Most people with ADHD have problems that fall into both these categories, but this isn’t always the case.
For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness. This form of ADHD is also known as attention deficit disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.
Symptoms in children and teenagers
The symptoms of ADHD in children and teenagers are well defined, and they’re usually noticeable before the age of six. They occur in more than one situation, such as at home and at school.
The main signs of each behavioural problem are detailed below.
The main signs of inattentiveness are:
having a short attention span and being easily distracted
making careless mistakes – for example, in schoolwork
appearing forgetful or losing things
being unable to stick at tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
constantly changing activity or task
having difficulty organising tasks
Hyperactivity and impulsiveness
The main signs of hyperactivity and impulsiveness are:
being unable to sit still, especially in calm or quiet surroundings
being unable to concentrate on tasks
excessive physical movement
being unable to wait their turn
acting without thinking
little or no sense of danger
These symptoms can cause significant problems in a child’s life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.
Related conditions in children and teenagers
Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:
anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals depression sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns autistic spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour epilepsy – a condition that affects the brain and causes repeated fits or seizures Tourette’s syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics learning difficulties– such as dyslexia
Symptoms in adults
In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.
ADHD is a developmental disorder; it’s believed that it can’t develop in adults without it first appearing during childhood. But it’s known that symptoms of ADHD often persist from childhood into a person’s teenage years, and then adulthood.
Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood.
By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives.
The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children.
For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.
Some specialists have suggested the following list of symptoms associated with ADHD in adults:
carelessness and lack of attention to detail
continually starting new tasks before finishing old ones
poor organisational skills
inability to focus or prioritise
continually losing or misplacing things
restlessness and edginess
difficulty keeping quiet and speaking out of turn
blurting out responses and often interrupting others
mood swings, irritability and a quick temper
inability to deal with stress
taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving dangerously
Additional problems in adults with ADHD
As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions.
One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include:
personality disorders – conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others bipolar disorder – a condition that affects your moods, which can swing from one extreme to another obsessive-compulsive disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job.
A couple of days ago I was having a chat with an old college buddy. He mentioned that he had become intolerant to gluten and that his doctor had put his on a gluten free diet. He then mentioned that he noticed that it had significantly improved his mild symptoms of ADD. To be fair I didn’t know he had ADD.
Now over the years a lot of research has been done on the relationship between bowel disorders and autism. And there certainly seems to be some kind of relationship. This research was certainly interesting!
So I thought I would open it up to my readers and find out if they felt diet had had any effect on their signs and symptoms of ADHD, autism and ADD. Firstly it would be great if you could take the poll below.
Second could you use the comments section below to tell us a bit more about your story! You might want to consider some of the following questions but everything you have to say is of great interest!
a) What was the original diagnosis of you or your loved one?
The costs of raising a child on the autism spectrum varies from one country to another. But we though it would be useful to share Iris Lee’s article on the cost of bring up a child with ASD in Malaysia.
Close to 30,000 children with disabilities were registered in Malaysia in 2012, and 19,150 of them were children with learning disabilities, according to UNICEF’s record.
Learning difficulties are intellectual capabilities that are not on par with a person’s biological age, such as Down Syndrome, Late Global Development, Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and dyslexia.
According to BERNAMA’s report in 2014, it is estimated that one out of every 600 children in Malaysia is born with autism. The article also shared recent statistics that revealed about 47,000 of the people in this country are autistic, with an estimation of four out of every 10,000 suffering from severe autism.
Autism is increasingly common today. Having a child with special needs often leads parents to a path that is riddled with frustration, difficult decisions, interfaces with various professionals and specialists, and endless research for better understanding and alternatives. A lot of the stress of this comes from the fact that all these things add onto the already heavy financial burden of raising a child.
According to an article published by Time Money in 2014, the cost of caring for an autistic individual over his or her lifetime in the US is US$1.4 million (RM5.4 million), based on a medical journal by JAMA Pediatrics.
This eviscerating cost of raising your special needs child can sometimes derail your family’s long-term financial goals. Knowing your options and how much they cost may help you in managing and balancing your finances.
We spoke to parents of autistic children in Malaysia to find out the financial story behind their unique family and the costs involved:
Often parents are the first people who notice something is amiss with their child. According to Autism Speaks, some of the early signs of autism are failure to make eye contact, being unresponsive to his or her name or the tendency to play with toys in unusual, repetitive ways.
In today’s clinical advancement and awareness, diagnosis of disorders like Autism Spectrum Disorder (ASD) is more common than before, and the chances of a professional diagnosis early on are also higher.
However, it wasn’t the case for a mother of an 8-year-old autistic child, Emily Loo, when her first child, J* was diagnosed at three years old, in 2010.
