How to deal with ADHD
By Mawi Fojas de Ocampo
Philippine Daily Inquirer
First Posted 00:34:00 11/19/2008
Filed Under: Lifestyle & Leisure, Health, People
ADHD OR ATTENTION DEFICIT Hyperactivity Disorder is a neurodevelopmental disability that affects children and adults alike. In the US, the incidence can range from four to eight percent of the population. Data from a 2006 study in the Philippines indicate a four-percent incidence (that’s more than three million!) assuming at that time the population was at 84 million.
Proclamation 472 has declared October each year as “National Attention Deficit/Hyperactivity Disorder Awareness Week.”
What is the cause of ADHD?
Doctors do not know what causes it. However, researchers who study the brain are coming closer to understanding what may cause it. They believe that some people with ADHD do not have enough chemicals called neurotransmitters in their brain. These chemicals help the brain control behavior.
It is important to note that parents and teachers do not cause ADHD. However, there are many things that both parents and teachers can do to help the child cope with ADHD.
What is the difference between ADHD and ADD?
Ria Vecin, founding partner for the Tomatis Center in the Philippines (Tomatis has been used as treatment for people with ADHD) says: “ADD or Attention Deficit Disorder is an older term used to describe children and adults with attention issues. However this term is no longer used. Normally ADHD is the term used to diagnose those with attention issues.”
Anna C. de Ocampo, MD, FAAP, Developmental & Behavioral Pediatrician practicing at the Melmed Center in Scottsdale, Arizona, USA clarifies:
“In reality, there is no ADD in the books (Diagnostic and Statistical Manual IV); but people have coined the term ADD for children and adults who do not have the hyperactivity component and are mainly inattentive and distracted.”
According to De Ocampo, there are three classifications of ADHD based on the DSM-IV (this is like the bible of psychiatry) as follows below:
ADHD-Inattentive Type:
This is characterized by no hyperactivity or impulsivity or just minimal hyperactivity or impulsivity. Predominant symptoms include:
Inattention, distractibility, daydreaming
Inability to finish work, reluctance to engage in tasks requiring sustained mental effort
Disorganization or executive function deficits (meaning not being able to prioritize tasks, having trouble getting started on a task, losing things, forgetfulness)
Making careless errors or mistakes
ADHD-HI Type-Hyperactive-Impulsive Type:
Kids with this type have normal attention span. The hyperactivity characteristics, however, include:
Fidgetiness or squirming in seat, out of seat, fidgeting with hands and feet and things
Inability to play quietly
Always on the go, as if driven by a motor, bouncing off the walls
Loud, excessively talkative and usually disruptive in class
Imparts an air or impression that they do not hear what is being told to them
Engaging in physically dangerous activities without thinking of the consequences
Often losing things necessary for tasks or activities at school
Does not follow instructions
Monopolizing conversations due to excessive talking
The impulsivity characteristics include:
Acting without thinking
Rushing through work
Blurting out answers before being called
Interrupting
Inability to wait for their turn
ADHD-Combined Type:
This is the most common in both girls and boys. Combined type means they are hyperactive, impulsive and inattentive (They have it all!). They are usually disruptive in class because of their symptoms. About 50% have ODD (Oppositional Defiant Disorder). Kids with ODD are defiant, quick to anger, argumentative, quick to get annoyed, and very oppositional.
De Ocampo explains: “So, to answer the question, ADD is the inattentive type of ADHD while ADHD is the combined type or hyperactive/impulsive type of ADHD.”
How can you know for sure that your child has ADHD?
If your child exhibits the signs mentioned above, it is best to consult with a developmental pediatrician. De Ocampo says that a diagnostic evaluation and treatment can be done by the following specialists:
Developmental and behavioral pediatricians
Child and adolescent psychiatrists
Neurologists
Clinical psychologists (who can diagnose but cannot prescribe medications)
General pediatricians and family practitioners (those mainly geared for seeing children) may also be able to diagnose and treat ADHD.
Living with ADHD
What is the treatment for it?
Vecin says, “There are varied treatments for ADHD. The most common goal of treatment is to manage the symptoms. Treatments vary from nutritional or dietary (though the GFCF diet— Gluten-Free Casein-Free Diet) to occupational therapy and alternative therapies, as well as changing teaching styles in schools.”
De Ocampo adds: “A multi-disciplinary approach is best for a child with ADHD, which includes family involvement, teacher support and the help of a doctor (a psychologist or developmental pediatrician).”
Dr. Lourdes Sumpaico-Tanchanco of Medical City (tel. 6356788) says: “The best evidence points to a multi-modal treatment—that means employing different approaches depending on the needs of the child. This may include the use of medications, behavioral therapy, occupational therapy, speech therapy and educational intervention. Again, all of these depend on the needs of the child.”
Can children with ADHD outgrow it?
Only about 40% will outgrow the symptoms or may have mild impairment as adults, De Ocampo says. About 60% carry symptoms through adulthood. “Although they may outgrow the hyperactivity, they may still be impulsive (i.e. poor judgement/jumps from one job to another/may have driving accidents; and most likely still inattentive, being unable to finish tasks and are forgetful),” she adds
Will a child ever have a normal life given this condition?
“Yes, there are many modes of intervention nowadays that can help manage symptoms of ADHD and can greatly diminish their occurrence,” Vecin says.
Are there special schools that cater to kids with ADHD?
“The problem in the Philippines are the big class sizes (about more than 40 in each class) which is less than ideal for a child with ADHD,” De Ocampo says. “They do benefit from small class sizes because there is less distraction, of course.”
“Most of the time, even in the US, children with ADHD are just mainstreamed in the regular classroom and given accommodations by the teacher to help them succeed academically. If the child has a severe case of ADHD, he may go to a Special Ed classroom for emotionally disabled children.”
According to De Ocampo, the trend in the US is just getting most of these kids mainstreamed unless they are so bad that they will end up being sent to behavior school (aka boot camp!).
Vecin says many schools in the Philippines are integrating inclusion programs for children with ADHD.
Check out these helpful websites:
ADHDsociety.org (ADHD Society of the Philippines)
This website offers support groups, meetings, seminars and other resources.
OCHADD.ORG (Childen and Adults with Attention Deficit Disorder)
This is a US based website and support group with lots of good information. They also conduct yearly meetings.
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