Hyperactivity Disorder Attention Deficit (ADHD). Answers to Common Questions

Questions about hyperactive children

Symptoms of ADHD

It is a syndrome or set of signs and symptoms, which usually begins in childhood, characterized by the presence of great nervousness motoric, which makes the child unable to sit still: constantly changing occupancy, shows great impulsivity and perhaps as consequence of the above or something added, suffers from a serious loss of its ability to focus attention and, especially, to maintain it. This behavior creates problems of family life and school, as well as learning and achievement.

The syndrome is well described characteristic of the hyperactive child with normal IQ, but can also occur in children with mental retardation, which is an added difficulty in the learning process, with negative behavior of opposition and defiance. However, it is important not to attribute to this picture situations that are strictly their own evolutionary stages of development and that, if development is slow, as in mental deficiency, may last longer than usual.

The condition may begin in early childhood, but can remain undiagnosed until after the symptoms have been present for several years.

Increasingly, this syndrome also frequently seen in adults, and presents it is estimated that 4-5% of the population, although sometimes confused with anxiety, obsession-compulsion or addiction to substances.

Finally, the syndrome may present without hyperactivity, which interferes with diagnosis then what prevails is the inability to organize an activity, the state of distraction, disorganization.

Possible causes of ADHD

The most reasonable biological hypothesis explaining this picture is the presence of a combined deficiency in the neurotransmitter systems (noradrenergic and domaninérgicos), involved in maintaining attention, executive function and laq correct motor activity.

Diagnosis of ADHD

It is difficult to diagnose this disorder in children under 5 years old. It is important to distinguish this condition from age-appropriate behaviors in active children and disorders such as mental retardation, mood disorders and anxiety disorders or personality changes caused by disease or chemicals. The criteria currently established by the American Psychiatric Association (APA) includes specific limits on the duration and severity of symptoms of inattention and hyperactivity-impulsivity. Clinical data have to be drastic enough to indicate maladaptive and inconsistent with developmental levels specified.

Conventional treatment of ADHD

With regard to the pharmacological control of hyperactivity with attention deficit must be referred to the drug of choice is methylphenidate (Concerta ®, among other brands).

All parents worry about giving medication to a child. Certainly it is normal and therefore the drug described below indicated above.

Methylphenidate inhibits the reuptake of certain neurotransmitters in the brain and facilitates the release of others. Their actions are similar to amphetamine, causing insomnia and anorexia, or loss of appetite. In children with attention deficit hyperactivity, makes the activity more effective and purposeful and improves learning ability. It is not advisable to give this drug to children under 6 years. It is important to start with low doses of 2.5-5 mg in the morning and at noon, increasing weekly at 5 mg to achieve a therapeutic effect without the toxic effect (maximum 80 mg / day). Note that at this age, in infancy, a higher dose of 20 mg / day may slow the growth effect is reversible. This drug causes tolerance, ie taking a dose for a while, the effects may wear become necessary to increase them.

Side effects of methylphenidate

With respect to adverse reactions are varied: nasopharyngitis, anorexia, decreased appetite, moderate reduction in weight gain and height (prolonged use in children), insomnia, nervousness, tics, aggression, anxiety, emotional lability, agitation, depression, abnormal behavior, headache, dizziness, dyskinesia, psychomotor hyperactivity, somnolence, arrhythmia, tachycardia, palpitations, hypertension, cough, sore faringolaringeal, abdominal pain, vomiting, nausea, diarrhea, upset stomach, dry mouth, alopecia, pruritus, rash, urticaria; arthralgia, irritability, pyrexia, growth retardation (prolonged use in children), weight loss, changes in blood pressure and heart rate.

Most common are normal, nervousness, restlessness and insomnia.

They can and should use naturopathy to alleviate these symptoms as bothersome for kids and parents. 1

Frequently asked questions about ADHD

Finally, there are certain questions that parents are concerned and sometimes are not able to make the respective specialists. Here we will clarify some of the most common:

1. How I can get my child to calm down?

Make sure you spend time alone with your child so you know you are interested in it. This will give you the opportunity to plan and reward their behavior.

