Saturday, October 1, 2011

Saudi-Arabia Suffers from ADHD

According to an Arab news article Saudis "suffer" from a high rate of Attention Deficit Hyperactivity Disorder, also know as ADHD. The rate in Saudi was found to be an alarming 15% (globally 3-5%).
ADHD is typically 4 times more common in boys than it is in girls. An estimated 50% of the children diagnosed with ADHD continue to have symptoms in adulthood.

The exact cause of the disorder is still unknown. The etiology of ADHD is a combination of multiple genetic and environmental factors such as: genes (estimated 70-80% of cases), food additives and preservatives, excess sugar, watching too much TV, discordant family relationships, mother's cigarette smoking and alcohol abuse during pregancy, infections in childhood and formula-feeding of infants. .
The high prevalence of ADHD in Saudi-Arabia does not surprise me one bit.
In fact I think it's more of a miracle the rate is not even higher considering the circumstances children are brought up in the Kingdom.

In some places it could even be assumed the ADHD prevalence in Saudi is somewhere around 90%.
Just entering any malls children's entertainment area at midnight and a typical scene is revealed:

A Saudi kid is frantically running around in the almost deafening noise of the fully-packed amusement area. He goes from one place to another screaming from the top of his lungs holding onto a bag of chips on one hand and an energy drink in the other. His maid has told him already 10 times they must leave but he does not seem to have heard anything. She is chasing after him while trying to feed  formula to a crying baby in her arms. The kid races over to the next machine pushing over three other kids with Bebsi-colas in their hands because he could not wait for his turn. They start hitting each other and calling each other donkies while the Bebsies go flying on the floor. No ones says a thing. The father comes to pat the kid on the shoulder offering an ice cream.
It's not the kids fault that he became this hyperactive- out-of control- junk-food eating-high on sugar- monster. It's the parents, the environment and the society. Saudi culture has a very relaxed outlook on child upbringing. In general the child will be allowed to do most things that in the west people might see as irresponsible or might even report as child abuse. The children are not usually given strict boundaries or rules but rather left to explore and find out for themselves. High activity levels, displays of superiority and pompousness, loudness and aggression in boys are perceived as desirable traits rather than problems in the Saudi culture.
Many cases of ADHD will go undiagnosed or their conditions will get worse due to this attitude.

Factors in Saudi society that contribute to or exacerbate the exceptionally high rate of ADHD:
  • inbreeding and genes (most marriages are between cousins)
  • consuming foods containing high amounts of additives and preservatives 
  • diet rich in sugars
  • children consuming energy drinks and cola drinks
  • lack of sleep at NIGHT
  • having maids (absence of parents)
  • lack of discipline
  • high prevalence of formula-fed babies
  • large family sizes

Back to the article, it raises the importance of early treatment of the condition for better prognosis. Early diagnosis and treatment of ADHD is crucial for the affected person to be able to lead a normal and successful life.
However this news article tells us that there are currently only approximately 40 specialist doctors in the Kingdom for the treatment of the one MILLION Saudi ADHD patients

In the article, Prince Saud bin Abdullah "urged all sections of society *pay attention* to this problem and understand how to deal with it adequately".
He did not disclose how that would happen though.

What would you suggest, how to help solve this problem?

Support group for ADHD in Saudi:


Sarah.UbaidulHaq said...

Oh, Wow.. Masha Allah. !

the only solution to this .. My mother .! She knows everything on how to solve his type of problems..Infact many school teachers and children counselors apporoach her for help on how to tackle such situations..

She makesa BUMPY ROAD SMOOOOOOTh ... Insha Allah.

Btw > i love ur blog. :)

Take care

Soile said...

Käyppäs tsekkaa meemi mun blogissa, jos vaikka jaksaisit itsekin moisen tehdä :-)

Anonymous said...

I think 100% Saudi kids have adhd they are so wild and dont think about others and with no manners at all!!!

Anonymous said...

Poor kids. It sounds like there needs to be training of the parents not the kids.I did not realize formula feeding in babies can affect having ADHD. Probably most Saudi women also do not know about this fact.


Layla said...

Sarah-thanks for your comment and your kind words! I wish your mother could help all those poor children who are left undiagnosed and suffer into their adulthood..

