At the end of the 20th century, a new diagnosis appeared in Russia - attention deficit hyperactivity disorder. It was given to all children who were unable to behave quietly and control outbursts of emotions. Today it has been proven that hyperactivity is not always a disorder requiring medical intervention. Sometimes it's just part of the child's character.

Signs of hyperactivity

It is sometimes possible to notice the first signs of the predominance of excitation processes over inhibition only when the baby reaches two or three years of age. It happens that from birth he grows calm, balanced and obedient, starting to “show character” during a three-year crisis. It is difficult for parents to distinguish between an anxious state and ordinary moody behavior. But in kindergarten, the symptoms begin to manifest themselves more clearly and require decisive action - it is difficult for a baby to learn and build relationships with other pupils.

Causes of hyperactivity can be as follows:

• complications during pregnancy, childbirth;
• wrong parenting tactics (overprotection or neglect);
• diseases of the endocrine and other body systems;
• stress;
• no mode.

IMPORTANT! The sooner behavioral disorders are noticed, the more successful treatment will be.

ADHD is characterized by the following symptoms:

The issue of hyperactivity is dealt with by a neurologist and a psychologist, a referral to these specialists can be obtained from a pediatrician. Not always the treatment consists in taking medications, sometimes doctors simply give recommendations on how to find the right approach to the child.

If the child is very hyperactive: what should parents do, treatment at home

To adjust the home environment, choose a mode for a hyperactive baby, it will be useful for parents to know a few recommendations:

1. Pay close attention to leisure. The games of the baby should be calm, aimed at developing his mental abilities. If the family has a TV, it should not be turned on all day long. It is safe for kids to enjoy TV shows for only a couple of hours a day, and by no means should it be action movies and sports programs. Good cartoons and programs for children are more suitable.

Clearly set tasks, be consistent in words. Parents should stick to the same parenting model. The situation in the house should be calm and positive, the task of adults is to smooth out conflict situations (especially if there is more than one child in the family).

Mode is important(schedule). If the baby is put to bed at different times, he seems to be faced with the unknown, and children need stability. For example, if they are usually fed after bathing, this should happen every day.

1. Physicians closely involved healthy eating, recommend it for children with ADHD. The child's daily menu should include red and white meat, fish, cereals, vegetables and fruits.

Choosing products for baby food, harmful additives should be avoided. Firstly, flavor enhancers, preservatives - nitrites and sulfites. If it is not possible to buy 100% natural food, you can try to at least reduce their number by choosing food with the lowest chemical content in the composition. It has been proven that about half of children have sensitivity to artificial food additives.

Behavioral disorders may be associated with an allergic reaction for products. The most dangerous for children with allergies: milk, chocolate, nuts, honey and citrus fruits. To determine if a child has a reaction to foods, one of them should be periodically excluded from the diet. For example, give up milk for a week, and then look at the emotional state of the baby. If it changes, then the reason is in the food. Do the same with other foods from your child's daily diet. Food allergy symptoms there may be a rash and stool disorders (diarrhea or constipation). You can conduct laboratory blood tests to identify what exactly causes such a reaction.

The children's diet must include food with essential fatty acids. The brain needs Omega-3, which can be obtained from fatty fish - salmon, trout, sockeye salmon, coho salmon, chum salmon, halibut. Children, starting from the age of one, should be given fish 2 times a week. Flaxseed is also rich in fatty acids, which can be ground and then added to porridge.

Minimize Fruit Juices. The child must consume enough pure water(6-8 glasses a day), because the brain needs it so much for normal operation.

Hyperactive child: treatment

How to treat? Some doctors say that until the age of four (or even before the first grade), hyperactivity can be left untreated, as children are just learning to express their emotions. Before a therapy is chosen, specialists must accurately determine whether the symptoms of hyperactivity are the causes of diseases such as epilepsy, hyperthyroidism, vegetovascular dystonia, autism, impaired functioning of the sense organs (partial or complete loss of hearing or vision).

The doctor then collects anamnesis- Talks with parents and observes the behavior of the child. An electroencephalogram of the brain is done, which can be used to determine whether there is organic lesions. There may be increased intracranial pressure. Based on the results, the most appropriate of the following hyperactivity treatment options is selected.

Medical treatment (drug)

What to take in this case? Nootropic drugs are usually prescribed, the action of which is aimed at improving the blood circulation of the brain: Cortexin, Encephabol, Phenibut and others. What medicines to give in cases of depressed mood in a child (as well as the emergence of suicidal thoughts in an older age)? Recommend the use of antidepressants: Fluoxitin, Paxil, Deprim. More "light" therapy - Glycine (amino acids) and Pantogam (hopantenic acid).

You might be able to get by with supplements. Studies confirm that B vitamins and calcium contribute to the normalization of the nervous system and soothe. Also, the lack of zinc can seriously affect the excitability of children.

IMPORTANT! Only a doctor should prescribe nutritional supplements and select their dosage.

Treatment with folk remedies

The pharmacy has a large assortment of soothing herbal preparations and herbs separately. The most popular are chamomile, lemon balm, mint. Also have herbal remedies:

• lemongrass tincture - a well-known antidepressant;
• ginseng tincture improves concentration, increases learning ability;
• Leuzea tincture tones and gives strength.

The drug Persen is popular, the active components of which are valerian, peppermint and lemon balm.

Folk remedies may also include aromatherapy. A few drops of peppermint and frankincense oil, added to the aroma lamp during a child's sleep, will help focus and calm the nerves.

It is important to remember that the child is not to blame for the occurrence of hyperactivity. No type of treatment can replace the main healing force - the love of parents.

ADHD – Attention Deficit Hyperactivity Disorder – is a diagnosis that has been controversial in all segments of the population for more than 40 years. Doctors talk about it, the media write about it, politicians and parents argue, but there is still no unequivocal decision on this issue. What is ADHD, where does this disease come from, what are the symptoms and how is it treated? And in general, does it exist or is it just a medical way to find control over hyperactive children?

ADHD - mild brain impairment

To answer all these difficult questions, you first need to understand what ADHD is, how it is diagnosed, what symptoms it manifests and how it is treated.

So, according to the definition of American doctors, ADHD (English Attention-Deficit / Hyperactivity Disorder - ADHD) is a neurological and behavioral developmental disorder that begins in early childhood and manifests itself in the form of difficulty concentrating, hyperactivity and uncontrollable impulsivity. Agree that all these symptoms can be attributed to any restless baby. However, there are a number of significant features that indicate developmental disorders, and not just character traits one child or another. But more on that later.

Svetlana Kuralina, a medical psychologist, explains in one of her works that ADHD is “one of the manifestations of minimal brain dysfunction (MMD), that is, a very mild brain insufficiency, which manifests itself in a deficiency of certain structures and a violation of the maturation of higher levels of brain activity . MMD is classified as a functional disorder that is reversible and normalizes as the brain grows and matures. MMD is not a medical diagnosis in the truest sense of the word; rather, it is only a statement of the fact of the presence of mild disorders in the brain, the cause and essence of which have yet to be clarified in order to begin treatment. Simply put, ADHD is a reversible brain disease, and such a diagnosis does not mean that your child is mentally retarded, on the contrary, children with ADHD can be much smarter and more capable than their peers.

