Pay attention and study hard!

China puts a premium on studious, high-scoring, well-behaved children and those who are restless, unruly and unfocused often have school, family and social problems. For Children's Day, Wang Jie looks at children who are inattentive and hyperactive.

A seven-year-old boy is given a book and told to sit alone for a while in a classroom. Through a door porthole, teachers observe whether he fidgets, squirms and walks around, or whether he's focused, calm and well-behaved.

To get into some top primary schools, children typically must pass written tests and also sit quietly with a book, alone, for 30 minutes. It's the sitting quietly part that many children flunk.

Some are naturally restless, some may have attention deficit hyperactivity disorder (ADHD), a range of symptoms that ranges from lack of focus to agitated, unruly or disruptive behavior.

With parents getting ready for fall enrollment in kindergarten, primary, middle and high schools, the topic of ADD or ADHD (duo dong zheng 多动症), literally "excessive movement syndrome") is becoming familiar. Parents who read a lot about child development want their children to perform well in school where they are evaluated by test scores throughout their lives.

ADHD is not an illness and is described by most experts as resulting from abnormal chemical levels in the brain that impair impulse control and attention skills. According to some controversial views, it's identified more in societies that value order and "good" behavior; thus, those on the active end of the active-passive spectrum may be seen as problems.

According to the Society of Pediatrics under the Chinese Medical Association, as many as 20 million children in China have some type of ADHD and less than 1 percent received appropriate treatment, which typically includes some medication.

"Different aged children have different symptoms," says Wu Qiong, professor at the ADHD Center of Shanghai Fu Da Hospital in Hongkou District. "ADHD is a common condition that affects both children and adults and it can have serious consequences for academic, emotional, social and occupational functioning."

For some parents, ADD or ADHD is becoming a synonym for what's called "naughty behavior" that can stand in the way of academic performance, good family relations and social acceptance.

Few parents get a medical diagnosis and most reject the idea of medication, believing that it has serious side effects and impairs IQ. There's also perception that "naughty" children or those with some kind of ADHD have a higher IQ and are more creative than disciplined and obedient children.

Doctors say that many but not all ADHD children have a high IQ and that medication doesn't affect intelligence, while it does help children to focus.

"My little boy must have ADD, see how naughty he is! He's not quiet for a moment except when he falls asleep," complains Wang Yang, who has a two-year-old boy. She hasn't seen a doctor.

"My boy has been so difficult to handle since the moment he was born," says Sophie Yang of her five-year-old son. "Compared with other mothers, I'm nearly in a state of collapse."

Yang has read many books and come across the term ADHD but when she told her mother, the older woman scoffed. "She told me no child is easy to deal with and my worry was pointless. But now he's five and as naughty as ever. My mom told me ADD children are smarter."

Grandparents often say that "naughty" and hyperactive children are smarter than their peers.

"If a kid remains silent and is quiet all the time, it is definitely not a good sign," says Feng Yuqi, grandmother of a six-year-old boy. "If a child is too active, that only proves he's smarter and it's nothing to worry about."

According to Tan Hui, a professor of child health care at Fudan University, the number of Chinese children with ADHD is increasing.