Mareli Fischer - PsychologistAttention Deficit/Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder:
What is all the fuss and research about?
During my Psychology Honours year at UCT in 2008, I conducted research that focused on children with ADHD and OCD, and how these disorders impact on their lives every day.
At the time, I could not find many other studies that looked at this topic, and none which had application in South Africa. It is essential to try and answer some of the many questions that parents and teachers often struggle with when dealing with these two disorders.
Why ADHD and OCD?
The first question that comes to mind will be: why am I focusing on these two disorders specifically?
It is important to start by defining the characteristics of each. Children with ADHD struggle to pay attention and finish tasks, and many have difficulty sitting still or playing quietly.
There are three different presentations of ADHD:
- those who present as predominantly inattentive (children struggle to keep attention focused and are often labeled as daydreamers),
- those who present as predominantly hyperactive (children run around and climb on things, struggle to remain quiet and seated, and are often labeled as naughty or trouble makers)
- and the combined presentation (children have characteristics of both inattention and hyperactivity – this is the most common presentation).
Whereas ADHD is a neurodevelopmental behavioural disorder, OCD is a classified as an anxiety disorder. Children have repetitive thoughts that they can not get rid of. These are called obsessions, and for many children these thoughts are scary or make them feel guilty.
Children with OCD also often have certain rituals, or things they need to do over and over again, for example counting or straightening their toys, or washing their hands over and over. They feel scared and anxious if they are not allowed to complete their rituals, called compulsions.
ADHD is very frequently diagnosed in classrooms, when children struggle to pay attention. The truth is that OCD is often wrongly diagnosed as ADHD. When a child struggles to pay attention, it might be because of an intrusive thought (OCD) and not because of ADHD. It is very important to diagnose these disorders correctly, and provide the right treatment to the child.
What is Functional Impairment?
Functional impairment is a term that refers to how well the child is coping in his/her life, in all the different areas like school, home and friendships. This is important, because this will show a parent, teacher or therapist which area to pay attention to.
For example, if a child is struggling to make and keep friends, exercises and games that will improve social skills should be focused on.
My study wanted to see how children with ADHD cope in these different areas, compared to children with OCD.
My Findings
The data collected during the 2008 revealed the following interesting results:
- Children with ADHD had most difficulty in the area of school. They struggled to learn on par with their peers and often got into trouble in the classroom.
- Children with OCD had the most problems with friends and their social life. Other children often thought they were strange and their many anxieties made it hard to befriend other kids.
- Children in the ADHD group often had other behavioural problems (comorbidities such as conduct disorder or oppositional defiant disorder), with symptoms such as angry outbursts, breaking rules and bullying their peers.
- Children in the OCD group often had other comorbid anxiety disorders, like phobias, fears of being separated from loves ones and being scared in big groups of people.
What does this all mean?
These results show us that children with OCD and ADHD have different kinds of problems and diagnosing them incorrectly can be devastating to them and their families. By identifying the area in which a child is having the most difficulty, we can help parents and teachers to pay attention to the right things and a big problem can become easier to manage.
If you suspect that your child may be struggling with symptoms of ADHD or OCD, reach out to a pediatrician, psychologist or other health professional in your network to help you with assessment, diagnosis and treatment.
There were so many families interested in taking part in this study, that I continued my journey with ADHD research over many years. This year, it culminated in the completion of my Doctorate degree.
Brief Bio: Mareli Fischer - Psychologist
I am a clinical psychologist working in private practice in Cape Town since 2013. I work from a space in Gardens, in the CBD.
I have a special interest in working with adolescents and young people, the LGBTQIA+ community, as well as anyone struggling with grief, relationships and intimacy challenges.
I completed my Masters in Clinical Psychology from Stellenbosch University in 2010, and then completed my internship and community service years in the SA Defence Force.
I recently finished my Doctoral degree, which I completed through the University of Cape Town.
My research has focused on the functional impairment of children with ADHD, and I designed a parenting intervention that focused on positive parenting and heathy family relationships.
My website: https://marelifischer.co.za