ADHD is increasingly being referred to as “ADHD,” but as the term becomes more common, so do the misconceptions that go along with it. It is dangerous to label a child as having ADHD, but it is also dangerous for a child to avoid treatment. Is it “Pee Wee” or “ADHD”? After more than a decade as a specialist in “learning difficulties” clinics, I have seen all kinds of children with “ADHD”, and this boy in front of me is clearly a typical one. He was seen before it was his turn to enter the clinic, and every few minutes he would push the door open. The doctor and parents told him not to push the door in, but the order obviously didn’t work for him. In the waiting room, the boy ran around, not stopping for a moment, and the nurses greeted and warned him, but he ignored them. During the consultation, the boy seemed distracted by the doctor’s questions, fidgeted, and then ran out of the room shortly after. After a detailed history and several tests and examinations, the boy was diagnosed with “ADHD”. Like many parents, the boy’s parents have always thought that their child was just more naughty and active than others, and despite being “told off” by the kindergarten teacher from time to time, they did not pay attention to it until they went to elementary school, when the parents realized that their child might really have “ADHD “. The difference between “Pee Wee” and “ADHD” is, in the opinion of some people, a subjective division between adults, but in the eyes of doctors, “ADHD” is the result of a subjective division between adults and ADHD. In the eyes of doctors, there are clear diagnostic criteria for “ADHD” and “Pee Wee” is not necessarily “ADHD”, but if “ADHD” is diagnosed, it requires standardized treatment. If the diagnosis of “ADHD” is confirmed, standardized treatment is needed. ”The core symptoms of ADHD are attention deficit (disproportionate to age development level), hyperactivity (activity level of apparently normal children) and impulsiveness, the difference between hyperactivity and hyperactivity is whether his activity is divided into occasions, whether there is no purpose, whether it affects the child’s adaptation to the environment, socialization and learning.” It is normal for children to be hyperactive, for example, some children like to run around in the hallways and playgrounds during recess, but are able to concentrate on lectures in class, which cannot be described as ADHD. “The activities of children with ADHD are also characterized by a lack of purpose. An active child may be playing a game when he or she runs around, but children with ADHD tend to run aimlessly. The ability to adapt to the environment is often not taken seriously by parents until after school, and parents often think of seeking medical attention only when they receive reports from teachers that their child is unable to concentrate in class, cannot listen to the teacher, and is even affecting schoolwork and interpersonal relationships (peer relationships, teacher-student relationships, family relationships). The term “ADHD” is so familiar to parents that they forget it is a disease. “ADHD is known by the professional name “Attention Deficit Hyperactivity Disorder in Children”. The main symptoms of ADHD are hyperactivity, impulsivity and difficulty concentrating, which last for at least 6 months and often appear before the child is 7 years old. “The ‘ADHD’ child does not not want to control himself, he cannot control his behavior and attention, which is distinctly different from being active and active.” The diagnosis of “ADHD” is much more complicated than many diseases. “You can tell if a child has a fever by taking his or her temperature.” “There is no “gold standard” for the diagnosis of ADHD, so a diagnosis is usually made after a detailed medical history, clinical examination, multiple tests, and a comprehensive evaluation by parents and teachers. A 10-year-old girl from Henan province was brought to Shanghai by her parents during the summer for medical treatment. The parents told the doctor that the teacher reported that the girl was inattentive in class, talked to her classmates, ran away every 5 minutes when doing homework at home, was careless in her homework, and often missed words when reading aloud. The doctor briefly spoke with the little girl and suggested a series of tests, but the results of the parents filling out the relevant scale were contradictory to the child’s situation as reflected by the parents, and asked the parents to bring back a relevant scale for the teacher to fill in the child’s daily performance and bring it back for a follow-up visit, and the doctor would make a judgment again by combining various factors. ”So is she ADHD or not? Should I take medicine?” The parents looked a little anxious and asked several times, hoping to get an immediate answer. Diagnosis is not that simple, and because there is no “gold standard”, doctors must be careful to diagnose and fully consider all possibilities, and it is not unusual for patients to be rediagnosed after several visits. Although parents find it difficult to accept, current medical research proves that “ADHD” is a lifelong chronic disease that cannot be “cured”, just like hypertension and diabetes, but only maximizes symptom control and corrects bad behavior. After learning about ADHD, the father of a young patient told the doctor that he was facing a similar problem to his child. The father, a business manager, has subordinates reporting to him every day, and he has to concentrate hard to hear and understand the reports of his subordinates. Don’t label them without permission From the current research findings, there are various causes of ADHD, among which genetic predisposition, psychological and social factors are becoming clear. She has been impressed by the variety of families with children with ADHD, and by the difficulty some parents have in focusing when doctors communicate with them. The father of a Taiwanese child she saw told the doctor himself that he had been diagnosed with ADHD as a child. Epidemiological studies have further confirmed the genetic predisposition to ADHD. A study of dizygotic twins showed that they had a 79% risk of being homozygous for ADHD if they were identical, and a 32% risk if they were dizygotic. Another obvious factor is family upbringing. Many reports have found that in families where parents are violent, often scolding and interfering with their children’s activities, and seriously damaging their children’s self-esteem and self-confidence, the children are in a state of high mental alertness for a long time, and when the conditions are right, they will vent their mental stress without control, manifesting themselves as hyperactivity and inattentiveness. It is difficult for a layperson to accurately determine if a child is “ADHD”, and some cases may be mistaken for “ADHD”. Based on more than a decade of clinical experience, some of the children who have been seen have behavioral patterns similar to ADHD, such as inability to sit still in class and distractions, some of which may be related to the child’s emotions and environment. The child did not like the teacher’s