Kuhu, aged 11 years, came for therapy with her mother. The sixth grader’s class teacher is frustrated by the problems Kuhu exhibits and it led to an evaluated for ADHD. Kuhu is described as overtly active and inattentive by the teacher. She prefers social isolation. Kuhu met the DSM-IV-TR (Diagnostic & Statistical Manual of Mental Disorders) criteria for attention-deficit/hyperactivity disorder, combined type.
Most people have heard of Attention Deficit/Hyperactivity Disorder (ADHD) and usually, think of it as describing someone who is “hyper”. However, many children who are diagnosed with ADHD actually have problems with attention (inattentive type), whereas others are hyperactive-impulsive (hyperactive-impulsive type), and yet others are both inattentive and hyperactive-impulsive (combined type).
The Inattentive type
Children who have inattentive type are often described as having difficulty focusing (e.g. listening, organising, carrying out tasks) or as being unable to sustain their attention (e.g. stay on task, avoid distractions, complete their work). In addition, their work is frequently incomplete or careless/messy and they are reluctant to engage in tasks that require sustained attention. These difficulties often lead to failing: with their school-work, in developing and sustaining friendships, in their relationship with their families.
The Hyperactive-Impulsive type
Children who have the hyperactive-impulsive type are more easily identified. These children behave impulsively (i.e. act without thinking). They are talkative, interrupt frequently and tend to blurt out answers even before the question has been completed.
In most instances, hyperactivity and impulsivity occur together. These children are often described as driven, always on-the-go, fidgety or squirmy, not able to sit still, and very talkative. They are also prone to accidents from climbing on furniture and other objects.
Heredity is one of the main causes of ADHD. The most hyperactive children have at least one close relative, usually the father, with a similar make-up.
Both under arousal and over-arousal of central nervous system processing and neurotransmitter imbalances have been suggested as “causes” and a great deal of research has been conducted on the neurological basis of ADHD. The symptoms of this disorder may also be caused by the reduction of two other neurotransmitters; nor epinephrine dopamine and serotonin.
The treatment of children with ADHD requires working with them on multiple levels and on a continuous basis. This often includes behavioral therapy, dietary restrictions and supplements, biofeedback, and family interventions in addition to medications. Behavior therapy aims to reduce problematic behavior and substitute more desirable ones through a combination of positive and negative reinforcement.
The case study
In Kuhu’s case, there are some recommendations and improvements noticed after she was put under treatment, such as reading and writing skills. Behavior therapy was applied and sunkhpushpi was recommended. Some steps were also taken to improve her self-esteem. Parents were advised to improve her social skills and self-esteem. Kuhu was encouraged to have eye contact with the person she was talking to.
Kuhu’s mother was advised to handle Kuhu with patience. The mother was asked to not get into a reactive frame of mind when dealing with Kuhu. One of the most important ways you can help a hyperactive child is to explain things with clarity and necessary detailing since they have problems with concentration and listening.
Over a period of a year, Kuhu has learned how to cooperate better. She has developed self-regulation skills too. As her behavior has improved, her social isolation has decreased. She has started to score better in her exams. No doubt, the condition of a child having ADHD can be improved with the joint efforts of his family, school, medication, and individual therapy.
Courtesy gave to Yogesh Kumar, Psychologist & Yoga Instructor, Delhi.