ADHD or attention deficit hyperactivity disorder 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.

As its name suggests, ADHD is a neuro-developmental disorder that involves hyperactivity and problems with attention span. Children with ADHD find it difficult to sit still and concentrate on a given task, which affects their behaviour at home, at school and in social situations. They also have problems with impulse control.

ADHD cannot be cured but ADHD symptoms can be successfully managed and may improve as the child gets older.

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

ADHD symptoms can be mild to severe and are grouped into two categories – inattention and hyperactivity / 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:

• 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

• 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,” says Dr Ong Say How, Head and Senior Consultant, Child and Adolescent Mental Wellness Service, KKH. “Children with ADHD may also experience peer relationship problems due to their poor impulse control and frequent emotional outbursts.”

“Life at home and at school can be very frustrating for a young person with ADHD,” says Dr Marimuttu. 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,” says Dr Marimuttu.

Read on to learn about the causes, risk factors and treatment of ADHD.

Ref: R14