The primary purpose of intervening in attention deficit and hyperactivity problems is not to increase the academic success of the child or to reduce his/her mobility or to prevent families and schools from complaining. Children with ADHD are children who are criticized and abused from an early age and spend their lives with many experiences that cause them to develop negative beliefs that they are incompetent / incompetent / unsuccessful / useless, unloved. Our main priority in treatment should be the prevention of these negative beliefs. Because these beliefs cause anxiety disorders, depression or behavioral problems to be added to ADHD problems. The treatment should be tailored to the individual, taking into account the age of the child/adolescent, the severity of the problems, and the presence of other accompanying psychiatric problems. The first treatment method that should be preferred in the preschool period is parent education programs. However, it should not be forgotten that ADHD is a neurobiological picture, and it is not possible to regulate dopamine and noradrenaline levels in the brain, which is the source of the problem, with any therapy method alone. For this reason, at the point where the personality development of the child is adversely affected and the inadequacy beliefs begin to develop, it should be supported with medication. However, medication alone will not suffice. Drug treatment must be supported by psychosocial approaches, parent education and behavioral treatments. In addition, the child psychiatrist-parents-teachers should cooperate in the treatment process. In general, there are 4 types of treatment methods for Attention Deficit and Hyperactivity Disorder: “CBT with the Child”, Family Education”, “Medication” and “Collaboration with School”. The first option in the preschool period is “Family Education”, and the most effective treatment method in school-age children is drug therapy in combination with behavioral interventions.
What Has Been Done in the Treatment of Attention Deficit and Hyperactivity Disorder in Our Clinic;
Cognitive behavioral therapy application “Family Education” program that will develop control mechanisms for attention and behavior problems with the child: Content of the program; It consists of 8 steps: providing parents with comprehensive information about ADHD and correcting wrong information, changing prejudices, applying special time, showing interest in the child’s positive behaviors and giving positive reinforcement, ensuring that the child is distracted without harming the environment, point system application and restriction application. Medical Treatment: Drugs used in the treatment of ADHD are divided into psychostimulants and non-psychostimulant drugs. The most commonly used and first choice drug group are psychostimulants. In our country, only methylphenidate is available as a psychostimulant. Collaboration with the teacher; Counseling services are provided to teachers on what needs to be done. Collaborating with the teacher will also provide the opportunity to get comprehensive information about the child and to closely monitor the child’s progress.
What Parents Can Do About Attention Deficit Hyperactivity Disorder; Providing a safe, quality, supportive and encouraging environment, not doing the child’s responsibilities for him, but creating opportunities for him to do, encouraging and rewarding positive social behaviors as much as possible (note: the time between the behavior and the reward should be kept short so that the child can understand which behavior is appreciated) Keeping the reward first and then the restriction on the agenda about the child, changing the rewards at certain periods, finding distracting games when he/she needs to wait, being creative (just be patient will not be enough), breaking long tasks into small pieces, how much time is left while working and how much time is left. Using a clock that will show that it goes by fast, children have trouble keeping in mind what needs to be done, so preparing warning notes for the child, if the child needs to be instructed, go to the child’s side, touch his shoulder, give short clear and understandable commands and ask the child to repeat if necessary. Organizing a routine sports or activity program, organizing a special time event (20 minutes each day), increasing the responsibility of the child towards other people, keeping the relationship warm and lively by making lots of jokes, touching more, talking less (not being told!), more supporting the child in more actions and saying less!, informing the child about the new environments, reminding the 2-3 rules about the new environment and rewarding him if he behaves positively when he enters the new environment, preparing a B plan by predicting the environments that will cause problems, giving the child the opportunity to rank the priorities. helping, trying to be forgiving (to yourself, your child, and others).
What Teachers Can Do About Attention Deficit Hyperactivity Disorder: Sitting in the front row, close to the teacher so that the student can pay attention for a longer time, sitting with a hardworking friend with whom the student can get along well, giving extra time to complete his homework or work, small pieces of long tasks ; Dividing long commands into small commands, making frequent eye contact with the student and touching them softly and affectionately are methods that can help to focus the student’s attention on the lesson and the subject. If the student is active in the classroom, giving a task such as taking a break from the task for a while, wiping the board to turn the activity in a positive direction, distributing homework papers to his friends or arranging the items on his desk, ignoring the student’s minor, inappropriate behaviors, positive behaviors such as words of praise or hugs. Rewarding with behaviors, stating that the student can speak and express his thoughts at appropriate times, listening to him when he speaks, seeing and praising this effort when he tries to answer the questions are the attitudes that can help. As a final word, it should never be forgotten that child psychiatrists, parents and teachers should always act in cooperation in order to manage attention deficit hyperactivity disorder.
