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Child abuse is when a parent or caregiver, whether through action or failing to act, causes injury, death, emotional harm or risk of serious harm to a child. There are many forms of child maltreatment, including neglect, physical abuse, sexual abuse, exploitation and emotional abuse.

Any intentional harm or mistreatment to a child under 18 years old is considered child abuse. Child abuse takes many forms, which often occur at the same time.

  • Physical abuse. Physical child abuse occurs when a child is purposely physically injured or put at risk of harm by another person.
  • Sexual abuse. Sexual child abuse is any sexual activity with a child, such as fondling, oral-genital contact, intercourse, exploitation or exposure to child pornography.
  • Emotional abuse. Emotional child abuse means injuring a child’s self-esteem or emotional well-being. It includes verbal and emotional assault — such as continually belittling or berating a child — as well as isolating, ignoring or rejecting a child.
  • Medical abuse. Medical child abuse occurs when someone gives false information about illness in a child that requires medical attention, putting the child at risk of injury and unnecessary medical care.
  • Child neglect is failure to provide adequate food, shelter, affection, supervision, education, or dental or medical care.

In many cases, child abuse is done by someone the child knows and trusts — often a parent or other relative. If you suspect child abuse, report the abuse to the proper authorities.


A child who’s being abused may feel guilty, ashamed or confused. He or she may be afraid to tell anyone about the abuse, especially if the abuser is a parent, other relative or family friend. That is why it is vital to watch for red flags, such as:

  • Withdrawal from friends or usual activities
  • Changes in behaviour — such as aggression, anger, hostility or hyperactivity — or changes in school performance
  • Depression, anxiety or unusual fears, or a sudden loss of self-confidence
  • An apparent lack of supervision
  • Frequent absences from school
  • Reluctance to leave school activities, as if he or she does not want to go home
  • Attempts at running away
  • Rebellious or defiant behaviour
  • Self-harm or attempts at suicide

Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that — warning signs. The presence of warning signs does not necessarily mean that a child is being abused.

Physical abuse signs and symptoms

  • Unexplained injuries, such as bruises, fractures or burns
  • Injuries that do not match the given explanation

Sexual abuse signs and symptoms

  • Sexual behaviour or knowledge that is inappropriate for the child’s age
  • Pregnancy or a sexually transmitted infection
  • Blood in the child’s underwear
  • Statements that he or she was sexually abused
  • Inappropriate sexual contact with other children

Emotional abuse signs and symptoms

  • Delayed or inappropriate emotional development
  • Loss of self-confidence or self-esteem
  • Social withdrawal or a loss of interest or enthusiasm
  • Depression
  • Avoidance of certain situations, such as refusing to go to school or ride the bus
  • Desperately seeks affection
  • A decrease in school performance or loss of interest in school
  • Loss of previously acquired developmental skills


Neglect signs and symptoms

  • Poor growth or weight gain or being overweight
  • Poor hygiene
  • Lack of clothing or supplies to meet physical needs
  • Taking food or money without permission
  • Hiding food for later
  • Poor record of school attendance
  • Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care

Parental behavior

Sometimes a parent’s demeanor or behaviour sends red flags about child abuse. Warning signs include a parent who:

  • Shows little concern for the child
  • Appears unable to recognize physical or emotional distress in the child
  • Blames the child for the problems
  • Consistently belittles or berates the child, and describes the child with negative terms, such as “worthless” or “evil”
  • Expects the child to provide him or her with attention and care and seems jealous of other family members getting attention from the child
  • Uses harsh physical discipline
  • Demands an inappropriate level of physical or academic performance
  • Severely limits the child’s contact with others
  • Offers conflicting or unconvincing explanations for a child’s injuries or no explanation at all

Child health experts condemn the use of violence in any form, but some people still use corporal punishment, such as spanking, as a way to discipline their children. Any corporal punishment may leave emotional scars. Parental behaviours that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.

When to see a doctor

If you are concerned that your child or another child has been abused, seek help immediately. Depending on the situation, contact the child’s doctor or health care provider, a local child protective agency, the police department, or a 24-hour hotline such as Childline or Lifeline.

If the child needs immediate medical attention, call your local emergency number.

Keep in mind that healthcare professionals are legally required to report all suspected cases of child abuse to the appropriate authorities or the police.

Risk factors

Factors that may increase a person’s risk of becoming abusive include:

  • A history of being abused or neglected as a child
  • Physical or mental illness, such as depression or post-traumatic stress disorder (PTSD)
  • Family crisis or stress, including domestic violence and other marital conflicts, or single parenting
  • A child in the family who is developmentally or physically disabled
  • Financial stress, unemployment or poverty
  • Social or extended family isolation
  • Poor understanding of child development and parenting skills
  • Alcohol, drugs or other substance abuse



Some children overcome the physical and psychological effects of child abuse, particularly those with strong social support and resiliency skills who can adapt and cope with bad experiences. For many others, however, child abuse may result in physical, behavioural, emotional or mental health issues — even years later. Below are some examples.

