Childhood hyperactivity

Childhood hyperactivity. : Conduct disorder in children, first described in 1902 , by Still. These are children who develop intense motor activity, who move continuously, without all this activity having a purpose. They go from one place to another, being able to start a task, but quickly abandon it to start another, which in turn, they leave unfinished again. This hyperactivity increases when they are in the presence of other people, especially those with whom they do not have frequent relationships. On the contrary, activity decreases when they are alone.

Summary

[ disguise ]

• 1 Hyperactivity at different ages
  • 1 From 4 to 6 years
  • 2 From 7 to 12 Years
  • 3 Adolescence
• 2 Indicators of hyperactivity according to age.
• 3 Causes of hyperactivity.
• 4 Evaluation
  • 1 Clinical interview:
  • 2 Observation of behavior.
  • 3 Individualized Evaluation.
• 5 Symptoms
• 6 Temperament and hyperactivity
• 7 Allergy and hyperactivity.
• 8 Education and Hyperactivity
• 9 Treatment
  • 1 Pharmacology
  • 2 Psychology
  • 3 Educational:
  • 4 Punishment:
  • 5 Token Economy:
  • 6 Contingency Contract:
• 10 See also
• 11 External links

Hyperactivity at different ages

From 4 to 6 years

According to the teachers’ assessment of the hyperactive child, he is restless, impulsive, inattentive, aggressive and disobedient. Parents describe him as impulsive, disobedient and aggressive. He is often distracted. He does not seem to listen when you talk to him, he does not know how to play alone and his relationships with his peers are characterized by fights and arguments. The play of these children is characteristic. On the one hand, they do not know how to play alone and they also tend to shy away from toys that are newer to them. They manipulate them until they get tired and leave them devastated. When they play alone they do not admit losing, they are not able to follow the rules of the game. This causes them to be rejected by their peers.

From 7 to 12 years

At this age the hyperactive child takes center stage in the class. His problem means that he does not know how to maintain discipline in class and he also has more learning difficulties than his classmates. For the teachers he is a “bad student” and a “lazy.” They think that the parents are to blame for his behavior, which makes the relationship between school and family more expensive and difficult. This in turn increases hyperactive behavior in the child. On some occasions, teachers, thinking that it is a problem of immaturity, advise parents that the child repeat a grade. This does not solve anything, since hyperactivity is not just a matter of course. At this age, learning difficulties appear in the child. The relationship with his classmates is not good, they reject him, due to the different attitudes they show towards the group ( aggressiveness , impulsiveness…). On other occasions the roles are reversed and they begin to play the role of leader of the class since their attitudes They are seen as feats and as something that entertains. At this age, due to their impulsiveness, they are also characterized by committing petty thefts. All of this generates feelings, states and sensations of insecurity, failure and dissatisfaction in the child. It is not easy to perceive low self-esteem and self-concept in children because they frequently lie to gain the approval of everyone around them (teachers, parents, classmates…). From the age of seven, if they are not helped, they can have symptoms of depression, a consequence of their failure to adapt to the demands of their environment. The disruptive behavior of the hyperactive child worsens after the age of seven, his interests change and everything becomes more complex.

Adolescence

If we start from the fact that adolescence is a difficult stage for any child, it is even more so for a hyperactive child. The relationship with parents worsens. The hyperactive child becomes more argumentative, defiant, rebellious… Academic performance decreases significantly and reactions with his teachers worsen. All this contributes to self-esteem becoming increasingly negative. Fathers of hyperactive children, at this age, face more serious problems than mothers of other children. It is all due to the fact that hyperactive children are more susceptible to certain risks such as: alcohol , or addition to another drug , sexual experiences (they are not mature enough to integrate the sexual act into their lives , leading to the act being carried out inappropriately). ) and traffic accidents (they are more likely to have traffic accidents, due to their recklessness and not anticipating the consequences of their actions.

