Attention Deficit and Hyperactivity Disorder is a significant problem that affects the academic and social relationships of many children in preschool and school age. In attention deficit and hyperactivity disorder, both components can coexist, or one can be more dominant than the other: In some cases, attention deficit is more pronounced; in some cases, hyperactivity is relatively more dominant. The severity of symptoms varies from child to child, and not all symptoms may be observed in every individual. The most important criterion for diagnosis is that the observed symptoms disrupt the child’s level of functionality.
Attention Deficit
Attention deficit becomes especially evident with the start of school life. In the preschool period, children can get bored and tired of everything quickly, and after playing with their toys for a short time, they can get bored and start to tear them apart. They cannot arrange the puzzle toys given to them, which are appropriate for their age, in the original way. They cannot watch a TV movie or cartoon for a long time. With the start of school, the lack of interest in learning is also noticeable. They do not like doing homework, but they do it only when their parents and teachers force them to. They cannot sit at the head of the table, and even if they do, they often get up from the table by making various excuses (such as going to the toilet, drinking water). They want their adults to be with them while they study.
They have difficulty finishing a task they have started, and they immediately move on to another task without completing one. When you talk to them, they give the impression that they are not listening to you. They can only do something that is asked of them after being told several times.
It is observed that they do not follow the lesson in class. Their attention is easily distracted by environmental stimuli. They are too interested in extracurricular activities, they turn the pen in their hand, they try to write or draw something in their notebook or on the desk, and they are busy with other equipment and cannot follow the lesson. Due to their boredom in class, they may exhibit behaviors that will disturb the attention and peace of the class (such as talking in class, shaking the desk, badmouthing their friends, standing up in class and distributing water and food, and making strange noises).
Their reading and writing skills may be worse than their friends, their notebook organization and writing may be bad. They may make frequent mistakes while reading and make up different words at the end of sentences. They often lose things in class and on the street. They may forget things they have learned quickly. They cannot develop a study routine and system that suits them. They do not like reading and writing. This is valid not only for textbooks but also for other storybooks.
They make careless mistakes in exams. Due to their impatience, they read the questions quickly, which leads to them reading half wrong. Thus, they may answer even the questions they know well incorrectly. They easily turn to confusing and distracting options in test exams. Especially in primary school years, they try to give the exam paper before everyone else. In the end, they get lower grades than those they know.
Attention deficit may not be noticeable in preschool. However, some of these children also show signs of getting bored easily in extracurricular activities. Children with good intelligence and no special learning difficulties may not have problems in lessons until the 3rd and 4th grades of primary school. They may not have bad grades even if they do not study and do not follow the lesson well. As the subjects become more difficult, they start to fail in lessons. They do not want to take responsibility for the daily chores they have to do at home. They are usually messy and do not like rules.
Hyperactivity (Excessive Movement)
In hyperactivity, the child’s mobility is excessive and there is a significant difference compared to their peers. These children are usually constantly moving as if they are controlled by a motor. They have endless energy. They exhibit behaviors that deserve the expression “climbing the wall”, they walk on top of couches, run around the house and do not understand warnings. They cannot play or sit calmly.
Even if they sit for a short time, they constantly shake and move their hands and feet. They talk a lot, often interrupt when two people are talking, and cannot wait their turn. They cannot sit at the head of the table, and therefore cannot study their lessons properly.
Treatment of Attention Deficit and Hyperactivity in Children
Many children begin to receive a diagnosis during school. Expectations from the child begin to increase during the school period due to the nature of the process: a child who cannot fully meet expectations such as being in class on time, learning to read and write, maintaining attention on the relevant task, fulfilling the responsibilities and homework expected of him/her, maintaining peer relationships, being able to postpone impulses (not talking in class, waiting for recess to play, etc.) or who has difficulty in this regard will have both academic and social skills damaged. Following these applications, which are usually made at school under the guidance of the teacher or through family observation, there are several suggested methods in the intervention phase.
In Attention Deficit and Hyperactivity Disorder, psychotherapy or medical treatment can be continued alone. In some cases, both treatment methods are used together. The appropriate medication is prescribed by the psychiatrist, taking into account the complaint history, the level of difficulty experienced by the child, his/her development and weight. It is very important to follow up on medication during the process, to share the observed changes with the doctor and to continue the treatment appropriately.
Therapy Approaches Used for Attention Deficit and Hyperactivity in Children
In addition to medical support, psychotherapy is another effective method used in the treatment of Attention Deficit and Hyperactivity Disorder. The most important step in a successful therapy process is a good assessment. At this stage, various assessment tools (such as tests, scales) are used and information is obtained from the school and the teacher.
Cognitive Behavioral Therapy is among the most commonly used therapy types. Necessary interventions are made so that the child can inhibit their behavior, act in accordance with the rules in the desired direction, and their academic success can be in line with their peers. The most important goal is to increase the child’s awareness, provide behavioral control, and strengthen anger management and self-control. In some children, symptoms that arise as a result of mental skills not being compatible with their age group may accompany the process. In such cases, the therapy process progresses in this direction. While progress is made in some children in 6-8 sessions, this period may be longer in others.
The family is the most important part of the process. Psychoeducation given to the family about parenting attitudes and how to behave is indispensable for the healthy progress of the therapy process. The cooperation to be established with the teacher/school aims to increase the gains in the therapy process.
