#HEALTH: ADHD — disorder or disruptive behaviour?

New Straits Times

28-07-2025

JOE is 8 and constantly fidgets or jumps up during class or when he's watching a movie, eating or even reading.
He tries to wait his turn but can't stop himself from blurting out answers during lessons and interrupting his friends.
He's been told over and over again that he's naughty and not trying hard enough to be better, but he does.
He struggles every day to be like his friends but fails.
Joe is a typical case of a child with attention deficit/hyperactivity disorder (ADHD) and while symptoms and specific challenges may vary from person to person, the helplessness and the feeling of being misunderstood are a shared struggle for those diagnosed with the condition.
In 2020, the Health Ministry estimated that 1.6 per cent to 4.6 per cent of the population had ADHD.
However, like many other disorders, it tends to be under-reported, says IMU University clinical psychologist and senior lecturer Dr Serena In.
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 processes things.
"It is not a behavioural problem. What happens in the brain affects the way a child functions," says In.
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 fidgety.
They can't sit still through a 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.
They don't appear to be listening well and lose interest, appear bored or seem like they are daydreaming.
"Whichever type of ADHD a child has, they are often dismissed as children with behavioural and discipline issues, and unfortunately, go through life labelled as rude, uncontrollable and naughty."
WHAT CAUSES ADHD?
Many different factors play a part in how our brains develop.
Genetics play a role, with children having a predisposition to ADHD if it runs in the family.
There are also environmental factors, such as toxins they were exposed to as children, as well as prenatal factors like 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 overwhelming and over-stimulating, especially for young malleable brains that are still developing."
Excessive screen time also means less exercise, less quality sleep and less time for homework, which affects a child's ability to be at their best, she says.
Once a diagnosis has been made, doctors can write reference letters to advocate for the accommodation of certain needs, such as longer exam times, to be allowed sit where he or she can get up and move during class without disrupting others, or to be allowed to use fidget toys in class.
"We need to manage and support these children effectively instead of just scolding or disciplining them every time," she says.
Outside of school, psychological therapy is also essential for addressing related issues like depression or anxiety.
Therapy often involves teaching children coping mechanisms, such as expressing their emotion constructively, as well as managing behaviours by using timers and reminders that can help a child stay focused.
At home, parents can relook how they organise family life and set up routines and habits, such as structured meal times. Ensuring the house is clean, neat and orderly also helps.
"These are little routines and structures that help everyone, but they are especially beneficial for individuals with ADHD."