ATTENTION DEFICIT HYPERKINETIC DISORDER
This is a syndrome first described by Heinrich Hoff in 1854.
INCIDENCE:
It occurs in about 3% of school age children.
Males are 6-8 times more affected.
TYPES OF ATTENTION DEFICIT
DISORDER:
They are of 4 types:
1. Attention deficit disorder with hyperactivity (Hyperkinetic disorder):
The characteristic clinical features are:
I.
Poor
attention span with distractibility
II.
Hyperactivity
III.
Impulsivity
2.
Attention deficit
disorder without hyperactivity
3.
Residual type
4.
Hyperkinetic disorder with conduct
disorder
ETIOLOGY:
Many factors like minimal brain damage,maturational lag,genetics,neurotransmitters
Attention-Deficit Hyperactivity Disorder Or ADHD
Attention-deficit hyperactivity disorder or ADHD is a common childhood condition that can be treated. ADHD may affect certain areas of the brain that allow problem solving, planning ahead, understanding others’ actions, and impulse control.
·
The behaviours must appear before age 7.
·
They must
continue for at least six months.
·
The symptoms must
also create a real handicap in at least two of the following areas of the
child’s life:
- in the classroom,
- on the playground,
- at home,
- in the community, or
- in social settings.
If a
child seems too active on the playground but not elsewhere, the problem might
not be ADHD. It might also not be ADHD if the behaviours occur in the classroom
but nowhere else. A child who shows some symptoms would not be diagnosed with
ADHD if his or her schoolwork or friendships are not impaired by the behaviours.
Inattention,
hyperactivity, and impulsivity are the key behaviors of ADHD. The symptoms of
ADHD are especially difficult to define because it is hard to draw the line at
where normal levels of inattention, hyperactivity, and impulsivity end and
clinically significant levels requiring intervention begin. To be diagnosed
with ADHD, symptoms must be observed in two different settings for six months
or more and to a degree that is greater than other children of the same age.
The
symptom categories of ADHD in children yield three potential classifications of
ADHD—predominantly inattentive type, predominantly hyperactive-impulsive type,
or combined type if criteria for both subtypes are met:
Predominantly inattentive type
symptoms may include:
- Be easily distracted, miss
details, forget things, and frequently switch from one activity to another
- Have difficulty maintaining
focus on one task
- Become bored with a task
after only a few minutes, unless doing something enjoyable
- Have difficulty focusing
attention on organizing and completing a task or learning something new or
trouble completing or turning in homework assignments, often losing things
(e.g., pencils, toys, assignments) needed to complete tasks or activities
- Not seem to listen when
spoken to
- Daydream, become easily
confused, and move slowly
- Have difficulty processing
information as quickly and accurately as others
- Struggle to follow
instructions.
Predominantly hyperactive-impulsive
type symptoms may include:
- Fidget and squirm in their
seats
- Talk nonstop
- Dash around, touching or
playing with anything and everything in sight
- Have trouble sitting still
during dinner, school, and story time
- Be constantly in motion
- Have difficulty doing quiet tasks or activities.
-
- and also these
manifestations primarily of impulsivity:
- Be very impatient
- Blurt out inappropriate
comments, show their emotions without restraint, and act without regard
for consequences
- Have difficulty waiting for
things they want or waiting their turns in games
TREATMENT:
The management of ADD consists of the following methods:
a)
Behaviour
modification
b)
Counselling
and supportive psychotherapy
c)
Pharmacotherapy:
Stimulant medication:
Dextro-amphetamine(10-14mg/day) and
methylphenidate(10-60mg/day) are the drugs of choice in the treatment of
hyperkinetic disorder,with a response rate of nearly 90M %.
