Manifestations and features of the diagnosis of attention deficit hyperactivity disorder

The most common behavioral disorder in childhood is Attention Deficit Hyperactivity Disorder. According to foreign and domestic studies, the frequency of ADHD among children of preschool and school age reaches 4.0 – 9.5% (according to other sources from 2 to 18%), while ADHD prevails among boys, and the ratio of boys and girls averages 5:1.

Currently, there is a trend towards overdiagnosis of this disease. Violations of behavior and attention may be due to the consequences of traumatic brain injuries or neuroinfections , somatic diseases, emotional disorders that manifested themselves as a reaction to a stressful situation, spoiledness, and temperament.

Some difficulties may arise in the differential diagnosis of hyperactivity with individual characteristics of temperament and character, especially in preschool age. If behavioral problems in children are observed only at home, then these are rather the consequences of improper upbringing. In preschool children with ADHD, hyperactivity is often non-directional and manifests itself both in a child care institution (kindergarten), at home, and in other situations. It is worth noting that one of the criteria for the diagnosis of ADHD is intact intelligence.

The DSM-IV diagnostic criteria are used to make a diagnosis of ADHD. The results of psychological and neurophysiological studies are only supplementary.

Behavior features:

– appear up to 7 years;

– are found in at least two areas of activity (at school, at home, in work, in games);

– not due to psychotic, anxiety, affective, dissociative disorders or psychopathy;

– cause significant psychological discomfort and maladjustment.

Inattention (of the following signs, at least 6 must persist for at least 6 months):

inability to complete a task without errors caused by the inability to focus on details;

inability to listen to speech addressed to them;

inability to complete the work performed;

inability to organize their activities;

avoiding unloved work that requires perseverance;

loss of items needed to complete tasks (stationery, books, etc.);

forgetfulness in daily activities;

distractibility to extraneous stimuli.

Hyperactivity and impulsivity (of the following signs, at least 4 must persist for at least 6 months):

Hyperactivity. Child:

– fidgety, cannot sit still;

– jumps up from a place without permission;

– aimlessly runs, fidgets, climbs in inadequate situations for this;

– can not play quiet games, relax.

Impulsiveness. Child:

– shouts out the answer without listening to the question;

– Can’t wait for their turn.

The diagnosis of ADHD should only be made by a psychiatrist, pediatrician, or other qualified healthcare professional trained and experienced in diagnosing ADHD, based on a complete clinical and psychosocial assessment of the individual, this should include a discussion of behaviors and symptoms in various settings of the individual’s daily life and a complete developmental history.

ADHD is a medical diagnosis, but a psychologist can make a preliminary diagnosis. Using the method of observation (systematic, fixed), it is possible to correlate the results with the main symptoms and with the DSM-IV diagnostic criteria.

In addition to observation, the psychologist can also be helped by an analysis of the products of the child’s activities: drawings, crafts. The inability to hold attention for a long time and do one thing, impulsiveness, difficulties in managing one’s behavior, which are characteristic of children with ADHD, cannot but be reflected in their creations. As a rule, hyperactive children find it difficult to keep notebooks clean and take notes in the designated places. The drawings are often asymmetrical. People and animals in the drawings are often in motion. When coloring a drawing, a child often goes beyond the edges of the image, sometimes beyond the borders of the sheet; one can observe uneven pressure and sweeping details of the drawing.

Thanks to directed observation, the psychologist will be able to note the features of the behavior and development of a child with ADHD, avoid the erroneous attribution of this syndrome to impulsive, gifted, anxious children, who may have some similar signs (intemperance, fussiness, inattention, etc.). The specialist will be able to give support and understanding to parents, as well as help develop a more effective strategy for raising a child with ADHD.

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