When Sitting Still Is A Difficult Task -- MEDICA - World Forum for Medicine
Picture: A child 
Lively does not automatically
lead to the diagnosis ADHD

The German physician Heinrich Hoffman already described Fidgety Philip in the nineteenth century in his children´s book “Struwwelpeter”. Fidgety Philip cannot stop fidgeting at the dining table until he tears down the tablecloth together with plates and bread. Nowadays doctors would probably diagnose him with Attention-Deficit Hyperactivity Disorder (ADHD). Children with ADHD find it very hard to concentrate on one thing. They are quickly distracted, hyperactive, jump up without a reason, run around wildly. In short: They act impulsively, without long meditation.

However, not every lively child suffers from ADHD. The noticeable problems have to occur over a period of more than six months and in different environments like at home and at school. It is not easy to diagnose the disorder. “A diagnosis resembles a mosaic which has to be brought together piece by piece before a whole picture can be detected. For there is no test for ADHD, “ says the paediatrician Dr. Klaus Skrodzki. If a child, which is suspected of having the disorder, comes to his surgery, Skrodzki not only talks to the child and the parents, he also calls the teacher and takes a look at the exercise books. “This takes a lot of time”, he says, “and not every physician is willing to take this time”. Thus many children with the disorder are still not detected.

Once identified, the disorder is treatable. Therapies vary from psychotherapy to medication depending on the age of the child. The stimulant methylphenidate has been in use for more than 50 years in the treatment of ADHD. It stimulates the control centres in the brain which are normally not sufficiently active in children with the disorder. “The active ingredient does not change the character of a child. It rather enables the child to behave in a manner similar to the one the child would have without suffering from the disorder”, says Skrodzki, who is also the chairman of the German Consortium ADHD of Paediatricians (Arbeitsgemeinschaft ADHS der Kinder- und Jugendärzte).He has often heard mothers say that since the child takes the drugs they feel for the first time that it really listens to them. However, even though all affected children must be treated, not every child needs drugs. “It is also possible to have `a little ADHD´”, states Skrodzki.

Many children with ADHD can discontinue the drug when older and are than able to lead a normal life. If the disorder remains undetected however one third of the children fails to graduate from school, according to Skrodzki. The risk of committing a crime is increased. He doesn´t think that the disorder is a temporary fashion: “It is only fashionable to be interested in ADHD, not the disorder itself.”

In order to spot ADHD and to be able to treat it correctly doctors have to continue their education. Therefore Skrodzki and PD Dr. Klaus-Peter Grosse conduct a seminar with the title “Attention-Deficit Hyperactivity Disorder – social phenomenon or medical problem” within the MEDICA congress. Skrodzki hopes that the participants will have an aha experience. “The best thing would be if the people left the seminar and thought: now I know what ADHD is and how it can be treated.” During the three hours different types of the disorder will be presented in films and cartoons and the physicians will come to know which therapies are reasonable and which aren´t - like algae as dietary supplements.