Statistics say that in Russia children with ADHD are from 4 to 18% (in this case, they mean diagnoses, how many children live with ADHD without treatment - sociologists have no right to say), in the USA - 4-20%, in the UK - 1- 3%, in Italy - 3-10%, in China - 1-13%, in Australia - 7-10%. At the same time, there are 9 times more boys diagnosed with ADHD than girls. It is also important that ADHD occurs not only in children, but also in adults, according to the US population, this disorder is also present in 3-5% of people. More than half of children with ADHD in childhood continue to suffer from it at a later age. In 30-70% of cases, ADHD symptoms remain with a person for life.

The disease is more common among boys than among girls. What is the reason for this, experts do not undertake to say. The cause of ADHD is also not exactly known, but there are a number of reasons that, according to doctors, can cause the appearance of this syndrome in newborns. In particular, the deterioration of the environment, infections of the mother during pregnancy, the use of potent drugs during this period, food poisoning of a pregnant woman, alcohol, drugs, smoking, severe injuries and bruises in the abdomen, immunological incompatibility of the mother and fetus (according to Rh- factor), the threat of miscarriage, chronic diseases of the mother, violation of labor activity (premature, transient or prolonged labor, stimulation of labor activity, anesthesia poisoning and caesarean section), birth complications (improper presentation of the fetus, entanglement of the umbilical cord and other disorders leading to injuries of the child's spine , asphyxia and cerebral hemorrhages). Other causes of ADHD include trauma to the baby's spine during a caesarean section, trauma from learning to sit before the baby can sit up, trauma from improper wearing in a sling, or any illness in infants that is accompanied by high fever and heavy medications. Asthma, pneumonia, heart failure and kidney disease can act as factors that disrupt the normal functioning of the brain.

Scientists from four countries - the United States, Holland, Colombia and Germany - hypothesized that 80% of the occurrence of attention deficit hyperactivity disorder depends on genetic factors. They conducted a study selecting three of more than 30 human candidate genes - a dopamine transporter gene and two dopamine receptor genes. However, the study showed that the prerequisites for the development of the syndrome are manifested in close contact with the environment, which, in turn, can both strengthen and neutralize these prerequisites.

ADHD - Diagnosis

Diagnosis of ADHD requires careful analysis and long-term monitoring of the child, since many of the signs of ADHD appear from time to time. Currently, the basis for the diagnosis are phenomenological and psychological characteristics. A phenomenological characteristic is a set and manifestation of personality deviations from the norm. The psychological characteristic is actually psychological picture personality. Psychologists and neuropsychologists are working on these things, they are the portrait of the child.

The diagnostic criteria are applicable for children from the oldest to school age, since this requires a qualitative assessment of the child's behavior in at least two conditions of the situation (the most striking example is school / garden and home). Most important for diagnosis is the presence of learning disabilities and social functions. There are no uniform diagnostic criteria and methods for assessing the symptoms of the disease, each country, each clinic has its own methods, and which one is more effective is a moot point.

Most of the criteria that children with ADHD meet (inattention, absent-mindedness, disorganization, hyperactivity, inability to listen to speech addressed to him, forgetfulness, anxiety, chaotic movements of the arms and legs, excessive talkativeness, excessive motor activity, inability to wait, etc.) apply to ordinary, ill-bred or restless children. However, according to experts, if you put a healthy child and a child with ADHD side by side and watch them for a while, the difference will be very noticeable. In addition, if there is convincing evidence of clinically significant impairments in social contacts or schooling, this makes it easier for physicians to make a diagnosis.

Treatment options for ADHD

There are several types of treatment, one of which is medication. In the United States, the addictive drug Ritalin is used to treat children with ADHD. In European countries, psychostimulants are used to correct ADHD, but they have a significant drawback - the duration of action is about 4 hours, so they need to be taken several times a day. In addition, these drugs contain amphetamine, a stimulant developed for the US Army Special Forces. Abuse of amphetamine in the 60s led to a sharp increase in drug addiction in the world.

In Russia, for the correction of ADHD, nootropic drugs are used that improve brain function, metabolism, energy and increase the tone of the cerebral cortex. In combination with nootropics, amino acid preparations are also prescribed that improve metabolism in the brain. However, there is no evidence that this treatment is effective.

It is also worth noting that the treatment of ADHD with drugs is used only for individual indications and in cases where the problem cannot be solved with the help of non-drug interventions.

Non-drug treatments for ADHD

The neuropsychological method involves the use of various exercises to restore malformed brain functions. The course of correction is designed for 9 months, as a result of passing the course, the brain of a child with ADHD begins to work more efficiently, spending less energy.

The syndromic method is based on an arbitrary activity that is interesting for the child. In this case, post-voluntary attention is turned on: the child is interested in the matter and, as a result, strains without additional costs. It can be drawing, outdoor games that require intense attention, etc.

Behavioral psychotherapy focuses on patterns of behavior and shapes them in accordance with social norms through rewards and punishments.

Family therapy forms the child's personality and determines in which area to direct the negative qualities of a child with ADHD (aggressiveness, hyperactivity, talkativeness, etc.).

As a rule, several methods are used at once to correct ADHD, which makes it possible to achieve a greater effect and enable children with ADHD to compensate for violations, restore brain function and fully realize themselves in the future life.

ADHD - myth or reality?

ADHD and its treatments have been controversial since the 1970s. Its existence is doubted by both doctors and teachers, politicians, parents and the media. Some believe that ADHD is a myth, while others believe that there are both genetic and physiological prerequisites for this disease. However, all controversy revolves around diagnosis and treatment methods. Much of the discussion questions the clinical diagnosis of ADHD and drug treatments.

For the diagnosis of ADHD, no special laboratory and radiological texts and analyzes have yet been developed - this is a fact. In the treatment, drugs containing narcotic substances are used - this is also a fact. But let's not forget that almost all substances labeled as narcotic were invented for medical purposes and some of them are still successfully used today. And also most serious drugs for the treatment of any other diseases have a number of side effects.

As for the existence of ADHD, it is quite possible that after a few years or several decades it will finally be recognized as an independent disease. It has been so many times. For example, the first mention of schizophrenia dates back to 2000 BC, however, it was recognized as an independent disease only in late XIX century, in 1893.

The term "hyperactive child" has recently been on everyone's lips: doctors, educators, teachers, psychologists, parents. How to distinguish a fidget from a baby with signs of attention deficit? How to distinguish ordinary pampering from neurological disorders?

A hyperactive child is characterized by a number of qualities: impulsive, excited, stubborn, capricious, spoiled, inattentive, distracted, unbalanced. It is important to understand: in what situations do you need professional help from a psychologist, drug treatment for attention deficit hyperactivity disorder (ADHD), and when it is necessary to revise the principles of education. It often happens that parents are looking for a "saving pill." But it is enough to rebuild relations with a son or daughter for recovery to come in the most natural way. This requires time, effort, patience and, most importantly, the desire to change something in yourself and your relationship with children.

What is hyperactivity associated with?

The causes of hyperactivity in children most often lie in the perinatal period of fetal development and difficult childbirth.

• Unfavorable pregnancy. Stress, smoking, unhealthy lifestyle, diseases, taking medications during pregnancy - all this can affect the development and formation of the fetal nervous system.
• Neurological disorders during fetal development and at birth. Hypoxia (lack of oxygen intrauterine development) and asphyxia (suffocation) - the most common causes ADHD. Rapid or premature labor, stimulation of labor can also affect.
• Additional factors. Unfavorable psychological atmosphere in the family, conflicts between parents, too hard or soft methods of education, nutrition, lifestyle, child's temperament.

The likelihood of ADHD is greatly increased when these factors are combined. For example, a child was born with asphyxia, premature, he is brought up in strictness and constant conflicts - hyperactivity in such a baby can be clearly manifested.

