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Attention Deficit Hyperactivity Disorder (ADHD)

  • What is attention deficit hyperactivity disorder (ADHD)?

    Attention deficit hyperactivity disorder

    Attention deficit hyperactivity disorder (ADHD) is a behavioural disorder that affects the behaviour or development of young children. Children suffering from ADHD show signs of inattention, overactivity or impulsiveness. Many children with ADHD cannot explain why they might feel lonely or out of control.

    The normal attention span of children usually develops in 3 stages. They begin from fixating on only one object for a long time to developing a wide and quick attention span, and finally they reach the selective attention stage where they are able to voluntarily shift their focus. The last stage is important for the child to work in a classroom setting. ADHD is more common in boys than girls. Children with ADHD start to develop symptoms before they turn 7 years old.

  • The causes of ADHD in children include:

    • Brain infections, head injury and lead poisoning
    • Drug use, high blood pressure and infections during pregnancy
    • Genetics
    • Neurological (brain) imbalance affecting areas that control focusing, planning and organisation

    Risk factors for ADHD

    A child is at a higher risk of developing ADHD due to the following risk factors:

    • Blood relatives (a parent or sibling with ADHD or another mental health disorder)
    • Exposure to environmental toxins (lead found in paint and pipes in older buildings)
    • Maternal alcohol/drug use, or smoking during pregnancy
    • Premature birth

    Preventing or reducing the risk of ADHD

    To prevent and reduce your child’s risk of ADHD, maintain a healthy lifestyle while you are pregnant. During pregnancy, avoid drinking alcohol, using recreational drugs or smoking cigarettes as these are harmful to foetal development.

    Moreover, protect your child from exposure to toxins and pollutants like cigarette smoke and lead paint. Additionally, it is helpful to limit screen time for children in the first 5 years of their lives.

  • There are 3 main signs and symptoms associated with ADHD in children. These include:

    • Being overactive
    • Displaying impulsive behaviour, eg. being short-tempered and prone to accidents
    • Inability to pay attention or concentrate on tasks

    These ADHD symptoms can cause the child to face the following challenges:

    Academic

    • Learning disabilities and not performing well in school

    Cognitive

    • Inability to understand the consequences of misbehaving
    • Talking to themselves in a childish way (for their age)

    Emotional

    • Depression and inability to control emotions
    • Unpredictable mood

    Social

    • Aggressiveness and lack of self-control
    • Inability to follow instructions
    • Inability to make friends
    • Lying, stealing and taking high risks
    • Poor social and problem-solving abilities
  • There is no specific test for ADHD, but making a diagnosis requires several tests and procedures, including the following:

    Hearing and vision tests

    Some symptoms of ADHD may be the same as other health conditions. Hearing and vision tests will help rule out other problems such as auditory processing disorder, ear infections, hearing loss, double vision, and blurry vision.

    Information gathering

    Current medical issues, personal and family medical history, and school records help the child's healthcare provider understand the child's unique situation and improve diagnostic accuracy.

    Interviews or questionnaires

    Observations of a child’s family members, teachers and caregivers matter in diagnosing ADHD. They will be interviewed or given questionnaires for the evaluators to understand the problem from everyone's different perspective.

    Assessment of symptoms

    Evaluating the symptoms of the child helps in diagnosing ADHD. ADHD rating scales are used to assess symptoms. The rating scales typically contain questions about the child’s behaviour such as frequent fidgeting, squirming, lack of focus on a task, difficulty staying still and paying attention.

  • Treatment of ADHD may include any or a combination of the following:

    Education

    As a parent, it is crucial to learn about ADHD as your child will need your guidance in properly managing their condition. Behavioural Parent Training (BPT) helps you learn ways to help your child behave better. It is facilitated by a mental health professional.

    Medication

    Medication is an important part of ADHD treatment. Common types of drugs used to control symptoms of the disorder include:

    • Stimulants – This may help your child focus their thoughts and ignore distractions. It is used to treat moderate and severe ADHD. Stimulants have side effects, which include loss of appetite, sleep problems, weight loss, crankiness, and tics. Long-acting stimulants may have greater effects on appetite and sleep.
    • Non-stimulants – They can help in cases where stimulants don't work or cause unpleasant side effects. This group of medicines can improve symptoms like concentration and impulse control. Common side effects of non-stimulants include fatigue, upset stomach, dry mouth, and nausea.
    • Antidepressants – This can be used off-label to treat ADHD symptoms. The side effects of antidepressants include having trouble sleeping, nausea, constipation, dry mouth, and sweating.

    Counselling and therapy

    Counselling, which may be provided by a psychiatrist, psychologist, or social worker is essential for a patient with ADHD. Moreover, behaviour therapy can help improve your child’s behaviour, self-control, and self-esteem as it can help curb symptoms of hyperactivity, impulsivity, and inattentiveness. It can also help the child do better in school or at home.

    Likewise, parents have a crucial role to play in the treatment of a child’s ADHD. Thus, it can be helpful for parents to undergo Behavioural Parent Training (BPT). In BPT, you will learn how to create routine, house rules and procedures that are healthy for your child. It also teaches you how to implement age-appropriate discipline at home.

    Treatment for ADHD may be a combination of different types of treatment. Consult our specialists regarding the best treatment for your child’s condition.

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  • If left untreated, ADHD can lead to complications such as poor self-esteem, drug and alcohol abuse, and delinquent behaviour. Likewise, kids with ADHD are also more likely to develop conditions such as:

    Anxiety disorders

    While it is normal to have anxiety from time to time, anxiety disorder severely affects the daily thoughts and behaviours of a child. Common symptoms of anxiety disorder include difficulty concentrating, waking in the night with bad dreams, not eating properly, easily gets irritable, difficult to control during outbursts, persistently having negative thoughts, and constantly feeling tense and fidgety.

    Oppositional defiant disorder

    A child who persistently and frequently shows a pattern of irritability, anger and defiance may be suffering from Oppositional Defiant Disorder (ODD). Treatment of ODD includes learning how to create positive family interactions. A child with ODD also needs therapy in managing problematic behaviours.

    Mood disorder

    A child with a mood disorder has a distorted emotional state. Their mood is inconsistent with their circumstances and affects their daily functioning. Mood disorder can cause a child to be extremely irritable or sad. They may also feel excessively happy after a period of depression. Some common mood disorders in children and adolescents are major depressive disorder, persistent depressive disorder, bipolar disorder, and mood disorder due to a general medical condition.

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