ADHD in Children
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ADHD in Children: Guidance from a Specialist Paediatrician & Paediatric Pulmonologist in Pretoria
ADHD in Children: Guidance from a Specialist Paediatrician in Pretoria
As a Specialist Paediatrician and Paediatric Pulmonologist based at Netcare Montana Hospital in Montana Park, Pretoria, I often meet parents who arrive worried, exhausted and unsure whether their child’s behaviour is “normal childhood energy” or something that needs medical attention.
As a Specialist Paediatrician and Paediatric Pulmonologist based at Netcare Montana Hospital in Montana Park, Pretoria, I often meet parents who arrive worried, exhausted and unsure whether their child’s behaviour is “normal childhood energy” or something that needs medical attention.
Some parents describe a child who cannot sit still, interrupts constantly, loses school items, forgets instructions or seems unable to finish homework without repeated reminders. Other parents describe a quieter child who is not disruptive, but who daydreams, works slowly, struggles to organise schoolwork and appears overwhelmed by everyday tasks.
Both children may be struggling with Attention-Deficit/Hyperactivity Disorder, commonly known as ADHD.
ADHD is not a sign of poor parenting, laziness or lack of discipline. It is a recognised neurodevelopmental condition that affects attention, self-control, planning, emotional regulation and, in some children, activity levels. With the right assessment, support and management plan, children with ADHD can thrive at home, at school and socially.
For families searching for a paediatrician in Pretoria, a paediatrician near me, or ADHD help for children near Montana Park, my goal is to provide clear, evidence-based guidance and compassionate care that looks at the whole child — not just the behaviour.
What Is ADHD?
ADHD is a condition that affects how a child’s brain manages attention, impulses and activity. Children with ADHD may find it difficult to concentrate, follow through on tasks, wait their turn, sit still, manage emotions or organise themselves in the way that is expected for their age.
It is important to understand that ADHD does not look the same in every child.
Some children are very active and impulsive. Others are mainly inattentive and may appear quiet, forgetful or distracted. Some have a combination of both. This is one reason why ADHD can sometimes be missed, especially in children who are not disruptive in class.
ADHD can affect:
- School performance
- Homework and study routines
- Behaviour at home and in the classroom
- Friendships and social confidence
- Emotional regulation
- Sleep routines
- Self-esteem
- Family stress levels
A child with ADHD is not choosing to be difficult. Many children with ADHD want to do well, but their brain struggles with the skills needed to pause, focus, organise, remember and complete tasks consistently.
Common Symptoms of ADHD in Children
Parents often ask, “How do I know if my child has ADHD?” The answer is not based on one behaviour alone. ADHD is considered when symptoms are persistent, age-inappropriate, seen in more than one setting and begin to affect the child’s functioning.
- Inattention
A child with inattentive symptoms may:
- Struggle to focus during lessons or homework
- Make careless mistakes despite knowing the work
- Seem not to listen when spoken to directly
- Start tasks but not complete them
- Lose books, stationery, clothing or school items often
- Forget instructions, chores or school tasks
- Avoid tasks that require sustained mental effort
- Become easily distracted by sounds, movement or thoughts
- Appear dreamy, slow or “in their own world”
This type of ADHD is sometimes overlooked because the child may not be disruptive. Parents may only notice when schoolwork becomes more demanding.
- Hyperactivity
A child with hyperactive symptoms may:
- Fidget constantly
- Leave their seat when expected to remain seated
- Run, climb or move excessively in inappropriate situations
- Struggle to play quietly
- Talk excessively
- Appear to be “always on the go”
- Become restless during church, school, meals or car trips
In younger children, high energy is common. The concern is when the activity level is far beyond what is expected for the child’s age and environment.
- Impulsivity
A child with impulsive symptoms may:
- Interrupt conversations or classroom discussions
- Blurt out answers before a question is completed
- Struggle to wait their turn
- Grab things from others
- Act before thinking
- Have sudden emotional outbursts
- Take unnecessary risks
- Find it difficult to stop a behaviour even after being corrected
Impulsivity can affect friendships because other children may see the child as bossy, rough or impatient, even when the child does not intend to upset others.