How to recognize hyperactivity in a child

Diagnosing ADHD is not easy, as signs of hyperactivity can be symptoms of other neurological disorders. What should you pay attention to?

• First symptoms. May appear during infancy. Poor sleep, a long period of wakefulness from the first months of life, excitability of the baby, an atypical violent reaction to noise, bright light, games, hygiene procedures, a slight lag in the development of motor skills - all these may be the first harbingers of hyperactivity in children under one year old.
• Age 3 years. A turning point in the life of the baby, when the famous crisis of three years comes. At this time, most children experience capriciousness, stubbornness, mood swings. In hyperactive babies, these signs are even more pronounced. Also, in children with ADHD, awkward, chaotic, fussy movements are noted, speech develops with a delay.
• Health. Hyperactive kids often complain of fatigue and headaches. These children are often diagnosed with enuresis, nervous tics.
• The first signs of restlessness. Kindergarten teachers can pay attention to them. When the process of socialization begins, and the child moves out of the family, the signs of restlessness become more pronounced. In kindergarten, it is impossible to put a baby to sleep, feed, seat him on a potty, and calm him down.
• Violations of the development of memory and attention in preschool age. Children under 7 years of age develop memory and attention intensively. A child with ADHD has a slow learning curve in preparation for school. And this is due not to a lag in development, but to insufficient concentration of attention. It is difficult for a child with signs of hyperactivity to sit in one place and listen to the teacher.
• Failure at school. We emphasize once again that poor grades in children are associated with hyperactivity disorder and attention deficit, and not with their mental inclinations. On the contrary, hyperactive students are often developed beyond their years. But the problem is that it is difficult for them to integrate into the system and discipline: it is difficult to sit through 45 minutes of a lesson, listen, write, and complete the teacher's tasks.
• Mental aspects. Over time, the following qualities appear: irascibility, irritability, resentment, tearfulness, anxiety, distrust, suspicion. Already in early age the baby may develop phobias that can persist into adolescence and throughout life if they are not dealt with.
• Perspective. In adolescence, such a child, as a rule, develops (more precisely, it is formed by adults) low self-esteem. A hyperactive teenager is aggressive, intolerant, conflict, non-communicative. It is difficult for him to find friends, to establish warm, friendly relations. In the future, he may develop antisocial behavior.

Symptoms of ADHD in children appear in a complex and regularly. You should not immediately attribute a “fashionable” diagnosis to a child with excitability, poor sleep, capriciousness, which are observed from time to time. Many objective factors can change the psycho-emotional state of the baby. The reason may be teething, a change of scenery, going to kindergarten, failing at a game, etc. Even climatic conditions affect the condition and behavior of the baby.

Diagnosis of ADHD

And yet, until the age of 6-7, no one makes a neurological diagnosis, even if there are signs of ADHD. This is due to the psychological characteristics of preschool children. At preschool age, children experience two serious psychological crises - at 3 years and 7 years. What are the criteria for a medical diagnosis of ADHD?

8 manifestations of hyperactivity

1. Chaotic, fussy movements.
2. Restless sleep: spins, talks in sleep, throws off blanket, can walk at night.
3. Cannot sit on a chair for a long time, constantly spinning around.
4. Not able to be at rest, often in motion (running, jumping, spinning).
5. If you need to sit and wait (for example, in a queue), you can get up and leave.
6. Overly talkative.
7. Does not answer questions, interrupts, interferes in someone else's conversation, does not hear what they say to him.
8. Shows impatience if asked to wait.

8 Attention Deficit Symptoms

1. Carelessly and quickly completes the assigned tasks (homework, cleaning the room, etc.), does not bring the matter to the end.
2. With difficulty concentrates attention on details, cannot remember them, reproduce them.
3. There is an absent look, immersion in one's own world, communication difficulties.
4. It is difficult to learn the rules of the game, often violates them.
5. Absent-minded, often loses personal belongings or puts them in such a way that they cannot find them later.
6. There is no self-discipline, all the time it is necessary to organize it.
7. Easily switches attention to other objects.
8. The “spirit of destruction” lives in him: he often breaks toys, things, but denies his involvement in the case.

If parents counted 5-6 matches from the listed criteria, you need to see a child neurologist, psychotherapist and psychologist.

How to treat a child

When treating hyperactivity in children, it is important to understand what will be most effective for a particular child? What is the degree of ADHD? Is it worth using medications right away or is psychotherapeutic correction enough?

Medical methods

Medical treatment of ADHD with psychostimulants is more commonly used in the West and in the United States. Stimulants help increase concentration in children, give a quick positive result. However, they have a number of side effects: poor sleep, appetite, headaches, irritability, nervousness, unwillingness to communicate. These signs usually appear at the very beginning of treatment. They can be reduced as follows: dose reduction and replacement of the drug with an analogue. Psychostimulants are prescribed only for complex forms of attention deficit, when no other method works. These include: "Dexedrine", "Fokalin", "Vyvans", "Adderall" and many others. In Russia, the prescription of psychostimulant drugs is avoided, because according to the protocol for the treatment of ADHD, they are prohibited. They are being replaced by nootropics. Strattera is widely used in the treatment of ADHD in children. Any antidepressants with attention deficit should be used with great care and only under the supervision of a physician.

Working with a psychologist and psychotherapist

This is the most important part of therapy, which in difficult cases carried out in parallel with drug treatment. A psychologist and a psychotherapist use a variety of techniques to correct the behavior of a hyperactive child. Various exercises are given to develop attention, speech, thinking, memory, self-esteem, creative tasks. Various communicative situations are also modeled that will help the child find a common language with parents and peers. Specialists have to work with anxiety and fears in hyperactive children. Relaxation methods are often used to help relax, relieve tension, and normalize the functioning of the brain and nervous system. For speech defects, classes with a speech therapist are recommended.

What is important to know? Psychocorrection in a child will be effective only when parents cooperate with a specialist and accurately fulfill all the tasks and advice of a psychologist or psychotherapist. Often parents have such a position - "cure the child", while relationships in the family need to be treated.

Lifestyle Correction

Daily routine and hyperactivity are two things, at first glance, incompatible. And yet, parents need to arrange for the restless life on schedule.

• It is extremely important to maintain a sleep schedule: go to bed and get up on time. If the fidget is out of schedule, it is difficult to put him to bed, it is difficult to bring him to his senses in the morning. You can not overload such children with information before going to bed, play active games. The air in the room should be fresh and cool.
• Arrange nutritious meals. Snacks should be avoided, especially fast food. It is advisable to reduce fast carbohydrates in the diet (sweets, pastries), which excite the nervous system.
• Walking before bed. Fresh air calms the nervous system. In addition, there will be a good opportunity to talk, discuss how the day went.
• Physical exercise. Necessary in the life of a hyperactive child to discharge his irrepressible energy. You can try yourself in individual and team sports. Although the latter will be more difficult. Athletics, gymnastics, cycling, swimming are most suitable. It is good if the child goes in for sports for himself. Competitions and any competitive moment will bring even more tension and aggression. Much in this situation depends on the coach and his pedagogical skills.

Reminder for parents raising a child with ADHD

How to raise a hyperactive child?

