WHAT IS ADD/ADHD?
ADD stands for Attention Deficit Disorder and ADHD for Attention Deficit Hyperactivity Disorder, although internationally ADHD is the referral term that includes both ADD and ADHD. ADHD is a term used to describe a group of children who have many problems in common.
We differentiate between three sub-types namely:
· Predominantly inattentive with little or no sign of impulsivity and hyperactivity
· Predominantly impulsive and hyperactive with little or no attention difficulties
· The combined type - these people are very distractible, hyperactive, and impulsive.
ADD stands for Attention Deficit Disorder and ADHD for Attention Deficit Hyperactivity Disorder, although internationally ADHD is the referral term that includes both ADD and ADHD. ADHD is a term used to describe a group of children who have many problems in common.
We differentiate between three sub-types namely:
· Predominantly inattentive with little or no sign of impulsivity and hyperactivity
· Predominantly impulsive and hyperactive with little or no attention difficulties
· The combined type - these people are very distractible, hyperactive, and impulsive.
AT WHAT AGE CAN ADHDBE DIAGNOSED?
Diagnosis should only take place from the age of 5 to 7 years although some of the symptoms could be present from birth. It is important that the symptoms, as per the DSMIV, be present for a period of more than six months in all situations. Symptoms usually appear before the age of seven, although diagnosis may only take place much later.
Diagnosis should only take place from the age of 5 to 7 years although some of the symptoms could be present from birth. It is important that the symptoms, as per the DSMIV, be present for a period of more than six months in all situations. Symptoms usually appear before the age of seven, although diagnosis may only take place much later.
WHAT COULD LOOK LIKE or MANIFEST AS HYPERACTIVITY?
It is very important when considering a diagnosis of ADHD, to rule out other conditions that can look like ADHD.
These could include:
It is very important when considering a diagnosis of ADHD, to rule out other conditions that can look like ADHD.
These could include:
· Allergies, Asthma - Difficulty with breathing can interrupt a child's concentration and cause ADHD-like signs
· Diabetes/Hypoglycaemia - These conditions relate to the quantity of sugar in the blood and can cause changes in concentration and activity levels
· Hearing or Visual problems - The inability to see or hear what is going on in the classroom can lead to behavioural outbursts, incompletion of work and disturbing of classmates and hyperactivity
· Iron Deficiency - Can lead to attention and impulsivity problems
· Lead Intoxication - Lead intoxication can lead to hyperactivity
· Learning problems - If a child is frustrated from learning disabilities, he or she may have ADHD-like behaviour
· Emotional difficulties - This could be due to a divorce, death in the family, an accident that could manifest with hyperactivity symptoms
IT IS THEREFORE CRUCIAL TO MAKE SURE THAT WE DO NOT MERELY TREAT SYMPTOMS BUT THAT WE HEAL AND TREAT THE CORE OF THE PROBLEM
· Diabetes/Hypoglycaemia - These conditions relate to the quantity of sugar in the blood and can cause changes in concentration and activity levels
· Hearing or Visual problems - The inability to see or hear what is going on in the classroom can lead to behavioural outbursts, incompletion of work and disturbing of classmates and hyperactivity
· Iron Deficiency - Can lead to attention and impulsivity problems
· Lead Intoxication - Lead intoxication can lead to hyperactivity
· Learning problems - If a child is frustrated from learning disabilities, he or she may have ADHD-like behaviour
· Emotional difficulties - This could be due to a divorce, death in the family, an accident that could manifest with hyperactivity symptoms
IT IS THEREFORE CRUCIAL TO MAKE SURE THAT WE DO NOT MERELY TREAT SYMPTOMS BUT THAT WE HEAL AND TREAT THE CORE OF THE PROBLEM
WHAT CAUSES ADD/ADHD?
Unfortunately, the exact cause of ADHDis unknown.
We do know the following:
Unfortunately, the exact cause of ADHDis unknown.
We do know the following:
· It is neurological - meaning that there is a imbalance of certain neurotransmitters;
· It is biochemical - meaning a deficiency in Prostaglandin's E1, E3 (PE1,PE3);
· It is an 80% genetic condition.