Physical issues

  • Premature death
  • Physical disabilities
  • Learning disabilities
  • Substance abuse
  • Health problems, such as heart disease, immune disorders, chronic lung disease and cancer

Behavioral issues

  • Delinquent or violent behaviour
  • Abuse of others
  • Withdrawal
  • Suicide attempts or self-injury
  • High-risk sexual behaviours or teen pregnancy
  • Problems in school or not finishing high school
  • Limited social and relationship skills
  • Problems with work or staying employed

Emotional issues

  • Low self-esteem
  • Difficulty establishing or maintaining relationships
  • Challenges with intimacy and trust
  • An unhealthy view of parenthood
  • Inability to cope with stress and frustrations
  • An acceptance that violence is a normal part of relationships

Mental health disorders

  • Eating disorders
  • Personality disorders
  • Behaviour disorders
  • Depression
  • Anxiety disorders
  • Post-traumatic stress disorder (PTSD)
  • Sleep disturbances
  • Attachment disorders


You can take important steps to protect your child from exploitation and child abuse, as well as prevent child abuse in your neighbourhood or community. The goal is to provide safe, stable, nurturing relationships for children. For example:

  • Offer your child love and attention.Nurture your child, listen and be involved in his or her life to develop trust and good communication. Encourage your child to tell you if there is a problem. A supportive family environment and social networks can foster your child’s self-esteem and sense of self-worth.
  • Do not respond in anger.If you feel overwhelmed or out of control, take a break. Do not take out your anger on your child. Talk with your doctor or therapist about ways you can learn to cope with stress and better interact with your child.
  • Think supervision.Do not leave a young child home alone. In public, keep a close eye on your child. Volunteer at school and for activities to get to know the adults who spend time with your child. When old enough to go out without supervision, encourage your child to stay away from strangers and to hang out with friends rather than be alone — and to tell you where he or she is at all times. Find out who is supervising your child — for example, at a sleepover.


  • Know your child’s caregivers.Check references for babysitters and other caregivers. Make irregular, but frequent, unannounced visits to observe what is happening. Do not allow substitutes for your usual child care provider if you do not know the substitute.
  • Emphasize when to say no.Make sure your child understands that he or she does not have to do anything that seems scary or uncomfortable. Encourage your child to leave a threatening or frightening situation immediately and seek help from a trusted adult. If something happens, encourage your child to talk to you or another trusted adult about the episode. Assure your child that it is OK to talk and that he or she will not get in trouble.
  • Teach your child how to stay safe online.Put the computer in a common area of your home, not the child’s bedroom. Use the parental controls to restrict the types of websites your child can visit, and check your child’s privacy settings on social networking sites. Consider it a red flag if your child is secretive about online activities. Cover ground rules, such as not sharing personal information; not responding to inappropriate, hurtful or frightening messages; and not arranging to meet an online contact in person without your permission. Tell your child to let you know if an unknown person makes contact through a social networking site. Report online harassment or inappropriate senders to your service provider and local authorities, if necessary.
  • Reach out.Meet the families in your neighbourhood, including parents and children. Consider joining a parent support group so that you have an appropriate place to vent your frustrations. Develop a network of supportive family and friends. If a friend or neighbour seems to be struggling, offer to babysit or help in another way.








If you worry that you might abuse your child

If you are concerned that you might abuse your child, seek help immediately.

To report a reasonable suspicion that a child has been or is being abused or neglected phone the Child Abuse Report Line (CARL) on 13 14 78. The report line is open 24 hours a day, 7 days a week. Call 000 in an emergency.

Childline :      08000 55 555

Lifeline:          0861 322 322

Or you can start by talking with your family doctor or health care provider. He or she may offer a referral to a parent education class, counselling or a support group for parents to help you learn appropriate ways to deal with your anger. If you are abusing alcohol or drugs, ask your doctor about treatment options.

If you were abused as a child, get counselling to ensure you do not continue the abuse cycle or teach those destructive behaviours to your child.

Remember, child abuse is preventable — and often a symptom of a problem that may be treatable. Ask for help today.


Article courtesy of Mayo Clinic


Ok so everyone celebrated the festive season and new Year, but does it really feel like a new year?

I had These thoughts pop up in my mind, over the past few weeks. We did celebrate Christmas, in an unconventional way, without family, but… did we really celebrate? Or did we just “wish” that the nightmare of 2020 would end and we all would wake up and the COVID-19 nightmare would end in a few seconds…. Boy where we wrong!

