15 February 2013

Nigeria: How to Deal With Hyperactive Children


Kaduna — Caring for hyperactive children is a challenging task for parents, guardians, teachers and caregivers because such children are always doing one thing or the other. Some children are hyperactive by nature while some become hyperactive due to lack of attention that they wish to get from their parents.

Even though hyperactive children are difficult to handle, it is not impossible for them to be managed successfully by their parents or teachers as it has been observed that many children behave in a hyperactive manner just to draw attention of their parents and people around.

Parents, guardians and teachers need to be patient and calm to be able to handle such children. Spending quality time with such children irrespective of their age will help parents have a good and healthy relationship with them.

According to Dr. Folorunsho Nuhu, a Consultant Psychiatrist and Head of Child and Adolescent Unit, Federal Neuro-Psychiatric hospital, Kaduna, hyper activeness could be the manifestation of so many psychiatric and medical problems.

He said a child who has Attention Deficit Hyperactivity Disorder (ADHD) can be hyperactive and at the same time restless. "Children with ADHD can exhaust their parents or caregivers' endurance. Apart from ADHD, a child who is mentally retarded can present with hyperactivity, a child with psychosis can present with hyperactivity so also a child who is confused. A child could also just be hyperactive because of the environment he or she is without having any psychiatric problem.

"Sometimes, some children have mood disorders like depression; one will expect them to be calm or to be hypo-active but some of them are agitated and are hyperactive. Those are few psychiatric entities that can present with hyperactivity.

"Medically, a child who is having pains can be restless because of the pain. A child who has severe headache can also be hyperactive because of the headache. It is the duty of the medical practitioner to assess and find out what the cause of the restlessness or hyperactivity in a child is."

He urged teachers and parents to strive to always find out what is responsible for hyperactivity in their children. If it is something obvious that they can handle, for instance maybe the child is angry and is hyperactive, such a child can be pacified until he becomes less restless but that if it is beyond that, he advised that the parents and teachers of such children should seek appropriate advice from medical practitioners.

The doctor said children by their nature hardly sit in one place over a long period of time like an adult will do but like to explore their environments. "If the child's movement from one place to the other is purposeful and is within the bearable level, then such child cannot be said to be hyperactive. For example, if a child moves from one chair to the other to take his biscuit , then that child is not hyperactive, but a child who cannot sit still for two-three minutes and will go from one place to another without any purpose can be said to be hyperactive."

He said some children are mildly, moderately or severely hyperactive. The level of hyperactivity reflects the psychiatric or medical condition causing the hyperactivity.

Does hyperactivity affects a child's intelligence?

Dr. Nuhu said some children with hyperactivity have normal intelligence cosset, some have just average, but a sizeable number of them are actually mentally retarded and have intelligence cosset below average.

"So when a child is extremely hyperactive depending on the condition that is responsible for the hyperactivity, then the intelligence cosset may be affected. One of the conditions that can cause hyperactivity is mental retardation, so a child who has low Intelligence Quotient (IQ) and who is mentally retarded may present with extreme hyperactivity. If a child is mentally retarded, depending on the level of retardation, the child may not be able to care for himself, his speech may not be normal; he may not be able to learn and may not be able to do common activities of daily living. In addition to all these symptoms, the child may now become very restless.

"Some mood disorders can cause hyperactivity, that is agitated depression; a child can also be manic that is a child may have mania which is the opposite of depression.

"For children with mania, it may not necessarily affect the intelligence. The hyperactivity we see in those children may be because at that particular point in time, they have so much energy that they have to dissipate and they just must move from one place to another to use up the energy. In such situation, the intelligence cosset may not be affected and the child may even go to school and perform wonderfully well. In fact, children who are hypo-manic may have higher ability to learn and retain what they are taught because they have increased energy for everything including learning.

"Some children with ADHD can also be intelligent depending on the degree of the inattention, so if a child has ADHD and most of the symptoms are tending towards the hyperactivity with very little effect on the attention, then the child may be able to focus and learn, but a child who has a lot of inattention with little hyperactivity surprisingly may not be able to learn so much," he explained.


He explained that from a psychiatric stand point, there are multi-factorial causes of ADHD . He said risk factors include nature and nurture. There are biological factors for example within the child together with environmental factors. One of the biological factor is genetics, that is hereditary factor. In view of this, some children who have hyperactivity have family history of hyperactivity, same is applicable to children who have mental retardation.

"Some children with epilepsy may also become hyperactive because of the epilepsy and epilepsy has been shown to be hereditary in nature. Apart from that, some injuries to the brain, either while the woman is carrying the pregnancy; the yet to be born foetus can suffer injury if the woman has medical problem like hypertension, anaemia or if she is exposed to excessive x-ray radiation or if there is infection when the woman is carrying the pregnancy. Some of these may cause direct injury to the foetal brain. Also during child birth, the woman may have difficult delivery and as such, the brain may be affected in the process of child birth."

"After delivery immediately, it is also possible for the baby to be affected with jaundice or the child may have infection while he is still a neonate. A child may fall down and sustain injury on the head and sometimes malnutrition which can make a child suffer lack of nutrient. All these factors can make a child develop any of the psychiatric conditions mentioned that can present with hyperactivity," he said.

Dr. Nuhu also said it is possible for children at older age to have hyperactivity due to infection like measles, viral encephalitis, stressful events in the family and environmental factors among others. These factors he said are capable of bringing out psychiatric entities in children who are already pre-disposed.

He advised parents, guardians and care givers to always be patient with hyperactive children and as well find out the cause of the hyperactivity. He noted that sometimes, they may be able to detect themselves but that in most cases, they have to see either a pediatrician or a child psychiatrist.

Tips given by other experts include ; Parents should teach their hyperactive children to be disciplined and at the same time pay attention to giving them some flexibility. Make sure they know when you mean discipline, it is purely business. Parents should not make their relationship with their children centred to instructions and orders but they should spend some time with their children as it is better to take them outdoors so that they can have full set of enjoyment and also make use of their energy level.

Parents should divert child's attention in right direction by imposing positive thoughts and activities in the child. They should also help the child pay attention to creativity and get engaged in activities that can divert his energy and help him stay focused and concentrate well in his activities. The energy of the child has to be channelled towards the right direction.

Such children should also be taught deep breathing exercises when parents notice aggressiveness and anger in them. If you are able to teach this to your child, your child will not hit or hurt any other child or himself on a matter of impulse or reaction. Deep breathing also helps provide more oxygen to the brain and this in turn calms down the child.

A hyperactive child can be engaged in household chores by fixing sometime either daily or on weekends and engage the entire family in some creative activity.

They should be encouraged to read something interesting. Make sure you provide the reading material that is of interest to the child and let him choose the book that he wants to read at that moment.

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