Attention Deficit Hyperactivity Disorder (ADHD), is the most common neurobehavioral disorder that affects about two-seven per cent of children around the world. These may consequently lead to long-term negative outcomes in terms of poor educational achievement, lack of employment opportunities and various forms of delinquency. While, socially, the presence of a super-active child can also raise the level of anxiety among others around them, creating tension in relationships between the child and its parents and between the child and siblings. Other adult ADHD-related mental issues such as emotional imbalances pose additional challenges — anger management problems, mood swings, depression, and an inability to cope with maintaining any relationship or workplace stability. Also common are behavioural issues that could involve any form of addiction, substance abuse, or chronic boredom. The prevalence study in Coimbatore, called “Prevalence of Attention Deficit Hyperactivity Disorder in Primary School Children,” suggested ADHD in children approximately 11.32 per cent, a number much higher than the global estimate. The highest prevalence was noted in children aged nine (26.4 per cent) and 10 (25 per cent).
School-based and hospital data point to Indian ADHD prevalence varying from 4.7 per cent to 29.2 per cent. Many studies regarding child ADHD prevalence have spread throughout India’s broad territory. Numerous research studies demonstrating prevalence rates have adopted a limited geographic focus which led to significant variations among observations. Research in Dehradun (North India) revealed a prevalence of 11.8 per cent of ADHD diagnoses. Results showed the ADHD prevalence among primary school children was 5.7 per cent in Belagavi South Indian locale and two neighbouring towns in the same area stated a 2.3 per cent prevalence. Research evidence indicates the ADHD prevalence gap between different regions stems from the combination of lower regional awareness and greater cultural tolerance for development differences along with local treatment stigmatisation and resource availability and assessment techniques and research methodologies. In diagnosing ADHD, a combination of screening and testing may include a behavioural analysis through a Conners Rating Scale. Treatments include stimulant-free medication such as atomoxetine and different types of talk therapy like Cognitive Behavioral Therapy (CBT) as well.
“Ethnic and cultural aspects have to be addressed when making such diagnoses, but education is of utmost importance. Indeed, the causes of ADHD are multifaceted and include genetic, neurobiological, and different environmental or psychosocial factors.”
Obtaining a diagnosis for ADHD in children is a multi-step process requiring collaboration between several medical specialists, including pediatric neurologists and child psychologists. The procedure involves the following steps:
a. Medical history: Parents as well as teachers could serve as primary sources revealing information regarding the student’s academic performance and family’s medical background. This is necessary for an ADHD diagnosis.
b. Behavioral assessment: Standardised forms will be filled out by caregivers as well as teachers detailing the behaviour and symptoms of the child in different environments. These assessments help identify patterns of inattentiveness, hyperactive actions and impulsive behaviours.
c. Physical examination: A thorough medical checkup will be conducted to determine whether other conditions are present that may cause ADHD-like symptoms. The practitioner could determine general physical health and check for hearing or vision issues.
d. Psychological testing: These include measures of general ability and other psychological tests that encompass cognitive skill and behaviour.
The growing rate of ADHD in India calls for immediate action to combat the hurdles that come along with this condition. Undoubtedly, the lack of societal resources to tackle mental health leads to more stigma. Setting aside India’s social taboos on mental health would greatly aid with the ADHD problem and its ever-increasing weight on the country.
(The writer is developmental behavioural paediatrician and adolescent mental health expert, co-founder of Continua Kids. Views expressed are personal)
