Prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with self-inserted nasal and aural foreign bodies

Abstract

Introduction Attention deficit hyperactivity disorder (ADHD) is one of the commonest behaviour disorders in children, characterized by hyperactivity, inattention and impulsiveness. Tendency towards risk-taking behaviour and accident proneness is well recognized in these children. Accordingly, it could be hypothesized that children with ADHD are at increased risk for self-inserting foreign bodies, but a Medline search did not reveal any studies that investigated this possibility. Objectives To study the prevalence of ADHD among children seen with self-inserted foreign bodies. Method Children attending ENT service in a tertiary care children's hospital with self-inserted foreign bodies were assessed for the presence of ADHD. Two rating scales, Strengths and Difficulties Questionnaire (SDQ)–Parent Version, and Conners Parent Rating Scale (CPRS) were used to identify the cardinal features of ADHD. Results A total of 34 children, age 3–10 years, participated in the study. Majority (51.6%) were female. Nearly 25% had one or more previous incidents of foreign body insertion and 20% had previous accidental injuries that needed hospitalization. A prevalence of 14.3% for ADHD was identified, which is almost 3 times more than that reported in a previous study among children attending medical and surgical outpatient clinics (5.1%). High rates for abnormal hyperactivity scores were reported by parents, 37.4% with SDQ and 20% with CPRS. Although 64.7% of the sample was under 5 years, almost all children who were identified with ADHD belonged to 5–10 year age group, thus effectively excluding younger aged children who may have age related apparent hyperactivity. Conclusions Awareness of possible association between self-insertion of foreign bodies and ADHD is needed and an assessment for hyperactivity/ADHD is justified in such children, especially in those over the age of 5 years.