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Why is ADHD more common in multiples?

Firstly it is only a little more common in multiples, whereas speech and reading problems are generally more common. So, it is important not to jump to conclusions. If a multiple is not doing well at school, this does not mean ADHD. Intervention for learning problems alone may be quite different from intervention for ADHD. There are some multiples where there have been significant problems before or at birth that may have contributed to their symptoms, but for most multiples this is not the case. No one really knows why the difference happens, but we suspect it has to do with developing along with one or more siblings the same age. How can you learn to concentrate when the other(s) are always around, playing with things at your developmental level and diverting your attention? So think about the common statement

"Well, they always have each other to keep themselves amused"

They also have each other to stop them learning to concentrate on something and seeing it through until it is finished. And the behaviour of one multiple does influence the others. Our recent Australian studies showed that twins become more similar in their Hyperactivity symptoms as they grow to adolescence, but do not necessarily become more similar in their Inattention symptoms. This makes sense. It would be difficult to ignore the behaviour of your overactive siblings, while their inattention does not have the same influence on you.

At the same time we need to think what life is like with and for multiples. As Hugh Lytton showed 20 years ago, twins are better than singleborn children at recognising rapidly spoken speech. Parents will recognise why! But there are key implications if ADHD is an issue. With multiples, there is often not the time to give each instruction by itself. So the children are told to "Brush your teeth, make sure your shoes are clean, get your schoolbag and collect your lunch money". This sequential list is too much for children with ADHD and parents and teachers need to make allowance if not everything is done.