DO YOU KNOW ATTENTION DEFICIT HYPERACTIVITY DISORDER?
Symptoms such as hyperactivity, attention problems, and inability to postpone requests observed in children and adolescents may be an indicator of “Attention Deficit Hyperactivity Disorder”. Misbeliefs such as “The active child is a smart child”, “He has too much energy, let him run”, “It gets better when he grows up” delays the recognition of this disorder with biological characteristics and the consultation of a specialist.
A genetically inherited disorder
Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric disorder that is also observed in adulthood, characterized by hyperactivity, difficulty in maintaining attention and impulse control, according to the level of development. Its incidence in the community varies between 5-7%, and it is observed 3 to 5 times more frequently in boys than in girls. Similar symptoms are 2 to 3 times more common in siblings of individuals with ADHD, and 2 to 8 times more common in their parents. The incidence of ADHD in both children in identical twins is around 80-90%.
The reasons for the emergence of this disorder are not known exactly. Studies have emphasized that ADHD arises due to hereditary features, various environmental factors, and structural and functional differences in the brain.
Symptoms are grouped under 3 headings
Symptoms observed in ADHD can be listed as follows:
a) Hyperactivity: If the activity observed in children is significantly higher than their peers, it can be defined as hyperactivity. is evaluated.
1. Often fidgets hands and feet or fidgets in sitting position.
2. Often gets up from seat in classroom or other situations where sitting is expected.
3. Often runs around or climbs in situations where it is inappropriate. (May be limited to subjective feelings of restlessness in adolescents or
adults)
4. Often has difficulty calmly participating in leisure activities or playing games
.
5. Often in motion or pretending to be driven by a motor.
6. He often talks a lot.
b) Impulsivity:
1. Often pasts the answer before the question is completed.
2. Often has difficulty waiting their turn.
3. Often interrupts others or interferes with what they are doing. (For example, meddling in other people’s conversations or games)
Symptoms such as inability to delay requests, haste, and acting without thinking suggest impulsivity problems.
c) Lack of attention:
1. Often fails to pay attention to details, makes careless mistakes in schoolwork, work, or other activities.
2. Often gets distracted by tasks or activities played.
3. Often does not seem to listen when spoken to directly.
4. Often fails to follow directions and complete schoolwork, chores, or duties at work.
5. Often has difficulty organizing tasks and activities undertaken.
6. Often avoids, dislikes, or is reluctant to take part in tasks that require sustained mental effort.
7. Often loses tasks or activities necessary for activities. (For example, toys, school assignments, pens, books, or equipment)
8. Often easily distracted by external stimuli.
9. Often forgetful in daily activities.
Course success and behavioral characteristics are decisive in the diagnosis
In order for ADHD to be diagnosed, the symptoms are more severe than expected according to the level of development, they are observed in more than one environment (for example, they are observed both at home and at school), It must have a negative impact on the life of the individual, some of the symptoms leading to functional impairment must have started before the age of 7 and have been ongoing for at least 6 months.
ADHD diagnosis is a clinical diagnosis and there is no laboratory test or specific marker used to confirm the diagnosis. In addition to the psychiatric examination, the diagnosis is made in the light of interviews with the family, information obtained from the teacher about the child’s academic success and behavioral characteristics, evaluation scales and the results of some neuropsychological tests if the child is at school age.
ADHD symptoms observed in the pre-school period differ
Mothers of children diagnosed with ADHD often state that the child is active while still in the womb. In the postpartum period, the first finding is hyperactivity, and these children are defined by their parents as children who have difficulty falling asleep, sleep less and wake up quickly, are restless, find it difficult to calm down, and do not like to be picked up.
In the pre-school period, symptoms of attention deficit are not in the foreground, and impulsive features such as not being able to postpone requests more, wanting to be done immediately, changing games frequently are observed together with mobility. In addition, aggressive behaviors such as hurting other children, shouting, and taking away their toys can be observed. He may be ostracized by his peers for reasons such as not being able to wait in line, having difficulty in following the rules, changing games frequently, and harming his friends.
