ADHD
Introduction
Introduction to ADHD in children Hyperkinetic syndrome (hyperkinetic syndrome) is a common problem of abnormal child behavior, also known as mild brain function disorder or mild brain dysfunction syndrome (MBD) or attention deficit disorder (ADD). The intelligence of these children is normal or basically normal, but there are defects in learning, behavior and emotions. The performance is that the attention is not easy to concentrate, the attention is short, the activities are too much, the emotions are impulsive and affect the academic performance, and it is difficult to be at home and school. People get along and make parents and teachers feel difficult in their daily lives. Some people compare this disorder to a symphony that loses coordination and harmony, and the prevalence of reported data is about 5-10%. Domestically, there are also a large number of school-age children, accounting for about 1 to 10% of all primary school students. Boys are far more than girls. Premature children suffer from this disease. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: children Mode of infection: non-infectious Complications: anxiety
Cause
Causes of childhood ADHD
Genetic factors (20%):
The blood brothers, fathers, etc. of the children have more hyperactivity or inattention; the prevalence of monozygotic twins in twins is as high as 51% to 64%; alcoholism among relatives, antisocial personality and snoring are also more .
Environmental factors (30%):
The influence of society, family, and psychological factors, such as poor social environment or family conditions (fractured family, economic poverty, housing overcrowding, bad parents, alcoholism, drug abuse, mental illness, etc.) can all be the cause of the disease and affect the course of the disease. Development and prognosis.
Other factors (20%):
Nutritional problems, vitamin deficiencies, food allergies, food flavorings or the addition of artificial colors may make children prone to ADHD.
Children with ADHD may have different causes. It is generally considered that prenatal, postpartum or postpartum mild brain damage is an important factor, mainly related to brain trauma, poisoning, etc. Some people think that urban environmental pollution, clinically mild symptoms of mild lead Poisoning can also be one of the causes. In recent years, the investigation and study, in the comparison of children with pedigree parents, foster parents and other pediatric children, found that the pedigree parents and other pediatric children compared, found some mental illnesses in the pedigree parents. The incidence of alcoholism and morbid personality is higher than that of the control group. The parents of ADHD children have more history of childhood, and the prevalence of siblings of ADHD children is 3 times higher than that of the control group. Affective psychosis is also common. In addition, the anti-social personality characteristics or alcohol dependence of the fathers of ADHD children, the mothers have more rickets, and the adult relatives of the hyperactive children with the disorder of conduct have higher personality disorder, alcohol addiction and rickets, and the research on the adopted children is also It was found that the antisocial personality, alcohol dependence and rickets of the biological parents of children with ADHD were significantly higher than those of the healthy parents or the control group. Parents, parents have more history of hyperactivity and conduct disorder in childhood and more people with mental disorders. The incidence of ADHD children with monozygotic twins is higher than that of twins, and the incidence of sibling children is also about half siblings. More than five times the brothers, suggesting that some children with mild brain dysfunction may have a certain effect on genetic factors, affecting children's psychological development, many children failed to find the cause.
Prevention
Prevention of ADHD in children
With the application of multiple treatment methods, the prognosis of children with hyperactivity is more optimistic, but if left untreated, about one-third of ADHD children meet the diagnosis of DSM-III-R axis I. There are four main categories: (1) residual symptoms of ADHD; (2) antisocial personality disorder; (3) alcohol dependence; (4) rickets, anxiety disorders and some schizophrenia. Many adults with personality disorders have a history of ADHD, uncontrollable impulsive behavioral disorders, low thresholds for stress, emotional instability, and long-term dissatisfaction. Tracking untreated or rarely treated ADHD children, give us Providing a natural course of children with ADHD, it has been reported that untreated children with ADHD have decreased levels of untargeted sexual overactivity with age, but 20% have criminal behavior during adolescence, substance abuse, and academic decline. Impulsiveness and inattention still exist.
