‘Nanny culture’ taking its toll
February 7th 2011 21:28
Children with ADHD need help
‘Nanny culture’ taking its toll
Does your child perform extremely poorly at school? Are you fed up of hearing complaints about him? Does he go from bad to worse the more you try to correct him? Then he could be suffering from a genetic disorder called Attention Deficit Hyperactivity Disorder (ADHD). Dr Renate Luedemann, a Pediatric Consultant at Inaya German Medical Center, in her interview to the Arab Times throws light on this debilitating condition, which affects 10 percent of children all over the world. A genetic malfunction in the brain affects their ability to pay attention and retain information, making them appear impossibly stupid. But before you write off any child remember that one of the finest brains the world has ever produced, Albert Einstein, suffered from ADHD too. So what exactly is this disorder, and how can children with it be helped... read on and find out. Also be prepared to take a peek into the intriguing mysteries of the human brain.
Q: Doctor, you are a pediatrician. What do children suffer from the most in today’s modern world?
A: In today’s world, we have all the facilities to ensure our children have a healthy body. We have vaccines for various epidemics and so on and so forth and our children are all healthy physically. However, the problem is with their mental development. This is one area where there is very little awareness and children suffer a lot.
Also, modern technology has made life very easy for them, they hardly have to apply their mind for solutions. The answers are all there at the touch of a button. Also, because of computers, children write less. They don’t use pens much. These stunt their natural development. The brain develops through neural networks, which are formed through such activities. Therefore, we find that the way the brains of the children of today develop is very different from what it was in the past.
In Kuwait, like all modern nations, children suffer from these drawbacks. Kuwait’s transformation into a modern nation was very sudden. People have not been able to cope with this change fully. Moreover, the private school education in Kuwait is very demanding of children, pushing them to their limits.
I think we must give children a chance to have a fair development. The nanny culture is also taking its toll on children’s development here. It is the maid who grows up children here and not the mothers. In children, the mothers do everything for their children, even if they are working women.
Q: What is the effect of these circumstances on children?
A: The environment can aggravate Attention Deficit Hyperactivity Disorder (ADHD), a severely mentally debilitating condition in children. It is however, a genetic disorder basically. All over the world, 10 percent of children suffer from ADHD. It is not just typical in Kuwait, but everywhere in the world.
Research has shown that the brain of ADHD children work differently from normal children. At a research center in Berlin, where I worked, we studied children with ADHD using MRI Scans of their brains, and we found that their brain works differently. We have tests for children with ADHD. We put them in a toy submarine and give them specific instructions to follow. We tell them not to follow red fish and to go after yellow fish. They never get it right, even if we instruct them a hundred times.
Q: What age group did these children belong to?
A: These children belonged to the age group between 8 and 12. The MRI scans showed that when ADHD children were involved in a task, a different brain area lit up than in normal children. So there is no way we can deny ADHD. These children have very, very short attention spans. They get easily distracted. When the teacher is teaching they look out of the window or get distracted with something else.
Q: Is this a disorder that came about just now or has it always been there?
A: It has always been there. But we now know more about the disorder and there are treatment methods to tackle the problem. These children lose concentration when given tasks that are of no interest to them. It is extremely difficult for them to focus on such tasks. However, if these are of interest to them, then they excel. If let’s say they spend 8 hours in school, their concentration lasts only for 30 minutes. The rest of the time at school, they are unable to focus.
Q: Is there enough awareness in Kuwait about this disorder?
A: I would say the awareness is increasing now. Rich families who find their children to be suffering from ADHD send them to the US for treatment. Others have to find treatment here, but there are not many experts in the field in Kuwait.
Q: When an ADHD child comes to you, how do you first diagnose the disorder?
A: I have many tests here in the hospital to diagnose ADHD. I give children these tests to gauge their attention spans. They are given a set of repetitive tests for a very short duration, and they get it right the first couple of times and then go haywire. This is a sign of ADHD.