Anon-I dont think all Saudi kids are badly behaved, there are so many lovely and sweet boys and girls out there too that have been taught Islamic manners and have been given boundaries and rules in their lives. Not all hope is lost for the future of this country!

Unfortunately there are also those kids that do not behave like the above commenter says even make fun of others but parents dont care to correct them :(

Lina- I think you might be right, no woman would give formula on purpose if they knew the adverse effects that it might have!The problem is there is not enough awareness about this in Saudi and women are not encouraged to breastfeed!But of course there are cases when formula feeding is the only option so we cannot judge by that alone.

Anonymous said...

I do think that there is a significant difference between a disease/disorder process that afflicts a child due to circumstances still not well understood and the behavior of children that lack proper parenting and firm expectations of how they are to act and react in the world around them.

Poor parenting does not cause ADHD, but certainly may exacerbate the symptoms. Adding to the rising numbers is the case that many parents find relief in knowing that their child acts they way they do (not because of how they were raised) but rather from a disorder with a name and drugs that might relieve the symptoms. And therefore, physicians hand out the title of ADHD at an alarming rate instead of informing parents that they basically are failing at raising their children.

Eliminate the poor parenting and then see if the symptoms remain. If all other plausible causes are removed and the child appears to have the diagnostic symptoms, then crown him/her with the title of ADHD.

if we do not confront parenting skills before making this diagnosis, we are blaming children for their parents' inabilities to care for them properly. And even worse, children diagnosed with such a disorder are drugged so that their parent's who lack the ability to properly care for them can "deal" with them.

Again, I believe that ADHD is real and there are children that benefit from treatments appropriate for their symptoms. However, I disagree that every poorly behaving little boy has a disorder simply because he doesn't "behave" properly or pay attention in class, and resorting to medicating children is not necessarily the appropriate answer to this issue...

Sandy said...

I agree with you 100% ADHD can be a convenient diagnosis to excuse lack of or poor parenting. I've seen many children who are basically raised to not behave or focus on anything. And also raised to find outside excuses for their own bad behaviors rather than taking responsibiity.

I do believe ADHD is real- but I don't believe that all that's described here is ADHD.

Layla said...

Stephi and Sandy thanks for your comments.
I agree ADHD can be over-diagnosed, and certainly its not CAUSED by bad parenting!Bad parenting however would definitely make an affected child much worse.
WHat I mean to say is the way that children are brought up here makes things so much worse. It makes it difficult to differentiate what is only lack of discipline, and what is the real condition. Lack of a set of rules will only make an affected child suffer more.
The children that do really have ADHD also suffer from their parents negligence of good eating and sleeping habits.The kids literally eat sugars only, and consume enormous amounts of cola and energy drinks..that will just exacerbate their ADHD and can even trigger it.
Genes remain the main cause and as we all know how common cousin marriages are here, that contributes to the problem too..

Anonymous said...

Not to say that cousin marriages couldn't be affecting the numbers, but I honestly feel like Western society (that all of a sudden turned its cheek to such marriages after the 19th century) seems fixated on the idea that marrying your cousin is disgusting and attributes a lot of weird things to the reproductive product of such marriages.

One can't dispute something like cystic fibrosis... but ADHD does not have the same ability to be so tightly linked to genetics at this time.

Layla said...

Stephi you're right and there's still no scientific proof that it would be genes only that cause ADHD.

Western society does look upon cousin marriages as something very wrong, almost like incest.
The fact is Islam does allow it. But nowadays there is genetic counselling available and many cousin couples can be perfectly suitable for each other(genetically speaking)but it does also reveal if there is a potential problem with the mix. This would often be the case when the parents and grandparents were also cousins.
The west I think people think cousin marriages are ALWAYS a bad mix of genes.

Oh and cystic fibrosis is a real problem in Saudi..those are some of the most heart breaking cases I saw, young girls and boys on "death row" waiting for lung transplants that never came :(

Sandy said...

Just an interesting fact- cousin marriage is not that far in the Western past. Einstein married a cousin for example. H.G. Wells- and ironically Charles Darwin. And first cousin marriage is legal in most of the US. Not sure about Europe. Doesn't happen that often, however.

