Let us assume for a minute that you work in a place where you are expected to sit still throughout the day, not turn around at any point, ask permission to use the washroom and to drink water, do not have the freedom to communicate with colleagues!
Most of us will not last long in such a place, due to the blatant lack of autonomy. However, most children in India are forced to adhere to these rules. If they do not follow these rules, complaints pile up from school.
The whole motive of this article is to educate the reader (especially primary caregiver and teachers) to understand what is Attention Deficit and Hyperactivity Disorder (ADHD) and when is it appropriate to give this diagnosis.
Prevalence of ADHD is 2-5% among children.1 However, an average of 33% of children are being diagnosed with ADHD and are being medicated for the same.2
It is by far the most abused diagnosis wherein children who are displaying higher than usual level of inquisitiveness are labelled as children in the ADHD spectrum and are medicated. It is easy to medicate the child and make them sit still in class for the required number of hours and make them subdued enough that there are no problems. However, what we are refusing to understand- a) how is this affecting the child? b) Are we expecting too much? c) Is medication the only option?
Appropriate diagnosis begins by observing the child across situation. Mostly, children do not act up in places where they are comfortable. So there might be a possibility that problem behaviours displayed by the child might come as a surprise to the parent. These problematic behaviour needs to be consistent and present in two or more situation. Symptoms of ADHD fall broadly into two major categories
- Inability to pay attention. ( across two or more situation i.e., have difficulty in school, home and or in the playground).
- Not able to follow instructions across situations.
- Easily distracted and forgetful- even in things that is of the child’s interest.
Hyperactivity and Impulsivity( if these symptoms are not displayed a diagnosis of .
- Blurts out answers in class.
- Inability to sit in one place- in school, home and/or playground.
- Inability to wait for their turn in games.
- Interrupts conversation.
- Talks a lot.
Once you have diagnosed correctly, what next?
In the therapy, the child will learn to control and channelize their hyperactivity. During the session, different activities are planned to help the child improve their focus, coordination and how to work on their social skills in the playground so that they are included while playing with other children.
- b) Behaviour modification
ADHD affects the child in many ways, from being targeted in class to being excluded from games. Resulting in rebellious behaviour which can be worked on in the therapeutic setting. It is natural for parents to feel overwhelmed by the child’s hyperactivity tendencies which might affect parent-child interaction. Parental training can reduce the oppositional behaviour of the child and improve the family atmosphere.
- c) Medication
Medication helps the child become calm so that they can sit in class without being disruptive and might make them more receptive towards finishing the task at hand.
Other things that help manage ADHD symptoms include: reducing the sugar intake and artificial food colouring, including regular physical activity in the child’s daily schedule and allowing the child some free time outside where the child can use the excess energy.
Most importantly teaching the child techniques to identify their symptoms and ways to manage the same can go a long way in assisting the child feel in control and help better assimilation of the child in mainstream schooling.
Deepapriya Vishwanathan has had 8 years of experience working as a therapist. She has working with children, their caregiver and on the family dynamics. She is trained in humanistic, Transactional analysis and Cognitive behavioral therapy.She has done her M.Phil from Tata institute of social sciences and her masters in applied psychology (Clinical) from Mumbai university, she also has advanced diploma in counselling psychology. In the past she has facilitated support group for parents of children diagnosed with cancer in Tata Memorial hospital and has conducted workshops on parenting, early intervention and benefits of the same in pervasive developmental disorders. At present she is practicing as a senior psychologist working with varied population.