ADHD signs and symptoms: Recognising the signs of ADHD with your foster child

What is ADHD?

Attention Deficit Hyperactivity Disorder, previously known as ADD, is one of the most widely recognised neurodevelopmental disorders. The condition is characterised by executive dysfunction alongside three behavioural traits: hyperactivity, impulsiveness and inattentiveness. There is no single cause for ADHD, with scientists believing that it is caused by a variety of factors, including genetics.

ADHD affects many looked after children. One American study suggests that there are many reasons for this link, including the effects of prolonged stress on the development of a child’s brain and the known links between prenatal exposure to harmful substances and ADHD.

Understanding the 3 types of ADHD

There is a misconception that ADHD only presents in one way: through hyperactivity. There are in fact 3 recognised types of ADHD. Let’s explore the differences between them.

1. ADHD (combined):

A child may receive this diagnosis if they score highly for all three traits associated with ADHD outlined in the DSM-5: inattentiveness, hyperactivity and impulsivity. This is the most common type of ADHD.

2. ADHD (hyperactive/impulsive type):

A child may receive this diagnosis if they score highly for symptoms associated with impulsiveness and hyperactivity, but don’t present many ‘inattentive’ behaviours.

There are lots of harmful stereotypes associated with these symptoms: hyperactive and impulsive behaviours may be misunderstood as attention-seeking or poor behaviour. If you believe that a child in your care may have undiagnosed ADHD, keep an eye out for some of these behaviours:

  • Fidgeting or restlessness
  • Stimming
  • Interrupting
  • Impatience
  • Being talkative
  • Making impulsive decisions
  • Little regard for danger
  • Excessive movement in inappropriate situations (for example, getting up to walk around during a school assembly or trying to climb inappropriate objects)
  • Struggling to manage big emotions

3. ADHD (inattentive type):

Inattentive ADHD is the lesser-known type, where a child scores highly for the symptoms associated with inattentiveness but scores low on hyperactive and impulsive-type behaviours.

This type of ADHD can often pass under the radar, and symptoms of inattentiveness can often be missed or dismissed as a child being a daydreamer or lacking discipline. In a child with this type of ADHD, you may notice behaviours such as:

  • Forgetfulness
  • Losing things
  • Distractibility
  • Making seemingly careless mistakes
  • A short attention span
  • Losing track of time
  • Struggling to follow directions
  • Avoiding tasks which take lots of mental focus (for example, homework)

Recommended reading: ADHD parenting books for foster parents

 

  • ‘The Gift of ADHD: How to Transform Your Child’s Problems into Strengths’ by Dr. Lara Honos-Webb
  • ‘The ADHD Parenting Guide for Girls’ by Richard Bass
  • ‘Practical Strategies for Parenting Your Child with ADHD’ by Thomas & Carrie Allen

Recognising ADHD in women and girls

One of the most harmful stereotypes around ADHD is the old-fashioned view that ADHD only really effects boys. In truth many women and girls have ADHD, though an estimated 50-75% of women in the UK who have the condition have never received a formal diagnosis. This is due to a range of factors, including:

  • Women and girls are far more likely to have inattentive-type ADHD, and as such their symptoms often go unnoticed
  • Women’s symptoms are regularly misdiagnosed as anxiety, depression or another mood disorder due to overlapping symptoms
  • Women and girls tend to be better at masking their ADHD symptoms

Many women to not receive a diagnosis until they have children of their own with the condition, and their genetic link is revealed. Shockingly, the average age for a woman to be diagnosed if her symptoms have been missed in childhood is during her late 30’s to early 40’s.

This means that there are hundreds of women and girls who are facing their symptoms alone without any support or guidance. This is a trend which really needs to change, and we can all play a role in by increasing our awareness of ADHD in women and girls.

ADHD and other conditions

ADHD and Autism

If you’re fostering a child with autism, you may wonder if they also have ADHD. It is common for children to be diagnosed with both autism and ADHD, commonly shortened to AuDHD. There is crossover between symptoms associated with the two conditions, including rejection sensitivity, emotional dysregulation and sensory seeking behaviours.

ADHD and FASD

FASD (Foetal Alcohol Spectrum Disorder) is an umbrella term for a range of conditions caused by pre-natal alcohol exposure. These conditions are often undiagnosed or misdiagnosed as ADHD or autism and can also occur alongside those conditions. An estimated 50% of children with FASD also have ADHD.

Managing ADHD symptoms with foster children

There is no cure for ADHD nor any other type of neurodiversity, but there are lots of strategies for managing ADHD. Some children may benefit from taking medication, whereas others may benefit from therapy such as CBT. Children with ADHD need care and support which is tailored to their individual needs, which usually includes reasonable adjustments at school.

