KOCHI: Manifesting mostly in childhood, attention deficit hyperactivity disorder or ADHD is identified by signs of hyperactivity, inattention and impulsivity in the kid. Left untreated, the syndrome can result in serious asocial implications as adult. Usually, ADHD is seen in children who are between the ages of six and 10. They find it difficult to pay attention in class and are prone to impulsive behaviour.
“A few years ago, these kids were branded as naughty troublemakers or brats but now people understand that the behaviour is due to certain neurochemical changes in the brain. There is increasing awareness among parents and teachers,” says Dr U Vivek, senior psychiatrist at Renai Medicity.
The natural course of the disorder is that it begins with hyperactivity as a kid and then offshoots into inattention and impulsivity which become more prominent around mid-teens. According to Dr Vivek, adult ADHD paints a different picture, “in children below 10, the syndrome comprises attention problems, irritability and hyperactivity.
As the child grows, the hyperactivity comes down but attention problems and impulsivity persist. Adults have difficulties in concentrating at work or engaging in worthwhile onversations,” he says. A teenager suffering from ADHD in some instances displays signs of conduct disorder that are either asocial or illegal. The adolescent seeks instant gratification through fast-paced video games or drugs and tends to lie, cheat and steal.
Apart from determinant signs of being overactive, unable to focus and acting without examining consequences, the other alarming symptoms of children with ADHD are that they tend to be demanding, irritable, prone to extreme anger and are typically careless. “These kids are also inclined to bullying or get bullied. Moreover, they seem disinterested in most tasks and have trouble in organising and keeping their things in order,” says Dr Vivek.
ADHD in children is further linked to learning disorders wherein they have normal intelligence but have difficulty in writing notes, speaking, reading and following what is being taught. “An important marker is that some of them mirror write–‘d’ is written as ‘b’ and vice-versa. Anxiety issues and severe mood swings are other associated symptoms,” adds Dr Vivek.
Procedures to control ADHD involve behavioural therapy and medication. The disorder is classified into mild, moderate and severe. For mild cases, behavioural management and memory therapy will suffice but moderate and severe cases are treated by prescribing medication in conjunction with therapy. “The medicines need to be taken for at least a year, even if the child shows signs of improvement within two or three months. These medicines are not to numb the brain but act in controlling undesirable qualities,” says Dr Vivek.
The causes of ADHD are multifactorial. “One aspect could be genetic. Having an older sibling who displayed hyperactive behaviour in the past can be determined as a hereditary reason resulting in irregular chemical changes in the brain. Another important cause is if the child is facing abuse either at home or school or if he or she is not getting proper care due to discord between parents. Smoking, alcohol or drug abuse by the mother during pregnancy is also an agent,” says Dr Vivek.
Diagnosis is carried through an extensive clinical study which is based on collecting the complete medical and behavioural history of the child and parents. There are also certain rating scales or questionnaires that parents can take for assessment. “ADHD is only diagnosed if the child is hyperactive or inattentive in two or more environments or situations,” observes Dr Vivek.