Zee Media Bureau
New Delhi: Attention deficit hyperactivity disorder (ADHD), formerly called attention deficit disorder or ADD, is one of the most common neurobehavioral disorders of childhood.
ADHD, as the name suggests, is a neurodevelopmental condition which is characterized by problems in paying attention (inattention), excessive activity than expected for age (hyperactivity) and difficult controlling behavior which is not appropriate for a person’s age (impulsivity).
It is a common misconception that ADHD can only occur in children as it begins in childhood, but may persist well into adulthood.
ADHD and specific learning disorders (SLDs) are an important cause of scholastic backwardness, which is a common issue among children in schools. Often the teachers report that the child is lagging behind despite other wise normal intelligence and functioning. These children are
often deemed “naughty”, “messy”, “absent-minded” or “disturbing elements of the class”. They may resort to mockery, disturbing the class by making noises, pushing/pulling in the queues, and blurting out answers when expected to keep quiet.
At home, the parents observe that the child may not sit still at one place to do their homework, often gets distracted easily (by fans, door bells, playing with stationary etc.) However, all is not a problem in such children. They may be full of vigor and energy, enjoy activities requiring lots of running around. Just that this energy may not always result in productive output, due to constant shifting attention.
According to Dr Era Dutta, Consultant Psychiatrist, SL Raheja Fortis Hospital Mahim, not all children with a few of the above symptoms can be diagnosed with ADHD. It is only when these symptoms begin by age six to twelve, present for more than six months, and cause problems in at least two places (such as school, home, or extra-curricular activities).
Academics become a difficult task for an individual with ADHD. Children with an ADHD are easily distractible. While inside the class, they can be attracted to the construction work happening outside the window and next moment be intrigued by the fan in the room.
As a result, an erroneous low IQ is often reported. This occurs not because the child doesn’t have potential, but because he is unable to sit at a spot and perform the test. They may just blurt out any answer to get done with the “boring” task.
Dr Dutta gives some tips to help parents, carers and teachers positively manage children with ADHD at home and schools.
Parents should assess whether their children are plain naughty at times or naughty, not paying attention and over-active almost all the time.
A psychiatrist can diagnose a hyperactive/impulsive/inattentive child by interviewing and observing them. Invasive blood tests are usually not required for this diagnosis.
The main ways of managing ADHD is through behavioural modification, dietary control and medication.
Behavioural modification is essential and goes a long way. Parents are encouraged to develop small tasks for the child, which may not require one to sit for very long hours.
Similarly, well-deserved breaks every few minutes helps in boosting the result. A star chart can be maintained to reward, encourage the child with a positive reinforcement, whenever he/she completes a task as expected.
At school, teacher may make the child the monitor of the class, help him set rules, reward positive behaviour. Social skills training, routine management and regular counseling help a long way too.
Avoiding excessive sugar and sugar products can effectively reduce hyperactivity bouts in such children. It is essential to avoid sugar, ice-creams, caffeine, or any stimulant items (e.g. Coca-cola) especially at nighttime.
Medication does wonders in children diagnosed with ADHD if they tolerate them well. Stimulants help the child to be more attentive and focus their attention if used judiciously. Howeve, drugs like methylphenidate should be avoided below 6 years of age, but other safer options are also available.
A medication-free summer holiday can be given to ensure adequate height and weight gain.
Any treatment works better if it is multi-pronged. Hence, a combination of the above works best. It is also important for the mothers, and other family members to come on board and be trained on how to deal with the child without getting frustrated.