Layla said...

Sandy wow I didn't know that, even Einstein and Darwin!Ironically also, the head genealogy dpt in our hospital is married to his cousin :)
People used to make jokes about it when his team would come for genetic counseling like how can ppl take him seriously.
I think he probably did all the possible research for their genetic background and maybe even wanted to give an example that cousins can be married without problems.

In Scandinavia they are banned by law I'm not sure about other european countries.

Anonymous said...

Cousing marriage in not prohibited in Sweden, nor in Norway as far as I know. I have never heard that they were prohibited in Denmark or Finland either.

Yulia Armani said...

I guess it's because of bad parenting, sometimes its looks that they just dont care what they children do. Also junk food is a big problems, but most of non informed enough about harm of that food. I remember when my emaraty friend have stomach pain, her mother advice her to drink sprite, because its soda, and soda good for stomach. lol, I guess next time when she will have a head ache, her mother will recommend to use axe. And about saudi woman, I see many couples with kids in Dubai from Saudia, all the mothers do, is shouting at they kids, they dont talk with them, same talk with husbands. I guess this womans just really deeply unhappy, because happy woman, just cant have bad kids with that kind of problem, because she will care.

Layla said...

A.M. I stand corrected, thanks for that!Cousin marriages are not against the law, but nevertheless very rare and widely frowned upon.

Amira-sometimes it does seem as if it does not matter what the child is doing. My friend who works here as pediatric nurse says it seems to her as if the children are there only to please the parents, when they no longer please them, they become ignored or neglected.

Nikki said...

First cousin marriages are against the law here in the U.S. unless both individuals are over 60 (past childbearing age). Anything other than first I think you can marry no problem.

Saudi children don't sleep!!! I know the schedules different in Saudi because of the weather, but here in the U.S., the Saudi families maintain the schedule. With all or most activity taking place late at night. I am always seen as "Crazy" when I leave a gathering after only one hour to put my son to bed. I'm sorry, but my two year old should not be up until 11, let alone past then (as they wanted me to stay possibly until 3 or so). I maintain a very regular sleep and nap schedule with my son and my Saudi parents-in-law and sister-in-law think I'm unnecessarily fretting and trying to make my son function like " a machine.". Well, even with his schedule, there are still many days I can see he has not had enough rest, and compare that to my niece, who goes to bed around 2 or later and gets up at 9 or 10, and then only takes a nap if she's drop dead tired.... I love my niece. She's the cutest toddler, masha'Allah, but she is a bit of a brat. She is mean to my son, hitting, biting, and screaming when she doesn't get her way or even if he just touches one of her toys. She wouldn't be so irritable if she had more adequate sleep, I'm sure. Also, when she does misbehave like this, there is hardly any discipline from her parents. When my parents-in-law were here witnessing this they would just shake their heads and laugh, "Oh, kids will be kids." Um, yes, it is natural for children to be selfish, but children have to be "taught" how to behave, and this seems to be beyond my Saudi family at the moment.

Sorry for the rant. There's a lot of things about Saudi parenting that really irk me, and I've never even been to Saudi, lol. As for ADHD, I think it's overdiagnosed anyway. Some problems are just because you have a more difficult child, or you didn't do your job 100% in teaching them how to behave properly. ADHD is a REAL condition, but I hate how the label is slapped on everyone.

Layla said...

Nikki I loved your rant thanks for venting it out!
I know exactly what you mean when it comes to expectations from Saudi relatives or the whole society in general to keep children up until LATE.

And here late is not say 11pm like in Finland we would consider normally as a bad time for the child to be up. But late like 2-4 am late..especially on weekends, and even small babies..Its like nobody cares!

And that attitude that when a child behaves badly, or even downright rude or aggressive toward strangers, they LAUGH. Seriously they think its the funniest thing in the world when their 3 yr old goes and stomps on an american ladies feet and shouts bad words at her.

What time do you put your little one to bed?

I aim for around 8, but sometimes she will go as early as 7, or if we're out at 10..the problem in Saudi is the shops are open so late and closed half of the day..

Nikki said...

