Shot of a young girl looking bored while playing at a school desk
Keywords:
Attention Deficit Hyperactivity Disorder, neurodevelopmental, neurotransmitters.
Introduction.
Attention Deficit Hyperactivity Disorder. How does the child behave? What of adult behaviours? Is ADHD a global issue? What can bring about ADHD? Complications from ADHD. Are there treatment for ADHD?
In the 1930s, children with this disorder were labeled as children with minimal brain dysfunction and trouble makers. As science continued to evolve, these children are now considered to have Attention, Deficit Hyperactivity Disorder.
Attention Deficit Hyperactivity Disorder, known as ADHD, is a nuerodevelopmental disorder which starts in early childhood. This is often between the ages of 6 years 7 years and continues into to adulthood. The disorder is due to a problem in the development of the central nervous system. And this affects the brain as well as the behavior of the child
A child with this disorder will show symptoms at home and at school. And it must affect the child’s functions at school and at home. The child also has problems with making friends, because other children reject them.
Treatment of ADHD involves medical or biological, psychological and social. These involves the psychiatrist, clinical psychologist, parents and teachers.
How does the child behave?
There are three subtypes of ADHD.
Predominantly Inattentive subtype:
The symptoms seen in children with this subtype are difficulty in concentration, calculation and easy distractions. They even have problems with remembering what is taught in school.
They have problems with remembering where they keep things and because of this their environment are always scattered. These persons also find it difficult to listen when being spoken to. So following instructions becomes difficult.
Predominantly Hyperactive/Impulsive subtype:
Such children are hyperactive, impulsive, restless and irritable. They run around in class during class period, and can leave the class without permission.
Staying in line is difficult for them and they are ready to blurt out answers without permission. And because they fidget a lot, they end up tearing their books and clothes.
The Combined subtype:
These children have both the inattentive and the hyperactive/impulsive type. So they present with both subtype symptoms.
What of adult behaviours?
Even in adulthood, the symptoms are just like those in childhood. But for some people, the symptoms of hyperactivity and impulsivity, may reduce.
In adulthood, they seek adventure by engaging in reckless driving and sex. And they may not use protection during sex.
They end up having anger issues. And they may also end up not completing tasks that they have started.
Is ADHD a global issue?
Many people have the wrong notion, that ADHD is a disorder that only affect American or European children. But unfortunately, it is a disorder that affects children all over the world.
Globally, the prevalence of ADHD among children and adolescents is about 8%. And this percentage is two times more in boys than in girls. This is because research has it that girls present more with the inattentive subtype of ADHD. With this, girls are under identified and can be missed in diagnosis. Also, girls internalize their symptoms and they may end up with anxiety or depression. And when any of these happen, the diagnoses are made as anxiety or depression, instead of ADHD.
This is unlike boys who are more likely to have the hyperactive/impulsive subtype. They also externalize their symptoms and present more of conduct disorder and oppositional defiant disorder.
The World Health Organization (WHO), puts the prevalence of ADHD, globally to be at 5% for for children. And for adults it is 2.5%.
Prevalence of ADHD in the Africa and Middle East:
According to studies documented in 2020, 7.47% of children and adolescents in Africa has ADHD. And the inattentive are more prevalent than the other 2 subtypes.
In Nigeria, a study put the prevalence of children with ADHD, aged 7 to 12 years at 8.7%. And the hyperactive/impulsive type, to be more than the other two. Then, there are state variations between 3% and 23%. But there are other reports that document that the inattentive and the combined types were higher that the hyperactive type.
In the Middle East and Northern African countries, the prevalence of ADHD, is 10.3%. Yemen has the least prevalence at 1.3%, while Iran has the highest at 22.2%.
These countries include Arabian and Northern African countries such as Algeria, Bahrain, Djibouti, Egypt and Iran. Others included countries are Iraq, Israel, Jorden, Kuwait, Lebanon, Libya, Morocco, Oman, Qatar and Saudi Arabia. Also included in the study are Syria, Tunisia, United Arab Emirate, Palestinian Territories, and Yemen. children and 2.5% for adults. This is according to a 2024 report.
