EULALEE THOMPSON
"If the country begins to tackle ADHD, then it will tackle a large part of the poor reading problem in schools ..." - Dr. Yvonne Bailey-Davidson, psychiatrist.
THE CHILD living with attention-deficit/hyperactivity disorder (ADHD) is often labelled as just a bad pickney and downright rude.
He or she doesn't pay attention at school and at home, is easily distracted, won't sit still for very long, leaves his seat quite often at school and may just come across as a nuisance, interrupting and intruding on others both in the classroom and at home.
"Usually, children three to 12 years old are the ones affected (by ADHD) and they are usually brought in by parents who are at their wit's end. So, they are prone to physical abuse because they don't listen or follow instructions well and do poorly in school and may just be a nuisance for the teacher," said Dr. Yvonne Bailey-Davidson, a psychiatrist specialising in counselling children and adolescents. "The child is just hyperactive, does not sit still, can't focus on any one thing for any extended period, always experimenting, always on the go, acting as if driven by a motor. Parents have to keep saying, 'don't touch this' and then they move on to do something else."
The condition was only recognised as a true diagnostic entity in 1998. The literature indicates that many features of ADHD are often noticed before age four and invariably before age seven but these features may not significantly interfere with the child's social and academic performance until he or she is fully settled in primary school.
ADHD takes in two concepts - firstly, attention deficit, the child's inability to sustain attention, concentration and complete a task; and secondly, hyperactivity, described as a physical extension of the attention deficit, where the child fidgets and squirms a lot and talks impulsively. Dr. Bailey-Davidson indicated that the diagnosis is usually made when the symptoms of hyperactivity and impulsiveness persist for more than six months and interferes with the child's proper function.
Dr. Bailey-Davidson said that it is important to identify and evaluate children who may be suffering with ADHD, as many of them perform poorly in school and undiagnosed children have especially poor reading skills. She said that if the country begins to tackle ADHD, then it will tackle a large part of the reading problem in schools.
"We don't have a statistical figure (on the prevalence of ADHD) but it is a common presentation in child guidance clinics all over the island and is impacting poor reading in school. At the University Hospital of the West Indies, we see two to three cases per week in our clinic," she said.
ADULT ADHD
In the American population, the prevalence of ADHD is estimated as between five and 12 per cent. The condition is also now being diagnosed in adults (adult ADHD) and it is believed that between two and four per cent of all American adults suffer from ADHD.
Recent research links the disorder to heredity and abnormalities in neurotransmitters or brain chemicals. However, perhaps, because ADHD is still a fairly new diagnostic entity, there has been ongoing debate about whether it is a true mental pathology versus just inquisitiveness on the part of the child; is the child's high activity level normal for that child or linked to emotional disorders or brain function abnormalities such as ADHD?
MANAGING ADHD
Dr. Bailey-Davidson said that a multimodal approach is used in the management of ADHD dipping into bio-psychosocial model. The management, therefore, includes medication (the drug Ritilin is often used), behaviour therapy, parenting skill training, educational therapy, social skills training, anger management, special education classes (these children usually tax school systems).
"Parents don't like to medicate their children for behaviour problems and they hope that child will improve over time and some of them do improve on therapy, and with good response, but, yes, medication is effective and usually, medication is only for a period of time," she said.
The children also benefit from mentoring, extra-curricular activity and sports to help them channel their high energy levels.
An ADHD parenting support group meets every second Saturday at Sts. Peter and Paul Church hall from 4:00 p.m. to 6:00 p.m.
Signs of ADHD
Attention-deficit/hyperactivity disorder involves inattentiveness, hyperactivity and impulsivity.
SIGNS OF INATTENTION
Often fails to pay close attention to details
Has difficulty sustaining attention in work and play
Does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish tasks
Often has difficulty organising tasks and activities
Is often forgetful
SIGNS OF HYPERACTIVITY
Often fidgets with hands or feet or squirms
Often leaves seat in classroom and elsewhere
Often runs about or climbs excessively
Has difficulty playing or engaging in leisure activities quietly
SIGNS OF IMPULSIVITY
Often blurts out answers before questions have been completed
Often has difficulty awaiting his turn
Often interrupts or intrudes on others.
- Source: Merck Manual of Medical Information
You can send your comments to eulalee.thompson@gleanerjm.com.
