Heritage Day 2025

As South Africans we celebrate the rich tapestry of cultures, traditions, and histories that unite us as one nation. On this HeritageDay, we honour our shared identity and the diverse roots that shape our collective story.

We wish all our members a meaningful Heritage Day filled with pride and togetherness.

Memories enable us to relive the past and preserve special moments that play a defining role in who we are. Every year we commemorate those who live with Alzheimer’s disease and other forms of dementia. The world honors World Alzheimer’s Day.

World Alzheimer’s Day is an opportunity to celebrate loved ones who live with Alzheimer’s disease but it is also an opportunity to:

• create awareness
• initiate research and collaboration for early detection and improved treatment
• highlight the value of support and
• honor the caretakes, healthcare staff and professionals, researchers and family members who care for their loved ones

You can make a difference:

• Volunteer
• Donate
• Educate yourself and others
• Support

Read more about World Alzheimer’s Day and Alzheimer’s:

• Alzheimer’s disease – Old friends and new promises: https://www.up.ac.za/research-matters/news/post_2995717-alzheimers-disease-old-friends-and-new-promises
• Alzheimer’s Association: https://www.alz.org/about/awareness-initiatives/world-alzheimers-day
• Mahomed A, Pretorius C. Availability and utilization of support services for South African male caregivers of people with Alzheimer’s disease in low-income communities. Dementia. 2020;20(2):633-652. doi:10.1177/1471301220909281
• Manderson L, Brear M, Rusere F, Farrell M, Gómez-Olivé FX, Berkman L, Kahn K, Harling G. Protocol: the complexity of informal caregiving for Alzheimer’s disease and related dementias in rural South Africa. Wellcome Open Res. 2022 Aug 25;7:220. doi: 10.12688/wellcomeopenres.18078.1. PMID: 37538406; PMCID: PMC10394391.
• orczyn, A.D., Grinberg, L.T. Is Alzheimer disease a disease?. Nat Rev Neurol 20, 245–251 (2024). https://doi.org/10.1038/s41582-024-00940-4

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition with a course that often extends beyond childhood. Prevalence estimates suggest that 2–16% of children meet criteria for ADHD (Boshomane, Pillay, & Meyer, 2020; Botha & Schoeman, 2023). In adulthood, rates decline to 2.5–4.2% (Schoeman & Leibenberg, 2017), yet research shows that 60–70% of children diagnosed with ADHD continue to experience symptoms into adulthood (Belanger et al., 2018). This continuity highlights the importance of recognising ADHD as a lifespan condition. For practitioners, an accurate and nuanced understanding of how ADHD evolves is critical for supporting children, adolescents, and adults alike.

Challenges in Diagnosis

Prevalence estimates vary widely due to differences in methodology, assessment tools, and practitioner expertise. Overdiagnosis in children, underdiagnosis in adults, and limited training in ADHD assessment contribute to these discrepancies (Schellack & Meyer, 2016). Given the impact of an ADHD diagnosis on an individual and their family, assessment should not be made hastily. A holistic approach, integrating developmental history, collateral information, and careful differential diagnosis, is essential before assigning the ADHD label.

ADHD Across Development: Children and Adults

ADHD is not static; its presentation changes with age. Symptoms that are visible and behavioural in children may become more internalised and functional in adults. The DSM-5-TR accommodates these shifts by adjusting diagnostic thresholds and providing developmentally relevant examples.

Increasing Demands, Decreasing Supports

Children often benefit from external structure, parental oversight, and consistent school routines. Transitioning into adulthood, however, brings greater demands—academic, occupational, financial, and relational—alongside a decrease in support. For individuals with ADHD, this can create a “perfect storm” where difficulties become more pronounced.

Opportunities in Adulthood

Despite these challenges, adulthood offers new possibilities for adaptive functioning. Adults can select environments that align with their strengths—roles that value creativity, movement, or rapid problem-solving. They may also develop personalised strategies, such as flexible scheduling, seeking supportive relationships, or outsourcing tasks that are consistently challenging (e.g., administrative tasks).

Areas of Vulnerability

Across the lifespan, ADHD is associated with a higher risk of impairment compared to the general population. In adulthood, consequences often become more significant and wide-ranging:

• Social: Interpersonal conflict, higher rates of separation and divorce.
• Emotional: Stress reactivity, emotional dysregulation, co-occurring depression, anxiety, and substance use disorders.
• Behavioural: Risk-taking, earlier initiation of substance use, higher relapse rates.
• Legal: Increased traffic offences, arrests, and recidivism.
• Academic/Occupational: Lower academic attainment, higher dropout rates, inconsistent employment, and negative performance reviews.
• Financial/Health: Lower lifetime earnings, impulse spending, increased rates of obesity, sleep disturbance, chronic illness, and a reduced life expectancy (by an estimated 9–10 years).

