ADHD Children - Egypt Running time …
1. Pre-title COMM
Greater Cairo. Home to more than six million children under 15.
Rich or poor, around one in ten of them has a medical condition that they and their families may not even be aware of. The signs are uncontrollable activity, impulsiveness and lack of attention.
But these symptoms can easily be confused with the naughty behavior of an ordinary child.
In fact, it’s a condition called Attention Deficit and Hyperactivity Disorder, or ADHD, and it can make family life unbearable.
This is the story of three Egyptian boys whose lives are dominated by their struggle to master this condition.
2. Title board Scenes From A Childhood:
They Are Not Naughty (Kids Living with ADHD)
This is Kareem. He’s 12 years old, and lives in a village just outside Cairo. His behaviour is often naughty, and he’s sometimes aggressive towards other children.
That’s because Kareem suffers from ADHD. It’s a condition that’s not well understood; but its symptoms are striking.
4. Kareem’s mother: He does not like anyone to tell him what to do, like “sit there,” no, he does not like that. He likes everything to be the way he wants it to be. If he wants to do something, that’s it, he will do it.
Mother: “Come here Kareem, Kareem.”
Mother: Come here.
Kareem: I don’t want to.
Mother: Come here for a second. Do you want to go get some falafel?
Kareem: I don’t care…It is not my business
Mother: Ok, stay where you are [?]. Listen then, see what’s on the stove and eat from it.
Kareem continues to make noises.
Mother: Hey! Boy! Come here and take this. Come here. Come and have some eggs with me.
Mother: Did you wash your hands?
Mother: Aren’t you going to wash your hands? Go wash your hands. Come on, get up quickly.
Kareem: I’m not going to wash them. I won’t. I said I swear I’m not going to wash them.
Mother: What the hell are you doing? Don’t touch it, don’t touch it. Who is…? Do you think you are the only one who wants to eat?
I get upset and everyone around him gets upset because of the terrible things he does, his hyperactivity and such like. Of course, it upsets me to see him like this. For his own sake, I want him to be good, calm and obedient.
Mother: He does not have a special place, somewhere he can sit down. Sometimes he spends a lot of time at home, other times he goes out. He does not have a special place. I mean, he does not spend time doing something he likes.
Mother: Kareem, I will tell Dad when he gets home.
Mother: He gets bored very quickly, with anything, he gets bored. Even on a trip, he never wants to stay very long. He likes to stay a short while and come back home. Even at a wedding, the same thing, he stays for a short while and then wants to leave. He’s had enough. He does not like to pursue any activity or to sit down. His life is like that, he is hyperactive and this means he does not stay in one place.
Kareem doesn’t realize how much his behaviour upsets his mother. His ADHD is made worse because he also has a weakness in the brain skills that underlie his thinking, remembering and learning.
According to the Egyptian health ministry, around a tenth of children have ADHD. This tallies with studies of its incidence worldwide. Because the symptoms can look like naughtiness, parents may suffer for years without realizing their children actually have a disorder.
7. Mother: [French- she asks him about homework].
Mother: Exactly, like that.
[They do homework together in French]
Mother: When he was very young, he used to play with his sisters a lot. But he did not play in an organised way. So, for example, we would all start playing a game but we could never finish it. There was always a mess around him too.
(up sound Chris with mom- homework)
When he started, in first elementary, his grades were quite good. But at this point it seemed to me that the teachers were calling me quite regularly. When I asked them if there was a problem, they replied: “No, he is ok, he is doing well academically, but he moves around a lot. He does not want to sit down quietly. He does not understand the concept of a classroom. He needs to get up quite regularly. He interrupts me when I am speaking.”
The teachers were failing to pick up what were really the symptoms of ADHD. Chris’s mother was sure there was more going on than just bad behaviour.
9. [Homework in French -multiplication]
Mother: But you still have to show this in writing. [French]
Mother: I thought to myself that this may be his age, but, of course, when I compared boys and girls – because of course there were his sisters, I felt that there was a difference. There was a difference at the same age when it came to the same circumstances and behaviour.
