ADHD: Why can’t you sit still kid?

Published: November 28, 2013

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 (

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