Thursday, June 27, 2013

Why is ADHD being overdiagnosed these days?

ADHD (attention deficit hyperactivity disorder), according to DSM IV (TR) means display of inattention, hyperactivity and impulsivity consistently for 6 or more months. These symptoms are more globally present and are not limited to selective activities like eating, learning, travelling etc. It is a serious disorder and often requires appropriate method of remediation depending upon the intensity, duration and impact of the problem on the child and people around him. It affects overall growth and development of the child.

Due to such threatening impacts of ADHD on a child, it is a term that parents fear a lot. Surprisingly, many kids have been found to be diagnosed with ADHD these days. Why should there be increase in ADHD cases? Is it because of our awareness about it and the fact that people are more psycho-educated? Or is it because of malpractice in doctors to get easy money by diagnosing and providing unnecessary remediation? Or is there yet another reason?

ADHD is a serious condition and requires medical and psychotherapeutic intervention. It is not same is general over enthusiasm and aggression in kids. Many people know about the term ADHD and fear its presence in their kids. Since little knowledge can be very misleading, any child who is found running around, giggling and not sitting down for food or studies, is readily tagged with ADHD. Such lose diagnoses brings parents’ world upside down, cornering the child with behavioural remedies, medication, counselling and everything else that is not really required.

What seems like ADHD could be simply restlessness. 

Reasons behind restless and edge :
1)    Inadequate options for physical activities: when children are not provided with enough options to play physically and vent out their surplus energy, they find it difficult to sit down at one place. In apartment cultures, there is not much space to run around, jump or cycle safely. Children go down in the society sand areas to play, but that’s for a very limited time. Rest of the time, they are physically inhibited in their houses. In the absence of adequate discharge of energy, they become fidgety.
2)    Too much television: TV is being used in many households to bind children for enough minutes to feed them without defiance. It is also used by many parents as a babysitter to get some free time for themselves. While some amount of TV watching is not bad, neither for the eyes nor for the overall development, too much of TV is making children couch potatoes. Whatever little play time they have is being consumed by TV. They also learn about violence from ‘cute’ shows like Tom and Jerry where the two of them are constantly fighting. Research shows that too much of TV just plays havoc with the brain cells. The whole wiring goes kaput. It has a bad effect on children’s appetite, physical growth, ability to focus, eyesight and psyche.
3)    High levels of empty calories and caffeine: children today have a free hand in buying and consuming chocolates, candies, aerated drinks, packaged fruit drinks, wafers etc. They whine for a chocolate, they get it. The high level of sugar and cocoa in the chocolates affect their neurological connections, by making them too charged up. This extra volatile energy, when non-discharged, makes them more impulsive and whining. It creates a vicious cycle, which many parents find difficult to break. Frequent intake of fast foods, lowers down intake of healthy food, resulting into malnutrition, which is often a big cause of irritability and restlessness in many kids.
4)    Lack of structured routine: kids find it easy to eat and sleep well when they follow a routine. In the absence of a routine, many kids feel lost, not knowing what to expect next. Lack of routine mainly affects two areas- sleep and appetite. They sleep at odd hours, when others in the house are awake and active. The constant noise level results into poor sleep thus making them cranky. They eat at odd hours, when others are doing something else, which mostly results into forced eating or distracted eating. Such poor eating and sleeping habits disrupt the routine further. On the other hand, kids who follow a routine at least on weekdays, show less restlessness as they find it easy to sleep, eat, play on time.
5)    Intestinal worms: Worms are bad ! Especially for kids, whose growth, appetite, sleep all get affected by worms they harbor in their intestines. Tape worms often cause the kids to eat a lot but hijack the nutrition from the food eaten, leading to malnutrition. Small worms often result into loss of appetite and extreme crankiness in kids. 
6)    Emotional factor: Anxiety, fear, excitement, shame can all make a child feel too restless from inside. When a child is too excited about going to park in the evening, he may find it difficult to sit down for coloring before the outing. While excitement is an overt feeling, many other covert feelings play important role in a child’s activity level. If a child is too scared of being judged for his coloring skills, he is not likely to sit down patiently with coloring books and crayons.

Recommendations for parents:
1)    Give your child enough opportunity to play rough. Opt for parks instead of malls on weekends. Buy him small trampoline before you get him Thomas engine set.
2)    Control quantity and quality of TV watching. Do not allow TV after 6 p.m. to help the child calm down by bedtime.
3)    Control sugar and caffeine intake. Do not give sweets, toffees, cold drinks after 6 p.m. to help the child sleep nicely.
4)    Make a routine on a chart paper with lots of pictorial details to help the child relate to his day-to-day activities without much fuss
5)    Increase his intake of omega 3 fatty acids. Give him walnuts, fish, flax seeds, pumpkin seeds, eggs in whichever form he likes.
6)    Deworm him regularly. Inculcate good hygiene habits to minimize the chances of harboring too many worms.
7)    Encourage pretend-play, role-play, relating of experiences in your child. The more he is able to cathart his emotions, the less he will be affected by them.  Children love personal and sensitive discussions with their parents. Use this tool to know more how and what he feels about things and people around.
8)    Don’t tag your child ‘hyper’. Tagging always acts as prophecy for kids
9)    Play quiet games with your child or listen to soft peaceful music with him. Show him again and again how you are sitting and enjoying it.
10) Teach your child some relaxation techniques

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