Attention Deficit Hyperactivity Disorder or ADHD is one of the most common neurodevelopmental behavioural childhood disorders. Although the terms overactivity, hyperactivity, attention deficit disorder and hyperkinetic syndrome are used synonymously, attention deficit or short attention span, refers to the basic difficulty in such children. Symptoms include: excessive motor activity, reckless and impulsive behaviour, proneness to accidents, lack of caution, defiance and often learning difficulties. Prevalence is between 3% – 7% and the hyperactivity is at its peak between 3 and 8 years of age with the onset before the age of 3 years. It is interesting to note that research shows among ADHD children, 60% also have another condition (comorbidity) such as anxiety, tics, oppositional defiant disorder (ODD), learning disability and mood disorder. Parents are urged to consult a pediatrician, psychiatrist or clinical psychologist in order to: 1) establish comprehensive evaluation of the child’s difficulties, 2) identify or exclude comorbidity and 3) create a care plan to deal with the child’s current and future challenges. ADHD is often diagnosed if the child has symptoms such as inattention or inability to concentrate on anything, lack of focus, exaggerated emotions or hyperactivity that have persisted for six months or more. However, it should be noted that symptoms vary from one individual to another and therefore, a professional diagnosis is absolutely necessary and the sooner it is done the better for everyone. Genetics may possibly play a part but the cause of ADHD is still unclear. Parents should note that ADHD is not due to bad parenting, too much sugar, food additives, abundance of computer games or other myths that are widely circulated in the media.
Since many symptoms of ADHD are typical of childhood exuberance, it is difficult to identify an ADHD child. Thus, the condition is often first identified in a school setting by teachers who may suspect the condition, although they are not trained to diagnose it. Nonetheless, teachers can provide crucial information on the child’s behaviour, school performance and disruptiveness in the classroom during the assessment by a specialist. Furthermore, students with ADHD may face academic difficulty with at least one out of two of those diagnosed requiring special education services. To try and understand the mind of someone with ADHD, one can imagine multiple pages are open on a computer, all trying to get your attention and you struggling to make sense of them all at the same time.
Most people with ADHD may have one or more of the following complaints of variable intensity: 1) problems staying focused (inattentive type), 2) fidgety or behave inappropriately (hyperactive impulsive type), or 3) combined type. Thus, the management of an ADHD individual must be fully assessed by a specialist who will carry out certain tests. Based on the results of the latter and the specialist’s personal observations a care plan will be tailored to the individual’s requirements. Specialised educators recommend classroom management styles such as a reward system or a daily report card and organisational training to teach children time management and planning skills. However, in order to deliver this effectively the staff must be suitably trained. It is emphasized that the family is involved and a clear policy of managing the child while at home is documented. In some cases, the specialist may prescribe stimulant drugs. A word of caution, parents should know why the medicine is given, its dosage and side effects. Parents are urged to strictly follow professional advice regarding the management of the child’s challenges.
As a society, we can all play our part. First and foremost, we must comprehend that the individuals and the parents or families of people with ADHD need our support, not pity. The ADHD child has the full rights as a citizen to live with dignity and deserves the best treatment available. We can learn of the symptoms of ADHD, understand the impairments, acknowledge the impact on the families, look at the best possible treatments available and finally evaluate what more can be done together. As a community, we can support the families, appreciate the sterling job of the health workers, and the dedication of special education teachers. With the participation of them all, we can provide a safe and caring environment. Thus, the child can attain his/her full potential and become a useful and endearing member of the community. Fairness and equity are not giving everyone the same level of service, but giving each one what they need – whatever that might be.
Nivedita M. Dhadphale. MSc (Psychology) (Strath), MBA (Strath).
PGD Psychology and Neuroscience of Mental Health (IOPPN, KCL)
Assistant Lecturer in Psychology at the British University of Bahrain.
Fellow of CIM, Member British Psychological Society (BPS) and Applied Neuroscience Association (ANA).