By Consultant Paediatrician Dr Priya Chandrasekar
One of the pleasing sights that we all like to see is children running about and playing. But when the running about is incessant with the child hardly listening and not concentrating or following simple instructions, we must take note and see if there is any problem.
One of the now increasing problems that we see such children having is a disorder called Attention-deficit / Hyperactivity Disorder (AD/ HD). This is an easily diagnosable, treatable, biologically based disorder.
Its essential feature is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and more severe than is typically observed in children at a comparable level of development (age and gender). Roughly, it is present in about 3-5% of school-age children. Boys are usually 2-3 times more likely to be diagnosed because they tend to be more active, aggressive and disruptive.
These children have a genetic basis for this problem and are unfairly blamed of being not caring, being lazy and having some character defect, when they are not wontedly exhibiting such behaviour.
The presence of at least six of the following symptoms according to DSM-IV criteria should prompt people to check their child is suffering from AD/HD:
- Having difficulty sustaining attention
- Making careless mistakes, not paying attention to detail
- The child doesn’t “seem to listen” or seems tuned ou
- Children fail to follow instructions or don’t get school work or chores done
- Difficulty in keeping track of things or with organisation,
- Losing things often – like a pencil, rubber, paper, homework etc.,
- Getting easily distracted by outside happenings, like people talking or things going on outside the window,
- Forgetting to do things,
- Fidgeting, can’t sit still,
- Difficulty remaining seated, waiting in line
- Overactive always “on the move”,
- Difficulty playing quietly or co-operating within a group,
- Reacting impulsively without thinking first – “act before you think” instead of think before you act.
Most of our children or even adults have some of these symptoms some of the time, but individuals with AD/HD have more of these symptoms more of the time (at least for more than 6 months) and to the point that it interferes with their ability to function normally in academic, work and social settings, and to their potential.
These children should be identified early, and remedial measures should be started as soon as the child is assessed by the paediatric family physician and psychologist. The child should be continued in a regular school.
Also read: School refusal in children and what to do
How you can help correct it:
Good parenting and good teaching can make a big difference in how well the AD/HD behaviours are managed and how well a child with AD/HD learns to cope with the symptoms.
A comprehensive treatment plan needs to “wrap around” the child. Medication is necessary, but not enough. Teacher – training, parent training, family therapy, or individual counselling are needed. Only then the child can gain confidence and try to get out of negative perceptions about him/herself based on past and repeated frustration, struggle or failure.
Other equally important components include providing a “supportive environment”, teaching the child organizational skills, study skills, memory skills, time management, and to learn how to be self-aware about how they learn best.
The learning of all these skills can be a lengthy process and must be reinforced regularly. There may be ups and downs, but persistence will show good results. It is very important to have a regular feedbacks with the paediatrician or physician, plan further treatment, c) offer a lot of praise and positive ideas rather than negatives or punishment d) and to have abundant patience and last but not the lease, 5)a good sense of humour.
Each child needs individualised attention Medication can help correct the underlying chemical imbalance, giving them a fair chance to learn, develop compensatory strategies, and face the challenges of growing up to become productive citizens.