vrijdag 20 juli 2007

ADHD in Belgium, and in the Expat Community

Please Pay Attention by Gudrun Lake

This article appeared in The Bulletin on 19/04/07 Reproduced by permission

By any standards, Donnalea Barber’s daughter Katherine is an academic success. Having completed the International Baccalaureate in Brussels, she now studies psychology and music at a bilingual Canadian University. But her achievements are particularly impressive considering she has Attention Deficit Disorder (AD/HD), a learning difficulty which she has overcome thanks to determination, her mother’s tenacity and the support of her school.
Many other children in Belgium are not so fortunate. Their parents say support is hard to find and that schools often fail to get the best out of these children A family cannot manage their child’s problems alone and without frontline support in the classroom, these children may face futures with few opportunities.” says Donnalea Barber, of the AD/HD Family Support Group.
As AD/HD is one of the most commonly diagnosed learning disorders, affecting around 3 to 5% of children, there is likely to be a case in almost every class. But child psychologist Dr Magali Coudeville believes it is under diagnosed in this country. Symptoms typically include an inability to concentrate or sit still, forgetfulness, and disorganisation. It is unconnected to intelligence and can range in severity although it may be accompanied by other learning disorders such as dyslexia and autistic spectrum disorders.

But people with AD/HD are often claimed to have special gifts including a creative, adventurous or entrepreneurial streak. Some groups believe that numerous historical and intellectual heavyweights, including Einstein and Mozart, displayed ADHD-type traits.

Early identification and treatment is crucial in helping a child achieve his or her potential. “Attention is the basis for learning. If you can’t focus, you won’t learn ‘says Kristen Pelletier, Head of Learning Support at the International School of Brussels (ISB). “The key is to find the hook: they can focus well on the things that interest them,” The price of failure can be high. “There is a real risk of teenagers with untreated AD/HD opting to self-medicate with illegal drugs or alcohol,” says certified ADHD coach Joanne Norris.

The disorder is still surrounded by myths: that it is caused by bad parenting and that drugs like Ritalin are being used as a pharmaceutical cosh sedating out of control kids for the convenience of teachers and parents. In fact, AD/HD is a neurobiological disorder, described by Education Leadership magazine as a complex syndrome of impairments in the brain’s cognitive management system affecting the ability to organise and start tasks, with children becoming distracted and unable to sustain focus and motivation .

Experts such as Doctor Christopher Green, author of Understanding AD/HD describes medication with drugs such as Ritalin as the single most effective form of therapy for AD/HD helping a child to focus and listen. He also maintains that when used correctly it is both safe and free from side effects.

AD/HD usually lingers into adulthood and there is a strong genetic link. Stephanie Clark, who runs a support group for adult sufferers in Brussels, is herself affected. Her children and grandchildren have also been diagnosed and she suspects her grandmother, who in 1902 was said to be suffering “Moral Conduct Disorder,” most likely had it too. Clark takes medication and describes her life prior to treatment was like being a fog, when simple tasks like following a conversation or doing housework were a challenge.
Diagnosis is usually carried out by a psychologist or psychiatrist, but for expat children or those learning in a second language, this can be tricky. “The early stages of language learning, especially if the children have recently arrived in the country are in a state of culture shock,” said Pelletier of ISB. Treatment may include medication with Ritalin or a variant, with doses carefully adjusted to suit the child. Coudeville says the medication helps with concentration and attention in the classroom. “The benefits can also be seen over the longer term as children feel more positively about themselves.”
Environmental modifications are also recommended. This can mean more dynamic teaching methods in school including the use of visual aids and very structured classes and tasks. The child’s emotional issues also need to be addressed, such as developing self esteem and promoting a positive body image.
The US and Australia are seen to lead the way, both in diagnosis and treatment, but in Belgium the disorder remains shrouded in ignorance and stigma, according to support groups . Stephanie de Schaetzen of TDA/H Belgique said: “There’s very little known about ADHD in the francophone schools and there is inadequate training for teachers. We’ve made a booklet and distributed it and have had some interest, but we are a small organisation.”
Belgium may have one of the best education systems in the world but Machteld Van Ostaede of Flemish support group Zit Stil, says schools too often fail to get the best out of children with special education .
Maria Dolores Poggi of Europe’s Children Our Concern (ECOC), a voluntary organisation which assists children with learning difficulties, agrees. She believes that despite good intentions, there is not enough training about learning disorders in the state schools. Her group has already held workshops in English for teachers on AD/HD and plans to hold its first workshops in French in May. In the meantime, it is often down to psychologists like Coudeville to go to schools to explain her patients’ needs and discuss teaching practices.
AD/HD support groups say the international schools in Brussels lead the way in assisting pupils with the disorder, singling out the International School of Brussels (ISB) singled out by them as the flagship for Special Education Needs (SEN) provision. Kristen Pelletier, Head of Learning Support, says around 12% of their pupils have a learning disability, many of whom involve attention issues.
Belgium support groups stress the importance of picking a school suited to a child’s individual needs. Some parents find that a big school does not neccessarily mean best. Helen (name changed) removed her 16 year-old son with AD/HD from a large international school in favour of one with much smaller class sizes. Although the large school had a good SEN program, the sprawling campus proved too much of a distraction for her son who was prone to wander off.

Belgian support groups recommend parents become their children’s advocates. “They must become experts because this is the only way that they can be sure that their child gets all the necessary support,” said coach Joanne Norris.

As well as developing an excellent rapport with schools, Donnalea Barber says children may need extra academic tutoring. She worked hard to support her daughter’s learning, from inviting experts from abroad to give talks to teachers at school, to sometimes just sitting with her child as she did her homework.
But for some parents, like single mother Marie, the burdens are hard to bear. “It’s a strain,” she says, “I live for my kids but we have conflict; my son doesn’t want me interfering. I’m on call 365 days, if I’m not there, it will not happen.”

Brussels Support Groups

English Speaking Adult Adhd Support Group
Stephanie Clark
Tel: 02 3059030

Association "Hyperactivité et troubles associés - TDA/H Belgique"
Tel: 0484 177 708
Website: www.tdah.be/

AD/HD Family Support Group Brussels (English speaking)

Tel: Donnalea: 02 653 42 00 (evenings)
Email: simon.barber@skynet.be

Zit Stil, (Dutch-Speaking)
03 8303025

Community Help Service CHS runs a mental health centre in Brussels with a professional team of psychologists, psychotherapists and psychiatrists. Tel: 02 647 67 80

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