ADHD
Introduction
Introduction to ADHD ADHD, or hyperactivity syndrome, is a common problem of abnormal child behavior, also known as mild brain function disorder or mild brain dysfunction syndrome or attention deficit disorder. 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, and the emotions are impulsive, which affects the academic performance. It is difficult to get along with people in both home and school, and it is difficult for parents and teachers in daily life. basic knowledge The proportion of illness: 0.005% Susceptible people: children under 7 years old Mode of infection: non-infectious Complications: Child anxiety
Cause
Cause of ADHD
Genetic factors (20%):
Current research indicates that the disorder is related to genetic factors, with a heritability of 0.75-0.91. The genetic pattern is still unclear and may be polygenic. Molecular genetic studies have shown that this disorder is associated with polymorphism in the dopamine receptor gene.
Neurophysiological factors (25%):
The abnormal rate of EEG in children with this disorder is mainly due to the increase of slow wave activity. EEG power spectrum analysis found that the slow wave power increased, the alpha wave power decreased, and the average frequency decreased. It is suggested that children with this disorder have delayed central nervous system maturation or insufficient arousal in the cerebral cortex.
Minor brain injury (15%):
Mild brain damage caused by various causes during pregnancy, perinatal period and after birth may be the cause of this disorder in some children, but no brain injury exists in all children with this disorder, nor is it all that has this damage. Children suffer from this disorder, and many children do not have evidence of brain damage.
Neuroanatomical factors (8%):
Magnetic resonance studies have reported a decrease in the volume of the corpus callosum and caudate nucleus in children with this disorder. Functional nuclear magnetic studies have reported a decrease in the metabolism of the caudate nucleus, frontal area, and anterior cingulate gyrus.
Psychosocial factors (10%):
Poor social environment, family environment, such as the economy is too poor, parents' feelings are broken, and improper education methods can increase the risk of children suffering from this disorder.
Other factors (15%):
This disorder may be related to zinc, iron deficiency, and elevated blood lead. Cola, coffee, and food additives may increase the risk of children suffering from this disorder.
Prevention
ADHD prevention
1, to promote pre-marriage inspection, to avoid close relatives marriage; choose a spouse should pay attention to whether the other side has epilepsy, schizophrenia and other mental disorders.
2, age-appropriate marriage, do not marry early, early pregnancy, do not be too late marriage, late pregnancy, to avoid the baby's congenital deficiency; planned eugenics.
3, in order to avoid birth injury, reduce the chance of brain damage, should be natural delivery, because the proportion of caesarean section in children with ADHD is higher.
4, pregnant women should pay attention to temperament, maintain a happy mood, peace of mind, avoid cold and heat, prevent disease, use drugs with caution, ban alcohol and tobacco, to avoid the effects of poisoning, trauma and physical factors.
5, create a warm and harmonious living environment, so that children spend their childhood in a relaxed and happy environment, to teach students in accordance with their aptitude, do not blindly look at Jackie Chan.
6, pay attention to reasonable nutrition, so that children develop good eating habits, not partial eclipse, not picky eaters; to ensure adequate sleep time.
7, try to avoid children playing lead-containing paint toys, especially in the mouth can not be included in these toys.
Complication
ADHD complications Complications, childhood anxiety
When children with ADHD grow up, nearly half of the children's hyperactivity will disappear, but some of the symptoms of children with ADHD, such as lack of concentration, impulsiveness can last for a long time. In youth, it can be characterized by academic ruin, social maladaptation, emotional naivety, and mutual struggle; adulthood, anxiety, poor self-esteem, personality disorder, interpersonal tension, lack of achievement, and poor socioeconomic status. Therefore, treatment must be carried out, and it must not be taken lightly.
Symptom
ADHD symptoms common symptoms attention deficit hyperactivity disorder unilateral and pseudo-hand and foot rhythm mood fluctuations easily excited attention inattention adult ADHD
Although ADHD is a child developmental behavioral disorder, some ADHDs continue into adulthood if they are not effectively controlled during childhood.
ADHD is different in different patients in different years. Below, we will specifically introduce the performance characteristics of ADHD in different periods.
Preschool period: The school age is the early stage of ADHD, the symptoms are gradually obvious, the kindergarten has hyperactivity, it is difficult to sit still, it is difficult to keep the rules, it is difficult to concentrate, the class does not listen, the learning difficulties, casual walking, disobedience, and other children Can not get along with each other, refuse to sleep, often punished by the teacher.
Primary school period: During this period, ADHD began to develop maturity, and all symptoms were revealed. For example, attention time was short, time was not concentrated, and it was easy to distract, difficult to learn, unable to complete homework, and tolerated with frustration. Responding to stimuli is too strong, irritating, emotionally unstable, aggressive, and difficult to get along with peers, the "clown" in the class.
Middle school period: With the increase of age, patients have the consciousness of self-control, the activity may be gradually reduced, the concentration is still difficult, the ability to receive education is dull, lack of self-respect and motivation, unreliable, aggressive, and exciting. Behavior, excessive response to soothing, negligent behavior, emotional sway, lying, truancy, prone to accidents or juvenile delinquency.
Adulthood: The peak incidence of ADHD is 6-15 years old. Only when there is no effective treatment in the initial stage, the disease will continue into adulthood, and the hyperactivity will be significantly reduced. More than half of the people are different from normal people. Most people pay attention to easy transfer, excitement, emotional outburst, easy to argue with people, nervous relationship with colleagues, difficulties in participating in group activities, gambling, gambling, incompetence, lack of ideals and perseverance, and difficult progress in career.
