Attention Deficit Hyperactivity Disorder (ADHD) refers to a set of behaviors which may include inattention, poor impulse control, restlessness and social difficulties. It causes clever children to do poorly in school and behave badly at home. 5 - 20% of all children may show the behavior patterns of ADHD and the majority of children with ADHD are boys.
HOW CAN YOU RECOGNISE CHILDREN WITH ADHD?
Children with ADHD are often very active right from their early childhood. These children look like any other typical child but behave in ways that are often labeled as “mischief” or “daydreaming”. Children with hyperactivity fidget all the time and appear to be always on the move. They have a short attention span, poor memory, cannot focus on one activity or subject for long and have difficulty following instructions, even when it looks like they’re listening. They do not like being restricted to one place, interrupt when others are talking and demand constant attention. They may be clumsy, break things and be impulsive and unsociable.
Children with poor concentration but without hyperactivity are often quiet and sit for a long time without movement. Their mind tends to drift off and they appear lazy, uninterested and forgetful. They may be disorganized and have problems in remembering time.
Learning disabilities (LD) are often associated with ADHD. This can affect several steps of learning, such as, the process of recording information (input); organizing and understanding this information (integration); storage and retrieval (memory); and finally communication of this learning (output). ADHD and LD must be treated separately. LD can be overcome through remedial education, by helping the child build on her or his strengths, providing a learning program that allows the child to experience success and gradually increasing its level.
HOW DOES ADHD HAPPEN?
In children with ADHD, there appears to be an immaturity in the cells of a particular area of the brain known as the reticular activating system, which is involved in concentration. In the human brain, messages are passed between cells by the release of chemicals, which are known as neurotransmitters. Children with ADHD have insufficient neurotransmitters, resulting in poor transfer of messages between cells. Approximately 80% of children with ADHD outgrow their condition by 14 years of age due to maturation in the affected area in the brain, resulting in improved neurotransmitter release.
Children are born with ADHD and it is no one’s fault. It is not caused by poor parenting or “working parents”. ADHD tends to run in families.
WHAT CAN BE DONE?
In the management of ADHD, consideration has to be given to the level of developmental and emotional maturity. The primary areas of concern are academics and social behavior. The usual methods of intervention are:
- Behavior therapy – the principle of behavior management is to “catch the child being good” and give immediate descriptive praise. Inappropriate behaviors can be ignored (if minor) or corrected firmly but calmly, without getting into an argument, when they are bothersome. Structure and routine should be provided in the home.
- Remedial teaching – this is required for children who have an associated learning disability.
- Medication – drugs can be used when behavior management has not shown the required response. The commonly used medication is methylphenidate, given orally, once or twice a day. Side effects and behavior changes must be monitored carefully while the child is taking the drug.
- Social skills training – as children with ADHD often have difficulty keeping friendships, social skills training is helpful to promote positive interactions with peers.
- Dietary control – high sugar foods, artificial flavors and colors and food with caffeine should be avoided.
There should be good communication between all the people who care for the child with ADHD – the family, school staff, teachers, therapists and doctors.
The child with ADHD thrives on calmness, consistency and structure. Give rapid rewards for good behavior and repeat rewards often. Do not get demoralised – every parent and teacher finds disciplining a child with ADHD difficult. However these children are often also very talented, creative, spontaneous and fun loving – you just have to learn how to direct their high energy levels into rewarding activities!