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Imagine being in a foreign language class and you are the only student who doesn’t know how to speak the language. You would become very frustrated because you wouldn’t understand a thing happening around you. The way you interact with your teacher and fellow learners would be negatively impacted and eventually keeping up with the rest of the class would seem impossible.

That level of frustration is what most children are feeling when they come to the General Paediatric Consultation Clinic at St. Joseph’s, says Dr. Eddy Lau, Chief of Paediatrics. Each year, the clinic sees approximately 3,500 school-aged children who have been referred to our hospital for learning, behaviour or developmental issues.

This outpatient clinic is part of the full compliment of paediatric services that St. Joseph’s provides as a Regional Paediatric Centre to the families living in Toronto’s West end. Today, there are long waiting lists for children who are experiencing problems in school that are associated with these types of learning disabilities and conditions. These issues can be difficult and time consuming to diagnose and treat.

“A lot of children can have difficulties at school, and when they have these difficulties it could be because of a learning disability, Attention Deficit Hyperactive Disorder (ADHD), other genetic, congenital disorders or neurological concerns. There is a difference between each of these conditions and each warrants a different type of investigation and management,” said Dr. Lau.

“There is evidence that children with Attention Deficit Hyperactivity Disorder do better when treated in specialized clinics than they do receiving routine, community care. Our clinic helps to provide this important type of care for these children closer to home,” said Dr. Mark Feldman, a paediatrician at St. Joseph’s. “When there is concern from the school or a parent that the difficulty with their child’s development, learning or behaviour may be due to a medical problem, then they would benefit from referral to our clinic.”

Children suffering from ADHD make up the largest patient population he treats in the clinic. “It is a genetic condition that leads to difficulty with sustained attention, distractibility, difficulty completing tasks and can lead to social difficulties for kids. They are also more accident prone,” said Dr. Feldman. “Treating children in the clinic with ADHD is really about improving their quality of life – socially, academically, developmentally and emotionally.”

If the problem is severe enough that it’s impairing the child’s life, and the paediatrician can’t find another explanation for the inattention based on all of the information collected through the parents, the school and medical examinations, then medication can be prescribed for the child. Dr. Feldman says along with proper medication, educational and behavioural modifications can also be effective including: remediation, reductions in distractions whenever possible, making school work more interesting, “chunking” school work to smaller bits, and positive reinforcement behaviour modifications.

“Going hand-in-hand with the treatment of a child with ADHD is the educational component for parents and de-mystifying false assumptions about the condition,” said Dr. Feldman. “So if you can educate and present good evidence to the parents, they feel a lot better about the (medical) intervention. Then they can see their child blossom.”

According to Dr. Feldman, about one in 20 children have ADHD. “Children with ADHD are excluded from everything because they suffer from so many issues.”

That’s why getting to the root of a child’s condition and behavioural problem is crucial. “I worked with a child who was abandoned by both parents and was cared for by his grandmother,” said Dr. Feldman, recalling one patient’s outcome that left a real impact on him personally. “He was a very difficult child, but once we treated his ADHD, he excelled socially and academically. One day as he was leaving his appointment, he came running back in to give me a hug without saying a word. These moments are the most rewarding.”