When Should Parents Consider an ADHD Assessment?
Parents in Montana Park, Pretoria North, Sinoville, Annlin, Wonderboom, Magalieskruin, Doornpoort, Waverley, Gezina, the Moot and surrounding Pretoria areas should consider a paediatric assessment if ADHD-like behaviours are causing ongoing difficulties.
You may need to seek help if your child:
- Struggles at school despite effort and support
- Takes much longer than expected to complete homework
- Frequently forgets instructions or loses important items
- Has repeated complaints from school about focus or behaviour
- Has emotional meltdowns that seem intense or frequent
- Struggles to maintain friendships
- Appears anxious, frustrated or discouraged because of repeated correction
- Cannot follow routines without constant reminders
- Has sleep difficulties, snoring, restless sleep or daytime tiredness
- Is falling behind academically or losing confidence
An ADHD assessment is not about labelling a child. It is about understanding why the child is struggling and creating the right support plan
ADHD Is Not Diagnosed by a Quick Conversation
A proper ADHD assessment should be thorough. In my practice, I believe it is important to look at the full child — their health, development, sleep, school environment, family context and emotional wellbeing.
There is no single blood test, scan or quick checklist that can diagnose ADHD on its own. A careful assessment may include:
- A detailed medical and developmental history
- Discussion with parents or caregivers
- School feedback where appropriate
- Behaviour rating scales completed by parents and teachers
- Review of academic concerns
- Screening for sleep problems
- Assessment of growth and general health
- Consideration of hearing, vision, learning and emotional difficulties
- Review of family history and any other medical concerns
This process helps distinguish ADHD from other conditions that may look similar.
How ADHD Is Managed
ADHD management should be individualised. There is no one-size-fits-all plan. The best approach depends on the child’s age, symptoms, school demands, family situation, medical history and level of impairment.
A good ADHD plan may include a combination of:
1. Parent Guidance
Parents need practical strategies, not blame. Helpful approaches may include:
- Clear routines
- Short instructions
- Visual reminders
- Predictable consequences
- Positive reinforcement
- Breaking tasks into smaller steps
- Reducing distractions during homework
- Encouraging movement breaks
- Consistent sleep and morning routines
Parent support is especially important because ADHD affects the whole household. When parents understand the condition, they are better able to respond calmly and effectively.
2. School Support
Teachers play an important role. Depending on the child’s needs, school support may include:
- Seating the child away from distractions
- Breaking instructions into steps
- Checking that homework is written down
- Allowing movement breaks
- Giving extra time for some tasks
- Using visual schedules
- Providing regular feedback
- Encouraging organisation systems
- Supporting the child without shaming them
A child with ADHD often does better when parents, teachers and healthcare providers work together.
3. Behavioural Strategies
Behavioural support can help children build skills such as planning, emotional control and task completion. Children with ADHD often respond better to structure, praise and predictable routines than to repeated punishment.
The goal is not to “force” a child to behave. The goal is to teach skills in a way the child can understand and practise.
4. Lifestyle and Routine
Healthy routines can support attention and emotional regulation. These include:
- Adequate sleep
- Regular meals
- Physical activity
- Limited overstimulating screen time
- Consistent homework routines
- Calm bedtime habits
- Organised school bags and study spaces
Lifestyle changes do not “cure” ADHD, but they can make symptoms easier to manage.
5. Medication When Clinically Appropriate
Some children benefit from ADHD medication, especially when symptoms significantly affect school, home life or social functioning. Medication should only be considered after a proper assessment and discussion with the parent or caregiver.
Before medication is prescribed, the child’s medical history, growth, blood pressure, pulse, sleep, appetite and relevant family history should be considered. Follow-up is important to monitor response, side effects and dosage.
Medication is not about changing a child’s personality. When used appropriately, it can help improve focus, reduce impulsivity and support learning. However, it should always form part of a broader care plan that includes home and school support.