My son has always gone to bed "late" according to American standards, but that is because he's never had to get up at any certain time for daycare, etc. The "norm" in America seems to be 8 o'clock. In the summer, that is just impossible because it's daylight outside until 10 or later. In the winter, at the earliest it gets dark around 4:30-5, and that's too early to go to bed, lol. My son has typically always gone to bed around 9, but during Ramadan this year he was going to bed at 11 or 12 every night and his nap increased from 2 to 3 hours to try and make up for the loss of night sleep. He's 3 next month, so I'm sure he doesn't sleep as much as your LO. Now he sleeps 10 hours a night, almost religiously. If he goes to bed at 9, he'll wake up at 7:30 at the latest, at 10, 8:30, etc. I aim for 9 every night but sometimes it doesn't happen. He also has a two hour nap every day, that I try to start around 1, but today he skipped it so hopefully he'll sleep in tomorrow. Insha'Allah! If I put him to bed at 8, he'd wake up at 6 or 6:30, and I'm a SAHM, so I see absolutely no reason to be up that early in the morning. We'll stick with 9 or 10. It works for us.

Sandy said...

Sorry you are wrong about cousin marriage in the US. It varies state to state but is legal in most- without any age requirement.

yasmine said...

Adhd is caused by a vitamin defeciency, specifically magnesium, fish oil, and others that go hand and hand with it. Calcium excites the body, magnesium calmer it. Preservatives cause it, as well as all the other poisons that are in "food" if you call it food, rather it is poison, cancer causing toxins. Adhd is not caused by parenting. The diet affect the body AND the MIND.

lola said...

This is shocking; the rate that has ADHD is very high. Let us put it this way, if things like this continue to heighten then it is going to become a serious problem to the Saudi society. They should do something to control the problem.

Selena said...

I was really alarmed and at the same time touched by the data you provide here. All the while I thought that the number of cases of children with attention deficit disorder or ADHD is increasing only in our area. Then I proved myself wrong. Now even Saudi Arabia is affected. Guys just to lend a hand, I found this info online: You might find time to read it and help our children with ADHD.

Anonymous said...

Asalaamualaikum Laylah

Why are the cystic fibrosis rates so high in Saudi? Can you please shed some light on the experience you have had with children suffering from this. I've heard a great deal about the Saudi children suffering from this and other conditions, the lack of treatment they get, the lack of recognition in society, the lack of love and support from their families. Its just so terrible. And with this topic of ADHD, I also agree that it can be over-diagnosed, but regardless of what it is, the problem is what caused these children to be in this predicament in the first place... I mean here's some problems that need to be addressed head on: why have maids taken the place of mothers? Why do children get what they want when they want it? Why don't parents put their children's needs first, before their own? Needs, not wants. The need to sleep properly at night, the need to eat the right food, the need to be exposed to good role models and not bad. It saddens me what the Muslim society has come to, especially in Saudi. They have so much potential to be better, inshaAllah one day they will.

Anonymous said...

hahahha....this is so true..i was born and brought up in saudi arabia....and i used 2 think why were the kids so hyperactive,aggressive and mischievious and they're parents never gave a fuck about it....never knew it was a diagnosed medical condition........the kingdoms still got a lot 2 develop....

Anonymous said...

Here I have a very desperate case for which I would like to receive some sage advice from you all.

We have received a family visa offer for my husband in one of the major cities in Saudi Arabia. We are Muslims from Pakistan and have always held KSA in esteemed regard for our religious affiliations.

One of our sons, 9 years old is a known case of cystic fibrosis, who is a rare occurrence in the Indian sub-continent. We cannot go for immigration to any of the Caucasian countries as CF is screened in immigrants. Hence our only refuge could be the Middle East if it provides medical coverage along with less pollution. My husband job covers free medical facility for the family.

We are still pursuing the application and are due for the medical exam in a few days. Do you guys think there is some chance of our family being denied of the family status after the finding of my son's being a known case?

We really are scared now. This lovely child of mine is the only reason why we want to apply to any other country promising better economic viability. It is for he ,we are looking forward to this destination.


Layla said...

Dear Desperate,
I truly hope that you will receive your visa and get to come here and your son gets better treatment!