Attention Deficit/Hyperactivity Disorder

Most parents and child minders are familiar with the term Attention Deficit/Hyperactivity Disorder  (ADHD). In fact, a lot of people easily refer to an active child as having ADHD, even if the child displays normal curiosity and restlessness.

How do you know when to start worrying if your child has ADHD?

On 14 September we celebrate the first official ADHD day in South Africa. As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate our members - and future members - on a range of healthcare topics, we would like to shed some light on this condition.

ADHD is a hereditary disorder that affects approximately eight to ten percent of South Africa's population. Although it can be present from birth, diagnosis should only take place between the ages of five and seven. The most common symptoms of ADHD are chronic behaviour patterns of inattentiveness, lack of impulse control and excess energy.

However, many children, especially those under the age of five, can be inattentive and restless and this does not necessarily mean that they have ADHD. "Unfortunately there is no simple test for ADHD and making a full diagnosis requires an experienced specialist assessment generally done by a child psychiatrist or specialist paediatrician," says GEMS, South Africa's second largest medical scheme.

Interesting enough, ADHD is not limited to children and can persist throughout a person's lifetime. Approximately 50% of ADHD sufferers have a reduction in symptoms in adolescence and adulthood. Because only a few adults outgrow the symptoms of ADHD completely, many will still have problems following conversations, forgetting assignments and anniversaries, or even shop and gamble compulsively.

What causes ADHD?

What exactly causes ADHD is still a mystery. The only certainty is that it is caused by a neurological and biochemical imbalance and that it is an 80% genetic condition.

The disorder therefore runs in families and boys are more likely to be affected than girls.

What are the signs of ADHD?

Your child may:

• be restless, fidgety and overactive
• continuously chatter and interrupt people
• be easily distracted and does not finish things
• be inattentive and cannot concentrate on tasks
• be impulsive, suddenly doing things without thinking first
• have difficulty waiting their turn in games, in conversation or in a queue

Most of the above behaviour is common in children but it becomes a problem when these characteristics are exaggerated, compared to other children of the same age.

What other conditions can be confused with ADHD?

It is very important to rule out other conditions that can look like ADHD:

• Allergies/Asthma - difficulty with breathing that can interrupt a child's concentration and cause ADHD-like signs
• Diabetes/Hypoglycaemia - these conditions relate to the quantity of sugar in the blood and can cause changes in concentration and activity levels
• Hearing or Visual problems - the inability to see or hear what is going on in the classroom can lead to behavioural disruptions, not completing the task at hand and hyperactivity
• Iron deficiency - can lead to attention problems
• Learning problems - if a child is frustrated from learning disabilities, he or she may have ADHD-like behaviour
• Emotional difficulties - these could be due to divorce, a death in the family or an accident that could manifest with trauma symptoms

How is ADHD treated?

Experience has shown that the most effective treatment is a combination of dietary intervention, medication and supplements. It is also recommended that children undergo counselling and/or therapy to learn skills to cope with their problems. This will also equip them with alternative behaviour in difficult circumstances. It is also imperative to alert your child's teacher or caretaker to his or her condition in order for them to accommodate the child's social and academic needs.

You may need to try different medications and dosages to find the right one that suits your child. It is recommended that parents and teachers maintain keen observation during the trial period for different medication.

Tips on coping with an ADHD child

• To maintain discipline it is advised to establish a few consistent rules that if broken will have immediate consequences. Praise the child for his or her good behaviour.
• A reward-system is a good idea to encourage the child to work in order to earn privileges that he or she wants by accumulating points for good behaviour. Removing points for undesirable behaviour will also teach them that their actions have consequences.
• A written agreement is an ideal way to have your child agree to do his or her homework every night or to demonstrate other desired behaviour in return for a privilege.
• Designate a specified time-out location for times when the child is out of control. This should be seen as a "calm down" spot and not as a place of punishment.
• Homework should be done at a specific time each day in a study area away from distractions.
• Ask the child's teacher to give you a checklist of homework to be done.
• Compile a calendar of long-term assignments as well as other tasks.
•  Showing emotional reactions such as anger, sarcasm and ridicule should be avoided.

Because ADHD children can be scolded so often, reassuring them of your love is vital in building a healthy self-image. When you point out a wrongful action, try to compliment them on something he or she has done right. Remember to show them you care even if you feel you have reached the end of your tether.

If you have any more questions on ADHD, you can phone the GEMS call centre on 0860 00 4367 or send a SMS to 083 450 4367. GEMS will assist you in every way possible to ensure your families health and well-being.