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Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD) is a syndrome that appears since childhood before age 12 which can affect child’s behaviors, emotion, learning and social engagement.

This syndrome includes
  • Attention deficit
  • Impulsivity
  • Hyperactivity
Some children may be predominantly hyperactive and impulsive which are common in boys or some may be predominantly inattentive which are equally common in girls and boys. Attention deficit hyperactivity disorder (ADHD) is common in all countries worldwide. It has been found in Thailand that about 8% of children in school age have attention deficit hyperactivity disorder (ADHD).
Indicative symptoms of attention deficit hyperactivity disorder (ADHD) in a child include
  1. Attention deficit: characterized as follows
  • Unable to finish a task as instructed by teachers or parents.
  • Inattentive during a task or play.
  • Seems not to listen when spoken to.
  • Unable to give close attention in listening and collecting details, resulting in frequent mistakes in work.
  • Rather disorganized.
  • Has trouble or tries to avoid a task that needs ideas and attention such as book reading, doing homework.
  • Easily distracted.
  • Often loses personal belongings or things necessary for task or school activity.
  • Forgetful.
  1. Hyperactivity and impulsivity: characterized as follows
  • Fidgety, squirming.
  • Unable to remain seated, get up to walk frequently while at home or in the classroom.
  • Likes running about, or climbing.
  • Talks excessively, talks away.
  • Unable to play quietly.
  • Always on the go, or seems to be easily flustered.
  • Likes blurting out answers before questions have been completed by teachers or parents.
  • Unable to wait a turn
  • Likes interrupting or intruding while others are talking.
If a child possesses characters in (1) or (2) together more than 6 symptoms for at least 6 consecutive months, there is a high possibility that he/she has attention deficit hyperactivity disorder (ADHD).
 
Current researches find that attention deficit hyperactivity disorder (ADHD) is caused by a deficiency of certain main chemicals in the brain with heredity as important factor. About 30-40% of children with attention deficit hyperactivity disorder (ADHD) will have a member in the family with attention deficit hyperactivity disorder (ADHD) as well.

Mother with nutrient deficiency, alcoholic drinking, cigarette smoking or certain toxins intake such as lead during pregnancy, will have a higher chance to cause her child with attention deficit hyperactivity disorder (ADHD).
Current researches do not reveal that over consumption of sugar or chocolate, vitamin deficiency, and allergy can be the cause of attention deficit hyperactivity disorder (ADHD). However, watching television or playing video games for hours may cause attention deficit and hyperactivity. The reason is while a child is watching television or playing video games, he/she will be continuously stimulated by the television or video game pictures that switch every 2-3 seconds hence enabling the attraction of child’s interest. Such child’s attention is developed by external stimuli which is opposed to child’s attention initiated during reading or performing tasks in which children with attention deficit hyperactivity disorder (ADHD) are deficient.
 
The treatment for attention deficit hyperactivity disorder (ADHD) with the highest efficacy includes a combination of various treatments as follows
  • Medical treatment
  • Behavioral changes and mental supports for child and family
  • Learning supports
 
Medical treatment
The most effective medications used to treat attention deficit hyperactivity disorder (ADHD) are a class of drugs known as psychostimulants such as methylphenidate (Ritalin®), long acting methylphenidate (Concerta®) or non-psychostimulant such as atomoxetine (strattera®). These drugs are safe with minor side effects and high treatment efficacy. Drugs will help the child to become more attentive, less hyperactive, feeling calmer, less impulsive and may enable better learning performance. As a consequence of the child receiving proper treatments, he/she will get better self-esteem and better relationship with friends or surrounding people.
Common side effects of these drugs include poor appetite, weight loss, insomnia, headache, stomach pain, bipolar disorder, irritability. These side effects are often not severe and go away when adjusting the dose or switching to other classes of medication.
 
Behavioral changes and mental supports for child and family
Parents and teachers of children with attention deficit hyperactivity disorder (ADHD) need to learn the proper techniques in order to help manage child’s inappropriate behaviors. Spanking or corporal punishment is not effective for behavioral changes and will cause children to have more anger or defiant and aggressive behaviors. The more effective ways are praising or rewarding (positive reinforcement) when children display proper and appropriate behaviors as well as inappropriate behavioral controls by discontinuing their preferable activities or withdrawing other rights (negative reinforcement).

The child with attention deficit hyperactivity disorder (ADHD) should have a chance to talk with a physician in order for physician to provide knowledge regarding child’s limitations and help recommend self-practice guidelines in order to enable the child with utilization of his/her abilities in other aspects to compensate for the impaired ones.

In some cases, family therapy is also needed for a family with a problem of interpersonal relationship in order to decrease the child’s anxiety and stress.
 
 
Learning supports
Most children with attention deficit hyperactivity disorder (ADHD) will also have associated learning problems or inability to reach full potential in learning. Therefore, teachers will have a very important role in supporting children with attention deficit hyperactivity disorder (ADHD) to achieve better learning performance.
When passing adolescence, about 30% of attention deficit hyperactivity disorder (ADHD) children have a chance to recover and can attend school or go to work as normal without need of further medication. Most attention deficit hyperactivity disorder (ADHD) children will still possess a certain deficiency of attention although they seem to be less hyperactive and impulsive.

When growing as adults, some who can adjust self and choose a job that does not demand much attention will have a chance to be successful and live a normal life. Some may still have much of attention deficit hyperactivity disorder (ADHD) symptoms which will be negative for their educations, careers and social engagements. Patients in this group need a continuous treatment.
 

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