THE STAR, TUESDAY 8 DECEMBER 2020
BRIGHT KIDS
Understanding ADHD in children
ATTENTION deficit hyperactivity
disorder, commonly known as
ADHD, is a neurodevelopmental
disorder that affects children’s
ability to self-regulate and control
their behaviour, and this impacts
upon their daily functioning,
learning and ability to form
meaningful relationships. Early
intervention can minimise long-
term difficulties, hence it is
important that parents seek early
diagnosis. ADHD presents
differently in different individuals
and the signs vary and at times
can be difficult to diagnose. It is
important to remember that
children with ADHD often present
with other developmental
disorders such as speech language
delay or delays in motor
coordination as well.
When it comes to the difference
between ADHD and ADD,
consultant general and
developmental paediatrician at
ParkCity Medical Centre Dr Rajini
Sarvananthan says, “ADD is an old
term used to describe
predominantly inattentive-type
ADHD. These children often have
more attention problems, are
forgetful and disorganised, while
hyperactivity and impulsive
behaviour are not as obvious.”
The latest diagnostic criteria
(DSM-5) for ADHD classifies it into
three categories: predominantly
inattentive, predominantly
hyperactivity-impulsive, and a
combination of both.
Children who display
predominantly inattentive signs of
ADHD have difficulties in focusing,
finishing tasks and following
instructions. Children with
predominantly hyperactivite-
impulsive presentation are often
on the go, fidgety and often
interrupt conversations or
Dos and Don’ts for children with ADHD
Dos
l Use behaviour
modification techniques – there
are behavioural strategies and
parenting techniques that are
known to be very effective for
children with ADHD. Behaviour
therapy works for children with
ADHD if parents set specific rules
for behaviour and enforce them
consistently with both positive
and negative consequences
(token system). It is important to
ensure there are set boundaries
and rules that your child is aware
of and these should be reviewed
often. Speak clearly and calmly
and ensure that any intervention
is done consistently in all settings
(school, home, daycare).
l Ask your child’s teachers to
set up a similar behavioural
system at school – meeting with
your child’s teacher to determine
desired classroom behaviours is
one of the best tools for parent-
teacher cooperation. Another
way to do this is for the teacher
to fill out a quick evaluation of
your child’s adherence to these
behavioural goals and send the
Children with ADHD may display signs that are sometimes difficult to recognise, or worse, misinterpreted.
However, if parents notice their children experiences speech language delay or delays in motor coordination,
it is best to consult a paediatrician.
activities and have difficulties
waiting and turn taking. Most
children present with the
combined type of ADHD, where
they have both the inattentive
features as well as impulsiveness
and difficulties in regulating their
activity levels and emotions.
Difficult to differentiate
While fidgeting and a lack of
focus are the most common signs
of ADHD, there are many other
signs that are sometimes difficult
to recognise, or worse,
misinterpreted. Among which is
the inability to follow instructions.
Dr Rajini explains that children’s
inability to follow an instruction
are sometimes misunderstood as
an act of defiance by adults. “It is
not a case of a child not wanting to
listen to you, but rather the
document home with the child.
You may then reward your child
for a good day at school with non-
material rewards where possible
(e.g.) extra- time to play outside.
l Assume a higher parental
responsibility – you can do so
by:
– maintaining frequent and
regular communication with
your child’s teachers
– keep an up-to-date and
accessible file of your child’s
important records and data (e.g.,
health history, report cards,
testing/reports, correspondence
to and from the school, meeting
summaries).
Don’ts
l Respond or give out
negative consequences when
you are in an angry or
emotional state – there are going
to be times when your child’s
misbehaviour or antics really test
your patience. If you do end up
in an angry or emotional state,
wait until you have had a chance
to calm down, regain your
composure and ability to think
inability to understand the whole
instruction because there are too
many words to focus on.
“For example, if the instruction is
to “Pick up the ball and put it into
the box”, children with ADHD might
only be able to focus on picking up
the box. Adults may believe this as
a child being stubborn, when most
of the time it is not.”
Dr Rajini also explains that it is
common for parents to adapt to
their children’s behaviours and not
perceive it as being a problem,
especially in milder case. She says,
“Parents tend to accommodate
some of their child’s difficulties, but
when these children go to school,
teachers are able to pick up their
difficulties when they are in a group
setting with their peers.”
