More than a century ago, in 1902, British physician George Still first described a behavioral pattern in children characterized by constant restlessness, lack of concentration, and hyperactivity. He interpreted this behavior as a "moral character problem," as the term was understood at the time. Over the years, the condition has been renamed and is now known as Attention Deficit Hyperactivity Disorder (ADHD).
Main characteristics of ADHD
ADHD manifests itself through symptoms in three main groups: inattention (distraction), hyperactivity, and impulsive behavior, at levels that do not match the child's age and negatively affect his or her functioning at school and at home.
This disorder can manifest in different forms: predominantly hyperactive, predominantly inattentive, or both. It affects about 4–8% of children worldwide. Although it is the most common neurodevelopmental disorder, it is often underdiagnosed and undertreated.
In the clinical population, ADHD occurs more often in boys than in girls, with a ratio of 3:1. In cases where inattention predominates, this ratio approaches 2:1.
Causes and factors that influence the development of ADHD
ADHD is a condition with multiple causes, arising from the interaction of genetic, epigenetic, and environmental factors, particularly during pregnancy. One of the key mechanisms thought to underlie ADHD is difficulty in stopping inappropriate behaviors. Children with this disorder have difficulty stopping an activity such as play, focusing on tasks that require attention, or coping with distractions in the environment.
ADHD is often present in other family members, such as parents or siblings. Genetic studies have found a link between ADHD and several genes that affect the dopamine and serotonin systems. The gene most closely associated with ADHD is DRD4, the human dopamine D4 receptor.
Among environmental factors, premature birth, exposure to alcohol or nicotine during pregnancy increase the risk of developing ADHD, especially in individuals with a genetic predisposition.
ADHD diagnosis
The diagnosis of ADHD requires a thorough and careful evaluation, including:
Evidence that the symptoms significantly affect the child's functioning in several areas of life: at school, in the family, in relationships with peers, and in daily behavior.
Possible assessment of the presence of other disorders that often accompany ADHD, such as: motor coordination disorder, specific learning difficulties (such as dyslexia), etc.
ADHD, like all neurodevelopmental disorders, is a clinical diagnosis; there are no biological or imaging tests that confirm it.
The diagnosis should be made by specialized doctors, such as developmental pediatricians or child psychiatrists, depending on the age and form of symptom presentation.
Therefore, a detailed developmental history is very important to accurately interpret symptoms.
ADHD treatment and management
Not all children with symptoms of attention deficit, hyperactivity, or impulsivity need treatment. But for those who are significantly affected in daily life, treatment is necessary.
The most effective treatment is a combined one, which includes:
Behavioral intervention, aimed at improving impulsivity control and concentration.
Education for parents, to help them improve ways of interacting and setting boundaries.
Medical treatment, in cases where the symptoms are more pronounced and significantly affect the child's functioning.
It is important to understand that ADHD is a neurobiological condition and is not related to "bad parenting" or negative childhood experiences, although such experiences can influence the course of the disorder.
For the most successful treatment, a collaborative interdisciplinary approach is required between the specialist, family doctor, therapists, and classroom teacher.
ADHD in Albania: The need for more data
Our country lacks comprehensive data on the prevalence and course of ADHD. Such studies would be extremely useful to improve services, raise awareness, and provide better support for children and families dealing with this condition.