If you believe that a child in your care may have undiagnosed ADHD, we recommend:

  • begin keeping a record of their behaviours
  • speak with the SENCO lead at their school
  • Speak with their GP

The GP may choose to refer the child for a detailed specialist assessment. To learn more about getting an ADHD diagnosis for a child in your care, visit the NHS website.

Accessing support for foster children with ADHD

Be sure to reach out to your Supervising Social Worker for help and advice if you believe that a child in your care may be living with undiagnosed ADHD. Our team here at FCA are on hand to provide guidance and support via our 24/7 helpline, and we’ll be by your side to support you through the assessment process.

We also offer a specialised training course through our online learning platform, ‘Understanding ADHD,’ designed to equip our foster parents with the skills they need to support a child with ADHD.

Interested in learning more about fostering a child with additional needs? Contact our team on 0800 023 4561 to join us in making the difference which lasts a lifetime.

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Fetal Alcohol Spectrum Disorders Awareness Month

Understanding FASD

September is Fetal Alcohol Spectrum Disorders (FASD) awareness month here in the UK, where we highlight the impact of this widely misunderstood condition which disproportionally affects looked after children. Let’s learn more about the science behind FASD and how best to support children living with the effects of fetal alcohol exposure.

What is Fetal Alcohol Spectrum Disorder?

FASD is an umbrella term for a range of conditions which are caused when a foetus is exposed to alcohol in the womb. When a pregnant woman consumes alcohol, the ethanol in her blood passes into her child through the placenta, causing damage to her developing baby.

Alcohol exposure in the womb can lead to miscarriage, premature birth, or to a baby being born with a FASD. Alcohol exposure can have a severe effect on a child’s overall health and wellbeing. The damage caused by prenatal alcohol exposure is irreversible, and people effected by FASD will live the effects of the condition for their whole life.

Preventing FASD

It is unsafe for a person to consume alcohol during any point in their pregnancy. FASD is completely avoidable if alcohol is not consumed, and it cannot be inherited from a parent who was born with FASD.

Alcohol can effect babies at any point during their growth in the womb, from conception to birth. It is not known how much drinking causes fetal alcohol syndrome or any other type of FASD, so doctors recommend that people who are trying to conceive or who may become pregnant avoid alcohol altogether.

While many assume that only the behaviour of a baby’s mother can contribute to FASD, recent studies suggest that the amount of alcohol consumed by a baby’s father pre-conception may also have an impact on the child’s development.

What are the effects of FASD?

Cognitive effects: FASD causes brain damage by disrupting healthy brain development. Children born with FASD may experience learning difficulties, developmental delays, poor mental health and a wide range of behaviour-related effects.

Health-related effects: Children with FASD can experience restricted growth, such as a short height and low birth weight, as well as a range of other physical problems caused by alcohol related birth defects. These issues can impact any part of a child’s body, including their nervous system, organs, muscles or bones. Children affected by drinking during pregnancy may also experience seizures or damage to their senses, such as sight and hearing.

Some children with a FASD, particularly Fetal Alcohol Syndrome (FAS), will have three facial features associated with fetal alcohol exposure: narrow eye openings, a smooth cupid’s bow and a thin upper lip.

Did you know?

It is estimated that 1/4 of looked after children who have gone on to be adopted in the UK have some form of FASD.

There are children up and down the UK effected by FASD who need dedicated, loving foster parents to take care of them and help them to thrive. If you’re interested in becoming a foster parent, give us a call on 0800 023 4561 or fill out our quick and easy enquiry form.

Diagnosing FASD

FASD is believed to be frequently missed in children and adults. A study by the University of Salford found that ‘up to a half million young people under 20 in England and Wales are careening toward their adult years with a hidden brain-based neurodevelopmental condition, undiagnosed and not receiving proper support.’

People with FASD often display a range of behaviours which are similar to those of some people with autism or ADHD/ADD. These behaviours include:

  • Inattentiveness
  • Developmental delays
  • Difficulties with memory
  • Social and behavioural problems
  • Hypersensitivity/ hyposensitivity to stimuli

Because of these similarities, FASD is often misdiagnosed. The earlier FASD is diagnosed, the better the outcomes are for a person effected by the condition.

It’s important that we raise awareness of FASD so that children who are affected by these conditions can receive the right support. If you believe that a child in your care may have undiagnosed FASD, speak with their GP.

Living with an Invisible Disability

Children and adults with FASD are often widely misunderstood. This is particularly true for people who do not share the visual characteristics associated with some types of FASD, such as the three cardinal facial features, or for those who have learned to ‘mask’ their symptoms.

Living with an invisible neurodevelopmental disability can be very difficult. When a child has an invisible disability, people may assume that they are at a certain level of development and ought to ‘act their age’. For children with developmental delays, this can be detrimental to their wellbeing and growth. Read on to learn how a lack of awareness of the symptoms of FASD can lead to misunderstandings.

