Sunday September 11, 2005
Desperate children...
TELL ME ABOUT...
By Dr YLM
I WAS watching Desperate Housewives, and much has been made about Attention Deficit Disorder. Apparently, a lot of children on that TV programme have it. Is this true in real life? I have never met anyone in Malaysia who claims that their children have it.
Attention Deficit Disorder is also called Attention Deficit Hyperactivity Disorder (ADHD). It is estimated that out of any classroom of 25 to 30 children, one will have it.
In Malaysia, it is extremely under-diagnosed. Not many parents realise there is such a disorder, and merely put it down to their hyperactive children “being naughty”. They therefore do not seek medical help for it.
ADHD usually manifests itself in kindergarten and early primary school. No one really knows for certain what causes it, but studies have postulated that if you smoke or drink alcohol during pregnancy, your child is more likely to have it.
Children who live in old buildings with lead paint or plumbing, or eat too much refined sugar have also been postulated to have more ADHD.
And very importantly, ADHD runs in families.
How will I know my son has ADHD and is not merely “naughty”?
ADHD has certain characteristics. The child usually starts off as being hyperactive. He might not be able to sit still, or is noisy and boisterous in school, enough to be disruptive. He can be impulsive.
Then inattention sets in, sometimes a year after the hyperactivity and impulsiveness. He may “daydream” in school and may appear sluggish during lessons.
Different children manifest with different symptoms. That’s why it’s important not to self-diagnose but seek the help of a medical professional instead if you suspect anything.
Normal children may also be inattentive, very active and impulsive. A lot of them are restless and easily bored. ADHD is usually suspected when all these traits are so severe as to impair your child’s ability to function in school, at home and with other children.
But that’s so difficult to tell! My son is very restless all the time. He fidgets while he is sitting down. His teacher has scolded him for fidgeting during lessons. Does that mean he might have ADHD?
The medical books (DSM-IV-TR) divide ADHD into different subtypes. These are:
1. The predominantly hyperactive-impulsive types.
They are always moving, running around and playing with everything in sight, or talking non-stop. They can’t sit still at the table or at school, and are always fidgeting or squirming.
They seem unable to think before they act. They throw tantrums without regard for the consequences, and cannot wait for their turn to play games or eat. They may also blurt out inappropriate comments.
2. The predominantly inattentive types. They cannot concentrate on anything, getting bored easily at tasks that need concentration. They find it difficult to learn new things. They are easily distracted by sights and sounds and cannot pay attention to details. In homework, they make a lot of careless mistakes.
They cannot follow instructions and are always forgetting or losing something. They hardly complete any task. Teachers may complain they are “dreamy” or “slow”. They are also usually not hyperactive or impulsive.
3. A combined type that displays both hyperactive-impulsive and inattentive.
But even I get fidgety during boring meetings! I am sometimes impulsive and inattentive, especially when my colleagues are making no sense!
That’s why ADHD is best diagnosed by a child psychiatrist/psychologist. In order to be diagnosed with ADHD, you have to have your symptoms before age seven, and for at least six months. The behaviours must be so bad as to create a handicap in at least two areas of the child’s life: such as school, at home, at the playground or in social settings.
Lots of parents who have children with ADHD fail to recognise it early because they always think it’s “normal”. Usually teachers are the ones who recognise it, because they are used to knowing many children, and can therefore compare and contrast them, especially those who are hyperactive-impulsive.
So pay attention when your child’s teacher singles you out for discussion!
If there’s anything a lot of teachers fail to notice, it’s the inattentive types. They may label your child as “lazy” or “stupid”.
I know from Desperate Housewives that there is medication for ADHD. So there’s hope, right? But will the medication make my children dopey and “stupid”? Will they still be able to function and learn properly?
The best treatment for ADHD is a combined regiment of medicine and behavioural therapy. But it all depends on your child – every child is different. Some thrive better on medicine alone. But known medicines include methylphenidate, amphetamines and atomoxetine.
Most of the drugs improve the child’s ability to focus and learn, and also their physical coordination. And don’t worry that some of these drugs are stimulants. They actually help rather than impair, and studies have shown the children do not get addicted to them in later life.
Remember that between 30 to 70% of children with ADHD may continue through to having ADHD as adults. Over 50% of the children need medication as adults. These adults are usually (without medication) restless, impulsive and easily distracted. They may have learnt to curb their impulses and tendencies to cope with work and social life, but find themselves anxious and depressed.
RSS