After going to a few places, J was finally brought to a Defeat Autism Now (DAN) doctor in Singapore for a full diagnosis and treatments. They spent S$600 (about RM1,417.10 at 0.4234 exchange rate in 2010) for the diagnosis, which includes the following:
1) Heavy Metal Testing -Hair Analysis
2) IGG Asian Food panel for 96 food items
3) Comprehensive Stool Analysis
4) Urine Organic Acid Test
Total cost of diagnosis:
This was what Loo paid for back in 2010, and it did not include the cost of other places she went to before, while in search for an answer nor the cost of going down to Singapore itself. Today, the diagnosis might cost more due to medical inflation, but you might save more on transportation as diagnosis can be easily availed in Malaysia these days. In most cases though, you may still want to get multiple opinions before arriving at a conclusion.
Most ASD cases require life-long treatments. After diagnosis, children suffering from this disorder may have to return for doctor’s visits to ensure that their body is coping with the many supplements they are taking.
One known intervention used on ASD individuals is the biomedical intervention. Based on the National Autism Association of Northwest Indiana, “biomed utilises standard medical tests to detect such things as: excessive amounts of bad bacteria in the gut, parasites, yeast, viruses, food allergies and heavy metal toxicity. These tests point out immune system dysfunction, metabolism abnormalities and underlying biochemical imbalances which are the cause of these medical problems and lead to autistic symptoms.”
J was put on biomedical intervention as soon as diagnosed, and the regular consultations and tests with the doctor cost about RM1,200 for each visit to Singapore.
These visits were scheduled for once every four months initially, then reduced to once every eight months, and eventually they stopped going to Singapore in 2012 when Loo found another DAN doctor in KL.
The local DAN doctor charged RM900 per hour, and they were scheduled for an hour session once every five months. Depending on the supplements prescribed to the child, the doctor might require the child to undergo a few tests, which cost about RM1,000 at Pantai Hospital Kuala Lumpur then. The tests were done to determine that the child’s liver is able to cope with the many supplements he/she is taking.
Cost for biomedical intervention (including tests) in Singapore:
RM1,200 x 3 times a year
= RM3,600 a year
Cost for biomedical intervention in Kuala Lumpur:
RM900 x 2 times a year
= RM1,800 a year
Cost of prescribed tests in Kuala Lumpur:
On top of the medical bills, there are many therapies and classes that children with autism are encouraged to go through to help them cope with their disorder and to eventually be independent. One of the most common therapies that autistic children subscribe to is the Applied Behavioural Analysis (ABA) therapy.
According to Behavioural Neurotherapy Clinic in Australia, “ABA therapy is based on the principle that influencing a response associated with a particular behaviour may cause that behaviour to be shaped and controlled. ABA therapy is a mixture of psychological and educational techniques that are tailored to the needs of each individual child to alter their behaviours. ABA involves the use of behavioural methods to measure behaviour, teach functional skills, and evaluate progress.”
Home-based ABA therapy costs about RM650 for J initially when they started out with two therapists, two hours each and four times a week. This was inclusive of the supervisor fee of RM90 per hour for once a month at the beginning.
When they saw improvement in the child, Loo and her husband increased the hours to three therapists for six hours a day and five days a week. This cost RM1,050, excluding the supervisor fee, which came for an hour once every two months (RM90 every two months).
Estimated cost for ABA therapy:
RM1,050 a month
Estimated supervisor fees:
RM90 every two months
Other therapies include Occupational Therapy (OT), which is important to an ASD child as it promotes, maintains, and develops the skills needed by them to be able to function well in a school setting and beyond. Therapist helps these children to develop skills for handwriting, fine motor skills and daily living skills. OT in Malaysia costs about RM120 per session. That would come up to RM480 for four sessions a month.
In severe cases of autism, the child can be non-verbal. Speech therapy helps autistic children to improve their verbal communications, and in severe cases, communications skills to help non-verbal children express themselves.
Loo also sent J for speech therapy once a week, at RM350 for assessment, RM135 per hour session, once a week. The cost came up to RM540 a month, and a one-time fee of RM350.
Another mother, Tan Wee Ling, a mother of a seven-year-old autistic son, enrolled him to speech therapy as well. According to Tan, speech therapy cost about RM70 per half an hour.
Education is one of the most important steps to preparing your special needs child’s future. Some of the main criteria a parent looks out for when choosing a school for their ASD kids are the teachers/therapists’ expertise in the field, cost, environment and facilities in the school. On top of this, location also plays quite an important factor.
Though special needs Malaysians who are enrolled in a national school are entitled to an allowance of RM150 from the government every month, parents still opt for private education for their special needs children mainly due to the lack of experienced teachers and facilities in national schools.
Private special needs education is expensive, and inclusive education where special needs children are able to learn together with neurotypical children is hard to come by.
Although generally private special needs education is more expensive than private schools for neurotypical children, comparing costs of the many special needs schools can still help you find one that will fit your budget.