[Chris in French]
Mother: I thought, no, I will go and see someone about this, a specialist, to seek their opinion.
We had four years, during which I could not understand what the problem was. I could not put a label to the situation we were experiencing. Was this a behavioural problem? Was this, for example, a natural phase he is just passing through? Or was it altogether a different issue? No one was giving me a clear answer. That this is the situation and you must take the following steps: 1,2,3,4. Finally, I took the decision to carry out several tests. And I did that. Finally, three years ago exactly, they told me he was an “ADHD boy,” hyperactive with attention deficit.
The causes of ADHD are not yet clear. It’s thought to be partly genetic, and certain areas of the brain also appear to be different in those who have the condition. Like other children with ADHD, Chris struggles to understand sequences, priorities and time management.
11. Mother: it is ok KIKO can we move now?
Chris: one moment.
Mom! Don’t say 6 minutes passed, the match is 12 minutes and I am in second half I am watching the time.
Mother: Can I turn it off? … I will turn it off, son. I will turn it off.
Mother: There you go, bravo, enough?
Mother: No there will be no three – [French] – I am not joking, I am serious, ok? Ok? I am turning off.
Chris: Can I … [French?]. [At door]: You are always speaking to someone.
Mother: I am speaking to Tamer
Kareem’s family are much less well-off than Chris’s. His father is a farm labourer. He’s close to his son, and tries to please him – even if this means giving Kareem time off school.
13. Dad: You can stay at home on Thursday if you want, but I don’t want any problems for you with your mother and grandmother. They get very upset.
The farm is one of Kareem’s favourite places. There are no rules, and no-one to bother him.
But even here, he can’t control his impulses and easily becomes frustrated.
15. Kareem: I want you to put it in the air.
Dad: What can I do for you? You’ve broken it.
Kareem: I told you, fix the tail. Untangle it.
Dad: How can I fix it for you dear Kareem?
Kareem: Ok, that’s enough.
Dad: Shall I do the bottom, here?
Kareem: No, that’s enough.
16. Najlaa: Why did you break the kite?
Kareem: Because it is bad. It is flipping.
Najlaa: But kites are supposed to flip, or do you disagree?
Kareem: some kites don’t flip.
Najlaa: and why didn’t you try again?
Kareem: I tried hard, but it didn’t work.
ADHD is treatable. Kareem’s hyperactivity could be reduced by medication. But he’d have to take it regularly, and the cost is beyond the means of his family.
By contrast, eight-year-old Samer’s parents can afford medicine. And it’s improved their lives dramatically.
Samer’s mother: When he started taking the medication – he takes two drugs, one to reduce the hyperactivity and one to increase his attention and concentration - of course, I felt a difference in my life. I could even socialise again. I could go visit my relatives, without being worried that there will be a problem or that something might happen. I felt a difference. I felt a big difference. But I have one problem – school.
Mother: “You are naughty” has become a normal phrase. “You are badly behaved.” “You do not listen,” – constantly. Always “You are a bad, bad, bad boy.” There was nothing positive being said to him despite the fact that he was academically clever. He understood things quickly. But he also got bored quickly when the teacher went on and on about something. When other kids would just grow tired, he would say to the teacher: “Enough. I don’t want this from you.” So he would get up and interact with the class, play with someone, take a book from the shelf, make something drop. Of course, then the teacher could not carry on with the lesson because he was distracting the other children.
So, of course, the teacher begins to abuse him, saying to him “You are naughty, you are bad, you are [?]. Leave the classroom.”
19. Mother: 30 what? What time is it?
Samer: no no no.
Mother: no no no what?
Mother: ok so why did you write 30?
Samer’s situation was about to get much worse. The school’s failure to understand his condition resulted in a terrible incident.
20. One day, he was bored, the teacher told him to sit down but he didn’t want to. So he wanted to aggravate her like she was doing to him. He got up and started hitting the other children on their heads. So it was “What do you think you’re doing?” and such like. Anyway, the specialist said to them that just like he had struck the other children, they should hit him back.
