Attention deficit hyperactivity disorder (ADHD)

by Assoc. Prof. Teoh Hsien-Jin

Attention deficit hyperactivity disorder (ADHD), a developmental disorder, typically presents itself in childhood, usually by the age of 7. It is one of the most prevalent childhood behavioural disorder. Worldwide, ADHD is said to affect 3% to 5% of the population.


ADHD can impact all major aspects of a child's life, including socialisation, academic achievement, physical and psychological wellbeing, and many more. However, research has found that some people do show a decline in symptoms as they age.

The symptoms of ADHD also seem to respond to treatment, proving that though ADHD is a serious diagnosis, it does not reflect a bleak future for people living with it.

Symptoms of ADHD

There are generally 3 core features that are observed in children with ADHD, which are inattention, hyperactivity, and impulsivity. In addition to that, some secondary features include impaired intelligence and academic achievement, socialisation difficulties, and emotional problems.

Inattention – Children with this symptom usually have a hard time sustaining their attention on tasks and they get easily distracted and bored with the tasks given, usually within a few minutes. More specifically, they are often easily distracted by irrelevant sights and sounds, failing to pay attention to details, and making careless mistakes. They find it difficult to follow instructions, often jumping from one activity to another.

Hyperactivity – Hyperactive children are constantly in motion and they often move around touching and playing with anything they see. They also talk incessantly. They find simple tasks like sitting still difficult. In young children, behaviours such as darting out of the house or into the street and climbing and jumping are often observed as these children seem to have boundless energy.

Impulsivity – Impulsive children appear to be unable to curb their immediate reactions or think before they act. It is observed when the child often answers a question before the questioning is completed, has difficulties waiting for his turn, and is always interrupting people. ADHD children showing signs of impulsivity are also restless, have difficulty staying still, and talk excessively. This symptom may also lead to anxiety, panic attacks, agitation, and depression.

Intelligence and academic achievement – Children with ADHD commonly show some intelligence deficit characteristics such as general coordinating deficit, attention deficit, memory deficit, specific learning disability, and disorders of speech and hearing.

Socialisation problems – ADHD children also show symptoms of poor social judgment in their behaviour and relationships. As a result of this, such children have difficulties in making and sustaining friends as they show poor communication and socialisation skills.

Emotional problems – Some individuals with ADHD tend to have symptoms of emotional instability, which include excessive worrying, sense of insecurity, mood swings, and low self-esteem.

In addition, numerous children with ADHD have other serious social and emotional disorders such as depression, anxiety, bipolar disorder, and so on.Arguments on ADHD

Is ADHD a real and behaviourally significant disorder?

For as long as ADHD has been recognised as a disorder, there have been arguments claiming that it is not. Opponents of the idea that ADHD is a behaviourally significant disorder claim that ADHD is merely a ploy and the symptom characteristics is actually brought upon by normal childhood energy and oversensitive parents.

Perhaps the most daring claim is that the symptoms of ADHD are exaggerated by pharmaceutical companies aimed at maximising their profits.

Nevertheless, based on the expert opinions of a group of highly educated professionals, which include the World Health Organisation (WHO), the National Institute of Health (NIH), and the American Psychological Association (APA), ADHD is not only recognised as a legitimate disorder, steps to improve the situation for people with ADHD have also been taken by these groups. The mutual acceptance is that ADHD is indeed a real disorder that is behaviourally significant.
Help is Available

Seeing that the symptoms of ADHD are highly impairing, naturally, as with other disorders, treatments are devised in order to improve such symptoms. These treatments include medical management, behavioural treatments (parent training), and child-focused treatments.

The most established and effective treatment for ADHD appears to be medical management. Medication can improve the individual's control of his ADHD symptoms, reduce aggressive behaviour, and reduce hyperactivity. Behavioural treatments also seem to be able to improve the academic performance and social behaviour of people with ADHD symptoms.

Parent training, which involves teaching parents how to specifically manage the ADHD symptoms of their children, has shown very positive results in reducing the severity of symptoms and problem behaviours at home.

Note that the diagnosis and treatment for ADHD may differ as the level of severity of this developmental disorder may vary across children. It is always important to seek the advice of your healthcare professional regarding the most appropriate intervention for your child.