Paediatric Neurologists Perspective on ADHD | Cadabams CDC
When everyday moments—finishing homework, sitting through dinner, or following directions—feel like uphill battles, parents often wonder: “Is this normal kid energy or something more?” A paediatric neurologists perspective on ADHD looks past surface behaviours to examine the developing brain itself. At Cadabams CDC, our specialists help families decode these patterns and find clear, science-backed paths forward.
Understanding ADHD Through a Neurological Lens
Neurobiological Basis of Attention Deficit Hyperactivity Disorder
Research shows that ADHD is not a discipline problem; it is a neurodevelopmental condition rooted in:
- Dopamine and norepinephrine imbalances in the prefrontal cortex
- Smaller total brain volume and slower cortical maturation in key regions
- Reduced activity in networks that govern attention, impulse control, and executive function
Brain Development Patterns in Children with ADHD
Children with ADHD often display:
- Delayed cortical thinning: The brain’s outer layer matures 2–3 years later than peers.
- Altered growth curves in the basal ganglia—an area critical for movement and reward.
- Atypical white-matter tracts that slow communication between hemispheres. These differences do not imply lower intelligence; they explain why skills like organisation and emotional regulation lag behind age expectations.
Key Neurological Markers and Indicators
Our neurologists watch for:
| Marker | What It Signals |
|---|---|
| Excessive theta waves on EEG | Day-dreaming or inattentiveness |
| Reduced N2 amplitude in ERP tests | Difficulty filtering distractions |
| Low ferritin (iron) levels | May worsen dopamine signalling |
Paediatric Neurologist's Diagnostic Approach
Comprehensive Neurological Evaluation Process
- Detailed history: Birth events, sleep patterns, seizure red flags.
- Neurological exam: Tone, reflexes, coordination, subtle motor signs.
- Behaviour rating scales: Parent- and teacher-reported data. This triangulation rules out mimics such as epilepsy or tic disorders. An accurate ADHD diagnosis is crucial.
Advanced Brain Imaging Techniques for ADHD
While not required for routine diagnosis, tools can clarify complex cases:
- fMRI: Measures real-time brain activity during attention tasks.
- DTI (Diffusion Tensor Imaging): Maps white-matter integrity.
- qEEG: Identifies brain-wave patterns linked to inattention. Cadabams CDC offers optional imaging when standard assessments leave questions unanswered.
Differentiating ADHD from Other Neurological Conditions
Overlapping symptoms—day-dreaming, fidgeting, forgetfulness—can cloud the picture. Our team screens for:
- Absence seizures (micro-blackouts)
- Tourette syndrome (motor/vocal tics)
- Learning disorders (processing speed deficits)
Neuropsychological Testing Protocols
Our in-house psychologists complement neurology findings with:
- Conners Continuous Performance Test (CPT-3): 14-minute computer task measuring attention lapses.
- NEPSY-II sub-tests: Memory, language, social perception.
- WISC-V: Cognitive strengths to build treatment plans around. This falls under our comprehensive ADHD assessments.
Neurological Treatment Perspectives
Medication Management from Neurological Standpoint
Stimulants (methylphenidate, amphetamines) increase dopamine and norepinephrine in the synapse, normalising neural firing rates. Non-stimulants (atomoxetine, guanfacine) are also part of ADHD treatment. Cadabams CDC monitors:
- Heart rate, blood pressure
- Growth velocity every 3–6 months
- Sleep and appetite changes
Neurostimulation and Brain Training Therapies
Emerging adjuncts include:
- Transcranial Direct Current Stimulation (tDCS): Gentle electrical currents to boost prefrontal activity.
- Cogmed Working Memory Training: Adaptive computer exercises proven to expand working-memory span.
- Neurofeedback: Real-time EEG feedback teaching self-regulation. These are innovative approaches in therapy for ADHD.
Lifestyle Interventions Supporting Brain Health
The brain thrives on:
- Omega-3 fatty acids (DHA ≥ 600 mg/day)
- 9–11 hours of sleep for school-age kids
- 20 minutes of moderate-to-vigorous exercise daily to elevate BDNF (brain-derived neurotrophic factor)
Monitoring Neurological Progress and Development
Every 6 months we re-assess:
- Cortical thickness via MRI (research cohort)
- Attention span on CPT-3 retest
- Academic and social milestones Parents receive a Neuro-Progress Report summarising gains and next steps.
When to Consult a Paediatric Neurologist for ADHD
Red Flags Requiring Neurological Assessment
Seek an appointment if your child shows:
- Sudden onset of attention problems after age 7
- Headaches, seizures, or loss of consciousness
- Marked clumsiness or uneven motor skills
- Unusual sleep events (night terrors, sleep-walking) A thorough assessment for ADHD is recommended.
Age-Specific Neurological Considerations
- Preschoolers (3–5 yrs): Rule out global developmental delay first. It's important to understand ADHD in kids at this age.
- School-age (6–12 yrs): Ideal window for stimulant trials, especially for ADHD in children.
- Teens (13–18 yrs): Screen for substance use that can mimic or exacerbate symptoms of ADHD in teens.
Preparing for Your Neurology Appointment
Bring:
- School report cards (last 2 years)
- Videos of concerning behaviours at home
- List of all medications and supplements
- Insurance card and photo ID