Another test involves matching pictures. They are given cards, which they are supposed to sort out by matching pictures in it with pictures given on a box. They fail in this test, as they don’t spot more than one picture at a time. They are hyperactive as well. They are impatient and always do things in haste. They have 10 minutes to sort out 45 cards. They are usually done in five minutes and they do it clumsily.
Similarly, I give them many tests before I arrive at a final conclusion. Children like to take these tests because they have been designed to be fun for children. They ask for more.
We also train the parents and teachers. We give a rating scale for the teachers and parents, based on the child’s performance. These also help us to diagnose the problem.
Q: Is this a problem of intelligence or just concentration?
A: Children with ADHD have high IQs. They are very intelligent. But they fail at school because they are unable to concentrate. Also, remembering things is a problem for these children. They learn today, and forget the next day. That’s also one reason why they fail in exams.
Q: What sort of treatment do you give to these children?
A: The first thing to know is that there is no cure for it. But we can help the child surmount some of the challenges and cope well with life. We can help the child retain information better. Usually, our brain stores information in two ways. One is short-term memory and the other is long-term memory. There are things that we will need to remember just for five minutes and such information is stored in the short-term memory area. Things that are important go into the long-term memory area. We can call back information from the long-term memory area any time in our life.
Q: Can you give some examples of short-term memory and long-term memory?
A: Things that are not very important to you like say the news of a politician making some statement does not remain in your brain for long. However, things that are very close to you, like the birthday of your wife, you tend to remember for life.
Information gets transported from the one neuron in our brain to the next by adrenalin. When adrenalin connects the neurons in this fashion, synapses are formed, which helps us call back information from our memory. Research has shown that ADHD children have genetic disorder that prevents the flow of adrenalin from one neuron to the next. This is the cause for their inability to retain information. They are unable to recall information from their memory.
There is a medical treatment that can help with the flow of adrenalin in the brain. It is known to be 80 percent successful.
Q: Which medicine is this?
A: During World War II, an Italian chemist discovered a drug that helped fighter pilots concentrate more during dog fights. It is called Ritalin. This was developed from Caffeine. An ADHD child who takes Ritalin quietens down, becomes less hyperactive. This makes people think that it is a tranquilizer, but no. It is not a tranquilizer. It is a stimulant. When normal people take it, there could be adverse affects. Once I tried it on myself, and I was shaking, and my blood pressure shot up. When you have enough adrenalin naturally, Ritalin will give an excess dose of adrenalin. But for children with ADHD, the adrenalin level will normalize with Ritalin intake. For normal people, Ritalin will have the effect of 10 mugs of coffee at one go.
Q: So Ritalin increases adrenalin in your blood, is that right?
A: No, not in the blood. It increases adrenalin in the brain. That’s why it is a very unique drug. It doesn’t work like normal drugs. It doesn’t affect your blood, but only the brain, where it is required for ADHD children. Ritalin forces open the doors in the neurons that block the flow of adrenalin, and connects the neurons.
Our research has also shown that the brains of ADHD children are smaller. Also we found that the brain cells of ADHD children have low sugar content.
Q: How long will an ADHD child have to take this drug?
A: It depends on what our target is. For some children the target is to complete school. For some the target is even higher. But for most, finishing school is all that they look for, because that is very basic to your survival in the modern world. Unemployment is a problem in all countries, and if you don’t even have a school education, your chances of landing a job are nearly zero. Research shows that 50 percent of school dropouts in America are ADHD children. These children get addicted to Coke and Pepsi initially, move onto cigarettes and then drug abuse. These give them a false sense of an adrenalin boost. Caffeine does the trick, but it’s really no solution to their problem. It’s harmful.
An ADHD child who takes Ritalin will be protected from falling into bad habits, because he will feel normal after taking Ritalin. Studies also show that 50 percent of drug addicts have ADHD.
Q: Do you have therapies for these children?
A: There are therapies, but they are not very helpful. We can help increase their attention spans through some therapies, but it works only if the task at hand is of interest to the child, not otherwise.
Q: How is it that if something is of interest to these children, they are able to concentrate well?