• Raise self-esteem. Hyperactive children are often punished and reprimanded: “sit down”, “don't turn around”, “shut up”, “calm down”, etc. This is regularly repeated at school, at home, in the garden. Such remarks create a feeling of inferiority in the child. All children need to be praised, but hyperactive children especially need emotional support and praise.
• Build personal boundaries with children. It is necessary to educate fidgets in severity, but justice. Punishments and restrictions should be consistent, adequate and agreed with all family members. Children with signs of ADHD often do not have "brakes". The task of parents is to show their own boundaries, show parental will and make it clear who is the boss in the house, clearly formulate prohibitions. There should be no aggression. If mom and dad have too soft a character, a hyperactive family member will certainly take the reins of power.
• Small and useful tasks. Hyperactive children need to be involved in household chores and encouraged to take initiative. It is better to give simple, step-by-step tasks. You can even draw a plan, diagram, step by step algorithm actions. These tasks will help the child organize their personal space and time.
• Do not overload with information. When reading books, doing homework, you need to give small loads - 15 minutes each. Then take a break with physical activity, then again proceed to a static activity that requires concentration. Overwork is detrimental to children with ADHD.
• Learn a new kind of activity. It is difficult for hyperactive children to be interested in something for a long time, they switch their attention too quickly. However, you need to look different types activities (music, singing, drawing, reading, modeling, dancing), in which the child will reveal himself as much as possible. It is necessary to find a business that will "educate" fidget in an invisible way and require some kind of personal effort, motivation.
• Communicative aspects. Everything is forgiven at home for hyperactive fidgets, but they often find themselves in a conflict situation with teachers and are rejected by their peers. It is important to discuss with children their life outside the home, difficult situations, causes of conflicts. This will help them adequately evaluate their actions in the future, control themselves, be aware of their emotions, and learn from their own mistakes.
• Diary of success. Psychologists recommend having a notebook or notebook where you can write down (or sketch) all the big victories and small successes. It is important that the child is aware of the results of their own efforts. You can also come up with a reward system.

Some parents believe that the best cure for hyperactivity in children is vitamin "Re", that is, a belt. This harsh remedy only exacerbates the problem and will never fix it. true reason disobedience. The behavior of children with ADHD often causes the righteous anger of parents, but it is still better to avoid spanking.

Difficulties of social adaptation

In kindergartens and schools, children with ADHD are classified as "difficult". Sometimes conflicts associated with inappropriate hyperactive behavior become so aggravated that the child has to be transferred to another kindergarten or school. It is important to understand that the system public education will not be adjusted to the individual characteristics of the child. You can search for a suitable kindergarten or school for a long time, but you can’t find it. In this situation, it is important to teach the child to show flexibility, patience, friendliness - all those qualities that are so important for communication and normal social adaptation.

• hyperactive students should be in the teacher's field of vision;
• it is better for them to sit at the first or second desk;
• do not focus on the behavior of such children;
• often praise, encourage, but do not overestimate;
• give small tasks in which the child will move: bring a magazine, distribute notebooks, water flowers, wipe the board;
• emphasize the strengths of the student, give them the opportunity to show.

• be on the side of the child, but at the same time not create an open conflict with the teacher;
• find compromise solutions;
• listen to the opinion of the teacher, because an objective view from the outside can be valuable for understanding your own child;
• do not punish, do not read morality to the child in the presence of a teacher and peers;
• help to adapt in the children's team (take part in joint events, you can invite children to visit, etc.).

It is important to find not some special school or private kindergarten, but a teacher who will treat the problem with understanding and be an ally of parents.

Treatment of a hyperactive child with medications is advisable only for complex forms of ADHD. In most cases, psychocorrection of behavior is carried out. Therapy is much more successful when parents are involved. After all, the child's hyperactivity is often associated with family relationships and improper upbringing.

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January 19

Attention deficit hyperactivity disorder (ADHD), similar to ICD-10 hyperkinetic disorder), is an evolving neuropsychiatric disorder in which there are significant problems with executive functions (for example, attention-related control and inhibitory control) that cause attention deficit hyperactivity or impulsiveness inappropriate for the person's age. These symptoms may begin between the ages of six and twelve and persist for more than six months from the time of diagnosis. In school-aged subjects, symptoms of inattention often lead to poor school performance. Although this causes inconvenience, in particular in modern society Many children with ADHD have good attention spans for tasks they find interesting. Although ADHD is the most well-studied and diagnosed psychiatric disorder in children and adolescents, the cause is unknown in most cases.

The syndrome affects 6-7% of children when diagnosed using the criteria of the manual for the diagnosis and statistical accounting of mental illness, revision IV and 1-2% when diagnosed using the criteria. The prevalence is similar among countries, depending largely on how the syndrome is diagnosed. Boys are approximately three times more likely to be diagnosed with ADHD than girls. About 30-50% of people diagnosed in childhood have symptoms in adulthood, and approximately 2-5% of adults have the condition. The condition is difficult to distinguish from other disorders, as well as from a state of normal increased activity. Management of ADHD usually involves a combination of psychological counseling, lifestyle changes, and medications. Medications are only recommended as first-line treatment in children who show severe symptoms and may be considered for children with moderate symptoms who refuse or do not respond to psychological counseling.

Therapy with stimulant drugs is not recommended for preschool children. Treatment with stimulants is effective up to 14 months; however, their long-term effectiveness is not clear. Adolescents and adults tend to develop coping skills that apply to some or all of their disabilities. ADHD, its diagnosis and treatment have remained controversial since the 1970s. The controversy spans practitioners, teachers, politicians, parents and the media. Topics include the cause of ADHD and the use of stimulant drugs in its treatment. Most medical professionals recognize ADHD as a congenital disorder, and the debate in the medical community is largely focused on how it should be diagnosed and treated.

Signs and symptoms

ADHD is characterized by inattention, hyperactivity (an agitated state in adults), aggressive behavior, and impulsivity. Often there are learning difficulties and relationship problems. Symptoms can be difficult to define as it is difficult to draw the line between normal levels of inattention, hyperactivity and impulsivity and significant levels requiring intervention. DSM-5-diagnosed symptoms must have been present in a variety of environments for six months or more, and to a degree that is significantly greater than in other subjects of the same age. They can also cause problems in a person's social, academic and professional life. Based on the symptoms present, ADHD can be divided into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and mixed.

A subject with inattention may have some or all of the following symptoms:

Easily distracted, missing details, forgetting things, and frequently switching from one activity to another

He finds it difficult to keep his attention on the task

The task becomes boring after only a few minutes if the subject is not doing something pleasurable.

Difficulty focusing on organizing and completing tasks, learning new things

Has trouble completing or turning in homework, often loses items (eg, pencils, toys, assignments) needed to complete an assignment or activity

Doesn't listen when talking

Soaring in the clouds, easily confused and moving slowly

Has difficulty processing information as quickly and accurately as others

Difficulty following instructions

A subject with hyperactivity may have some or all of the following symptoms:

Restlessness or fidgeting in place

Talks non-stop

Throws at everything, touches and plays with everything in sight

Sits with difficulty during lunch, in class, performing homework and while reading

Constantly on the move

Difficulty doing quiet tasks

These symptoms of hyperactivity tend to disappear with age and turn into “inward restlessness” in adolescents and adults with ADHD.

A subject with impulsivity may have all or more of the following symptoms:

Be very impatient

Spout inappropriate comments, express emotion without restraint, and act without regard for the consequences

Difficulty looking forward to the things he wants or looking forward to returning to the game

Frequently interrupts communication or activities of others

People with ADHD are more likely to have difficulty with communication skills, such as social interaction and education, and maintaining friendships. This is true for all subtypes. About half of children and adolescents with ADHD exhibit social withdrawal compared to 10-15% of non-ADHD children and adolescents. People with ADHD have an attention deficit that causes difficulty with verbal and non-verbal language, which negatively affects social interaction. They may also fall asleep during social interaction and lose social stimulus. Difficulty managing anger is more common in children with ADHD, as are poor handwriting and slow speech, language, and motor development. While this is a significant inconvenience, particularly in today's society, many children with ADHD have good attention spans for tasks they find interesting.

