Rise in ADHD among kids here

New MOH guidelines aim to help doctors diagnose and manage the condition more effectively
By Janice Tai, The Sunday Times, 15 Feb 2015

More children in Singapore are being diagnosed with attention deficit hyperactivity disorder (ADHD). And the Health Ministry (MOH) has come up with guidelines to help doctors better manage the condition.

Last year, 550 new child and adolescent patients were seen at the Institute of Mental Health's (IMH) Child Guidance Clinic, up from an average of 350 new cases treated in the early 2000s. In total, its doctors saw 1,802 young patients for ADHD last year.

The impact that the condition - characterised by hyperactivity, impulsiveness and inattention - has on academic and social performance is increasingly being recognised, said a spokesman for MOH.

For instance, the Singapore Burden of Disease Study in 2010 found that ADHD was the fourth highest contributor of disease burden, or the number of years lost to disease, in children aged 14 and below.

That is why the Academy of Medicine and MOH came up with a set of guidelines late last year to ensure that the condition is being diagnosed and treated accurately. It informs doctors on the assessments required before diagnosing ADHD, and about various medication and non-drug options.

Associate Professor Daniel Fung, chairman of IMH's medical board, said the guidelines enable doctors to discuss with teachers how to help students with ADHD in the classroom; and with parents on which treatment is best.

Prof Fung attributed the rise in ADHD cases to greater awareness among parents and teachers of the condition. ADHD results from an imbalance in brain chemistry, though its exact causes are unclear. Generally, such children suffer academically, as they cannot concentrate well, and have lower self-esteem. Others have poor relationships with peers. Prof Fung said only about a third of children recover completely. Another third learn to cope with ADHD while the rest get worse if the condition is not identified.

Doctors estimate that 3 to 5 per cent of children here have ADHD. This means that at least 1,500 children in every cohort have the condition, with two-thirds remaining undiagnosed.

IMH, together with other partners, initiated a community-based mental health-care service in 2007 to work with schools, voluntary welfare organisations and general practitioners to identify and help affected children early. Last year, the service was rolled out to cover all special education schools as well.

A clinical trial to train children with ADHD to be attentive will also be completed next year. It uses technology to measure a child's attention span by analysing brain waves.

Ms Pauline Tan, a mother of an eight-year-old who has ADHD, said it has been a tiring journey caring for her son Justin. Even as a baby, he was extraordinarily active and would refuse to sleep at night. When he entered school, he would walk around in class barefoot, singing, and was often bullied by classmates.

He was eventually referred for professional help in Primary 1 after he punched a classmate in the face after being provoked. Currently on medication, his behaviour has improved slightly.

"I hope there will be more awareness of the condition so that his teachers and friends won't simply label him as 'naughty'," said his 37-year-old mother, who works as a manager.

Adults' Group Therapy
By Janice Tai, The Sunday Times, 15 Feb 2015

Putting a bunch of adults with attention deficit hyperactivity disorder (ADHD) in a room together may sound like a bad idea to some, but it has actually worked wonders in getting them to sit still and focus.

"Meeting others who face similar challenges is fascinating and we can usually sit, listen and speak to one another for hours," said Ms Annelaure Vuillermoz, 37.

She facilitates the first support group here for adults with ADHD. It is run by Psalt Care, a charity that focuses on mental health and addiction issues. The group, made up of 20 adults in their late 20s to 50s started monthly meetings last year to share their experiences and come up with ways to help one another.

More adults with the condition are seeking help at the Institute of Mental Health. The facility saw 115 adults with ADHD last year, up from 63 in 2012. Many of them have had ADHD since childhood, said doctors. Some were diagnosed late.

Adults with ADHD are usually mentally restless and may have problems with attention and memory. One 30-year-old IT developer has switched jobs six times in the last five years because he gets bored quickly and cannot deliver work. "They often procrastinate or have difficulty organising themselves when tasked with routine work, but when their projects are challenging and require interaction, they may perform above expectations," said Ms Vuillermoz.

A young woman mustered the courage to quit her sales administrative job for an entrepreneurial one after realising that the others in the support group were facing similar issues of boredom, forgetfulness and anxiety when tasked with repetitive work.