Hyperactivity and why children have no choice in matter

Qn “What causes hyperactivity insome toddlers? My nephew has become a handful and the mother risks sliding into depression due to the endless frustrations”.

The commonest cause of hyperactivity in children is Attention Deficit Hyperactivity Disorder (ADHD). Some mothers say that they can tell that the baby in the womb will turn out to have ADHD after birth. Such mothers state that such babies keep moving in the womb all the time. One such mother came to us distressed and embarrassed because the baby in her womb kept pushing her dress away, even when she was in prayer in Church!

ADHD is what is called a neurodevelopmental disorder, meaning that it arises from the malfunction of certain parts of the brain as it develops. The hyperactive child, therefore, does not “choose” to be hyperactive and no amount of telling him off will settle him down. Such children show poor ability to concentrate at home and in class and are impulsive in both settings.

A thirsty seven-year-old boy impulsively drank water from the toilet bowl because the mother was “taking too long to bring the water”.

These behavioral challenges often lead to academic problems. Of such children, teachers typically note in the end of term report “Clever child who is too playful. Must do better next term”. Another common comment is “A clever child who does not concentrate in class”. Another comment is “A clever child who is lazy”. When we see a child described in these terms, we are bound to establish if indeed we are dealing with ADHD. Many children with this type of report card will benefit from careful evaluation.

For many years, doctors believed (wrongly) that ADHD “gets cured” after the age of 13. Another (wrong) belief was that ADHD was a figment of the imagination of rich American parents who had nothing better to do than to pay doctors to treat children for their failure as parents.

The truth, however, is that approximately 10 per cent of all children suffer from various degrees of severity of ADHD. Some are severely afflicted and cannot remain in school without treatment while others are milder but do not benefit fully from being in school. Still others are affected but go on to finish primary school only to be diagnosed with ADHD in high school. Others are diagnosed when the challenges of university life become too much to handle.

Behaviour such as absconding from school, bullying, drug abuse as well as aggression are sometimes adolescent manifestations of ADHD.

If not detected in high school, a number of students fail to perform at University because the challenges of being at University without the support structures created by parents earlier in life lead to academic difficulties. When an otherwise bright student fails at university, the diagnosis of ADHD must be considered.

Experts do not know exactly what causes ADHD, but we know that it tends to run in families. In a recent case, a 22 year old girl was brought to us by her parents from a police cell.

She had been arrested with a few rolls of cannabis, was drunk and disorderly and had been in a fight with other girls at the local nightclub. It turned out that her grades at school (Law student) had deteriorated over some months and to help her concentrate, she had been advised by a friend to use cannabis. As often happens, there seemed to be initial benefit from initial use but by the time the police caught up with her, she was a heavy user with poor grades.

During the evaluation, it turned out that she had symptoms of poor concentration, made careless mistakes, was often easily bored, was impulsive and generally disorganised.

During the interview, her mother sat with her mouth open. Eventually she said, “That cannot be a medical condition, I am exactly like that, and so was my father” (who also abused alcohol). If that is ADHD then my father and I have the same she concluded. This illustrates the fact of genetic loading in ADHD.

So, if your nephew has ADHD, it is possible that his mother or father could have the same.

If it is the mother, depression is a real risk because the two conditions often occur together!