What is Attention Deficit Hyperactivity Disorder? Is your child extraordinarily active, non-stop activity, or lack of patience and difficulty concentrating on one thing for a long time? This is exactly the type of child we are going to discuss here. Maybe he has been a pain in the neck for parents. The teachers keep complaining about him, which not only makes you feel humiliated but also aggravated. You are not letting your child off the hook, but he seems to be making slow progress, always making the same mistakes, can’t stay idle for a moment, talks too much, gets into trouble with others, and has no sense of humor, so that classmates don’t want to play with him, and parents are on edge all day long. Or homework is not staring at not do, other students in the school on the homework done, he always want to bring home, always procrastinate until can no longer delay before starting to write, all day do not know what to think, learned things old can not remember, almost every day by the teacher left. Maybe his test scores are not bad, but how much time and energy have the parents put in? You may be secretly worried about his future, but he doesn’t seem to be in any hurry. Attention Deficit Hyperactivity Disorder (ADHD), commonly known as “hyperactivity disorder” and abbreviated to ADHD, is one of the most common behavioral disorders in children and adolescents, and there are 2-3 children with ADHD for every 50 school-age children in China. Major Symptoms of ADHD Most clinicians consider ADHD to be a developmental disorder of self-control that consists of three underlying problems: difficulty maintaining attention, impulsive behavior, and hyperactivity. Hyperactivity: excessive hand and foot movements or frequent squirming in their seats, leaving their seats in the classroom or other situations that require them to stay in their seats, running or climbing in inappropriate situations, touching things, difficulty playing quietly or engaging in leisure activities, talking excessively, and often being busy, as if driven by a motor. Maintaining Attention Difficulty: can’t pay attention to lectures or homework, easily influenced by the environment, can’t always remember to talk to him, doesn’t know what he’s thinking about, confused all day long, always reluctant to do homework, puts it off until he can’t put it off any longer, does it late, often doesn’t finish it, is especially careless, often loses his mind, can’t do his homework without supervision, needs repeated directions, moves on to another activity before he’s completed it. ” Behavioral impulsiveness: often speaks in class without raising his hand, even before the question is finished the answer has already blurted out, and as a result often says the wrong thing, impatient, wants what he wants right away, hard to wait, often interrupts or inserts himself into other people’s activities, causing trouble in social interactions, school or workplace. Differences between ADHD and normal active children Normal children may also be active, but they are more active in specific situations, such as after-school play and outdoor activities. They tend to stay still in situations that require quietness or discipline, and they do well in school, in partner interactions, and at home. Children with ADHD, on the other hand, behave more severely than the average active child, with too short attention retention, too high activity levels, too little impulse control, and age-inappropriate behavior in multiple settings in the classroom, on the playground, and at home. They have difficulty completing homework, do not get along well with their partners, and are unable to follow instructions to complete tasks because they do not have parental supervision, often leading to family conflict. These problems impair a child’s ability to adapt and are difficult to fully recover from, even with age, and therefore cannot be considered normal. If this is the case with your child, not taking these problems seriously or tolerating the child’s slow maturation may be detrimental to the child’s psychological and social health. Problems associated with ADHD Learning problems: Inattention can affect classroom performance and academic achievement. As the school year progresses many children with ADHD “hit rock bottom,” falling behind week by week and falling farther and farther behind until the gap is too large to catch up. Attention deficits are often brought to the attention of children in the third grade and are treated in hospitals. Because third grade is when children with ADHD most often “hit rock bottom,” it is widely believed that third graders are able to do more and more tasks independently, and as a result, their homework load increases. There are also many children who seek treatment after graduating from elementary school and moving on to middle school, when the amount of classes and teachers increases and many children with ADHD who were able to keep up in elementary school are not able to cope at all in middle school. Confrontation and behavioral problems: Hyperactivity and impulsivity may cause children with ADHD to break school discipline, house rules, or interpersonal rules more often, and to get into more trouble than children with attention deficits alone, and significantly more of them have combined confrontation and behavioral problems. These include refusal to obey or active disobedience to adults, irritability, temper tantrums, grudges or retaliation, hostility, resentment, and even aggressive and disruptive behaviors such as stealing, truancy, running away from home, lying, setting fires, animal cruelty, and bullying. Emotional instability: About 20% of children with ADHD may experience severe and intense emotional episodes, impulsive and reckless, and outbursts of physical or verbal aggression, which seriously affect daily life and interpersonal relationships. How ADHD develops The cause of ADHD has not been fully researched. Existing research suggests that ADHD is a genetic disorder, and a complex polygenic genetic disorder, and is also influenced by a variety of natural and social environmental factors. It is the combination of genetic and environmental factors that leads to ADHD, and is not a problem of the child’s moral character or simply the result of poor upbringing. Since the Human Genome Project was launched, many medical scientists have put forward their visions for the future of healthcare, one of which is to decipher the genetic code and accurately diagnose and treat based on genetic profiles. In recent years genetic studies of ADHD have identified many genes associated with the development of ADHD. These genes control important chemicals in the brain, and it is changes in these chemicals that reduce the function of the brain’s “commanders” and decrease the ability to manage behavior, resulting in hyperactivity and inattention. Does it get better as the child grows older? If left untreated, 70% of children with school-age ADHD will continue to have symptoms into adolescence. Although most children’s hyperactivity levels will decrease, there may be learning difficulties, confrontation with parents and teachers, discipline, aggression, truancy or suspension from school, and about 35 percent begin to use alcohol or even drugs. Thirty percent of children with ADHD have symptoms that will continue into adulthood. They often have a poor work record and low work performance, appear overwhelmed