Hyperkinetic behavior disorder is a set of complex violations of behavioral reactions, characterized by the presence of certain signs from three categories: impulsiveness, inattention and hyperactivity, in the presence of special criteria for behavior disorder in society.
Basic terminology
There are several terms that describe such violations of the child’s behavior: ADD (attention deficit disorder), ADHD (attention deficit disorder, combined with hyperactivity), the actual hyperkinetic disorder and hyperactivity of children.
All these concepts are somewhat different from each other. However, they are based on concentration problems and hyperactive behavior.
Hyperkinetic disorder is a behavioral deviation that worries parents at an early age. At the same time, the baby is extremely inattentive, impulsive and overly active.
However, do not think that many children, for example, of the age of five (which is characterized by anxiety and carelessness) suffer from a similar disorder. Such behavioral features become a problem when they are significantly hypertrophied, compared with peers, this negatively affects academic performance, communication with friends and family.
Only 5% of schoolchildren have hyperkinetic behavior disorder, with boys being slightly more likely.
Causes of occurrence
The causes of the appearance of such disorders are not known for certain, however, there is a clear connection between the disease and traumatic experiences and hereditary (family) factors.
Such factors can provoke the development of hyperkinetic behavioral disorders:
- insufficient / unbalanced nutrition (including the wrong introduction of complementary foods);
- severe intoxication, for example with chemical compounds;
- constant stress, unfavorable conditions in the team or family;
- the use of certain drugs;
- damage or malfunction in the development of the brain, especially its right hemisphere);
- pregnancy problems (oligohydramnios, fetal hypoxia, etc.).
Varieties of ailment
Such disorders are classified in accordance with the severity: lungs and severe.
In addition, there are several types of deviations in accordance with the age of the child:
- Toddlers 3-6 years old are emotionally unstable and overly mobile. They sleep poorly at night, often wake up and refuse to sleep during the day, which further exacerbates the situation. Such children in every possible way show disobedience, ignore the prohibitions and rules required by educators or parents.
- Younger students do poorly at school and do not follow the rules of school behavior. Such a student cannot concentrate on the lesson, and independent tasks are given to him very hard. It is difficult for a child to keep attention and perseverance, because of this he is distracted, makes ridiculous mistakes and does not absorb material.
- High school students with hyperkinetic behavior disorder are prone to antisocial behavior, smoke or drink alcohol, begin sex early, especially not thinking about choosing a partner.
The main symptoms of pathology
Do not think that hyperkinetic behavior disorder (F 90.1) is just a temperament characteristic. This condition is included in the ICD-10 as a pathology requiring medical correction.
Some parents attribute this to excessive control of the child, but there is no evidence that harsh or poor parenting leads to such disorders.
Hyperkinetic disorders in children can be expressed in a number of different signs in accordance with age, motivation and the environment in the classroom, kindergarten and at home. The main groups of symptoms are three: impaired attention, impulsivity and hyperactivity.
So, for some children attention problems come to the forefront, while the child is often distracted, forgets important things, interrupts the dialogue that has begun, is disorganized, starts a lot of work and does not bring to the end.
Hyperactive babies are overly fussy, noisy and restless, the energy in them literally is in full swing, and actions are almost always accompanied by incessant chatter.
When the symptom of impulsiveness prevails, the child does things without thinking, it is extremely difficult to bear the wait (for example, the queue in the game) and is very impatient.
In addition, other symptoms are often present: neurological manifestations (epilepsy, tic, Tourette’s syndrome), impaired coordination, social adaptation, problems with learning and organizing activities, depression, autism, anxiety.
In one of three cases, children with a similar problem “outgrow” the pathology and do not need special treatment or support.
Parents often wonder what the danger of hyperkinetic disorder is.
This condition is fraught (but, fortunately, far from always) with problems not only in childhood (poor performance, problems with classmates, teachers, etc.), but also in adulthood (at work, in relationships and addictions to alcohol or drugs).
Where to go
If parents suspect the baby has such a condition, a psychiatrist consultation is necessary.
Only a specialist, observing the behavior of the child and his character, can establish an accurate diagnosis.
Signs indicating the presence of an ailment cannot be single, that is, symptoms that are periodically recurring for at least 6 months are considered diagnostically significant.
