Introduction

ADHD is one of  the common behavioural problems in children. It is a neurodevelopmental disorder which involves 3 areas of difficulty :

• Innability to sustain focus or inattention
• Hyperactivity
• Impulsivity

A study of Malaysian children between the ages of 5 – 15 years showed that 4.3% had symptoms of ADHD. It is more commonly found in boys. No specific cause has been found though genetic factors and chemical imbalance in the brain have been strongly linked to ADHD.

Signs & Symptoms

A child is said to have ADHD if he has more than 6 symptoms from A and/or B.

The child often

The child often :

The child also :

If your child fulfils these criteria seek professional help as soon as possible.

1. Inattention
   • Makes careless mistakes in his school work
   • Has problem organizing his activities
   • Loses things at home and at school
   • Has problem finishing tasks
   • Appears not to listen when spoken to
   • Is unable to follow instructions
   • Avoids activities that require thinking and concentration
   • Is easily distracted
   • Is often forgetful
2. Hyperactivity
   • Fidgets with his hands and feet and squirms in his seat most of the time
   • Leaves his seat in the classroom when he should be sitting down
   • Runs and climbs excessively (more than most children)
   • Has difficulty playing quietly
   • Is always “on the go”
   • Talks excessively
3. Impulsivity
   • Blurts out answers before the question has been completed
   • Has difficulty awaiting his turn
   • Interrupts others when they are talking or playing games
   • In addition :
     • The symptoms must have occurred before the age of 7 years
     • The symptoms must have occurred for more than 6 months
     • The symptoms occur in more than 1 place or situation e.g. school, home, public places
     • The behaviour is inappropriate for the child’s age
     • There is no other major health and development problem
     • The behaviour is causing the child to have problems in school, with friends or with his daily living.

Complications

• ADHD often co-exists with Oppositional Defiant Disorder or conduct problem where the child is stubborn, has temper outbursts and shows defiance.
• Problems with self esteem may occur because of difficulties at school, home or with friends
• Learning problems are common because the child has difficulty in concentrating and paying attention.

Treatment

Medication can reduce a child’s hyperactivity and helps him to learn better. Medication for ADHD is used for long term and is known to be safe. It is usually recommended in children over 6 years old. The medication most commonly used is Methylphenidate (Ritalin). Loss of appetite and weight and poor sleep are commonly seen in children on Ritalin. Discuss these issues with your doctor.

Rehabilitation

Behavioural Intervention

There are some techniques which parents can use at home and may also be discussed with teachers to be applied in school. These are :

• Give your child clear step-by-step instructions and make sure they are paying attention to you.
• Praise your child when they have done something well. This will increase their self esteem. Be specific about your praise e.g. how happy you are that they have kept their toys properly.
• Have a system of reward to encourage good behaviour. A star chart (hyperlink)can be a good way to help your child behave better.
• Keep to a routine so that the child knows what to expect every day.
• Help your child organize their day by having daily checklists to ensure that tasks are completed.
• Encourage your child to control his impulses e.g. to think before he blurts out something.
• Build on your child’s strengths and don’t focus on his weaknesses
• Place the child in the front of the class.
• Ask teachers to help by writing down homework that needs to be done in a special notebook which your child can show to you.

Special education

Children with ADHD can be registered with the Department of Special Education, Ministry of Education and placed in Special Education classes. They will benefit from the smaller classes and more individualized attention.

Support Groups

• FAMILY SUPPORT GROUP FOR ADHD/LD AND RELATED DISORDERS Website : http://groups.yahoo.com/group/myadhdsupport
• Adult, adolescents, and children with Attention-Deficit/Hyperactivity Disorders (CHADD) www.chadd.org
• www.adders.org