Suddenly everything in the world came to a halt. The hectic traffic that frustrated you, were no more. Streets seemed lonely, awaiting the laughing children going to school. The person you sometimes drove next to on your way to work, suddenly vanished…. You, as an essential worker, were left to feel (like) you are driving around a ghost town. You know, those that you see on television with the sand and the tumbleweed blowing across the road. Not even the beggar with her orange-yellow hair was at the traffic light to greet you. It was just…… quiet.

At your workplace you suddenly are greeted with a sanitizing tunnel, and co-workers covered with masks. You barely recognise any of them. Then a general meeting is called on ground floor. All the directors, managers, general-, cleaning- and all other staff eagerly awaits the briefing. Good news is that as far possible we would work according to a schedule, but “lets use this lockdown as an opportunity to rest” the news came. “and at the employer’s cost ALL personnel will be tested for COVID-19 to ensure that our workplace stays safe”. This becomes the new normal for the next two to three months.

Anxiously, we would wait every morning to find out what the new statistics were and then we would ease ourselves by stating that we follow all the rules and regulations and do not go anywhere unless it is ABSOLUTELY necessary. You would talk to family and close friends and even arrange a SKYPE/ZOOM braai to ease the loneliness. We felt sympathetic to the people who lost loved ones due to COVID-19 complications and we would hope and pray that we or anyone close to us would not succumb to this dreadful disease.

With all these emotional stressors we also had to deal with the financial strain as well.” You are glad to still have a job” you would hear some people say. Eventually “those people” became someone you knew through a friend or a far off relative that you would maybe see at a wedding or funeral.  This quickly changed as the disease gets closer and closer to you. First a colleague from works’ aunt, then another colleague’s father and before you know it one of your close family members or friends that is lost to this disease.

Then…. We had some of the restrictions lifted and everyone breathed a sigh of relieve…. For a few weeks we had a new normal. Kids went to school; you could get a haircut and buy your favorite beverage without having to pay an astronomical amount.

As we got used to the “new normal” we hurried to get all the stationery bought and get back to work, you guessed it…. another lockdown. New plans had to be made as to where our kids would stay and how would we cope with everyone back at the workplace?

With all of this happening, I wondered what happened to our kindness? You would walk into a grocery store and smile to people, but now your smile gets stuck behind a mask. How do we know if the person that sees our eyes, that they are sending the message of a smile? They say “the eyes are the windows to the soul” and I have seen a lot of souls… broken ones, empty ones, discouraged ones and most of all souls full of fear. Fear of the disease, fear of losing loved ones, fear of being left behind…. Alone.

I came across a picture that someone sent me and I realized: We only have to be kind to one another.


From cleaner air to liberated wildlife, coronavirus lockdowns across the world appear to have had a number of positive effects on the environment. Modern life as we know it has largely been put on pause with millions of us cooped up indoors as governments try to curtail the spread of the Covid-19 pandemic. But outside, the natural world has continued to rumble on, and even shown signs of benefiting from our absence

Below, we take a look at some of the notable impacts of coronavirus lockdowns our surroundings.

  • Cleaner air has perhaps been the single greatest positive effect of the lockdowns on the environment
    • Citizens in Northern India are seeing the view of the Himalayan mountain range for the first time in their lives, due to the drop in air pollution caused by the country’s coronavirus lockdown.
    • Those living in Jalandhar in northern Punjab have shared pictures of the mountains from rooftops and empty streets, amazed by the view which has been hidden by pollution for 30 years.
    • While in China, where the Covid-19 pandemic originated, carbon emissions fell by around 25 per cent over a four-week period at the beginning of this year as authorities shuttered factories and people were instructed to stay home, according to an analysis carried out for the climate website Carbon Brief.

In fact cities across the world have seen pollution levels plummet as people have spent less time in vehicles, offices and factories and more time at home.

