A Word with the DOCTOR
by Dr John Winsor
The Sunday Times of Malta

CHILDREN who can never sit still cause great disruption both at home and outside.
I see them in the surgery. All is relatively quiet until a small package of human energy rushes in. Mother looks exhausted but the child is full of life and only manages to sit down for about three seconds before rushing around again.

Next thing, you know, the consulting room looks as if a bomb has hit it. The paper clips on the desk are scattered, plants are knocked over and the child has climbed onto the window frame and jumped up and down on my weighing scales before I can say "good morning".

My first thought is that this wilfully disobedient child is suffering from lack of parental discipline. But when it is obvious that the parents are trying their best to control the child - and the child doesn't take a blind bit of notice -- there could be another underlying problem.

Some parents, teachers and doctors label children like this as "over-active" but it is best not to bundle them all under one label. There appear to be three types of problems: simple overactivity, hyperactivity or short attention span and the hyperkinetic child, who lacks any attention capability.

The child who is just full of energy needs firm handling and may well grow out of it. About one in 20 children have a permanent short attention span and cannot concentrate for more th an a few moments on anything. Psychiatrists call this "core attention deficit" and these children are often aggressive, disobedient, bad-tempered and accident prone.

Real hyperactive children number about one in 200. Their minds flit from one thing to another and their attention span is very short.

The real test to determine if your child is hyperactive rests on whether they can read a book, watch TV or assemble a constructive toy such as Lego and concentrate long enough to learn from the activity.

The cause of this extreme overactivity depends on many factors, ranging from problems at birth, slow language learning, clumsiness and behavioural difficulties.

Parents often think hyperactivity stems from something in the diet. This is frequently misleading as they miss other avenues of help. Food allergies causing hyperactivity are rare.

Special diets only help a few but the results are dramatic and are usually seen in children who are exhibiting other symptoms of allergy, such as wheezing and rashes.

Doctors tend to under-diagnose these problems. All over-active children need psychiatric and educational assessment and parents need counselling and advice on how to manage the tricky problem.

Paradoxically, stimulant drugs - which you'd expect to make things worse - sometimes bring an improvement.