Could your child have ADHD without you even knowing it? Two parents share their stories.
“Your son is a bully.” Even today, Diana Nasali, a 38-year-old higher planning executive, can still vividly recall the stinging words of her child’s playschool teacher.
She was told that Danny, barely two years old then, had shoved another toddler in the playgroup. The troubles didn’t let up. During his preschool years, Danny received so many complaints that he switched childcare centres six times.
His reputation as a bully also meant that parents would request that their kids be separated from him during playtime. While other pupils obediently napped in the afternoons, Danny would be the only one who couldn’t stay still.
“He could go on all day without feeling tired. Obviously, that was a major problem for the childcare centres,” Diana recalls (she requested not to use his full name).
Danny’s mischief didn’t end even when he landed in the principal’s room several times. He got so bored while in the office that he peeled paint off the walls, adds Diana.
Mum thought he was lazy
Like Danny, 11-year-old Joven Lim cannot sit still either. Getting him to complete his homework on time is a near impossible task for his mum, Karen Wong. When he finally settles down at his desk, he ends up fidgeting and fiddling with his stationery.
In a bid to get him to complete his schoolwork, the 33-year-old senior account manager recalls how she once kept him up until 3am. “Joven is brilliant at dismantling pens and cutting erasers into small cubes. He’s also very good at folding the page edges of his homework. What he can’t do is to concentrate on his work,” shares Karen.
“The exasperating part is that I know he knows the answers to the questions.” As a result, Joven has failed almost every major examination since Primary 1.
Are Danny and Joven simply naughty, lazy and out-of-control kids? Karen used to think so, until a friend pointed out that her son could possibly have attention deficit hyperactivity disorder (ADHD) of the inattentive variety.
True enough, he was formally diagnosed with the condition last year.
“No one ever flagged it out to me that he could have ADHD,” she says. “In a way, I was actually relieved when he was diagnosed because I knew I could move on and try to find a solution to the problem.”
But Karen was also racked with guilt after Joven’s diagnosis. “I used to cane and punish him all the time, thinking that he was lazy and not putting in his best,” she confesses.
“In the process of doing so, I’d also unwittingly damaged his self-esteem. The truth was that my poor boy had no idea why he behaved in that manner.”
Why kids get ADHD
An estimated 3 to 5 per cent of Singapore children grapple with ADHD, a neurobiological condition that affects the child’s ability to regulate behaviour and impulses, as well as concentrate, plan and focus on tasks at hand.
In most kids, parts of the brain governing behaviour and executive functions – such as organisation and planning – mature at around the age of four to five, says Dr Janice Wong, a paediatrician specialising in neurology, neurorehabilitation and neurodevelopment at Thomson Paediatric Centre.
“By five, a child would know that if he dashes across the road during rush hour, he might get knocked down by a car,” she shares. “A child with ADHD won’t know that, and will end up dashing across the road.”
One theory is that children with it have lower levels of neurotransmitters – chemicals that transmit nerve signals in the brain.
There are two main types of ADHD: the hyperactive-impulsive types who are always on the go and can be very disruptive, and the inattentive ones who tend to space out and have problems concentrating on tasks and activities.
Most children with ADHD will have both types of symptoms, according to Dr Lim Boon Leng, psychiatrist and medical director of Dr BL Lim Centre for Psychological Wellness at Gleneagles Medical Centre.
He adds that the symptoms tend to be particularly pronounced when the child is bored. “They can still concentrate on their task, but only if they find it interesting enough,” he says.
(Also read: Why is my kid bored in preschool?)
Such behaviour, especially in its milder forms, are easily misconstrued as bad or naughty by parents and teachers. “Even after the diagnosis, these mothers, fathers and educators often require plenty of education and convincing before realising that the kids are not wilful or deliberately bad in nature,” says Dr Lim, who believes this is why ADHD remains one of the more under-diagnosed childhood mental disorders in Singapore.
In spite of their seemingly boisterous and loud behaviour, most children with the disorder suffer from low self-esteem and might feel that they’re a failure. It doesn’t help that they’re often likely to be the first to get into trouble.
Many of them also lack social skills, which further isolates them from their peers, says Gladelind Koo Wei Ling, an allied educator (learning and behavioural support) at Yangzheng Primary School. She works with ADHD pupils.
It’s common for their parents to yell, scream and punish them for “bad” conduct, says Bella Chin, president of Society for the Promotion of ADHD Research and Knowledge (Spark), which holds support groups for mums and dads.
“People who don’t understand this group of children tend to judge them immediately and start implementing punishments,” adds Gladelind.
What’s the difference?
Diana wishes there was more awareness about ADHD. “To most of his teachers, my son is simply a naughty and overactive boy,” she says. “On the other hand, those who understand his condition are able to help him excel in his schoolwork.”
But how can parents tell the difference between a kid who’s throwing a tantrum and one who has ADHD?
While it’s normal for children to misbehave every now and then, those with the disorder behave similarly in most situations. “If your kid is naughty at home but obedient at school, that’s not ADHD,” explains Dr Wong.
While timely detection and intervention is crucial, she cautions against bringing kids in too early for a formal assessment. It will not be accurate.
“Some parents bring their two- and three-year-olds in, thinking their kids have ADHD, when these children can’t sit still,” she shares. But that’s actually normal behaviour for a toddler.
In Singapore, the disorder is usually diagnosed only when the child is around six years old, says Dr Lim. And seven to nine is a good age for him to receive treatment and therapy to help manage the symptoms, before he gets additional responsibilities and workload in the upper primary school years, says Dr Wong.
Bella adds that since ADHD is a neurobiological condition, children with the disorder don’t actually “recover”. But they can successfully learn to cope with their symptoms when given adequate treatment and support from their families and schools.
One success story is 18-year-old Victoria Junior College student Shaun Sim, who clinched the inaugural Ace award (teen category) for outstanding children and youth with ADHD in 2012.
Diagnosed with ADHD while in kindergarten, Shaun – who’s still on medication to help him concentrate at school – recalls giving his parents and teachers a hard time during his childhood.
One of his most vivid memories involves him being restrained by his mum and three teachers on the bus, returning from a school excursion, while a fourth attended to the rest of his 40 classmates.
“Growing up, I recall my mum holding on to me a lot to stop me from getting into more trouble. Maybe that’s one of the reasons why I’m very close to her now,” he says, chuckling.
Despite his condition, Shaun found ways to cope and achieved a perfect score of eight A1s in his O-level examination.
He aspires to become a child psychiatrist. “I’d love to specialise in treating children with special needs like myself,” he says, crediting his success to his family’s love and support.
Focus on the positives
Indeed, while medication and therapy can help, parents need to “embrace” their child’s condition and focus on the positives, advises Gladelind.
Karen admits that she used to place Joven’s grades as her utmost priority. But not any more.
“I’ve realised that there’s another side to my son – he’s so talented at puzzles and fixing robots,” she shares. “I’ll be happy to nurture that strength instead, as long as he makes the minimum mark to move on to the next level at school. Chasing paper qualifications isn’t everything.”
The Society for the Promotion of ADHD Research and Knowledge (Spark) holds monthly parent support group meetings and talks. Visit www.spark.org.sg for details. This article was first published in 2016 in Young Parents magazine.