Basic facts explained about ADHD in children

ADHD often comes in disguise and parents are at a loss of understanding their child and are delayed in diagnosis and remedial action. This conversation with a leading pediatric neurologist based in Gurgaon, Dr Puja Grover Kapoor, clearly explains the basics of ADHD.

What is ADHD?

Attention Deficit / Hyperactivity Disorder (ADHD)  is one of the most common neurodevelopmental psychiatric disorder in children. It affects about 6-7% of children.

Symptoms include: 
 
1. Inattention: Does not seem to listen when spoken to, Has difficulty sustaining attention on tasks or play activities, Is forgetful in daily activities. 
 
2. Impulsivity: Has difficulty awaiting turn, Blurts out answers before the questions have been completed, Interrupts or intrudes on others etc  
 
3. Hyperactivity: Fidgets with hands or feet or squirms in seat, Talks excessively, is “on the go” or often acts as if “driven by a motor”.

How to diagnose and manage ADHD?

The child has to be referred to a pediatric neurologist, followed by a developmental pediatrician for diagnosing and management of ADHD. He may require the help of psychologist, counsellor and special educator for behaviour management and education. 

What are the risk factors and causes of ADHD?

ADHD is currently considered to have multiple causes however exact etiology of ADHD is unknown.

Genetic:
Research supports a strong genetic component. For example, first degree relatives (parents, siblings and children) of people with ADHD have a 3 to 5 times increased risk.

Environmental factors: Low birth weight, prenatal and perinatal obstetric complications, intrauterine toxins such as nicotine or alcohol, severe early deprivation, institutional rearing.

How to manage a child with ADHD?

Management of primary problem:

Treatment includes various forms of psychotherapy, medication, education or training or a combination of treatments. With treatment, most people with ADHD can be successful in school and can lead a productive life.

Behavioral and Psychological Treatment:

• Psychoeducation, Parent training and school-based intervention 
• Reinforcement of positive behaviors by praise or by providing incentives like (gold star or happy face) in daily consistency charts
• Providing a distraction-free environment in school and at home for children
• Social skills training
• Adapting tasks to the child’s abilities

Medicines available for treatment

It includes use of:

• Stimulant medication: Methylphenidate and Atomoxetine
• Non-stimulant medication: These are useful in around 30% of children who may not tolerate or respond to stimulant medicines.

What about diet in attention deficit hyperactivity disorder (ADHD)?

It is recommended that all people with ADHD should have a normal healthy balanced diet, with less of sugar intake and also do some regular exercise.

What measures can be taken to prevent ADHD?

Primary:

Avoiding environmental risks such as the mother smoking during pregnancy and lead exposure.

Tertiary: 

In school

• Provision of integrated and inclusive education in schools
• Close monitoring in the classroom, preferably seated in front row in the class
• Predictable schedules and brief study periods
• Special education and remedial teaching

If you are struggling with any of the symptoms mentioned above or know a parent whose child has such symptoms, please consult a pediatric neurologist at the earliest. Early remedial intervention can save the child and his/her family a lot of trouble in future.

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