DR FAITH B YISRAEL
“De pickney bad!” a comment we frequently hear from parents, teacher, and even other children, to describe a child who may have behavioural challenges. What we may not understand, is that the child may not be “bad” but may have undiagnosed attention-deficit/hyperactivity disorder (ADHD).
What is ADHD?
According to the American Psychiatric Association, “Attention-deficit/hyperactivity disorder is one of the most common mental disorders affecting children. It also affects many adults. ADHD is diagnosed as one of three types: inattentive type, hyperactive/impulsive type, or combined type. A diagnosis is based on the symptoms that have occurred over the past six months.
Inattentive type – six (five for people over 17 years) of the following symptoms occur frequently:
• Doesn’t pay close attention to details or makes careless mistakes in school or job tasks.
• Has problems staying focused on tasks or activities, such as during lectures, conversations, or long reading.
• Does not seem to listen when spoken to (seems to be elsewhere).
• Does not follow through on instructions and doesn’t complete school work, chores, or job duties (may start tasks but quickly loses focus).
• Has problems organising tasks and work (does not manage time well; has messy, disorganised work; misses deadlines).
• Avoids or dislikes tasks that require sustained mental effort, such as preparing reports and completing forms.
• Often loses things needed for tasks or daily life, such as school papers, books, keys, wallet, cell phone and eyeglasses.
• Is easily distracted.
• Forgets daily tasks, such as doing chores and running errands. Older teens and adults may forget to return phone calls, pay bills, and keep appointments.
Hyperactive/impulsive type – six (five for people over 17 years) of the following symptoms occur frequently:
• Fidgets with or taps hands or feet, or squirms in seat.
• Not able to stay seated (in classroom, workplace).
• Runs about or climbs where it is inappropriate.
• Unable to play or do leisure activities quietly.
• Always “on the go,” as if driven by a motor.
• Talks too much.
• Blurts out an answer before a question has been finished (for instance may finish people’s sentences, can’t wait to speak in conversations).
• Has difficulty waiting his or her turn, such as while waiting in line.
• Interrupts or intrudes on others (for instance, cuts into conversations, games, or activities, or starts using other people’s things without permission). Older teens and adults may take over what others are doing.”
October is ADHD Awareness month. This year the theme is Reframing ADHD, Discovering New Perspectives. The aim of the programme is to highlight the issues of ADHD, review the conventional methods of treating with it, while ensuring that best practice is highlighted and promulgated .
The Mayo Clinic has outlined five behavioural strategies to help manage your child's ADHD:
1. Give praise and rewards when rules are followed.
Children with ADHD often receive and expect criticism more so than other children. This can really impact self-esteem. Some days, you might have to really look for the good behaviour, but you should praise good behaviour at least five times more often than you criticise bad behaviour.
2. Give clear, effective directions or commands.
Make eye contact or gently touch on arm or shoulder to get his or her attention. Give brief, simple steps and short commands that get to the point rather than multiple directions or wordy statements and questions.
3. Establish healthy habits.
If your child is on a medication, it should be taken as prescribed. Contact your child's health care provider if problems arise. Make sure your child is getting enough sleep, eating a well-balanced diet consisting of three meals, a snack and adequate fluids daily, and has an outlet for some form of daily exercise. These healthy habits will help your child to feel his or her best and help minimise ADHD symptoms.
4. Develop routines around homework and chores.
Work together to make a checklist of what needs to be done surrounding daily chores, getting ready for bed and school for your child to refer to when he or she gets off task. Encourage your child to use a daily planner so he or she is aware of all homework assignments. Have an established time and location for homework and use a timer to remind your child to show you how the homework is going two to four times per hour. Factor in brain breaks if your child needs them and movement between tasks or use of an appropriate fidget.
5. Help your child build relationships, strong social skills and maintain friendships.
Be a good role model of behaviour you want your child to use. Factor in some special time three to five days a week with your child that is conflict-free and does not involve a screen to help maintain a strong parent-child relationship. Help your child develop at least one close friendship. With younger children, parents may need to take the lead to arrange and host play dates or get kids involved in activities where there are kids the same age.
Where to get help
Have an honest conversation with your child’s teachers and principals. This allows both parties to understand your child’s circumstance, and therefore partner to ensure the best for your child. The Student Support Services Unit of the Division of Education, Innovation and Energy is an option. The unit may be reached at 1 (868) 299-0781.
The Child and Adolescent Centre, a component of the Tobago Regional Health Authority is also available to assist with the assessment and treatment of children with ADHD. They are situation at the Old Scarborough Hospital, Fort Street, Scarborough, and may be reached by calling 660-4744 extensions 3400 and 3401, or by calling 660-7338.
Dr Faith B Yisrael is a health educator, social scientist, public health specialist and politician.
Email address: Imani.Consulting.Tobago@gmail.com
Phone number: 494-8827
Facebook Page: @ImaniConsultingAndFoundationTobago