ADHD symptoms observed in school age are more decisive
School-age children can’t sit in the classroom, can’t concentrate and take care of the environment, answer questions without being able to speak, have problems in friendships, have difficulty in doing and completing their homework for a long time Symptoms such as withdrawing, making careless mistakes in exams, missing course materials or losing them are observed.
Mobility decreases during adolescence
Examples of symptoms observed during adolescence are partial decrease in mobility, serious problems in school success, problems in relationships with family, friends and teachers, decrease in self-esteem and depression, volatile mood, Symptoms such as sudden irritability or cheerfulness, dangerous and risky behaviors that may cause legal problems may be given.
Adjustment problems increase in adulthood
Inability to read newspapers, books, watch television for a long time, distraction, inability to concentrate on a certain task for a long time, forgetfulness, remembering what was said or daily tasks in mind Symptoms such as incontinence, inability to finish and organize tasks, difficulty in solving problems and using time, thinking that one cannot achieve one’s goals, frequent job changes, lability in mood, sudden anger, problems in social relations, marital problems, alcohol-substance addiction are observed.
Are there any other diseases associated with attention deficit?
ADHD can be associated with Oppositional Defiant Disorder, Conduct Disorder, Specific Learning Disorders, Anxiety Disorders, Sleep Disorders, Tic Disorders, Depression, Enuresis (urinary incontinence) and Encopresis (poop incontinence).
A multifaceted approach should be taken in treatment
In the treatment of ADHD, a multi-faceted treatment approach that includes various psychosocial interventions in addition to drug therapy is required. The most effective method in ADHD is drug therapy. The most effective drugs in the treatment are stimulant drugs. These drugs affect the release of certain substances such as dopamine and noradrenaline in areas of the brain that are responsible for regulating behavior and attention. Along with the increase in attention and maintenance, increase in school success, impulse control, decrease in mobility, decrease in behavior problems and social problems, and increase in self-confidence are provided with drug treatment. Thus, a significant improvement is observed in conditions that impair the individual’s quality of life before treatment.
Drugs do not cause growth and developmental retardation
The main side effects of stimulant drug therapy include loss of appetite, headache, abdominal pain, and insomnia. Cases requiring discontinuation of drug therapy are extremely rare. Studies have shown that stimulant drug therapy does not cause growth-developmental retardation. Before starting the treatment, the specialist physician may request some tests if he deems it necessary. The duration of drug therapy is closely related to the characteristics of the patient. Some patients may require treatment for many years.
Attention deficit drugs are not addictive
There are false beliefs among the public that stimulant drugs used in the treatment of ADHD are addictive. Although it has been reported in some studies that treatment may be protective against alcohol-substance addiction, which is reported to be observed more frequently in individuals diagnosed with ADHD than in the normal population, more studies are needed on this subject.
Psychosocial interventions, which are the other part of ADHD treatment, are information and trainings for families and teachers about the nature of the disorder and methods of coping with symptoms, various arrangements to be made in the home and school environment, therapies for the development of behavior control skills and trainings for increasing communication skills. including methods such as
As a result, although some findings in ADHD tend to decrease with age, considering the academic and social problems experienced by the child diagnosed with ADHD in daily life, the most appropriate approach in the management of this disorder is in addition to drug therapy, accompanied by the psychosocial interventions I mentioned above. will follow a path.
Sources:
Ercan ES., Aydın C. (2005). Attention Deficit and Hyperactivity Disorder: Features-Treatment, Symptoms in Children and Adults.12. Press, Istanbul: Gendaş Publications.
Lee, SS, Humphreys, KL, Flory, K., Liu, R., & Glass, K. (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clinical psychology review, 31(3), 328-341.
Driver Ö. (2003). The Parent-Teacher Handbook. Attention Deficit Hyperactivity Disorder. Istanbul: Ya-Pa Publications.
Senol S. (2008). Attention deficit hyperactivity disorder. Çuhadaroğlu F.C. (ed) In The Basic Book of Child and Adolescent Psychiatry, (p. 293-311) Ankara: Child and Youth Mental Health Association.
** This article was published in the 3rd issue of Istanbul Health magazine in 2014.
