ADHD in Children

ADHD in Children: A Parent’s Guide by Dr XL Jingxi, Specialist Paediatrician in Mthatha

As a Specialist Paediatrician in Mthatha, I often meet parents who are worried because their child is struggling to concentrate, constantly moving, acting impulsively, falling behind at school, or being described as “naughty” when something deeper may be going on. One of the conditions that can affect a child’s behaviour, learning, emotions and confidence is Attention-Deficit/Hyperactivity Disorder, commonly known as ADHD.

ADHD is not simply bad behaviour. It is not caused by poor parenting, laziness or a lack of discipline. ADHD is a recognised neurodevelopmental condition that affects how a child’s brain manages attention, activity levels, impulses, organisation and emotional regulation. With the right assessment, support and treatment plan, children with ADHD can do well at home, at school and socially.

At my paediatric practice at Herolim Private Hospital in Mthatha, I support families from Mthatha, Kokstad, Libode, Tsolo, Qumbu, Ngqeleni, Mqanduli, Port St Johns, Lusikisiki, Flagstaff, Mount Frere, Mount Ayliff, Ntabankulu, Idutywa, Elliotdale and surrounding areas who are concerned about ADHD symptoms, school difficulties and child development.

What Is ADHD?

ADHD stands for Attention-Deficit/Hyperactivity Disorder. It is a condition that usually begins in childhood and may continue into adolescence and adulthood. A child with ADHD may have difficulty paying attention, sitting still, waiting their turn, following instructions, completing schoolwork, organising tasks or controlling impulses.

Every child can be energetic, distracted or forgetful at times. The difference with ADHD is that the symptoms are persistent, occur in more than one setting, such as home and school, and interfere with the child’s daily functioning, learning or relationships.

ADHD can present in different ways. Some children mainly struggle with attention and focus. Others are more hyperactive and impulsive. Some children have a combination of both.

Common Signs of ADHD in Children

Parents often notice ADHD when a child starts school, because the classroom requires sitting still, listening, following instructions and completing tasks. However, signs may be present earlier.

A child with ADHD may:

Struggle to pay attention during lessons or homework
Make careless mistakes in schoolwork
Seem not to listen, even when spoken to directly
Start tasks but not finish them
Lose school items, books, toys or clothing often
Be easily distracted by small things around them
Avoid tasks that require long mental effort
Forget instructions, chores or daily routines
Fidget, tap, move around or struggle to sit still
Run, climb or move excessively in inappropriate situations
Talk excessively or interrupt others
Struggle to wait their turn
Act before thinking
Become easily frustrated or emotional
Have difficulty following classroom rules
Struggle with friendships because of impulsive behaviour

Some children with ADHD are not obviously hyperactive. This is especially important because quieter children, including some girls, may be missed. They may appear dreamy, forgetful, disorganised, slow to finish work or overwhelmed by instructions.

ADHD Is Not the Same in Every Child

One of the most important things I explain to parents is that ADHD does not look the same in every child. Some children are constantly on the move. Others sit quietly but cannot focus. Some perform well in certain subjects but struggle in others. Some children can focus for long periods on activities they enjoy, such as games, TV or building toys, but cannot maintain attention on schoolwork.

This does not mean the child is choosing when to concentrate. ADHD affects attention regulation. A child may focus intensely on something highly stimulating but struggle with tasks that require sustained effort, planning or delayed reward.

This is why children with ADHD are sometimes misunderstood. They may hear comments such as “you are not trying,” “you are lazy,” or “you are being difficult.” Over time, this can affect their self-esteem. Early recognition and compassionate support can make a meaningful difference.

When Should Parents See a Paediatrician About ADHD?

Parents should consider booking a consultation with a paediatrician if attention, hyperactivity or impulsivity is affecting the child’s school performance, behaviour at home, emotional wellbeing or social relationships.