· It is biochemical - meaning a deficiency in Prostaglandin's E1, E3 (PE1,PE3);
· It is an 80% genetic condition.
HOW MANY CHILDREN IN SOUTH AFRICA HAVE ADD/ADHD?
According to the most recent data, approximately between 8 and 10% of the South African population have ADHD. It could be present from birth (often not recognised) or early childhood and usually persists throughout a person's lifetime. IT IS NOT LIMITED TO CHILDREN ONLY!
CAN YOU OUTGROW ATTENTION DEFICIT HYPERACTIVITY DISORDER?
Although many people with ADHD (around 50%) have a reduction in symptoms during adolescence and adulthood, only a few people no longer have any symptoms. Many still continue to have problems following conversations, forgetting assignments, wedding anniversaries, birthdays, being disorganised, shopping or gambling impulsively, switching jobs often, have relationship problems, or procrastinating. Often more secondary problems like low self-esteem, anxiety and depression start to manifest during adolescence and adulthood.
WHAT ARE THE DIAGNOSTIC CRITERIA FOR DIAGNOSIS?
Some factors that seem to be associated with the occurrence of ADD or ADHD – many are impressionistic and controversial, and much more research is needed to clarify their relevance. They can be interpreted somewhat like pieces of evidence - the more there are, the firmer the diagnosis becomes. Most of these characteristics are associated with a greater than chance likelihood of the syndrome, but no ADHD child has all these indicators, and many occur in non-ADHD children.
Foetal Indicators:
· Apparent hyperactivity in the womb. About one-third of ADHD children are hyperactive while still
unborn. Mother’s report the child kicks and turns and punches or bruises her ribs. This increased activity
is especially pronounced when the expectant mother is sitting or lying down.
· Poor maternal health.
· Mother under 20 years of age.
· First pregnancy.
· Elevated blood pressure during pregnancy.
· Convulsions in the mother during latter stages of pregnancy or during childbirth.
· Maternal alcohol abuse.
· Heavy maternal smoking.
· Drug abuse.
WHAT ARE THE DIAGNOSTIC CRITERIA FOR DIAGNOSIS?
Some factors that seem to be associated with the occurrence of ADD or ADHD – many are impressionistic and controversial, and much more research is needed to clarify their relevance. They can be interpreted somewhat like pieces of evidence - the more there are, the firmer the diagnosis becomes. Most of these characteristics are associated with a greater than chance likelihood of the syndrome, but no ADHD child has all these indicators, and many occur in non-ADHD children.
Foetal Indicators:
· Apparent hyperactivity in the womb. About one-third of ADHD children are hyperactive while still
unborn. Mother’s report the child kicks and turns and punches or bruises her ribs. This increased activity
is especially pronounced when the expectant mother is sitting or lying down.
· Poor maternal health.
· Mother under 20 years of age.
· First pregnancy.
· Elevated blood pressure during pregnancy.
· Convulsions in the mother during latter stages of pregnancy or during childbirth.
· Maternal alcohol abuse.
· Heavy maternal smoking.
· Drug abuse.
Birth Indicators:
· Extreme prolonged lack of oxygen at birth.
· Labour lasting longer than eighteen hours.
· Birth injuries.
· Congenital problems or physical malformations.
· Foetal alcohol syndrome. This syndrome include low birth weight, small head size, birth defects, withdrawal symptoms, and mental retardation. When the expectant mother consumes a large amount of ethyl alcohol, she can cause foetal damage. The actual amount needed to harm the nervous system and period of pregnancy in which the developing child is most sensitive to this insult are yet unknown.
· Prematurely. Studies of low birth weight babies suggest a relationship between prenatal factors and the syndrome. In one study, prematurely was found to be associated with hyperactivity at age seven. In another study, the ADHD rate was 18 % in low birth weight children and 6.5 % in full birth children.
· Low placental weight.
· Breech presentation.
· Inflammation of the outermost of the two membranes enveloping the unborn child.
Early Infancy Indicators:
· Inadequate sleep.
