ADHD and children

KATIE'S son Paul has always been an active child. As a toddler he would tear through the house like a whirlwind, shouting, running and climbing the furniture. Toys and activities held his interest for no more than a few minutes and he would often run off without warning, seemingly unaware of the dangers of a busy street or a crowded shop.

It was a full-time job taking care of Paul, but Katie argued that boys will be boys. Hers was just a bit more active than normal and one day, he'll grow out of it. Unfortunately, this never happened. At the age of eight, he was still a whirlwind. It was a struggle just to get Paul took too long to settle down and complete even the simplest tasks, from chores to homework.

When the teacher's comments about his inattention and disruptive behaviour in class became too frequent to ignore, Katie took Paul to a doctor, who told her that he probably has Attention Deficit Hyperactivity Disorder (ADHD).

ADHD is a common behavioural disorder that affects an estimated eight per cent to 10 per cent of school-age children. Boys are about three times more likely than girls to be diagnosed with it, though it's not yet understood why. They think it is because girls are not so violent or physically troublesome. Children with ADHD act without thinking, are hyperactive, and have trouble focusing. They may understand what's expected of them but have trouble following through because they can't sit still, pay attention, or attend to details.

The good news is, with proper treatment, children with ADHD can learn to successfully live with and manage their symptoms.

Although there are several different types of ADHD, the most common symptoms are:

1. Inattention: children find it difficult to focus on a task.

2. Impulsivity: children will do things without thinking.

3. Hyperactivity: children are very restless.

4. Boredom: children lose interest very easily.

Many of these symptoms are already apparent before the age of seven. Boredom and inattention are aggravated when the child starts attending school where work is required in a disciplined atmosphere.

The effects of ADHD may frighten parents, but today the condition can be controlled and the state offers help to ADHD students. Parents must also remember that more than half ADHD children may become normal after the age of 16 if treated at an earlier age. Whatever the outcome, treatment helps to alleviate most of the problems associated with ADHD and allows both adult and children patients to lead an almost normal life.

How do you know your child has ADHD?

The best way to diagnose a child suspected of having ADHD is by first visiting the family doctor, paediatrician or child psychologist. On assessing the child, they will realise that he is exhibiting symptoms of ADHD and will refer the child to the Child Development and Assessment Unit at St Luke's Hospital. The approach taken here is a holistic one where the child is first seen by a paediatrician and a child psychologist to determine if he/she has ADHD and how severe it is.

The child's IQ (Intelligence Quotient), speech and motor skills and optical functions are also checked.

The parents will be asked to discuss their child's history with the child psychologist and psychiatrist. It is important that the parents be honest and open, even sharing any family problems they may be having. Continuous bickering and fighting will result in an unstable family environment that may produce symptoms in the child that mimic ADHD.

The next step is to study the child's behaviour both at home and at school. Teachers' testimonies are very important in providing the right diagnosis and the best help for the child at school.

ADHD presents a vast spectrum of behaviours from really annoying and apparent ones to others that are barely perceptible. The latter need surveillance because they may provide information on co-morbid disorders that afflict ADHD children such as Tourette's Syndrome, Oppositional Defiant.Disorder and Conduct Disorder.

Many assume that ADHD children do badly in school. This is not true. Although learning will present a greater challenge, they do excel in certain subjects if they are helped and supported by their parents.

As a teacher, I've seen a number of ADHD children do well. One student was excellent in English and poor in Mathematics; another always scored high marks (more than 85%) in Science, Geography, History and Home Economics, but was weak in languages. Another student, already a gifted artist, was a genius in mathematics. Unfortunately, the remaining subjects never interested him, and it is a real pity that our educational system does not cater for kids like him.

ADHD children who are not helped by their parents are destined to fail, and it is important that parents know their children's strengths and weaknesses. Praise can help a lot in getting their cooperation and they should be commended when they do well.

When a child is diagnosed with ADHD, then it must be determined the best way to help the child in class and at home. There are a number of different ways of how this can be done and many are quite effective:

i. Chemical treatment in the form of pills such as Ritalin or Strattera. These are the most effective treatments of ADHD known.

ii. Behavioural therapy to improve his demeanour by allowing him to function better at home and in class.

iii. Academic help in the form of a facilitator and/or specific learning aids.

It is important that parents do not panic and learn to accept that their child suffers from ADHD. This doesn't automatically mean that the child will not do well in school. Just don't pressure the child to be first in class. Some children may exhibit a combined form of ADHD and may not need any medication. But you will only be harming your child and your family if your child needs to take medication and this is withheld.

Whatever people may tell you, the only effective way to treat and control full-blown ADHD is by medication. This has been proven by an untold number of scientific studies. Behavioural therapy and vitamins (omega3) may also help especially in cases with milder or fewer ADHD symptoms.

The reason is that ADHD is a biochemical problem that stems from a deficiency in brain chemicals called neurotransmitters, namely dopamine and noradrenaline. It is still unclear how medication actually works but Ritalin and Strattera seem to increase the concentration of these chemicals in the prefrontal lobe or cause the brain to secrete more.

As a teacher, I have seen medication in action and know how effective it is. ADHD students quieten down and concentrate more without any loss of "character".

It is important that when dealing with ADHD, parents reason with their minds not hearts. Scientific studies show that chemical treatment is the only viable treatment currently available for full-blown ADHD; and it will dramatically improve both the child's behaviour and the family's environment. Think about this and make the right decision. It could mean choosing the direction of your child's future.

Mr Pace is a teacher who has a child with ADHD, and has vast experience of dealing with the condition. He has written many articles on the subject and has given lectures to teachers on how to deal with ADHD children in the classroom and improve their academic performance. He is also a member of the ADHD Family Support Group.

For more information contact the chairperson, Tessa Anastasi, ADD/ADHD Family Support Group (Malta), c/o Tal-Andar, Swieqi Road, Swieqi on tel. 2123 3749 (answering machine) or e-mail: nastas@waldonet.net.mt