By Margaux RICHARD and Estelle LEVAL
Key words: Attention-deficit hyperactivity disorder (ADHD), Impulsivity, Symptoms, Children, Psychologist, Treatment
What is ADHD?
Attention Deficit Hyperactivity Disorder, more commonly known as ADHD, is a neuro-developmental disorder, characterized by symptoms of inattention, motor instability, and impulsivity; accompanied by social and family repercussions (Mazeau, 2005). The primary characteristics are: an inappropriate level of inattention development, hyperactivity, and impulse control that may affect cognition but also behavior (Camus, 1996).
On the other hand, contrary to what one might think ADHD is not motor instability, even if hyperactivity is often common in this disorder, it is not necessarily present (APA, 2015).
When does it occur?
ADHD usually appears early with onset of symptoms around 3 or 4 years old, and some distinctive signs. Most of the time it is the school that alerts you to certain disturbing behaviors (Berquin, 2005).
Signs and symptoms?
ADHD therefore impacts children’s daily lives, feelings and relationships with others; and often has effects at the expense of academic performance. According to the DSM-5 (APA, 2015), the main feature of ADHD is a persistent mode of inattention and / or hyperactivity-impulsivity that interferes with functioning or development:
- Inattention is behaviorally characterized by distractibility, lack of perseverance, and difficulty in sustaining attention. The child is often disorganized and this is not due to an attitude of opposition or a lack of understanding (like sensory disturbance).
- Hyperactivity refers to excessive motor activity (child running everywhere) in situations where it is inappropriate, or one through excessive « fidgeting », tapping fingers or chatter.
- And impulsivity rests on precipitous actions happening instantly without reflection on their possible consequences and with a great risk of causing the subjects to be upset (for example, rushing into the street without looking). It can also manifest itself by imposing one’s presence (for example, interrupting speech).
Why?
ADHD is associated with a set of early risk factors of a genetic and environmental nature. However, the nature of the risk factors is only partially identified. The dominant hypothesis is that it is a complex and multi-factorial origin resulting from the combination of different risk factors specific to each individual. It is therefore more an idea where many risk factors each having a weak effect will contribute to the appearance of the disorder (Berquin, 2005).
What to do?
The first thing to do, is seeing a doctor or a pediatrician who will make exams and will point to a psychologist. This specialist will give to parents an idea of their child’s difficulties and maybe diagnosed an attention deficit disorder (Haute Autorité de Santé, 2014)
There are also a lot of adaptations for children with ADHD in daily life that parents and teachers can do at home or at school (Robitaille & Vezina, 2003):
- Increase organization: implement simple routines, make tasks lists, using diary, reinforce each step, etc.
- Decrease inattention, agitation, and impulsivity: sporting activities, give responsibilities, explain simply and clearly the rules, etc.
- Increase self-esteem: Reinforce good behaviors, limit the number of objectives, etc.
- Increase social abilities: Communicate with them and promote dual relationships, etc.
Any treatments?
There are three types of treatments, firstly medications that will help child to concentrate, but there is also cognitive and behaviorism sort of exercises that can help with ADHD.
Each of these three treatments are not to be done at the same time, and one needs to be adapted to the child. This is why it is necessary to go see a specialized psychologist that can examine attention of your child (with the help of a multi-disciplinary team) and who can then adapt the care to his needs (Haute Autorité de Santé, 2014).
American Psychiatric Association (2015). DSM-5: manuel diagnostique et statistique des troubles mentaux (5e ed). Issy-les-Moulineaux, France: Elsevier Masson.
Berquin, P. (2005) Le trouble déficitaire d’attention avec hyperactivité (TDAH). In C. Hommet, I. Jambaqué, C. Billard, & P. Gillet (Dirs.), Neuropsychologie de l’enfant et troubles du développement (p. 131-148). Marseille, France: Solal.
Camus, J.-F. (1996). La psychologie cognitive de l’attention. Paris, France: Masson.
Gourtay-Saussaye, M. (2011). TDAH Trouble du déficit de l’attention avec ou sans hyperactivité. S.l.: Enrick B. Editions.
Haute Autorité de Santé (2014). Conduite à tenir en médecine de premier recours devant un enfant ou un adolescent susceptible d’avoir un trouble déficit de l’attention avec ou sans hyperactivité: méthode recommandations pour la pratique clinique. Retrieved on https://www.has-sante.fr/portail/jcms/c_2012647/fr/trouble-deficit-de-l-attention-avec-ou-sans-hyperactivite-tdah-reperer-la-souffrance-accompagner-l-enfant-et-la-famille
Mazeau, M. (2005). Neuropsychologie et troubles des apprentissages: du symptôme à la rééducation. Paris, France: Elsevier Masson.
Robitaille, C., Vézina, N. (2003). TDAH trouble de déficit de l’attention/hyperactivité: agir ensemble pour mieux soutenir les jeunes : document de soutien à la formation: connaissances et interventions. Retrieved on http://publications.msss.gouv.qc.ca/msss/document-001393/?&date=ASC