen must match what the child or family needs. Some of the options include:
Behavior therapy: one of the objectives of behavior therapy is to transform negative behavior into positive behavior. It usually requires implementing a reward system at home. This form of therapy is beneficial for some kids with ADHD and is sometimes used together with medications.
Cognitive-behavioral therapy (CBT): This is a form of talk therapy. CBT aims to encourage patients to express or think about their thoughts, behavior, and emotions. It is not specific to ADHD, but it may prove helpful for some patients. Partially, CBT assists patients by substituting negative thoughts with ones that are more practical and positive. It is also helpful for building self-esteem, which tends to be impacted by attention deficit hyperactivity disorder. CBT is also effective for treating depression and anxiety, which comorbidly occurs in 50 percent of all ADHD cases.
Social skills group: for some patients, ADHD symptoms can make socializing difficult. They may talk excessively or struggle to think before speaking. They may also have challenges in managing their emotions. Participating in a social group managed by a professional can help patients learn and practice skills necessary for interacting with people.
Other Non-Medication Therapy Options
Some non-medication treatment alternatives for ADHD have some research supporting their effectiveness for relieving symptoms of the condition. These treatments or therapies include outdoor activities, omega supplements, exercises, mindfulness, and changing diet. Some options have not been supported by research. These include certain over-the-counter supplements and games that "train the brain." It is necessary to note that OTC supplements are not regulated by law.
School Support For ADHD
Many classroom provisions are available to aid students with ADHD. These include conditions like getting front row seats in class, allowing extra time on tests, and receiving permission to stand up and move around during lessons. These accommodations can help children live up to their potentials and improve their performance. Parents can also discuss with the child's teacher about receiving informal support.
A behavioral intervention plan (BIP) might be beneficial for some children with ADHD. The plan describes the steps taken by teachers to mitigate problem behaviors in school. A BIP also demonstrates how the school and teachers will encourage the desired behavior.
There are many ways to help a child with ADHD at home. Talk to different professionals who assist children with ADHD and learn about what steps to take if your child has been diagnosed.
Although genetics is not the only risk factor for developing ADHD, there is a genetic component that has the backing of scientific research years. However, there is no particular gene directly linked to ADHD.Other nongenetic risk factors may contribute to a patient's ADHD.
Regardless of the condition's cause, there are different treatment options available to help manage ADHD symptoms and improve one's lifestyle. These treatments may include medications, behavioral therapy, and support and tools to teachers and caregivers to improve communication with children with ADHD. You can start your journey to recovery by taking this ADHD assessment test.