ADHD in children

ADHD is associated with neural pathways in brain functioning where it yields to problematic behaviours.
Representational Image
Representational ImageMubashir Khan/GK File

Attention deficit hyperactive disorder is one of the most missed out conditions in children as it is either attributed to their disruptive behaviour, being naughty, over pampered, inattentive, a spoiled child, a mess maker in class.

But beyond these labels lies a diagnosis- ADHD: A Neurodevelopmental Disorder. ADHD is associated with neural pathways in brain functioning where it yields to problematic behaviours.

We all may have gone through a phase where it is difficult to sit at one place, not able to pay attention or have difficulty in controlling impulses. But for some people this phase is forever and it is so pervasive and persistent that it interferes with all the aspects of life: personal, educational, occupational and social.

ADHD is still one of the most common neurodevelopmental disorders of childhood affecting approximately 11 percent of school going children. The symptoms of ADHD continue into adulthood in more than three quarters of cases.

ADHD is characterized by developmentally inappropriate levels of inattention, impulsivity and hyperactivity.

When do you know that your child can have ADHD:

When these signs are persistent and pervasive, it can be indicative of your child having ADHD.

Inattention

Forgetfulness

Daydreaming a lot

Making careless mistakes in school work like in spellings, calculations

Poor study skills for age

Difficulty in listening to others and following instructions

Difficulty in initiating a task (e.g., hard to wake up in the morning, slow to react)

Difficulty attending to details

Difficulty in focusing on things (e.g., starting on a task), or sustaining attention (e.g., not able to pay attention on one thing) or shifting attention (e.g., will keep on playing video games for hours together once started)

Poor organizational and prioritizing skills (e.g., procrastinates excessively)

Impulsivity

Often interrupts others

Has difficulty waiting for his or her turn in school and/or social games

Tends to blurt out answers instead of waiting to be called upon

Takes frequent risks, acting without thinking of the consequences Hyperactivity

Seems to be in constant motion; runs here and there, as if he’s driven by motor, doesn’t get tired

Has difficulty remaining in his/her seat even when it is expected- trouble staying still

Fidgets with hands or squirms when in his or her seat; fidgeting excessively

Talks excessively

Has difficulty engaging in quiet activities

Loses or forgets things repeatedly and often (like notebooks, pencils, erasures, etc)

Inability to stay on task; shifts from one task to another without bringing any to completion

Engaging in activities loudly and disruptively (e.g., while playing can hurt others, gets hurt often)

Life of an ADHD child

The Pre-school years: ADHD kids have poor intensity of play and excessive motor restlessness. Associated difficulties, such as delayed development, oppositional behaviour, and poor social skills, may also be present.

The primary school years:

ADHD in primary school years begins when the child is seen as to be different from his/her classmates as they start developing skills that help them to learn and adapt in school. The ADHD child will start experiencing academic failure, rejection by peers, low self esteem and negative feedback by teachers. Comorbid problems, such as specific learning difficulties, may also start to impact on the child, further complicating diagnosis and management. Family members will face difficulty in handling the child at home or at outings. The child may not be invited by other children for play activities or people may refuse to take care of the child as the child needs more supervision. Children with ADHD may also have poor sleep patterns.

ADHD in youngsters:

Overactivity may decrease by adolescence but inattention, impulsiveness, inner restlessness, not being able to prioritise and organise will remain major difficulties. Excessive aggression and antisocial behaviour may also develop. Curiosity to try out drugs or engage in other risk taking behaviour will be higher in adolescence with ADHD. They may witness more parent teen conflict and severe lack of friendship. They are at increased risk of academic failure, dropping out of school or college and criminal behaviours. They also tend to have problems with driving, they are at increased risks of traffic violations- especially over speeding, and can also get into traffic accidents especially the fatal ones.

ADHD in adult life:

Approximately 60 percent of individuals with ADHD symptoms in childhood continue to have difficulties in adult life. Adult ADHD is complex, as due to their inattention or indecisiveness or difficulty in organising and prioritising work they have higher chances of getting dismissed for job, not able to decide what specific work they want, aren’t satisfied with the jobs they are in, frequently will change jobs and are frequently self-employed. They will witness higher rates of interpersonal difficulties with employers and colleagues. Further problems are caused by lateness, absenteeism, excessive errors, and an inability to accomplish expected workloads. At home, relationship difficulties and break-ups are more common. The risk of substance abuse is significantly increased in adults with persisting ADHD symptoms.

How to help your child:

As a parent, you did not cause your child’s ADHD, but you hold a key to helping your child get better.

FOCUS ON WHAT YOUR CHILD DOES RIGHT RATHER THAN WRONG: Appreciating and rewarding the good behaviours verbally or with physical gestures (clapping, etc) or some incentives and not paying too much of attention on bad behaviours- this will eventually decrease the bad behaviours and increase the good behaviours.

SET CLEAR EXPECTATIONS & BE CLEAR: Creating a daily routine, with rules about doing homework, bedtime, getting ready for school in the morning, and other key moments in the day. Giving your child specific rather than general directions.

CLUTTER FREE SPACE: Minimizing distractions in your home while he is studying (for e.g., keep his desk clean and study space away from noises, TV or family).

SET SMALL ACHIEVABLE TARGETS: Helping your child break down large tasks and set small, achievable goals that, over time, add up to more substantial accomplishments.

AGE-APPROPRIATE REWARDS: Give incentives to your child for good behaviour but it should be age appropriate.

DAILY REPORT CARD: Working with a teacher to create a daily report card (DRC) on certain behaviours that you want to see improved, behaviours that, if changed, would lessen the child’s problem in daily life. The behaviours can be peer relations, academic work and relationships with adults.

SCREAM LESS PARENTING: It may be difficult for you to control your anger when your child makes a mistake but change will occur only when a message is conveyed without shouting.

LESS SCREEN TIME: Screen time should be minimal as it activates a child’s brain and affects his/her sleep.

AVOID SUGAR: Consumption of sugary products increases the energy making the child’s body more hyperactive.

EXERCISE: Your child’s daily routine should include some sort of sports, cycling, etc for channelisation of energy.

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