‘My child is hyperactive' is a very common grouse of most of the parents today. Unfortunately, hyperactivity is a liberally used term to refer to any active and boisterous child. Hyperactivity technically is a clinical condition and the complete name of this condition is Attention Deficit Hyperactivity Disorder (ADHD). The incidence of this disorder has been reported to be around 5%, but some studies have also reported that the incidence is close to 11%. If this is true, it would roughly mean that in a classroom of 50 children, more than 5 would be showing symptoms of this disorder.
A very basic thumb rule to understand the difference between an overactive and hyperactive child would be to understand their ability to control themselves. In situations requiring restraint, an overactive child can control himself but a hyperactive child would find it extremely difficult and would fidget or squirm in his seat if he is forced to sit. Secondly, an overactive child's boisterous behavior is mostly goal directed. This may not be the same with a hyperactive child. The neurological disturbances do not allow him to sit still. A psychologist is best equipped to make this distinction through the tools that she or he has.
What is ADHD?
Attention Deficit Hyperactivity Disorder has two components, inattention and hyperactivity, impulsivity. Depending on the symptoms shown, a child is diagnosed with ADHD inattentive type, ADHD hyperactive impulsive type or ADHD combined. Not responding to being called, unable to focus on the task at hand, being lost in their own world are some symptoms of inattention type. Inability to sit still, acting as if driven by a motor, inability to control impulses are some symptoms of hyperactive, impulsive type. Traditionally ADHD has been associated more with boys than girls. This may not always be true, but girls are however more likely to show symptoms of inattention than hyperactivity, impulsivity. It is essential to note that any condition calls for attention when the symptoms manifested interfere in the normal day to day functioning of the individual. Therefore, if you have been receiving consistent complaints, or if the child has difficulties in school or at play it is better to consult a psychologist.
What causes it?
Causes of ADHD are not clearly known. But there appears to be some genetic component to the disorder. Some researchers have linked ADHD to the consumption of alcohol and cigarettes during pregnancy. Head injury during delivery, infancy or early childhood has also been considered a related factor.
Will it go away on its own?
Whatever the causes, what is of practical importance is the management part. The biggest mistake that parents can commit is to believe that the disorder will fade away with age and not do anything about it. Untreated ADHD often leads to conduct problems in adolescence and adulthood and in extreme cases, could also lead to an antisocial personality. This is very likely when the child is diagnosed with ADHD impulsive type. If we do not teach the child to manage his impulses, aren't the above mentioned possibilities the logical consequences of his unrestrained behavior?
What is the treatment?
Treatment plan can be roughly divided into two parts: pharmacological and non-pharmacological.
Most parents are initially reluctant to put their children on medication for this disorder. The need for medication is determined by the severity of the disorder. Initially, non pharmacological methods are tried, but sometimes it becomes imperative to put the child on medication. In severe cases, the child just cannot sit in the classroom and focus on the task, however much he wishes to or tries. At such times, there is no option but to start medication. Contrary to popular belief, these are not addictive or do not have serious side effects. But it is essential to be in constant touch with the doctor to monitor the dosage.
The second aspect of the treatment is non-pharmacological. This involves child and parental counseling and occupational therapy. Parental counseling starts with explaining the disorder so that parents know what they can expect from their child. It helps them to understand their child's limitations and to deal with the frustrations associated with them. The nature of child counseling depends upon the age of the child. Setting short term goals and helping the child to attain them remains the focus of counseling.
Through a structured plan, the occupational therapist makes use of various instruments and exercises to increase the sitting tolerance, concentration and attention span of the child.
Attention Deficit Hyperactivity Disorder is the most common clinical condition associated with childhood. With appropriate therapies and medications this can be managed well, enabling the child to lead a fairly well functional life. As is the golden rule for any clinical condition, early intervention is the magical key. And as stated earlier, in case of any doubts regarding your child's behavior, please consult a psychologist at the earliest.
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