  • Clearer water
    • In Venice, famous for its winding canals, water quality appears to have improved amid Italy‘s stringent coronavirus lockdown. Residents in the city have said the waterways are benefiting from the lack of usual boat traffic brought on by the hoards of tourists who visit each year. Emptied of the usual array of motorboat taxis, transport and tourist boats which clog the canals, there has reportedly been a sharp uptick in the clarity of the water.
    • The change has meanwhile reportedly offered locals clear views of shoals of small fish, crabs and multicolored plant-life – sights often obscured by busy boating movement in the Lagoon. I honestly believe we should take the opportunity of this lockdown to reflect and see how we can be more organized in the future to find a balance between the city and tourism
  • Liberated wildlife
    • While there have been a host of now debunked fake stories about animals’ activities during Covid-19 lockdowns, there have also been plenty of instances of creatures across the world appearing to emboldened, and perhaps a bit bemused, by our ongoing lack of activity.
    • From a herd of marauding goats taking over a Welsh seaside town to deer in a Japanese city roaming the roads in search of food, the shift in behaviours has ranged between the beautiful and the downright bizarre.
    • In Barcelona, Spain, boars have been spotted along the city’s normally bustling avenues, snuffling and trotting around where vehicles once jostled for position.
    • Meanwhile in Chile’s capital, Santiago, a wild puma was captured after being found wandering around the city’s deserted centre during a night-time curfew. It is thought that the animal may have ventured down into the capital from nearby surrounding hills.
    • “This is the habitat they once had and that we’ve taken away from them,” said Marcelo Giagnoni, the director of the agricultural and livestock service that took part in an operation to capture the puma alongside police and the national zoo.
    • The deer in Nara, Japan, have meanwhile been on the move because the park they inhabit has become devoid of tourists – and as a result, the food they are given by visitors and have become accustomed to relying on.
    • Small herds venturing into the city have been spotted nibbling at flowers and plants.
    • In the UK, a host of animals also appear to have been liberated by lockdown restrictions imposed on us. Reports of increased sightings of moles clambering above ground near well-walked footpaths and predictions from conservationists that many of Britain’s rare birds will enjoy a respite from visitors to the countryside point to wildlife benefiting from our absenteeism.
    • It’s also thought wild flowers could bloom in their greatest number for years throughout the UK this summer because of councils cutting back on mowing services, according to research released by conservation charity Plantlife.
    • Trevor Dines, Plantlife’s Botanical Specialist said: “An unintended but understandable consequence of lockdown may be reduced mowing that has the potential to benefit wild plants and the bees, butterflies, birds, bats and bugs that depend on them for survival.

      “Across the world, the lockdowns may just be showing us how quickly the natural world around us can adapt and thrive in our absence when given some space. Or to put it simply, when we move out, nature can move in



Learning how to stay positive in negative situations helps toward living a healthy lifestyle. But even typically positive people are being tested by the stress of the COVID-19 pandemic. If you’re looking for help in focusing on the positive, here are five life hacks for this time of social distancing.


Keep It Positive

Surrounding yourself with positive people (and positivity online) will help you stay positive during this uncertain time. There are plenty of negative people out there – avoid them! Negative attitudes will only bring you down. Set the example. When you are positive, your friends and family will be encouraged to follow your lead.


What Are You Grateful for? 

Even in the worst of times, most of us realize that we still have things in our lives for which we are grateful. Say it out loud! Practice gratitude. Keep a journal – maybe even a family journal. Talk about the things your entire family is grateful for. Develop a family mantra, and say it together at the start of every day. Actively acknowledging what you are all grateful for will help your family have grateful minds and hearts.


Be Mindful

Do you constantly question your actions or beat yourself up mentally? Retrain your brain. The more you talk negatively to yourself, the more that negativity will become a part of you. Instead, practice the power of positive thinking. Any time a negative thought comes into your mind, replace it with a positive one. This will become more natural as your brain automatically turns a negative into a positive.


Exercise Your Mind

We know that exercise is good for our bodies, but what about our minds? Sure it is! It releases those natural endorphins that make us feel better. Exercise has physical as well as mental and emotional benefits. Getting active will keep your body in better shape and boost your self-esteem. Yoga can also help you learn to really focus.


Embrace Change

Many of us are resistant to change in our lives. That’s why social distancing is so taxing on everyone. We’re used to doing what we want when we want. But now we must learn to accept that we’re not in control. We must learn to adapt. We have to follow new rules. These changes are foreign to us and often limiting.

So, what can you do? No, you can’t travel where you want right now. Yes, you’re spending a lot of time at home with your family – in very close quarters. So, let’s look for the positive. This is a chance for all of us to recalibrate and focus on what’s truly important. What’s more important than our family and friends? Nothing! Let’s learn to appreciate each other again. Relearn how to communicate. Stay connected. Once we put this negative situation into perspective, surely, we can come out on the other side more appreciative, grounded and content.

More Resources


The wave of lockdown restrictions are proving even more challenging for many of us. This time around we not only have the disruption of social distancing, but the added gloom of rainy days, dark evenings, political uncertainty and general emotional fatigue. At times like this it can be difficult to stay positive, so we asked 10 leading experts to give us their top tips for lockdown happiness.


‘Pets can be your best pill against loneliness with its devastating mental and physical health effects during lockdown! Their companionship combats loneliness, social isolation, and provides a clear daily structure and routine. Pets help against stress, depression, anxiety, and emotional pain through their calming and comforting effect.

Dr Margit Gabriele Muller, world-leading vet, NLP Master and author of Your Pet your Pill.


‘Lockdown presents several challenges in our ability to stay connected. We need to keep social distance, we cannot visit as we used to, and the way we share experiences radically changed. As staying connected is incredibly important for our wellbeing, we need to be intentional about it and prioritise it… Learn to maximise the ability to connect through an online platform or just using the phone to say: “I am thinking about you” or “how can I support you?”

