Children's "hyperactivity" is not necessarily "ADHD", so don't label children easily.

There is a kind of children in life who are extremely active and have difficulty in concentrating, and are regarded as "troublemakers" who deliberately undermine classroom discipline or challenge parents' bottom line. Some parents may receive feedback from teachers, such as "inattention in class", "unable to sit still in their seats" and "disturbing other children".

Yang Xingjie, the attending physician of huilongguan hospital Children's Psychology Department, and YiBo, a student of Chengde Medical College, said that for a long time, in the public's cognition, such children suffered from ADHD. However, with the in-depth study, we found that "ADHD" is a complex disease, and whether it is sick or not can neither be easily determined nor underestimated. The professional name of ADHD in medicine is "attention deficit and hyperactivity disorder". What are its typical symptoms? How to distinguish hyperactivity from normal hyperactivity?

How long does a child's attention last?

ADHD is a neurodevelopmental disorder, which starts in childhood and is a common mental and psychological problem for children. Abnormal development of nervous system will lead to poor development of patients' fine movements, coordinated movements, sense of spatial position (referring to feeling and judging the body's position in space without the help of vision and touch, or inducing proprioception of posture reflex), such as handspring, finger-pointing movement, inability to tie shoelaces and button buttons, and difficulty in distinguishing between left and right directions.

The prevalence rate of ADHD is generally reported to be 3%-5%, with the ratio of male to female ranging from 4 1 to 9 1, and the incidence rate is higher in boys. Compared with peers, patients have obvious main characteristics such as difficulty in concentration, short attention duration, hyperactivity and/or impulsiveness.

Children's concentration time is different at different ages, and the normal situation is gradually prolonged with age. Generally speaking, the concentration time is 12-15 minutes for 5-6 years old, 2 minutes for 7-1 years old, 25 minutes for 1-12 years old, and 3 minutes for those over 12 years old. Only when the children's attention time is obviously shorter than the above time, and it is obviously different from the children of the same age in the class, will it be considered abnormal.

It should be noted that some parents think that children who are obviously unable to concentrate on other things are normal when they see that their children can keep their attention for a long time while playing tablet games or watching cartoons, which is really not necessarily true. The pictures of cartoons and games often change and are irritating, and the time required for children to maintain staged attention is also very short, about 2-3 minutes, so it is not possible to judge whether attention is barrier-free just based on this.

In addition, children's inattention is difficult to maintain for a long time, which is typically characterized by active random attention disorder, that is, when children complete a boring task that requires their own efforts (such as doing homework and listening to lectures in class, etc.), they show attention defects (such as often being distracted and skipping numbers, etc.). At the same time, their passive and involuntary attention will be relatively enhanced, that is to say, children have poor anti-interference ability to irrelevant external environment stimuli, such as being distracted by the sound of airplanes or birds flying outside the window when attending classes.

symptoms are not only hyperactivity

hyperactivity, which is what we often say, is another main symptom of ADHD, which is mainly manifested in the fact that the activity level is significantly higher than that of normal children, especially when it is necessary to be quiet or obey order.

ADHD children's hyperactivity is different from normal children's liveliness, and their behavior has many occasions, such as playing, attending classes, doing homework, and public places where quiet is needed. The normal children's liveliness is divided into occasions, and they can be quiet and obey the order and rules when they need to be quiet. The impulse of ADHD children is very reckless and abrupt, and they often do things without considering the consequences. Their demands need to be met immediately and they can't stand waiting. Because their hyperactivity and impulsiveness are due to their poor self-control ability, it is difficult to accept the constraints of the environment. Therefore, it is often the case that their parents and teachers' criticism and discipline do not work.

It should be specially mentioned that there are actually three types of ADHD: attention deficit type, hyperactivity impulse type and mixed type. Among them, children with attention deficit may not have obvious symptoms of hyperactivity and impulsiveness, so some cases can not be distinguished only by hyperactivity and impulsiveness.

The symptoms of attention deficit can be shown as follows: often careless and careless, not paying attention to details; It is difficult to keep attention when listening to lectures, reading or talking; When talking to people, he often looks absent-minded; It is difficult to do things according to instructions and requirements, and school-age children can't finish their homework; It is difficult to complete the assigned tasks or activities, messy and disorganized, and the time management ability is poor; Unwilling to do things that require continuous brain use, such as homework and reading; Often lose school tools, daily necessities, such as pencils, books, etc. Often distracted by extraneous stimuli; It is easy to forget things in daily activities, such as assignments or tasks.

The symptoms of hyperactivity and impulsiveness can be manifested as: often unable to sit still, hands and feet constantly moving or wriggling in the seat; Leave your seat during class in the classroom, or often leave your seat in other situations where you need to sit in your seat; Often run around or climb up and down in inappropriate occasions; Often unable to study or do things quietly; Often talk a lot, "gushing"; Often busy; Often answer questions before they are finished; It is often difficult to wait in order, such as always being impatient when waiting in line; Often interrupt or disturb others, such as interrupting others' conversations, games, etc.

mixed symptoms are both of the above. When children are found to have these manifestations, it is suggested to seek the help of professional child psychologists in time to rule out the possibility of ADHD.

