Five-year-old Sumit's parents were on edge. He was falling behind in school, being disruptive in class, rejected by peers and hyperactive at home. He felt that nobody liked him. He was slightly below his classmates in his ability to recognise letter, numbers and shapes.  Overwhelmed by the situation, his parents turned to professional help.  The child psychiatrist diagnosed him of having ADHD Combined Type and learning disability in reading.
He underwent treatment for this, which consisted of a  combination of medicines and social skills training.  Today he is a happy child in first grade with relieved parents.

Child and behavioural disorder has off late become a major concern among health professionals in the developing countries. The most crucial part of the condition is that it is extremely difficult and controversial to diagnose and parents are often caught up in a dissonance of conflicting advice. One of the most prevalent conditions among children is Attention Deficit Hyperactivity Disorder.

Understanding ADHD

ADHD or Attention Deficit Hyperactivity Disorder is a condition of the brain that makes it difficult for children to control their behaviour. It is one of the most chronic conditions of childhood. It affects 4 to 12 per cent of all school age children. Boys are known to be more susceptible to the disorder with 3 times more boys diagnosed with ADHD as compared to girls.

Causes

There are multiple causes for ADHD, there is no single reason children have ADHD. It is clearly a genetic / familial disorder. Family studies, twin studies and adoption studies show that it is more common in biological relatives and has a high heritability.

Other possible causes include perinatal complications like haemmorhage, prolonged labour, and others like birth trauma, cranial abnormalities, head injuries, fetal alcohol syndrome, stress and so on. While none of these causes is important in more than a small minority of ADHD cases,  in the aggregate, they complicate a considerable number of cases.

Symptoms

ADHD includes 3 behaviours symptoms -Inattention, Hyperactivity and Impulsivity.

Inattention

*Has a hard time paying attention, does not seem to listen.
*Is easily distracted from work or play, does not seem to care.
*Makes careless mistakes when it comes to details.
*Does not follow through on instructions or finish tasks.
*Loses a lot of important things
*Forget Things

Hyperactivity

*Appears as if “driven by a motor”
*Cannot stay seated
*Squirms and fidgets.
*Talks too much.
*Has tendency to run, jump and climb when not allowed.

Impulsivity

*Acts and speaks without thinking — may even walk into the street without looking for traffic.
*Has trouble in hearing
*Impulsive
*Tells out answer/ interrupts before the question is complete

How can one decide if the child has ADHD?

It is normal for all children to show some of these symptoms from time to time. Most children may be reacting to stress at school or home. But if the child has shown symptoms of ADHD on a regular basis for more than 6 months, it is important that parents consult a child psychiatrist immediately.

To confirm a diagnosis of ADHD these behaviours must:

*Occur in more than 1 setting, such as home, school and social situations.
*Noticeable difference with other children of the same age
*Start before the child reaches 7 years of age (However these may not be recognised as ADHD symptoms till a    child is older.)
*Continue for more than 6 months.
*Make it difficult to function at school, at home and or in social situation.

Treatment

Once the diagnosis is confirmed, the outlook for most children who receive treatment for ADHD is very encouraging. There is no specific cure for ADHD but there are several effective treatment options.  Each child’s treatment must be tailored to meet individual needs.

To sum up, dealing or parenting a child with ADHD is not easy and can be rewarding and frustrating at the same time. Many parents feel alone raising a child with ADHD.

The best way to deal with this problem is to get a better understanding of the condition and find strategies to cope with symptoms. But to improve child's life and the harmony within the entire sphere, it is always advisable to consult a child psychologist who will identify the exact problem and will suggest the relevant remedies.

It is extremely important for parents to spend quality time with the child to ensure comfort and praise even when all is going fine, which gives them a strong sense of security and confidence.

Creating a fine balance of discipline with both positive and negative reinforcements is also very important to create boundaries for the child to enhance his/her social skills, values, morals and judgments.