It’s easy to label him as hyperactive. Some well-meaning relatives or friends may have even asked you, does he have attention deficit hyperactivity disorder (ADHD)?
Here are symptoms of the condition:
· Does not listen or focus.
· Has trouble completing a task.
· Talks excessively.
· Has problems remembering things and following instructions.
· Interrupts and disrupts conversations.
· Unable to keep emotions in check.
· Often stares into space or daydreams.
“Most symptoms are only observed when they are of school appropriate age, in a natural school setting.”
But before you go self-diagnosing your child, know that it’s important to seek a professional diagnosis and early intervention, if necessary.
SmartParents gets details on ADHD from Alex Liau, clinical director, and therapist Hazirah Adilah Sahal of Nurture Pods, an early intervention centre.
How can you tell whether a child has ADHD, or whether he is merely being playful or hyperactive?
A diagnosis depends on the symptoms that have occurred in the course of the past six months. This way, you’ll know that the child is not being playful, or hyperactive temporarily. ADHD is diagnosed as one of three types: inattentive type, hyperactive/impulsive type or combined type.
The child will be assessed for ADHD symptoms by the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM V). Additionally, the criteria indicates where and how frequently the symptoms are displayed, and the degree to which they interfere with daily life. Specific DSM V symptoms and diagnoses can be found on the American Psychiatric Association (APA) website.
At what age can ADHD be diagnosed?
ADHD can be diagnosed from as early as 4 years old, but most symptoms are only observed when they are of school appropriate age, in a natural school setting. The symptoms are more likely to begin before 7 years of age, and be evident for at least six months. It is better for the child to be diagnosed as early as possible, as early intervention can promote healthy development.
How does ADHD affect the lifestyle of a child and his family?
Children with ADHD may suffer from low self-esteem, which results in them blaming themselves for behaving badly, or for not being academically inclined.
Having a child with ADHD is distressing for the entire family, especially when the child does not respond to requests or advice. As such, ADHD can strain relationships among guardians and the children, between two parents, as well as the extended family.
How does it affect the other children in the family (the child’s siblings)?
Siblings may resent the time and attention that their sibling (with ADHD) needs. They may take it out on the sibling for upsetting the family, or on the parents for condoning such behaviour.
For this reason, families of children with ADHD have a tendency to have less contact with others (including friends and extended family), which can lead to isolation and further amount of stress.
“Children with ADHD may suffer from low self-esteem, which results in them blaming themselves for behaving badly, or for not being academically inclined.”
Who can diagnose your child with ADHD?
An appropriate diagnosis can only be given by a licenced health professional that has accumulated data about the child, his behaviour and his environment. Physicians ranging from developmental paediatricians, psychiatrists and neurologists are able to diagnose a child with ADHD.
What kinds of tests determine whether the child has ADHD?
The ADHD assessments used at hospitals such as the Institute of Mental Health are the Conners scale and the Continuous Performance Task (CPT).
The Conners scale is made up of questionnaires that help screen for emotional, behavioural, and academic disorders. The CPT test measures an individual’s sustained and selective attention. Sustained attention is the ability to maintain consistent attention on a stimuli, whereas selective attention is the ability to maintain attention on a relevant stimuli while ignoring competing stimuli.
So, if I suspect that my child has ADHD, where do I go?
The medical institutions that offer consultation and treatment for ADHD include:
· Singapore General Hospital (SGH), at the department of neonatal & developmental medicine.
· The Institute of Mental Health’s Neurobehavioural Clinic (Child).
What kinds of treatment are available?
Occupational therapy helps children with ADHD improve certain skills such as organisation, physical coordination and controlling their hyperactivity. It also helps them with daily tasks appropriately, such as taking a shower, making their bed and so on.
Another treatment is the early intervention programme, which consists of structured teaching using the TEACCH method, and Applied Behavioral Analysis (ABA), which uses techniques like positive reinforcement to teach positive behaviour. Good behaviours are rewarded while undesirable behaviours are ignored.
Do fidget spinners* help kids with ADHD?
For kids who always move around, climbing up on chairs, and getting out of class, for instance, the fidget spinner can help to distract them in place of the ADHD behaviour. The fidget spinner is appropriate because they can be seated while playing with it. But it’s not a long term solution. You’ll need to praise them for sitting down, and let them find the intrinsic motivation to stay still and eventually wean them off the spinners.
*A fidget spinner is a small toy comprising two or three prongs arranged around a central bearing, designed to be spun by the fingers as means of improving concentration or relieving stress.
Is medication necessary for kids with ADHD?
In severe cases, the child might need medication. Sometimes, behaviour therapy is recommended, together with medication.
Stimulant medication may include methylphenidates (like Ritalin, Metadate and Concerta), which are central nervous system stimulants. Amphetamine-based medication, like Adderall and Dexedrine, are known to influence the neurotransmitters, dopamine and noradrenaline, which act as signaling molecules in the brain. Consult a professional doctor to see what your child may require.
“Parents should also limit choices between a few things, so the child doesn’t get overwhelmed and over stimulated.”
Any other tips for parents who need to manage ADHD in their child?
Parents can enrol in psychosocial intervention programmes such as parent-training that teaches parents to understand ADHD and to utilise behaviour therapy techniques with their child. In addition, the programmes help the parents become more confident in raising the child, and can help to improve parent-child relationships through effective communication. Parents will learn to pay positive attention to their child, to aid their development and manage difficult behaviour.
Another thing that parents can do is to create a routine for the child to follow, from the time they wake up to when they go to bed. Parents should also limit choices between a few things, so the child doesn’t get overwhelmed and over stimulated.
Discipline techniques such as time-outs or removal of privileges as consequences for inappropriate behaviour should be used instead of spanking or yelling. Praise or reward the child to encourage him, and to let him know that he has done well. This can reinforce positive behaviour.
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