ADHD: Why can’t you sit still kid?

Published: November 28, 2013
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While growing up, in school, did you ever notice that distracted, uninterested class mate, who would just not sit still, was annoyingly talkative and almost always failed in studies? Did you follow up as to what he managed to do later in his life?

From my experience, most of these students either leave school at an early age to do something else or are sent abroad to study and work. Though some of them do very well later in life, a majority of them have problems in their social and financial matters soon after.

Most of us are so busy in the race of securing our careers, making our parents and teachers happy that we do not even think about what is wrong with these individuals and why are they the way they are.

They were irresponsible, careless and just did not want to study.

They were the “bad” guys our parents did not want us hanging out with.

Mental health in children is an ignored subject, globally. Even in a developed country like the United States, only one fourth of the 30,000 child psychiatrists provide services professionally, whereas in Pakistan they can be counted on ones finger tips. There are no institutions and no professional services where doctors can assess, diagnose and treat children with mental health problems.

Some of the most common mental health problems being reported in children are Attention Deficit Hyperactive Disorder (ADHD), Autism Spectrum Disorder (ASD), Conduct Disorder, and Oppositional Defiant Disorder (ODD). There are some mental health problems associated with adults, which can be seen in children as well, like depression, anxiety, schizophrenia, anorexia nervosa and substance misuse in adolescents.

ADHD generally presents itself with a variety of symptoms, broadly categorised in the domains of hyperactivity, inattentiveness and impulsivity. These children often face difficulty in concentrating and sitting still, possess weak memory, lack patience and are extremely talkative. Hence, they start lagging behind in academics.

Frustration often arises due to social pressure when the desired results are not achieved. They often become argumentative, disruptive and start lying or cheating in order to get parents and teachers to let them be. This behaviour causes further problems for these individuals at work, home, school and even in relationships.

According to the Centre for Disease Control and Prevention (CDC), approximately five% kids are diagnosed with this relatively common disorder. Often children with ADHD have co-occurring conduct disorder and oppositional defiant disorder. This makes them even more socially unacceptable as they start to defy rules, become argumentative, aggressive and shortly afterwards become involved in drug addiction and crimes. There is no blood test or X-ray that can be done to diagnose kids with ADHD. The diagnosis mostly depends on parents or teachers, who notice behavioural changes and symptom patterns in kids.

Once diagnosed with ADHD, children can be prescribed with medications that can aid their symptoms and enhance the abilities they lack. Even though the safety of such medication has long been established, they come with their own side effects. Hence it is important to follow up very closely with a specialist who can monitor the progress of these medications and the occurrence of any problematic side effects.

Educating the parents about the relevant prescriptions and the behaviour patterns they should expect to notice, is a crucial part of the treatment and is often ignored. Parents have to be open to altering their methods of supervision as the consistency in disciplining is also a key principle of the management that will be required of them.

Most kids show a very good response to the medication and the behavioural modification techniques. Their productivity increases and they gradually start making progress. Some of them grow out of this illness with age, whereas with others this continues to be a problem even in adulthood.

In a developing country such as Pakistan, where many children don’t even go to schools, it is even harder to prepare a well-structured frame work for treating these kids. Some of the prescribed medication available in Pakistan can be useful and can be used for kids diagnosed with ADHD.

I am reminded, even today, that I was one of the ‘distracted’ kids in my class. This could have been much easier for me, and those around me, if someone had taken notice of my affliction earlier and done something about it in my early years.

I hope this can help someone who needs to be noticed right now.

Disclaimer: This information given here is for educational purposes only. Please consult a doctor for any queries regarding diagnosis.

Dr Muhammad Khalid Zafar

Dr Muhammad Khalid Zafar

A resident psychiatrist in Philadelphia, Pennsylvania who is also interested in child psychiatry. He likes to write about current affairs and social issues. He tweets @khalid307 (twitter.com/khalid307)

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Necromancer

    Excellent………Wake up Pakistan look at the progress the world has made………and we haven’t even eliminated polio yetRecommend

  • Osman

    Very well discussed, my little bro is showing the symptoms of ADHD, Psychiatrists here in lahore said his behaviour is normal as all kids show hyperactivity, i believe i should be looking for some better Psychiatrist for treatment, as ADHD is causing him academic letdown.Recommend

  • Sarah_Yk

    OR just take him/her to the ‘pir’…jinn hain, bhai

    Jokes aside, thank you for trying to spread awareness about learning disabilities. It’s about time we get rid of mental health taboos.Recommend

  • sundus khalil

    Can you please suggest the best child psychologist or psychiatrist in Islamabad?Recommend

  • Custard_Pie_In_Your_Face

    The awareness of ADHD needs to be tempered with abit of caution as well. In the US kids are being fed Ritalin like it was candy.Recommend

  • Zunaira Butt

    it’s helpful for me as being teacher i have been interacting with kids having such symptoms.. and i toatally agree with the writer, if we know we can help kids, atleast we can try to understand themRecommend

  • Ali Rizvi

    What kind of side effects? Monitoring, really? My opinion and experience would tend me to say it’s an administered dependency of drugs.Stimulant medications are helpful for some, yet can also make some people with ADHD symptoms much worse.Recommend

  • Arshad Latif

    Osman Please done be bent over in trying to label your child as sufferer of ADHD. If Psychiatrists think its not ADHD then please dont worry..
    Read the following article and be rest assured>>
    http://m.psychologytoday.com/…/why-french-kids-dont…Recommend

  • Arshad Latif

    Cant agree with you more!!Recommend

  • Arshad Latif

    Nice article khalid bhai.
    But being a GP and having been on the other end of the spectrum i must assert caution. Especially in the zeal to ‘diagnose’ and then ‘medically treat’ adhd, we are increasingly making parents and teachers super sensitized to normal child behaviour.
    I to this day have days when i cant study and dont want to study but given that i am an adult i am ‘lucky’ not to be ‘stigmatised’ as sufferer of adhd. Phew! !
    I say this only because of increasing number of unnecessarily ‘overly’ concerned parents who have absolutely normal child but having read an article or two are bent on being referred to a psychiatrist.