house, missed his parents and former peers, could not concentrate in class, made small movements, did not do homework, had a strained relationship with the teacher, and his grades dropped significantly. Some may be mildly mentally retarded, “just like when we listen to a foreign language and go off on a tangent when we don’t understand it. Children with mental retardation can’t concentrate because they can’t fully understand what the teacher is saying.” To rule out this possibility and to find out if the child’s language and manipulative skills are developing in a balanced way, doctors may recommend that some of their patients undergo intelligence testing. Other parents find that their child’s inability to follow classroom discipline and do whatever they want when they first enter elementary school cannot simply be judged as ADHD. It is likely that this is just a behavioral problem that occurs during the transition to elementary school, especially in children who go to kindergarten and “fish for three days and then fish for two days,” where the family is child-centered and allows the child to do whatever he or she wants, making it difficult to follow the rules for a short period of time. In such cases, the doctor recommends that parents communicate with teachers and work together with the home and school to gradually improve the child’s behavior through guidance and encouragement. We understand the parents’ concern and anxiety about their children’s behavior problems. Since the “only child” era began 30 years ago, Chinese parents have been paying more and more attention to their children’s education, and they have been doing their best to raise their children to be successful. “In the past, there were always a few ‘skinheads’ in a class, and people thought it was normal, because there were many children in the family and parents had no time to care.” Memories are common among Chinese people before the “only child” era. The “learning difficulties” clinic at Shanghai Children’s Hospital, the highest-volume “ADHD” specialist clinic in Shanghai, has seen a change in parents’ perceptions, as reflected in its outpatient figures. In 2011, the number increased to more than 13,000. Such figures are a world away from the 1990s, when the clinic was first established. One obvious change is that many migrant workers bring their children to Shanghai from their hometowns during the winter and summer holidays. The increase in the number of visits reflects the growing awareness of ADHD, but also the growing misconceptions about the disorder. In particular, teachers who lack expertise in the field may label students with ADHD, which is likely to hurt their self-esteem and confidence. It is good for teachers to suggest that parents bring their children with suspected ADHD to the clinic for consultation, but when communicating with parents and students, it is important to pay attention to the wording and manner in which the child’s feelings are taken into account. For example, a discussion in front of classmates is likely to cause stress to the child and parents. For this reason, the Shanghai Children’s Hospital has conducted training for teachers in some districts in Shanghai, combining medical and educational efforts to give teachers a proper understanding of ADHD. ”The treatment and correction of ADHD places special emphasis on the cooperation between doctors, teachers and parents, so the Shanghai Children’s Hospital has a special school for parents. The “Parent School” teaches parents specific measures to take. “Parents of children with ADHD, who are always “in trouble”, can easily get angry with their children. Doctors suggest that parents should first learn to control their emotions, separate from their children when they are excited, listen to their children after their emotions have calmed down, find the reasons for their mistakes, and guide them patiently. Is it terrible to take medicine? ”Children are skinny when they are young, they will be fine when they are older.” In the face of popular beliefs, if ADHD is diagnosed, timely, active and standardized treatment is necessary. Related surveys show that about two-thirds of children with ADHD have symptoms that last through adolescence and one-third have symptoms that carry over into adulthood. If left untreated, ADHD is prone to co-occurring learning disabilities, emotional disorders and social adjustment disorders, which have a wide range of negative effects on the academic, vocational and social life of patients. Therefore, the use of drugs to modify these abnormalities has become the basis of treatment. The first two drugs are central stimulant drugs. Figuratively speaking, these children are a car without brakes, the role of drugs is like brakes, it will help patients control the “speed”, on the basis of “brakes” and then teach the child “traffic rules “After long-term training, children can slowly control their behavior. At the beginning, most parents were averse to taking the drug, worrying that their children would “become stupid” and “not grow taller”. More than 70 years of research at home and abroad have proven that central stimulants are safe and efficient drugs for the treatment of ADHD. The side effects of the drugs are mainly in the appetite and, to a lesser extent, in the sleep and prolonged sleep time. Long-term studies have found that the effects of medication on appetite generally improve after 2 weeks to 1 month, and a 21-month survey showed that children on medication lagged 0.23 cm behind the height of children not on medication. long-term studies have not found any effect on children’s intelligence, so doctors generally consider medication safe. “Parents should be prepared for at least 1-2 years of medication.” ”The prevalence of ADHD, defined as a chronic disease, varies from country to country and is now generally reported to be around 3-5%, with a much higher prevalence in males than females, 4-9:1. If you calculate a class of about 30 students, theoretically, there could be an “ADHD” student in every class. “Students with ADHD can be found in every classroom. At the same time, the diagnosis of ADHD is complex, so it is dangerous to label ADHD indiscriminately or to avoid treatment when ADHD is diagnosed. There are also “wizards” among the “ADHD” population, who turn their perceived “deficits” into extraordinary abilities. Phelps, the American swimmer “The Flying Fish”, just made history at the London Olympics by becoming the most decorated athlete in Olympic history. After becoming the “greatest athlete”, Phelps’ childhood anecdotes were also unearthed. Foreign media reported that Phelps was diagnosed with “ADHD” as a child, and after he learned to swim, his excessive energy was released in the water. However, there are foreign doctors disagree with the media’s interpretation, a British doctor believes that “attention deficit hyperactivity disorder” will not only help improve the performance of athletes, but, on the contrary, may also affect training. There are always people who are a little different from the majority of the population, and society should give those “special people” more opportunities and space.