Once thought to be only a childhood condition, global cases of ADHD have risen dramatically in both adults and children in the past 20 years.
During the pandemic diagnoses of the condition have skyrocketed further, with 17% of children and 22% of adults taking ADHD medication for the first time, according to surveys by ADDitudemag.com. “Parents gained a front-row seat to their kids’ attentional and educational struggles during remote school, while adults’ own coping mechanisms and systems broke down, revealing core problems with motivation, memory, and organization,” say the survey editors.
While the symptoms mean that it's hard to diagnose a child before the age of about 5 (children are expected to be energetic and impulsive after all), latest research suggests that it's important to factor in the possibility of ADHD at a pre-school level, in order to best help little ones who may otherwise struggle. Here’s what you need to know about ADHD in children in the UAE.
What is ADHD, and how is it different from ADD?
Attention Deficit Hyperactivity Disorder, or ADHD, is a common childhood condition which affects a child’s school, social and home life. Studies show that ADHD may affect certain areas of the brain that allow us to solve problems, plan ahead, understand others’ actions, and control our impulses. This is the reason that children with ADHD exhibit symptoms of physical hyperactivity or excessive restlessness, a decrease in focus or attention and impulsivity.
“The difference between ADD – Attention Deficit Disorder - and ADHD is that the diagnosis of ADHD includes hyperactivity whereas in ADD, children are not necessarily hyperactive; they can be calm and serene,” said child psychologist Dr Haneen Jarrar. “They will, however, have difficulty with concentration and attention.”
How common is ADHD?
It is believed that up to 11 per cent of children aged 4-17 have been diagnosed with ADHD at some point in their lives, according to US research. Boys are nearly three times more likely to have been diagnosed with ADHD (13.2 per cent) than girls (5.6 per cent).
What are the symptoms of ADHD?
Classic symptoms of ADHD include inattention, hyperactivity and impulsivity. Children with ADHD have trouble maintaining focus and controlling their behaviour. “These children may struggle at school, get into frequent trouble, and find it hard to get along with others or make friends,” says Dr Jarrar.
At what age do symptoms begin to show?
It can be difficult to diagnose ADHD completely before the age of 5 because most young children are highly energetic, easily distractible and impulsive. “According to research, the average age of diagnosis is 8 years for ADHD and 10 years for ADD,” says Dr Jarrar.
A child who shows a pattern of inattention may often:
• Fail to pay close attention to details or make careless mistakes in schoolwork
• Have trouble staying focused in tasks or play
• Appear not to listen, even when spoken to directly
• Have difficulty following through on instructions and fail to finish schoolwork or chores
• Have trouble organizing tasks and activities
• Avoid or dislike tasks that require focused mental effort, such as homework
• Lose items needed for tasks or activities, for example, toys, school assignments, pencils
• Be easily distracted
• Forget to do some daily activities, such as forgetting to do chores
HYPERACTIVITY AND IMPULSIVITY
A child who shows a pattern of hyperactive and impulsive symptoms may often:
• Fidget with or tap his or her hands or feet, or squirm in the seat
• Have difficulty staying seated in the classroom or in other situations
• Be on the go, in constant motion
• Run around or climb in situations when it's not appropriate
• Have trouble playing or doing an activity quietly
• Talk too much
• Blurt out answers, interrupting the questioner
• Have difficulty waiting for his or her turn
• Interrupt or intrude on others' conversations, games or activities
TYPICAL BEHAVIOUR V ADHD?
Most healthy children are inattentive, hyperactive or impulsive at one time or another. It's typical for preschoolers to have short attention spans and be unable to stick with one activity for long. Even in older children and teenagers, attention span often depends on the level of interest.
The same is true of hyperactivity. Young children are naturally energetic — they often are still full of energy long after they've worn their parents out. In addition, some children just naturally have a higher activity level than others do. Children should never be classified as having ADHD just because they're different from their friends or siblings.
Children who have problems in school but get along well at home or with friends are likely struggling with something other than ADHD. The same is true of children who are hyperactive or inattentive at home, but whose schoolwork and friendships remain unaffected.
WHEN TO SEE A DOCTOR?
If you're concerned that your child shows signs of ADHD, see your pediatrician or family doctor.
How does having ADHD impact the life and development of a child?
ADHD can cause impairment in all areas of functioning in a child’s life, said Dr Jarrar. “For instance, the child can get trouble at home with his/her parents regarding behavioural problems, may have difficulty making and maintaining friends at school, may get in trouble with the teacher in class for not be able to sit in the chair properly, or blurt out answers before being called upon.”
How often are children misdiagnosed with ADHD?
“A comprehensive diagnostic assessment should include a standardised assessment test that involves a child psychologist or psychiatrist administering the test, and producing a report detailing how the child meets the diagnosis,” said Dr Jarrer. “The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association and has strict guide lines on what symptoms a child should exhibit to confirm a diagnosis. These guidelines can be found online and are easily accessible to parents.”
Why is ADHD on the rise?
Even before the pandemic, studies showed that ADHD was on the rise. “A 2015 study showed that diagnoses of ADHD have risen by 43 per cent in the USA between 2003 and 2011. Different countries have different rates of increase, however studies have indicated that several factors affect the prevalence of ADHD, including genetic factors, environmental factors and health and dietary factors” said Dr Jarrer.
What are the challenges of parenting a child with ADHD?
“Having a child with ADHD can be very challenging for parents.They have to be extremely patient, learn new methods to positively discipline the child, be understanding towards his/her condition, deal with the child’s school regarding difficult behaviour, constantly find creative ways to help them adjust at home and at school. Finding support groups is also very helpful.”
THE MOST COMMON MYTHS ABOUT ADHD
- The child can outgrow his/her ADHD with time and age.
- Medication alone cures ADHD entirely.
- Parents of children with ADHD have done a poor job disciplining their children.
- ADHD behaviour is caused by eating too much sugar.
• Therapy is usually the first port of call for treating ADHD in young children, while diet and supplements can also play a part in treatment, and more severe cases may involve medication. The UK's NHS has guidelines for treating ADHD.
• Finding a centre that includes a multidisciplinary team is very important for a child with ADHD. This is because treatment should always be multidisciplinary and include a psychiatrist, psychologist, occupational therapist, speech and language therapist and other health professionals.
• Psycho-education is very important in any and all psychological conditions. It is important to educate the family and school about ADHD symptoms, diagnosis, and prognosis; it helps everyone involved manage expectations and be more understanding towards the child’s difficulties.
• A combination of positive parenting strategies along with behaviour therapy is a great way to tackle the difficulties caused by ADHD.
• Focusing on the child’s positive behaviour instead of negative behaviour can seriously help in not only managing difficult behaviour, but also maintaining self-confidence and self-esteem.
• It is also important to help the child feel supported and accepted by his/her family, school and peers.