Attention Deficit Hyperactivity Disorder (ADHD).
The first bibliographic mention of what is now known as Attention Deficit Hyperactivity Disorder (ADHD) was in the year 1798, in Great Britain. However, it is not until 1992 that the World Health Organization recognizes it and includes it within the list of behavioral and emotional disorders.
It is currently known that 5% of the world’s children and adolescents are affected by ADHD , a disorder that can be identified from childhood.
ADHD has its origin at the neurobiological level, which is why it has been categorized as a neurodevelopmental disorder. It is genetically based (with a 76% probability of being inherited) and affects both brain function and development, especially the prefrontal region.
Attention deficit hyperactivity disorder is diagnosed mainly in males . In 70% of children, symptoms can persist into adolescence and into adulthood depending on their intensity.
What are the most common symptoms of ADHD?
This disorder is characterized in general because people have difficulty concentrating and paying attention. This compromises your ability to organize and plan. They also show difficulty controlling behavior. Additionally, they manifest excessive activity and agitation.
Symptoms related to ADHD interfere with the social, emotional and cognitive development of the child who suffers from it, causing dysfunction in their school group and in the family.
They are classified into three types based on their symptoms:
- Predominantly Hyperactive-Impulsive: Although most symptoms fall under the classification of hyperactivity-impulsivity, they can have some symptoms of inattention.
- Difficulty in maintaining attention predominates: it is the most difficult to diagnose since most of the symptoms are due to inattention, so they tend not to show symptoms or have difficulties in social relationships with other children. The little ones may be calm, but they are not paying attention to what is happening in their environment.
- Combination of hyperactive-impulsive and inattentive: it is the most commonly diagnosed, where children present more or less the same amount of symptoms from the two previous categories.
|Easily distracted, not perceiving details, and prone to switching from one activity to another.||Be restless and fidgety in their positions, either standing or sitting.||Be impatient.|
|It is difficult for them to focus on just one thing.||They don’t stop talking.||Make inappropriate comments.|
|If the activities are not of interest to them they get bored quickly sometimes after only a few minutes.||They have to touch everything, play with everything in sight, moving from one place to another.||Act without considering the consequences.|
|Inability or trouble organizing and completing a task.||Having trouble sitting down, whether it’s eating, at school, or at work.||They have difficulty waiting their turn.|
|They seem to be not paying attention when spoken to.||They are in constant motion.||They interrupt conversations and activities.|
|They have trouble following instructions.||They have difficulty performing tasks that require reassurance.|
What are the causes of ADHD?
The main cause of the appearance of ADHD symptoms is an alteration of some brain neurotransmitters, whose production is insufficient. Among these neurotransmitters, those most clearly involved in this disorder are dopamine and catecholamines, more specifically norepinephrine.
The neural circuits that are most affected in ADHD are those of the prefrontal cortex and the corpus callosum. The first of these is essential in the development, execution of tasks, attention and correction of errors. The second, the corpus callosum, plays a fundamental role in the coordination between the two cerebral hemispheres.
The causes of the deficit in neurotransmitter production have not yet been clearly established, but the most accepted version is that it is a combination of various factors such as:
- Genetic inheritance
- Low birth weight.
- The presence of a mother who smokes or has consumed alcohol during pregnancy.
- The physical and chemical conditions associated with brain activity.
- Research indicates that there is a strong relationship between the family environment and psychological disorders, especially with ADHD.
- Social factors such as living in poor neighborhoods, marginalization and social exclusion notably increase the possibility of suffering from ADHD.
ADHD and family conflicts.
Since the ADHD diagnosis process is not usually very fast, feelings of frustration, guilt and anger can build up within the family nucleus. This generates conflict situations between the child with ADHD and the rest of the family members. Conflicts may appear between other members of the family due to not having a clear way of acting before the child with ADHD.
The lack of knowledge on the subject and the difficulty of establishing clear limits by adults cause behavior problems in children and adolescents, not only within the family nucleus, but also in the school environment and in the development of social skills in the community.
Although aggressiveness is not included as a characteristic for this disorder, it is considered that the violent behaviors of those with ADHD are characterized as reactive, in the face of a hostile environment generated by the behaviors in their environment.
Difficulties they may have at school.
Although this disorder was recognized in the World Health Organization 27 years ago, there is still not enough information at the level of schools and the general population. Consequently, they tend to discriminate against people who suffer from this disorder, for not knowing how to handle it properly, they generally associate it with a basic behavior problem.
Individuals with ADHD are excluded, considered mentally ill or lazy, and do not receive the support of teachers or directors of educational institutions. In many cases, situations of violence occur in the school context that involve teachers, students, friends and strangers.
Difficulties they may have in the community.
When it comes to relationships with relatives, friends, and strangers, these children and youth with ADHD are commonly perceived as “rude” and disobedient. They can be misinterpreted as unruly, leading to aggressive and oppositional behaviors on the part of the individual with ADHD.
The different treatment options including:
- Special education programs
- Behavioral treatments
The most recommended are multimodal approaches, which include the combination of a pharmacological and psychological treatment, directly linked to the needs of each individual and the moment of development. With proper treatment, affected children are more likely to develop their full potential in the long term.