The result was that the sub-warden held his arms back, sat on top of him and let all the other children hit him. My son, his psyche was – “How can this happen to me? I get held down and the entire class has a field day hitting me.” So of course the kid was – I decided to move him to another school.
ADHD can be treated by therapy as well as medication. Kareem is on his way to a centre called Helm Tefl. It’s a charity that treats children with a wide range of physical and mental disabilities. Kareem’s been going for two [CHECK] years, and it’s made a big difference.
22. Therapist: Before the treatment, Kareem was hyperactive, distracted. His worse symptom was attention deficit. Now he can sit down – in the beginning he could not sit down for a whole session. For him to sit down for 15 minutes, we used to have to do the impossible, just to make him sit down for 15 minutes and that was without him paying attention or concentrating. Now, when Kareem is with me, he can concentrate for the whole session, which is an hour long.
23. Look, can you see? Whose name is that? Kareem.
24. The problem is that Kareem’s school is not qualified to handle a case like this. The teacher has to deal with a huge number of students so it becomes “I have no time for Kareem.” Kareem needs “one to one” – that’s it. This is a problem that holds us back a lot, we need someone who understands, his teacher also must believe in Kareem’s abilities. In fact they see him as someone who is of below average ability and therefore think “I will not bother.”
If the treatment is to be most effective, Kareem’s family also have to change their behaviour. The therapist has given them instructions on how to build Kareem’s self-confidence. Sometimes this can be a challenge.
26. Mother: I told you the first time. I told you the first time. Show me, come on… Come here and show me. Enough! Finish. What did you do at school today? Did you go today?
Karim: and I want go tomorrow, (shouts)
Mother: No, we said, no.
Kareem: I went today.
Mother: We agreed –
Kareem: No, I went today. Enough.
Mother: No… What do you mean enough? It is only tomorrow and that’s it, because we are travelling.
[Argument about whether he should go tomorrow]
Mother: Come back, I will not make you go. If you behave like this, I will make you go to school.
Cairo gvs COMM
At his home in central Cairo, meanwhile, Chris is getting ready for school. He finds the process stressful, and needs his mother to encourage him.
28. Chris’s mother: Do you want some toast and sugar, Chris?
Mother:… ok, so what are you going to do then?
Chris: [inaudible] I will sit at the front.
Mother: What do you mean you will sit at the front? So if a teacher, for example, was not very nice to you, what will you do?
Chris: I will not say anything to him.
Mother: In his school – he is in a foreign private school – and they demand a certain kind of behaviour in the classroom, a very specific behaviour. They want the child to sit down and not move. Therefore, as soon as he starts to stir, or get up, or interrupt the teacher or do anything “due to the hyperactivity,” they begin to pigeonhole him and say that this behaviour is not correct and that this is a child who is not following school rules.
Mother: Come on. Did you take the thingy? The “foil”? I was worried that you would forget it.
The school is reluctant to make special allowances for Chris, so it’s all the more important that he remembers his medication.
Chris: No, I have it with me.
Mother: Where? I feel that you are going to forget it. Before we go downstairs, remember to take it to the car.
The drug is called Ritalin and is the commonest medication for ADHD. It’s believed to work by altering the chemistry of the brain, though it can have unpleasant side-effects. But even if Chris is taking his pills, his mother is worried about the school.
So now, for the eight or nine hours he is there, I do not feel that I can trust this place, so this creates a problem. A mother will be anxious. How will he deal with this issue today? How will they behave? Do they understand the problem or not? How will they react? This is what worries me about the school.
RAMONA is now thinking seriously about taking Chris out of his smart school. Samer is more fortunate. He’s attending a school that gives him the supportive environment he needs. His teachers understand ADHD and know how to treat it.
34. Mother: In his current school, the thing that I seriously commend them for is that they do not just teach, they raise the children well and teach them.
Samer: Enough! … Miss, I still haven’t said anything.
