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Is It Really Attention Deficit Hyperactivity Disorder (ADHD)

ADHD, Attention Deficit Hyperactivity Disorder

 

Distinguishing ‘Normal’ Challenging Behavior from ADHD

Have you noticed signs of distractibility, hypersensitivity, or forgetfulness in your child? It could be attention deficit hyperactivity disorder (ADHD). Data from the department of mental health in 2016 shows that there were 420,000 children aged between 6-15 years suffering from ADHD. Boys are 4-6 times more likely to develop this condition compared to girls. On average, every 40-50 student classroom will contain 2-3 children with ADHD. It is one of the most common conditions faced during childhood. It impacts how children function in school and in everyday life. Understanding the challenges of ADHD allows you to find the best help possible for your child.

 

What is attention deficit hyperactivity disorder?

Attention deficit hyperactivity disorder (ADHD) is a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness. It is common among children aged 3-7 years. The symptoms may become more noticeable when a child begins to attend school. While the exact cause of attention deficit hyperactivity disorder is not clear, there is evidence that children with ADHD show less activity in their frontal lobes than children who do not have the disorder.

 

Symptoms

The primary features of ADHD include inattention and hyperactive-impulsive behavior. ADHD symptoms can be noticeable as early as 3 years of age. The diagnosis also depends on setting and duration that the patient has had the symptoms

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1. Might have (A) or (B) symptoms

 

(A) Six or more symptoms of inattention that are inappropriate for developmental level:
 

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities
  • Often has trouble holding attention on tasks or play activities
  • Often does not seem to listen when spoken to directly
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked)
  • Often has trouble organizing tasks and activities
  • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework)
  • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones)
  • Is often easily distracted
  • Is often forgetful in daily activities

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(B) Six or more symptoms of hyperactivity-impulsivity that is disruptive and inappropriate for the person’s developmental level:
 

Hyperactivity

  • Often fidgets with or taps hands or feet, or squirms in seat
  • Often leaves seat in situations when remaining seated is expected
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless)
  • Often unable to play or take part in leisure activities quietly
  • Is often “on the go” acting as if “driven by a motor”
  • Often talks excessively

Impulsivity

  • Often blurts out an answer before a question has been completed
  • Often has trouble waiting his/her turn
  • Often interrupts or intrudes on others (e.g. butt into conversations or games)

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2. Have these symptoms before 7 years old
3. Several symptoms are present in two or more settings, such as at home and school
4. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functions
5. The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder

 

ADHD alert
 

Differentiating children’s typical behavior from signs of attention deficit hyperactivity disorder can be tricky. While 15-20% of kids with ADHD may seem to outgrow the disorder, in most cases kids with ADHD grow up to be adults with ADHD. Knowing the signs of ADHD will help parents get treatment for their kids right away.

  • Underachievement at school – This can be found in grade 1-2 in children with severe ADHD. If the patient has high IQ (Intelligence Quotient), the performance at school might be normal but tend to decline in secondary school. In children with both ADHD and learning disorder (LD), they often perform poorly at school and fail a subject.
  • A child’s teacher reports learning problems
  • A child's distractibility, hyperactivity, or impulsivity becomes more noticeable
  • Inattention might cause your child to be heedless of danger and impulsivity often makes your child fearless
  • Your children has trouble making friends or quickly loses friends

 

Treatment
 

There are 4 treatment options available for ADHD.

  1. Behavior therapy - to learn or strengthen positive behaviors and eliminate unwanted or problematic behaviors
  2. Medications - Stimulants such as methylphenidate are the best-known and most widely used ADHD medications. Between 70-80% of children with ADHD have fewer ADHD symptoms within 1-4 weeks when they take these fast-acting medications.
  3. Educational support – 1 on 1 classroom or extra support is beneficial for children with ADHD
  4. Doctor consultation - With proper medical care, children with ADHD can live successful and productive lives.

 

Hyperactivity vs ADHD
 

Most kids have moments when they have excess energy. Hyperactivity is a classic sign of attention deficit hyperactivity disorder but not all hyperactive children has ADHD. Hyperactive or over-activity can be caused by ADHD, giftedness, anxiety, delayed motor-sensory development, and brain injury. The exact cause of ADHD is not fully understood, but research shows that if a parent has ADHD, a child has a 50% chance of having it.

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Possible Link Between ADHD in Children and Mobile Phone Use

Nowadays, smartphones are the fastest selling electronic gadget. All parents own smartphones and have used it to distract their children. Maybe you needed a free minute at the grocery store or the bank. Maybe you needed both hands to get a start on dinner. So, you did what works best— you hand the kid your phone with a video or a game, and get done what needs to be done.

There is a correlation between ADHD and mobile phone usage. The increase in children diagnosed with the disorder make researchers wonder how the rise of mobile technology impacts the attention levels of young children and teens. Research shows that children who play games on cell phones were at increased risk of ADHD. However, it is possible that children may play more games on their phone because they already have symptoms of ADHD, such as inattention and hyper-focus.

It is recommended that parents should discourage phone use, monitor the length of use and the content accessed on their child’s phone. Less phone usage will not feel like a punishment if kids and teens have flexible, fun options when it comes to their attention. Other activities or a day at the park or the pool can improve family relationships as well.

 

If you are concerned that your child could have ADHD, it is best to consult a specialist right away. Treatment for ADHD is not just about taking medications. There are many other effective treatments that can help kids with ADHD improve their ability to pay attention, control impulsive behavior, and curb hyperactivity. A balanced treatment plan can improve your child’s performance at school ,relationships with others, and decrease stress and frustration.

 

Reference: 
Dr. Chollapat Chaturongkul, a child and adolescent psychiatrist, child development clinic, Bangkok hospital
www.dmh.go.th
www.psychiatry.or.th
www.thaipediatrics.org


For more information:

Child development clinic, Bangkok child health center

4th floor, Bangkok hospital

8:00-18:00

Tel 0 2755 1213

Email: bmcped@bgh.co.th