What is it like to have Attention Deficit Hyperactivity Disorder (ADHD)? What is the feel of the illness? What is the subjective experience of ADHD children, and what is it like to live with?
One metaphor that those diagnosed with ADHD find they can relate to is this: it's like driving a car in with bad windshield wipers during a downpour. You are trying hard to see what’s ahead, but everything is a blur and far from clear. You have to do your best just to avoid a mishap,,,to just survive…
ADHD is a fairly common illness - data suggest that 5% of school-going children have the problem. Boys are twice as likely as girls to be diagnosed with ADHD. ADHD is probably under-diagnosed in girls, since their symptoms tend to be less dramatic than those in boys and thus draw less attention from parents and teachers. While it is true that any child may show distractibility, impulsivity or restlessness at times, the child with ADHD manifests these behaviors more frequently and severely than other children of the same age or developmental level.
There are three subtypes of ADHD: the predominantly hyperactive type (that does not show significant inattention), the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) and the combined type (that displays both inattentive and hyperactive-impulsive symptoms).
What causes ADHD?
One of the first questions a parent will have is "Why? What went wrong? Did I do something to cause this?" There is no evidence to suggest that ADHD is the result of social factors or child-rearing methods. Most substantiated causes appear to fall in the realm of neurochemistry. Two neurotransmitters in particular – dopamine and norepinephrine – are primarily involved in the causation of ADHD.
Recognizing the illness...
The principal characteristics of ADHD are inattention, hyperactivity and impulsivity. . Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination by a professional, before a diagnosis is made.
In many cases, it is a teacher who initiates the process of seeking professional help by informing parents that their child is daydreaming in class, failing to complete assignments or is unable sit in his place in class. If more than a few of the following statements accurately describe your (school-going) child, there may be reason to suspect ADHD:
Often fidgets or squirms in seat
Has difficulty remaining seated
Is easily distracted
Has difficulty awaiting turn in groups
Often blurts out answers to questions
Has difficulty following instructions
Has difficulty sustaining attention to tasks
Often shifts from one incomplete activity to another
Has difficulty playing quietly
Seems to have boundless energy
Often interrupts or intrudes on others
Often does not seem to listen
Often loses things necessary for tasks
Often engages in physically dangerous activities, without considering consequences
Does ADHD need treatment?
There is no question that ADHD can, and does, disrupt lives. The parents of children with ADHD may be ostracized by neighbors and relatives, who blame them for failing to control the child. "I've got criticism of my parenting skills from strangers," the mother of a hyperactive boy told me. "When you're out in public, you're always on guard. Whenever I'd hear a child cry, I'd turn to see if it was because of Ashish". School can be a shattering experience for such kids. Frequently reprimanded and tuned out, they lose any sense of self-worth and fall ever further behind in their work. ADHD kids are also prone to accidents, because of their poor impulse-control. The injuries to self-esteem are often greater. Both social and academic learning are below the child’s potential. By age ten, a third are hostile and defiant. By age fourteen, they run the risk of developing another psychiatric illness, Conduct Disorder. With timely and adequate treatment, such undesirable outcomes can be prevented.
Treatment
While there is a lot that parents and teachers can do, it is important to remember that medicines are central to the treatment of ADHD. Assuming a rigorous diagnostic process, about 70% of children respond to medical management. The first-line medications used to treat ADHD include methylphenidate and the mixed amphetamine salts.
Evidence suggests that some children get better results from one medication, some from another. However, given that amphetamines are banned in India, methylphenidate is the go-to medication; it is also the gold standard globally for the treatment of ADHD. For many children, the medicine dramatically reduces their hyperactivity and impulsivity and improves their ability to focus, work and learn.
Medication may also improve physical coordination, such as that needed in handwriting and in sports. Methylphenidate , when used under medical supervision, is safe.
A word of caution regarding alternative therapies, which tend to play down the medical basis of the illness and to focus excessively on dietary modification / parenting styles: Bear in mind that the term "alternative" often means unscientific because there is little or no credible research to support these suggested interventions. If there were, they would be called scientifically-based interventions, not alternative ones.
What parents SHOULD do:
Children with ADHD may need help in organizing. Therefore:
Schedule. Have the same routine every day, from wake-up time to bedtime. The schedule should include homework time and playtime (including outdoor recreation and indoor activities such as computer games). Have the schedule written down and displayed in a spot where everyone in the family can see it. If a schedule change must be made, make it as far in advance as possible.
Organize needed everyday items.Have a place for everything and keep everything in its place. This includes clothing, books and school supplies.
Use homework and notebook organizers. Stress the importance of writing down school assignments and bringing home needed books.
Children with ADHD need consistent rules that they can understand and follow. If rules are followed, give small rewards. Look for good behavior and praise it.
What parents SHOULD NOT do:
Blame yourself: ADHD is not caused by poor parenting, family problems, poor teachers/schools
Avoid milk, sugar, soft drinks and chocolates. These is no credible scientific evidence which links these with ADHD
Provide zinc and multivitamin supplements as ADHD "cures": again, no reputable research supports their use
What the school / teachers CAN do:
Within the classroom, some simple, practical things work well. Let hyperactive kids move around. Give them stand-up desks, for instance. To minimize distractions, ADHD children should sit close to the teacher and be permitted to take exams in a quiet area.