Update: October 2018
It often happens that parents complain that their
the child is restless, does not obey, does not sit still for a second
it is very difficult to sit down at least a little and be engaged in business.
Could this just be a feature of a child’s character,
bad manners or a pathological condition that requires
Often these children have psychologists as a result of diagnosis.
determine the presence of attention deficit hyperactivity disorder
(WITHДВГ). Below we describe the causes of hyperactivity, what is manifested
this syndrome, what are the criteria for the diagnosis of this
pathologies, how to treat hyperactivity and give a number of tips for
parents and educators.
WITHДВГ – стойкое поведенческое расстройство с дебютом в детском
age, manifested by impulsivity, difficult handling,
decreased concentration and a number of other symptoms.
A bit of history
Back in the 19th century, a German neuropsychiatrist G. Hoffman first described
too mobile and active child, nicknamed him “Fidget
Phil. WITH 60-х годов XX века подобное состояние стали считать
pathological and called minimal disruption of activity
brain. In the 80s this disease got its place in
международной классификации болезней и стало называться WITHДВГ.
Причины развития WITHДВГ
Adverse factors during pregnancy:
- Fetal hypoxia
- Haveгроза прерывания беременности
- WITHтрессы во время беременности
- Malnutrition during pregnancy
Adverse factors in childbirth:
- Prolonged labor
- WITHтремительные роды
- WITHтимуляция родовой деятельности
- Prematurity (giving birth to 38 weeks of pregnancy)
- The presence of a child’s neurological diseases
- Conflict situations in the family, tensions between
- Excessive rigor on the child
- Heavy metal poisoning such as lead
- Some role also plays the wrong nutrition of the child.
WITHуществует мнение, что травмы шейного отдела позвоночника
являются причиной WITHДВГ, это заблуждение.
If a child has a combination of several developmental factors.
diseases, the risk of developing hyperactivity syndrome in such
Depending on the dominant features
гиперактивности выделяют три типа заболевания:
- WITHиндром гиперактивности без дефицита внимания
- WITHиндром дефицита внимания без гиперактивности
- WITHидром гиперактивности, сочетающийся с дефицитом внимания –
This type of disease is most common.
How hyperactivity manifests
The prevalence of the disease is 4-5% among children. The boys
страдают WITHДВГ примерно в 6 раз чаще девочек.
Consider what and at what age can occur
hyperactivity in children. WITHимптомы впервые могут появиться еще до
of the year. At this age, such children may be different.
irritability, may react too violently to various
manipulation, bright light, sound. Have них часто имеются нарушения сна
– they hardly fall asleep, often wake up, the period of wakefulness
is increased. In physical development, they may somewhat lag behind
peers (for 1-1.5 months). Speech development can also be
Similar symptoms can occur in many other diseases,
therefore, if available, it is not worthwhile to draw conclusions about
the reasons for their occurrence. WITHледует обратиться к врачу для своевременной
It should also not be attributed to pathology, if one of the symptoms
appear only occasionally. It is quite normal if the child is outta
mode, and he can not sleep at his usual time or just
carried away by the game and it turns out to fall asleep. Reasons for whims in a child
may be a lot, ranging from teething, ending
abnormalities in the diet of the child.
Haveже примерно в 2-3 года появляются отчетливые симптомы, но
most parents don’t notice them or consider them
manifestations of the norm. Naturally, this is not a reason for them
to go to the doctor, but in vain, because the sooner you identify the problem, the
easier to deal with it. At this age may already appear
restlessness, we can note an excessive amount of movement in
child, these movements are chaotic. WITHпециалист может определить
delayed speech development, and then the presence of “motor
Often it is at the age of 3 that parents can pay attention
on the condition of the child. It is in 3 years that the next one begins.
age crisis in a child, when he realizes his I, explores
the boundaries of what is permitted, in connection with which it becomes very stubborn,
moody, this is a normal period of mental development of the child, but
при этом у детей с WITHДВГ все признаки обостряются.