at work, are unable to work independently, are unable to be punctual and complete tasks on time, are unable to work consistently and efficiently, and are unable to get along with coworkers in a friendly manner. As a result they change jobs frequently, their socio-economic status is often lower than that of other people, and the risk of anti-social behavior, drug addiction, and delinquency is 5-10 times higher than that of the general population. It can be seen that the adverse consequences of ADHD on the patient’s daily life and social functioning far exceed the disease itself. Why ADHD needs medication Currently, both domestic and international expert guidelines take medication as the first choice of treatment for ADHD. Medication is considered to be the fastest and most effective method. For most children with ADHD, psychotherapy and behavioral interventions alone are not as effective as medication. Medication directly targets the cause of the disease, restores normal levels of important chemicals in the brain, and directly controls the symptoms of the disease. After taking medication, most children with ADHD have less hyperactivity, longer attention span, can pay attention to class, take the initiative to do their homework, complete their homework in a shorter period of time, and have fewer errors; the children feel that they “can control themselves”, their memory and other learning abilities are improved, and their self-esteem improves; they don’t fight with their classmates anymore, they can be friendly with their buddies, and listen to their parents and teachers. Parents and teachers will listen to their requests. Therefore, medication is the main treatment for ADHD, and on the basis of medication, it can be supplemented with psychological and behavioral interventions. What are the medications used to treat ADHD? There are two types of medications currently used to treat ADHD: central stimulants and non-central stimulants. Central stimulants: Methylphenidate and its controlled release agent (FocusTM). Methylphenidate has a shorter duration of efficacy and needs to be taken 2-3 times a day. Focus TM is a controlled-release form of methylphenidate, and its unique controlled-release capsule allows the drug to be released gradually at a specific rate in the body, so that the drug only needs to be taken once in the morning every day to control hyperactivity and inattentiveness symptoms throughout the day. Non-Central Stimulants: Commonly used are atomoxetine (Zesta?), colistin, some antidepressants, and other medications. , colistin, and some antidepressants. Zesta? is a new alternative medication used to treat ADHD in recent years, and is taken once a day in the same convenient way as Focus TM. Large-scale clinical studies have proven it to be effective in relieving ADHD symptoms, with comparable efficacy to methylphenidate, and good safety and tolerability. Colistin is effective in improving symptoms of hyperactivity and impulsivity, and is effective for tics, especially for patients with tics, defiance, conduct disorder, aggressive behavior, and sleep disorders. Coladin may also be used for those who do not respond well to methylphenidate. Zoloft? Antidepressants such as Zoloft are currently second-line drugs for the treatment of ADHD, and are mainly used to improve children’s depression or anxiety. Adverse drug reactions and countermeasures Some children may exhibit side effects during medication, especially when first started, but most are mild and go away quickly. Even if the side effects are severe and intolerable, the medication will be completely removed from the body soon after stopping and most of the discomfort will disappear. Loss of appetite: This occurs mainly in the morning or midday, with most children regaining their appetite in the evening. Children taking the drug should be given plenty of food every day, especially when their appetite is good (e.g., at dinner), to supplement the nutrients they need for growth and development. Appetite-enhancing enzymes or herbal preparations may also be used. Taking the medication with breakfast or after a meal may reduce the side effects of decreased appetite, but it may also be slightly less effective. Increase in heart rate and blood pressure: Your child’s heart rate and blood pressure may increase slightly during the course of the medication; however, these changes are mild and do not pose any risk to most children. However, if your child already has high blood pressure, or has a family history of high blood pressure, you should tell your doctor so that the medication can be properly monitored as the dose is adjusted. Insomnia: Some children who take the medication fall asleep later than usual at night, especially those who take the medication late in the day or in the afternoon. If severe difficulty in falling asleep occurs, the doctor should be told to adjust the dose of the medicine or combine some medicines to improve sleep. Neurologic tics: such as involuntary blinking, frowning, or shrugging of the nose, or short vocalizations. Most often occurs when children with previous tics or a family history of tics take methylphenidate preparations. Usually Zesta? has no side effects that induce or worsen tics. Sleepiness: Patients taking Zesta? patients may feel sleepy when the drug is first started or when the dose is increased, which usually decreases spontaneously in 1-2 weeks. Why do hyperactive children still need stimulant medication? Children who are hyperactive may have a decrease in chemicals in certain areas of the brain, a decrease in the excitability of the “commanders”, and a decrease in management and control functions, including control over movement, attention, logical reasoning, and planning, resulting in abnormalities in these areas. Abnormalities. The purpose of taking excitatory drugs is to increase the excitability of the brain’s “command” to ensure the effective control of the “command” of the behavior, so as to achieve the purpose of reducing hyperactivity and focusing attention. Is it possible to become addicted to a stimulant drug There is no evidence to suggest that the medical use of methylphenidate produces dependence. On the contrary, several studies have reported that adolescents with ADHD treated with central stimulant medications have a significantly lower risk of developing addictions to other substances than those who are not treated. Parental Responsibilities During Medication Administration 1. Supervise your child’s medication and strengthen the storage of the medication, do not allow your child to take it by himself or herself to avoid accidents. 2.Observe the changes of the child Attention: whether to do homework attentively, anti-interference, initiative, completion of homework, completion time, correctness; whether to pay attention to listening to others, orderliness of life, storage and carrying of goods Activity: small movements, large movements, energy, volume of speech, tone of voice Reactivity: whether to grab words, interrupt, sudden behavior, patience Other: mood, partnership, parent-child relationship Side effects : eating, sleeping, involuntary movements, other discomforts 3. Communicate with the teacher to understand the child’s performance at school, remind and assist the teacher to complete the questionnaire assessment 4. Describe the child’s changes to the doctor and help the doctor to accurately adjust the dose of medication