ADHD

Updated 19 July 2017

ADHD and Ritalin:the latest facts

What does Ritalin and ADHD have to do with the little dreamer staring out of the classroom window or the wild boy forever disrupting the class?

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They all suffer from Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD). About 1–2 children in a class of 20 suffer from these disorders and need to be treated with Ritalin or other prescribed medication. Not all children with learning problems suffer from ADHD. Yet a lot of children who should not be treated with Ritalin, are using it, while a lot of children who can benefit from medication, are not diagnosed and treated.

What is ADHD?

According to Dr. Colleen Adams and Prof. Mick Leary, paediatricians at the Red Cross Children’s Hospital, ADHD is a neuro-behavioural problem resulting from a malfunction in part of the brain controlling self control. The frontal lobes and adjacent brain areas are not functioning at full capacity, and the child’s concentration, activity and self control are affected.

It appears that the areas of the brain receiving auditary and visual information might be overloaded in children with ADHD. These overloaded brain areas are bombarded with unfiltered and insufficient information. Research has shown an imbalance in the neurotransmitters noradrenalin and dopamine in the frontal lobes of ADHDchildren.

Most children with ADHD are born with this disorder, but it is only diagnosed at schoolgoing age. Hereditary factors cannot be ignored. It is six times more common in boys than in girls. It affects about 5-7% of all children, with 2% affected severely.

The disorder consists of two components: some children are hyperactive (restless, impulsive, irritated, frustrated, discontented, impatient), while others are hypoactive (dreamers, not paying attention, easily distracted, subtle learning problems) or even a combination of these two flip sides of the coin in one child.

Academic performance

Most children with ADHD suffer academically despite being intelligent, and have difficulty with learning, reading, spelling and mathematics. A genius like Einstein might have suffered from ADHD. A lot of these kids can’t concentrate, disrupt the class, do not complete tasks and are not well liked by peers.

They have problems with their short-term memory, are disorganised and disgruntled. Most ADHD kids exhibit the social and emotional maturity of a child two thirds his age, and show a lack of common sense. They are accident prone due to poor impulse control and lack of fine motor skills.

Up to 60% of these kids will continue their strange behaviour into their adult life. More and more children with ADHD need medication as teenagers and adults.

Treatment

Treatment involves medication and structuring of a routine at home with all the family members involved, less stress and confrontations, behavioural therapy and a better self image. It is important that all the correct tests are done to establish the diagnosis of real ADHD. If more than 10% of a class is treated with Ritalin, it is overprescribed to children not really suffering from ADHD, warns paediatricians.

Ritalin is effective in 80% of real ADHD cases. It stimulates the underutilised self control area of the brain, resulting in the hyperactive child calming down and the dreamer being activated. In both cases, concentration improves. In the other 20% of cases medication like Tofranil, Catapres, Aurorix or Petrofan work well. The right medication can improve a child’s problem by 80%.

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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