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.