Attention Deficit Hyperactivity Disorder (ADHD)

A child with ADHD has difficulty to pay attention, control himself or herself, behave, and sit still.  The symptoms appear before 12 years of age.  While ADHD affects behavior, emotion, learning, and social skills, the exact symptoms vary from person to person.  Some children are naughty, unable to sit still and control their behavior.  Others find it hard to pay attention and being forgetful in daily activities. ADHD occurs in children around the world and the disorder affects 6 - 9 % of school-aged children in Thailand.    

a. Lack of attention including:

1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities. 
2. Often has difficulty sustaining attention in tasks or play activities. 
3. Often does not seem to listen when spoken to directly. 
4. Often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace. 
5. Often has difficulty organizing tasks and activities. 
6. Often avoids, dislikes engaging in tasks that require sustained mental effort (such as schoolwork or homework). 
7. Often loses things necessary for tasks or activities (e.g. school assignments, pencils, books).
8. Is often easily distracted by extraneous stimuli. 

9. Is often forgetful in daily activities. 

    

b. Hyperactivity and Impulsivity:

1. Often fidgets with or taps hands or feet, or squirms in seat. 
2. Often leaves seat in situations when remaining seated is expected (e.g. leaving seat in classroom or in their workplace). 
3. Running or climbing in situations where it is inappropriate. 
4. Blurting out answers before hearing the whole question. 
5. Talking excessively. 
6. Interrupting or intruding on others. 
7. Having difficulty waiting in line or taking turns. 
8. Unable to play or engage in leisure activities quietly. 
9. Feeling very restless, as if “driven by a motor”, and talk excessively. 

ADHD is caused by the genes that control brain maturation and chemicals in the brain. Some types of child rearing style and environment around the child might be contributing factors of ADHD. A child’s mother who is smoking, drinking alcohol or exposed to some chemical toxin during pregnancy increases the risk of ADHD.  In addition to learning problems, 20 to 60 percent of children with ADHD also have a learning disorder. However, high consumption of sugar and chocolate do not bring out ADHD symptoms.

1. Providing information about ADHD to parents and teachers.
2. Make a collaboration system in family, school and hospital to help the child.    
3. Behavioral management and psychological counseling for children and families.
4. Medication.
5. Preventing complications of ADHD.

In addition to the ADHD children who get proper treatment, 20-30% of them have a chance to outgrow their symptoms when they enter their teenage years. They can study or work without using medication. However, most children still have concentration problems and remain with mild hyperactivity-impulsivity. Their work performance and social interaction will be affected, therefore, continuing treatment is important.

1. Seat the child at the front of the class or in close proximity to the teacher. 
2. Seat the child away from doors or windows.
3. List the homework or class assignments on the board.
4. Check the child’s notebook for completed assignments.
5. Do not assign lots of work at the same time and have the child complete one step before introducing the second step.
6. Provide the child with private, discreet cues to stay on task without embarrassing the child.
7. Provide an opportunity for the child to release some energy such as giving more time for sports, cleaning the board, handing out papers in class, joining the running team, etc. 
8. Give an immediate compliment or reward to reinforce appropriate behavior.
9. Avoid the use of sarcasm, harsh criticism, embarrassment, or corporal punishment (hitting) when the child does something wrong. 
10. Punishments should include deducting points, withholding recess, cleaning the classroom, and staying after school (to complete the unfinished work).
11. Allow the child to have more time during examinations.