Examine
ADHD examination
an examination
Nervous system examination, full physical examination.
Clinicians can use diagnostic criteria as needed. At present, DSM-IV is used in the diagnostic criteria for ADHD: AE is required.
A symptom standard:
(1) Attention Deficit Symptoms: Meet at least 6 of the following symptoms of attention deficits for at least 6 months, to the extent of maladaptation, and not commensurate with the level of development:
1 In the study, work or other activities, often pay attention to details, it is prone to errors caused by carelessness;
2 It is often difficult to stay focused during learning or gaming activities;
3 When he talks to him, he is often absent-minded and seems to be listening.
4 often can not complete the homework, daily housework or work as directed (not due to confrontation or failure to understand);
5 It is often difficult to complete a structured task or other activity;
6 Do not like, do not want to engage in things that require energy (such as homework or housework), often try to escape;
7 often lose what is necessary for study and activities (eg toys, textbooks, pencils, books or tools, etc.);
8 is easily distracted by external stimuli;
9 Often lost in the daily activities.
(2) Hyperactivity/impulsive symptoms: Meet at least 6 of the following hyperactivity and impulsive symptoms for at least 6 months, to the extent of maladaptation, and not commensurate with the level of development:
1 often keep moving your hands and feet, or twisting and twisting in your seat;
2 often leave the seat without permission in the classroom or other places where you are required to sit;
3 often rushing over or climbing up and down in inappropriate situations (in adolescents or adults may only have a subjective feeling of restlessness);
4 often can not play quietly or participate in leisure activities;
5 Often moving around for a moment, as if a machine is driving him;
6 often talked a lot;
7 Often people rush to answer when they are not finished.
8 In the event, it is often impossible to wait patiently in a queue to wait for rotation;
9 Often interrupt or interfere with others (such as interjecting or interfering with other children's games when someone speaks).
B Course criteria: Some symptoms that cause damage appear before the age of 7.
C Damage caused by certain symptoms occurs in at least two environments, such as school and home.
D Severity criteria: Clear evidence of clinically meaningful impairment in social, academic, or occupational function.
E Exclusion criteria: Symptoms do not occur in the course of extensive developmental disorders, schizophrenia, or other psychotic disorders, nor can they be explained by other mental disorders such as mood disorders, anxiety disorders, separation disorders, or personality disorders.
Diagnosis
Diagnosis of ADHD
Diagnosis should be based on the results of a comprehensive medical history, physical and neurological examination, mental examination, and auxiliary examination. In this process, it is very important to collect detailed and correct medical history. The symptoms may not be prominent during the short-term mental examination of children with milder conditions.
Diagnostic points
1. The onset of symptoms is at least six months before the age of 7 years.
2, with attention to obstacles, hyperactivity, good impulses as the main clinical manifestations.
3. Badly affecting social functions (scholarship or interpersonal relationships, etc.).
4. Exclude mental retardation, extensive developmental disorders, and mood disorders.
Diagnostic identification
1. Mental retardation: Children with this disorder may be accompanied by hyperactivity and attention disorder. If they can go to school, their learning difficulties are also very prominent, so it is easy to be confused with attention deficit and hyperactivity disorder. However, the history of the disease can be found that the child's growth and development from childhood is slower than that of normal children of the same age, the social adaptability is low, the academic level and intelligence level are much equal, and the IQ is less than 70. The above helps to identify.
2, children with autism: Although children with this disease often have hyperactivity, attention disorders, but children also have three core symptoms of childhood autism, namely: social communication barriers, communication barriers, narrow interest and stereotyped behavior Way, therefore, it is not difficult to identify with attention deficit and hyperactivity disorder.
3, conduct disorder: conduct disorder and attention deficit and hyperactivity disorder with the same high rate. If the child is not accompanied by hyperactivity and attention disorder, only the conduct disorder is diagnosed. If the child is accompanied by hyperactivity, attention disorder, and meet the diagnostic criteria for attention deficit and hyperactivity disorder, both diagnoses need to be made.
4, children with emotional disorders or mood disorders: children in the state of anxiety, depression or mania may have too many activities, attention to concentration, learning difficulties and other symptoms, children with attention deficit and hyperactivity disorder because of frequent criticism from teachers and parents And the rejection of peers can also cause anxiety and depression, so both need to be identified. The main points of identification are as follows: 1 attention deficit and hyperactivity disorder start before the age of 7 years, and the onset time of children with mood disorder or mood disorder can be early or late; 2 attention deficit and hyperactivity disorder is chronic persistent disease The course of emotional disorders is different, and the mood disorder is a paroxysmal course; 3 The first and main symptoms of attention deficit hyperactivity disorder are attention disorder, hyperactivity and impulsivity, and the first and main mood disorder or mood disorder Symptoms are emotional problems; 4 children with mood disorders or mood disorders after treatment to improve mood, hyperactivity and attention disorders will disappear. In children with attention deficit and hyperactivity disorder who take anti-anxiety drugs or antidepressants to improve their mood, overactivity, attention disorder and impulsiveness may improve, but they persist.
5, children with schizophrenia: the onset of the disease is more late than attention deficit and hyperactivity disorder, the peak incidence time is pre-puberty and adolescence, in the early stage of inattention, academic performance decline, often accompanied by other emotions, Behavioral or personality changes, and as the disease progresses, there will be symptoms of schizophrenia such as sensory impairment, thinking disorder, apathy and incoordination, behavioral bizarreness, and lack of intention, which can be associated with attention deficits and hyperactivity. Identify the obstacles. [1]
