By The Nation
Thonburi Healthcare Group
Dr.Tanatip, this centre has three major sections. The first section is for sick children, who need treatment for cold and coughing or diarrhea or any other acute illness. The second part of this centre is for well children who need vaccinations and other services. They are separate to prevent infection and other problems.
The third section is aimed at child development issues, which have become more important due to the rising number of medical issues affecting kids during their early years.
Among the top issues are Attention Deficit Hyperactivity Disorder (ADHD), child obesity and Obsessive Compulsive Disorder, or Nomophobia (no mobile phone phobia) or computer game addiction or slow reading development.
What are the major changes over the past 30-40 years regarding medical issues among kids? In my opinion, there are two big changes. First, medical problems which were previously not widely recognized have become more apparent. For example, our generation had some friends in school who probably suffered from the attention deficit and hyperactivity problem (30-40 years ago). There were neither diagnosis nor treatment back then.
However, we’re now better equipped to deal with this kind of problems. The class’s teacher would have reported to parents any kids who are suspected to have this problem. Parents are often advised to see the pediatrician.
Another change is that we have observed some relatively new medical issues such as child obesity or even obsessive compulsive disorder. In the older days, overweight kids, for example, were rare as more kids had suffered from malnutrition. So back then we talked about better nourishment. Now, the opposite is true, over-eating as well as insufficient physical activity are the problems.
Medical issue among kids in Thailand when compared to those in other countries, are there any significant differences? Dr Tanatip, the world has become smaller due to technology advances. Developed and developing countries mostly have the same digital gadgets such as Internet and smart phones or Ipads or more ready-to-eat meals at convenient stores next door.
The current generation are less physically active and some stay in smaller places such as condominium units with no or little space for an active lifestyle, while both parents usually work so they have less time for kids.
Next, we will talk to specialist doctors covering each of the medical issues mentioned earlier. First is the Attention Deficit Hyperactivity Disorder (ADHD).
Here is Dr Chalermphol, the pediatrician, what’s the definition of this medical issue. Dr Chalermphol, parents usually tell me that their kids might be hyperactive from a very young age as they could play around non-stop without being exhausted.
In the older days, some people thought hyper-active kids were probably smart kids but some of these so-called smart kids were in fact suffering from the attention deficit problem.
Since they are hyperactive, they also disturb the class and teachers may not be able to handle them. Some also abuse their classmates.
Teachers should report such as a problem to parents so that they may see the doctors. Parents who have multiple children may notice that one of them is rather hyperactive compared to the rest or the teachers would in some cases ask the parents to see the doctors before having the kids back to the classroom.
What is the definition of ADHD and its diagnosis? Dr Chalermphol, ADHD in very young kids is obvious when kids have little or no self control largely due to a chemical imbalance in the brain where concentration is managed.
There are varying degrees of ADHD patients, starting from mildness to a serious level. Symptoms are consistent hyperactivity, restlessness, impulsiveness, lack of a focus. Some kids have problems at school in terms of inability to follow the lessons or play too hard with classmates.
In these cases, parents should bring their kids to specialists on child development. In serious cases, these kids could not act normally in class, or they have to walk around or they would just physically abuse other kids due to the lack of self-control.
Many of these kids also perform badly in class with low grades due to the inability to focus for an extended period. Their attention span is very short so learning is a big challenge for them. In short, kids who can focus for a reasonable amount of time can learn better.
What is the treatment plan for those diagnosed with ADHD? Dr Chaelermphol says parents should be cautious especially when their kids have problems at school.
In some cases, kids may have some inclinations such as they may like maths more than other lessons that need a lot of reciting or they may like some teacher characters and hate the others.
As a result, we have to find out if they are really ADHD sufferers or they are affected by other factors as mentioned. If the kids are confirmed to be ADHD, parents and teachers need to be involved in helping the kids. Basically, we try to help kids manage their weaknesses while strengthening their positive behaviors so they can adapt and lead a more normal lifestyle at home and at school.
In some cases, we also need medication to tackle the brain chemical imbalance.
What is the heredity factor? Dr Chalermphol, we could say that this is a major factor as we often learn that parents who are ADHD usually have a higher probability that one of their kids could also suffer from ADHD.
As a result, we often ask parents if they used to experience some forms of ADHD when they were young. However, the body of ADHD knowledge is quite new so we are still learning about this medical issue. Many parents told me that they faced a lot of difficulties at learning during their school years. Some said when they grow up they still have some of these symptoms or tend to make impulsive decisions.
Sometimes, they find it hard to stick to a long-term plan.
What is the timeline of ADHD from a young age to adulthood? Dr Chalermphon says we can expect the brain function to improve when kids get older as can observe from previous generations. When you get older, you tend to have less problems with ADHD.
For ADHD in adults, they are more obvious in terms of emotional rather than physical areas.
Besides heredity, ADHD has other causes. For example, kids who are born significantly prematurely could suffer from ADHD or kids who have brain damage.
In fact, brain function development started long before kids are born. As a result, a pregnant mother who smokes or drinks alcohol would hurt their unborn baby who will likely suffer from ADHD.
As a result, pregnant women are advised to refrain from smoking and alcoholic consumption while fathers are also advised to stop smoking since second-hand smoking has similar adverse effects on unborn babies.
What is the ratio of ADHD cases in Thailand? The findings show that over 10 per cent. The sooner we diagnose ADHD cases, the less severe consequences are found among kid patients. However, if left untreated for a long time, the consequences could be more serious.
Just imagine if ADHD kids are not treated, they could face psychological effects from their inability to focus such as punishment from adults. These are good kids but they don’t follow instructions due to the inability to focus and listen attentively.
So the kids are under constant pressure to conform leading to problematic relationship with their parents or teachers and later on emotional problems as well as aggression.
It’s the duty of parents to observe their kids’ behavior closely, especially when they start school or around kindergarten level 3. More serious ADHD cases could be seen at an even younger age.
Digital technology has a significant impact on people’s lifestyle. Dr Chalermphol, please explain Nomo-phobia or the so-called no mobile phone phobia. This means people are anxious when their mobile phones are not around.
Due to the current lifestyle, you and me are often worried if personal smartphones are not handy. In many cases, people feel lonely when they do not have smartphones with them. In serious cases, they suffer from acute moodiness when there is no Internet connectivity or their phones are lost or batteries are out. Some also have headaches or stomach pain.
The suffering is obvious among those who use smartphones many hours a day. Teenagers are most vulnerable to this Nomo-phobia, aged 18-24. About 70 per cent of this age group are found to have suffered some degree of this Nomo-phobia.
Some adults also have suffered such as an anxiety. We think this stems from the lack of self-confidence when their smartphones are not around and usable.
Some people are worried that if they are in trouble they could not ask for help. Another factor is the rise of social media. People want to know what happens instantly or learn the latest about their friends or their communities so when they don’t have smartphones or connectivity they suffer.
They feel they are left out if unable to check Facebook or Instagram as often as they like. That’s a new phenomenal.