Dr Guy Lubitsh is a psychologist and co-author of Connect: Resolve Conflict, Improve Communication, Strengthen Relationships.


‘Do you have an idea that you’ve never had the time to get off the ground? Whether you’ve been toying with starting a new business doing something you love, launching a community project or making a major life change, this could be the perfect time to put it to the test and find out whether it is worth going for. Don’t just sit on your idea and wait for someone else to do it – this time could be used to start something new and exciting to focus on for 2021.’

Julia Shalet is an innovation expert and author of The Really Good Idea Test.


‘Numerous studies have showed that creativity and happiness are intrinsically linked. We’re going to need all our creativity to work effectively and solve the new challenges we’re faced with in lockdown. It is therefore important to not forget about the little rewards, or ‘lockdown luxuries’, throughout the day that make you happy. For me it starts with a stretch in the fresh air first thing, it is a coffee and a chat with the family, a brisk walk before the afternoon shift and a belly full of laughs at the end of the day. But everyone is different, so take some time to create your own daily happiness routine and all areas of your life will benefit.’

Mark Simmonds is a creativity expert and the founder of GENIUS YOU.


‘Beat lockdown blues through the life-changing power of film. Whether it’s an old classic like It’s a Wonderful Life, a contemporary adventure like Eat Pray Love, an indie like Peaceful Warrior, or a documentary like Tony Robbins: I Am Not Your Guru, movies have the ability to make us forget our struggles and feel better about ourselves and our lives. For example, Nelson Mandela (Morgan Freeman) teaches us gratitude in Invictus, Erin Brockovich (Ellis, Julia Roberts) teaches us resilience and Christopher Gardner (Will Smith) teaches how to achieve greater health, wealth and happiness in The Pursuit of Happyness.

Dawud Abdul-Hamid Gurevitch, The Movie Mentor, is the author of May The Source Be With You: A Filmic Guide To Change Your Life.



‘All emotions are chemicals – strands of neuropeptides. Three “feel good” chemicals are key for mood: oxytocin (social bonding and trust), dopamine (pleasure and reward), and serotonin (happiness). Here are a few techniques that will help: Meditating and eating bananas or 70% dark chocolate boosts serotonin. Smiling at others, even through the camera lens of your computer/phone, boosts oxytocin. When people smile back, it boosts dopamine. Sending a text/calling someone to ask how they are doing/if you can help also boosts oxytocin. Their response boosts dopamine. Physical contact (even hugging yourself) and petting your pets boost oxytocin. Start mixing your mood-boosting chemical cocktail!’

Claire Dale is co-author of award-winning wellbeing book Physical Intelligence.


‘Whenever we suffer a loss, regardless of what that loss is – family, job, freedom, health etc. – we grieve. Don’t be afraid to allow yourself to feel the pain of the loss and accept the feelings it brings. Often, we are told to not to feel bad, but sadness like happiness needs to be felt. Process your thoughts so you can draw conclusions, accept and move forward. Life is inevitably interspersed with all sorts of experiences – good and bad – so don’t take it personally and realise that each loss can be an opportunity for growth and learning. Stay open to change.’

Lianna Champ has over 40 years’ experience in grief and bereavement counselling and is author of practical guide, How to Grieve Like A Champ.



‘Radical empathy is the committed practise of considering the world through the context and reality of other people without judgement. When you see behaviour or hear views that jar, instead of getting angry or upset, take a moment to consider “what might have led them to this?” When we empathise, we don’t need to agree, we simply need to use our imagination to be curious and to try and understand their viewpoint. This builds our ability to empathise and it helps us understand why the other person feels the way they do. We can get closer to people without feeling ‘judged’ and create happier, more positive relationships.’

Mimi Nicklin is a globally recognised millennial thought-leader and author of new book Softening the Edge.


‘Discovering a hobby that you love is a great way to incorporate some self-care and recharge into your lifestyle. Research shows that people with hobbies are less likely to suffer from stress, low mood, and depression. Finding time for self-care, especially during lockdown when our nervous systems are on high alert, is crucial.

Carina Lawson is a Time Management Coach and the Founder of Ponderlily Planners & Journals.  


‘At difficult times, it is important practice gratitude – when we’re grateful for what we DO have, we forget about what we don’t have. Sometimes it is a question of identifying what you need to give up on or let go. You might find it helpful to ritualise the process of completion, so try saying to yourself – “I am complete!” But most of all, remember that, like all the challenges you have already been through and overcome in life, this too shall pass!’

Karlin Sloan is a global leadership & development coach, CEO of Sloan Group International and author of new book, Inspiring Leadership for Uncertain Times.