Teacher: Please do not read before he does. Read it again.
Samer: The mouth and teeth.
[Class repeats: The mouth and teeth.]
It took time to find the right school for Samer. Now he’s doing well, partly thanks to the private treatment he’s been having for the last year.
Psych: if you behave well at school, I will teach you this.
What does it mean to behave at school?
Samer: to sit quietly and don’t hit anyone.
Psych: what else?
Samer: do not annoy my friends
Psych: what else?
Samer: and not to touch my friends.
There are three types of ADHD. It can appear either as hyperactivity, or lack of attention, or a combination of the two. Samer’s therapy focused on his anger and impulsiveness, while Chris needs most help with his concentration.
38. Alan at Lighthouse
How are we?
Alan: you had good day off yesterday?
Alan: are you ready for this?
Chris : yes.
Exercise super hard super-fast, all right bring your chair
The great thing we see about someone like Chris, we see the potential. This is why I have to be tough with Chris I have to do this because I see your potential. You have now had through the course of the program I unlocked your cognitive processing to allow you to say what you want to do, you choose it is up to you.
Over the next two hours Chris will do exercises to help him process information without getting distracted.
40. Are you ready for two hours with me, Mr Chris?
Alright, you’re ready? Bring your water. Stay standing, let me find the story for you. So let’s go. On the beat, stand still.
Miss Mary Mack all dressed in black with a big red bow in the middle of back she carried her lunch in a big red bag
What was the lady’s name
What colour was she dressed in
What was she wearing
A red bow
Chris: With Mr. Alan, I don’t like him because he makes me feel tired. I feel tired, sleepy and hungry. I make an effort, I like to swing, and I don’t like to stay standing. I don’t like to stay sitting like this or standing too. I can’t hold my hands like this, I try but it is difficult.
Alan – thank you Mr Chris. Well done.
Today is a turning point for Chris. He has just received his school report, and it’s by no means all good.
Chris: I am going to tear it up.
Mother: No, no, no. You will not tear it up? Why do you want to tear it up?
Regarding the work in class: no concentration. He moves a lot.
Good and hard work, music.
Ok that is good, see? Good hard work,
Noticeable Progress this semester, technology that is good.
But work at home has been made this semester and that is good.
Chris’s report serves to confirm RAMONA’S suspicions about the school. She’s no longer sure that it’s right for him.
44. Mother: I am quite sure that if he was in a school system that encouraged him, he will be able to produce many things that are within him but that he could not produce before. He will start to make progress and he will start to like a certain subject that he had not noticed before. I think that he will find himself.
He really needs to feel that he is responsible for his own success – or failure.
A child may be inattentive but that doesn’t mean he’s lacking intelligence. ADHD sufferers can excel in many different ways, and Samer is already showing a talent for sport.
46. Samer’s mother: His coach says that he is good and talented. By the way, in the summer I will try to find him another sport, swimming for example, or any other sport. He is talented in many things and I will now begin to discover them. I could not discover them before.
Kareem too is discovering the joys of sport. It’s a way for him to channel his sometimes wild energy.
48. Coach: Come onto the field, Kareem, Come on.
Karim needs someone to constantly talk to him, to tell him to move and to run. But he follows instructions very well
)Run around the cones, Kareem. Come and turn around my cone. Better, well done. (
His concentration is a problem, he would do the excercice but he needs me or his mate to remind him, otherwise He functions normally, like any other normal person, but his only problem is forgetfulness.
ADHD imposes huge strains, both on its sufferers and their families. Even if it is diagnosed early, there’s no complete cure, though it can be managed, and the symptoms usually improve with age. But some people will experience problems into adulthood. For them it will always be hard to find a place in the world.
50. Kareem’s mother: My wish for Kareem is that he is firstly educated, secondly to find something useful to do when he grows up. What will he be? Will he work?
No one is willing to accept my son as he is now. “We cannot take your son. No. Your son’s behaviour is not acceptable. Everybody rejects him, They will not deal with him. So what can I do?