Also during this period, many children are given to the kindergarten, where
other people observe and they often tell their parents that their
the child is restless, inconsiderate, does not obey the educators, his
impossible to put to bed. This may be the first bell for
parents, so they turned to a specialist. At this age is
intensive development of memory and attention in children with ADHD it goes
As a child with ADHD, the nervous system does not cope with
increasing demands, physical, mental stress, then
ухудшение может наблюдаться у детей дошкольного возраста (в
age 5-5.5 years). At this time in kindergarten in children begin
preparatory activities that require concentration,
ability to sit in one place for some time and listen
The mental development of these children is lagging, it can manifest
in low self-esteem, lack of balance, quick temper. Such
children may complain of headaches, they may have nervous
tiki, they have phobias (fears). Some are diagnosed
In children of school age, despite the preservation of intelligence,
poor academic performance. They are inattentive in the classroom, they find it difficult to do something.
get carried away. They hardly find common language with peers, such
children tend to conflict. Due to intolerance they rarely have
good relationships with classmates and teachers. Such дети не
able to assess the consequences of their actions, they are very
impulsive, often – aggressive, that in the absence of diagnosis and
treatment subsequently can lead to asocial behavior.
The sooner you start treating hyperactivity, the smaller
The consequences can be avoided.
Diagnostic criteria for ADHD
It is advisable to use them not earlier than 6 years. To establish
A diagnosis of ADHD at the age of 6-17 years old is enough 6 coincidences, for persons
over 17 years old – 5 matches. These criteria can and should
be present in a child with ADHD and an earlier age.
Criteria related to manifestations of hyperactivity:
- Restless movements with arms and legs.
- Sitting on a chair, constantly spinning, spinning.
- In situations where you need to stay in one place – rises,
- Having aimless movements – jumping, running, spinning then
when it is not appropriate and not necessary.
- Inability to sit quietly and quietly
- Constantly in motion.
- Too talkative.
- Answers the question without hearing it out to the end.
- Can’t wait for his turn or this is given to him with great
- Constantly interferes with someone else’s game, conversation.
- During sleep constantly turns over, throws off the blanket,
crumples the sheet.
Criteria relating to manifestations of attention deficit:
- The inability to keep attention on small details allows
mistakes in school due to negligence and inattention.
- Cannot concentrate attention while playing or
fulfilling the task.
- When talking to a child, it seems that he doesn’t
- Cannot complete the task, lessons, household chores,
This behavior is not related to the child’s protests.
- The child is difficult to organize independent activities.
- Consciously avoids any assignments, work where required.
- The child often loses his stuff.
- Easily distracted by external stimuli.
- Differs in forgetfulness in various daily
- There is a tendency to destructive behavior, often breaks
while denying any involvement.
If a child has an ADHD suspected, parents should contact
doctor neurologist for consultation and examination. Often under the mask
ADHD can hide another serious disease. Differentiation
The diagnosis is carried out only by a doctor.
Коррекция гиперактивности должна проводиться с помощью
several techniques, among which there are drug and
non-drug. Mostly used non-drug
methods of treatment. Medicines are used in case
all other methods were ineffective. Main directions
Proper motor activity
Children with ADHD should not play sports with
competitive elements, as they can enhance the manifestations
diseases. Also not recommended games with indicative
performances and with static loads. Useful will be
light aerobic workouts such as swimming, skiing, riding
Classes with a psychologist
There are different techniques to reduce anxiety,
increase the child’s communication skills. The psychologist can model
different situations of success, to help pick up the scope of activities for
child, in which he will feel confident. Are given
exercises for the development of speech, memory, attention. When serious
speech disorders are recommended classes with a speech therapist. Also helpful
happens to change the environment for the child, with positive changes in
treatment, in the new environment to the child will form a good
The problem of the child leaves its mark on the parents,
especially on the mother of the child who is most often in contact with him. Have
these women are 5 times more likely to become depressed, they are irritable,
impulsive, intolerant. Family Psychotherapy поможет ребенку
get rid of ADHD faster.
