James is a Primary Three student. According to his parents, his teachers have been complaining about his behaviour since preschool.
"We often had teachers calling us to complain and even other parents too!" said Jame's mother. "He was so restless and would run out of his seat to disturb his classmates. He kept disrupting classes and the teacher and other parents were getting really upset."
His teachers assumed that Jame was just mischevious and he was often punished in class. But the punishments did not stop Jame's from misbehaving, they made his behaviour worse. James was not a "naughty" child that his parents and teachers thought he was. He had Attention Deficit Hyperactivity Disorder or ADHD.
According to Dr BL Lim, Psychiatrist and Medical Director of our clinic, Attention Deficit Hyperactivity Disorder (ADHD) affects 5.3% of the children of the world. In Singapore, 1 child in every 20 children will have ADHD. "This means that i every class of twenty students, 2 students will be having ADHD and will not be listening to their teachers if not treated!" he says. "Also, ADHD is not just a childhood disorder, symptoms of ADHD particularly inattention can continue into adulthood."
Symptoms of ADHD
Jame's mum had noticed that Jame was more restless than other kids. "He would be dashing here and there all the time," she said. "And he had a nickname at home called Monkey King!"
Jame's mum also noticed that Jame was always day dreaming and was unable to complete his homework in time.
"There are children who are mainly hyperactive and those who are mainly inattentive. But most children have a combination of both hyperactivity and inattention." says Dr Lim. According to Dr Lim, commonly noted symptoms include:
- difficulty paying attention and making careless mistakes in school
- inability to stay in or to complete tasks and activities
- appears not to listen to and not follow instructions
- disorganized and loses things like toys and stationaries easily
- distractible and forgetful
- fidgety, restless and have difficulty staying seated
- runs and climbs excessive
- always on the "go" and cannot play quietly
- talks excessively and blurts out answers before hearing full questions
- tendency to disrupt or interrupt activities like classes and will cut queues
ADHD in Adults
About 2 in 3 children who had childhood ADHD will have symptoms into adulthood. Adults with ADHD can have problems with forgetfulness, following directions, retaining information, focusing, organizing things or completing work within schedule.
"If these problems are not addressed and treated appropriately, they can cause emotional, social, occupational and academic difficulties," says Dr Lim.
Treatment of ADHD
According to Dr Lim, it is important for sufferers of ADHD to be treated. Understanding that the behaviour of the child is due to ADHD and not because he is lazy, naughty or mischevious will prevent parents and teachers from taking unecessary punitive actions. Often it is these punitive punishments from parents and teachers as well as the fact that the child is being ostracised by their peers that results in them having further behavioural problems.
In children, the first line of treatment is with behavioural therapy. Some children's behaviour can improve with behavioural modifications. Parents and teachers play a big role in implementing these programmes for the child. In many cases, stimulant medications have to be used to help the child concentrate and decrease his or her hyperactivity during lessons. Likewise, stimulant medications are useful in the treatment and control of ADHD symptoms in adults.
"James improved tremendously after treatment. He can now sit through classes and his results have also improved," reports his mother. His mother also reported that he had more friends in the neighbourhood now that he takes turn and was less impulsive when playing with other kids.