Indicators of hyperactivity according to age.

• From 0 to 2 years. Clonic discharges during sleep, problems with the rhythm of sleep and during eating, short periods of sleep and startled awakening, resistance to usual care, high reactivity to auditory stimuli and irritability.
• From 2 to 3 years. Immaturity in expressive language, excessive motor activity, poor awareness of danger and propensity to suffer numerous accidents.
• From 4 to 5 years. Problems of social adaptation, disobedience and difficulties in following rules.
• From 6 years old. Impulsivity, attention deficit, school failure, antisocial behaviors and social adaptation problems.

Causes of hyperactivity.

Childhood hyperactivity is quite common. It is estimated that it affects approximately 3 percent of children under seven years of age and is more common in boys than in girls (it occurs in 4 boys for every girl). In 1914 , Dr. Tredgold argued that the causes are due to minimal brain dysfunction, a lethargic encephalitis in which the behavioral area is affected, hence the consequent compensatory hyperkinesia; explosiveness in voluntary activity, organic impulsivity and inability to sit still. Later, in 1937 , C. Bradley discovered the therapeutic effects of amphetamines in hyperactive children. Based on the previous theory, he administered brain-stimulating medications (such as benzedrine ), observing a notable improvement in symptoms.

Assessment

Hyperactivity is a disorder that is not easy to measure, since the behavior is not usually strange or unusual in children of the same age. The critical age is five or six years. At this age, disciplined behavior is required at school and the hyperactive child is not always able to adjust his behavior to the rules of the class, so if from this age onwards there is strange behavior, it is advisable that he be diagnosed as soon as possible. before. The diagnosis of a hyperactive child requires a rigorous assessment of the different contexts (school, home, etc.) and the various caregivers (parents, teachers, etc.) who live with him. The diagnosis of hyperactive children does not have tests or techniques that confirm the disorder in a precise and obvious way, such as when, for example, a blood test is done. The presence or absence of hyperactivity cannot be established through an intelligence test, brain mapping or an interview with parents. The instruments and successive phases followed for the diagnosis would be the following:

Clinical interview:

The interview aims to obtain information from the parents about the child’s development and behavior. To do this, it is necessary to evaluate the following aspects: pregnancy , childbirth , psychomotor development , illnesses suffered, schooling and the emotional-behavioral sphere.

Observation of behavior.

In addition to the information we obtain from parents, we need the presence of a specialist to observe the child’s behavior. This observation can be done from the natural context (home, school…) or in the consultation itself where the evaluation is being carried out. For such observation we can use the Observation Code on Mother-child Interaction. It is used with 2 and 3 year old children in a play situation and the style of communication between mother and child is analyzed: the tone and appropriateness of the mother’s directivity, the emotional tone in which they are and the degree of conflict between the two. The Code of Observation in the classroom by Abikoff and Gittelman is a good help to evaluate the child’s behavior at school.

Individualized Evaluation.