Best Practice in Diagnosis

A robust ADHD assessment should include:

1. Comprehensive History: Clinical interview, developmental history, and input from multiple informants.
2. Differential Diagnosis: Ruling out conditions that can mimic ADHD, including sleep deficits, vision problems, nutritional issues, epilepsy, trauma, anxiety, depression, or learning disorders.
3. Application of DSM-5-TR Criteria: Symptoms must be persistent, developmentally inappropriate, present in multiple settings, and impairing.
4. Consideration of Trauma: Adverse childhood experiences and traumatic stress can exacerbate or resemble ADHD symptoms. Careful screening is essential.

Managing ADHD: A Multimodal Approach

Treatment planning should be holistic and individualised, often combining:

• Medication: Stimulants and non-stimulants remain first-line pharmacological options. Regular monitoring for side effects and interactions is essential.
• Psychological Interventions: Cognitive behavioural therapy, psychoeducation, and skills training to address emotional regulation, planning, and interpersonal functioning.
• Environmental Supports: Classroom accommodations for children, workplace adaptations for adults, and structured routines across the lifespan.
• Lifestyle Factors: Adequate sleep, balanced nutrition, hydration, and physical activity significantly influence symptom management.
• Support Systems: Parents, teachers, therapists, mentors, and support groups can all play a vital role in scaffolding functioning.

Reframing ADHD

While ADHD presents challenges, it is equally important to acknowledge its strengths. Creativity, innovation, high energy, and unique problem-solving skills are common among individuals with ADHD. By moving beyond a deficit-focused perspective, practitioners can help clients harness these strengths while managing difficulties, thereby fostering resilience and self-efficacy.

ADHD does not simply “end” with childhood. It is a lifelong condition that evolves across developmental stages. For registered counsellors, psychometrists, and other health practitioners, recognising these changes is vital for effective screening, supportive intervention, and timely referral for diagnosis and treatment by psychologists or psychiatrists. By combining early identification, holistic support, and a strengths-based approach, practitioners can play a critical role in empowering individuals with ADHD to move beyond survival and toward thriving.

On a warm afternoon in Lehurutshe, Zeerust, a young boy named Thabo sat under a marula tree, rhythmically tapping a stick against the soil. At the same time, his teacher grew increasingly frustrated at his “restlessness.” Thabo’s inability to “sit still” or follow long instructions was quickly labelled as defiance, poor discipline, or even laziness by many around him. Yet, what Thabo was living with was not a character flaw; it was Attention Deficit Hyperactivity Disorder (ADHD).

Thabo’s story is not unique. Across our towns, villages, and cities, countless children and adults live with ADHD, often misunderstood and mischaracterised in ways that deepen stigma and silence. This is why National ADHD Awareness Day on 14 September 2025, commemorated under the theme Sea of Yellow for ADHD Awareness, is not only a call to wear colour, but also a call to open our eyes, to see ADHD through lenses that make sense in our South African realities.

DECOLONISING OUR UNDERSTANDING OF ADHD

When we speak about decolonising ADHD, we should not dismiss or reject the valuable knowledge that global research has provided. Instead, it ensures that our understanding of ADHD resonates with people’s lived experiences, languages, and cultural frameworks.

In many communities, behavioural signs of ADHD are easily interpreted through moral, spiritual, or disciplinary lenses. A child is “naughty,” “bewitched,” or “undisciplined,” rather than neurodivergent. These cultural meanings matter because they shape how families seek help or whether they seek help at all. Decolonising ADHD means situating the condition in our own socio-cultural realities, making space for multiple ways of knowing, while also ensuring evidence-based psychological care is accessible.

ADHD does not occur in isolation. In South Africa, its impact is magnified by intersecting realities of poverty, overcrowded classrooms, and limited access to healthcare. For children like Thabo, ADHD is often compounded by hunger, trauma, or unsafe environments.

Our teachers are often the first to notice signs, but individualised support becomes near impossible with class sizes of 45 to 70 learners. Many families rely on traditional explanations of behaviour, while medical and psychological resources remain concentrated in urban centres. Raising awareness is not enough; we need to translate awareness into contextually appropriate, culturally sensitive, and socially just support systems.

As psychologists, our role is twofold:

1. Early Intervention: Advocating for accessible assessments and interventions that can be delivered not just in urban clinics, but in community-based and school-based settings.
2. Public Awareness: Engaging in public education that reduces stigma, communicates in all official languages, and affirms that ADHD is not a moral failing but a neurodevelopmental difference.

In this light, we invite our colleagues to reflect on psychology’s role in supporting individuals and families affected by ADHD, to advocate for early intervention, and to advance public awareness and care strategies. We collectively highlight PsySSA’s commitment to human rights, dignity, and social justice.

WAY FORWARD

On this National ADHD Awareness Day, let us wear yellow not only as a symbol of solidarity but also as a pledge: to listen more carefully, contextualise more deeply, and act boldly. Thabo and the many children and adults like him deserve to grow up in a society that understands them on their own terms, in their own contexts, with dignity and hope.

Together, as psychologists, educators, parents, and community members, we can ensure that ADHD is not a hidden struggle but a recognised difference that calls for compassion, understanding, and care.

Dr Momi Kemoneilwe  Metsing
Chairperson: Society for Educational Psychology of South Africa (SEPSA)