The hyperactive child is a child with a syndrome of deficiency of attention and a hyperactivity (SDVG), the neurologic and behavioural violations developing at children's age. Restlessness, an otvlekayemost, difficulties of concentration of attention, impulsiveness, the increased physical activity etc. are peculiar to behavior of the hyperactive child. The hyperactive child needs neuropsychological and neurologic (EEG, MRT) inspection. The help to the hyperactive child assumes individual psychology and pedagogical maintenance, carrying out psychotherapy, non-drug and medicinal therapy.
SDVG - the syndrome of the increased physical and intellectual activity which is characterized by prevalence of processes of excitement over braking. The hyperactive child experiences difficulties with concentration and maintenance of attention, self-control of behavior, training, processing and deduction of information in memory. According to official statistical data, in Russia from 4 to 18% of children have the diagnosis of SDVG. Moreover, this syndrome is present at 3-5% of adult population as in half of cases the hyperactive child grows up in "the hyperactive adult". For boys of SDVG it is diagnosed by 3 times more often than at girls. SDVG is a subject of fixed studying of pediatrics, children's psychiatry, children's neurology, children's psychology.
Experts are at a loss in definition of the exact reasons a syndrome of deficiency of attention and a hyperactivity. It is considered that the hyperactivity at children can be caused by genetic factors and early organic damage of TsNS which are quite often combined with each other. Modern researches indicate that at SDVG the mismatch of functioning of the structures providing the organization of any behavior and control of attention namely - associative bark, basal takes place a thalamus, a cerebellum, prefrontal cortex.
The SDVG genetic mechanism is explained by inheritance of the genes regulating exchange of neurotransmitters (dopamine and noradrenaline) in a brain. Owing to dysfunction of neuromediator systems process of synoptic transfer is broken that involves dissociation of communications between bark of frontal lobes and subcrustal structures. In favor of this theory specifies the fact that in treatment of a hyperactivity children have effective medicines promoting release and braking of the return capture of neurotransmitters in the presynaptic nervous terminations.
In number pre-and the perinatal factors determining development of SDVG it should be noted different adverse effects promoting development of the minimum brain dysfunction in the hyperactive child. Mother can have it the pathological course of pregnancy and childbirth (, an eklampsiya, threat of an abortion, a hemolytic disease of a fruit, rapid or long childbirth, the use of the pregnant woman of alcohol or some medicines, smoking), asphyxia, prematurity, patrimonial injuries at the child, etc. Can lead the infectious diseases and ChMT postponed to the first months and years of life to development of a syndrome of a hyperactivity in children.
In formation of a hyperactivity at children influence of adverse ecological factors, first of all pollution of the environment neyrotoksikant is not excluded (lead, arsenic, mercury, cadmium, nickel, etc.). In particular, correlation between the increased content of lead in hair according to the spectral analysis and the hyperactivity level, cognitive and behavioural violations at children is proved. Emergence or strengthening of manifestations of SDVG can be connected with unbalanced food, insufficiency of receipt in an organism of micronutrients (vitamins, an omega-3 of fatty acids, minerals – magnesium, zinc, iron, iodine). Strengthening of difficulties of adaptation, behavior and attention at the hyperactive child is promoted by the adverse intra family relations.
Classification of SDVG
The international psychiatric classification (DSM) allocates the following options of SDVG:
- mixed – a hyperactivity combination to violation of attention (meets most often). Usually comes to light at boys with a certain phenotype – a fair hair and blue eyes.
- inattentive – prevails deficiency of attention. Meets at girls more often, it is characterized by leaving to the world, the rough imagination, the child's "vitaniye" "in clouds".
- hyperactive - prevails a hyperactivity (the most rare type). With identical probability it can be caused both by specific features of temperament of children, and certain violations of TsNS.
In the early childhood the hyperactive child often has the raised muscular tone, suffers from numerous and unmotivated attacks of vomiting, badly falls asleep and uneasily sleeps, is easily excited, has hypersensibility to any external irritants.
The first signs of a syndrome of a hyperactivity, as a rule, are found in children at the age of 5-7 years. Parents usually begin "to sound the alarm" when the child goes to school that demands from him a certain organization, independence, observance of rules, concentration and so forth. The second peak of manifestations falls on the pubertatny period (13-14 years) and is connected with teenage hormonal splash.
As the main kliniko-diagnostic criteria of SDVG serve the carelessness, a hyperactivity and impulsiveness.
The carelessness at the hyperactive child is expressed in inability of deduction of attention; impossibility to concentrate on a game or performance of a task. In view of the raised otvlekayemost on foreign incentives, the hyperactive child makes a set of mistakes in homeworks, cannot carry out up to the end offered instruction or the charged duties. The hyperactive child has difficulties with the organization of independent activity, absent-mindedness, forgetfulness, a constant pereklyuchayemost from one occupation on another, tendency to failure to complete of the begun affairs is noted.
