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The Predominantly inattentive Group is called ADD (Attention Deficit Disorder)

They are a group of children (20-30%) with mostly inattention problems.  They are not excessively hyperactive or impulsive behaviour.  The most common type is the combined type with all three classical signs of the disorder.  A small group consists of mostly hyperactive – impulsive children (less than 15%)

• The disorder is usually inherited.
• Some studies have shown a possible correlation between a mother’s use of cigarettes, alcohol or drugs during pregnancy and ADHD.
• Prenatal and peri natal obstetric complications as well as low birth weight are also associated with ADHD.
• Brain injuries or diseases.
• Free fatty Acid Deficiencies.

Pre School Years

• The child is restless (always on the go)
• Insatiable curiosity
• Fearless – may endanger self or others
• Vigorous and often destructive play
• Demanding, argumentative, noisy
• Interrupts others

School children

• Easily distracted
• Homework poorly organised, careless errors, often incomplete or lost.
• Do not reach academic potential.
• Blurts out answer before question completed (often disruptive in class)
• Low self esteem
• Displays aggression
• Difficult peer relationships
• Does not wait turns in games
• Unwilling or unable to do chores at home
• Accident prone

Adolescents

• Procrastinates and displays disorganized school
• Work with poor follow through
• Fails to work independently
• Poor self-esteem
• Poor peer relationships
• Inability to delay gratification
• engage in ‘risky’ behaviour – speeding, unprotected sex and substance abuse

ADHD negatively affects the child’s – interaction with other children ability to follow family routine, mealtimes, family activities and parent’s emotional health.

Diagnosing ADHD can be difficult and requires information from a number of sources.  It should be made in a timely, comprehensive assessment conducted by a medical doctor with expertise in ADHD.  It should also involve the child, his/her parents, care-givers and the child’s school, and take into account cultural factors in his/her environment.

Assessing a child usually begins with gathering complete medical, school and family histories and doing a medical exam to exclude other conditions.

As ADHD cannot be determined by a simple blood test or physical evaluation, the diagnosis should only be made after symptoms have persisted over an extended period of time, and interfere with the ability to function.

Physical examination should be done to make sure that there is no evident underlying physical illness, hearing should be checked, and any history of epilepsy sought.

Symptoms must be evaluated carefully against what is expected and that developmental level; the assessment needs to be full enough to find any alternative explanation of the symptoms that may be present.

A well-thought out and Comprehensive Treatment plan should be developed for the patient with ADHD.  The treatment plan should be regularly reviewed and modified if the patient’s symptoms do not respond.  Medication combined with psychosocial interventions is most effective.

Medication is not a cure for ADHD but research show significant improvement in academic performance, social interaction, participation in sport and family unit cohesion.

The medicines licensed in South Africa for ADHD are Methylphenidate (known as Ritalin or Concerta) and Atomoxetine (Strattera).

Your doctor will determine the most suitable treatment for your child.  Side-effects are minor and usually related to the dosage.  Most common side effects include headache, reduced appetite, stomach ache and sleeplessness.

Your doctor will sit down and discuss all possible pros and cons regarding medicine as well as possible side-effects.

The existence of other types of problems are very common and include Oppositional Defiance Disorder (ODD), Anxiety or Mood Disorders, and Learning disabilities.

It is important that the other conditions are also effectively managed.

For sure.

ADHD effects approximately 4% of adults worldwide.   Adults present with poor planning and organisation, poor memory, emotional distress.  They have difficulty finishing daily jobs and often lower occupational achievement.  Adults can be treated effectively with medication.

A team effort with parents, teachers and doctors working together, is the best way to help your child.  Equip yourself with knowledge about the condition, so that you can make informed decisions.  Unfortunately there is a lot of misinformation and children are often not achieving their potential because of parent’s unrealistic fears of medication.  Give your child a fair chance, they deserve it.

Helpful websites – www.adhdsupport.co.za; www.help4adhd.org; www.myadhd.co.za