    I know i might sound very naive but the following article will hopefully explain my views on it.

    Having said that i do believe that adhd is a well known entity. I just feel that it is over diagnosed especially in western lands. But nonetheless a good article by all means. Well written Khalid bhai.

    http://m.psychologytoday.com/…/why-french-kids-dont…Recommend

  • Hassan

    The writer raised a good point. We need to treat these kids so they can be useful members of society. Very well written, informative and helpful. Recommend

  • Shameel Faraz

    you didn’t mention another related disorder, called ADD – abbreviated as Attention Deficit Disorder, it is a bit different from ADHD, as it is categorized for individuals who have trouble concentrating not because of hyperactivity, but because of inattentiveness…Recommend

  • Sam

    one of the things that differs ADHD kids from others is that there behavior effects there life socially and academically. as a ADHD person myself, i would recommend academic counseling, cuz it really helps. best wishesRecommend

  • Sam

    thank you very much Dr Zafar for this article we need so many professionals like you. I had ADHD too and now am working towards MD degree, lets hope for the best.Recommend

  • Zara

    …and over here we have another problem where the parents are ‘selling’ their kids ADHD drugs as reactivation drugs…to stay awake and party all weekend !!Recommend

  • Zara

    Very relevant point about ADHD hindering academic potential especially in boys.Recently I went to a seminar on ADHD in Manchester. ADHD had been very poorly diagnosed in the UK and it has been only very recently that doctors and teachers have been made more aware of it which has led to better development of specialist services. So, I can imagine that in Pakistan that the situation must be even more difficult

    During the seminar we had 2 boys who attended the Manchester Grammar School (MGS) talking about their experiences of ADHD . MGS is a boys selective private grammar school and in the top 10 schools in the UK. Competition to win a place is extremely tough and bursaries are offered to able boys who would normally not be able to afford the fees. MGS has an excellent Learning Support Department on the school premises. They are very pro-active and actually pick up and diagnose through in school assessments boys who are showing ADHD tendencies or other learning problems.Parents are then advised to get formal diagnosis via their family doctors and referral on to child specialists.The school will then provide special support for these boys in school so that their academic studies are not compromised.Boys are given extra time to sit all exams including external exams. The department has picked up large numbers of boys with ADHD over the years and these boys with their support have gone onto attend the top universities here.
    I was amazed at how this school has set up its own department and how enthusiastic they were. This should be a model for ALL schools so that children with ADHD always achieve their potential. However, unfortunately this is not the case in Uk schools even now. MGS’s model is light years away from the reality in most UK schools never mind Pakistan !

    There are some very interesting on line resources available regarding ADHD and how you could help your brother practically.Recommend

  • Hassan

    Very well written. Thank you for bringing the matter into the attention. I hope with this effort some kids will get treatment.Recommend

  • Vikram

    I wonder if pets (dogs, cats, guinea pigs) are also being diagnosed with ADHD.
    A non-drug method should be used to change this behavioral problem. It will be nice to develop some kind of games that can stimulate part of the brain that causes this problem. Labeling a kid with ADHD may give him a feeling of psychological abnormality for his whole life.Recommend

  • Moiz Omar

    I have ODD. I just figured out this year when my parents took me to the psychologist,Recommend

  • Be Patient

    I was diagnosed with ADHD at an early age. I struggled in school quite a bit initially but excelled in college. I’m now in the second-year of my PhD at a tier-1 university in the US. Kids with ADHD need patience and time. They learn to cope with it as they age.Recommend

  • tungi

    sometimes i think i have ADD.attention deficit disorder. i tend to forget even the most trivial things! my car keys for example, or what somebody asks me to do something, i would have forgotn half a min later. im good in studies, but was just wondering whether i have this condition or not. im not hyperactive thoughRecommend

  • Vikram

    Same drug stimulates people to stay awake and calms down overactive kids.Recommend

  • Vikram

    Stop messing your brother’s life. Looks like you know better then Psychiatrists you have talked to. Find ways to make learning interesting for your brother. You seem determined to make your brother a mental patient. You may be the one who needs some counseling.

    Psychiatrists can’t fix many common simple problems………
    http://www.foxnews.com/us/2011/08/04/md-psychiatrist-teen-son-dead-in-murder-suicide/Recommend

  • Dr Muhammad Khalid Zafar

    Thanks a lot for your valuable comments. This article is just an attempt to raise awareness about a common mental health problem in kids.Recommend

  • Supriya Arcot

    Well I prefer calling such children as ‘late bloomers’ rather than thinking that something is wrong with them.Recommend

  • Zara

    Yes I agree partly. Medication in many studies has shown benefit in moderate to severe ADHD sufferers. However, behavioural techniques are more important especially in mild ADHD sufferers.
    As a doctor I also feel many parts of our lives are being medicalized such as sadness, loneliness as well as behavioural problems in children. We cannot all ‘fit’ nicely into boxes and we should recognise there is a wide ‘spectrum of normal’ behaviours in humans. It’s OK to be different !Recommend