The last step of the diagnosis would be to obtain detailed information about intellectual development, cognitive styles, presence or absence of minor neurological symptoms, impulsivity, perceptual development, motor coordination, attention capacity and level of motor activity. To measure the intellectual development of the child, the “Wechsler Intelligence Scale for Children” is used (it is made up of twelve tests distributed in two groups: verbal and manipulative. Cognitive styles refer to the different ways that children with Deficits have of attention to confront learning. “Reflection” has been studied against “impulsivity”, which consists of choosing between several alternatives. The test most used to evaluate this cognitive style is the “Family Figure Matching Test”, Cains. and Cammock, 1978. “Dependency” versus “field independence” is about evaluating how the child perceives his environment, that is, whether he perceives parts as elements of the context (independence) or the context as a whole (dependence). The instrument used for this has been the “Masked Figures Test” Karp and Konstandt , 1963. The last cognitive style is that of “flexibility” versus “reflection”; it is about seeing the child’s ability to control. unimportant stimuli and omit incorrect responses. The test that is most used is the “Color Distraction Test”, Santostefano and Paley, 1964. Another important aspect for the individualized evaluation of the child in visual-motor integration. For this purpose, the “Bender Gestaltic Test” is used, which aims to measure the maturity and visual coordination of the manual search and execution of drawings presented using cards. Measuring minor neurological signs is important, since many hyperactive children present it. For this we use the Rapid Neurological Discriminative Test, by Sterling and Spalding.. It has tasks such as: Manual ability, Recognition and reproduction of figures, Rapid manual movements, recognition of shapes in the palm of the hand, Making circles with the fingers… Neurophysiological Exploration, recent in the evaluation of hyperactive children, is used brain mapping, a functional neuroimaging technique that allows us to know the degree of electrical activation of the cerebral cortex through its representation in color maps. Attention Deficit, the tests used for this are diverse, depending on the attention capacity (Reaction time in choice tasks, in sequential tasks, continuous execution test and vigilance tasks.) Finally, the Level of Attention motor activity, for this two instruments are used, the “pedometer” (counts the steps the child takes), the “actometer” (wristwatch that also measures movement) and the “stabilimeter cushion” measures the child’s movement while Who is sitting. We can also have a scale for parents and teachers. It is the so-called Conners Scale”, 1969 .

The Corners Parenting Scale contains 96 questions grouped into 8 factors:

• Behavioral alterations
• Fear
• Anxiety
• Restlessness-Impulsivity
• Immaturity- learning problems
• Psychosomatic Problems
• Obsession
• Antisocial Behaviors
• Hyperactivity

The Corners scale for teachers is much shorter and is made up of 39 questions grouped into 6 factors:

• Hyperactivity
• Behavior problems
• Emotional lability
• Anxiety-Passivity
• Antisocial Behavior
• Sleep difficulties

Each question describes a characteristic behavior of these children, which parents or teachers must evaluate, according to the intensity with which they occur (not at all = 0, a little = 1, Quite a bit = 2, A lot = 3) for teachers and parents. from 1 to 4.

Symptoms

Symptoms can be classified according to attention deficit, hyperactivity and impulsivity:

• Difficulty resisting distraction.
• Difficulty maintaining attention on a long task.
• Difficulty paying attention selectively.
• Difficulty exploring complex stimuli in an orderly manner.
• Excessive or inappropriate motor activity.
• Difficulty finishing tasks already started.
• Difficulty staying seated and/or still in a chair.
• Presence of disruptive behaviors (with a destructive nature).
• Inability to inhibit behavior: they always say what they think, they do not repress themselves.
• Inability to postpone gratifying things: They cannot stop doing the things they like in the first place and they postpone duties and obligations as much as they can. They always end doing first what they will.
• Cognitive impulsivity: haste, even at the level of thought. In games it is easy to beat them for this reason, because they do not think twice before acting, they do not foresee, and they even answer questions before they are asked.
• Consequences in the family with a hyperactive child

Parents usually define a hyperactive child as immature, rude and a hooligan. Their behaviors generate conflicts in the family, disapproval and rejection. They are irritating and frustrating to parents’ educational success, and some children tend to become socially isolated. This disorder is already detected before the age of 7 and some have more severe symptoms than others. One thing that must be taken into account is that if parents scold the hyperactive child excessively, they may be promoting a self-esteem deficit on his part (especially if they criticize him for everything he does) and feed the disorder, since the little one You will end up not making an effort to behave well, because you will see that they always end up scolding you no matter what you do.

