What does the little dreamer staring out of the classroom window have in common with the wild boy forever disrupting the class with his hyperactive and energetic behaviour, or with the morose, irritated child wanting to smack the little boy next door?
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They all suffer from Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD).
What is ADHD?
According to paediatricians at the Red Cross Children’s Hospital in Cape Town, ADHD is a neuro-behavioural problem resulting from a malfunction in frontal lobes of the brain regulating self-control. The child’s concentration, activity and self-control are affected.
Most children with ADHD are born with this disorder, but it is only diagnosed at school-going age. It is always present, although a child may be able to attend to TV games and activities that they find particularly interesting.
Some children are hyperactive (restless, impulsive, irritated, frustrated, discontented, impatient), while others are hypoactive (dreamers, not paying attention, easily distracted, subtle learning problems). Then there are some children who have a combination of these two.
Does your child behave like this?
If a child suddenly develops problems with concentration, it is not a sign of ADHD. It is most probably due to a mood or anxiety disorder.
Complete this diagnostic checklist to see if your child should consult a paediatrician or psychiatrist.
1. Have any of the following symptoms of inattention been present for at least six months?
a) often fails to pay close attention to details or makes careless mistakes at school or elsewhere
b) struggles to sustain attention
c) often does not seem to listen when you speak to him directly
d) often does not carry out instructions and does not finish schoolwork or other duties
e) often struggles to organise tasks and activities
f) often avoids, dislikes or is reluctant to take part in activities for which concentration is necessary
g) often loses things
h) is often easily distracted
i) is often forgetful.
2. Have any of following symptoms of hyperactivity or impulsivity been present for at least six months?
a) often fidgets with hands or feet or squirms in seat
b) cannot sit still in the classroom or any place where he is expected to sit still
c) often runs around or climbs excessively
d) often finds it difficult to play quietly
e) is often “on the go”
f) often talks excessively
g) often blurts out answers before questions have been completed
h) finds it difficult to wait his turn
i) often interrupts or intrudes on others (e.g. butts into conversations or games)
If you answered “yes” to six or more items in (1) or (2), if the symptoms appeared before the child was seven years and if they impair functioning at school and at home, your child should consult a paediatrician or psychiatrist.
Watch out for the following additional symptoms
Aggressive or disruptive behaviour: Is he arguing with adults, losing his temper, refusing to follow rules, blaming others, deliberately annoying others and being angry, resentful, spiteful and vindictive? Some may even be aggressive to people or animals, destroy property or steal things.
Depression: Sadness, social withdrawal, loss of appetite, self-blame, insomnia or excessive sleeping and loss of interest in activities that were previously enjoyed are common symptoms.
Learning disabilities: Up to 60% struggle with learning, reading, spelling and mathematics.
Mood swing: Periods of abnormally good mood or irritability, or unprovoked aggression may alternate with episodes of depression.
Stressed: One third of children with ADHD may feel edgy, stressed out, tired, and have trouble getting restful sleep.
Tics: Seven percent of those with ADHD may have sudden, rapid recurrent movements or vocal tics.
Alcohol abuse: Recent research suggests that adolescents with ADHD are at a high risk to start smoking at an early age. This is likely to be followed by alcohol and drug abuse.
Take Action: Treatment
Treatment involves dietary changes (such as avoidance of preservatives) structuring the routine at home with all the family members involved, reducing stress and confrontations, teaching the child self-regulatory skills and developing a better self-image.
The right medication can improve a child’s problem by 80%, while your child may also need the services of an occupational therapist, remedial teacher or psychologist.
Ritalin (methylphenidate) effectively improves concentration in the majority of cases. In the cases where Ritalin is ineffective or where side-effects become problematic, treatments such as Tofranil, Catapres, Aurorix or Petrofan could be used.
Up to 60% of children with ADHD may continue to need medication throughout their teenage years and adult life.
ADHD seems to affect families. Parents may recognise their own symptoms of ADHD – these might be difficulties in delaying gratification, time management and prioritising tasks. It can impair inter-personal relationships and work achievement. Medication and psychotherapy can be helpful.
Stat: It is six times more common in boys than in girls due to hereditary factors.
Fact: Not all children with learning problems suffer from ADHD.
Tip: It is important that all the correct tests are done to establish the diagnosis of real ADHD.
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