Don't shout, whisper

Children with Attention Deficit Hyperactive Disorder are not problem children. They are children with a problem. They need to be treated gently

"I wish I could glue Johnny to the chair, he just never settles down."
"Tara is always so disorganised. She hardly remembers where she puts her things."
"Rahul has so much potential. If only he focused on his work like he does on computer games and TV, he would be able to do well."
"Although Melvin is always looking out the window, he knows exactly what we are talking about."
"Sam is always raising his hand in class and blurting out the answers. And most of the time his answers are incorrect."

Do the statements sound familiar? If so, there is a possibility that your child may have a condition known as Attention Deficit Hyperactive Disorder (ADHD).

ADHD is a neuro-developmental disorder and children diagnosed with it have difficulties with concentration, hyperactivity and/or impulsiveness. ADHD is more common among boys than girls.

The features of ADHD include:

1. Inattention, i.e., the child has a hard time paying attention, does not seem to listen, is easily distracted, has difficulty sustaining attention, is disorganised, makes careless mistakes, avoids tasks that require mental effort and does not follow instructions.
   
2. Hyperactivity, i.e., the child is in constant motion, cannot stay seated for more than a few minutes, squirms and fidgets and talks excessively.
   
3. Impulsivity, i.e., the child acts and speaks without thinking, has no idea about cause and effect, often has mood swings and temper outbursts, has trouble taking turns and interrupts others.

Children with ADHD often end up having learning difficulties, behaviour problems, low self-esteem and poor social skills.

There are three types of ADHD:

• Inattentive only (ADD): Children with this form of ADHD are not overly active but have problems with concentration and paying attention. Since these children are not disruptive, it is difficult to notice the symptoms. Among girls this type of ADHD is most common.
  
• Hyperactive/Impulsive: These children can pay attention but have problems of hyperactivity and impulsiveness.
  
• Combined Type: In this type of ADHD children display all three symptoms and it is the most common form of the disorder.

The exact cause of ADHD is still unclear, but research done states that:

• ADHD is a biological disorder and children diagnosed with it have problems with chemicals that send messages to the brain.
• ADHD tends to have a genetic link. In many cases the father of the child is also diagnosed with the disorder.
• Recently, studies have shown the presence of a specific gene abnormality especially involving the dopamine system in individuals with ADHD.
• In some cases exposure of the mother when carrying the child to toxins may lead to ADHD.
• Very severe head injuries may also cause ADHD in few cases.

Management of children with ADHD would involve:

1. Medications: Medication is not necessary in all cases, however, there is strong evidence that use of medication along with other strategies can be very effective in the management of ADHD.
2. Behaviour therapy: House rules, token economy systems, time out, charts, contracts etc., are all behaviour techniques that help when dealing with a child with ADHD.
3. Diet management: Although there is no strong evidence, diets free from artificial colouring, preservatives and amines have been reported to help children with this condition.
4. Educational strategies: Strategies aimed at reducing distractions and providing learning support to children with ADHD are essential.
5. Counselling: This is helpful for children who have low self-esteem and are demotivated. Counselling also helps children improve social skills and peer relations.

Family counselling is effective as an effort to support parents and siblings cope with the stress of managing a child with ADHD.

Parents must consult with a qualified psychologist, psychiatrist or pediatrician for an assessment of the child who they suspect has ADHD. It is important to bear in mind that children with ADHD are not problem children, but children with a problem.

If undiagnosed and untreated ADHD can prevent children from having a happy childhood and leading a productive life, which is the right of every child.

Acceptance of the existence of ADHD is the first step toward helping your child cope with the problem. A positive approach to helping children to effectively cope with the symptoms of ADHD can turn their life around making it more meaningful.

The writer is a DOH, Dubai and US certified guidance counsellor with an M.Ed degree in school counselling from Boston, USA. She is currently working as co-ordinator ? counselling services, GEMS, UAE.