ADHD; with symptoms of distraction, hyperactivity and impulsiveness that are not suitable for age and developmental level; It is a neurodevelopmental disorder that manifests itself as such problem behaviors being so intense and widespread that they negatively affect the child’s life. The prevalence of ADHD in children and adolescents is between 5-10%. It is more common in boys. Although the cause of Attention Deficit and Hyperactivity Disorder is not known exactly, we can say that the most common cause is genetic predisposition. ADHD may occur as a result of a defect in the development of the brain regions that maintain attention and control behavior in the person’s brain due to a genetic predisposition. It is known that the presence of conditions such as smoking, alcohol use or intense stress during pregnancy, prematurity, and low birth weight increase the risk of developing ADHD. Attention Deficit and Hyperactivity Disorder is not a discipline problem caused by faulty parental attitudes. In other words, children with ADHD are not “spoiled” children who weren’t brought up properly by their families. ADHD is basically a type of cognitive dysfunction. Children with ADHD are children whose “stop button” responsible for behavioral control in their brains is not working properly.
What are the Symptoms of Attention Deficit and Hyperactivity Disorder (ADHD)?
Three main problem areas are defined in Attention Deficit and Hyperactivity Disorder; attention deficit, hyperactivity (excessive activity), and impulsivity (impulsivity). In addition to these three basic symptoms, additional symptoms such as developmental, emotional, learning and movement planning problems and low motivation are often accompanied.
Attention Deficit Sub-Dimension;
attention; We can define it as a series of mental processes such as the ability to focus for learning, distinguishing priorities, adjusting alertness, controlling oneself and one’s actions. In ADHD, inability to concentrate, short attention span, and rapid dispersion are in question. Difficulty in focusing on details, making too many careless simple mistakes, forgetfulness, being unable to take care of one’s belongings, avoiding long and challenging tasks such as writing, are among the difficulties they experience in this area. The most common complaints we hear from parents are; “He is distracted”, “forgetful”, “he doesn’t hear us, we have to say the same thing over and over”, “not paying attention to the lesson”, “makes very simple mistakes”, “he will never complete the lesson if you don’t sit next to him”, “it takes hours to finish homework” or sometimes completely we see the opposite; They quickly finish their homework in 10 minutes and make a lot of mistakes. So why do some kids have such a hard time focusing? There are two systems responsible for maintaining attention. The first is the “focus” system. the second is the “brake” system that prevents his attention from diverting. We can say that the main problem in Attention Deficit and Hyperactivity Disorder is in the braking system. In other words, the sound, light, movement or thoughts passing through his mind are perceived much more intensely. This causes distraction. Sometimes, parents say that their children pay attention to every detail, and they notice things that they do not even notice. This does not mean that the attention is good, but rather that the brake system is not working, that the attention is bouncing around like a rabbit. Another confusing situation for families is this; The fact that the child focuses very well when he wants. For example, some children with ADHD may play computer for hours. At this point, we actually talk about the “hyperfocus” symptom of ADHD. In other words, a child with ADHD may focus more than normal on activities that are within his area of interest and enjoyment. However, he will have a hard time concentrating and sustaining attention in activities that are boring to the mind (such as lessons). Of course, not every reason for focusing difficulties is “Attention Deficit Hyperactivity Disorder (ADHD)” and inattention may accompany as a symptom in many different mental problems. The cause of the problem can be determined by a psychiatric evaluation by a Child and Adolescent Psychiatrist.
Hyperactivity and Impulsivity Sub-Dimension;
The symptoms we define in this group are seen as being constantly fidgety, not being able to stay still, wanting to move constantly, not being able to sit in the same place for a long time, running around, climbing on things. Talking a lot, difficulty trying to play quietly are other features. What we mean by impulsivity is manifested by features such as acting without thinking, haste, not being able to wait for one’s turn, impatience, speaking without thinking, intervening when two people are talking, and answering questions without completing them. Regarding the hyperactivity and impulsivity sub-dimension, the most common complaints we hear from parents are “too active”, “cannot sit still for a long time”, “constantly wanders even when eating”, “his hand does not stop even if his feet are still”, “he constantly fidgets on the table”, “very insistent” , “he insists until he gets what he wants done”, “I can’t even talk on the phone”, “he keeps interrupting”, “he is in a hurry” and “he doesn’t listen to the lesson because of talking to his friends”… the list goes on and on. There are some situations that we should pay attention to when evaluating all these symptoms. First of all, we should not forget that all these symptoms are mostly normal behaviors for children aged 2-4 years. Another thing we should pay attention to is that the presence of one or both of these symptoms can be seen in every child. The things that make us think that these behaviors are caused by Attention Deficit and Hyperactivity Disorder are that many of them are together, their severity is high, and most importantly, they negatively affect the child’s life.
How is ADHD (Attention Deficit and Hyperactivity Disorder) Diagnosed?
The diagnosis of Attention Deficit and Hyperactivity Disorder is made by evaluations made by a Child and Adolescent Psychiatrist. In particular, it is necessary to diagnose whether ADHD symptoms are observed in more than one environment, the severity of the symptoms, their intensity, and most importantly, how negatively they affect the child’s/adolescent’s life. Although Attention Deficit Hyperactivity Disorder (ADHD) is diagnosed as a result of clinical observation, there are also psychological and psychometric tests to help diagnose it. The most frequently used auxiliary tests are sub-parameters of intelligence tests such as “MOXO Attention Test”, “neuropsychological test battery” and “WISC-R , WISC-IV”. The most frequently preferred test in my clinical practice is the “Moxo Attention Test”. MOXO Attention Test; It is a computer-based test developed for objective evaluation in the areas of attention, timing, mobility and impulsivity. If deemed necessary, intelligence tests such as WISC-R and WISC-IV, in which the child’s capacity, learning, attention and perception skills can be evaluated, can also be applied. In addition, the extent of the problem is revealed by comparing the information obtained through the scales filled in by parents and teachers with the data obtained in clinical evaluations. Finally, we need to know that there is NO blood, urine analysis or imaging method such as CT, EEG, MRI that can help in the diagnosis of ADHD!!!
