Pharmacist Sheds Light on ADHD Treatment for Children

ADHD, or Attention Deficit Hyperactivity Disorder, is one of the most common neurodivergent conditions among children.

With proper screening and medical intervention, this condition can be successfully managed at home.

We had a chat with pharmacist Nazatul Amira Hamzah from Primabumi Sdn Bhd to find out more about ADHD in children and steps parents can take to address this condition.

Question 1: What is ADHD and what are the symptoms?

ADHD stands for attention-deficit/hyperactivity disorder.

A child with ADHD has differences in brain development and brain activity that cause them to persistently display symptoms of inattention, hyperactivity, and impulsivity. 

• Inattention: The child has difficulty paying attention, staying on task, or being organised
• Hyperactivity: The child tends to move, fidget, or talk constantly and excessively
• Impulsivity: The child often lacks self-control, leading to erroneous actions and behaviours

Question 2: Is ADHD common? How is it diagnosed?

ADHD occurs in approximately 3 to 5 percent of Malaysian school-aged children.

ADHD is often first diagnosed before the age of 6 or 7 years old, when symptoms are most noticeable.

In addition, ADHD is more likely to occur in males and is more common in first-born children. 

Diagnosis usually involves a full evaluation by a paediatrician, psychologist or psychiatrist, which may include interviews, surveys for parents and teachers, and behaviour analysis.

Question 3: Will ADHD severely impact a child’s development?

Children with ADHD experience significant problems in behavioural control, mood regulation, academic performance, and social interactions.

These often present real challenges not only to the children themselves but also to their parents, family members, caregivers, and educators.

Although many children with ADHD improve at some point, inattention may persist into adulthood. 

Question 4: What causes ADHD?

A child with ADHD tends to inherit the condition from their parents.

However, genetics is not the only factor.

Scientists discovered that children with ADHD have certain areas in their brains smaller or bigger than those of non-ADHD kids.

Additionally, ADHD children may have chemical signal imbalances in their brains.

A child may be more likely to develop ADHD if they:

• were born prematurely, i.e. before the 37th week of pregnancy
• were born with low birth weight
• also suffer from epilepsy
• had a brain injury occurred either during pregnancy or later in life

Question 5: How is ADHD managed?

The management of ADHD in children encompasses three key areas:

• Psychological education provided to the children, parents, caregivers, and teachers. 
• Non-pharmacological (not involving medicines) therapies for the children, such as occupational therapy, organisational skills training, and cognitive behavioural therapy.
• Pharmacological treatments with medicines that are primarily categorised as stimulants and non-stimulants.

Depending on the symptoms and severity of a child’s ADHD, clinicians often combine two or more types of therapies for better outcomes.

Question 6: At what age can children start taking medicines for ADHD?

Medicines for treatment of ADHD are prescribed mainly for children aged 6 years and above.

Currently, there is not enough data to support the use of these medicines in preschoolers (children below 6 years old).

If medication for ADHD is required in children in preschoolers, it should be initiated by a child psychiatrist or a paediatrician with expertise in managing ADHD.

Question 7: What are the medication options for ADHD and how do they work?

The table below highlights the treatment options that are currently available in Malaysia.

It is important to understand that medicines do not cure ADHD permanently.

However, they can assist children with ADHD in the following ways:

• Focus better, especially at school.
• Have better self-control.
• Feel more relaxed and less anxious.
• Have a greater ability to adopt and apply new skills.

Clinicians often begin a child’s treatment with low doses, gradually increasing them based on the child’s response to the treatment.

Regular visits to the paediatrician or psychiatrist are crucial to ensure the treatment is working effectively and monitor for any signs of any side effects.

Question 8:  How long do children with ADHD need to be on their medications?

In general, children with ADHD need to continue their medications, as long as they help control their symptoms.

Many children outgrow their ADHD by the time they become teenagers and may no longer require medicines.

Parents must consult their children’s specialists at the right time to take their children off their medicine.

Question 9: Are there any natural remedies for ADHD that parents can explore?

Zinc, iron, omega-3, vitamin C, and acetyl-L-carnitine are among the nutrients that were suggested to have potential positive effects in ADHD.

However, their roles in improving ADHD are still inconclusive, according to experts.

In addition, a growing number of clinical studies are being conducted to investigate the possible beneficial effects of certain probiotics, particularly from the families of Lactobacillus and Bifidobacterium, on ADHD symptoms. 

Parents must consult the child’s doctor before starting their children on any dietary supplements.

Question 10: How can parents support their children in managing their ADHD?

Parents play a critical role in providing the support their children need, and they can do this in a variety of ways.

Pay attention to your child’s nutrition

Ensure your child gets a healthy, well-balanced diet rich in proteins, whole grains, fruits, and omega-3 fatty acids.

It is also important to limit their intake of processed and sugary foods or drinks.

Take note of and avoid any foods or beverages that may cause changes in your child’s behaviour.

Certain food additives, colourants, and flavourings have been found to worsen ADHD symptoms.

Encourage physical activity

Exercise boosts dopamine and serotonin levels in the brain, improving attention and reducing hyperactivity and impulsivity.

Ensure your child gets the medical attention they need

It’s crucial to have regular follow-ups with your child’s healthcare providers to assess the effectiveness of their treatment and make any necessary adjustments.

Establish a routine

Consistent routines help children with ADHD understand what to expect and reduce impulsive behaviours.

Set regular times for meals, homework, bedtime, and other activities.

Visual schedules, such as charts or calendars, can also help them stay on top of their daily tasks and stay organised.

Use positive reinforcement

Reinforce good behaviour with praise, rewards, and encouragement.

Parents should also promote activities that highlight their child’s abilities to help boost their self-esteem.

Set clear expectations and boundaries

Be clear and specific about rules and expectations.

Giving the child one or two clear tasks at a time is more helpful than overwhelming them with long or complex instructions.

Practise calmness and consistent discipline

Maintain consistent consequences for bad behaviour, but emphasise teaching over punishing.

Use a gentle approach to reinforce learning and encourage better options.

Teach time management and organisational skills

Help your child learn to manage time by setting timers for tasks, breaking assignments into smaller steps, and scheduling breaks.

Visual timers, time management apps, and simple organisational tools can help them stay focused.

Use ‘Stop and Think’ techniques.

Practise role-playing situations where your child have to stop, think, and choose a response.

Over time, this technique can help them develop better self-control.

Teach your child social skills

Help your child develop social skills by enrolling them in structured training, encouraging cooperative play, and modeling appropriate social behaviour.

Stay involved with schools and teachers

Talk to the teachers about your child’s progress, any challenges, and any learning methods that might help. Knowing what works for your child at school can help you use similar methods with them at home.

Consider behavioural therapy

Behavioural therapy teaches strategies for managing ADHD symptoms and problematic behaviors.

Working with a therapist can help parents learn new methods and improve their responses, resulting in a more positive home environment.

Create a supportive environment

Provide a space where your child feels safe, accepted, and understood.

Showing empathy and being patient can make them feel more confident and supported.

Educate yourself, your child, and your family members about ADHD.

Learning about ADHD helps you to have a better understanding of your child’s needs.

Additionally, it enables you to provide better support to other family members and help them cope with challenges.

Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd

Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.

For more insightful stories and fun recipes, stay tuned to Motherhood Story!