It will have a long-term impact on children

The etiology of ADHD is very complicated, and at present it tends to be thought that it is the result of a combination of biological factors, psychological factors and social factors. Studies have shown that ADHD has a genetic tendency. Smoking, drinking, infection, poisoning, malnutrition and abnormal delivery during pregnancy may increase the risk of ADHD in future generations. Excessive blood lead is also a high risk factor in children's growth. In addition, ADHD is also related to the serious disharmony of children's family relationship and the simple and rude parenting style; It is related to the school environment and social environment where children are located. If teachers lack knowledge and understanding of the disease and adopt improper discipline methods, it will also affect the development of children's behavior and emotions.

So, what kind of influence will ADHD bring to children?

First of all, ADHD patients often show learning difficulties, because attention disorder and hyperactivity affect the effect of classroom listening and the quality of homework, and their academic performance is often lower than that of their intelligence.

Secondly, the impulsive characteristics of ADHD patients will cause difficulties in interpersonal relationships, and there are many problems in social skills and communication skills, so it is difficult to manage and regulate emotions well, so they are often rejected by their peers in peer communication and it is difficult to maintain lasting interpersonal relationships. At the same time, they also have the same problems in communication with their families, with many family conflicts and low intimacy.

To sum up, ADHD children have more or less impaired functions in many fields, poor academic and professional achievements, and poor interpersonal and family relationships after entering adolescence and even adulthood.

"ADHD" needs to be evaluated and diagnosed by the hospital

The label "ADHD" cannot be attached to children casually and easily.

Some parents who are too anxious think that their children are restless all day. Do they have ADHD? The child is inattentive, is it ADHD? Too many labels too early will not only convey anxiety in the parent-child relationship and teacher-student relationship, but also make the whole family fall into the shadow of bad emotions, so that children can be examined by classmates in school with colored glasses, which will have a serious adverse impact on their growth.

The diagnosis of ADHD needs to exist in more than two scenes (such as school and family) for a relatively long time, and it needs to comprehensively consider the children's age and its influence on functions (such as school and communication). Therefore, if parents realize that their children are different in attention, activity and emotion compared with their peers, they should go to the hospital for further evaluation and diagnosis.

Is medication safe?

Clinically, the symptoms of ADHD children are influenced by age factors, and decrease with age. However, in view of the adverse effects of ADHD on children's growth, it is suggested to intervene as soon as possible once diagnosed.

For school-age ADHD patients, drug therapy is the first choice, and of course it is also a way that parents are most worried and have the most questions. A large number of studies have proved that drugs are effective and safe in the treatment of ADHD, which can alleviate the symptoms of ADHD, thus improving academic performance and interpersonal communication. At present, the commonly used drugs are methylphenidate and tomoxetine. Common adverse reactions include loss of appetite, sleep effects, etc., which are generally alleviated with the increase of taking time or adjustment of taking methods.

can medication finally cure ADHD? Unfortunately, there is no medicine or method to cure this disease at present. The treatment and management of ADHD is a long-term process. On the basis of drug treatment, parents, children and schools need to cooperate in many aspects to manage related symptoms for a long time.

Doctors suggest

Parents of patients can learn the "eight-step method of parent-child growth"

As mentioned above, after a child is diagnosed with ADHD, parents need to pay for it. Parents should first adjust their mentality and try to cooperate with doctors to assist their children's treatment. Complaining about others or complaining in front of children will undoubtedly increase children's subjective pain. Some parents try to force their children to improve their self-control ability to fight diseases, which is unwise. The reason why ADHD is a mental disorder means that it is not under the patient's own subjective control, and patients need positive behavior guidance from their parents. When parents get along with their children, they should adopt a "kind and firm" attitude, which not only expresses respect for their children, but also adheres to principles.

To treat ADHD, training parents is a major non-drug treatment. At present, there are two kinds of training methods, one is to provide parents with knowledge about diseases and treatment, and the other is behavior management training. We focus on the "eight-step method of parent-child growth", an effective treatment.

In addition, the intervention of the school system will have a positive effect on ADHD children. The more appropriate intervention goals are to help children learn to finish their homework independently, better obey the teacher's instructions, and cooperate with classmates in group activities. Teachers blindly let children control small movements, but it will cause their dislike of the classroom. If children can concentrate on the lecture most of the time in class, then minor movements can be ignored.

Specifically, try to avoid hanging decorations that can distract children in the classroom; Teachers should make some important requirements, such as not insulting others, waiting in line patiently, raising their hands when answering questions, etc., into clear rules to communicate with ADHD children; The good behavior of ADHD children should be affirmed and praised immediately, and the bad behavior should be stopped immediately. Sometimes in the early stage of behavioral intervention, ADHD children behave worse, which requires teachers to praise children's good behavior firmly and consistently, so that children can realize that teachers' praise is sincere, thus gradually increasing their self-confidence and having more positive interaction with teachers.

Photo courtesy of vision china.