Attention Deficit Hyperactivity Disorder (ADHD): The Restlessness Within

Nature of the Illness

Frequently misunderstood as a purely behavioural or "discipline" problem, ADHD is in fact a brain disorder characterised by inattentiveness, hyperactivity, and impulsiveness (or any combination of the three). The condition is more common in males than in females, and symptoms tend to appear early in life; for that matter most cases are diagnosed when children are between 6 and 12 years old.

In Hong Kong, the prevalence of ADHD among primary one Chinese schoolboys is reported to be 8.9% - in everyday terms, that's nine out of every 100 boys. What's more, the trend is on the rise: in a local study covering the period 2001 to 2013, the number of children on ADHD medication was found to have increased 14 times.

How can parents distinguish their children's behavior?

So what are the signs that distinguish ADHD from normal "kid behaviour"? The major symptoms parents should watch out for in their child (whether boy or girl) are:

  • Gets easily distracted or bored with a task before it's completed
  • Habitually loses or misplaces school materials, toys or other items
  • Pays scant attention to details or makes careless mistakes
  • Has a quick temper or is easily frustrated
  • Talks and fidgets excessively
  • Routinely interrupts others; blurts out inappropriate comments at inappropriate times

If a child shows the above signs across all environments - not just at home but also at school and at play - a closer look is certainly a good idea, as ADHD symptoms if left untreated can persist into adulthood, affecting the sufferer's ability to hold down a job, manage their finances, enjoy healthy relationships, and so forth. ADHD often also has associated conditions such as learning disabilities or depression… which makes early intervention all the more crucial.

Treatment of the Illness

Assessment is normally made by specialists such as a paediatrician, psychiatrist, learning disability specialist, or an occupational therapist with expertise in ADHD. There is no simple test, but an accurate diagnosis can be made after a detailed assessment that includes: a physical examination (to rule out other possible conditions), a series of interviews with the suspected patient, and information gathered from caregivers, particularly parents, nannies and teachers.

The treatment options are two-fold:

  • Sustained psychological intervention or behavioural therapies, supplemented by customised nutrition, for close monitoring in the early stages; and
  • Pharmacological intervention.

Most experts agree, however, that a combination of both medication and some form of therapy is best, especially for patients with aggressive tendencies.

The preferred first-line medical treatment of ADHD in Hong Kong - following the lead of medical authorities in America - is methylphenidate (Ritalin), a type of stimulant. But as the reaction to this medication may differ from patient to patient, switching of drugs during the course of treatment is also common.

There is no cure for ADHD, and the search for optimal results almost always entails varying modes of intervention, multiple visits to doctors, and an indefinite duration of treatment. In Hong Kong, the situation can feel more dismal because of the long waits involved in going through the public healthcare system - precious time that potentially adds to a child's developmental delays, and causes the family even greater anxiety and fatigue.

Treatment Cost

In the private sector, seeking proper diagnosis alone can cost upwards of HK$5,000 for a special test for children administered by a psychiatrist. Thereafter, in pursuing treatment, a speech therapist's services could amount to HK$3,200 per month for once-a-week sessions that must be sustained for the long term. And we haven't even begun to consider the cost of switching medications and adjusting dosages to find the best fit for the patient - a process that can go on for life, as some symptoms are managed over time, but other conditions such as addiction or depression appear. Little surprise, then, that the costs involved in tackling ADHD can place a tremendous burden on a family's finances.

Is DNA testing useful?

Extensive research has recently found that certain genes and gene variations are linked with mental disorders. While it is true that many such ailments are ultimately triggered by a combination of factors, including the biological, environmental and psychological, the presence of those gene variants does play a role in increasing or decreasing a person's risk of developing a disease or condition.

DNA testing for whether or not a person has such genes, thus offers a 'peek' into the person's risk of developing a mental disorder such as ADHD.

The benefits of verification are obvious. Finding out your (or your child's) risk factor means you can take preemptive action, and seek the advice of experts through proper referrals. You can also keep your child's (possible) developmental delays in check, by minimising the impact of external variables and maximizing your child's potential for finer behaviour at home, better performance at school, stronger friendships in the playground, and an all-round positive impression.

In the event that your child's genetic makeup does express ADHD, having timely access to relevant information becomes critical. This is where educational workshops prove useful: to equip parents with helpful, practical skills for dealing with the condition of their loved one, and preventing further deterioration.

Emotional assistance in the form of sympathetic professional counselling is another effective channel for alleviating parents' anxiety and concern, which arises as a natural response to their child's situation.

Remark

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