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Attention-Deficit / Hyperactivity Disorder

What is attention-deficit / hyperactivity disorder?

Attention-deficit / hyperactivity disorder (ADHD) is a common neurobehavioural developmental disorder. Children suffering from ADHD usually present with hyperactivity, impulsiveness and inattention symptoms. These symptoms create obstacles in learning and interpersonal relationships, which may lead to emotional problems, low self-esteem, and difficulties in coping with everyday life.

How common is attention-deficit / hyperactivity disorder?

Prevalence rate

The prevalence of ADHD among Hong Kong school children is similar to that of the international figure, which is around 5-9%.

Gender ratio

It usually affects male more than female.

What causes attention-deficit / hyperactivity disorder?

A smaller-than-normal brain volume

Up till now, the definite causes of ADHD remain unclear. But research points out that the volume of the brain of an ADHD child may be smaller than that of a normal child by 3-5%. This reduction in size is particularly significant for the frontal lobe and temporal lobe. The frontal lobe is the brain area which is responsible for attention, impulse control, and some higher cognitive functions, such as planning, organising and problem-solving.

Imbalanced neurotransmitter

Research also points out that there may be an imbalance in the dopamine system (a type of neurotransmitter) in the patient’s brain.

What are the symptoms of attention-deficit / hyperactivity disorder?

Symptoms of ADHD include:

Hyperactivity	Fidgety on seat, unable to sit still Frequently off-seat Run and climb excessively when it is socially inappropriate Always 'on the go' Talkative and cannot keep in silence
Impulsiveness	Continuously chatter or interrupt people Blurt out an answer before questions have been finished Have difficulty in taking turns or queuing up Low frustration tolerance
Inattention	Cannot concentrate, take a long time to or even fail to complete tasks Cannot thoroughly follow instructions Appear daydreaming when being talked to Avoid mental task Miss small details, frequently make careless mistake Forgetful, frequently lose belongings Disorganised

Tips for parents:

Many children are inattentive and restless, especially during their very young ages. This does not necessarily mean they have ADHD. To establish the diagnosis of ADHD, the child must be assessed by a professional. Please consult your doctor if you suspect your child is suffering from ADHD.

Besides, clinical features of ADHD evolve with the children’s developments:

Infancy and preschool age

The core feature is hyperactivity. They are energetic and are often running about or climbing.
Some children may cry and lose their temper easily. They may have greater emotional response to events and become excited or angry easily.
Some may have sleeping problems as well.

School-age

Problems related to inattention will become increasingly obvious.
Children may have difficulties in learning. Their inattention in class may affect their classroom and academic performance.
They are impulsive, weak at self-control and compliance, leading to discipline punishments, problems in social relationships and conflict with peers.
Some children may also show oppositional, risk-taking and/or dangerous behaviours.

What are the treatments of attention-deficit / hyperactivity disorder?

Medication

Drugs may help to improve the patient's attention and impulsive and hyperactive symptoms.

Behavioural intervention

A systematic way of parenting to improve a child's behavioural problem.

Treatments that are tailor-made for patients' needs may benefit considerably. Most ADHD children will have settled down by the time they reach their mid-teens, and some of them will be able to catch up with their learning, improve their school performance and make friends. Please discuss with your family doctor immediately if you suspect your child has the abovementioned symptoms of ADHD.

For more details, please visit: https://www3.ha.org.hk/cph/imh/mhi/article_02_01_01.asp#3

and http://kch.ha.org.hk/form/A11-ADHD.pdf

Tips for parents:

Good parent-child relationships are keys to success.
Teaching the child on proper ways to handle emotions, effective problem-solving skills, and the establishment of good living habits are also beneficial and important.

How to support and help children with attention-deficit / hyperactivity disorder?

Supports for ADHD suspected cases:

Parents may approach the following organisations for initial evaluation and further referral when necessary:

Department of Health’s Maternal and Child Health Service (preschool) or Student Health Service (school-age)
Your family doctors, clinical or educational psychologist

Supports for children with ADHD:

Parents may seek help from the following organisations:

The Child Assessment Service of the Department of Health offers behavioural and developmental assessment for the child, as well as interim support for the family, including parent workshops and parenting skill training groups.
Under the Hospital Authority, Child and Adolescent Mental Health Services and Department of Paediatrics and Adolescent Medicine provide assessment, as well as medical and behavioural treatment for children with ADHD.
Psychiatrists and paediatricians in private practice may prescribe medication for children with ADHD.
In schools, supports are provided to teachers and children by school social workers and educational psychologists.

Supports for carers:

Many community centres and non-government organisations also offer training programmes and activities for children with ADHD and their families.
Apart from seeking professional help, parents, teachers and other carers should be caring and considerate to help children with ADHD to tackle the problems.

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Reference source(s): Websites of the Institute of Mental Health, Castle Peak Hospital and the Child Assessment Service, Department of Health