In order to identify the presence of pathology, the doctor uses the following methods:
- conversation (often the child does not recognize the presence of any of the symptoms, and adults, on the contrary, exaggerate them);
- assessment of behavior in a natural environment for the child (kindergarten, family, school, and so on);
- modeling of life situations to assess the behavior of the child in them.
Diagnostic criteria
There are a number of criteria, the presence of which confirms the presence of a baby with a hyperkinetic disorder:
- Attention problems. At least 6 manifestations (forgetfulness, distraction, inattention, inability to concentrate, etc.) for 6 months.
- Hyperactivity. Within six months, at least 3 symptoms from this group are manifested (children jump, twist, swing their legs or arms, run in cases that are not suitable for this, ignore prohibitions and rules, cannot play quietly).
- Impulsiveness. The presence of at least 1 sign (inability to wait and have a dialogue, excessive talkativeness, etc.) for 6 months.
- The appearance of signs before the age of seven.
- Symptoms appear not only at home or at school / kindergarten.
- Present signs significantly impede the educational process and social adaptation.
- The criteria that are present do not correspond to those for other pathologies (anxiety disorders, etc.).
Therapy
The treatment of hyperkinetic disorder in children involves the following goals:
- ensuring social adaptation;
- correction of the psychological state of the child;
- determination of the degree of ailment and selection of treatment methods.
Non-drug phase
At this stage, specialists advise parents about the disorder, explain how to support such a baby, and talk about the features of drug treatment. In cases where the child has difficulties with learning, he is transferred to a correctional (special) class.
In addition, non-drug treatment of hyperkinetic behavior disorder in children implies the use of certain methods. These include the following:
- Group LF.
- Cognitive psychotherapy.
- Training with a speech therapist.
- Physiotherapy.
- Pedagogical correction of hyperkinetic behavior disorder in children.
- Massages of the cervical collar.
- Conductive pedagogy.
- Normalization of the day.
- Classes with a psychologist.
- Creating a comfortable psychological atmosphere.
Drug therapy
- "Methylphenidate" - a stimulant that increases alertness and energy with a useful distribution. Depending on the form used, 1-3 times / day is prescribed. Moreover, the medication should occur in the first half of the day, since later use is fraught with sleep disturbances. Dosage is selected individually. Physical dependence, as well as drug tolerance, are not characteristic.
- In case of intolerance to psychostimulants, nootropics are prescribed: "Noofen", "Glycine", etc.
- Antioxidants: Actovegin, Oksibal.
- Normotimic anticonvulsants: valproic acid, Carbamazepine.
- General strengthening agents: folic acid, magnesium-containing agents, B-group vitamins.
- In cases of ineffectiveness of the above drugs, tranquilizers are used: "cllorazepate", "Grandaxin".
- In the presence of severe aggressiveness or hyperactivity - antipsychotics ("Thioridazine", "Chlorprotixen").
- In cases of secondary depression, antidepressants are indicated: Melipramine, Fluoxitin.
Parent help
Important in the treatment of hyperkinetic behavior disorder is the correction of the behavior of the child at home. Therefore, parents should adhere to some rules:
- optimize the diet, that is, exclude products that increase the excitability of the baby from the menu;
- to engage the child with active games and sports in order to spend excess energy;
- make a list of daily household chores for the baby and place it in a conspicuous place;
- any request should be made in a calm voice and in an understandable form;
- in the case of any task requiring perseverance, it is necessary to give the child a rest of 15 minutes. and make sure that he does not overwork;
- you need to make detailed simple instructions for doing household chores, which contributes to self-organization.
Preventative measures
The following should be taken into account:
- pedagogical control;
- the exclusion of side effects of anticonvulsants and psychostimulants;
- maintaining a normal psychological climate in the family;
- improving the quality of life;
- when taking medications, take periodic breaks in treatment to determine further tactics;
- daily contact with school staff;
- in case of drug inefficiency - the involvement of teachers and psychiatrists for corrective therapy.
Further actions
- D-registration by a neurologist.
- In the case of the appointment of psychostimulants - control of sleep and the appearance of side effects.
- In cases of taking antidepressants - monitoring of ECT (with tachycardia), and when prescribing anticonvulsants - monitoring of ASAT and ALAT.
- Providing the most comfortable conditions for learning, self-organization and socialization of the baby.