ADHD (Attention Deficit Hyperactivity Disorder): What is it?

ADHD (Attention Deficit Hyperactivity Disorder), which can also be ADD (without hyperactivity), is a chronic neurobiological disorder, characterized by impulsivity, hyperactivity and / or inattention. It appears in childhood.

In other words, it is a neurodevelopmental disorder that, although symptoms may vary in intensity and frequency, is for life. In this article we give you a summary of its symptoms, causes and treatments.

ADHD: what is it?

ADHD, as we anticipated, is a neurodevelopmental disorder. It manifests itself from early childhood, and mainly affects attention, concentration, control of impulsivity, behavior in cognitive activities (where there is a difficulty in controlling impulses) and control of motor activity (where there is an excess of movement).

These symptoms affect the child in different areas of his life, such as: his relationships with peers and his adaptation to the environment, both family and school.

A little history

ADHD is not a new disorder, although in recent years its diagnosis has multiplied. Throughout history, and since it was defined for the first time, it has been called in different ways. References and descriptions of ADHD have been found in the medical literature for more than 200 years.

The first to define it was Sir Alexander Crichton, in 1798. He gave it the name "Mental Restlessness". The name has gone through different changes, until today, where the DSM-5 itself (Diagnostic Manual of Mental Disorders) classifies it as such (ADD or ADHD).

Symptoms

The symptoms of ADHD are basically three: inattention, hyperactivity and impulsivity. In DSM-5, depending on whether one symptom or another predominates, we find three types of ADHD: predominantly hyperactive-impulsive, predominantly inattentive, and combined.

Behavioral problems are sometimes added to these three types of symptoms, the result of the original three symptoms.

1. Inattention

The symptom of ADHD inattention is characterized by an inability (or great difficulties) to fixate attention to certain stimuli, to concentrate, to attend in class, to attend to conversations, etc. It also translates into an inability to perform two tasks simultaneously (divided attention), such as attending class and taking notes.

This inattention causes difficulties in the child when performing homework or studying, since it is very difficult for him to concentrate without being distracted by irrelevant stimuli from the environment.

2. Hyperactivity

Hyperactivity implies that the child acts as if "had a motor inside." That is, she cannot stop moving, goes from one task to another without finishing the first, talks quickly, etc. This hyperactivity interferes with your personal relationships and academic performance, just like the other symptoms.

3. Impulsiveness

Impulsivity, the third symptom of ADHD, implies that the child is impatient, that he acts without thinking about the consequences of her actions, that he has deficits in self-control, responds without listening to the question completely, does not respect turns (for example in games), etc.

Like the rest of the symptoms, it also damages their academic performance and their relationship with their peers, since who may act unconsciously or disrespecting others (even if not in a way intentional).

Causes

The etiology of ADHD is multifactorial. That is, it is a heterogeneous disorder, with multiple possible causes.. Its origin is really unknown, although most experts bet on an interrelation of multiple factors causing ADHD: genetic, brain, psychological and environmental

Some research points to a hereditary component of ADHD, and even different neuroimaging tests have been able to detect how people with ADHD present abnormal functioning in certain areas of the brain.

Perinatal risks

On the other hand, certain perinatal risks have also been discussed as a possible origin of ADHD: alcohol and tobacco consumption during pregnancy, drugs, mother's stress, etc. Complications or abnormalities during childbirth (for example, low birth weight, prematurity, etc.) are also mentioned as factors involved in the origin of ADHD.

Other features

On the other hand, the boy or girl himself also presents a series of personal characteristics that can influence, as well as the attitudes and educational habits of parents and teachers. Family relationships and family climate can also play a role.

Treatment

Treatment of ADHD It must be multidisciplinary, and include professionals from different fields (doctors, psychologists, teachers, psychopedagogues ...). We are going to see the different treatments within this multidisciplinarity, with an emphasis on psychological treatment:

1. Psychological treatment

The psychological treatment of ADHD has the objective of helping the child and her family to manage the symptoms of the disorder itself, as well as the consequences that these have on a day-to-day basis.

For this, aspects such as: self-control, behavior, self-esteem and socialization are worked on.

1.1. Self-control

Self-control is the ability to modulate and control one's actions in relation to the environment, appropriately and effectively. Self-control implies a sense of internal control.

To work with children with ADHD, techniques such as self-instructions are applied, which have the objective of the child to internalize a series of instructions (and to say them to himself) when doing the things. That is, it is about structuring your actions. A simple example of self-instruction would be: step 1, stop, step 2, think, and step 3, do.

1.2. Conduct

To work on behavior in ADHD, behavior modification techniques are used, such as: positive reinforcement, negative reinforcement, positive punishment, negative punishment, time out, cost of answer, etc. It is important that the child is aware of what is “expected of him”, what are the appropriate and inappropriate behaviors, and so on.

When it comes to working on self-esteem, it is important that the child learns to recognize his strengths, her strengths, and can acquire strategies to enhance her weaknesses. It is also important that the child does not stay with the label of "ADHD", but understands that he is much more than that, and that behaviors do not always define the person.

1.4. Socialization

To work on socialization, the child with ADHD should be instructed in social skills; that is, she learns which behaviors are the most appropriate in social interactions from a social point of view. This includes: how to say hello, how to approach people, how to intervene, what talking points to bring up, etc.

2. Other treatments: psychopedagogy and pharmacology

We cannot forget psycho-pedagogical and pharmacological treatment in cases of ADHD. For its part, psychopedagogy is aimed at improving the child's academic performance. That is, it allows you to enhance your learning school.

Pharmacology, on the other hand, includes the prescription of psychostimulants, mainly, such as methylphenidate for example. Logically, in terms of medication (which has been proven effective in many cases), it will be the parents who decide whether or not to medicate their child with ADHD.

Bibliographic references

• American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.

• Belloch, A., Sandín, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.

• De la Peña Olvera, F. (2000). Attention deficit hyperactivity disorder (ADHD). Rev Fac Med UNAM, 43 (6): 243-244.