Rahul’s parents were called into school for the fourth time this term. His parents knew what would be in store- they would hear the teacher describe their son’s antics in class in this mildly exasperated and reproaching tone. The litany of complaints would be all too familiar – Rahul can’t sit still, he’s so hyper, he’s so fidgety, he’s distracting, his work is not complete, he cannot focus without the teacher reminding him constantly, he’s getting into fights with his classmates, he doesn’t follow rules, he is not performing up to his potential and similar such remarks. The parents observed that these dreaded school meetings were beginning to happen more frequently and they were at their wit’s end in trying to figure out how a regular 10 year old could be causing them such worry.

Faced with the possibility that the school may ask their child to leave, the parents eventually sought out a trained clinical psychologist. Sessions with the psychologist helped them recognize that there was more to Rahul’s behavior than what they had earlier dismissed as just naughtiness. After a series of detailed tests and interviews they were informed that Rahul’s difficulties could be explained by Attention Deficit Hyperactivity Disorder (ADHD).

What is ADHD?

ADHD is a common neurobehavioural disorder of childhood. The core symptoms typically include inattention, hyperactivity and impulsivity. Children with a diagnosis of ADHD usually have a fairly consistent history of difficulties in being able to stay focused in class, being restless or fidgety, being easily distracted, coming home with incomplete class written work, being dreamy, not following through on instructions and being impulsive.
Parents of children with ADHD observe that even at home the child may display difficulties such as following routines, be fidgety or restless, show reluctance to complete homework, need several reminders to complete tasks and may express defiance. Coping with a child who demonstrates these behaviours on a daily basis can be very frustrating and challenging. Parents may also be at the receiving end of well meaning relatives and teachers who question their basic parenting and disciplining skills.

While the words hyperactive and attention difficulties are bandied about in urban Indian classrooms, there is only an emerging awareness about ADHD as a diagnostic entity among teachers and parents. What makes understanding the condition perhaps more challenging is that most of the symptoms of ADHD are also observed as part of a child’s regular behaviour repertoire. Parents often ask whether their child is being ‘just naughty’ or whether they should be considering a formal diagnosis.

Behaviours to watch out for

If you are a concerned parent, these are some behaviours to watch out for in your child that may indicate the need for a comprehensive diagnosis and intervention:

• Behaviours displayed are usually not age appropriate. Temper tantrums in a two year old may be normal but they indicate difficulties in a 9 year old
• Difficult behaviours observed appear to be far more frequent and more intense. A child who is restless/fidgety/very talkative in class and who may have received comments such as, ‘He is so hyper!’ ‘Your child has so much energy’
• Difficulty completing tasks- frequently switches attention from one task to the next
• Instructions have to be repeated- often not because the child hasn’t understood them but because he wasn’t listening
• Displays a poor sense of time- can spend hours on activities of intrinsic interest such as electronic games but may have difficulties in staying seated to complete a homework task for 5-10 minutes
• Gets into trouble with peers, parents and teachers for engaging in impulsive acts- behaves without thinking through consequences
• May appear dreamy, lost in thought or pre-occupied in class or while attending to tasks at home
• May have academic difficulties – poor handwriting, reading, spelling or math difficulties
• Often places demands that must be met immediately

Not all children who demonstrate these behaviours will meet criteria for an ADHD diagnosis- a process best left to a professional! A clinical or child psychologist would conduct detailed assessments to better understand the nature of attention difficulties your child is displaying. Unfortunately parents do get confused by what others tell them. Statements such as ‘Don’t worry, he will grow out of it’, ‘His father was also like this, but see how successful he is today’ – tend to get parents to deny that a difficulty exists, delay diagnosis and intervention. Early intervention aided by your understanding and acceptance of the condition can make a world of difference to your child.

If there are behaviours that your child has been demonstrating for a while that are leaving you feeling perplexed or bothered, talk it over with a trained professional.

Talk It Over