Temperament and hyperactivity

In recent years, as new tools and techniques have been developed to study the brain, scientists have been able to evaluate more theories about what causes ADHD. Recent research allows us to maintain that the problem of hyperactive children is a temperament problem. There are temperamental differences between a hyperactive newborn and other children. It is possible that the origin of these temperamental differences is conditioned by the biochemical levels of the nervous system. In our brain, a neuron releases a small amount of chemical substance (neurotransmitter) that another neuron picks up, at the same time it becomes excited and sends the message to another neuron. When a neurotransmitter is scarce or given in excess, the neuron is not excited or is excited too much, resulting in an imbalance between the neurotransmitters. This imbalance would be the agent responsible for the difficulties that the child has in focusing his attention and maintaining it for a certain time, as well as the lack of self-control and adjustment of his behavior to the demands of the environment. It would also be responsible for sudden changes in mood, an important characteristic of a hyperactive child.

Allergy and hyperactivity.

Hyperactivity has also been explained as an allergic reaction to certain types of foods such as sugar and condiments in general. However, this theory has not been confirmed since it is known that a diet without condiments or sugar does not correct hyperactivity.

Education and Hyperactivity

It is known that a stressful and disorganized environment can accentuate hyperactivity in children, but hyperactivity does not produce it. A child with an organized and calm family environment is still hyperactive. This leads us to not know with certainty the real causes of hyperactivity.

Treatment

Currently, we can have three modalities to help the child: pharmacological, psychological and educational.

Pharmacology

According to García Pérez and García Campuzano, Alborcohs group, 1999, the treatment followed for these children is, in its best case, the use of medications. The main drug used is METHYLPHENIDATE . This chemical substance is marketed under different names in different countries. Its immediate effects are an increase in the child’s attention and concentration capacity and a reduction in the child’s hyperactivity and mobility, because through this external agent the brain is stimulated to reach the activation levels necessary for proper maintenance. of attention (which results in an improvement of many other symptoms). Side effects include a lack of appetite and sleep in some cases. However, these effects last a short time: it is eliminated through the urine in a few hours and it is necessary to take another pill.

According to the latest reviews (Vallejo, 2012) ^[1] , psychostimulant drugs for ADHD have shown effectiveness for the following symptoms: sustained attention, impulsive behavior, academic performance, reduces fatigue and improves social relationships.

On the other hand, it has not been shown to be effective for the acquisition of academic skills nor does it improve IQ. ^[2]

Generally, one pill is taken when you wake up and another at midday so that the effect is maximum when the child goes to school, but it depends on the medical prescription that is made based on the child’s age. the severity of their problems… The medications used with these children are good support as long as they are combined with teaching processes so that they learn to regulate their behavior on their own. Normally it is appropriate to medicate the child after 5 years of age. Before this age, medication cannot be administered because it is difficult to diagnose attention deficit in the child, since he or she is developing his or her attentional capacity and is in a period of exploration and manipulation, which makes it difficult to discriminate between what is his or her normal behavior and the one that is not. These drugs do not create dependence in the child, although so that they do not get used to the substance and stop responding positively to it, it is advisable to temporarily withdraw from it. But it can create psychological dependence in parents since they fear withdrawal for fear that the situation could get out of control without the drug. Depending on the child’s progress, it may be recommended that it be withdrawn permanently or that it be resumed at specific periods. Generally, from the age of 12 it is not necessary if the child has received other types of psycho-pedagogical help . It is not recommended to use tranquilizers because it would further depress their activation level, therefore increasing their motor behavior to stimulate themselves and thus increase their level.