Relaxation autotraining have a beneficial effect on
such children, as they normalize the activity of the central and
peripheral nervous system, stimulate the reserve activity
Not only the child should change, but also the adults around
him. Children with ADHD have a very high threshold for negative emotions,
therefore, they are immune to prohibitions and punishments, but at the same time
it is very easy to respond to positive emotions, their much
it is more efficient to praise for good deeds than to blame for bad ones. WITH
such a child should minimize prohibitions and denial. Of course not
need to go beyond reasonable. Should be prohibited only
what could be dangerous or harmful to a child. Relationship with such
the child must be built on mutual understanding and trust. Important and
microclimate in the family. Parents should also minimize
quarrels among themselves, especially not to quarrel with a child! Important
spend leisure time with the whole family. The child needs help to organize
mode and place to practice.
В WITHША активно применяются психостимуляторы для коррекции WITHДВГ.
They are very effective, but they have many side effects, which is why
It is decided that such therapy is carried out at
inefficiency of other methods.
В России психостимуляторы запрещены к использованию при WITHДВГ.
Instead, they try to use nootropic drugs to improve
metabolic processes of the brain, but the evidence base to
использованию ноотропов при WITHДВГ нет.
Recommendations for parents
- Use a positive parenting model – more than enough
baby when he deserves it. Be more attentive
encourage even minor gains, use the word “yes” more often,
than “no” and “no”.
- Think up his daily housework, do not do them
for him (make a bed, wash the dishes after dinner or take out
- Get a notebook where you will describe each child with the child.
the evening of his successes for the day.
- Do not overstate and do not underestimate the requirements for the child, put in front
Him tasks, which correspond to his abilities, for fulfilling
praise these tasks.
- Define a clear framework for it – what can and can not
do. Ребенок с WITHДВГ должен учиться справляться с обычными для
his age difficulties. It should not form him “greenhouse”
- Ask the child about something, do not order him.
- If your child behaves defiantly, it means that he wants
привлечь ваше внимание, но не знает как иначе это сdo.
Spend more time with him.
- Houses should be a clear daily routine. WITHоблюдать его должен не
only a child, but also adults!
- Do not go with the child in too crowded places in shopping
malls, to market. It can perezbobit.
- Protect your child from overwork, as this causes
excessive motor activity and reduces the possibility
- Do not let sit for a long time at the TV, enter the view mode
cartoons, how long and at what time, clearly follow it.
- Any restrictions and rules that you enter must be
feasible before you enter them think about whether you can
execute them. For example, do not tell your child that he will
watch TV once a week, you still can not always
follow this rule and surrender yourself first. In that case, everything
what you require, all your rules will be discounted.
- Adjust the sleep mode. The baby must go to bed and wake up
At the same time. He should get enough sleep. Otherwise, the child is reduced
self-control, and in the evening you can see it uncontrollable.
- Haveчите ребенка себя контролировать, думать о последствиях своих
- Be calm, no matter how difficult it is. You are an example for
- It is important for children to be aware of their importance, to be successful in
something Help him choose some area of activity in
which he will be able to reveal his abilities and will
Recommendations for teachers
- Reward the child even for small successes, oral praise
also means a lot.
- During the lesson, arrange a couple of times a minute of active rest,
stand up and do a little exercise.
- Class schedule should be permanent.
- The classroom should not be distracting objects, paintings, crafts,
- For hyperactive children need an individual approach, it is not necessary
in general, children are treated as a mass, they are all different, to each
нужен разный подход, а детям с WITHДВГ это необходимо еще больше.
- Such дети должны находиться в центре класса, напротив доски,
in the first and second rows, they should always be visible to the teacher and
be able to quickly get his attention.
- Involve the child in action during the lesson.
– Ask to wash the board, collect notebooks or distribute them.
- Avoid monotony and monotony in the classroom. Enter
creative element, motivate children, make sure the lesson is
interesting, and was not just a mandatory dozens
minutes It is useful for all children, so much better assimilated.
the material, and the children will want to see you again.
- Break larger tasks into smaller ones, control
performing each of the parts.
- Do not overstate or underestimate the requirements for the child.
- WITHоздавайте ребенку «ситуацию успеха», такую, в которой он
will be able to express yourself.
- Help your child adapt to the team, teach him
social rules and regulations help him make contact with
Автор: Ревус Олеся Григорьевна врач-невролог