· Irritability.
· Excessive crying and colic.
· Feeding problems such as difficulty nursing or accepting a formula and differing appetite levels.
· Health problems such as allergies, colds, asthma, upper respiratory infections, and fluid in the ears.
· Poor bonding. The baby is not cuddly and responsive and is restless and difficult to manage during such routine activities as bathing, nappy changing, or feeding.
Late Infancy Indicators:
· Unusual crib behaviour such as foot thumping, excessive rocking, head banging, and climbing out of the crib.
· Rapid or delayed development of physical skills such as crawling, sitting, standing, walking, and running.
· Delayed or rapid development of verbal skills, such as saying the first word prior to ten months or after sixteen months of age.
· Low adaptability to change.
· Sleep difficulties including getting to sleep, staying asleep, obtaining restful sleep, and arising refreshed and pleasant in the morning.
Toddlerhood Indicators:
· Aggressive: pushes, shoves, pinches, kicks, bites and grabs toys and can't play cooperatively for a sustained period.
· Destructive: breaks, throws, and tears apart things, toys, and clothing because of anger, curiosity, or wear-and-tear from high activity level.
· Overactive: acts as if driven by a mainspring that is wound to tightly, resulting in non-stop movements and an inability to sit quietly for more than a few minutes.
· Incorrigible: under responsive to parental correction, seems unconcerned when threatened with punishment, and requiring constant attention, reminding and restraining.
· Reckless: accident prone, careless with common dangers such as traffic, and susceptible to accidental poisoning.
Pre-school Indicators:
· Stomach problems. By the time they are five years old, hyperactive children on the average have had more serious gastrointestinal complains resulting in contact with physicians than their peers.
· Lack of coordination in large or small muscle group activities. The child tends to produce sloppy and messy seatwork at preschool or kindergarten.
· Off task behaviour. These children wander away from their tables at school and do other than what the teacher is instructing the class to do, thus requiring an excessive amount of attention and supervision.
· Over activity. They won't sit still and pay attention, won't sit for story time, are out of their seats too often, talk out of turn, and make inappropriate and disrespectful comments to classmates and the teacher.
· Intrusiveness: Hyperactive children are almost universally unpopular throughout their childhood and adolescence. They bother other children by talking to them, touching them, or intruding on their projects and play, as well as by inappropriately seeking attention, such as by clowning. This trend starts shortly after they learn to walk and begin interacting with other children and becomes a lifelong problem of getting along in groups and a secondary problem of self-esteem.
· Aggressiveness. These children are aggressive toward classmates and can't play cooperatively. They take their classmates toys and hit, kick, and make them cry.
· Distractibility. These children appear to have too short an attention span when compared to other children of the same age.
· Parent-child conflict. Patterns of family disruption, such as nag-yell-spank cycles, become established. The parents perceive the child as a negative influence on the family.
Age 6-13:
· Labour lasting longer than eighteen hours.
· Birth injuries.
· Congenital problems or physical malformations.
· Foetal alcohol syndrome. This syndrome include low birth weight, small head size, birth defects, withdrawal symptoms, and mental retardation. When the expectant mother consumes a large amount of ethyl alcohol, she can cause foetal damage. The actual amount needed to harm the nervous system and period of pregnancy in which the developing child is most sensitive to this insult are yet unknown.
· Prematurely. Studies of low birth weight babies suggest a relationship between prenatal factors and the syndrome. In one study, prematurely was found to be associated with hyperactivity at age seven. In another study, the ADHD rate was 18 % in low birth weight children and 6.5 % in full birth children.
· Low placental weight.
· Breech presentation.
· Inflammation of the outermost of the two membranes enveloping the unborn child.
Early Infancy Indicators:
· Inadequate sleep.
· Irritability.
· Excessive crying and colic.
· Feeding problems such as difficulty nursing or accepting a formula and differing appetite levels.
· Health problems such as allergies, colds, asthma, upper respiratory infections, and fluid in the ears.
· Poor bonding. The baby is not cuddly and responsive and is restless and difficult to manage during such routine activities as bathing, nappy changing, or feeding.
