SINGAPORE — A typical three-year-old toddler has an attention span of about eight to 10 minutes, even though parents and teachers often expect their children to concentrate on work for up to half an hour at a time.

This is one of the misconceptions regarding child inattention that Dr Tammi Quek hopes to address this Saturday at a public symposium on understanding children’s wellness needs.

Inattention — a child’s inability to focus on one particular task for a certain period of time — is one of the most common observations picked up by teachers and parents as a “problem” in schools and at home.

However, it may be the manifestation of a myriad of different problems, ranging from attention deficit hyperactivity disorder (ADHD), to primary learning difficulties, to a simple lack of sleep, according to Dr Quek, a consultant at the National University Hospital’s Child Development Unit.

In every cohort, however, there will be a group of children who are inherently unable to pay attention due to the way their brains are wired. This group may stand out as being extremely active and incapable of sitting still, especially during pre-school.

There is a possibility that these children have ADHD, though diagnoses cannot be certain until they are about seven years old, when they are realistically supposed to be able to “sit down and do things”, Dr Quek said.

However, these active children, who “tend to get into trouble and are picked out by teachers as problematic”, are usually only the active portion of the population, who tend to not fare well in classroom settings that “emphasise strongly on sit-down, table-top work”.

Diagnosis for ADHD is complex, as there is no clear-cut test to categorise a child; it relies on observation by the doctor, parents and teachers. According to the manual used by doctors in Singapore, a child is diagnosed with ADHD if he has at least six of the nine symptoms of hyperactivity and/or inattention and is shown to be consistently behaving in this manner across multiple environments, with such behaviour detrimentally affecting the child’s academic work or social life.

This is further complicated by the inconsistent nature of behaviour, which changes from day to day. ADHD itself is known to be better on some days than others.

Before diagnosing it, though, doctors have to first rule out all other plausible causes of inattention. For example, a child with intellectual disability may be inattentive in school because the child is unable to understand what is happening and will naturally start daydreaming. Children who are bullied may also be inattentive if they are worrying about the bullying rather than listening in class.

“We have to make sure that we are not missing something else that is masquerading as inattention,” Dr Quek said.

ADHD is usually treated with a combination of behavioural training and medication. This is where parents come in. By modifying the way they respond to the child, parents and teachers can help the child to stay at a task longer and learn to manage the condition.

For example, three pages of homework can be broken down to half-page portions, with breaks in between.

“Active kids are difficult to parent from the word go, and there are parents who struggle to manage their child,” Dr Quek said.

Scolding or caning children is not recommended by doctors, as generating fear in the child is counter-productive for his or her well-being. The more sustainable and encouraging method is to teach them the skills they are lacking so that they will change their ways.

There is no local data on ADHD, but worldwide prevalence is estimated at about 3 to 7 per cent of the population. There are two types of ADHD, inattention, meaning the ones who daydream, and hyperactivity, the ones who cannot sit still.

The hyperactive children tend to be picked up early as they disrupt class, but the inattentive ones may be missed. If left untreated, this may affect their education as they grow older.

Children with ADHD are also very disorganised, missing deadlines, forgetting consent forms and losing things, said Dr Quek.

Hyperactivity tends to get less as the children grow older, but inattention is likely to stay.

The good news is that the disease is manageable and skills can be taught, the earlier the better.

“The general rule of development is that if you suspect something is not quite right, bring your child to be checked early, don’t delay it,” said Dr Quek. “The kids (with ADHD), they don’t look any different from you and I, and they’re all really nice people, they just don’t know how to control their actions, and we need to teach them these skills.”

Learn more about children’s health

How can today’s society and the environment affect your child’s mental and physical health? This Saturday’s National University Hospital symposium will touch on the impact of technology on children, how to help them focus in a noisy world, help for picky eaters and how to deal with emergencies at home.

Registration is S$5 per person or S$8 per couple. For registration and enquiries, email miao_qin_tay [at] nuhs.edu.sg or call 6772 5466/6772 5465. Visit www.nuhkids.com for more information.

Date: Sept 7, 2012 (Saturday)

Time: 2.20pm – 4.30pm (registration starts at 2.00pm)

Venue: Singapore Management University, Function Rooms 4.1 and 4.2 (Level 4)