29/07/2025

LYFE TUESDAY | JULY 29, 2025

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J OE is eight and he constantly feels the need to fidget and jump up during class, in a movie, as he eats his meals, or tries to read a book. He tries to wait his turn, but cannot stop himself from blurting out answers during lessons and interrupting his friends. No matter how hard he tries he cannot remember where he left his favourite dinosaur toy, or his pencil, or his schoolbag, or his half-eaten sausage bun. He has been told over and over again that he is naughty and frustrating. They keep telling him he is not trying hard enough. But he does. He struggles every day to be like his friends, but every day he seems to fail. Joe is a typical case of a child with attention deficit/hyperactivity disorder (ADHD) and while symptoms and specific challenges may vary from one person to the next – the helplessness and the feeling of being misunderstood are a shared struggle for those diagnosed with the disorder. In Malaysia, the Health Ministry in 2020 estimated 1.6% to 4.6% of the country’s population was diagnosed with ADHD. The wide range reflects the fact that ADHD is not always recognised and diagnosed. Like many other disorders, it tends to be under-reported. The available statistics show that it is more prevalent in boys who are three to four times more likely to have ADHD compared with girls. However, these figures may not be entirely accurate as girls tend to adapt their behaviours in socially desirable ways thus leading to fewer diagnoses. What is ADHD? ADHD is a neuro-developmental disorder that starts in early childhood. It affects how our brain develops and how it processes things. It is not a behavioural problem. What happens in the brain affects the way a child functions. There are three types of ADHD – the predominantly hyperactive-impulsive type, the predominantly inattentive type or a combination of both. The hyperactive-impulsive types have difficulty staying on a task, are always on the go and are fidgety. They cannot sit still through a class lesson, or even a movie. They may also display a lack of self-control. For example, a typical child would be able to learn behaviours such as lining up and taking turns, but a hyperactive-impulsive type will find it very difficult to do so. On the other hand, the inattentive types tend to forget things or lose things, are easily distracted and find it difficult to concentrate. Students may frequently say they forgot their homework or appointments that they have made. They do not seem to be listening well and lose interest, appear bored or seem like they are daydreaming. Whichever type of ADHD a child has, they are still often dismissed as children with behavioural and discipline issues – and unfortunately, they can go through their lives labelled as being rude, uncontrollable and naughty.

Struggling to be ‘normal’: Understanding ADHD o Children diagnosed with condition will be better served by informed parents

Inattentive types tend to be forgetful. – PEXELSPIC

The predominantly hyperactive-impulsive types have difficulty staying on a task.

sessions. During the sessions, a clinical psychologist will use a combination of assessment tools, behaviour observations, cognitive assessments as well as other adaptive functioning screening to rule out other disorders. Trying to self-diagnose with online tests is a sure way to misdiagnose or over-diagnose. Always see a registered professional as they are adequately trained to diagnose accurately. Parents can go to private or public health clinics depending on levels of affordability and urgency of the case. The private sector will be able to see a child quite immediately while those seeking help at government hospitals will have to wait to get an appointment. You also need to get a referral letter from a clinic or a general practitioner if you want to get an appointment at a government facility. During the sessions, a clinical psychologist will also identify the child’s strengths. Through a thorough assessment, psychologists will highlight the child’s strengths for example memory abilities, creativity or the ability to hyperfocus on areas of interest. Essentially, a diagnosis leads to specific and practical recommendations, as well as a treatment plan that is tailored for the child. That is why a psychological assessment by a mental health professional is so beneficial. A treatment plan could rely on therapy, medicine or a combination of both – and it helps to guide the parents or caregivers on what to do. If medication is recommended, the child will also need to see a psychiatrist for the necessary prescription. Setting up for success To help children with ADHD handle school routines better, doctors can write reference letters to advocate for certain needs accommodations such as longer exam times, to be allowed sit where they can get up and move during class without disrupting others, or to be allowed to use fidget toys in class. There is a need to learn to manage and support these children effectively instead of just scolding or disciplining every time.

What causes ADHD? Many different factors play a part in how our brains develop. Genetics play a role, with children having a predisposition to it if it runs in the family – with identical twins, if one twin has it, it is very likely the other has it too. There are also environmental factors such as toxins that we may be exposed to as children; as well as maternal prenatal factors such as medication consumed by a pregnant mother

that can expose a foetus to potential hazards. Expert groups have also advised parents to delay screen time in children for as long as possible. The increasing speed of movies, constant advertisements and notifications can be very overwhelming and over-stimulating especially for young malleable brains that are still developing. These also can increase addictive behaviours and shorten attention spans. Excessive screen time also means less exercise, less quality sleep, less time for homework which ultimately affects a child’s ability to be at their best. More longitudinal studies need to be done to really understand the impact of over-using devices. How to get a diagnosis For children, it starts with the observations of parents and caregivers in the child’s many multiple settings – from home to school, at the babysitter’s, during recreational activities and so on. Observations need to come from more than one person and from different settings. When you see that the behaviours across these settings form a pattern, then there could be cause for concern. Parents who bring their children for assessment have often been asked to do so by teachers. Teachers play an important role in recognising when a child needs help. In Malaysia, there is not a standard procedure, but best practices in other countries stipulate that you would see a clinical psychologist. Comprehensive assessment will take a minimum of three

See also page 23

There are three types of ADHD.