CHILDREN with attention deficit hyperactivity disorder (ADHD) are often dismissed as badly behaved. They usually exhibit two core symptoms — hyperactivity/impulsivity or inability to pay attention.
But there is a third core symptom that is equally significant, says Pantai Hospital Ayer Keroh, Melaka consultant psychiatrist Dr Lau Harn Ni.
These children's brains are wired in a way that they lack a working memory. This makes them forgetful and less likely to remember instructions or follow through with tasks. When combined with the other two core symptoms, it ultimately affects their learning.
For most of us, when we face a lot of information, we know how to focus or zoom in, says Dr Lau.
"It's like holding a torch and pointing it in a certain direction, but those with ADHD don't even know how to hold the torch or manoeuvre it."
The condition not only affects learning, but also socialisation and their ability to control their emotions.
"Due to their lack of working memory, the information gets in but it doesn't stay. In the classroom, they have difficulty sustaining attention and zone out," she says.
In school, they may not complete all tasks or assignments and they make careless mistakes. They face difficulties in planning, organising and executing tasks.
"They might come across as messy and disorganised, but that's just due to their lack of working memory."
Dr Lau says boys generally exhibit the hyperactivity component of ADHD while girls present with inattention. This makes it more likely for boys to get noticed and eventually diagnosed.
Most children are diagnosed when they start formal schooling, usually between the ages of 5 and 7. A diagnosis can be made by a paediatrician, developmental paediatrician or psychiatrist.
There is a strong genetic link to this condition, adds Dr Lau. In over 70 per cent of cases, there is a family history of ADHD. It can manifest among siblings, twins and cousins.
Research suggests that women who are obese during pre-pregnancy are also more likely to have a child with ADHD. Babies born preterm or with a low birth weight are also at increased risk.
The condition can be managed using a behavioural approach that helps the child develop habits which can compensate for the challenges brought on by ADHD.
Some children are able to cope effectively once they acquire these habits. Medication is usually prescribed on a case-by-case basis and taken during learning hours so the child can focus better.
MANAGING THE CONDITION
*Establish a fixed routine for the child.
*Use "to do" lists to help them remember/focus on what has to be done.
*Break up complex tasks into smaller parts so they can manage it better.
*Give clear, short instructions. Children with ADHD have trouble deciphering complex instructions.
*Use positive reinforcement when the child is able to complete a task.
*Medication may be prescribed if the child needs it.