Associated violations

In children with ADHD, other disorders are observed in about ⅔ of cases. Some common violations include:

1. Learning disabilities occur in approximately 20-30% of children with ADHD. Learning disabilities may include impairments speech development and language, as well as learning disabilities. ADHD, however, is not considered a learning disability, but often causes learning difficulties.
2. Tourette's syndrome is more common among ADHD sufferers.
3. Oppositional defiant disorder (ODD) and conduct disorder (CD), which are observed in ADHD in approximately 50% and 20% of cases, respectively. They are characterized by antisocial behavior such as stubbornness, aggression, frequent temper tantrums, duplicity, lying and stealing. Approximately half of those with ADHD and ODD or CD develop antisocial personality disorder in adulthood. Brain scans prove that conduct disorder and ADHD are separate disorders.
4. Primary attention disorder, which is characterized by low attention and concentration, as well as difficulty staying awake. These children tend to fidget, yawn, and stretch, and have to be hyperactive in order to remain alert and active.
5. Hypokalemic sensory overstimulation is present in less than 50% of people with ADHD and may be the molecular mechanism for many ADHD sufferers.
6. Mood disorders (especially bipolar disorder and major depressive disorder). Boys diagnosed with the mixed subtype of ADHD are more likely to have a mood disorder. Adults with ADHD also sometimes have bipolar disorder, which requires careful evaluation to make an accurate diagnosis and treat both conditions.
7. Anxiety disorders are more common in ADHD sufferers.
8. Obsessive-compulsive disorder (OCD) can occur with ADHD and shares many of its characteristics with it.
9. Disorders caused by the use of psychoactive substances. Adolescents and adults with ADHD are at increased risk of developing a substance use disorder. Most of it is associated with alcohol and cannabis. The reason for this may be a change in the reinforcement pathway in the brain of subjects with ADHD. This makes ADHD more difficult to identify and treat, with serious substance use problems usually being treated first due to the higher risk.
10. Restless legs syndrome is more common in people with ADHD and is often associated with iron deficiency anemia. However, restless leg syndrome may be just a subset of ADHD and requires precise evaluation to distinguish between the two disorders.
11. Sleep disorders and ADHD usually coexist. They can also occur as a side effect of drugs used to treat ADHD. In children with ADHD, insomnia is the most common sleep disorder, with behavioral therapy as the treatment of choice. Trouble falling asleep is common among ADHD sufferers, but more often they are deep sleepers and have significant difficulty waking up in the morning. Melatonin is sometimes used to treat children who have difficulty falling asleep.

There is an association with persistent bedwetting, slow speech and dyspraxia (DCD), with about half of people with dyspraxia having ADHD. Slow speech in people with ADHD may include problems with hearing impairments such as poor short-term auditory memory, difficulty following instructions, slow speed in processing written and spoken language, difficulty hearing in distracting environments such as in the classroom, and difficulty understanding read.

The reasons

The cause of most cases of ADHD is not known; however, environmental involvement is assumed. Certain cases are associated with a previous infection or brain injury.

Genetics

See also: Hunter-Farmer Theory Twin studies show that the disorder is often inherited from one parent, with genetics accounting for about 75% of cases. Siblings of children with ADHD are three to four times more likely to develop the disorder than siblings of non-ADHD children. Genetic factors are thought to be relevant to whether ADHD persists into adulthood. Usually several genes are involved, many of which directly affect dopamine neurotransmission. Genes involved in dopamine neurotransmission include DAT, DRD4, DRD5, TAAR1, MAOA, COMT, and DBH. Other genes associated with ADHD include SERT, HTR1B, SNAP25, GRIN2A, ADRA2A, TPH2, and BDNF. A common gene variant called LPHN3 is estimated to be responsible for approximately 9% of cases, and when this gene is present, people respond partially to the stimulant drug. Since ADHD is widespread, natural selection probably contributes characteristic features, at least individually, and they may provide a survival advantage. For example, some women may be more attractive to male risk-takers by increasing the frequency of genes that predispose to ADHD in the genetic pool.

Since the syndrome is most common in children of anxious or stressed mothers, some have suggested that ADHD is an adaptation that helps children cope with stressful or dangerous environmental conditions, such as increased impulsivity and exploratory behavior. Hyperactivity can be useful from an evolutionary perspective in situations that involve risk, competition, or unpredictable behavior (such as exploring new places or finding new food sources). In these situations, ADHD can be beneficial to society as a whole, even if harmful to the subject himself. In addition, in certain environments, it can confer benefits on the subjects themselves, such as quick responses to predators or superior hunting skills.

Environment

Environmental factors are thought to play a lesser role. Alcohol use during pregnancy can cause fetal alcohol spectrum disorder, which may include ADHD-like symptoms. Exposure to tobacco smoke during pregnancy can cause problems with the development of the central nervous system and increase the risk of ADHD. Many children exposed to tobacco smoke do not develop ADHD or have only mild symptoms that do not reach the limit of a diagnosis. A combination of genetic predisposition and exposure to tobacco smoke may explain why some children exposed during pregnancy may develop ADHD while others do not. Children exposed to even low levels of lead or PCBs can develop problems that resemble ADHD and lead to a diagnosis. Exposure to the organophosphate insecticides chlorpyrifos and dialkyl phosphate has been associated with an increased risk; however, the evidence is not conclusive.

Very low birth weight, preterm birth, and early exposure to adverse factors also increase risk, as do infections during pregnancy, birth, and early childhood. These infections include, among others, various viruses (finnosis, varicella, rubella, enterovirus 71) and streptococcal bacterial infection. At least 30% of children with traumatic brain injury later develop ADHD, and about 5% of cases are associated with brain damage. Some children may react negatively to food coloring or preservatives. It is possible that certain colored foods may act as a trigger in those with a genetic predisposition, but the evidence is weak. The UK and the EU have introduced regulation based on these issues; The FDA didn't.

Society

A diagnosis of ADHD may be indicative of family dysfunction or a poor educational system rather than an individual's problems. Some cases may be explained by heightened educational expectations, with the diagnosis in some cases representing a way for parents to obtain additional financial and educational support for their children. The youngest children in a class are more likely to be diagnosed with ADHD, presumably because they lag behind their older classmates in development. Behavior typical of ADHD is more common in children who have experienced abuse and moral humiliation. According to social order theory, societies define the boundary between normal and unacceptable behavior. Members of the community, including physicians, parents, and teachers, determine which diagnostic criteria to use and thus the number of people affected by the syndrome. This has led to the present situation where the DSM-IV shows an ADHD level three to four times the ICD-10 level. Thomas Szas, who supports this theory, argued that ADHD was "invented, not discovered."

Pathophysiology

Current models of ADHD suggest that it is associated with functional impairments in several brain neurotransmitter systems, in particular those involving dopamine and norepinephrine. Dopamine and norepinephrine pathways, which originate in the ventral tegmental region and the locus coeruleus, target different regions of the brain and mediate many cognitive processes. Dopamine and norepinephrine pathways, which target the prefrontal cortex and striatum (particularly the pleasure center), are directly responsible for regulation of executive function (cognitive control of behavior), motivation, and reward perception; path data play leading role in the pathophysiology of ADHD. Larger models of ADHD with additional pathways have been proposed.