A: It is so because when you are interested in something, the rush of adrenalin is high. So, these children are able to produce enough adrenalin in the brain to form the networks in neurons while they are involved in interesting activities. That’s why these children excel in certain skills and not in others. For example, the world champion swimmer, Michael Phelps, has ADHD. He didn’t finish school.
Q: There are many cases where children who are usually bad at a subject do well after a teacher makes the subject appear interesting to them. Is that possible for ADHD children?
A: Yes. Once I had a child in my clinic in Germany with ADHD. He was sitting slumped in his chair, with a long face. I asked him how much is three times four. He started counting on his fingers, and struggled hard to find an answer. After about five minutes, he said, “Eleven.” I didn’t say he was wrong. I said, “Good,” because he tried hard. When I said that, he immediately sat up straight and was excited. He solved the second problem I gave him correctly, because now his adrenalin level had gone up. When you give them negative feedbacks, keep complaining about their inability to fulfill a task successfully, their adrenalins are so down that they go into a cocoon. This can do them a lot of harm. Teachers have to welcome them into the classrooms with a broad smile and give a lot of positive comments like, “I am so happy to see you,” and so on. Otherwise, school gets boring for them and their attention is never there while at school.
Q: So training for teachers is also important to help ADHD children?
A: Of course. Before I start my treatment, I hold four counseling sessions with the parents. I advise them to give positive comments to their child. I tell them to say things like, “Very good, bravo, excellent!” This helps the child produce adrenalin.
Q: Doctor you took the example of Michael Phelps, who is a champion swimmer. Wouldn’t it make more sense to let ADHD children pursue their dreams, instead of forcing math and geography on them?
A: Yes. Earlier nobody knew about ADHD, or they didn’t believe it was true. But now we know that it is true; it has been proven scientifically. And we know that these children can excel in certain activities, but there again sometimes they will need help. For example, I knew a boy, 16, who was extremely good in football. He needed Ritalin to cope in studies. He was invited by a football club in Berlin to play for them. However, there he found that he still needed to take Ritalin because when the spectators were noisy, he was unable to focus on the game.
Q: What problems do these children face when they grow up?
A: When they get into a profession of their interest they do very well. They are very successful in their chosen fields. These children must be allowed to do what they like best, and you can rest assured that they will be successful in life. We have a study that says that ADHD people make very successful pilots. Most of the pilots have ADHD. But if they go into the wrong profession, life can be hell for them. They are never successful, and they are always in depression. These people also tend to run afoul with law, because they don’t remember rules.
A lot of famous people had ADHD. The son of late President Kennedy, who died in a plane crash, had ADHD. Paris Hilton has ADHD. The most famous personality with ADHD might be Albert Einstein. He was so bad at studies that he was taken out of school and given home tuition by his mother.
Q: I heard that Einstein was dyslectic. Is that the same as ADHD?
A: Yes, it’s the same. It’s a type of ADHD. All these come under learning disabilities. I once had a 10-year old girl who was sent to me by her teacher. This girl couldn’t write her own name. There were three mistakes in the first name.
Q: Will they have problems in family life?
A: Of course. Divorce rates are high among them, because they forget to do important things in life that can upset their partners. A patient once told me that he broke up with his girl friend, because he forgot to set two plates at a dinner, and just had one for himself.
ADHD people also find automatic tasks difficult to do. More than 90 percent of the things that we do in a day are done automatically, as in we don’t have to apply our mind on the task to do them, like for example brushing the teeth, wearing clothes, driving and so on. But people with acute ADHD are only able to do fifty percent of their routine tasks automatically. That makes life very difficult for them. It takes a lot of effort for them. For example, while we drive, our foot automatically shifts from the accelerator pedal to the brake pedal when we see red light. But an ADHD person will have to make a very conscious effort to do so.
That’s why they need assistance to do everything in life. Mothers are patient and help their children, but not so wives. They get fed up of their ADHD spouses because they are clumsy in life and give up after some time. So their family life suffers.
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