ADHD Awareness Month 2020

THE South African Depression and Anxiety Group (Sadag) has officially launched their toll-free Attention Deficit Hyperactivity Disorder (ADHD) line aimed at assisting those affected by the disorder. The helpline was officially launched on ADHD Awareness Day on 14/09/2014.  The helpline number is 0800 55 44 33 and is toll-free.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Children with ADHD may also struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.

While treatment will not cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.


Some people with ADHD have fewer symptoms as they age, but some adults continue to have major symptoms that interfere with daily functioning. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness and restlessness. Symptoms can range from mild to severe.

Many adults with ADHD are not aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.

Adult ADHD symptoms may include:

  • Impulsiveness
  • Disorganization and problems prioritizing
  • Poor time management skills
  • Problems focusing on a task
  • Trouble multitasking
  • Excessive activity or restlessness
  • Poor planning
  • Low frustration tolerance
  • Frequent mood swings
  • Problems following through and completing tasks
  • Hot temper
  • Trouble coping with stress

What is typical behavior and what is ADHD?

Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably do not have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.

Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.

When to see a doctor

If any of the symptoms listed above continually disrupt your life, talk to your doctor about whether you might have ADHD.

Different types of health care professionals may diagnose and supervise treatment for ADHD. Seek a provider who has training and experience in caring for adults with ADHD.


While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:

  • ADHD can run in families, and studies indicate that genes may play a role.
  • Certain environmental factors also may increase risk, such as lead exposure as a child.
  • Problems during development. Problems with the central nervous system at key moments in development may play a role.

Risk factors

Risk of ADHD may increase if:

  • You have blood relatives, such as a parent or sibling, with ADHD or another mental health disorder
  • Your mother smoked, drank alcohol or used drugs during pregnancy
  • As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings
  • You were born prematurely


ADHD can make life difficult for you. ADHD has been linked to:

  • Poor school or work performance
  • Unemployment
  • Financial problems
  • Trouble with the law
  • Alcohol or other substance misuse
  • Frequent car accidents or other accidents
  • Unstable relationships
  • Poor physical and mental health
  • Poor self-image
  • Suicide attempts

Coexisting conditions

Although ADHD does not cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:

  • Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems are not necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.
  • Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorders may cause overwhelming worry, nervousness and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.
  • Other psychiatric disorders. Adults with ADHD are at increased risk of other psychiatric disorders, such as personality disorders, intermittent explosive disorder and substance use disorders.
  • Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education. Learning disabilities can include problems with understanding and communicating.


It’s a question that’s asked all the time: how much alcohol is safe to drink during pregnancy? Globally, Fetal Alcohol Spectrum Disorder (the term used to describe all developmental abnormalities caused by alcohol consumption during pregnancy) is the most common form of mental and intellectual disability, and is 30 to 50 times more prevalent than the next most common disability, which is Down Syndrome.

According to the World Health Organization, South Africa has the 7th highest per capita reported rate of alcohol consumption in the world. And while the worldwide rate of FASD sits at 1,5%, in South Africa the prevalence rate ranges between 2,7% and up to 28% in some communities.

So exactly how much alcohol is safe to drink during pregnancy?

According to the Foundation for Fetal Alcohol Research (FARR), the answer is none. Because alcohol is metabolized differently by everyone – affected by body weight, gender, and general health, among other factors – some people might feel tipsy after just a few sips of alcohol, while others are able to tolerate more. When a woman is pregnant, her body’s ability to metabolize alcohol also changes, which is compounded by how susceptible the fetus’s nervous system is to the harmful effects of alcohol, as well as the inability of the immature fetal liver to metabolize alcohol.

Here’s how alcohol affects an unborn baby at each stage of pregnancy

What is Fetal Alcohol Spectrum Disorder (FASD)?

FASD is the broad term used for all developmental abnormalities caused by alcohol consumption during pregnancy.

Fetal Alcohol Spectrum Disorder (FASD) is caused by alcohol exposure during pregnancy. Alcohol acts as a powerful toxin (poison) to the developing fetus and can affect the fetus within 20 minutes after the ingestion of alcohol. It affects the development of all fetal tissue and organs, although the brain and the nervous system are the most vulnerable.

After birth, the baby may present with a range of physical, neurological, behavioral and intellectual abnormalities that become more evident over time. In addition to intellectual deficits, an individual with FASD may present with the following:

  • Growth retardation (small for age before and after birth)
  • Organ damage, especially the brain, eyes, ears and heart
  • Abnormal facial features
  • Brain damage, which result in lifelong challenges such as learning disability, interpersonal relationship problems, developmental disability such as fine motor development and coordination. In addition, most of these children also present with attention and hyperactivity symptoms.

