ADHD is the common name for Attention Deficit Hyperactivity Disorder (ADHD). These children are easily distracted in class; they are careless and procrastinate; they are absent-minded and tend to stop halfway; they often lose things and make small movements in class; they talk a lot, interrupt, and make excessive noise. …… brings troubles to the family, causes problems to the school, and even causes some social problems. I don’t know how many parents are desperate because of their children’s problems. Indeed, ADHD children cause countless problems and troubles for their families, and are typically “troublemakers”. If parents do not recognize this and learn some reasonable coping strategies, they will be driven crazy by their children. So, how much do you know about ADHD? Cao Aihua, Department of Child Health Care, Qilu Hospital, Shandong University
1. Are children with ADHD deliberately misbehaving?
A large number of studies have found that ADHD patients have structural abnormalities in certain areas of the brain such as the frontal lobe of the brain, corpus callosum, cerebellum, etc. The cerebral cortex becomes thin, neurotransmitter metabolism is disturbed, and cortical development is delayed. The abnormalities in brain structures lead to difficulties in concentration, hyperactivity/impulsivity and emotional dysregulation in children with ADHD. Therefore, these symptoms in children with ADHD are the result of the disease, and parents should not criticize and scold their babies for being mischievous, disobedient and bad children. And over time, children will appear rebellious and increasingly disobedient.
2.Does hyperactivity necessarily mean ADHD? If you don’t have hyperactivity, you don’t have ADHD?
Children between the ages of 3 and 5 have a high activity rate and a short attention span, which is very natural and can be gradually controlled as they grow older. Normal children are also hyperactive, however, they are generally active only in appropriate situations and their hyperactive behavior is purposeful, while social functions such as learning and partnerships are not affected. In addition, children with stress, anxiety, depression, anemia, elevated blood lead levels, and apnea during nighttime sleep may also exhibit hyperactivity and inattention, and the symptoms will disappear once these causes are removed. There is another group of children who, in addition to hyperactivity symptoms, also have a late start in walking, late speech, interaction with children, repetitive movements, and stereotypes, which should alert them to mental retardation, autism, Aspergers, and other disorders. Therefore, parents with hyperactive children should not just label their babies as ADHD, but should always go to the hospital for a clear examination.
There are three types of ADHD: attention deficit oriented, hyperactive impulse oriented, and mixed. Younger children with ADHD are mainly hyperactive, can’t sit still, and have many small movements, while older children are mainly inattentive and easily diverted. So the absence of hyperactivity symptoms does not necessarily mean that it is not ADHD.
3.Will ADHD be better when they grow up?
The prognosis of ADHD is not optimistic, some of the symptoms disappear with age and turn out well, but up to 50% of children with ADHD will continue to have symptoms into adulthood. Moreover, as they grow older, ADHD patients often develop more and more social dysfunction such as low self-esteem, disruptive behavior, poor learning ability, poor social adjustment; delinquent behavior, conduct disorder, provocative behavior, unmotivated, oppositional behavior, multiple learning difficulties, etc., and have serious impact on the whole family.
4.How is ADHD diagnosed?
When you feel that your child is hyperactive, inattentive, and procrastinating when you need to be quiet and do homework, you should communicate more with the teacher to further understand your child’s situation at school. When you are sure that your child is showing signs of ADHD, please promptly take your child to a regular hospital’s child health department, psychology department, or neurology department for further consultation and treatment. Doctors complete the diagnosis by observing the child, interviewing parents who are familiar with the child, having the parents fill out a diagnostic form, and performing intelligence and attention tests on the child, and if necessary, examining an EEG, brain CT or MRI, blood lead, etc.
5. Why should ADHD be treated early?
Because ADHD children are always in a vicious cycle of “criticism and blame from parents, teachers and classmates – low self-esteem and rebelliousness —- more criticism and blame”, which will lead to oppositional defiance, depression, anxiety, conduct disorder and other co-morbidities, which will increase the difficulty of treatment. If children with ADHD are treated early, they will enter a virtuous cycle of “praise —- positive mindset – more praise”. Therefore, early detection and treatment is conducive to faster recovery of children with ADHD.
6.Does ADHD have to be treated with medication?
ADHD is a disease that has its own pathophysiological changes, and therefore requires discretionary medication depending on the condition. However, we can not generalize, such as school-age children in class due to inattention, hyperactivity, impulsivity, etc., there are learning difficulties, poor academic performance, and even affect the learning and life of other students, and the effect of psychological counseling and behavior therapy is not good, then you need to give drug treatment. However, for infants, toddlers and preschool children with ADHD, although they also have too much activity and inattentiveness, these performances should be guided and corrected by parents appropriately as long as they do not affect the normal life of the children, and generally do not need medication.
7.What are the non-pharmacological treatments?
Psychotherapy: It mainly focuses on the emotion, parent-child relationship, interpersonal communication and self-perception of children with ADHD. These aspects are very beneficial for children with ADHD to adapt to society and build self-confidence, and can be used as a regular adjunctive treatment for ADHD.
Behavior therapy: It has a significant effect on improving children’s behavior. It is mainly reflected in self-management, time management, school and family behavior control. Behavioral therapy is a necessary treatment for ADHD. If medication alone is used it is likely that the effect will disappear with the discontinuation of medication, but if synchronized with behavioral therapy it will maintain these good behaviors even after the discontinuation of medication.
Others: Biofeedback, CES, etc.
8.Why adopt the “parent-teacher-doctor” three-axis treatment model?
The teacher can not only detect the early signs of ADHD children, but also observe the treatment effect during the treatment process, therefore, the teacher must be involved in the treatment. Doctors need to not only treat children, but also train parents to recognize ADHD, understand it, and master the methods and techniques of behavioral treatment in order to better understand their own children and create a harmonious and warm environment for them to establish good learning communication and living habits in a relaxed and pleasant atmosphere.