Sending her son to school costs Loo about RM4,000 a month for half-day programme, and an additional RM1,500 every six months for other miscellaneous charges.
Mark Jackson, a father of a 13-year-old child diagnosed with autism and multiple disorders (speech and occupational), spends about RM4,500 a month on school fees. However, as the school his son attends also provide speech and occupational therapies, he does not need to fork out additional money for these therapies outside of school.
According to the Journal of Music Therapy 2004, music was found beneficial as interventions for children and teens with ASD. It was found to improve social behaviours, increase focus and attention, improve communication such as vocalisations, verbalisations, gestures, and vocabulary, reduce anxiety, and improve body awareness and coordination.
As such, Tan enrolled her son for music classes which sets her back by RM180 a month.
Children with autism benefit greatly from physical activity such as swimming, as they can help them improve speech, coordination, social skills, self-esteem, and cognitive processing (Autism Spectrum Disorder Foundation (ASDF)).
All three parents interviewed send their children to swimming classes, specialised in special needs children. This can cost about RM200 a month.
Though, these fees are not much higher than what you would pay to send a neurotypical child to these classes, they are more important to ASD children compared to other children. Missing classes or opting out of these classes may affect the child’s improvement.
Cost of extra-curricular classes:
RM530 a month
Gym fee is based on a gym in Bandar Sunway, swimming is based on the rate of a specialised special needs swimming instructor in Bangsar.
Autism is a complex disorder, and many interventions include elimination of allergens such as gluten and casein from the child’s diet. According to Autism Research Institute, dietary intervention is a medical approach with convincing practical evidence that special diets help many with autism. What this means is, without following the right diet, medical treatments might not be as effective.
Many parents of ASD children observed behavioural improvement when their children eat a gluten- and casein-free diet. Gluten is found primarily in wheat, barley and rye, while casein, in dairy products.
Loo, believes this helped J, and she constantly stocks up on such food. Initially, when they used to go to Singapore for J’s medical follow-up consultation, she would stock up on gluten- and casein-free food products there, as these products were not easily available in Kuala Lumpur back then. She spent RM300 on these every visit.
As these products became more commonly available in Malaysia, she started shopping for the specific food for J in Malaysia. However, with inflation, the cost of food has also increased. When J was still on gluten- and casein-free diet, she used to spend RM170 a week on special allergen-free and organic food for him.
RM680 a month
How much does everything cost?
A special needs child needs so much more attention and intervention to help, and all of these cost money. Here is a list of expenses a parent with a special needs child can expect:
Supervisor fees for therapies
Assessment for Occupational Therapy
Special needs education
Total one-time cost
Total yearly cost
Yes, the sad truth is, to provide proper and the best help for your special needs child in Malaysia is not cheap.
Education is one of the most expensive aspect of raising a special needs children, and if private education is not an option, parents can still consider national schools. Here’s a list of government schools that offer special education.
Therapy and schooling options are also available for those who are financially tight. National Autism Society of Malaysia (NASOM) offers vocational, residential, early intervention, mainstreaming, pre-vocational, and transition programmes, therapies and assessment and diagnosis, with 19 centres across Peninsular and East Malaysia.
The IDEAS Autism Centre (IAC) in Rawang also offers special needs education and therapies for ASD children from low-income families.
For parents who would like to continue the therapy with the child at home, ANDI Initiative, led by Intan Miranti, offers a 5-month parent training programme, since 2007, to equip parents with more skills and support to teach their child the missing skills, and to manage their child’s behaviour in a child-respectful manner. The average cost for the training programme is RM650 per month, with total cost coming up to RM3,250.
This may seem like a big sum for most parents, but being equipped with the skills to support your child at home may be able to save you cost on therapies in the long-run. The intakes for the programme run twice a year.
Whichever option you choose for your ASD child, some of the most important factors that Jackson, the father of an ASD teen considered are, firstly, the qualification and expertise of the teachers and their experience in managing special needs children. Secondly, ask if they have a well-rounded curriculum that caters to the needs of the child whether it’s physical or educational, or both.
“As a parent, you need to identify where in the spectrum does your child “fit”, and with the help of the teachers, work out a plan for your child’s needs,” added Jackson.
Parents of special needs children are constantly going against the flow that society set on what constitutes good and healthy children. It’s undoubtedly tiring trying to change the world’s view on their child and you’d always want to make it easier by reducing the pressures on your finances.
With the costs we’ve illustrated above, we hope that parents of ASD children will have an idea of what costs to expect and to factor that in to where they stand financially. This will help them plan and rein in their finances if needed to cope with the additional financial costs.
Parents of autistic children worry about what the future will hold for their special children, but perhaps, we just need to take a glimpse into the world of an autistic child to understand them better.
As said by Chuck Grassley, a senior United States Senator from Iowa, “What makes a child gifted and talented may not always be good grades in school, but a different way of looking at the world and learning.”
* Name has been changed to protect the identity of the child.