Children with ADHD will
continue to exhibit these traits, and
although the level of hyperactivity
about the situation in order for
you to have an appropriate
response.
l Be unrealistic or over
demanding of teachers – the
teacher’s responsibility is towards
ALL the students in their
classroom. So, keep in mind what
is “reasonable” when making
request of teachers regarding the
individual attention and degree
of accommodations you expect
for your child.
l Use the services of
professionals if you doubt their
knowledge and expertise on
ADHD – choose professionals
(such as physicians, psychologists
or tutors) that you feel
comfortable with and who have
experience and training to work
with children who have ADHD.
l Believe everything you
read – not everything you read
or hear about ADHD is worth
believing if it is not coming from
a reputable and reliable source as
there is a lot of misinformation
about this disorder. Instead, look
for information that has
scientific research into ADHD and
proven treatments.
often reduces over time, if not
addressed, these difficulties
become more apparent.
Dr Rajini stresses that the first
few years, when brain
development is at its most critical,
is when intervention should take
place. As they get older, it can be
difficult for children with ADHD to
catch up with their peers once they
start formal schooling.
Making a difference
“When we diagnose a child with
ADHD, we also need to look at the
impact on a child’s other
developmental skills including his
or her self-care, social and learning
abilities. To address the core ADHD
symptoms, we start with
behavioural interventions which
involves the parents and where
possible, other carers and teachers
as well. We often work with other
health professionals such as
clinical psychologists, occupational
therapists and speech language
therapists to address the
behaviour and developmental
issues the child may be facing.
Medication is also used in the
management of children with
ADHD, to work on their attention
Various signs of ADHD
1. Fidgeting or constantly on
the go
2. Tendency to interrupt
conversations
3. Trouble waiting their turn
4. Emotional outbursts
5. Problems playing quietly
6. Inability to complete tasks
7. Easily distracted
8. Avoidance of tasks needing
extended mental effort
9. Often make mistakes
10. Constantly daydreaming
11. Trouble getting organised
12. Forgetfulness
Symptoms as children
get older
When children with ADHD
grow older, they may also have
Dr Rajini Sarvananthan.
and impulsive behaviour.
She explains the planning of
intervention will depend on the
needs of the child and their age.
For example, with preschool
children, behavioural interventions
are used first and medication is
only used when these interventions
have not helped. Older children in
primary school will at times be
started on medication at the same
time as behavioural interventions
as research has shown this
combination works well.
Above all else, Dr Rajini believes
parents of children with ADHD
must always remember that there
is help available. While she
understands that parents may
be in a state of denial after their
child is diagnosed with ADHD,
it is extremely important that
they understand that their
child’s behaviour is a result of a
brain disorder.
She advises, “As a
developmental paediatrician, I
strongly believe there is a lot we
can do to help children with
ADHD learn strategies that they
can use to help them navigate
difficulties and lead productive
lives and be an asset to our society.
To do that we need to diagnose
them early and work with families,
schools and communities”
n For more information, call
03-5639 1212.
less self-control than most
children their age. This can make
children and adolescents with
ADHD seem immature next to
their peers. Some daily tasks that
adolescents with ADHD may have
trouble with include:
• focusing on schoolwork and
assignments
• reading social cues and
friendships
• maintaining personal hygiene
• time management
• controlling urges to try
smoking, illicit drugs
2 Bright Kids
Nurture good values
BUILT on the twin pillars of educational
excellence and values, elc International
School believes that without sound values,
students stand on shaky ground. However,
once the values are in place, the rest of the
pieces fit in perfectly. Values form the
building blocks of education and the way of
life at elc.
Sungai Buloh Campus head of secondary
Chong Soh Nee shares, “Courtesy, concern
for others and care for the environment are
all actively encouraged while a firm stand is
taken against negative social behaviour.
These values are important to us and are a
part of the foundation of the success on
which we have painstakingly built.”
Values-coaching happens on a daily basis,
both inside or outside the classroom. It can
happen along the corridor, at the canteen,
on the field, at the bus shelter or even in
the swimming pool. The observant teacher
will always spot student behaviour that
falls short of our expectations. These
situations are used to coach students on
expected values.
Values-coaching has to be a concerted
effort on the part of all teachers. This
becomes a way of life, resulting in a culture
of well-being and kindness, as explained by
Cyberjaya Campus principal Kothai
Chidambaram. “We at elc strongly believe it
is a culture of kindness that creates this
climate of happiness. Nurturing students in
a virtuous cycle of kindness, consideration,
empathy, gratitude and ultimately, long-term
happiness in their lives will continue to be
our aspiration.”
Regrettably, over the past few years, there
is often an incompatibility or disconnect
between the values espoused in school and
the values students are exposed to outside of
school. Consequently, elc has had to modify
its approach to cushion the disconnect.
