Dear Counsellor,

First permit me please to congratulate you on your decision to use this medium to communicate with your wide-ranging readers, some of whom I'm sure (myself included) may wish to retain your advice for later review/reflection.

I am now writing to seek your advice on parenting children who are lethargic and underperforming.

- Maureen

Dear Maureen,

I wish to thank you for your kind comments about my column. Today, we will look at the lethargic, underperforming child.

It is a challenge to parent children and whenever you have one who is not working to his/her potential, then parents, teachers and caregivers are put under stress. The problem can be either physical or psychosocial. As with any problem solving, one has to look for reasons why a child is having the problem. There are several reasons a child may be lethargic and underperforming.

The child requires a medical evaluation by a doctor to determine the medical reasons. A complete history and physical examination will rule out the possible causes. Certain investigations may need to be done to help the process.

healthy lifestyle

It is therefore important that children get a medical examination on a yearly basis and attention paid to nutrition, exercise and activities for a healthy lifestyle. The other causes include depression, anxiety, attention deficit hyperactivity disorder - inattentive-type learning disabilities and mental retardation. The child may have schizophrenia or sleep deprivation. The child may be tired or exhausted and easily fatigued.

Child abuse and violence in homes and communities impact greatly on the health of children. Children who don't have breakfast or lunch will tire easily and are unable to perform at home or school. A detailed psychological evaluation is therefore mandated to identify the possible factors and stresses that are impacting the child. A simple thing like lack of adequate sleep can be cured by restoring a proper bedtime. The psychological and social factors will require intervention and management to aid the healing process. Medications as well as counselling are some measures which can be used.

Parents should be close to their children so that they can identify early-warning signs of problems. Lots of warmth and attention with discipline and love go a far way to meet the needs of the children. Rewards and positive reinforcement are important to maintain motivation in an underachieving child.

Breakfast in the morning, lunch money for a nutritious meal, nutritional supplements, and a balanced meal with an annual check up is vital. Children should be involved in sports and other extra-curricular activities to build confidence and self-esteem. An early bedtime after completing work is also important. Parents must always ensure that children have the relevant books and equipment and that homework is completed neatly and accurately. Parents must meet with the teacher regularly to collaborate for the welfare of the children.

Parenting is a task that requires the linkage of caregivers and professionals for the optimum outcome of the children.

Attention deficit disorder

Dear counsellor,

I am interested in learning about attention deficit hyperactivity disorder (ADHD). I teach a lot of children who I think have ADHD.

- Lois.

Dear Lois,

ADHD is a common condition that interferes with the learning capacity of students. It is good that you are interested in ADHD as it is a common condition in the classroom and many times, that diagnosis is not considered. Most times, these children are considered rude or lazy.

The features of ADHD are inattention, hyperactivity, distractibility and problem with impulse control.

Boys are more affected than girls. These children have a great difficulty in staying in their seat in class, are very talkative and do not complete their academic assignments. They are easily distracted and tend to drift from task to task. Teachers have great difficulty in getting the children to remain seated and quiet. Many times, there are several children in a class with this condition. This makes the teachers' job very challenging.

ADHD coexists with learning disorder and so these children have an additional reason for not doing well. Learning disorders are conditions in which the children have difficulty in learning English, maths and writing. These children fall under the heading of special education so individualised education plans need to be put in place for them.

get involved

Parents need to be involved in the teaching of these children. Many times, a tutor is needed to provide one-on-one instructions. Parents need to supervise the children at home so that homework is completed and reading assignments done.

On suspicion of a problem, the class teacher should refer the child to an assessment centre so that the state of affairs can be fully delineated. Many children need to be on medication which will calm them and help them to focus on their academics. Children on medication do well in the classroom and get scholarships base on merit.

Children with ADHD can be quite loving and helpful. They, however, have difficulties with peers as they are interfering and inattentive. They get depressed and/or anxious and have problem with self-esteem. Students and friends call them names like 'Maddie, Maddie' and 'Loony'. These children tend to be marginalised and are at risk for academic failure, substance abuse, suicide and criminal activities.

Dr Yvonnie Bailey-Davidson

978-8602, 791-1778

yvonniebd@hotmail.com