“My thoughts are like butterflies. They are beautiful, but they fly away.”

Nowadays, parents are finding it increasingly difficult to keep up with their children. Parents frequently complain that their children are so mischievous that controlling them and disciplining them is becoming a task. Many people are of the opinion that children trouble them on purpose, despite telling them repeatedly to not do something, they still do it. We resort to explaining to the children if that doesn't work we shout or hit but still when they don't listen we need to look for other reasons. 

Children who have ADHD are not purposely troubling their parents and family. They are not being mischievous on purpose. A child with ADHD can get on the nerves of the family member and stretch their patience to an insurmountable level, but it is important to understand that the child is not at fault.

According to the National Institute of Mental Health (NIMH), Attention Deficit/ Hyperactivity Disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/ or hyperactivity-impulsivity that interferes with functioning or development.

Childrens with ADHD are intelligent, with proper care and treatment they can excel in life

  • Inattention: means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.
  • Hyperactivity: means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity.
  • Impulsivity: means a person makes hasty actions that occur at the moment without first thinking about them and that may have a high potential for harm, or a desire for immediate rewards or inability to delay gratification. An impulsive person maybe socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.

SYMPTOMS OF ADHD:

According to the National Institute of Mental Health (NIMH), inattention and hyperactivity/ impulsivity are the key behaviours of ADHD. Some people with ADHD only have problems with one of the behaviours, while others have both inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD.

In preschool, the most common ADHD symptom is hyperactivity.

It is normal to have some inattention, unfocused motor-activity and impulsivity, but for people with ADHD, these behaviours:

  • Are more severe.
  • Occur more often.
  • Interfere with or reduce the quality of how they function socially, at school, or in a job.

Inattention:

People with symptoms of inattention may often:

  • Overlook or miss details, make careless mistakes in schoolwork, at work, or during other activities.
  • Have problems sustaining attention in tasks or play, including conversations, lectures, or lengthy reading.
  • Not seem to listen when spoken to directly.
  • Not follow through on instructions and fail to finish schoolwork, chores or duties in the workplace or start tasks but quickly lose focus and get easily sidetracked.
  • Have problems organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines.
  • Avoid or dislike tasks that require sustained mental effort, such as schoolwork or homework, or for teens and older adults, preparing reports, completing forms or reviewing lengthy papers.
  • Lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones.
  • Be easily distracted by unrelated thoughts or stimuli.
  • Be forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments.

Hyperactivity-Impulsivity:

People with symptoms of hyperactivity-impulsivity may often:

  • Fidget and squirm in their seats.
  • Leave their seats in situations when staying seated is expected, such as in the classroom or in the office.
  • Run or dash around or climb in situations where it is inappropriate or, in teens and adults, often feel restless.
  • Be unable to play or engage in hobbies quietly.
  • Be constantly in motion or "on the go", or act as if "driven by a motor".
  • Talk nonstop.
  • Blurt out an answer before a question has been completed, finish other people's sentences, or speak without waiting for a turn in the conversation.
  • Have trouble waiting for his or her turn.
  • Interrupt or intrude on others, for example in conversations, games, or activities.

ADHD not only affects children but also continues into the teenage years and adulthood. ADHD is more common in boys than in girls. ADHD is usually diagnosed between 6 to 12 years of age.

CAUSES OF ADHD:

The exact cause of ADHD is unknown, but ongoing research indicates that ADHD has a genetic factor. In fact, research also indicates differences in the brains of people who have ADHD and those who don't have ADHD.

