”ADHD, or Attention Deficit/Hyperactivity Disorder, is the most common behavioral disorder in children and adolescents and one of the most prevalent chronic disorders in school-aged children. Research shows that 4-6 out of every 100 school-aged children have ADHD.
The main manifestations of ADHD are persistent inattentiveness, hyperactivity and impulsivity, and children should consult a relevant doctor when they are
1. fidgeting.
2. noisy, noisy.
3. excitement, impulsiveness.
4. inattentive and easily distracted.
5. inability to finish what he/she started to do (note the short duration)
6, good quarrelsome.
7. acting without thinking.
8, love to lose temper.
9, confrontational behavior.
10. uncooperative.
When these conditions are present and are severe, the child should be evaluated and diagnosed accordingly. Here is a brief introduction to the standard treatment routine for ADHD.
I. Initial diagnosis
The doctor will take a medical history to understand the child’s current behavior and its impact on the child’s life and learning; to understand the child’s condition at different ages, growth and development, and previous diagnosis and treatment; the doctor will ask some questions based on the child’s condition, including the child’s family environment, parenting style, family history, and so on. At the same time, the doctor will observe the child’s behavior in the consultation room, conduct a basic physical examination, and have a brief interactive conversation with the child. Based on this, the doctor will make a preliminary judgment and determine the next step in the evaluation.
Tips.
1. Before the consultation, parents can review their child’s performance from childhood to adulthood and the main problems that currently exist; they can ask their teachers about their child’s performance at school (e.g., are the teachers difficult to manage? Are different teachers reporting inattentiveness in class? What is the level of inattention in the class?) You can bring your child’s homework, test papers, etc. to help the doctor understand your child.
Many parents do not know how to explain to their children why they need to see a psychiatrist, and are afraid of putting a psychological burden on their children, sometimes using some coaxing methods (a child once said his mother said she took him to McDonald’s, but he was brought here to see a doctor). Parents can choose the appropriate method to communicate with their children according to their age, and generally the child can also realize their problems and tell him that we go to professionals for help.
Second, examination
There is no way to diagnose ADHD through blood tests or films. For ADHD, tests are mostly done to rule out other diseases that cause inattention and hyperactivity and impulsivity. Tests that can be considered include
Trace element tests: High blood lead or zinc deficiency may lead to inattention and hyperactivity, and trace element tests can help clarify this.
Thyroid function tests: Hyperthyroidism may cause similar symptoms, and should be performed when the doctor considers the child to be at risk or if there is a family history of hyperthyroidism in the child.
Routine blood tests, liver and kidney function, ECG, EEG: These basic tests are recommended when medication is being considered, and although the medication used to treat ADHD does not have a significant effect on this, it is still recommended that regular tests be performed during the initial phase of treatment.
Other: When the doctor considers that the child may have other problems that need to be ruled out after the initial diagnosis, relevant tests are required.
Tips.
1. Liver and kidney function tests need to be performed on an empty stomach, while blood tests such as routine blood tests, trace elements and thyroid function are not affected by diet.
2.Electrocardiogram and electroencephalogram are non-invasive tests and will not bring adverse effects to the child.
3, recent test results from other hospitals can be brought to the doctor to reduce some repeated tests. However, if the interval is longer, it is recommended to re-examine.
III. Assessment
Assessment is an important part of ADHD diagnosis, and the general assessment includes the following aspects.
1. Intellectual assessment: Understanding the child’s intellectual level is the basis for judging a child’s behavioral problems, and it also provides insight into the characteristics of his or her intellectual structure and identifies the child’s strengths and weaknesses. Children who are clearly inattentive are reflected in their behavior during testing as well as in the distribution of test scores.
2. Attention test: Conducting a continuous attention test is an important part of diagnosing ADHD and understanding the child’s level of attention and response control.
3.Parent scale: Parents fill out a professional standard scale to understand their child’s behavior and emotional performance.
4.Teacher scales: It is meaningful for teachers to reflect the child’s performance in school. If we can get the support of teachers to fill in some special scales, it can help doctors to diagnose.
5.Children’s scales: For older children, you can fill out some special scales by yourself to understand your child’s view of himself/herself.
6.Other: ADHD often has some co-occurring problems, such as tic disorder, emotional problems, social problems, etc. Depending on the situation, the doctor will choose the appropriate assessment to help clarify the diagnosis.
Tips.
1.Evaluation needs to be done by appointment, the intelligence test takes about 1 hour, and the attention test takes about half an hour.
2. Hunger, sleepiness, bad mood, psychological resistance, etc. may have an impact on the assessment results, so it is recommended to deal with these problems and maintain a good state when bringing your child to the assessment.
3.Teachers are very important in the diagnosis and treatment of ADHD children. It is necessary to communicate more with teachers to understand the child’s performance at school and get their support.
IV. Diagnosis
After the initial consultation, examination and evaluation, the doctor will synthesize the information collected and make a diagnosis. Most of the time the diagnosis can be clear, but for some borderline children, further observation may be needed.
Tips.
1. The diagnosis of ADHD is an objective diagnosis with strict diagnostic criteria, and is not a subjective judgment of the doctor.
2. Test results such as scales are only diagnostic tools for doctors, and diagnosis should not be made simply based on the results of the scales.
V. Treatment
ADHD is a chronic disease, treatment is a long-term thing, treatment should be a comprehensive treatment, including the following aspects: 1.
Parents need to know about ADHD, understand the mechanism, performance, consequences and treatment methods of ADHD, etc.
Parents should understand the effects, side effects and reasons for medication, and know how to observe the efficacy and side effects while the child is taking medication.
3.Psychological intervention for children: Psychological treatment for children with ADHD includes.
① Let children understand themselves and have confidence to face their difficulties: Many children cannot understand why they need to see a doctor or take medication and think whether they have psychological problems. They should discuss these problems with their children and help them build the right attitude.
②Help children deal with emotional problems: Children with ADHD often encounter some frustrations, parents, teachers, and classmates will have some negative comments about them, and these will bring psychological stress as well as some emotional problems that they need to help them solve.
③Help to improve their social skills: Some children with ADHD have difficulties in socializing and are unable to establish good relationships with their friends, and need guidance.
4.Parents learn ways to get along with their children, communicate and manage their children.
5.Collaboration with teachers to help children adapt to school life.
6.Family therapy: In some cases, the family environment may be the reason for the existence or aggravation of the child’s problems, and intervention is needed accordingly.
7.Psychological support for parents: Raising a child with ADHD is a hard task, parents often feel tired, frustrated, anxious and depressed, parents need to get psychological support and adjust their emotions in order to better face their children.
8, some training for children: biofeedback therapy, cognitive function training and other therapeutic methods may bring benefits to children with ADHD.
Tips.
1, the most important thing for ADHD treatment is persistence, which is a challenge for parents.
2. Comprehensive, long-term treatment will bring the most benefits to the child.
3.Parent, doctor, and teacher cooperation is the best treatment model.