Attention deficit hyperactivity disorder (ADHD)

What is it?

Attention deficit disorder (ADD) is a biologically based disorder, which involves a pattern of decreased attention span interspersed with periods of hyperactivity and impulsivity. Both ADD and ADHD are similar conditions and are often difficult to distinguish in children. Children with ADD have a very short attention span, while those with ADHD are hyperactive and may not be able to sit in one place for long. Some children might naturally be more active than others but this does not amount to ADD.There are three subcategories of ADD: predominantly inattentive predominantly hyperactive combined typeThe disorder is more common in males and is mostly observed in children. Though traits can be carried over to adulthood, the disease is eminently treatable in childhood, and the symptoms can be easily brought under control.

What are the causes?

The exact cause of the disorder is not known. However, there may be certain risk factors that predispose a child to the disorder. Exposure to toxins before birth and premature birth are two such factors. Children with ADD usually have a family history of discord, bad performance in school and other related behavioural disorders. ADHD is also more common in children who have a close relative with the disorder. Sometimes, injury to the central nervous system may also lead to the condition.

What are the symptoms?

Children with the disorder are not able to concentrate on one thing for long. Their attention span may range from a few seconds to a few minutes. These children may be irritable most of the time. Some children may also be extremely destructive and prone to breaking objects.While in a structured activity like a classroom session, ADD children may seem to "phase out" and the teacher may feel that they are not paying attention. Some hyperactive children may walk out in the middle of a class, and may have to be kept occupied in a separate section for special children.Some of the salient behaviours of a hyperactive child may be as follows: Fails to pay close attention to details Makes careless mistakes, especially in school work Is very fidgety with his hands and feet Throws temper tantrums and may resort to breaking things Talks too much Has difficulty awaiting his turn Is easily distracted by things happening around him

How is the diagnosis made?

In most cases, the disorder comes to light when the child fails to do well in school. The school counsellor may test for signs of hyperactivity in the child. The diagnosis for ADHD is given only when the counsellor feels that the child's hyperactivity is interfering with his daily routine.

What is the treatment?

Since ADHD is not a disease, it cannot be cured. Most children with ADHD may however, be prescribed medicines like Methylphenidate (Ritalin) to curb their hyperactivity. A dual approach however is necessary to bring the condition under control. The child may need to be put in special education classes where the pace is set by the child and he is not unduly pressured. Integrative education is the new form of classroom teaching that is of much help to children with lack of concentration. In this form of education, the child studies at his own pace and academic education is supplemented with behaviour therapy to mould his behaviour to social norms.

What are the complications?

Children with ADHD usually grow up to be useful citizens of the society. If the disorder is diagnosed and treated early, these children adapt themselves to the ways of the society and may have no problems in adjusting to the normal routine. Though the treatment measures used may cause some stunting of growth in children, most children catch up later on. The prognosis for children with ADHD is usually good.

DoctorNDTV Team

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