You should seek medical guidance if your child:

Is struggling significantly at school despite support
Cannot concentrate long enough to complete age-appropriate tasks
Is frequently in trouble for impulsive behaviour
Is very forgetful or disorganised
Has difficulty following instructions
Becomes easily frustrated, angry or overwhelmed
Has poor sleep, anxiety or emotional outbursts
Is being labelled as “naughty” but may be struggling to cope
Has learning difficulties or developmental concerns
Has symptoms that are present both at home and at school

A proper assessment is important because ADHD symptoms can overlap with other conditions, including anxiety, sleep problems, hearing or vision difficulties, learning disorders, trauma, emotional stress, autism spectrum disorder and other developmental concerns. The goal is not to label a child quickly, but to understand the full picture.

ADHD and School Performance

Many children with ADHD are bright and capable, but their school performance may not reflect their true ability. A child may know the answer but forget to write it down. They may understand the work but fail to complete tasks. They may study but lose marks because of careless mistakes. They may struggle to copy from the board, finish tests on time or remember homework.

Teachers may report that the child is distracted, disruptive, forgetful, always moving, not listening, careless or underperforming. These observations are important because ADHD must be understood across different environments.

Parents in Mthatha, Kokstad and surrounding areas often come for help after repeated school concerns. This is a good time to involve both the family and the school so that the child can receive appropriate support.

How ADHD Is Assessed in Children

An ADHD assessment is a careful process. It is not based on one symptom or one difficult week. During a consultation, I take a detailed history from the parent or caregiver and consider the child’s development, medical history, behaviour, sleep, school performance, emotional wellbeing and family context.

An ADHD assessment may include:

A detailed discussion with the parent or caregiver
Review of symptoms at home and school
Teacher feedback where possible
Developmental and medical history
Screening for learning difficulties or other developmental concerns
Assessment of sleep, hearing, vision and general health where needed
Consideration of emotional, behavioural and social factors
Use of standardised ADHD rating scales when appropriate

The aim is to understand whether the child’s difficulties are consistent with ADHD and whether there are any additional concerns that need support.

ADHD Care in Mthatha, Kokstad and Surrounding Areas

Families searching for a “paediatrician near me,” “Paediatrician Mthatha,” “ADHD doctor near me,” or “ADHD assessment for children” often want a doctor who understands both child health and child development.

Dr XL Jingxi is a Specialist Paediatrician based at Herolim Private Hospital in Mthatha, providing paediatric care for children from Mthatha and surrounding areas, including Kokstad, Tsolo, Libode, Qumbu, Ngqeleni, Mqanduli, Port St Johns, Lusikisiki, Flagstaff, Mount Frere, Mount Ayliff, Ntabankulu, Idutywa, Elliotdale and nearby communities.

If you are concerned about your child’s attention, behaviour, school performance, hyperactivity, impulsivity or emotional regulation, an assessment can help identify the best way forward.

Why Early ADHD Support Matters

When ADHD is not recognised, a child may be punished for symptoms they are struggling to control. This can lead to poor self-confidence, school failure, family conflict and emotional distress. Early support can help the child understand themselves better and develop skills that improve learning and behaviour.

The aim of ADHD care is not to change a child’s personality. Many children with ADHD are creative, energetic, curious, warm, humorous and full of potential. The goal is to help them manage the parts of ADHD that interfere with their daily life.

Can ADHD Be Treated?

Yes. ADHD can be managed. The treatment plan depends on the child’s age, symptoms, school challenges, emotional needs and family situation. A good ADHD plan is usually not one single intervention. It often includes parent guidance, school support, behavioural strategies, lifestyle routines and, where appropriate, medication.

Treatment and support may include:

Parent education about ADHD
Practical behaviour strategies at home
Classroom support and teacher communication
Structured routines and clear expectations
Positive reinforcement and reward systems
Sleep and screen-time guidance
Support for emotional regulation
Assessment for learning difficulties
Medication when clinically appropriate
Follow-up care to monitor progress

Medication is not always the first or only answer. For some children, behavioural and school-based support may be very helpful. For others, medication may be considered as part of a broader treatment plan when symptoms are significantly affecting learning, behaviour or daily functioning. This decision should always be made carefully with a qualified healthcare professional.

