I’m Dr. Prashant Shah, a psychiatrist from Ghatkopar, Mumbai. Today I am going to speak about Attention Deficit Hyperactivity Disorder also known as ADHD. ADHD as the name suggests the full form is Attention Deficit Hyperactivity Disorder. This is a common disorder seen in children and adolescence and at times may extend also into adult life. The common features of this problem are diminished attention, hyperactivity, and impulsivity. As I said earlier, it is most commonly seen in children and adolescents, the usual complaints will be from the parents and teachers. The parents and teachers will complain that these children have difficulty sustaining attention, they are hyperactive and they are impulsive in their day to day activities.
Sustaining attention means that these children cannot sustain or carry out any particular task to the end. They get bored very easily, they will lose interest, they may want to start many activities; they will say that they want to join this activity, they want to do this thing but then halfway down the line they will get bored, and they will stop doing that activity. They would have difficulty in focusing which will result in making careless mistakes in their works, in their calculations, in their day to day works, in their homework. They will be making careless mistakes because they cannot just focus on what they are doing. They get distracted very easily. The teachers will complain that in the school when the teacher is teaching they are looking out of the window or they are speaking with other children. They will drop down their pencil, eraser, and maybe make mischief with other children. Many times there are younger children; they are always on the go. They cannot sit in one place. They are not in their seat; they are roaming around in the class; they talk excessively; they will blurt out answers; they are forgetful; they will not mention about homework or assignment which has been given to them or the project work which has been given. They will inform their parents just at the last minute and then everything will have to be rushed. They will forget or they will misplace their books. Their clothes will be in disarray at home if you visit their room. Everything will be like it is not in its place. They cannot wait for their turn. Now all these are problems which the children-parents pick up.
What is the effect of this on the children? Because of this kind of behavior they are labeled as mischievous. They are the ones who get pointed out whenever something goes wrong in the class. They will be the first ones to be signaled out and given punishment. And at times maybe it is not their fault also but because they show this kind of behavior they are labeled as mischievous and it is they who get the punishment. Everyone ridicules them for this kind of behavior. Even the parents punish them. This will lead to many times frustration, decreased confidence which in turn affects their school performance. Many times this results in deviantju8 behavior. In adolescence if we go on to see this may result in risk-taking behavior, seeking novelties and at times in drug-addiction also.
Now, what can be done about this?
As I said earlier it is a neuro-developmental disorder, we do not know as psychiatry illnesses, we don’t know what the causes are of this illness or why does this illness occur. It may range from genetic to neurological to psychopharmic or neuro-developmental problems in the brain. But what is good is that treatment options are available. So what treatment options are there for ADHD? They are both pharmacological and non-pharmacological treatments available. Usually for children less than five years initially we advise non-pharmacological treatment. This non-pharmacological treatment is occupation therapy and sensory integration where depending upon the severity of the problem, children are called for occupation therapy sessions, parents maybe also given some home programme which they can carry out at home and this results in improvement. The improvement is slow but carried out religiously, diligently by the parents for a period of 1 year to two years this definitely is going to show improvement.
In other children or if the problems are severe enough, we do start medicines. In children parents are hesitant to start medicines and that too from a psychiatrist. But believe me there are good medicines available for ADHD, they do show response, there are no major side effects. The groups of medicines that are available are stimulants or non-stimulants. Stimulants are the first choice of drugs, usually we start with a low dose, so that the child can tolerate the dose, there is no side effect and then we gradually build up the dose so that the improvement is seen. Even if there is some side effect there is minor side effect which can be always taken care of. It is not that there is only one drug available, the child is not responding, we can definitely shift to some other. But the thing to understand is that treatment is required. This ADHD can be controlled and if the signs and symptoms of ADHD are controlled then the child’s performance is definitely going to improve. It will not only reflect in the child’s studies but also overall development of the child. So it is for the parents and teachers working in this field to find out these kinds of children who maybe having this problem and refer them for treatment.
Thank you. For any further enquiries you can always get me to me through Lybrate