Spend time with your child doing something he likes. Establish a routine and plan what you will be doing during the day or the weekend. You can book some time to play energetic, noisy and consume part of their energy. You can also search periods of time to play quietly alone.
Take every opportunity to reward your child. Be as clear as possible. It is vital that they understand exactly what they did to please their parents. For example, "you've been so quiet ... playing by yourself, do more good you guy" or "what a good player you are."

2. Where I can get help?

The lively and excitable behavior of children is a common problem for parents. If your child had a hearing problem or has had any reaction to food, the family doctor will be able to help. If he thinks he could be a hyperactivity disorder or learning difficulty, you will be referred to a clinical psychologist, a pediatrician or child psychiatrist.

3. What causes ADHD / hyperkinetic disorder?

We do not know exactly what causes these disorders, but genetic factors seem to play an important role. These disorders occur in families, with children more often than girls who have them.

4. Where I can get help?

There is no simple test to determine the ADHD / hyperkinetic disorder. To make a full diagnosis requires an assessment of an experienced specialist, usually a child psychiatrist or a pediatrician. Diagnosis is made by recognizing patterns of behavior, observing the child and obtaining reports of behavior at home and at school.
Your GP can offer advice and support and usually refer you to a specialist. A child and adolescent psychiatrist will make a comprehensive assessment and provide treatment. Some clinical psychologists and pediatricians also have experience and ability to bring this problem.
Effective treatment will include advice and support to parents.

5. How to manage ADHD by a psychologist?

You should have:
- A full explanation of the problem for you and your child.
- Advice on how to handle difficult behavior.
- A communication between the specialist and teachers to guide them on structured activities and reward systems for positive behavior that may be helpful. You may also be necessary specialized support and tutoring.
- Support for the difficulties that may have arisen as a result of ADHD / hyperkinetic disorder, low self-esteem, difficulties in friendships, tantrums or aggression.

6. And the medication help?

The medication causes a short-lived improvement after each dose but not a permanent cure. Create a time period in which the child can learn and practice new skills. Children often say that the medication helps them get along better with peers, to think more clearly, to understand things better and feel more in control of themselves. Not all children with this condition require medication. Those who need it, also often require psychological and educational support.

7. Is there a relationship between diet and the condition?

There is some evidence on the effect of diet on some children. A few may be sensitive to certain foods. Avoid additives.
If parents notice that certain foods worsen hyperactivity, these should be avoided. It is best to discuss this to the specialist.

8. Have you ever happen?

Children who receive specialized treatment tailored to their needs, can benefit considerably. Some problems of restlessness, inattention and lack of control may continue into adulthood. However, with help, most hyperactive children will be stabilized upon reaching adolescence. Have been able to recover their learning, improve their performance in school and making friends.

References:

1. Florez, J. Jordan J. Abizanda, P. Galindo, MF. Pharmacology of dementia and abnormal behavior. In: J Florez, director. Human pharmacology. 5th edition. Barcelona: Masson, 2008. p.691-705.

2. Enfermeria21, attention deficit disorder with hyperactivity [web site]. Madrid: enfermeria21.com. [Last accessed on October 22, 2011]. Available at:

3. Vademecum.es [web site]. Centrally acting sympathomimetics. Madrid, 2010 [accessed 20 October 2011]. Methylphenidate. Available at: http://www.vademecum.es/principios-activos-metilfenidato-n06ba04

4. Spanish Society of Psychiatry [web site]. London: Royal College of Psychiatrists, 2004. [Updated in June 2009, date accessed on 21 October 2011]. The restless and excitable child. Available at: http://www.sepsiq.org/file/Royal/1 The% 20ni% C3% B1o% 20inquieto% 20and% 20excitable.pdf

5. Spanish Society of Psychiatry [web site]. London: Royal College of Psychiatrists, 2004. [Updated in June 2009, date accessed on 21 October 2011]. ADHD and hyperkinetic disorder. Available at: http://www.sepsiq.org/file/Royal/5-TDAH.pdf

6. Spanish Society of Psychiatry [web site]. London: Royal College of Psychiatrists, 2004. [Updated in June 2009, date accessed on 21 October 2011]. Stimulant medication for ADHD and hyperkinetic disorders. Available at: http://www.sepsiq.org/file/Royal/6-La% 20medicaci% C3% B3n% 20estimulante.pdf

Signed.: Rafael Vazquez Godino.
University Diploma in Nursing, University of Cadiz.

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