Wendel Abel - I AM WHAT I THINKAT AGE six, Sean was unable to sit still. He would shout out of turn and destroy his toys.
Elaine wept as she spoke about her daughter, Anna, who is not able to concentrate. She gets bored easily; she gets 'in trouble a lot'. She is constantly fussing with other children. She has not been doing well at school.
Peter's mother is frustrated. He gets excited when he is in a crowd and he breaks everything in the house.
"I can't keep a clean sofa. When I take him to visit relatives he touches everything. He handles things roughly and is always breaking objects. I have to watch him constantly. I feel I am in hell! His father has given up and I am emotionally drained. Help my child is driving me crazy,"' she shouted.
His behaviour gets worse when he is tired, hungry or sleepy.
These children have attention deficit hyperactive disorder (ADHD). What is ADHD? It is a disorder characterised by the following features:
Trouble paying attention
Inattention to details and making careless mistakes
Easily distracted
Loses school supplies, forgets to turn in homework
Difficulty finishing class work and homework
Trouble listening
Trouble following adult commands
Impatience
Fidgets or squirms
Always 'on the go'
Talks a lot and have difficulty playing quietly
Interrupts or intrudes on others
"Inattention and poor academic performance are usually the reasons these children present to us," says Dr. Gillian Lowe, child psychiatrist. She also commented that there is a high level of learning disability and conduct problems among these children.
ADHD occurs in three to five per cent of children in school and may run in families. It is far more common in boys than girls and may run in families. A number of medical problems may produce the condition although in most cases an identifiable cause is not known. Dietary causes for the disease have been proposed but not established.
These children are often perceived as being 'bad or mischievous' as the disorder may not be recognised. If children are not treated appropriately they may not perform well in school, their friendship with other children is often affected. These behaviours may get worse in the classroom, in noisy and crowded places. The condition may be more obvious to the teacher.
Other children may perceive children with ADHD as irritating and annoying. They may shun them. Children often tease them or set them up to get into trouble with adults. Parents often get frustrated, angry, embarrassed at behaviour. This may result in harsh punishment, abuse and rejection.
This disorder continues into adulthood for many children. Many parents think treatment can be disastrous to the child. "No!" says Dr. Lowe. "Children with ADHD respond readily to treatment. Early treatment and appropriate behaviour management will make a significant difference in the lives of children with ADHD."
HERE ARE SOME TIPS:
1. If you suspect that your child may have ADHD, seek professional help immediately. The child with ADHD will need a proper physical and psychological evaluation.
2. A proper understanding of the condition is important. Parents should learn
strategies to deal with the child with ADHD. Limit setting is important. Praise the child appropriately. Issue instructions one at a time rather than many requests at once. Harsh punishment does not help.
3. Special education is not always required but may be useful. The following may be helpful; small classes, thoughtful selection of where the child is seated in class, small, group activities and one-to-one teaching. Discuss with the child's teacher whatever concerns you may have.
4. Attempts should be made to build the child's self esteem, reduce negative thought, manage anger and improve their problem-solving skills.
5. Start or find a support group to share information and provide mutual support for each other. Support groups help.
6. Diet special diets have not been found to be generally helpful. Diet however, should be nutritionally balanced.
7. Medication Many new drugs are available to treat ADHD. Research demonstrates that medication can be helpful. Discuss these options with your family doctor.
Dr. Wendel Abel is a Consultant Psychiatrist and Senior Lecturer, University
of the West Indies.