Complication
Children with ADHD complications Complications
If left untreated, the prognosis of children with ADHD is mostly poor. In terms of learning, it leads to a decline in academic performance. Some of them are difficult to complete compulsory education. In terms of personality, they often balance their mentality with lying, bragging, strange actions, violations, confrontation, etc. After adulthood, they are not highly educated, lack skills, are not serious about learning, are willful, impulsive, and have poor interpersonal relationships. Coupled with some bad habits, it is difficult to adapt to society and is not welcomed by the society. It cannot be a useful one. People, personality is distorted, easy to go astray, after ADHD children grow up, nearly half of children's hyperactivity will disappear, but more than half of ADHD children's symptoms, such as lack of concentration, impulsive and sustainable long-lasting, youth Can be expressed as academic ruin, social maladaptation, emotional naive, fighting each other; adulthood anxiety, poor self-esteem, personality disorder, interpersonal tension, lack of achievement, poor social and economic conditions, it must be treated, must not be taken lightly.
Symptom
Children with ADHD symptoms Common symptoms Attention deficits, ups and downs, learning difficulties, excitement, constant blinking behavior, and emotional abnormalities
1. Completely collect the history of ADHD, whether there is a similar disease or other neuropsychiatric history in the family, the mother's pregnancy status and the history of childhood growth and development.
Second, clinical characteristics:
1. Excessive activity: Most of them start in early childhood. After entering primary school, the performance is remarkable. During the class, the small movements are kept, the book is torn, and the books are not painted. Anything that can be touched is touched, and it is fun, often fighting with classmates.
2, inattention: not concentrated during the study, the time spent in class during the class is short, and respond to the stimulus from all parties.
3, emotional instability, impulsive, will scream for no reason, no patience, doing things in a hurry.
4, learning difficulties: children with normal intelligence, but due to hyperactivity brought learning difficulties, some children have cognitive activities and comprehensive analysis of obstacles, the course of disease, usually starting before the age of 7 years, duration of more than 6 months.
Third, differential diagnosis:
Need to be differentiated from extensive developmental disorders, mental retardation, childhood mental disorders, organic mental disorders, neuropsychiatric disorders and drug side effects.
So far, there is no clear pathological change as a basis for diagnosis, so it is still mainly based on the medical history, clinical manifestations, physical examination (including neurological examination) mental examination provided by the parents and teachers of the child:
1. Symptom criteria: The following symptoms are more common than most children of the same age, and eight of the following behaviors are required.
(1) Frequent hands or feet move or keep twirling in the sitting position (older or juvenile is limited to subjective feeling of restlessness).
(2) It is difficult to sit quietly when you sit still.
(3) Distracted by external stimuli.
(4) Can't patiently wait in line for a rotation in a game or group event.
(5) Often people rush to answer when they are not finished.
(6) It is difficult to do things according to the instructions of others (not due to defiant behavior or failure to understand), if not doing housework.
(7) It is difficult to maintain concentration during work or games.
(8) Often one thing is not finished and another thing is changed.
(9) It is difficult to play quietly.
(10) Frequently speaking.
(11) often interrupt or interfere with activities that disrupt others, such as games that interfere with other children.
(12) When someone talks to him/her, they often hear it.
(13) Items that are used in school or at home for learning and activities (such as toys, pencils, books, and homework) are often lost.
(14) Often participate in activities that are dangerous to the body without regard to possible consequences (not for seeking excitement).
2, the course of disease criteria: usually start before the age of 7 years, the course of disease lasts more than 6 months.
3, exclusion criteria: not due to extensive developmental disorders, mental retardation, childhood mental disorders, organic mental disorders, neuropsychiatric diseases and drug response.
4. Classification of severity:
(1) Mild: Symptoms meet or slightly exceed the symptoms required for diagnostic criteria, with little or no impairment of school and social function.
(2) Moderate: Symptoms and damage are between mild and severe.
(3) Severe: Many symptoms are required to exceed the diagnostic criteria, and there are significant extensive impairments in the social function of schools, families, and partnerships.
Examine
Pediatric ADHD check
Most of the physical examinations of children with this disease are normal. The neurological examination shows that the fine movements are uncoordinated, the rapid rotation is awkward, the mutual aid movement is uncoordinated, the pathological joint movement and other soft signs, and some children have abnormal EEG and brain evoked potentials. However, there is no specific diagnostic significance.
Diagnosis
Diagnosis and diagnosis of ADHD in children
There are six major conditions in the identification criteria that are similar to those of ADHD.
1. Mental retardation.
2, lonely obstacles.
3. Depression.
4. Caused by chronic social environmental problems.
5. Tourette syndrome or multiple tics syndrome.
6. Other behavioral disorders.
