The article concludes the two-part series on ADHD and examines the disorder in terms of hyperactivity and impulsivity

Is ADHD a real disorder or a myth? Is it true that children with hyperactivity are uncontrollable? I am often asked these questions. Those who have never had to cope with the problems presented by hyperactive and impulsive children on a day-to-day basis have little knowledge of the colossal commitment, time and energy involved. These are children who won’t listen to anyone. Disciplining them is an uphill task and because of their constant motion and explosive energy, they get into trouble with teachers, parents and peers. On many occasions, there is no understanding of the child’s basic temperament; with the result parents, especially the mother is frequently blamed for being unable to control the child. This results in the mother being overwhelmed with the task of taking care of the child.

ADHD arises as a developmental failure in the brain circuit that underlines inhibition and self-control. This loss of self-control in turn impairs other important brain functions that are crucial for maintaining attention, including the ability of behavioural organisation.

No one knows for sure what causes ADHD; there is no simple primary cause. However, heredity or a positive family history appears to be the most common identifiable cause.

The touchstone

Attention has been a touchstone in education for the last couple of decades. It is the ability to select and focus on what is important for the right amount of time and discard what is irrelevant. It allows us to plan, monitor and regulate our thoughts and actions. It also supports the more complex neurodevelopmental functions such as language and higher order cognition. When attention is focussed as it is supposed to, it helps a student learn, become productive and behave appropriately; on the other hand, when we are unable to be attentive it leads to chaos in the learning process and in the daily life of a family. Children with hyperactivity and impulsivity are driven by the moment. Because of delay in inhibitions, they often say or do what first comes to their mind, without stopping to think about the consequences. They lack control needed to slow down.

Children with ADHD are known to flit from one activity to another as maintaining focus is an issue. They are perceived to have a short attention span. But what is surprising is that when the same children are introduced to stimulating situations, they are as attentive as those without ADHD. In fact these children baffle their parents and teachers by being able to attend to high interest activities such as video games, TV shows and projects for a long period of time, they get so hooked on what they are doing that they are oblivious to what is happening around them. This inconsistency in task performance confuses teachers and parents. The ability to perform on some days and not on others brings with it the burden of unfair accusations of laziness and wilfulness.

Redeeming traits

Luckily, children who struggle to focus their attention often possess remarkable redeeming traits, we cannot afford to overlook. They are often amazing people in their own right, displaying refreshingly unorthodox pathways of thought. There is more that is right than wrong with these kids. Many of them turn out to be extraordinary adults. Parents and teachers have to be on a constant diligent quest to discover the buried treasures within these children.

ADHD kids with impulsivity have an insatiable appetite for stimulation, entertainment, and new play things. In their frenzied quest for stimulation, they look for opportunities to provoke excitement. They behave recklessly and this makes them prone to accidents. Permissive parents allow children who are already uninhabited and extrovert by nature to do “their own thing”. It may be easier for the moment, but the long term consequences can be disastrous. It can impair the development of important brain processes relating to self and impulse control, empathy and behavioural organisation.

Treatment involves a mix of medication, behavioural therapy, occupational therapy and educational support. Treatment is individually designed, as each case is different in symptoms, intensity, response and family background. Children with constitutional hyperactivity usually outgrow the disorder even without treatment. They just need proper handling — discipline and direction. In cases where neurological causes are behind the problem, neuronal maturation and impulse control can come with age and development.

Children with ADHD are perceived as being lazy, having an attitudinal problem or simply bad behaviour. Yet, these are struggling and confused students, who very much want to succeed and win the respect of adults. They need our support and want us to help them to cope with attention issues. When they sense we are on their side and not accusing them of being bad or lazy, they often rise to the occasion and show steady improvement. Teachers need to form strong alliances with their students rather than adversarial relationships. Forming relationships built on trust, respect and empathy is one of the most important strategies for success. Children with ADHD benefit the most when families, teachers and when necessary, doctors work together.

The writer is a Remedial Educator. Email: rajfarida@gmail.com

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