Conditions That Can Look Like ADHD
Not every child who is restless, distracted or impulsive has ADHD. Several other factors can affect attention and behaviour, including:
- Poor sleep
- Anxiety
- Learning difficulties
- Hearing or vision problems
- Stress at home or school
- Bullying
- Speech and language delays
- Seizure-related concerns
- Depression or low mood
- Excessive screen time
- Poor routine
- Chronic illness
- Breathing problems during sleep
As a Paediatric Pulmonologist, I pay particular attention to sleep and breathing. A child who snores, sleeps poorly, wakes often or struggles to breathe comfortably at night may appear inattentive, irritable or hyperactive during the day. Before assuming ADHD, it is important to ask whether the child is sleeping well and breathing well.
This is one of the reasons a paediatrician-led assessment can be valuable. Children are complex, and behaviour is often only one part of the picture.
Why Early Support Matters
Untreated ADHD can affect more than school marks. It can affect a child’s confidence, relationships, behaviour and emotional wellbeing. Many children with ADHD are repeatedly corrected before anyone understands what is driving the behaviour.
Early support can help:
- Improve school functioning
- Reduce family conflict
- Improve homework routines
- Support friendships
- Build confidence
- Reduce emotional frustration
- Help parents understand the child better
- Prevent unnecessary shame and blame
Children with ADHD often have strong positive traits such as creativity, energy, curiosity, warmth, determination, humour and observation skills. The goal of treatment is not to remove these strengths, but to support better functioning and emotional balance.
ADHD in Girls: Why It Can Be Missed
Girls with ADHD are sometimes diagnosed later than boys because symptoms may be less obvious. Instead of hyperactivity, they may present with:
- Daydreaming
- Disorganisation
- Forgetfulness
- Slow task completion
- Anxiety about schoolwork
- Emotional sensitivity
- Quiet underperformance
- Difficulty keeping up despite effort
Many girls cope by “holding it together” at school and then becoming overwhelmed at home. A combined home and school history is essential for accurate understanding.
ADHD and Emotional Regulation
ADHD is not only about attention. Many children struggle with emotional regulation, meaning they may react quickly, become frustrated easily or have strong emotional responses.
Parents may notice:
- Sudden anger
- Crying over small issues
- Difficulty calming down
- Low frustration tolerance
- Sensitivity to correction
- Feeling rejected easily
- Intense reactions that pass quickly
With appropriate support, children can learn coping strategies and parents can learn how to reduce conflict and improve communication.
What Parents Can Do While Waiting for an Assessment
- Keep routines predictable
- Give one instruction at a time
- Use short, clear sentences
- Praise effort and improvement
- Create a quiet homework area
- Use checklists for routines
- Break homework into short sections
- Encourage daily physical activity
- Maintain consistent bedtime routines
- Communicate with teachers for feedback
Avoid constant criticism. Children with ADHD respond better to structure, encouragement and consistency than repeated punishment.
Seeing a Paediatrician for ADHD in Pretoria
If you are searching for a paediatrician Pretoria, ADHD doctor Pretoria, specialist paediatrician in Montana Park, or paediatrician near me, it is important to choose a doctor who performs a thorough child-focused assessment.
At my practice at Netcare Montana Hospital in Montana Park, Pretoria, I provide calm, structured and family-focused care for infants, children and adolescents. Many parents arrive feeling worried or unsure, and my role is to listen, explain clearly and guide informed decisions.
Families are seen from Montana Park, Montana, Sinoville, Magalieskruin, Annlin, Wonderboom, Doornpoort, Pretoria North, Zambezi, Waverley, Gezina, the Moot, Akasia, Soshanguve, Mabopane, Ga-Rankuwa, Kameeldrift, Roodeplaat and greater Pretoria/Tshwane.
When to Book an Appointment
Consider booking an appointment if your child’s attention, activity level, impulsivity or emotional regulation is affecting daily life, school progress or family relationships.
You do not need to wait until school failure occurs. Early assessment can prevent long-term stress and help identify the right support sooner.
A paediatric assessment can help answer:
- Is this ADHD?
