ADHD: Welcome to the Foundation Phase

The first term of the new school year is in full swing and already the teacher is raising concerns about your child’s ability to sit still, follow instructions, concentrate and complete tasks. It may be a little better with a few reminders and when seated at the desk with a quiet, diligent child next to him but it seems that he just can’t contain his “enthusiasm” when seated on the mat. There also seem to be some scrapes on the playground. You don’t think of him as a clumsy child yet he always seems to be running and bumping into things because he doesn’t look where he is going.   You’ve had his eyes and ears tested and it’s all fine.

J. has always been a busy boy. He can focus when building Lego or playing on an IPad - as long as he is interested in what he is doing. He is a bit like his Uncle Joe that way. His Grade R teacher said this day might come but he did the OT and you thought he would mature and settle down. Now it seems he is not keeping up with the others. He is getting frustrated and starting to call himself “stupid”. What now?

Well, an assessment is going to start by looking at J.’s general physical and emotional well-being and routines. Is he a physically healthy child or are there some medical issues to be addressed? You’ve already established that his Hearing and Vision are normal. Does he go to bed at a decent hour and sleep well? Does he follow a healthy diet and eat a good breakfast? How much screen time does he get and do you encourage a physically active life style? Does your household follow a structured routine? Has the family experienced any recent disruption or trauma that might causing stress? Is J. a happy child or could he be anxious or depressed?

Does your family have a history of ADHD and learning difficulties? These conditions tend to run in families. Perhaps J. already has had an occupational therapy, speech and language and/or educational assessment on account of some developmental challenges. Perhaps it’s time to get that assessment from your paediatrician or a child psychiatrist to see if J. does meet criteria for the diagnosis of ADHD and if further intervention is needed. Yes, this seems like a scary and momentous step but what you are committing to is a process of understanding why J. is struggling at school and what can be done to help him. Once you are empowered with this knowledge, you will be in a position to make an informed decision about how best to help your child overcome the challenges he is facing and to build his confidence and self esteem in the class room.


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Dr Lesley Carew is a registered Child and Adolescent Psychiatrist practising at the Netcare Christiaan Barnard Memorial Hospital in Cape Town with a satellite sessional room on Thursday afternoons at the Akeso Milnerton.


Tel: 021 423 8774/6
Fax: 086 641 5388