Actually the hyperactivity at children assumes uneasy behavior, restlessness, excessive physical activity in situations which demand preservation of relative rest. At observation of the hyperactive child it is possible to notice the constant stereotypic movements in brushes and feet, twitchings, tics. Lack of any control of the behavior therefore children with SDVG constantly are in the aimless movement (run, turn, talk and so forth) in situations improper for this purpose is peculiar to the hyperactive child, for example, during school lessons. At 75% of hyperactive children the dispraksiya – awkwardness, slowness, inability to perform the movements and the work demanding a certain dexterity is noted.
Impulsiveness at the hyperactive child is expressed in impatience, haste of performance of tasks, the aspiration to give the answer, without having thought of its correctness. The hyperactive child cannot usually play collective games together with peers as he constantly disturbs people around, does not follow the rule of the game, clashes etc.
The hyperactive child often complains of headaches, fatigue, drowsiness. At some children night and day enuresis is noted. Among hyperactive children delays of psychomotor and speech development, are widespread in school age - a dysgraphia, a dyslexia, a diskalkuliya. According to children's psychologists, 60-70% of children with SDVG are the hidden lefthanders or ambidexters.
The Rastormozhennost and recklessness is followed by decrease in an instinct of self-preservation therefore the hyperactive child easily gets different injuries.
Diagnostics of SDVG
According to the criteria elaborated by DSM in 1994, SDVG can be recognized at preservation at the child, at least, of 6 signs of a carelessness, a hyperactivity and impulsiveness within half a year. Therefore at primary address to experts the diagnosis of SDVG is not made, and observation and examination of the child is conducted. In the course of kliniko-psychological inspection of the hyperactive child methods of an interview, conversation, direct observation are used; obtaining information from teachers and parents by means of diagnostic questionnaires, neuropsychological testing.
Need of carrying out basic pediatric and neurologic inspection is caused by the fact that various somatic and neurologic frustration (, anemia, epilepsy, a trochee, a hearing disorder and sight and can be behind a SDVG-like syndrome. other). For the purpose of the specifying diagnostics to the hyperactive child consultations of narrow children's experts (the children's endocrinologist, the children's otolaryngologist, the children's ophthalmologist, an epileptolog), brain EEG, MRT, the general and biochemical blood test etc. can be appointed. Consultation of the logopedist allows to carry out diagnostics of violations of a written language and to draw up the plan of correctional work with the hyperactive child.
The hyperactivity at children should be differentiated from a fetalny alcoholic syndrome, post-traumatic defeat of TsNS, chronic poisoning with lead, manifestations of individual characteristics of temperament, pedagogical neglect, mental retardation, etc.
Correction of SDVG
The hyperactive child needs the comprehensive individualized support including psychology and pedagogical correction, psychotherapy, non-drug and medicamentous correction.
The sparing training mode (a class of small fullness, the reduced lessons, the dosed tasks), sufficient dream, good nutrition, long walks, sufficient physical activity is recommended to the hyperactive child. In view of hypererethism it is necessary to limit participation of hyperactive children in mass actions. Under the leadership of the children's psychologist and the psychotherapist autogenic trainings, individual, group, family and behavioural psychotherapy, the corporal focused therapy are held, it is BAREFOOT - technologies. All environment of the hyperactive child has to be actively involved in correction of SDVG: parents, tutors, school teachers.
The pharmacotherapy is an auxiliary method of correction of SDVG. She assumes purpose of the atomoksetin of the hydrochloride blocking the return capture of noradrenaline and improving synoptic transfer in various structures of a brain; medicines of a nootropic row (a piritinola, a korteksina, the alfostserata, a fenibuta, gopantenovy acid is well-cared); micronutrients (magnesium, pyridoxine), etc. In some cases the good effect is reached by use of a kinezioterapiya, massage of cervical department of a backbone, manual therapy.
Forecast and prevention of SDVG
Timely and complex correctional work allows the hyperactive child to learn to build relationship with peers and adults, to control own behavior, prevents difficulties of social adaptation. Psychology and pedagogical escort of the hyperactive child promotes formation of the social acceptable behavior. In the absence of attention to SDVG problems the risk of social disadaptation, alcoholism and drug addiction increases in teenage and mature age.
Prevention of a syndrome of a hyperactivity and deficiency of attention has to begin long before appearance of the child on light and provide conditions for the normal course of pregnancy and childbirth, care about health of children, creation of a favorable microclimate in a family and children's collective.