- Could something else be contributing?
- Does my child need school support?
- Are sleep or breathing issues affecting concentration?
- What can we do at home?
- Is medication necessary?
- How do we protect confidence while managing behaviour?
The earlier we understand the child, the better we can support them.
ADHD and School Performance
Many children with ADHD are intelligent and capable, yet their school results may not reflect their ability. They may understand the lesson but fail to complete the work. They may know the answer but rush and make careless mistakes. They may study but forget to submit the assignment.
Parents may hear comments such as:
- “He can do the work, but he does not focus.”
- “She is bright, but she daydreams.”
- “He rushes through everything.”
- “She needs constant reminders.”
- “He disrupts the class.”
- “She does not finish tasks.”
These comments can be painful for parents and discouraging for the child. Over time, repeated correction can affect confidence. A child may begin to believe they are naughty, lazy or not clever, when the real issue is that they need the correct support.
Early assessment and intervention can help protect a child’s self-esteem and improve daily functioning.
Frequently Asked Questions About ADHD in Children
What is ADHD in children?
ADHD is a neurodevelopmental condition that affects attention, impulse control and activity levels. Children with ADHD may struggle to focus, sit still, complete tasks, organise themselves or control impulsive behaviour.
Is ADHD caused by bad parenting?
No. ADHD is not caused by bad parenting. Parenting style can influence how symptoms are managed, but ADHD itself is a recognised medical and developmental condition. Parents need support and practical strategies, not blame.
When should I see a paediatrician for ADHD in Pretoria?
You should consider seeing a paediatrician if your child has ongoing problems with concentration, impulsivity, hyperactivity, school performance, homework, emotional regulation or behaviour in more than one setting.
Can a child have ADHD without being hyperactive?
Yes. Some children mainly struggle with inattention. They may be quiet, forgetful, disorganised, slow to complete work or easily distracted. This type of ADHD can be missed, especially in girls.
Can sleep problems look like ADHD?
Yes. Poor sleep, snoring and breathing difficulties during sleep can affect concentration, behaviour and mood. As a Paediatric Pulmonologist, sleep and breathing are considered as part of the overall assessment.
Does every child with ADHD need medication?
No. Treatment depends on the child’s age, symptoms and level of impairment. Some children benefit from parent guidance, school support and behavioural strategies. Others may need medication as part of a broader treatment plan.
Can ADHD affect school performance?
Yes. Children with ADHD may understand the work but struggle to complete tasks, follow instructions, remember homework, organise books or stay focused during lessons.
Where is Dr Sizakele Mokati based?
Dr Sizakele Mokati is based at Netcare Montana Hospital in Montana Park, Pretoria, offering specialist paediatric care for children and adolescents.
Which areas does Dr Sizakele Mokati serve?
The practice serves families from:
- Montana Park
- Montana
- Sinoville
- Annlin
- Wonderboom
- Magalieskruin
- Doornpoort
- Pretoria North
- Waverley
- Gezina
- The Moot
- Akasia
- Soshanguve
- Mabopane
- Ga-Rankuwa
- Kameeldrift
- Roodeplaat
- Greater Pretoria/Tshwane
How do I find a paediatrician near me for ADHD?
If you are searching online for “paediatrician near me”, “paediatrician Pretoria” or “ADHD doctor Pretoria”, look for a specialist who offers a thorough child-focused assessment, considers school and home feedback, screens for other possible causes and provides a clear management plan.
Contact Us
Book an ADHD Assessment With Dr Sizakele Mokati
If your child is struggling with attention, impulsivity, hyperactivity, school performance, emotional regulation or sleep-related concerns, a proper paediatric assessment can provide clarity and direction.
Dr Sizakele Mokati is a Specialist Paediatrician and Paediatric Pulmonologist based at Netcare Montana Hospital in Montana Park, Pretoria. Her practice offers compassionate, evidence-based care for children and families across Pretoria and surrounding areas.
Book an appointment today for child-focused ADHD guidance from a trusted paediatrician in Pretoria.