Late Infancy Indicators:
· Unusual crib behaviour such as foot thumping, excessive rocking, head banging, and climbing out of the crib.
· Rapid or delayed development of physical skills such as crawling, sitting, standing, walking, and running.
· Delayed or rapid development of verbal skills, such as saying the first word prior to ten months or after sixteen months of age.
· Low adaptability to change.
· Sleep difficulties including getting to sleep, staying asleep, obtaining restful sleep, and arising refreshed and pleasant in the morning.
Toddlerhood Indicators:
· Aggressive: pushes, shoves, pinches, kicks, bites and grabs toys and can't play cooperatively for a sustained period.
· Destructive: breaks, throws, and tears apart things, toys, and clothing because of anger, curiosity, or wear-and-tear from high activity level.
· Overactive: acts as if driven by a mainspring that is wound to tightly, resulting in non-stop movements and an inability to sit quietly for more than a few minutes.
· Incorrigible: under responsive to parental correction, seems unconcerned when threatened with punishment, and requiring constant attention, reminding and restraining.
· Reckless: accident prone, careless with common dangers such as traffic, and susceptible to accidental poisoning.
Pre-school Indicators:
· Stomach problems. By the time they are five years old, hyperactive children on the average have had more serious gastrointestinal complains resulting in contact with physicians than their peers.
· Lack of coordination in large or small muscle group activities. The child tends to produce sloppy and messy seatwork at preschool or kindergarten.
· Off task behaviour. These children wander away from their tables at school and do other than what the teacher is instructing the class to do, thus requiring an excessive amount of attention and supervision.
· Over activity. They won't sit still and pay attention, won't sit for story time, are out of their seats too often, talk out of turn, and make inappropriate and disrespectful comments to classmates and the teacher.
· Intrusiveness: Hyperactive children are almost universally unpopular throughout their childhood and adolescence. They bother other children by talking to them, touching them, or intruding on their projects and play, as well as by inappropriately seeking attention, such as by clowning. This trend starts shortly after they learn to walk and begin interacting with other children and becomes a lifelong problem of getting along in groups and a secondary problem of self-esteem.
· Aggressiveness. These children are aggressive toward classmates and can't play cooperatively. They take their classmates toys and hit, kick, and make them cry.
· Distractibility. These children appear to have too short an attention span when compared to other children of the same age.
· Parent-child conflict. Patterns of family disruption, such as nag-yell-spank cycles, become established. The parents perceive the child as a negative influence on the family.
Age 6-13:
It must be remembered that not every child has ALL the symptoms. An ADHD child must manifest with at least six symptoms out of each category in ALL situations. Children without this disorder may also manifest from time to time with some of these symptoms
DIAGNOSTIC CRITERIA AS PER THE DSM IV (Statistical Manual for mental disorders)
ATTENTION DEFICIT DISORDER:
· Often fails to give close attention to details or makes careless mistakes
· Often has difficulty sustaining attention in tasks or activities
· Often does not seem to listen when spoken to directly
· Often does not follow through on instructions
· Often has difficulty organizing tasks and activities
· Often avoids tasks that require sustained attention
· Often loses things necessary for tasks
· Easily distracted by extraneous stimuli
· Is forgetful in daily activities
DIAGNOSTIC CRITERIA AS PER THE DSM IV (Statistical Manual for mental disorders)
ATTENTION DEFICIT DISORDER:
· Often fails to give close attention to details or makes careless mistakes
· Often has difficulty sustaining attention in tasks or activities
· Often does not seem to listen when spoken to directly
· Often does not follow through on instructions
· Often has difficulty organizing tasks and activities
· Often avoids tasks that require sustained attention
· Often loses things necessary for tasks
· Easily distracted by extraneous stimuli
· Is forgetful in daily activities
ATTENTION DEFICIT HYPERACTIVITY DISORDER:
· Often fidgets with hands or feet or squirms in seat
· Often leaves seat in classroom or other situations
· Often runs or climbs excessively in situations where it is inappropriate to do so
· Often has difficulty playing quietly
· Is often "on the go" or often acts as if "driven by a motor"
· Often talks excessively
· Often blurts out answers before questions have been completed
· Often has difficulty awaiting turn
· Often interrupts or intrudes on others
· Often engages in dangerous activities
· Often leaves seat in classroom or other situations
· Often runs or climbs excessively in situations where it is inappropriate to do so
· Often has difficulty playing quietly
· Is often "on the go" or often acts as if "driven by a motor"
· Often talks excessively
· Often blurts out answers before questions have been completed
· Often has difficulty awaiting turn
· Often interrupts or intrudes on others
· Often engages in dangerous activities
Teenagers:
Unfortunately, ADHD may not be recognised or treated for years. When it is only diagnosed in an adolescent for the first time the problems are compounded. Not only do they often have learning difficulties but they may be years behind in basic social and learning skills and/or be turned off to learning.