In Adolescence an individual with FASD may present with additional challenges such as:

  • Poor scholastic performance
  • Mental health- and substance abuse problems

Fetal Alcohol Syndrome (FAS) is the most severe form of Fetal Alcohol Spectrum Disorders. Other disorders within the FASD spectrum are:

  • Alcohol Related Neurodevelopmental Disorders (ARND):  Any of the developing fetus’ organs can be affected by the poisonous (toxic) effect of alcohol; however, the brain is especially vulnerable. Children with ARND will present with brain (neurological) damage, but few of the other obvious signs or symptoms of FASD. Diagnosing ARND demands specialized neuro-developmental assessments (psychological testing) using scientifically developed assessment measures for FASD. This needs to be corroborated by a positive history of alcohol consumption during pregnancy, through an extensive maternal interview. Children with this condition are often wrongly labelled as naughty, hyperactive and / or with attention deficit disorder (ADHD-like behaviour).
  • Alcohol Related Birth Defects (ARBD):  ARBD is characterized by organ damage caused by alcohol consumption during pregnancy.  These individuals do not present with any other signs of FASD, only developmental abnormalities of organ systems, i.e. heart, eye, hearing, skeletal.  Diagnosing ARBD would include an extensive maternal interview confirming alcohol consumption during pregnancy as well as clinical examination by a trained medical specialist.
  • Partial FAS (PFAS):  An individual with PFAS usually presents with some of the facial and physical signs of FASD, but do not show all features associated with FAS.

How much alcohol is safe to consume during pregnancy?

No amount of alcohol is safe to consume during pregnancy.

Alcohol is metabolized differently in all individuals. Some people may feel intoxicated from a few sips of wine while others may be able to tolerate more alcohol. The body’s response to alcohol will vary from person to person due to various factors such as body weight, nutritional status, general health and gender. When a woman is pregnant, her body’s ability to metabolize alcohol also changes. This is compounded by the fetus’ susceptible nervous system to the harmful effect of alcohol as well as the inability of the immature fetal liver to metabolize alcohol.

What is the extent of FASD?

The prevalence and extent of FASD is a worldwide challenge.  Formal figures of the incidence for a few countries such as America (0,1 3%), France (2,1%) are available. Prevalence studies conducted by FARR (see table below) has shown that South-Africa has the highest reported rate of FASD worldwide. It is 30 – 50 times more common than the next most common birth defect, namely Down Syndrome.


BabyYumYum – 9 SEPTEMBER 2020


What is muscular dystrophy?

Muscular dystrophy is a group of inherited diseases that damage and weaken your muscles over time. This damage and weakness is due to the lack of a protein called dystrophin, which is necessary for normal muscle function. The absence of this protein can cause problems with walking, swallowing, and muscle coordination.

Muscular dystrophy can occur at any age, but most diagnoses occur in childhood. Young boys are more likely to have this disease than girls.

The prognosis for muscular dystrophy depends on the type and the severity of symptoms. However, most individuals with muscular dystrophy do lose the ability to walk and eventually require a wheelchair. There’s no known cure for muscular dystrophy, but certain treatments may help.

What are the symptoms of muscular dystrophy?

There are more than 30 different types of muscular dystrophy, which vary in symptoms and severity. There are nine different categories used for diagnosis.

Duchenne muscular dystrophy

This type of muscular dystrophy is the most common among children. The majority of individuals affected are boys. It’s rare for girls to develop it. The symptoms include:

  • trouble walking
  • loss of reflexes
  • difficulty standing up
  • poor posture
  • bone thinning
  • scoliosis, which is an abnormal curvature of your spine
  • mild intellectual impairment
  • breathing difficulties
  • swallowing problems
  • lung and heart weakness

People with Duchenne muscular dystrophy typically require a wheelchair before their teenage years. The life expectancy for those with this disease is late teens or 20s.

Becker muscular dystrophy

Becker muscular dystrophy is similar to Duchenne muscular dystrophy, but it’s less severe. This type of muscular dystrophy also more commonly affects boys. Muscle weakness occurs mostly in your arms and legs, with symptoms appearing between age 11 and 25.

Other symptoms of Becker muscular dystrophy include:

  • walking on your toes
  • frequent falls
  • muscle cramps
  • trouble getting up from the floor

Many with this disease don’t need a wheelchair until they’re in their mid-30s or older, and a small percentage of people with this disease never require one. Most people with Becker muscular dystrophy live until middle age or later.

Congenital muscular dystrophy

Congenital muscular dystrophies are often apparent between birth and age 2. This is when parents begin to notice that their child’s motor functions and muscle control aren’t developing as they should. Symptoms vary and may include:

  • muscle weakness
  • poor motor control
  • inability to sit or stand without support
  • scoliosis
  • foot deformities
  • trouble swallowing
  • respiratory problems
  • vision problems
  • speech problems
  • intellectual impairment

While symptoms vary from mild to severe, the majority of people with congenital muscular dystrophy are unable to sit or stand without help. The lifespan of someone with this type also varies, depending on the symptoms. Some people with congenital muscular dystrophy die in infancy while others live until adulthood.

