ADHD is a neurodevelopmental disorder affecting approximately 129 million children worldwide. ADHD, over a lifespan, differs in presentation. Symptoms are dependent on the developmental stage of the individual.
Stereotypically, in preschool age, ADHD is characterised by hyperactivity, difficulty in co-operation with peers and non-compliance with instructions. In adolescents, hyperactivity lessens, conflicts with parents, risk-taking behaviours and impulsivity become predominant. In adulthood, inattention remains and may be accompanied by substance misuse, infidelity, the disintegration of relationships with peers and poor adherence to career choice.
ADHD is a complex impairment often accompanied by other challenges such as:
• Hyper focus (inability to shift attention from points of interest)
• Poor sleep initiation (6% of children use melatonin for sleep pattern problems)
• Time insensitivity or time blindness (poor time management)
• Challenges with co-ordination
New evidence verifies increased screen time as a risk factor for the development of ADHD. The study conducted in the USA has found that by the age of five, children who spent two hours or more on screen time were 7.7 times more likely to meet the criteria for a diagnosis of ADHD, when compared to age-matched peers exposed to 30 minutes of screen time.
Long-term studies have revealed that early appropriate pharmacological intervention in childhood diminishes challenges of concentration and restlessness and also impacts on long term trajectory of ADHD. Medication is found to be protective against substance abuse, depression and even motor vehicle accidents.
It is imperative for appropriate early diagnosis of ADHD in accordance with the DSM 5 diagnostic criteria. This would require assessment by a skilled clinician that can exclude conditions that mimic ADHD and detect disorders that co-occur with ADHD.
By Dr Nerica Ramsundhar, Neurodevelopmental Paediatrian, admin@blossoimngkidz.co.za
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