As many as one in 20 children in South Africa are believed to have ADHD - and their parents don’t know they have it. Picture:
At least one in 20 children in South Africa are believed to have ADHD and their parents don’t know it. Marchelle Abrahams finds out more.

When Nicola Carter took her seven-year-old son, Ryan, to a paediatrician specialising in neurology as a last-ditch attempt to diagnose his hyperactivity, she laughed after being told that he was a carbon copy of a child suffering from attention-deficit hyperactivity disorder (ADHD).

It wasn’t a shock, says Carter, but rather a relief after visiting specialist after specialist.

Finally, she could put a label on her son’s overtly busy nature.

“He was overweight and busy from Day 1. I was a single parent at that stage and just put it down to him having a tough start because he had spent the first 10-and-a-half months of his life in a children’s home.”

Ryan started his ADHD medication at age four.

Carter admits it’s been a gruelling two years as she tries to find the right balance for his dosage.

“We started him on a low dosage of Ritalin because he was very young. That didn’t work. Then we changed to Concerta – it worked for two to three weeks.

“Ryan had no impulse control, he was emotionally stressed, moody and crying all the time.”

Eventually, after much trial and error, and finding the right dosage, Carter and psychiatrist Dr Renata Schoeman achieved success.

Today, Ryan is a thriving happy boy at a Cape Town remedial school where he also receives speech and occupational therapy.

Carter’s first-hand experience of proper diagnosis and treatment has changed her and Ryan’s life.

“I’m pro-medication if you have the right diagnosis. Too many times parents give up because they find the meds don’t work.

“Keep your channels open with your doctor – once you have the right combination, it’s worth it.”

Ryan is one of the lucky ones. Thanks to his mom’s persistence, his ADHD was diagnosed and treated.

But at least one in 20 children in South Africa are believed to have ADHD and their parents don’t know it.

Dr Schoeman and top athlete Nic de Beer launched the Goldilocks and The Bear Foundation, which will offer the country’s first non-profit ADHD screening and early intervention mobile clinic in rural and township schools.

The foundation plans to intervene at school level by educating teachers and parents about the symptoms and signs of ADHD.

“We teach them what to look out for, what the kids might be struggling with, how they might be behaving,” says Schoeman.

She uses questionnaires that teachers and parents complete with regard to the symptoms the child is displaying.

Possible ADHD children are screened further with additional questionnaires and interviews.

Schoeman is quick to point out that they rule out other variables such as tiredness, visual problems, depression and anxiety.

Once children are identified as “probable ADHD”, they are referred to Department of Health mental health clinics.

Schoeman says that sometimes, when children are deemed uncontrollable and wild, they are labelled as naughty and bad-mannered. ADHD is the furthest thing from a parent’s mind.

There are three core symptoms, she says: inattention, hyperactivity and impulsivity.

Some children also display emotional difficulties such as poor self-esteem and social difficulties in a group.

If your child displays these signs, it doesn’t necessarily mean they have ADHD.

Misdiagnosis could lead to inappropriate labelling and treatment.

On the other hand, missed diagnosis and non-treatment can cause significant personal, interpersonal and social burdens, impacting negatively on the overall quality of life.

Not being diagnosed can sometimes lead to depression or anxiety and might lead to inappropriate treatment.

“Children could suffer from learning disabilities, anxiety, depression, conduct disorder, oppositional defiant disorder, tics/ Tourette’s syndrome and substance abuse; also poor self-esteem and not fulfilling their potential,” says Schoeman.

Mention ADHD medication and Ritalin comes to mind. The drug has been receiving some bad press lately.

But medication alone does not make up the treatment.

Dr Schoeman believes psychotherapy, parental guidance, educational support, physical exercise and nutritional intervention should encompass successful ADHD treatment.

The notion that ADHD is a childhood disorder prevailed until the 1990s.

Now research and public awareness have highlighted the presence of ongoing symptoms in 60% of adult patients. Only about 40% of children seem to “outgrow” ADHD, says Schoeman.

But there is light at the end of tunnel.

She says symptoms often appear to decrease over time – in number and in severity.

And some adults can go on to lead normal lives by choosing lifestyles and careers that suit them.

* Visit Goldilocks and The Bear’s Facebook page for more info or if you want to get involved.