Attention deficit hyperactivity disorder (ADHD). Psychological help

     High physical activity, instability of attention and impulsivity are all characteristics of the normal development of a child. And the need for movement in it is inherent in nature itself. But there is a group of children with a sufficiently high such need, which reaches a pathological level. These children are called hyperactive or hyperactive.

     Hyperactivity as one of the pathological manifestations is part of a whole complex of disorders that make up “attention deficit hyperactivity disorder (ADHD)”, which includes disorders of the emotional regulation system.

   The mood of hyperactive children is unstable, hot temper, aggressiveness is observed, this often leads to conflicts with others. The child experiences great difficulties in a team of peers who refuse to communicate with him, motivating this with his pugnaciousness and inability to play.

     A hyperactive child is not able to endure resentment for a long time, it may seem that everything is “like water off a duck’s back.” Such children are spoken of as insensitive and sometimes cruel. This fact can be explained by the fact that at the neurophysiological level, children with ADHD have a reduced pain threshold, i.e. they are less sensitive to pain than their peers. And without experiencing pain in full, they do not pay attention to the fact that they are hurting others, they do not understand this.

     A complex of clinical manifestations of attention deficit in children is distinguished (according to A.D. Goneev):

– restless movements in the hands and feet;

– inability to sit in one place;

– easy distraction to extraneous stimuli;

– impatience;

– inability to bring what has been started to the end;

– very fast switching from one thing to another; 

– talkativeness;

– inability to play, speak quietly and calmly;

– lack of ability to predict the consequences of their actions;

– spontaneity and thoughtlessness of actions;

– fussiness;

– lack of formation of praxis and fine motor skills;

– short sleep duration and difficulty falling asleep.

     In addition to attention deficit, children with ADHD are characterized by increased fatigue, memory impairment, and low mental performance. Evidence of increased fatigue is the increase in absent-mindedness as the length of time required to complete a task increases. The main characteristic of the mental activity of children with ADHD is cyclicity, a short period of working capacity (5-15 minutes) is replaced by a period of “rest” of the brain (3-7 minutes). In these moments of a kind of “shutdown” the child does not react to comments, but outwardly remains focused, he seems to be accumulating strength, recharging. Then he rejoins the activity. Hence the impossibility of working in a group-wide mode.

     The unusual behavior of children with ADHD is not the result of bad temper, stubbornness, or bad manners, as many adults believe. It can be argued that this is a specific feature of the psyche, due to both physiological (disturbances in the activity of individual brain structures, heredity, pathology of pregnancy and childbirth, infection and intoxication in the first years of life) and psychosocial factors. 

     A step-by-step model of supporting a hyperactive child (by I.P. Bryazgunov) includes the following stages:

  1. Every day, parents set a specific goal for the child, which he must realize. Formulate the goal clearly and concisely.
  2. Parents need to think in advance of the incentives that will stimulate the child’s efforts to achieve this goal. They can be both moral and material.
  3. At the end of the day, the parents together with the child should analyze his behavior, assess the degree of achievement of the goal.
  4. Parents systematically record changes in the behavior and personality of the child, describing them in specific manifestations, and report his achievements to the doctor and / or psychologist.
  5. If the child achieves significant achievements, he must definitely receive the remuneration promised by the parents.

      Such a model is designed to help parents and teachers in systematizing the child’s life, its rational organization, which will contribute to positive changes in his personality and behavior.

      Such psychocorrectional work (through the training of parents and teachers) should go in parallel with the direct psychocorrectional influence of the psychologist and the child.

     Analysis of modern approaches to the organization of the psychocorrectional process with the participation of children with ADHD allows us to conclude that it is necessary to include various forms and methods. The most complete scheme of psychological correction (Bryazgunova I.P., Kasatikova E.V., Lyutova E.K., Monina G.B.) includes:

• Physical rehabilitation. Shown are physical exercises of an aerobic nature, which help to improve the activity of the cardiovascular and respiratory systems, increase endurance, in contrast to exercises of the anaerobic type, which increase the strength and volume of muscles. In addition, it is better for children to avoid games with a strong emotional component. Sports such as jogging, swimming, skiing will be useful. 

• Teaching self-regulation skills. This is one of the most difficult areas of corrective work with hyperactive children. It is better to start by suggesting that relaxation and rest is not punishment, but pleasure. This is important because such children, like no others, often hear the instructions of adults: “Lie still!”, “Don’t turn around!”, “Calm down!”, The implementation of which requires certain volitional efforts. The task of the adult at this stage is to ensure that the children feel calm, feel inner comfort and satisfaction. With preschool children, it is effective to use meditative fairy tales, which allow you to achieve the effect of relaxation in an accessible form. 

• Development of communication skills. It is necessary to start work with individual lessons, during which the child must learn to interact with another person, hear him, and be aware of the rules of behavior. It is most appropriate to use game therapy during this period. Gradually include in subgroup work. It is better if it is a group of 2-3 people with various behavioral disorders. It is not recommended to include two hyperactive children at the same time, as the work will be ineffective. 

• Correction of negative emotions. You can use the elements of sand therapy, which allows you to freely express your negative feelings towards others. 

• Development of deficient functions in the system of the syndrome. It is recommended that such development be based on clear phasing. For example, if you start with the development of stability of attention, the ability to switch it arbitrarily, then you should move on to the development of another quality only after achieving a stable positive effect. Then you can exercise the child in the parallel development of two functions at once, for example, the ability to concentrate attention and the skills of volitional regulation of their behavior. 

     The proposed recommendations for the provision of psychological assistance to children with ADHD are of a general nature, indicate the necessary directions, methods and techniques.

     In each case, they must be systematized by a specialist to help the child and parents.   

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