Five percent of the world's population is understood to suffer from Attention Deficit/Hyperactive Disorder (AD/HD) - amounting to around one in every 20 children in Bermuda.

That means that at least one youngster in every classroom on the Island needs additional attention, and greater understanding, when it comes to how they learn and why.

But consultant paediatrician Dr. Bente` Lundh said she feared that many sufferers on the Island had never been diagnosed with the genetic condition, and so had been left to deal with the disorder alone.

She said there were some who managed to scrape through their school years and go on to be successful career people, but equally, she said a disproportionate number of the prison population was made up of inmates with unrecognised AD/HD and learning disabilities.

"This is a brain-based disorder that can totally disrupt the way people cope with everyday tasks, yet I think a huge amount of people have never been diagnosed, and so have been left to get through it on their own," said Dr. Lundh.

"Some people believe that AD/HD does not exist, but it is very real. Neuro imaging studies have revealed differences in parts of the brain that deal with issues like concentration and impulse-control.

"If we get early diagnosis we can really help sufferers and their families to adjust themselves accordingly.

"They can stay in school, achieve good grades and go on to be successful, but the longer the disorder is unrecognised, the greater effect it has, possibly leading to low self-esteem, depression and failing academics."

Dr. Lundh said she often diagnosed parents with AD/HD when they brought their children to be assessed., and when they thought about it, they saw some of their own tendencies in their children.

The consultant said for those children who have ADD with hyperactivity, the disorder is often noticed more quickly by parents and teachers as behavioural problems can become an issue and school work is disrupted.

However, the consultant said she believed there were many ADD sufferers, particularly girls, who went unnoticed because they simply appeared to day dream a lot and had a great tendency to go into a world of their own.

"Because they are not getting up and wandering around the classroom, being impulsive and disruptive, they are not noticed as having a problem," said Dr. Lundh.

"We find that boys tend to have ADD with hyperactivity more than girls, and a lot of girls who suffer from just ADD are classed by their schools as needing to try a bit harder.

"A child with ADD who has a good IQ and who is from a well-structured family can get through primary school without any obvious problems.

"But it is when they change schools, where there is less structure, that the problems seem to come out, and by then, other issues have often arisen."

Dr. Lundh said she received mixed reports from parents about school and teacher support. But she said she noticed a big difference between the high support of the primary and middle schools, when compared to secondary schools, and said she believed that teachers needed to receive regular training in dealing with children with AD/HD.

However, the doctor said parents of AD/HD children had to be proactive in visiting teachers and talking to them at length about their child and their specific problems.

And she said, where possible, schools should make special arrangements for students with AD/HD in a bid to keep them busy and successful in mainstream education.

"Studies in the US have shown that about 50 percent of AD/HD children can stay in mainstream education without any additional support," said Dr. Lundh.

"About 35 percent can stay in the class but require additional support, and only ten to 15 percent need to be placed in a different school altogether."

But she said with medication, 80 percent of people with the condition do find a vast improvement.

She said due to US restrictions, primarily short-acting drugs were available in Bermuda (and elsewhere in the world), but said if used properly, they were highly effective.

The consultant admitted they had some side effects, but said the pros nearly always outweighed the cons.

She added: "It's important for parents to know that there are medications for these conditions which do make a big difference for more than 80 percent of the children.

"They are tried and tested drugs, which have been used over many years, and they are very well tolerated.

"These drugs are not over-prescribed. Quite often it takes parents a couple of years to come back to me and say they want to try the medication. But it almost always works."