Attention Deficit Hyperactivity Disorder is a mental illness which affects millions of children. Nupur Khandelwal, however, was unaware of this developmental disorder until her 3-year old son Mohit was diagnosed with ADHD.
“Mohit has been an energetic kid from the start, jumping here and there all the time. He often has difficulty in paying attention to one thing for long but I had no idea that this could be a sign of something so serious,” said a distressed Nupur.
She got a hint of Mohit’s condition after she heard from his preschool teacher who was concerned about his behaviour.
“Mohit’s ability to focus has gone down drastically. He often finds it difficult to pay attention in class and gets easily distracted by sounds outside. Also, he has become very fidgety. He keeps on tapping on his table disturbing the entire class,” Mohit’s teacher said.
Nupur felt extremely worried when she heard these facts. She tried talking to her son but it didn’t make a difference. Finally, she sought medical advice from Ms. Rashi BIjlani, Clinical Psychologist, at the Child Development Clinic at Sitaram Bhartia Hospital in Delhi.
Diagnosis of ADHD
Diagnosis of Attention Deficit Hyperactivity Disorder is a long process and sometimes it is difficult to diagnose due to some coexisting conditions like anxiety, mood or sleep disorders.
Rashi asked Nupur to describe his behaviour at home and school and since when he had been exhibiting these ‘symptoms’.
“Neurological conditions such as ADHD often have comorbidities so there are a few prerequisites which confirm the diagnosis of ADHD,” explained Rashi.
To be diagnosed with ADHD, children must:
- show at least 6 out of 9 symptoms of ADHD.
- start showing symptoms early in life i.e. before age of 12.
- have symptoms for at least 6 months in at least two settings – home and school.
Mohit’s symptoms fulfilled all the above prerequisites.
Rashi proceeded to ask Mohit a few questions to understand how his mind worked. She also gathered information from his other family members and teachers to reach a proper diagnosis.
“Has anybody from your family ever experienced ADHD?” Rashi asked Nupur.
Upon Nupur’s denial, Rashi continued with her examination.
After a thorough physical examination and a proper study of all his reports, Mohit was diagnosed with Attention Deficit Hyperactivity Disorder.
Symptoms of ADHD
Nupur requested Rashi to explain the condition and its symptoms to her in detail so she could understand what was happening to her son.
ADHD symptoms are spread across three key behavioral issues. The child may not show symptoms across all the three areas and can be restricted to only one area.
The three areas are:
- Inattention: The common symptoms a child shows under this are:
- lack of persistence
- difficulty in focusing on one thing for a long time
- inability to follow instructions
- problem in organizing things
- careless mistakes in schoolwork
- Lack of interest in doing tasks which require sustained mental effort
- Hyperactivity: A few common symptoms are:
- being fidgety
- squirming in the seats
- having trouble in waiting for one’s turn
- inability to do things which need a lot of sitting like attending classes
- Impulsive actions: A child showing symptoms of acting on impulse often:
- makes hasty decisions without thinking
- blurts out answers interrupting the other person
- wants immediate gratification.
Based on the above symptoms there are three types of ADHD witnessed in children –
- Predominantly inattentive ADHD
- Predominantly hyperactive and impulsive ADHD
- Combination of both
“What causes such a disorder in children so small?” asked Nupur.
Causes of ADHD
The cause of ADHD is often unknown.
“ADHD can be a genetic condition and can run in families. Increased exposure to lead or pesticides via food may also increase the risk of having ADHD,” informed Rashi.
Treatment of ADHD
“Is ADHD curable?” asked a panic-stricken Nupur.
There is no treatment to cure ADHD but its symptoms can be managed with proper educational support and counselling.
“Stimulant medicines are sometimes used to control the symptoms of ADHD. These medicines boost and balance the levels of chemicals in the brain like neurotransmitter dopamine which help in effectively improving the symptoms of inattention and hyperactivity,” said Rashi.
Your child can also avail behavioral therapy and counselling to manage his symptoms better.
Role of Parents in Managing ADHD
“How can I help him?” asked Nupur.
Some of the ways you can help your child are::
- Plan the day for your child so that he knows what to expect.
- Find ways to improve your child’s self-esteem and sense of discipline.
- For example, Nupur learned from Mohit’s teacher that he loved running in his physical education classes. She planned his day’s activities in such a way that it involved 30-45 minutes of races. Every time he won a neighbourhood race, she cheered and congratulated him. This gradually improved his self-esteem and helped him remain active. It was also a good way to channelize his energy.
- Give specific, brief instructions and praise your child when he does them right.
- With the guidance she received from the psychologist, she understood she had to give Mohit clear instructions on what to do so he could organize his thoughts accordingly. She began to be more direct, using sentences like “Please brush your teeth.” “Please do not play with your food.”
- Make sure your child gets enough exercise.
Overlapping or Co-morbid conditions your child may experience
Children with ADHD have higher chances to develop the following psychological conditions:
- Learning disabilities
- Anxiety disorder
- Disruptive mood dysregulation disorder marked by irritability
- Oppositional defiant disorder characterized by negative, defiant and hostile behaviour towards figures with authority
- Conduct disorder depicted by negative behaviour like stealing, fighting, destroying property and harming animals and people
- Depression or bipolar disorder
The most important aspect of managing ADHD in children is to identify and manage any comorbid conditions that might exist.
Mohit was prescribed some stimulant medications and advised to take regular counselling sessions to help him cope with the symptoms.
As time went by and Nupur worked with his preschool teacher to monitor his progress, and plan his days accordingly, she noticed that he became more disciplined as compared to earlier.
There were times that she struggled to get Mohit to pay attention but instead of getting angry with him, she reassured him that he was doing well and that he just needed to focus a little more.
“As parents, you must realize that children with ADHD cannot control their behaviour, so it’s important to be as patient as possible with them as they adjust to their new routine, “ concludes Rashi.
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