Online schooling has also limited the
opportunities for values-coaching as teachers
no longer see students during break times, at
the canteen, on the field, etc.
To make up for the lost opportunities,
teachers have capitalised on three situations
– morning (online) attendance taking
session, online classes and online Personal,
Social, Health and Economic Education
(PSHE) lessons to carry out values-coaching.
elc continues to work on plans to revitalise
values-coaching in an online setting. There is
to be no compromise when it comes to
educational excellence and values-coaching.
Value education helps students become
increasingly more responsible and level-
headed. It helps them to understand the
perspective of life in a better way, and
hopefully, will lead them to a successful life
as responsible citizens.
n For more information visit www.elc.
edu.my
THE STAR, TUESDAY 8 DECEMBER 2020
Introducing children
to various industries
THE leap from secondary school to
university is a big one, and many students
who have just transitioned – or are about to
– are daunted by the plethora of courses that There are many young
people who are uncertain
higher educational institutions offer. There
are many young people who are uncertain
about what career path to make; some may about what career path
even be unaware about the huge number of
industries available out there and for them,
to make; some may even
this step into university or college would be unaware about the
seem especially intimidating.
Moreover, students who lack knowledge
huge number of industries
on the tertiary possibilities may be more available out there.
prone to making such an important decision
following influence by their family or
friends, instead of choosing a course that’s great way to expose her to all the different
based on their own preferences. This may colleges and tertiary possibilities, and the
then lead to dissatisfaction with their tertiary child can always take home brochures from
studies later in university, or an unhappy life the universities she’s interested in. However,
in a career unsuitable for them. with the current pandemic in place, it’s
It’s therefore important for a child to gain advisable to look for alternatives. Parents
awareness about tertiary education – can try looking up virtual educational fairs
otherwise known as post-secondary or a fair that has strict SOPs in place.
education – as early as reasonably possible.
Knowing what tertiary education is and > TURN TO PAGE 4
what it can offer are boons to a kid’s future,
and as a result, the child would have greater
confidence in herself when it comes to
choosing a course in college.
There are several ways to acquaint a child
with the numerous possibilities in tertiary
education. Here are four to consider:
1. Higher education fairs: These
education fairs are often a great start
to introducing secondary school
students to universities and tertiary
education. These fairs can host as
many as 100 universities and colleges
both local and abroad, and can feature a
wide range of courses ranging from
aviation to interior design. Attending
one of these fairs with a teenager is a
THE STAR, TUESDAY 8 DECEMBER 2020 3
4 Bright Kids
High-strength, clinically proven
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THE human gut consists of a complex
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A disrupted gut in kids may result in
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Probiotics, as defined by the World
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growing kids can help to improve their
intestinal function and restore the balance
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Building necessary confidence
> FROM PAGE 2
2. Internship or workshop
programmes: Another option is to explore
internship opportunities or workshop
programmes for youths; for example,
Garden International School provides
internship programmes for its secondary-
level students. Being part of an internship
pre-higher education comes with many
benefits, like gaining extra experience in a
specific industry and earning knowledge on
what is to be expected in the working field.
Students who have engaged in workshop
programmes may also find new interests in
other skills and industries.
3. Talk with the child: One of parents’
most important jobs is to provide guidance
to their children whenever necessary and
introducing them to tertiary possibilities is
no exception. What are their interests and
passions? Is the child artistically inclined, or
does she have a soft spot for animals? Help
her further her passions and nudge her in
the direction of tertiary education that may
suit her interests best. However, don’t
enforce specific career paths or courses onto
When it comes to choosing a college course, the child will have greater confidence in herself
when she knows what tertiary education is and what it can offer.
THE STAR, TUESDAY 8 DECEMBER 2020
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KKLIU No.2920/2018
children – what they choose should be up to
them, and forcing them may discourage
them entirely from tertiary education.
4. Take children to work: A good start to
exposing a child to any field or industry
would be to bring them to the workplace. A
parent working as a veterinarian could show
her children how animals are handled and
cared for, or an owner of a small business
could show them the basics of finance
management and running a business.
Showing children how the work is done
provides them with valuable insight into the
field or industry and allows them to make
more educated choices when it comes to
picking their tertiary education. Moreover,
it teaches them valuable knowledge about
how the work environment is truly like
and arms them with skills necessary for
the workforce.
With the abundant choices offered at
universities and colleges today, it’s just a
matter of children picking the right ones. By
exposing them to alternatives sooner, these
youths will have a head start in knowing
how to choose what’s best for themselves.