How to establish a favorable relationship with the educational unit for the well-being of the child?
When there is a suspicion that a child has ADHD, the first thing that is done is a detection of some symptoms by the school counselor and teachers, who suggest an evaluation by specialists.
The specialists (neurologists, psychologists and psychopedagogues) will evaluate the child and make the formal diagnosis with which the institution will work. After having confirmed the diagnosis, a work team is created (therapists, teachers and family) which together and following the same parameters will structure the routines and work plans with the child.
The objective is to improve their school adaptation. It is about stimulating educational inclusion and thus achieving the integral development of the child.
Tips to follow.
- Notify teachers that your child has ADHD when a new elective year begins or changes schools.
- Be patient as you establish new routines and assignments for each school year.
- Establish a joint work plan with the teacher, communication is essential.
ADHD in adolescence.
Although ADHD is mostly studied and diagnosed in childhood, it persists until adolescence, it is estimated that 75% of children with ADHD will be adolescents with ADHD.
There are cases that are not diagnosed until adolescence, mainly when the symptoms are of the type of inattention, because they do not show discipline problems at home or at school.
When children reach this stage, the symptoms of this disorder are added to the behaviors of adolescence. In this stage, the structuring of the personality takes place and the limitations of the disorder largely condition its development.
Adolescence and brain maturation.
At this stage, the adolescent brain has completed its development, but it needs to mature. It is a phase with important morphological changes that vary according to the degree of maturation of each region of the brain. Either due to the characteristics of adolescence or the symptoms of ADHD, caused by the impairment in the development of brain regions, subjects with this disorder tend to have poor academic performance and difficulty in interpersonal relationships, so problems become more complex.
The low academic performance begins to be noticeable with the increase in academic responsibilities and demands, since they are expected to be more independent. As a result, they have great difficulty staying in the regular school system and completing their studies. The hyperactivity is decreasing in intensity, although they continue to be restless.
Young people with ADHD are more likely to develop problems with aggression, alcoholism, tobacco use and other substances. For this reason, they must have a good support team (counselors, therapists, teachers, family) to lead these young people to successfully complete high school studies.
An important problem is that adolescents with ADHD are victims of teasing and psychological violence. C omo know not efficiently handle frustration, it is important to have the support and supervision of teachers and administrators of educational institutions.
12 tips to help kids with ADHD.
|1. Structure the schedule very well : maintain the same routine every day, from the moment of getting up to the moment of going to bed.
2 . Organization : everything should have a place: clothes, school supplies, toys.
3. Be clear and consistent : Children and youth with ADHD need consistent rules that they can understand and follow.
4. Offer praise or rewards when rules are obeyed : Since you always expect to be criticized, it is important to observe good behaviors and praise them.
5. Encourage the use of organizing notebooks : encourage young people to use materials to organize their homework at school.
6. Make lists of tasks and responsibilities at home , leaving spaces for them to mark the completed tasks.
7. Avoid overstimulation : structure everyday life situations so that the child is not overstimulated.
8. Share a pleasant or relaxing activity with the child: to identify and praise the child’s abilities.
9. Learn and teach techniques to manage stress and manage frustrations .
10. Support them in the development of social skills .
11. Communication, negotiation, and agreement are helpful .
12. Seek the support of therapists both for the child or youth with ADHD and for family members , in order to reduce harmful behaviors and achieve behavioral changes.
Do adults also have ADHD?
There are many adults who suffer from ADHD and do not know it, while 50% of adolescents with ADHD become adults with ADHD.
Generally, the adult with ADHD feels that he is unable to organize himself, keep a job, or remember and keep appointments. Also, daily tasks are challenging. They have a high probability of school failures on their record, problems at work, or frustrated relationships.
Symptoms in adults tend to be more varied and possibly not as limited as in children. The diagnosis includes many more interviews with people in the environment than in the case of children (spouse or partner, parents, close friends and other people related to the patient).
The consequences of not identifying this disorder in time are problems of emotional instability, low self-esteem and a negative image of oneself, so the diagnosis is usually a relief. It is usually treated with medication and psychotherapy.
Research on ADHD today.
Currently, some genes related to people affected with ADHD have been identified. Mutations have been found in different genes (DRD4 and DRD5) that influence dopamine metabolism at the level of its receptors. Other genes (DAT1, DAT5) would act on the transport of this neurotransmitter.
Genetic studies are accompanied by pharmacogenomics studies in order to find an optimal drug therapy regimen that adapts to each individual and their characteristics, since today it is known that the effectiveness of drugs is affected by the genetics of the drug. patient.
Also, genetic research is underway to see if there are specific genes that affect children’s response to methylphenylate. Finally, clinical trials sponsored by the National Institute of Mental Health (NIMH) are in search of the biological basis of this condition.
Alexa Clark specializes in Cognitive Behavioral Therapy. She has experience in listening and welcoming in Individual Therapy and Couples Therapy. It meets demands such as generalized anxiety, professional, love and family conflicts, stress, depression, sexual dysfunction, grief, and adolescents from 15 years of age. Over the years, She felt the need to conduct the psychotherapy sessions with subtlety since She understands that the psychologist acts as a facilitator of self-understanding and self-acceptance, valuing each person's respect, uniqueness, and acceptance.