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Attention Deficit Hyperactivity Disorder (Child)

Overview
Causes
Symptoms
Risk Factors

Prevention
When To Seek Help
Treatment Options
Where To Seek Treatment

Singapore General Hospital
Contributed by Dept of Neonatal & Developmental Medicine

Overview

ADHD-ChildAn estimated three to 10 percent of the global population has Attention Deficit Hyperactivity Disorder (ADHD). This disorder is more common in boys than girls. Every three boys to one girl are diagnosed with ADHD. Children with ADHD start to face problems in school and at home before they turn seven years old.

ADHD is diagnosed after the child has shown signs of inattention and/or hyperactivity on a regular basis for over six months in school and at home.

A child’s normal attention span is believed to develop in three stages. In the first stage, a child’s attention is focused solely on one object for a long time and he tunes out all other stimuli. If a child gets stuck at this stage and doesn’t move on, he could have autism.

In the second stage, the child develops a wide but rapidly changing attention span. A child who is stuck at this stage of attention span is diagnosed as having an attention deficit disorder.

Finally, the child develops selective attention where he is able to shift focus at will, from being inclusive to being exclusive. This is a mature pattern of attention and concentration that is required for a child to succeed in a classroom setting.

Some people with ADHD do become successful later in life. However, others continue to have strong symptoms as adults. Some are not able to adapt to society on their own. These people often drop out of school and social life. It is for this last reason that children who have signs of ADHD should receive all the help to spare them frustration and anguish later on in life.


Causes

ADHD is believed to be caused by a neurological imbalance within the brain, affecting areas associated with focusing, planning and organisation. The condition is either hereditary or acquired.

Like many other disorders, a child may have the symptoms while his parents do not. But usually there will be aunts, uncles, grandparents or cousins with the disorder.

Possible causes include the use of drugs, hypertension and infections during the pregnancy, overexposure to radiation and a premature or complicated childbirth.

A child may acquire ADHD as a result of brain infections, fits, head injury and lead poisoning.

Eating too many sweets does not cause ADHD although it may make the symptoms worse for some children who already have the condition.


Symptoms

The three main signs of ADHD are: unable to pay attention or concentrate, hyperactive and impulsive behaviour.

As a result, children with ADHD may face many problems at the same time:

Social
Children with ADHD usually have poor social and problem-solving skills. They have poor relationship with their peers and do not obey commands or requests. Some can be aggressive, use rude language and even lie or steal. They may also have poor self-control and like to take high risks.

Cognitive
They may talk to themselves in a childish way and are unable to understand the outcome of misbehaving.

Academic
Children with ADHD tend to be underachievers in school and may have learning disabilities.

Emotional
They may show signs of depression, are easily excited, immature in handling their emotions, overly frustrated, and have unpredictable moods.


Risk Factors

ADHD tends to run in families. If one or both parents have ADHD, their children are more likely to have the condition.

In some cases, ADHD has been diagnosed in children whose mothers smoked or drank alcohol during pregnancies or had complicated pregnancies. Babies born underweight or prematurely also appear to have a higher chance of developing ADHD as they grow up. The same is true for children who suffered head injuries or who have had been exposed to lead or other environmental toxins such as PCBs.


Prevention

Currently, there are no proven natural or clinical methods for preventing this condition.


When To Seek Help

If your child has not been able to pay attention or concentrate and has been hyperactive and behaving impulsively for some time, you should take him or her to a developmental paediatrician.

In addition to a body checkup and the right laboratory tests, the doctor may ask the parents and teachers to fill in questionnaires about the child’s behaviour. The doctor may also refer parents to a psychologist or mental health doctor for further checks. Following this, your child may be given medication and options for behavioural or psychological treatments.


Treatment Options

Medication

Medications such as stimulants have been used for a long time to treat ADHD by reducing the chemical imbalance in the brain. These medications are not tranquilisers or sedatives. They do not slow down the nervous system but actually stimulate various parts of the brain so that its focusing and self-control functions work better. Medication must be used together with educating the child and family for behaviour change.

Psychological Treatment

Research has shown that behaviour therapy and other psychological treatments can have a positive effect on the child’s condition. They should be used together with medication for best effect. Counselling may also be used to help build self-esteem that has been damaged as a result of having ADHD.

Diet and Nutrition

Research has shown that a change in diet and nutrition does not effectively treat ADHD. Obviously, a good diet is recommended for the well being of anybody. Taking sweets out of the diet does reduce the symptoms in some children but it usually does not fully control the condition.

Many new "natural" products have been launched as "cures" for ADHD. Be careful of what is sold out there as some products may be harmful to your child.


Where to Seek Treatment

The medical institutions within SingHealth that offer consultation and treatment for this condition include:

Singapore General Hospital
Dept of Neonatal & Developmental Medicine
Outram Road, Singapore 169608

Online : Request Form
Email : appointments@sgh.com.sg
Call : +65 6321 4377

Overseas Referrals:
Online: Request Form Email: ims@singhealth.com.sg Call +65 6326 5656


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