FASD and Behaviour

There are several symptoms associated with the brain damage caused by FASD which, if a person does not fully understand FASD, might lead to them becoming frustrated by a child’s behaviour. These include:

  • Information processing. People with FASD often have a limited understanding of cause and effect and can have difficulty understanding and remembering information due to memory problems, which may lead to them repeating behaviours without seeming to learn from previous mistakes.
  • Confabulation. Many people with FASD experience confabulation. Confabulation is easily confused with lying. It’s a condition where the brain distorts memories as a result of memory loss. A person who confabulates is not lying; they genuinely believe that what they are saying to be true.
  • Understanding ownership. People with FASD may take things which do not belong to them, due to a lack of impulse control or not understanding that, if an item is not with its owner, it still belongs to another person. This lack of understanding of the concept of ownership can lead to children with FASD getting into trouble.

Without proper diagnosis and support, young people with FASD are more likely than their peers to be misunderstood and let down by the system, with FASD having links to increased risk of incarceration in youth offender facilities and homelessness.

Supporting children with FASD

Due to alcohol having disrupted the healthy development of the brain in the womb, children with FASD have a limited ability to change some behaviours. They develop at a slower pace than their peers and may need lifelong support to help them succeed. Caregivers should use a therapeutic approach and focus on tailoring children’s environments so that children with FASD are able to reach their full potential.

The approach of ‘strategies, not solutions’ gives empathetic understanding to the range of abilities and challenges a child with FASD may experience. Being consistent, patient, and developing a strong trusted bond with a young person forms the foundation of ensuring they are able to achieve the best outcomes.

Here at FCA we offer tailored support and training for our foster parents, helping them to understand FASD and how to best support the children in their care with strategies such as therapeutic parenting and positive behavioural management. For more information, check out our guidance on fostering a child with disabilities.

Interested in learning more? This free guidebook produced by EFAN has a vast range of in-depth strategies to help you to support a child effected by FASD.

Are you thinking of fostering?

Download the FCA’s complete beginner’s guide to fostering a child. Find out more on how to foster a child and the process involved.

Download Guide

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International Fetal Alcohol Spectrum Disorders (FASD) Day

Friday 9th September is International Fetal Alcohol Spectrum Disorders (FASD) day,

In the UK over 21,000 babies are born with FASD, which is range of difficulties of which can be physical and mental that they are born with due to exposure to  alcohol in the womb.

Alcohol use during pregnancy can lead to lifelong effects on babies which could include:

  • Mental health issues
  • Distinctive facial features
  • Speech and language delays
  • Challenging behaviour
  • Complex physical, emotional and learning difficulties
FASD infographic

Recent research highlighted 75% of children released for adoption have FASD, and yet it is so under diagnosed and often misdiagnosed as ADHD or autism.

To raise awareness FCA North West therapy team are providing an information session on FASD to staff and foster parents.  Very few of understand the behavioural difficulties that can be misdiagnosed so the sessions are vital in helping to identity children with FASD.

The Hidden Disability is a 45 minute film that reveals myths behind FASD that prevent treatment and diagnosis.

The National Organisation for FASD has a wealth of information and resources.

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Dealing with Mental Health Disorders in Children

Mental health disorders in children

It’s not just adults that struggle with their mental health. Children and young people also feel the strain and stresses of life, especially if they’ve come from difficult backgrounds like many of the youth we see in care. When a child develops a mental health disorder, it’s usually a direct response to their immediate situation, which disrupts or delays their behavioural, emotional and social development.

Why is good mental health so important for children?

Having a healthy mind gives children the ability to cope with change and build confidence in themselves and the world around them. These are important building blocks to growing into a well-rounded young adult that’s able to make good decisions and take control of their life. Looking after a child’s physical health is a good starting point, with a balanced diet and regular exercise, but it goes deeper than that. A child that has freedom to play, is part of a loving family, goes to a good school and is listened to are more likely to feel a sense of belonging, which goes a long way in terms of positive mental health. Unfortunately, as we see with our foster children, not everybody gets to experience such a bright and happy childhood.

Foster Children’s Mental Health

Number of children and young adults with mental health disorders

Mental health disorders in children have actually increased since 2017, with now one in six (16.0%) children aged 5 to 16 having a probable mental health disorder. The pandemic has also really taken its toll on young people’s mental wellbeing. Being homeschooled and not seeing friends will have been hard to adjust to for many children, while not having the option to go to school will have been detrimental for those who don’t feel safe at home. 54.1% of 11 to 16-year-olds with a probable mental health disorder found that lockdown made their life worse.

The causes of mental health disorders in children

Mental health conditions can be triggered by traumatic events such as physical or sexual abuse, sustained neglect, domestic violence or a death in the family. These types of events are called adverse childhood experiences (ACEs), and they can affect a child’s emotional, social and behavioural development, leading to long-lasting psychological damage.