Structure of the brain

Children with ADHD have a general decrease in the volume of certain brain structures, with a proportionately large decrease in the volume of the left-sided prefrontal cortex. The posterior parietal cortex also shows thinning in ADHD subjects compared to controls. Other brain structures in the prefrontal-striate-cerebellar and prefrontal-striate-thalamic circuits also differ between people with and without ADHD.

Neurotransmitter pathways

It used to be thought that the increased number of dopamine transporters in people with ADHD was part of the pathophysiology, but the increased number appears to be related to adaptation to stimulant exposure. Current models include the mesocorticolimbic dopamine pathway and the coeruleus-noradrenergic system. Psychostimulants for ADHD effective treatment, since they increase the activity of neurotransmitters in these systems. Additionally, pathological abnormalities in the serotonergic and cholinergic pathways may be observed. Also relevant is the neurotransmission of glutamate, a dopamine cotransmitter in the mesolimbic pathway.

Executive function and motivation

Symptoms of ADHD include problems with executive function. Executive function refers to several mental processes that are required to regulate, control, and manage the tasks of daily life. Some of these impairments include problems with organization, timing, excessive procrastination, concentration, execution speed, emotion regulation, and short-term memory use. People generally have good long-term memory. 30-50% of children and adolescents with ADHD meet the criteria for executive function deficit. One study found that 80% of subjects with ADHD were impaired in at least one executive function task compared to 50% of subjects without ADHD. Due to the degree of brain maturation and the increased demand for executive control as people get older, ADHD disorders may not fully manifest until reaching adolescence or even older teens. ADHD is also associated with motivational deficits in children. Children with ADHD have difficulty focusing on long-term rewards over short-term rewards and also show impulsive behavior towards short-term rewards. In these subjects, a large amount of positive reinforcement effectively increases performance. ADHD stimulants can increase resilience in children with ADHD equally.

Diagnostics

ADHD is diagnosed through an assessment of a person's childhood behavior and mental development, including ruling out exposure to drugs, medications, and other medical or psychiatric problems as explanations for symptoms. Feedback from parents and teachers is often taken into account, with most diagnoses made after the teacher has raised concerns about it. It can be seen as an extreme manifestation of one or more permanent human traits found in all humans. The fact that someone responds to medication does not confirm or rule out a diagnosis. Since brain imaging studies did not provide reliable results in subjects, they were only used for research purposes and not diagnosis.

The DSM-IV or DSM-5 criteria are often used for diagnosis in North America, while European countries generally use the ICD-10. At the same time, the DSM-IV criteria make the diagnosis of ADHD 3-4 times more likely than the ICD-10 criteria. The syndrome is classified as a developmental neurodevelopmental disorder. In addition, it is classified as a social conduct disorder along with oppositional defiant disorder, conduct disorder, and antisocial personality disorder. The diagnosis does not suggest a neurological disorder. Comorbid conditions that should be screened for include anxiety, depression, oppositional defiant disorder, conduct disorder, learning and speech impairment. Other conditions to be considered are other neurodevelopmental disorders, tics and sleep apnea. The diagnosis of ADHD using quantitative electroencephalography (QEEG) is an area of ​​ongoing research, although the value of QEEG in ADHD is not clear to date. In the United States, the Food and Drug Administration has approved the use of QEEG to estimate the prevalence of ADHD.

Diagnostics and statistical guidance

As with other psychiatric disorders, a formal diagnosis is made by a qualified professional based on a combination of several criteria. In the United States, these criteria are defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Illness. Based on these criteria, three subtypes of ADHD can be distinguished:

Predominantly inattentive ADHD (ADHD-PI) presents with symptoms including mild distractibility, forgetfulness, daydreaming, disorganization, low concentration, and difficulty completing tasks. Often people refer to ADHD-PI as "attention deficit disorder" (ADD), however, the latter has not been formally approved since the 1994 revision of the DSM.

ADHD predominantly hyperactive-impulsive type manifests as excessive anxiety and agitation, hyperactivity, difficulty waiting, difficulty staying still, infantile behavior; destructive behavior can also be observed.

Mixed ADHD is a combination of the first two subtypes.

This division is based on the presence of at least six of the nine long-term (lasting at least six months) symptoms of inattention, hyperactivity-impulsivity, or both. To be taken into account, symptoms must appear between the ages of six and twelve and be observed at more than one environmental stop (for example, at home and at school or at work). The symptoms must not be acceptable to children at this age, and there must be evidence that they cause school or work-related problems. Most children with ADHD have a mixed type. Children with the inattentive subtype are less likely to pretend or have difficulty getting along with other children. They may sit quietly but not paying attention, whereby difficulties may be overlooked.

International classifier of diseases

In the ICD-10, the symptoms of "hyperkinetic disorder" are similar to ADHD in the DSM-5. When a conduct disorder (as defined by ICD-10) is presented, the condition is referred to as hyperkinetic conduct disorder. Otherwise, the impairment is classified as activity and attention impairment, other hyperkinetic disorders, or unspecified hyperkinetic disorders. The latter are sometimes referred to as the hyperkinetic syndrome.

adults

Adults with ADHD are diagnosed according to the same criteria, including signs that may be present between the ages of six and twelve. Questioning parents or caregivers about how the person behaved and developed as a child may form part of the assessment; a family history of ADHD also contributes to the diagnosis. While the main symptoms of ADHD are the same in children and adults, they often manifest themselves differently, for example, excessive physical activity observed in children can manifest as a feeling of restlessness and constant mental activity in adults.

Differential Diagnosis

Symptoms of ADHD that may be associated with other disorders

Depression:

Feelings of guilt, hopelessness, low self-esteem, or unhappiness

Loss of interest in hobbies, ordinary activities, sex, or work

Fatigue

Too short, poor or excessive sleep

Appetite changes

Irritability

Low stress tolerance

Suicidal thoughts

unexplained pain

Anxiety disorder:

Restlessness or a persistent feeling of anxiety

Irritability

Inability to relax

overexcitation

easy fatigue

Low stress tolerance

Difficulty paying attention

Mania:

Excessive feeling of happiness

Hyperactivity

Leap of ideas

Aggression

Excessive talkativeness

Big crazy ideas

Decreased need for sleep

Unacceptable social behavior

Difficulty paying attention

Symptoms of ADHD such as Bad mood and low self-esteem, mood swings, and irritability may be confused with dysthymia, cyclothymia, or bipolar disorder, as well as borderline personality disorder. Some symptoms that are associated with anxiety disorders, antisocial personality disorder, developmental or mental retardation, or chemical dependency effects such as intoxication and withdrawal may overlap with some of the symptoms of ADHD. These disorders sometimes occur along with ADHD. Medical conditions that can cause ADHD symptoms include: hypothyroidism, epilepsy, lead toxicity, hearing loss, liver disease, sleep apnea, drug interactions, and traumatic brain injury. Primary sleep disturbances can affect attention and behavior, and ADHD symptoms can affect sleep. Thus, it is recommended that children with ADHD be monitored regularly for sleep problems. Sleepiness in children can lead to symptoms ranging from classic yawning and eye rubbing to hyperactivity with inattention. Obstructive sleep apnea can also cause ADHD-type symptoms.

Control

Management of ADHD usually involves psychological counseling and medication, alone or in combination. While treatment may improve long-term outcomes, this does not rule out negative outcomes in general. Drugs used include stimulants, atomoxetine, alpha-2 adrenergic agonists, and sometimes antidepressants. Dietary changes may also be helpful, with evidence supporting free fatty acids and reduced exposure to food coloring. Removing other foods from the diet is not supported by the evidence.

