Understanding the overactive child

by Dr. R.A.R. Perera

A typical overactive child is about 3-7 years old and has an excessive general overactivity, is restless, and has constant and impulsive behaviour. This impulsive behaviour includes running, climbing and restless movements without any preparation or thought. In later childhood or adolescence, the behaviour may consist of an inability to sit still, getting up and down constantly, and fidgeting. Some of these children are described as if 'driven by a motor', they wear out shoes and clothes, and are prone to accidents.

Over activity in a child may simply be a reflection of high energy levels in otherwise well adjusted children, it could be an expression of agitation and anxiety in children with emotional disorders, or it can feature in children with a psychiatric condition like autism. Such children have difficulties in sustaining attention to tasks (especially in the class room), are easily distracted by stimuli and often have difficulty, following through a task. Their performance deteriorates in unsupervised situations. They have a short attention span.

These problems present particular difficulties in the classroom and contribute to the learning problems of the hyperactive child. Hyperactive children are described as impulsive, interrupting others, and having difficulties in waiting turns. They are careless and lose things, or dash heedlessly to the road. The symptoms are made worse in a large class and may not be apparent in a one-to-one situation. They are unable to tolerate frustration, have sloppy schoolwork and poor writing, and impulsive fighting. They also make thoughtless remarks.

Hyperactive children have difficulties in accepting social rules, such as cooperation, sharing, giving away, playing fair and accepting defeat. This leads to rejection by other children. Most of the hyperactive children behave in an antisocial way and by late childhood, the antisocial behaviour tends to be more of a concern than the hyperactivity. Aggression, rebelliousness and defiance leaf to conflict with parents, teachers and friends.

Over activity usually decreases with age, and is occasionally substituted by hypo activity during adolescence. However, about one-third of affected children will continue to show hyperactive features into late adolescence. These children will have low self-esteem, antisocial behaviour and difficulty in schoolwork.

Psychological treatment of these children includes behaviour modification therapy, which is very useful to control specific problems. The nature of the disorder and the importance of structuring the child's environment should be explained to the parents, so that regular daily routines and firm limits to behaviour can be set.

It is very important to avoid over-stimulation, excessive fatigue and situations known to cause difficult behaviour. Changing the residence to a place with enough garden space can help overcome this difficulty. Medications, for a short period is helpful in some overactive children.

The immediate families of hyperactive children have an increase incidence of alcoholism, anti-social personality and hysteria. Minor physical abnormalities like ear lobe deformities could be present in these children.

Disagreements or lack of mutual support between parents in the control of their children can contribute to a child's over-activity. Sometimes the parents also need antidepressant medication to overcome their difficulties, due to long-term handling of these children.