  • Genes: ADHD has a genetic factor, research stipulates that both parents and siblings of a child with ADHD are four to five times more likely of having ADHD too. The inheritance of ADHD is more complex than it seems and it is not just due to a single genetic fault. 
  • Brain function and structure: Research has indicated various possible differences in the brains of people with ADHD compared to those who don't have ADHD. Certain studies involving brain scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger. Studies also suggest that people with ADHD may have an imbalance in the neurotransmitter level in the brain, or the chemicals in the brain may have an imbalance due to which their functioning may be disrupted. Research has also indicated that the brain may take an average of 2 - 3 years longer to mature in children with ADHD, compared to children who don't have ADHD.  
  • Cigarette smoking, alcohol use, or drug use during pregnancy: If the child’s mother continually uses cigarettes, alcohol, nicotine or cocaine during pregnancy, then the child is at risk of developing ADHD.
  • Exposure to environmental toxins, such as high levels of lead, at a young age: If children have chronic exposure to environmental toxins and high levels of lead, it may influence behaviour and brain chemistry which may lead to the development of ADHD.
  • Low birth weight.
  • Brain injuries.
  • Being born prematurely (before the 37th week of pregnancy).

COMPLICATIONS:

Attention-deficit/hyperactivity disorder can make life difficult for children. The complications that children with ADHD face are as follows:

  • Children with ADHD struggle in school, which can lead to academic problems.
  • They may have poor self - esteem.
  • They are likely to be judged by others, they may have trouble interacting and being accepted by peers and others.
  • They are more prone to having accidents and injuries.
  • They are at an increased risk of alcohol and drug abuse and other delinquent behaviours.

CO-EXISTING CONDITIONS:

Children with ADHD are more likely than others to also have conditions such as:

  • Learning Disorders
  • Oppositional Defiant Disorder (ODD)
  • Disruptive Mood Dysregulation Disorder (DMDD)
  • Depression
  • Tourette Syndrome
  • Conduct Disorder
  • Bipolar Disorder
  • Anxiety Disorder

TREATMENT OF ADHD:

  • Medications: The medications for ADHD help reduce hyperactivity and impulsivity and help improve their concentration, ability to focus which further helps them learn, study and work. Medications may also help in improving the child's physical coordination. Parents are often very worried to give medication to children for treating ADHD but for moderate to severe ADHD, medications work very well and can be a big help to improve the child's academic performance and behavior.
  • Stimulants: Stimulants are also used for treating ADHD. Stimulants help increase the brain chemicals dopamine and norepinephrine, which further constructively helps in thinking and attention. Stimulants include amphetamine and methylphenidate.
  • Non-stimulants: Another type of medication that helps in ADHD are Non-stimulants. Non-stimulants take longer to start working as compared to stimulants, but they help improve focus, attention, and impulsivity. Non-stimulants include atomoxetine, clonidine, or guanfacine. These medicines can be used alone or in combination with stimulant medicines.
  • Psychotherapy: With the help of Behavior Therapy, parents learn about ADHD and to deal with their child, they also learn strategies, such as positive reinforcement, to improve their child's behaviors. Cognitive behavioral therapy (CBT) helps the child in learning to be aware and accepting of one’s own thoughts and feelings to improve focus and concentration. Family therapy helps family members understand their child's condition and deal with the child's troubling behaviors and teaches them techniques as to how to handle their child and deal with them in an effective manner.

CARING FOR A CHILD WITH ADHD:

It can be very difficult to handle a child with ADHD. They are always on the run and dealing with them can be quite exhausting not only for the parents but for the other family members as well. Children with ADHD cannot follow complex routines like we do, so simplifying their day would make their life much simpler. Children with ADHD have short attention spans so treating them with short breaks will help them and you as a parent to take a breath. The following are certain pointers you can follow to take care of your child:

  • Simplify your child's routine, set pre-decided times for your children which can be easier for them to follow.
  • Give them simple instructions. Your child may not be able to retain complicated instructions because they are easily distracted.
  • Make sure you have your child's undivided attention while talking to them.
  • If you have given them certain instructions, make sure that they repeat it back to you, to ensure that they have understood.
  • Give them simple rules to follow and remind them calmly if they forget.
  • Be patient with your child.
  • Praise your child for appropriate behaviour.
  • For inappropriate behaviour or for behaviours that you feel are unacceptable, do not reprimand your child by hitting or shouting. On the other hand, explain to them why their behaviour is inappropriate. Use time-out for younger children and for older children use an appropriate technique.

"ADHD is a behavioural disorder, not an illness or a sign of low intelligence. With understanding, care and medical treatment, a child who has ADHD can lead a normal life."