Myotonic dystrophy

Myotonic dystrophy is also called Steinert’s disease or dystrophia myotonica. This form of muscular dystrophy causes myotonia, which is an inability to relax your muscles after they contract. Myotonia is exclusive to this type of muscular dystrophy.

Myotonic dystrophy can affect your:

  • facial muscles
  • central nervous system
  • adrenal glands
  • heart
  • thyroid
  • eyes
  • gastrointestinal tract

Symptoms most often appear first in your face and neck. They include:

  • drooping muscles in your face, producing a thin, haggard look
  • difficulty lifting your neck due to weak neck muscles
  • difficulty swallowing
  • droopy eyelids, or ptosis
  • early baldness in the front area of your scalp
  • poor vision, including cataracts
  • weight loss
  • increased sweating

This dystrophy type may also cause impotence and testicular atrophy in males. In women, it may cause irregular periods and infertility.

Myotonic dystrophy diagnoses are most common in adults in their 20s and 30s. The severity of symptoms can vary greatly. Some people experience mild symptoms, while others have potentially life-threatening symptoms involving the heart and lungs.

Facioscapulohumeral (FSHD)

Facioscapulohumeral muscular dystrophy (FSHD) is also known as Landouzy-Dejerine disease. This type of muscular dystrophy affects the muscles in your face, shoulders, and upper arms. FSHD may cause:

  • difficulty chewing or swallowing
  • slanted shoulders
  • a crooked appearance of the mouth
  • a wing-like appearance of the shoulder blades

A smaller number of people with FSHD may develop hearing and respiratory problems.

FSHD tends to progress slowly. Symptoms usually appear during your teenage years, but they sometimes don’t appear until your 40s. Most people with this condition live a full life span.

Limb-girdle muscular dystrophy

Limb-girdle muscular dystrophy causes weakening of the muscles and a loss of muscle bulk. This type of muscular dystrophy usually begins in your shoulders and hips, but it may also occur in your legs and neck. You may find it hard to get up out of a chair, walk up and down stairs, and carry heavy items if you have limb-girdle muscular dystrophy. You may also stumble and fall more easily.

Limb-girdle muscular dystrophy affects both males and females. Most people with this form of muscular dystrophy are disabled by age 20. However, many have a normal life expectancy.

Oculopharyngeal muscular dystrophy (OPMD)

Oculopharyngeal muscular dystrophy causes weakness in your facial, neck, and shoulder muscles. Other symptoms include:

  • drooping eyelids
  • trouble swallowing
  • voice changes
  • vision problems
  • heart problems
  • difficulty walking

OPMD occurs in both men and women. Individuals usually receive diagnoses in their 40s or 50s.

Distal muscular dystrophy

Distal muscular dystrophy is also called distal myopathy. It affects the muscles in your:

  • forearms
  • hands
  • calves
  • feet

It may also affect your respiratory system and heart muscles. The symptoms tend to progress slowly and include a loss of fine motor skills and difficulty walking. Most people, both male and female, are diagnosed with distal muscular dystrophy between the ages of 40 and 60.

Emery-Dreifuss muscular dystrophy

Emery-Dreifuss muscular dystrophy tends to affect more boys than girls. This type of muscular dystrophy usually begins in childhood. The symptoms include:

  • weakness in your upper arm and lower leg muscles
  • breathing problems
  • heart problems
  • shortening of the muscles in your spine, neck, ankles, knees, and elbows

Most individuals with Emery-Dreifuss muscular dystrophy die in mid-adulthood from heart or lung failure.

How is muscular dystrophy diagnosed?

A number of different tests can help your doctor diagnose a muscular dystrophy. Your doctor can:

  • test your blood for the enzymes released by damaged muscles
  • test your blood for the genetic markers of muscular dystrophy
  • perform an electromyography test on your muscle’s electrical activity using an electrode needle that enters your muscle
  • perform a muscle biopsy to test a sample of your muscle for muscular dystrophy

How is muscular dystrophy treated?

There’s currently no cure for muscular dystrophy, but treatments can help manage your symptoms and slow the progression of the disease. Treatments depend on your symptoms.

Treatment options include:

  • corticosteroid drugs, which help strengthen your muscles and slow muscle deterioration
  • assisted ventilation if respiratory muscles are affected
  • medication for heart problems
  • surgery to help correct the shortening of your muscles
  • surgery to repair cataracts
  • surgery to treat scoliosis
  • surgery to treat cardiac problems

Therapy has proven to be effective. You can strengthen your muscles and maintain your range of motion using physical therapy. Occupational therapy can help you:

  • become more independent
  • improve your coping skills
  • improve your social skills
  • gain access to community services

Last medically reviewed on February 12, 2019



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