«The environment plays a central role in ADHD therapy»

Time: 3 min

«The environment plays a central role in ADHD therapy»

Attention deficit hyperactivity disorder (ADHD) is the most common behavioural disorder in children and adolescents. It manifests itself in everyday life with an enormous urge to move, lack of concentration and impulsiveness. Paediatrician Oskar Jenni explains in an interview why it can be challenging for doctors to diagnose ADHD.

Interview: Stefanie Wolff-HeinzePicture: Adobe Stock

Mr Jenni, you describe an ADHD diagnosis as a complex puzzle - why?

To date, there is no official or objective ADHD test available to us. We therefore have to include our own behavioural observations, test modules and the subjective assessment of various people from the close environment, such as parents, teachers or therapists, in the diagnostic process.

We know that medication alone is useless.

There is also a great deal of developmental dynamism in children: you have to take a close look at whether it is «just» immaturity in the child's behaviour or a disorder that lasts for a long time. The question is: what grows out and what doesn't? A diagnosis must therefore not be based on a snapshot. Another challenge is differentiating ADHD from other disorders that are associated with ADHD symptoms - such as a speech development disorder, an autistic or motor disorder or even depression.

The diagnosis of ADHD is made up of many different parts. — Oskar Jenni is Head of the Department of Developmental Paediatrics at the University Children's Hospital Zurich. He appeals to those around affected children: «If you can adapt expectations to the individual characteristics and needs of a child, you can reduce their suffering!» (Image: Filipa Peixeiro / 13 Photo)

What opportunities and challenges are associated with an ADHD diagnosis?

Opportunities open up because the difficulties a child has are given a name. This enables access to therapies. It can also have a relieving effect on parents and teachers when they know: The abnormalities are not vague, they can be named. On the other hand, the diagnosis carries the risk of stigmatisation and exclusion of the affected child as well as a focus on drug therapy.

Why are you committed to so-called environment-centred therapy? And what does that mean in concrete terms?

We know from everyday clinical practice that medication alone is useless. ADHD therapy is only effective if we work together with the child's environment. The first step in treatment should be to familiarise caregivers, parents and teachers with the child's strengths and weaknesses profile. The child's distress is reduced when his individual strengths are encouraged and his weaknesses are accepted and supported - and the environment adjusts its expectations of the child. And in a second step, the therapeutic work begins: we develop strategies with the child on how they can better deal with their weaknesses and, if necessary, support them with medication.

What are the causes of ADHD according to current studies? What challenges and opportunities does an ADHD diagnosis harbour for children and parents? Prof Dr Oskar Jenni from the University Children's Hospital Zurich provides answers and practical recommendations for everyday family and school life in his video lecture as part of the Kosmos Kind lecture series.

Lecture cycle «Cosmos child»

The Elternsein Foundation, publisher of the Swiss parenting magazine Fritz+Fränzi, has launched the "Akademie. For the child. Giedion Risch" has launched the exclusive lecture cycle «Kosmos Kind». Recognised experts address different aspects of childhood and convey them in a way that is understandable and relevant to everyday life. Fritz+Fränzi subscribers benefit from discounted tickets.