Behavioural problems may have initially been a consequence of the ADHD but now may be more severe than the ADD/ADHD. Depending on the age special education might have to be shifted towards vocational planning. The same treatment approaches, as for younger children, are needed, however, the work is harder. Medication can now be helpful in combination with natural supplementation. Individual therapy along with group and family therapy is often necessary. Ideally, children with ADHD should be identified early. By adolescence they could well be on their way towards overcoming their difficulties. Some may have remaining
learning problems and may continue to need help. The added troubles and sensitivities of adolescence may cause your child to suddenly refuse to have extra classes, remediation, or to take medication. Teenagers do not want to be different, but handled with sensitivity and a sense of humour. Most problems can be overcome.
Adults:
If you have a child who has ADHD, the chances are that either you or your spouse also has the condition. "Hyper actives" tend to be drawn to people who are also dynamic, over-active and often vivacious. So it could be that there are characteristics of ADHD in both sides of your child's family (so no finger-pointing, please!)
Maybe, as you watch your child experiencing certain difficulties, you remember your own childhood, and you wonder ...Perhaps you've had persistent problems that have plagued you throughout your adulthood. It is possible that they are due to the condition of ADD/ADHD. It is used to be though that ADHD was outgrown at adolescence, but now it is generally accepted that it usually continues into adulthood, although it may manifest differently. A check-list of these characteristics is available from our office and if you experience some or most of these traits, then very possibly you are an ADHD adult.
Unfortunately, ADHD may not be recognised or treated for years. When it is only diagnosed in an adolescent for the first time the problems are compounded. Not only do they often have learning difficulties but they may be years behind in basic social and learning skills and/or be turned off to learning.
Behavioural problems may have initially been a consequence of the ADHD but now may be more severe than the ADD/ADHD. Depending on the age special education might have to be shifted towards vocational planning. The same treatment approaches, as for younger children, are needed, however, the work is harder. Medication can now be helpful in combination with natural supplementation. Individual therapy along with group and family therapy is often necessary. Ideally, children with ADHD should be identified early. By adolescence they could well be on their way towards overcoming their difficulties. Some may have remaining
learning problems and may continue to need help. The added troubles and sensitivities of adolescence may cause your child to suddenly refuse to have extra classes, remediation, or to take medication. Teenagers do not want to be different, but handled with sensitivity and a sense of humour. Most problems can be overcome.
Adults:
If you have a child who has ADHD, the chances are that either you or your spouse also has the condition. "Hyper actives" tend to be drawn to people who are also dynamic, over-active and often vivacious. So it could be that there are characteristics of ADHD in both sides of your child's family (so no finger-pointing, please!)
Maybe, as you watch your child experiencing certain difficulties, you remember your own childhood, and you wonder ...Perhaps you've had persistent problems that have plagued you throughout your adulthood. It is possible that they are due to the condition of ADD/ADHD. It is used to be though that ADHD was outgrown at adolescence, but now it is generally accepted that it usually continues into adulthood, although it may manifest differently. A check-list of these characteristics is available from our office and if you experience some or most of these traits, then very possibly you are an ADHD adult.
FIND THE TALENTS AND ENCOURAGE THEM!!
No comments
Post a Comment