To learn more about the causes, effects and different types of trauma, download our Guide to Complex Trauma in Children here.

A child doesn’t always have to experience trauma to develop mental health issues. Changes like moving home or switching schools can leave children feeling out of control or insecure in their new surroundings, which can lead to anxiety. Puberty can also have a massive effect on teenagers due to the increase in hormones, physical changes to the body and feelings of insecurity. This can lead young people to turn drugs and alcohol to cope with these new, intense emotions; sink into depression or even develop an eating disorder.

Spotting the signs of mental health disorders in children

It’s not always easy to know the difference between a child going through normal developmental changes and a child that is seriously struggling with their mental health. Mental health disorders commonly presenting in children may be difficult to distinguish, but here are some warning signs to keep an eye out for.

  • Feelings of sadness that continue for an extended period of time.
  • Always wearing long sleeves, even in hot weather. They could be trying to cover up self-harm marks.
  • Withdrawing from social events or shutting themselves in their bedroom more than usual.
  • Extreme emotional outbursts or a drastic change in their mood, behaviour or personality.
  • Being discreet around food, skipping meals, having a sudden lack of interest in food or rapid weight loss can be indicators of an eating disorder.
  • Having difficulty sleeping or wanting to take frequent naps during the day.
  • A drop in their school performance, skipping school or making excuses to avoid school.

Types of mental health disorders in children

The most common mental health disorders children are diagnosed with include depression, anxiety and conduct disorder, which is a type of behavioural problem, but there are others too. These are the most common mental health disorders in UK children:

    • Depression – cases of depression in young people have risen dramatically over the last few decades, with it being more likely to impact teenagers than young children. A depressed child will often lose interest in activities, begin to isolate themselves and struggle to focus on tasks.
  • Mood disorders such as bipolar – when a child swings between spells of extreme depression and exhilarating highs, they could have bipolar disorder that sees children engage in risky, impulsive behaviour.
  • Generalised anxiety disorder (GAD) – this causes children to become extremely worried to the point where it impacts their day-to-day life. It’s also seen in very young children when starting school for the first time.
  • Post-traumatic stress disorder (PTSD) – this is when a child experiences long-lasting emotional distress after being victim to or witnessing a traumatic event. They may have recurring nightmares, flashbacks or suffer with anxiety.
  • Attention deficit hyperactivity disorder (ADHD) – children with this disorder find it hard to pay attention, are hyperactive and struggle with impulse control.
  • Eating disorders – young girls and boys may develop disordered thoughts around their body, food, eating and weight, and engage in dangerous dieting habits. This can have severe consequences on both their physical development and mental health.

How to help children who have mental health disorders

When it comes to mental health disorders in children, there are steps you can take to ensure you’re offering them the right support emotionally and practically to help them through their struggles.

Listen to them

It sounds simple, but children experiencing mental health issues will quite often feel alone in their battles. Offering an ear to listen and empathising with their pain will help them feel understood and cared for. Opening up a dialogue and having healthy conversations can build trust, which is especially important between foster children and their foster families.

Learn about their diagnosis

If the child in your care has a formal diagnosis, make sure to learn all about it because as the saying goes, knowledge is power. The more you know about the disorder, the more you’ll be equipped to respond effectively to their behaviour, which is some cases may be challenging or unpredictable.

When you foster with FCA, you get access to excellent training courses where you can expand on your knowledge of managing challenging behaviour and other topics that can help you support children with mental health disorders.

Focus on their strengths and achievements

You don’t want your child to be consumed with the negative aspects of their mental health problems, so make sure to focus on other areas of their life they’re doing well in. Mental health disorders can affect children’s learning, as they may struggle to focus, lose interest or have disruptive behaviour in the classroom. However, they might be good at sport, have a natural affinity with animals or enjoy painting, which is important to encourage. Encouraging their interests shows you’re involved in their life, which helps children value themselves and see themselves as important. This is vital for building up positive mental health.

Look after your own mental health

By looking after your own mental health, you’ll be in a better position to support youngsters with mental health conditions. You’ll not only be more alert and reactive to sudden shifts in behaviour, but you’ll be mentally strong enough to deal with them and influence positive change.

Seek professional help

If you’re concerned about the child’s safety, the most important thing to do is seek help, either through the child’s GP, teacher or if you’re a foster parent, you should raise any concerns with their social support worker. Foster parents with FCA have a team of professionals at their fingertips to help support them with any aspect of their foster child’s life, from their educational needs to specialist therapy and treatment.

If you’re new to fostering and want to learn more about becoming a foster parent, download our Beginner’s Guide to Fostering a Child. It’s everything you need to know about fostering in one, handy place. Or, get in touch and we’ll happily answer any questions you have.

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