Sunita Mohan’s eight-year-old son Girish stood out at school, but not for the right reasons. His teachers complained that he fought with his classmates, that he never paid attention and his marks were going downhill. Initially, his parents thought that he was just a normal child, easily distracted and forever impatient. They knew that other children got into the teachers’ bad books occasionally. But their son seemed to be a perpetual troublemaker.
Girish’s parents gave him pep-talks and tried to make him focus on his studies. But the situation progressively worsened. Girish lost his notebooks often. He would begin a conversation about his day at school. But, suddenly in the midst of his talk he would start discussing his breakfast requirements for the next day, or he would switch on the TV, thus abruptly ending the conversation. A worried Sunita took her son to a clinical psychologist who diagnosed attention-deficit/hyperactivity disorder (ADHD) in Girish.
Many children run around wildly. They race cars, yell non-stop, blurt out answers or crash into furniture despite normal eyesight. A few get easily distracted, tend to act impulsively or struggle to concentrate on the tasks at hand.
“Such behaviour is normal but may be mistaken for ADHD. However, children with ADHD have frequent behavioural problems which severely interfere with their ability to live normal lives. It is then that the parents and teachers should suspect ADHD and consult a psychologist,” says Ravi Samuel, a Chennai-based cognitive behaviour psychotherapist.
ABCs of ADHD
ADHD, a neurobehavioral disorder, is characterized by inattention, impulsivity and hyperactivity. Children with ADHD tend to have abnormal functioning of specific brain chemicals called neurotransmitters. Nerve pathways that regulate behaviour are also affected. Studies suggest that genes, environmental factors, brain injuries during childhood, nutrition and social environment may contribute to ADHD. Psychologists believe that approximately 3-5% of school-going children in our country have ADHD.
“ADHD is more common among boys with studies showing about 4 boys with this disorder for every girl diagnosed. It is difficult to come up with correct statistics as not much field research has been conducted in India on ADHD,” says New Delhi-based clinical psychologist Dherandra Kumar.
ADHD symptoms usually appear when the child is 3-6 years of age. The American Academy of Pediatrics (AAP) defines three types of ADHD. One is the predominantly inattentive type ADHD and the second one is the predominantly hyperactive-impulsive type ADHD. Children having aspects of both fall under the combined type ADHD. Children should have at least six of the defined symptoms with some of them present before the age of seven. The symptoms must be present for at least six months to a degree that is inconsistent with developmental level and should be seen in two or more settings (home, school, or with peers).
Predominantly inattentive type often:
- Fails to pay attention to detail, makes careless mistakes
- Has difficulty sustaining attention in tasks or play
- Does not seem to listen when spoken to directly
- Does not follow through and fails to finish tasks
- Has difficulty organizing tasks and activities
- Avoids tasks requiring sustained mental effort
- Loses things
- Is easily distracted by extraneous stimuli
- Is forgetful in daily activities
Predominantly hyperactive-impulsive type often:
- Fidgets or squirms when sitting
- Has difficulty remaining seated
- Runs around or climbs excessively in inappropriate situations
- Has difficulty playing quietly
- Is often ‘on the go’
- Talks excessively
- Blurts out answers to questions before they have been completed
- Has difficulty waiting for her turn
- Interrupts or intrudes upon others
The ADHD outcome
Other childhood behaviour disorders: “ADHD does not cause other psychological or developmental problems. However, children with ADHD are more likely to have other childhood behaviour disorders or a learning disability,” says Chennai-based psychiatrist Dr U Gauthamadas.
Poor academic performance: Despite having normal intelligence, their academic performance will stay poor. This is because such children are invariably too restless or inattentive – they cannot focus on studies or memorize dates and facts. Children may not have the patience to even finish reading a passage.
Performing executive functions: “Some children may have trouble performing executive functions. They may not be able to hold information in short-term memory or may not be able to shift from one mental activity to another. They may have poor planning skills, and have trouble understanding the importance of goals,” says Dherandra.
Return to normalcy? It cannot be cured or prevented. “But with early intervention and a suitable school environment, many children with ADHD learn to control disruptive behaviour, and improve their concentration skills. They develop personal strengths, and become productive and successful adults. Many have become lawyers, fashion designers and architects. But those with severe ADHD may not go past their high school graduation and would be comfortable with lesser demanding job roles where they assist, but do not lead,” says Ravi.
Parents of children who have ADHD often find it difficult as well as frustrating to cope with the situation. However, remaining calm and maintaining a positive outlook is key. This ClipBook looks at ways of parenting a child with ADHD.