In Asian Indian, Indonesian countries:
The prevalence of ADHD in some Asian countries such as China, Taiwan and Hong Kong, is 6.3%.
Then India, has a prevalence of 7.1%, while that of Indonesia is between 4.2% and 26.4%.
The prevalence among European countries:
One study documented that the prevalence of ADHD among children and adults in European countries. The figures range from 5% to 7% in children and 2% to 4% in adults.
In the Americas:
In Canada, the prevalence of ADHD in children were 8.6%, while in adults it is 2.9%. Another study, puts the prevalence in adults to be up to 7.33%.
At the United States of America, in a study among patients in 2022 the prevalence showed ADHD of 10.70%.
Then in South America or Latin America, the general prevalence is, 11.8%, this is quite high, compared to the rest of the world.
This figure ranged from 10% in Chile to 20.4% in Colombia, while it is between 14.6% to 16% in Mexico. Then in Ecuador, the prevalence ranges from 16.6% to 20.5%.
What can bring about ADHD?
Attention Deficit Hyperactivity Disorder, is brought about by a combination of genetic and environmental factors. When it comes to genetic factor, it means that there are inherited factors from the parent(s) that are passed down to the offspring.
Genetic factors.
Attention Deficit Hyperactivity Disorder is highly inherited from parent or parents. There are genes transferred from parents to offspring.
Neurotransmitter issues:
Many small genes, with issues come together and into play here. This genetic problem affects some chemicals in the brain of the child i.e. neurotransmitters. These neurotransmitters include dopamine, nor epinephrine and serotonin, are inadequate in their levels.
Brain structure:
Genetic factors can also affect the structure of some parts of the brain, making them smaller and under functioning. The brain of a child with ADHD, develops slower than that of a child without the disorder.
Those parts of the brain that are not functioning optimally include, the prefrontal cortex, hippocampus, amygdala, and the basal ganglia.
The brain connections:
The different brain areas also have weak connections with each other. For example, there are weak connections between the frontal lobe and the amygdala. So, due to this weak connections, the frontal lobe cannot properly control the amygdala. We know that the amygdala is responsible for our emotions. And when the prefrontal lobe and the frontal lobe cannot control the amygdala, emotions go haywire. So, the child or adult may have anger issues, impulsive, etc.
Environmental risk factors.
These environmental risk factors include socioeconomic factors, like poverty and the environment the child lives in. It also include factors that that affected the mother while the child is in the womb. Other factors are issues that occur while the baby is being born. For example, the mother giving birth through her narrow birth canal. This can negatively affect the child’s brain.
Factors that affect the baby after birth, including infections and malnutrition are risk factors too. Children who have also experienced abuse, are at risk of having ADHD.
Complications from ADHD.
Children who suffer from ADHD, are at risk of having complications. These include conduct disorders, oppositional defiant disorders, anxiety and depressive disorders, etc.
They can also engage in substance abuse, and suicide. Academically, they lack behind.
Adults will end up with personality disorders and have problems having lasting relationships. They may also have problems retaining jobs and may have issues with the judiciary.
Are there treatment for ADHD?
Treatment for ADHD is multidisciplinary. This means that it involves different cadre of specialists and parents. These include, clinical psychologists, psychiatrists, social workers, teachers and parents.
It is advised that the diagnosis be made early enough. This is to ensure that treatment will start early so as to prevent complications.
At the early age, treatment is better with a clinical psychologist. The psychiatrist will come in when psychotherapy from the clinical psychologist is not enough. And the job of the psychiatrist is to give medications for the disorder and the complications that may arise.
It is important that teachers are specially trained to take care of the children. Parents have their own job to do after they have been taught by the clinical psychologist and social worker.
