Once thought to be only a childhood condition, global cases of ADHD have risen dramatically in both adults and children in the past 15 years, and in the UAE, ADHD has even been blamed for the country's spike in the number of road traffic accidents due to inattentive driving. While the symptoms mean that it's hard to diagnose a child before the age of about 5 (children are expected to be energetic and impulsive after all), latest research suggests that it's important to factor in the possibility of ADHD at a pre-school level, in order to best help little ones who may otherwise struggle. We spoke to Dr Haneen Jarrar, psychologist and counsellor at Camali Clinic, about what we need to know about ADHD in children in the UAE.
1. What is ADHD, and how is it different from ADD?
Attention Deficit Hyperactivity Disorder, or ADHD, is a common childhood condition which affects a child’s school, social and home life. Studies show that ADHD may affect certain areas of the brain that allow us to solve problems, plan ahead, understand others’ actions, and control our impulses. This is the reason that children with ADHD exhibit symptoms of physical hyperactivity or excessive restlessness, a decrease in focus or attention and impulsivity.
The difference between ADD and ADHD is that the diagnosis of ADHD includes hyperactivity whereas in ADD, children are not necessarily hyperactive; they can be calm and serene. They will, however, have difficulty with concentration and attention.
2. How common is ADHD?
ADHD is more common than doctors may have previously believed, according to new statistics from the Centre for Disease Control and Prevention (CDC).
The report, released in November of 2013, shows that up to 11 per cent of children aged 4-17 have been diagnosed with ADHD at some point in their lives. In 2003, that estimate was only 7.8 per cent. Boys are nearly three times more likely to have been diagnosed with ADHD (13.2 per cent) than girls (5.6 per cent).
3. What are the symptoms of ADHD?
Classic symptoms of ADHD include inattention, hyperactivity and impulsivity. Children with ADHD have trouble maintaining focus and controlling their behaviour. These children may struggle at school, get into frequent trouble, and find it hard to get along with others or make friends.
4. At what age do symptoms begin to show?
It can be difficult to diagnose ADHD completely before the age of 5 because most young children are highly energetic, easily distractible and impulsive. According to research, the average age of diagnosis is 8 years for ADHD and 10 years for ADD.
5. How does having ADHD impact the life and development of a child?
ADHD can cause impairment in all areas of functioning in a child’s life. For instance, the child can get trouble at home with his/her parents regarding behavioural problems, may have difficulty making and maintaining friends at school, may get in trouble with the teacher in class for not be able to sit in the chair properly, or blurt out answers before being called upon.
6. It’s been said a diagnosis of ADHD is thrown around loosely these days and that sometimes children who don’t have ADHD are diagnosed with it. What are your thoughts on this? And if your child is diagnosed with ADHD, how can you be sure?
A comprehensive diagnostic assessment should include a standardised assessment test that involves a child psychologist or psychiatrist administering the test, and producing a report detailing how the child meets the diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association and has strict guide lines on what symptoms a child should exhibit to confirm a diagnosis. These guidelines can be found online and are easily accessible to parents.
7. Do you believe that ADHD is on the rise? If so, why do you think that could be?
Recent studies have shown that ADHD is in fact on the rise. A 2015 study showed that diagnoses of ADHD have risen by 43 per cent in the USA between 2003 and 2011. Different countries have different rates of increase, however studies have indicated that several factors affect the prevalence of ADHD, including genetic factors, environmental factors and health and dietary factors.
8. What are the best methods for helping a child with ADHD?
• Finding a centre that includes a multidisciplinary team is very important for a child with ADHD. This is because treatment should always be multidisciplinary and include a psychiatrist, psychologist, occupational therapist, speech and language therapist and other health professionals.
• Psycho-education is very important in any and all psychological conditions. It is important to educate the family and school about ADHD symptoms, diagnosis, and prognosis; it helps everyone involved manage expectations and be more understanding towards the child’s difficulties.
• A combination of positive parenting strategies along with behaviour therapy is a great way to tackle the difficulties caused by ADHD.
• Focusing on the child’s positive behaviour instead of negative behaviour can seriously help in not only managing difficult behaviour, but also maintaining self-confidence and self-esteem.
• It is also important to help the child feel supported and accepted by his/her family, school and peers.
9. What are the biggest difficulties when it comes to parenting a child with ADHD?
Having a child with ADHD can be very challenging for parents. They have to be extremely patient, learn new methods to positively discipline the child, be understanding towards his/her condition, deal with the child’s school regarding difficult behaviour, constantly find creative ways to help them adjust at home and at school. Finding support groups is also very helpful, and we are lucky to have a wonderful ADHD support group in Dubai.
10. What are the most common misconceptions about ADHD?
• The child can outgrow his/her ADHD with time and age.
• Medication alone cures ADHD entirely.
• Parents of children with ADHD have done a poor job disciplining their children.
• ADHD behaviour is caused by eating too much sugar.
Therapy is usually the first port of call for treating ADHD in young children, while diet and supplements can also play a part in treatment, and more severe cases may involve medication. The UK's NHS has guidelines for treating ADHD.
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