ADHD stands for Attention Deficit Disorder and Hyperactivity. It is a neurobiological disorder originating in childhood character that involves a pattern of attention deficit, hyperactivity and / or impulsivity, and that often is associated with other comorbid.
It is essential for the diagnosis of ADHD evaluate these core symptoms we have discussed ( attention deficit, hyperactivity and impulsivity) submitted:
1. From an early age: before 12 years.
2. With an intensity and frequency than normal for age and developmental stage of the child.
3. That damage or interfere significantly in the child's performance in two or more areas of your life: school or work, family and social.
4. Not caused by another medical problem, toxic, a drug or another psychiatric problem.
Although there may be clinical suspicion in children under 6 years the diagnosis of ADHD must have passed this age. further, ADHD is often recognized in children when primary education begins, coinciding with difficulties in school performance and presentation of social dysfunctions.
Disorder D & eacute; deficit Attentions & COLLISION AND Hyperactivity (TDAH) has 3 nuclear symptoms (main):
– Lack of attention options | n
People with ADHD show a pattern & oacute; n persistent lack of attention & oacute; n or hyperactivity / impulsivity that interferes with the operation or development:
- Lack of attention options | n: Six or m & aacute; s s & iacute symptoms of lack of attention & oacute; n or for CHILDREN up 16 to CHILDREN old, the five the m & aacute; s for teens 17 to CHILDREN old or m & aacute; s and adults. The s RIVER symptoms of lack of attention & COLLISION AND have been present for at least 6 months and are inappropriate for developmental level of the person
- It fails to give adequate attention to details or makes careless mistakes in school activities, at work or other activities.
- Has trouble keeping attention on tasks or recreational activities.
- It seems that does not listen when spoken to directly.
- It does not comply with instructions and fails to complete school activities, household chores or duties in the workplace (p. not., loses concentration & oacute; n, is desv RIVER to).
- It has trouble organizing tasks and activities.
- Avoid, dislikes or refuses to perform tasks requiring mental effort for a long period (as activities or homework).
- Loses things necessary for tasks and activities (p. not., school supplies, lápices, books, tools, wallets, keys, papers, glasses, tel & eacute; cell phonos).
- It is easily distracted.
- He forgets things during daily activities.
2. Hyperactivity and impulsivity: Six or M & aacute; s s & iacute; symptoms of hyperactivity / impulsivity for TODDLER you up 16 to CHILDREN old, the five the m & aacute; s for teens 17 to CHILDREN old or m & aacute; s and adults. The s RIVER symptoms of hyperactivity / impulsivity have been present for at least 6 months to the point that are harmful and inappropriate for developmental level of the person:
- He fidgets and taps with hands or feet, or squirms in asient
- Leaves his seat in situations where they are expected to stay seated.
- Runs or climbs in situations where it is not appropriate (in adolescents or adults may be limited to a FEELING oacute; n of concern).
- You can not play or participate in recreational activities quietly.
- It is "moving" and acts as if "will drive a motor".
- Talks excessively.
- Blurts out answers before the question is finished.
- It is costing wait their turn.
- Interrupts others or intrudes (p. not., gets into conversations or games)
further, must satisfy the following conditions:
- Several of the s & iacute; symptoms of lack of attention & oacute; n or hyperactivity / impulsivity were submitted before the 12 to CHILDREN old.
- Several s RIVER symptoms is present in two or m & aacute; s contexts (and at home, school or work; with friends or family; in other activities).
- There are clear indications that the s & iacute; symptoms interfere with social functioning, school and work, or reduce its quality.
- The s & iacute; symptoms do not have an explanation & oacute; n better if they are associated with another mental disorder (as mood disorder, anxiety disorder, dissociative disorder or personality disorder). The s & iacute; symptoms do not happen only during the course of episodes of schizophrenia or other disorder sic & oacute; tico.