Behavioral Therapy

There is strong evidence for the use of behavioral therapy for ADHD, and it is recommended as a first-line treatment for those with mild symptoms or for preschool children. Physiological therapies used include: psychoeducational stimulus, behavioral therapy, cognitive behavioral therapy (CBT), interpersonal therapy, family therapy, school interventions, social skills training, parenting training, and neural feedback. The preparation and education of parents has short-term benefits. There is little high-quality research on the effectiveness of family therapy for ADHD, but the evidence suggests that it is equivalent to health care and better than placebo. There are some specific ADHD support groups as information sources that can help families deal with ADHD.

Social skills training, behavioral modification, and drugs may have limited benefits to some extent. The most important factor in alleviating late psychological problems such as major depression, delinquency, school failure, and substance use disorder is the formation of friendships with people who are not involved in delinquent activities. Regular physical activity, in particular aerobic exercise, is an effective adjunct to the treatment of ADHD, although best type and intensity are currently unknown. In particular, physical activity causes better behavior and motor abilities without any side effects.

Medications

Stimulant drugs are the preferred pharmaceutical treatment. They have at least a short-term effect in about 80% of people. There are several non-stimulant medications such as atomoxetine, bupropion, guanfacine, and clonidine that can be used as alternatives. There are no good studies comparing different drugs; however, they are more or less equal in terms of side effects. Stimulants improve academic performance while atomoxetine does not. There is little evidence regarding its effect on social behavior. Drugs are not recommended for preschool children, as long-term effects in this age group are not known. The long-term effects of stimulants are generally unclear, with only one study finding beneficial effects, another finding no benefit, and a third finding harmful effects. Magnetic resonance imaging studies suggest that long-term treatment with amphetamine or methylphenidate reduces the pathological abnormalities in brain structure and function found in subjects with ADHD.

Atomoxetine, due to the lack of addictive potential, may be preferable for those at risk of addiction to stimulant drugs. Recommendations for when to use drugs vary between countries, with the UK's National Institute for Health and Care Excellence recommending their use only in severe cases, while US guidelines recommend the use of drugs in almost all cases. While atomoxetine and stimulants are generally safe, there are side effects and contraindications to their use.

Stimulants can cause psychosis or mania; however, this is a relatively rare occurrence. For those undergoing long-term treatment, regular check-ups are recommended. Stimulant therapy should be temporarily discontinued to assess the subsequent need for the drug. Stimulant drugs have the potential to develop addiction and dependency; Several studies suggest that untreated ADHD is associated with an increased risk of chemical dependency and conduct disorders. The use of stimulants either reduces this risk or does not affect it. The safety of these medicinal products during pregnancy has not been determined.

Zinc deficiency has been associated with symptoms of inattention, and there is evidence that zinc supplementation is beneficial for children with ADHD who have low zinc levels. Iron, magnesium, and iodine may also have an effect on ADHD symptoms.

Forecast

An 8-year study of children diagnosed with ADHD (mixed type) found that adolescents often have difficulty with or without treatment. In the US, less than 5% of subjects with ADHD receive a college degree, compared to 28% of the general population aged 25 and over. The proportion of children meeting the criteria for ADHD drops to about half within three years of diagnosis, regardless of the treatment used. ADHD persists in adults in about 30-50% of cases. Sufferers of the syndrome are likely to develop coping mechanisms as they grow older, thus compensating for previous symptoms.

Epidemiology

It is estimated that ADHD affects about 6-7% of people aged 18 and over when diagnosed using the DSM-IV criteria. When diagnosed using the ICD-10 criteria, the prevalence in this age group is estimated to be 1-2%. Children in North America have a higher prevalence of ADHD than children in Africa and the Middle East; this is presumably due to differing diagnostic methods rather than differences in the incidence of the syndrome. If the same diagnostic methods were used, the prevalence in different countries would be more or less the same. The diagnosis is made approximately three times more often in boys than girls. This gender difference may reflect either a difference in predisposition or that girls with ADHD are less likely to be diagnosed with ADHD than boys. The intensity of diagnosis and treatment has increased in both the UK and the US since the 1970s. This is presumably related initially to changes in the diagnosis of the disease and how willing people are to take medication, rather than to changes in the prevalence of the disease. Changes in diagnostic criteria in 2013 with the release of the DSM-5 are expected to have increased the percentage of people diagnosed with ADHD, especially among adults.

Story

Hyperactivity has long been part of human nature. Sir Alexander Crichton describes "mental agitation" in his book An Inquiry into the Nature and Origin of Mental Disorder, written in 1798. ADHD was first clearly described by George Still in 1902. The terminology used to describe the condition has changed over time and includes: in the DSM -I (1952) "minimal brain dysfunction", in DSM-II (1968) "hyperkinetic childhood reaction", in DSM-III (1980) "attention deficit disorder (ADD) with or without hyperactivity" . In 1987, it was renamed ADHD to the DSM-III-R, and the DSM-IV in 1994 reduced the diagnosis to three subtypes, ADHD of the inattentive type, ADHD of the hyperactive-impulsive type, and ADHD of the mixed type. These concepts were retained in the DSM-5 in 2013. Other concepts included "minimal brain damage" used in the 1930s. The use of stimulants for the treatment of ADHD was first described in 1937. In 1934, benzedrine became the first amphetamine drug approved for use in the United States. Methylphenidate was discovered in the 1950s and enantiopure dextroamphetamine in the 1970s.

Society and culture

controversy

ADHD, its diagnosis and treatment have been the subject of debate since the 1970s. Doctors, teachers, politicians, parents and the media are involved in the controversy. Opinions about ADHD range from being merely the extreme limit of normal behavior to being the result of a genetic condition. Other areas of controversy include the use of stimulant drugs and especially their use in children, as well as the method of diagnosis and the likelihood of overdiagnosis. In 2012, the UK National Institute for Health and Care Excellence, acknowledging the controversy, argues that current treatments and diagnostics are based on the prevailing academic literature.

In 2014, Keith Conners, one of the first advocates for disease confirmation, spoke out against overdiagnosis in an article in the NY Times. On the contrary, in 2014 a peer-reviewed review of the medical literature found that ADHD is rarely diagnosed in adults. Due to the widely varying intensity of diagnosis among countries, states within countries, races, and ethnic groups, several confounding factors other than the presence of ADHD symptoms play a role in diagnosis. Some sociologists believe that ADHD is an example of the medicalization of "deviant behavior" or, in other words, the transformation of a previously non-medical problem of school performance into one. Most medical professionals recognize ADHD as a congenital disorder, at least in a small number of people with severe symptoms. The controversy among healthcare professionals is mainly focused on diagnosing and treating a larger population of people with less severe symptoms.

In 2009, 8% of all US Major League Baseball players were diagnosed with ADHD, making the syndrome highly prevalent in this population. The raise coincides with the League's 2006 ban on stimulants, raising concerns that some players were faking or faking ADHD symptoms to get around the ban on stimulant use in sports.

Speaking of treatments for ADHD First of all, it should be noted that the treatment of this disease is quite complicated. As a rule, it lasts several years and requires the participation of many people.

It is worth recognizing this at the very beginning in order to form the right attitude, and then be patient in striving for the goal, which is to minimize symptoms and improve the quality of life of the child. Treatment for ADHD includes pharmacological and psychotherapeutic methods.