Psychology

Life can be difficult for children with attention deficit disorder. They are the ones who often get into trouble at school, can’t finish a game, and lose friendships. They may spend agonizing hours each night struggling to concentrate on homework and then forget to take it to school. It is not easy to deal with these frustrations day after day. Some children release their frustration by acting out, starting fights, or destroying property. Some take their frustration out on bodily ailments, such as the child who has a stomach ache every day before school. Others keep their needs and fears inside so no one can see how bad they feel. It’s also hard to have a sister or brother or classmate who gets angry, takes your toys, and loses your things. Children who live or share a classroom with a child with these characteristics also become frustrated. They may also feel abandoned as their parents or teachers try to cope with the hyperactive child as best they can. They may resent the brother or sister who never finishes their homework or feel bullied by a classmate. They want to love their brother and get along with their classmate, but sometimes it’s so hard! It is especially difficult to be the parent of a child who is full of uncontrolled activities, makes messes, throws tantrums, and does not listen or follow instructions. Parents often feel helpless and without resources. The usual methods of discipline, such as reasoning and challenges, do not work with this child because the child does not actually choose to act in these ways. It’s just that her self-control comes and goes. Out of pure frustration, parents react by beating, ridiculing, and yelling at their child even though they know it is inappropriate. His response leaves everyone more upset than before. Then they blame themselves for not being better parents. Once the child is diagnosed and treated, some of the emotional turmoil within the family begins to fade. Given all this, parents have to create a stable family environment (that is, whether or not to comply with certain rules proposed by the parents have the same consequences), consistent (not changing the rules from one day to the next), explicit (the rules are known and understood by both parties) and predictable (the rules are defined before they are “broken” or not. We also have other types of psychological interventions that facilitate the treatment of these children, such as: Cognitive-behavioral therapy It helps people work through more immediate issues. Instead of helping people understand their feelings and actions, therapy directly supports them in changing their behavior. Support can be practical assistance.such as helping them learn to think about each task and organize their work or encouraging new behaviors by giving praise or rewards every time the person acts in the desired way. A cognitive-behavioral therapist can use such techniques to help a belligerent child (learn to control his tendency to fight) or an impulsive teenager to think before speaking. Social skills training can also help children learn new behaviors. In social skills training, the therapist talks about and models appropriate behaviors such as taking turns, sharing toys, asking for help, or responding to teasing, and then gives the child an opportunity to practice. For example, a child can learn to “read” other people’s facial expressions and tone of voice so they can respond more appropriately. Social skills training helps you learn to participate in group activities, make appropriate comments, and ask for help. A child can learn to see how her behavior affects others and develop new ways to respond when she is angry or pushed. Support groups connect people with common concerns. Many adults and parents of affected children may find it helpful to join a local or national support group for this disorder. Support group members share frustrations and successes, recommendations from qualified specialists, information about what works, and hopes for themselves and their children. Sharing experiences with others who have similar problems helps people know that they are not alone. Parenting skills training, offered by therapists or in special classes, gives parents the tools and techniques to manage their child’s behavior. One of these techniques is to separate the child from the rest for a short time when the child becomes unruly or out of control. During times when he is separated from the rest of the children, the child is removed from the disturbing situation and sits alone and still for a while until he calms down. Parents can also be taught to give the child “quality time” each day during which they share a pleasurable or relaxing activity. During this time together, the parent looks for opportunities to observe and point out what the child does well and to praise her strengths and abilities.The therapist talks about and models appropriate behaviors such as taking turns, sharing toys, asking for help, or responding to teasing, and then gives the child an opportunity to practice. For example, a child can learn to “read” other people’s facial expressions and tone of voice so they can respond more appropriately. Social skills training helps you learn to participate in group activities, make appropriate comments, and ask for help. A child can learn to see how her behavior affects others and develop new ways to respond when she is angry or pushed. Support groups connect people with common concerns. Many adults and parents of affected children may find it helpful to join a local or national support group for this disorder. Support group members share frustrations and successes, recommendations from qualified specialists, information about what works, and hopes for themselves and their children. Sharing experiences with others who have similar problems helps people know that they are not alone. Parenting skills training, offered by therapists or in special classes, gives parents the tools and techniques to manage their child’s behavior. One of these techniques is to separate the child from the rest for a short time when the child becomes unruly or out of control. During times when he is separated from the rest of the children, the child is removed from the disturbing situation and sits alone and still for a while until he calms down. Parents can also be taught to give the child “quality time” each day during which they share a pleasurable or relaxing activity. During this time together, the parent looks for opportunities to observe and point out what the child does well and to praise her strengths and abilities.The therapist talks about and models appropriate behaviors such as taking turns, sharing toys, asking for help, or responding to teasing, and then gives the child an opportunity to practice. For example, a child can learn to “read” other people’s facial expressions and tone of voice so they can respond more appropriately. Social skills training helps you learn to participate in group activities, make appropriate comments, and ask for help. A child can learn to see how her behavior affects others and develop new ways to respond when she is angry or pushed. Support groups connect people with common concerns. Many adults and parents of affected children may find it helpful to join a local or national support group for this disorder. Support group members share frustrations and successes, recommendations from qualified specialists, information about what works, and hopes for themselves and their children. Sharing experiences with others who have similar problems helps people know that they are not alone. Parenting skills training, offered by therapists or in special classes, gives parents the tools and techniques to manage their child’s behavior. One of these techniques is to separate the child from the rest for a short time when the child becomes unruly or out of control. During times when he is separated from the rest of the children, the child is removed from the disturbing situation and sits alone and still for a while until he calms down. Parents can also be taught to give the child “quality time” each day during which they share a pleasurable or relaxing activity. During this time together, the parent looks for opportunities to observe and point out what the child does well and to praise her strengths and abilities.Sharing experiences with others who have similar problems helps people know that they are not alone. Parenting skills training, offered by therapists or in special classes, gives parents the tools and techniques to manage their child’s behavior. One of these techniques is to separate the child from the rest for a short time when the child becomes unruly or out of control. During times when he is separated from the rest of the children, the child is removed from the disturbing situation and sits alone and still for a while until he calms down. Parents can also be taught to give the child “quality time” each day during which they share a pleasurable or relaxing activity. During this time together, the parent looks for opportunities to observe and point out what the child does well and to praise her strengths and abilities.Sharing experiences with others who have similar problems helps people know that they are not alone. Parenting skills training, offered by therapists or in special classes, gives parents the tools and techniques to manage their child’s behavior. One of these techniques is to separate the child from the rest for a short time when the child becomes unruly or out of control. During times when he is separated from the rest of the children, the child is removed from the disturbing situation and sits alone and still for a while until he calms down. Parents can also be taught to give the child “quality time” each day during which they share a pleasurable or relaxing activity. During this time together, the parent looks for opportunities to observe and point out what the child does well and to praise her strengths and abilities.

