Does my child have ADHD?

THOUGH ATTENTION deficit hyperactivity disorder (ADHD) may be one of the most common neurobehavioral disorders, all children do not have ADHD.

ADHD consists of persistence of hyperactivity and impulsivity or inattention, or a combination of all three. Hyperactivity may be in the form of not being able to sit still through dinner or at school, being fidgety, such as consistently rocking the chair, fiddling with objects in the hand and for some children, being verbally hyperactive. This Impulsivity puts many caregivers and teachers on edge as they are never sure what to expect from a kid. At any minute, a kid may sprint across the road just to see how quickly they can run or if they can outrun the passing turbocharged sports car.

However, they may butt into conversations more than what would be expected for being at a developmental age or even prevent the completion of others sentences. Distractibility may

manifest as a child who seems not to listen to instructions, one who is forgetful, e.g., not being able to copy off the homework, or take it out at home, or even to submit it though it has been done. Commonly reported by parents is the comment, ‘If breeze blow, he stops what he is doing’ as they try to describe how easily their child may be distracted.

PERSISTENT SYMPTOMS

These symptoms, however, must not occur infrequently but should be persistent, occurring in multiple environments and be noted before the age of 12 years. They must also not be better accounted for by another cause. For instance, children who may not be able to get adequate sleep due to issues with upper airway obstruction may appear ‘hyperactive’ as they try to stay awake or may simply seem inattentive as they fall asleep in class. Children who are unable to comprehend the lesson being taught may feel as though the teacher is speaking in a foreign language and again, they will appear inattentive. A certain pattern of seizures may also be mistaken for inattentive symptoms.

DIAGNOSIS

So what should a parent do if they are concerned that their child may have ADHD? Talk to your paediatrician. Discuss when and where symptoms manifest and ensure that there are no other factors that could be contributing to the presentation. Parents and class teachers will be asked to complete ADHD-specific parent and teaching rating scales. These should be done by a teacher who has interacted with the child in the classroom for no less than six weeks. There are no blood or imaging investigations to confirm ADHD, and responses from these parent-teacher scales, as well as history and observation, serve as the backbone of diagnosis.

If a diagnosis is reached, recommendations for lifestyle changes will be made for the home and classroom. Referral for behavioural management and possibly use of medications may be considered.

ADHD is a chronic disease. It has its impact in childhood, adolescence and adulthood. Its occurrence should be addressed and managed appropriately.

DR ANDREA GARBUTT, Developmental Paediatrician, UWI/UHWI

If a diagnosis is reached, recommendation s for lifestyle changes will be made for the home and classroom. Referral for behavioural management and possibly use of medications may be considered.