Sec STILL types of s & iacute; symptoms, They can be three types (presentations) the TDAH:
- POSING combined n: If present sufficient s RIVER symptoms of both criteria, the lack of attention & oacute; n and hyperactivity / impulsivity, during the STILL last 6 months.
- POSING n which is dominated by the lack of attention & oacute; n: If you had enough s & iacute; symptoms of lack of attention & oacute; n, but not hyperactivity / impulsivity, during STILL last six months.
- POSING n in which predominantly hyperactive / impulsive: If you had enough s & iacute; symptoms of hyperactivity / impulsivity, but not lack of attention & oacute; n, during STILL last six months.
Since the s & iacute; symptoms can change over time, the POSING also n & eacute; n can change over time.
These symptoms can occur with varying intensity in each patient and can occur independently. Thus, the symptomatic profile of those affected will vary in intensity and presentation (based on the predominant symptoms)
Not everything that looks like what is ADHD.
You will often see these characteristics of inattention, hyperactivity or impulsivity own behavior in childhood, since it is natural that children are very active, pay little attention, listen little ... But it is important to differentiate between a "normal" behavior and one that is not.
To be able to propose a possible Diagn & oacute; stico ADHD, They should meet the following criteria established by the DSM-5 (Manual Diagn & oacute; stico and be RIVER stico of Mental Disorders, Fifth edition):
- Manifest these behaviors or some of them disproportionately compared to other TODDLER years of age and about their level of development.
- Est & aacute; present from an early age (before 12 years).
- It affects at least two different environments of life TODDLER or: school, social and / or family.
- significantly impair their quality of life.
- It is not caused by a problem m & eacute; doctor, toxic or other psychiatric problem.
It is important to see a health professional who specializes in ADHD so you can perform Diagnostic & oacute; stico cl RIVER appropriate nico and avoid as & iacute; one Diagnostic options | err stico & COLLISION neo.
The diagnosis of ADHD:
It must be based on a thorough assessment to exclude other possible causes of the child's difficulties, including information about your family, of teachers and evaluation by health professionals from different areas: child psychiatrists, Child psychologists, pediatricians, neuropsiquiatras, neuropsicólogos, etc.
The evaluation of this complex disorder must be done from a multidisciplinary perspective that addresses both psychological assessment, educational and medical.
ADHD assessment protocol
There is no single reliable test that alone allows make an exclusive diagnosis and.To establish the final diagnosis judgment is necessary to collect information from different sources around and intervene in the child and make systematic observations of their behavior and retrospective assessment of their behavior from the earliest agess.
ADHD evaluation should include:
1. A full medical examination to assess the overall health of children and discard problems visual type, auditory, anemias or lack of vital components for health.
2. A professional psychological evaluation to have a clear idea of the emotional condition of the child, including tests of intellectual ability and cognitive development.
3. A family assessment scales which are used behavior.
4. School evaluation that includes academic and behavioral history of the child in the classroom.
Diagnosis is based on compliance with the criteria DSM-V, which they are the diagnostic criteria established by the American Academy of Psychiatry (1994) or criteria CIE-10 (1992) recognized and established by WHO.
ADHD treatment should be individualized multimodal, taking into account the patient and his family. The objective of multimodal treatment is to reduce symptoms while complications from the disorder and the negative impact it can have on the lives of patients and their environment are reduced.
Multimodal treatment of ADHD involves three approaches:
- Cognitive behavioral therapy
- Treatment psicoeducativo (parents and teachers)
Hence the multimodal treatment is also known as combination therapy, because it requires multiple approaches and the involvement of different professionals.
According to the results of studies, drug treatment would be the most effective method to reduce nuclear symptoms of ADHD (attention deficit, hyperactivity and impulsivity)1, and psychological treatment (behavioral and psychoeducational) primarily help improving executive functions (cognitive skills like starting tasks, get organized, plan things ...).
And it has been shown to educate the patient and family about the disorder, adapt the environment to the needs of each person and improve skills approach to patients, Parents and educators, They can help you get good results in the treatment of ADHD, when it combined with pharmacological intervention.