Attention deficit hyperactivity disorder (ADHD) is a childhood disorder that affects about 3 to 5 per cent of children worldwide, including Singapore. It is four times more common in boys than girls.

While ADHD can be diagnosed as early as the age of 5, doctors typically prefer to wait until the child is 6 or 7 years old, when the child has more control over his or her behaviour. ADHD symptoms must be present before the age of 12 and must be observable in more than two settings (e.g. school and home) for a diagnosis to be made.

“Recent research suggests that ADHD symptoms may continue into adulthood in 2 out of every 3 cases,” explains the Child and Adolescent Mental Wellness Service at KK Women's and Children's Hospital (KKH), a member of the SingHealth group.

9 ways parents can help their child with ADHD (attention deficit hyperactivity disorder)

1. Let your child feel the support and love. Know that your child’s problems are not your fault and it is not caused by bad parenting. Acknowledge your child’s strengths, and validate each attempt he makes to succeed. Children with ADHD have low self-confidence and give up before they have a chance to succeed. Support and work along with your child to maintain their self-esteem. Reaffirm good efforts and mention positive qualities and tiny improvements.

2. Establish a consistent and structured home environment. Establish basic rules when your child is young and continue those rules into the teenage years. Implement rewards and consequences to motivate the child to succeed in his challenges.

3. Make a list to help your child manage his daily routine. Make a list of things to be done – Keep the list short and prioritise things that need to be done immediately. Use simple drawings or pictures if child has reading issues. 
   Remember your child may have difficulty with planning and remembering things for very long. To help them, use the four questions – What? Where? When? Why?

4. Instill self-discipline and a sense of responsibility in your child. The child should have chores to do the same as any other child. Children with ADHD feels bored easily, thus you may want to give your child different chores each day.

5. Keep instructions short and simple. Some very active children will be able to follow only one simple instruction at a time.

6. Give reminders about chores and tasks. You can help by being patient in a loving way. Remember to make lists and keep calendars of the family activities and give advanced warnings about any changes. With proper incentives, reminders, monitoring and breakdown of tasks, responsible habits can be learned.

7. Ask your child for feedback, such as “Did that make sense?” Ask child to repeat to make sure he understood you.

8. Ask your child questions that encourages them to be self-aware, such as “Do you know what you just said / did?”.

9. Find out more on ADHD to help you better manage his / her behaviour and difficulties.

Symptoms of ADHD (attention deficit hyperactivity disorder) 

ADHD symptoms can be mild to severe and are grouped into two categories:

1. Inattention and 

2. Hyperactivity and impulsivity

A child should have several ADHD symptoms from one or both categories to be diagnosed with ADHD. The following are some common ADHD symptoms:

1. Inattention 

• Difficulty sustaining attention whilst doing a task or playing 

• Often appears not to be listening when spoken to 

• Prone to daydreaming 

• Difficulty following instructions 

• Difficulty organising tasks and activities 

• Prone to losing items e.g., toys, school assignments, books, stationery 

• Easily distracted 

• Forgetful in daily activities 

• Often fails to finish schoolwork, homework and other tasks

2. Hyperactivity and impulsivity 

• Restless and fidgety 

• Often leaves classroom seat and moves around inappropriately 

• Unable to play quietly 

• Often runs around the room, climbing onto furniture

• Prone to being over-talkative 

• Often interrupts during a conversation

“ADHD is most prominent during situations when prolonged sitting is required, like in the classroom, and during the performance of tasks and assignments that require substantial concentration and mental effort,” adds the Child and Adolescent Mental Wellness Service from KKH. “Children with ADHD may also experience peer relationship problems due to their poor impulse control and frequent emotional outbursts.”

Causes and risk factors for ADHD (attention deficit hyperactivity disorder)

Research has yet to detect a single cause for ADHD. Some possible factors related to the condition may include:

• Family history of ADHD

• Premature birth and low birth weight

• Psychosocial stressors, such as chaotic family background can aggravate the severity of the conditions

• Abnormalities found in brain chemistry and how the brain tracts function

• Chemical toxins, such as lead poisoning

Treatment for ADHD (attention deficit hyperactivity disorder)

ADHD treatment involves managing the symptoms with medication, occupational therapy, and behaviour strategies.

• Occupational therapy: This may improve attention and concentration and help the child to filter external distractions and achieve better motor coordination.

• Behaviour strategies: Consult with a Psychologist for behavioural therapy.

• Medication: Stimulants boosting certain brain chemicals can help reduce hyperactivity and improve attention in moderate and severe ADHD cases.

“Parenting skills training programmes can help parents learn ways to better manage their child’s ADHD symptoms,” says the Child and Adolescent Mental Wellness Service from KKH.

“While children with ADHD may also benefit from specific educational support, anger management as well as social and problem-solving skills training.”

A key aspect of ADHD treatment is loving support both at home and at school. This can help ADHD children better manage their symptoms and build their self-esteem.

FAQs about ADHD (attention deficit hyperactivity disorder)

1. What is life like at home and at school for a child with attention deficit hyperactivity disorder?

Life at home and at school can be very frustrating for a young person with ADHD. At school, it can be hard for a child with ADHD to focus on what the teacher is saying and to keep up with school work.

Being impulsive and impatient, the child may get in arguments with peers and family members.

Hyperactive ADHD children may distract other children in the classroom, promoting indiscipline. At home, the hyperactive child may find it difficult to sit still for meals and be constantly running and climbing on to furniture around the house. 

In the long term, the frequent scolding and the poor academic grades can affect the ADHD’s child self-esteem and self-confidence.

2. Does ADHD increase a child’s risk of developing other health conditions?

Currently, evidence indicates that a child with ADHD is not at risk of developing other physical health conditions. However, there is a high association with learning problems, mood and anxiety symptoms, and conduct disorders.

ADHD children are prone to accidents due to their hyperactive and impulsive behavior. They need to be taught to follow safety rules.

Undiagnosed and untreated ADHD has been associated with poor academic achievement in children. In adults, it has been associated with a higher rate of divorce, substance and alcohol misuse, difficulties at the work place and higher rates of contact with the criminal justice system, underscoring the importance of proper diagnosis and treatment at an early stage.

Ref: I23 (ed)

Other mental wellness articles for youth:

Teen Depression: Early Signs and What Can Parents Do

Social Media Use: How to Prevent It From Affecting Mental Health

20 Tips to Better Cope with Stress

Eating Disorders: Types and How to Cope