JEDDAH — Not every rowdy, active, and untidy kid who talks too much can be labeled as a child with attention deficit and hyperactivity disorder (ADHD). Most kids at one time or another demonstrate such behaviors as talkativeness, inattentiveness, and bursting energy during different situations and it may be difficult for parents to decipher whether it is ADHD or not. Experts say that these behaviors are a warning signal of the presence of ADHD only when they are persistent and severe enough to affect the child's academic progress and social life. To be diagnosed with ADHD, a child's symptoms must have continued for at least six months and has created real problems in the child's life at school, home, and social circle. Usually the symptoms will be noticeable before the age of seven. Symptoms of ADHD include hyperactivity: the child constantly fidgets and moves around, talks excessively, has difficulty playing quietly or relaxing, and may abruptly get out of his/her seat in class. The child has a short attention span, is easily distracted, frequently loses or misplaces things, gets bored with a task before completing it, appears not to listen when spoken to, has difficulty following instructions, and randomly bounces from one activity to another. Most kids with ADHD also exhibit impulsiveness, meaning they are unable to wait for a turn, they interrupt conversations, act without thinking, cannot keep powerful emotions in check and may have frequent temper tantrums, and they have little or no sense of danger. "Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed neurobehavioral disorders in children and adolescents. It is characterized by constant unsuitable levels of inattention and or impulsivity, and hyperactivity. School teachers can detect ADHD and refer the child for behavioral observational assessment. "ADHD may affect quality of life, and may have serious consequences for children including school failure, low self-esteem, poor peer relationships, family stress, and risk of antisocial behavior patterns and criminal actions. "ADHD is also linked to an increased risk of other disorders, such as depression, anxiety and sleep related problems. Therefore, early recognition and treatment of ADHD is vital," said Dr. Mansour Tobaiqy, consultant pharmacologist and director of patient safety at the Maternity and Children's Hospital in Jeddah. Studies on the prevalence of ADHD in Saudi Arabia are lacking but it is known that ADHD is more common in boys than in girls. ADHD affects approximately 5 percent of school aged children in the UK, 8.7 percebr in the US, 9.5 percent in Korea, 20 percent in India, and 29.7 percent in the UAE. A study conducted by Dr. Amr Ahmed Sabra, a sample was selected of 1,287 male students between the ages of 6 and 13 from government and private schools in Dammam found the prevalence of ADHD to be 16.4 percent among the boys. There is a pressing need for more studies and research on ADHD in Saudi Arabia to assess the national prevalence in children and to look at treatment methods for this disorder. Children who are unable to control their impulsiveness or focus attention long enough may struggle in school and find it hard to get along with other kids or make friends. The frustrations can cause a blow to the child's self-esteem and create stress for the entire family. "Managing ADHD should involve a well-rounded plan that includes a carefully balanced diet, plenty of exercise, and making changes in the home environment to minimize distractions. "Behavioral therapy and social skills teaching sessions should be implemented, along with parent education and training, social support groups, and special assistance at school. Medication is usually used as the last resort," said psychologist Alya Al-Akhras. "In some cases, the symptoms of ADHD are severely aggravated by certain foods and eliminating the foods that the child is sensitive to may result in a noticeable improvement. "Parents can closely watch the days that the hyperactivity is out of control and examine the child's diet to pinpoint the exact foods that are worsening the ADHD symptoms. "Removing or minimizing some foods from the child's diet may be helpful in the treatment of ADHD, for example, sugar, chocolates, candy, foods with artificial additives and dyes, sodas, eggs, soy, and of course caffeine," added Al-Akhras.
"Pharmacological treatments may not be necessary for all children with ADHD. The judgment to use medicine must be based on a careful assessment of the severity and the lasting effects of ADHD symptoms in relation to the child's age. "Treatment must be initiated under the supervision of a specialist pediatrician and/or child psychiatrist," said Dr. Tobaiqy. The current medications used for ADHD are not free of undesirable side-effects. "Although the incidence of serious adverse drug reactions is small; there are a number of widespread uncomfortable and less serious reactions that may negatively affect the quality of life of the child, such as insomnia and anorexia. "Common complaints from the use of ADHD drugs include appetite suppression, weight loss, headache, insomnia, quickened heart rate, and nervousness," said Dr. Tobaiqy. It is important to note that in addition to the challenges and difficulties that these children and their families face, children with ADHD also have very strong positive traits which should be built on. "Many children with ADHD are highly intelligent and some are artistically gifted. These kids are creative, imaginative, flexible, and are open to new ideas. "To be sure, children with ADHD are not boring. They are brimming with enthusiasm, spontaneity, energy, and are motivated at tasks that interest them," said Al-Akhras. Having a child with ADHD in the home can be frustrating and exhausting at times. If someone offers to help with cooking or caring for other children, accept their offer so you can have more time for your child with special needs. Read a lot and attend seminar or workshops about this disorder. Children with ADHD need structure, consistency, clear communication, and rewards and consequences for their behavior. They also need lots of love, support, encouragement, and the opportunity to run, exercise, and play outdoors to release some of the excess energy that they have.