Educational:

An effective way to modify a child’s behavior is through educational help governed by rewards, punishments, token economy and contingency contracts. PRIZES For a child, a prize is something pleasant that he wants to achieve, in such a way that he will do whatever it takes to get it. The activities that the child likes the most and that he usually does, such as playing with his toys, watching television or going to the movies with your cousins ​​can be understood and used as a reward. Ultimately it must be something that the child wants and that he wants to achieve. So the child will receive a reward every time he completes the desired task.

Punishment:

Punishments involve depriving a child of something he likes or forcing him to do something unpleasant. It can be effective at times, but it does not always eliminate inappropriate behavior in the hyperactive child. Punishment can be useful to control certain behaviors temporarily, but it is ineffective in the long term. If the behavior is undesirable, the most effective punishment is to ignore it. As long as the behavior is not dangerous. It is most advisable that the time elapsed between the behavior and the reward or punishment be short to ensure its effectiveness.

Token Economy:

This technique consists of giving negative or positive points depending on whether or not a certain behavior is followed. Each negative point eliminates the value of the positive point. The total number of points is exchanged for different prizes. The list with the “target” behaviors must be visible to the child, as well as the points achieved. It is recommended to use with children from 3 to 12 years old.

Contingency Contract:

This technique is recommended for use with children of 12 or 13 years old. It consists of making a written contract with the child about her behavior. Each one has to record in specific terms the behavior that he wants in the other. This is how a dialogue and agreement is established between parents and children. Therefore the child plays an important role in controlling her behavior.