Practical Tips for Parents Supporting a Child With ADHD

Parents play a powerful role in helping a child with ADHD succeed. Small changes at home can reduce frustration and improve cooperation.

Helpful strategies include:

Keep routines predictable, especially mornings and bedtime
Give one instruction at a time
Use short, clear sentences
Break homework into smaller sections
Allow short movement breaks during tasks
Praise effort and progress, not only results
Use visual reminders or checklists
Reduce distractions during homework
Keep school items in the same place daily
Prepare bags and uniforms the night before
Avoid constant criticism
Focus on connection before correction

Children with ADHD often receive more negative feedback than other children. Encouragement, structure and patience can help them feel understood rather than constantly corrected.

Supporting ADHD at School

School support is an important part of ADHD management. Teachers can help by using practical classroom strategies that improve attention and reduce overwhelm.

Support may include:

Seating the child closer to the teacher
Giving instructions in smaller steps
Checking that the child understands the task
Allowing short breaks where appropriate
Providing extra time for certain tasks when needed
Reducing unnecessary distractions
Using a homework diary or communication book
Encouraging positive behaviour with praise
Helping the child organise books and assignments

A child with ADHD does not need to be made to feel different or incapable. With the right support, many children become more confident, more organised and more successful in the classroom.

ADHD and Emotional Wellbeing

ADHD affects more than concentration. Many children with ADHD struggle emotionally because they are often corrected, misunderstood or compared to other children. They may feel embarrassed, rejected or frustrated. Some may develop low self-esteem, anxiety, anger outbursts or avoidance of schoolwork.

This is why compassionate care is essential. A child with ADHD needs understanding, not shame. Parents also need support because raising a child with ADHD can be emotionally exhausting when there are constant school complaints, homework battles or behaviour concerns.

As a paediatrician, my approach is to support both the child and the family. The goal is to help parents understand what is happening, guide the child with kindness and structure, and work towards realistic improvements.

Supporting ADHD at School

ADHD in Toddlers and Preschool Children

Young children are naturally active and curious, so ADHD can be more difficult to assess in preschool years. Not every busy toddler has ADHD. However, some children show levels of impulsivity, activity or inattention that are far beyond what is expected for their age.

Parents should seek advice if a young child is extremely difficult to settle, constantly unsafe because of impulsive behaviour, unable to engage in age-appropriate play, very delayed in communication or development, or showing behaviour that causes major concern at home or preschool.

Early assessment can help identify whether the concern is ADHD, a developmental delay, speech and language difficulty, autism spectrum disorder, emotional stress or another medical issue.

ADHD in Teenagers

ADHD can continue into adolescence. Teenagers may become less visibly hyperactive, but still struggle with planning, time management, studying, forgetfulness, emotional regulation and impulsive decision-making.

In high school, ADHD may show as:

Poor organisation
Missed assignments
Procrastination
Difficulty studying independently
Forgetting deadlines
Emotional outbursts
Low motivation
Risk-taking behaviour
Poor sleep habits
Declining school performance

Teenagers with ADHD need respectful support. They should be included in discussions about treatment, routines and school strategies so that they feel involved rather than controlled.

Book an ADHD Consultation with Dr XL Jingxi

If your child is struggling with concentration, behaviour, learning or emotional regulation, you do not have to wait until the problem becomes overwhelming. Early guidance can help you understand your child’s needs and put the right support in place.

Book a consultation with Dr XL Jingxi, Specialist Paediatrician in Mthatha at Herolim Private Hospital, for a compassionate and thorough assessment of ADHD symptoms and related child development concerns.

Your child is not lazy. Your child is not hopeless. With the right support, children with ADHD can grow in confidence, improve at school and thrive in daily life.

Schedule a visit

Thank you for your interest in Herolim Private Hospital. We value your feedback, inquiries, and concerns. Please feel free to reach out to us

Dr. XL

Jingxi

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