Symptoms of ADHD

ADHD begins in early childhood, most often in the first five years of life. To help your child, you must understand that ADHD in children is not only trouble concentrating or constantly moving. This disease changes the way a child behaves, thinks and feels. ADHD manifests itself in each child a little differently.

Some children will be constantly restless, fidgety, without even realizing it. Others will stare into space in a stillness or constantly hover in the clouds, making it difficult to study at school or form friendships with other children.

To make sure your child is indeed suffering from Attention Deficit Hyperactivity Disorder, answer yes or no to the following questions.

Your child:

• constantly moving, fidgeting, making quick, unnecessary movements, twitching?
• running, walking, jumping up, even if everyone around him is sitting?
• having trouble waiting in line?
• any occupation quickly bores him and brings only a few moments of pleasure?
• constantly thinking about something, do you get the impression that he lives in another world?
• says when others are trying to say something?
• does before he has time to think?
• Is he constantly distracted by what is going on around him?
• Has constant problems with work in class and at home?

If you answered “yes” to most of these questions, it's best to take your child to the doctor. Only a specialist can accurately diagnose ADHD. A list of disturbing actions of the child, take with you to the appointment.

Remember that ADHD symptoms don't only show up in one place (such as at school). This disorder causes problems no matter where the child is. Child with ADHD may have problems not only with science, but with establishing contact with parents.

Who treats ADHD

Effectiveness of pharmacotherapy in the treatment of ADHD

It is worth knowing to what extent drugs can help in treatment. You can't expect them to fix all ADHD-related problems. However, in some cases they are an integral element of treatment.

What can be expected from pharmacotherapy in this case?

There are several directions the effects of drugs for ADHD:

• help to calm the symptoms of hyperactivity;
• help the child concentrate during study, help to keep attention on the work performed;
• reduce disagreements with the environment - information coming to the child from the outside, what other people tell him, becomes more accessible and understandable to him;
• contribute to the fact that the child is able to cope with himself.

However, it must be remembered that there are some limitations on the effectiveness of pharmacotherapy. You cannot expect drugs to replace the right approach in education and training.

As follows from observations, the creation of appropriate conditions for the functioning of the child by parents and teachers is the basis proper development and symptom reduction.

Of course, as mentioned earlier, drugs will increase concentration during classes and homework, but you cannot expect the average student to suddenly be among the best. Medications can slow down to some extent child's impulsiveness.

However, if a child is characterized by a high level of aggression, despite the systematic administration of drugs in the correct dose, then other sources of aggression (eg, improper family relationships, physical abuse) should be considered.

One of the most difficult problems that accompany ADHD is dyslexia and dysgraphia. Unfortunately, in the case of these disorders, drug treatment does not work.

Natural Treatments for ADHD

From year to year, more and more children and adults are diagnosed with psychomotor hyperactivity disorder. Treatment of such a disorder is costly and can cause side effects.

Therefore, it is worth knowing ways to treat ADHD.

• Step 1. Fish oils and other fish-derived oils naturally increase concentration and allow you to focus for longer, which is a problem with ADHD. Today this tool is available in the form of lozenges without taste and smell. Take one tablet daily with food and do not exceed the recommended dose.
• Step 2. Look for supplements containing pine bark extract - it relieves ADHD symptoms.
• Step 3. Enjoy the benefits of coffee or tea, especially in the morning and early evening. If you have ADHD, caffeine stimulates the body and increases the ability to focus.
• Step 4. But don't overdo it with coffee! Coffee in the evening will keep you awake. Take this into account before brewing your next cup. What's more, this flavored drink can even aggravate ADHD symptoms by dehydrating the body if we drink too much of it.
• Step 5. herbal teas, available without a prescription, containing maidenhair, improves blood circulation, and also facilitates the delivery of blood to the brain. These are important factors in the fight against ADHD.
• Step 6. Products containing oat extract stimulate the body in the same way as caffeine. Their action, however, is not so violent and long-lasting.
• Step 7. If ADHD does not allow you to calm down, drink chamomile tea. Calms the nervous system and helps to cope with nervous symptoms of ADHD. Please note that this tea has the opposite effect on some - try to drink chamomile in the evening, not in the morning.

Always take into account all your allergies when you want to treat ADHD naturally. If you have a seafood allergy, you may need to stop taking fish oil. If you notice symptoms that could be caused by an allergy, see your doctor. Most herbal medicines take time to make any difference to the symptoms of ADHD.

Diet and treatment for ADHD

The introduction of a special diet is one of the alternative treatments for attention deficit hyperactivity disorder. The diets used to treat ADHD involve the most natural diet. They are based on the elimination of certain substances in the child's diet and the expansion of the content of others.

Gaining great popularity diet of Dr. Benjamin Fiengold, based on the theory of the connection of attention deficit hyperactivity disorder with intolerance to bread products. This diet involves the avoidance of food colorings and preservatives, as well as their natural counterparts.

Some researchers have noted a slight improvement in a proportion of children with ADHD (about 10%) when given this diet. However, in most studies, information about the effectiveness of the Fiengold diet has not been confirmed. The same is true with a diet based on the replacement of sugar with honey.

Here, too, objective studies have not confirmed the effectiveness of this method. In people with ADHD, a phosphate-restricting diet, called the diet, is recommended.

All these diets require a lot of sacrifice on the part of the child and increased responsibility on the part of the parents. They can also be a source of conflict. Therefore, it is necessary in each specific case to take into account that the costs of introducing a food regimen are commensurate with the profit.

The second group of diets used in the treatment of ADHD provides for the replenishment of the deficiency of certain nutrients. Among the substances taken that improve the functioning of the nervous system are vitamins, trace elements, protein supplements and polyunsaturated fatty acids.

Any changes in the diet should, however, be made with caution and always after consulting a doctor. And, above all, we must remember that they are not a panacea.

Supporting a child with ADHD at home

Effectiveness of treatment for children with ADHD largely dependent on their parents. Therefore, it is very important that they are well informed about this disorder from the very beginning, and also have training in caring for a child with this problem.

There are some general rules that parents must follow:

• show understanding and acceptance of the child: negative emotions can further aggravate the symptoms;
• emphasizing the correct behavior of the child;
• strict observance of rules and regulations;
• setting the child's responsibilities in proportion to his abilities.

Supporting a child with ADHD at school

School is the second environment in which a child spends the most time, so teachers should be trained in caring for children with ADHD. General rules behaviors with the child at school are similar to those listed in the family topic.

However, there are additional conditions, the fulfillment of which can help to cope with the problem:

• creation of appropriate conditions during lessons - it is important that in the hall where classes are held, the number of objects and colors that can be distracting is reduced;
• the child should sit next to the teacher, so it is much easier for him to focus the attention of the student on himself;
• division of labor - the actions that the child must do should not be too long;
• it is necessary to divide the work into several stages;
• presentation of the lesson plan at the beginning of the lesson;
• providing children with didactic methods that help the assimilation of information;
• interesting lessons, including work in groups, etc.

To be sure about what is important for a child, consult a pediatrician or ask the opinion of a school psychologist. After a long conversation about the child's behavior and the situation at home and at school, it may turn out that the symptoms are caused by other factors than the disease.

Sometimes it is problems at home (divorce, frequent quarrels of parents, death in the family) or at school are responsible for this child behavior.

If, after a visit to the doctor, you find that your child suffers from attention deficit disorder, do not panic. Remember that children with ADHD very often feel that they are disappointing their parents and those around them. Lack of self-control is not a reason to reject a child. Rather, on the contrary, he needs even more love and support.