Hyperdynamic syndrome general motor restlessness. Clinical picture of hyperdynamic syndrome and principles of its treatment. Psychological characteristics of children with ADHD

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Introduction

Chapter I. Theoretical aspects of studying the manifestations of hyperdynamic syndrome in children under school age

1.3 Psychological features children preschool age with hyperdynamic syndrome

Chapter I Conclusions

Chapter II. Formation of attention of preschool children with hyperdynamic syndrome

2.1 Analysis of various methodological approaches to the formation of attention of preschool children with hyperdynamic syndrome

2.2 Modification of methods and techniques of corrective work on the formation of the properties of attention of preschool children with hyperactivity

Chapter II Conclusions

Conclusion

Bibliography

Introduction

In recent years, more and more attention has been paid to the problem of children with hyperdynamic syndrome in many countries. This is evidenced by the growing number of publications on this topic. The reason for this was the catastrophic increase in the number hyperactive children. AT recent times due to its wide prevalence, hyperdynamic syndrome is the object of research by specialists in the field of medicine, psychology and pedagogy.

The literature on this syndrome is extensive. It discusses both the methodology of the "norm" (B.S. Bratus, V.V. Luchkov, V.G. Rokityansky), and specific forms of deviation from it (3. Trzhesoglava, Madne) and the origin of deviant forms of behavior (3. Trzhesoglava ).

It is necessary to develop and improve diagnostic methods for identifying this category of children; study basic information about the manifestations, causes, signs of this disorder; to effectively practice and implement psycho-correctional work in the processes of raising and educating growing children with the appropriate diagnosis and, most importantly, to actively educate parents and teachers in helping the child to overcome the problems of disturbed behavior.

To date, there has been a contradiction between the importance of psychodiagnostic and psychocorrectional work with children suffering from hyperdynamic syndrome, and insufficient theoretical and practical development of this problem in practical work teacher-psychologist.

In any case, no matter how the problem is called, it is very acute and needs to be addressed. The number of such children is growing. Parents give up, kindergarten teachers and teachers in schools sound the alarm and lose their temper. The very environment in which children grow up and are brought up today creates exceptionally favorable conditions for the increase in their various neuroses and mental deviations. This determines the relevance of the chosen topic.

The purpose of the study: to study and analyze the methods and techniques for correcting the attention of preschool children with hyperdynamic syndrome.

Object of study: the attention of preschool children with hyperdynamic syndrome.

Subject of research: formation of attention of preschool children with hyperdynamic syndrome.

Research hypothesis: the formation of attention in preschool children with hyperactivity will be successful if:

Timely detection of shortcomings of attention;

Selection of didactic games and exercises;

Systematicity and direction of correctional and pedagogical influence.

To substantiate the hypothesis and achieve the goal of the study, the following tasks are defined:

1. To study and summarize the special literature on the research problem.

2. To reveal the essence of the concept of hyperdynamic syndrome.

3. Determine the psychological characteristics of children with hyperdynamic syndrome.

4. Determine effective methods and techniques for the formation of the attention of preschool children with hyperdynamic syndrome.

5. To develop a system of corrective work to overcome the attention disorders of preschool children with hyperdynamic syndrome.

Research methods: analysis of scientific and methodical literature.

Theoretical and methodological basis of the study: studies of teachers and psychologists, such as Ya.A. Pavlova, and I.V. Shevtsova, L.V. Ageeva, G.D. Cherepanova, E.A. Vasilyeva, M.V. Lutkina, B.A. Arkhipov, I.P. Bryazgunov, V.D. Eremeeva, N.N. Zavadenkov, A.R. Luria, Yu.V. Mikadze, T.P. Khrizman, L.S. Tsvetkova, D.A. Farber.

The practical significance of the study: the results of the study and the recommendations developed for parents and educators can be used in the educational process of pedagogical universities in the preparation of psychologists in the form of lectures, laboratory and practical classes, in individual correctional work, in writing term papers and final qualifying works, for practical application in the work of psychologists in preschool institutions, rehabilitation centers, and teachers elementary school for psychodiagnosis and correction of hyperdynamic syndrome in children.

The structure of the course work: introduction, two chapters, conclusion, bibliography and applications.

hyperdynamic syndrome preschooler attention

Chapter 1. Theoretical aspects of studying the manifestations of hyperdynamic syndrome in preschool children.

1.1 Characterization of the concept of hyperdynamic syndrome in the scientific literature

In this paragraph, we reveal theoretical approaches to the study of the problem of hyperdynamic syndrome in preschool children.

The issues of studying hyperactivity in children have worried doctors and educators since the middle of the 19th century. The first mention of hyperactive children appeared in the special literature about 150 years ago. In 1845, the German physician Heinrich Hoffmann poetically described an extremely active child, calling him "Fidget Philip". The problem became more and more obvious and by the beginning of the 20th century caused serious concern among specialists - neuropathologists, psychiatrists.

In 1902, a lecture by the English physician G. F. Still appeared in the Lancer magazine, which linked hyperactivity with a biological basis, and not with poor education, as was tacitly assumed at that time. At the same time, he believed that such children show a decrease in “volitional inhibition” due to insufficient “moral control”. He suggested that this behavior was the result of hereditary pathology or birth trauma. In addition, Still was the first to note the predominance of this disease among boys, its frequent combination of antisocial and criminal behavior, with a tendency to depression and alcoholism.

In 1902, a rather large article was devoted to her in the Lancet magazine. Information about a large number of children whose behavior goes beyond the usual norms began to appear after the epidemic of Economo lethargic encephalitis. This is probably what led to a closer study of the connection: the behavior of the child in the environment and the functions of his brain. Since then, many attempts have been made to explain the cause, and various methods have been proposed for treating children who have observed impulsiveness and motor disinhibition, lack of attention, excitability, and uncontrollable behavior.

So, in 1938, after long-term observations, Dr. Levin came to the unexpected conclusion that the cause of severe forms of motor restlessness is an organic brain lesion, and the basis of mild forms is the incorrect behavior of parents, their insensitivity and violation of mutual understanding with children. By the mid-1950s, the term “hyperdynamic syndrome” appeared, and doctors began to say with increasing confidence that the main cause of the disease was the consequences of early organic brain lesions.

In the USSR, the term “mental retardation” was used. Since 1975, publications have appeared using the terms "partial brain dysfunction", "mild brain dysfunction" and "hyperactive child", "developmental disorder", "improper maturation", "motor disinhibition syndrome", and later - "hyperdynamic syndrome". Most psychologists have used the term "perceptual movement disorder". In the Anglo-American literature in the 1970s, the definition of "minimal brain dysfunction" is already clear. It is applied to children with learning or behavioral problems, attention disorders, who have a normal level of intelligence and mild neurological disorders that are not detected by standard neurological examination, or with a sign of immaturity and delayed maturation of certain mental functions. To clarify the boundaries of this pathology in the United States, a special commission was created that proposed the following definition of minimal brain dysfunction: this term refers to children with an average level of intelligence, with learning or behavioral disorders that are combined with pathology of the central nervous system.

Despite the efforts of the commission, there was still no consensus on concepts.

After some time, children with such disorders began to be divided into two diagnostic categories:

1) children with impaired activity and attention;

2) children with specific learning disabilities.

The latter include dysgraphia(isolated spelling disorder), dyslexia(isolated reading disorder), dyscalculia(counting disorder), as well as a mixed disorder of school skills.

In 1966 S.D. Clements gave the following definition of this disease in children: “A disease with an average or close to average intellectual level, with mild to severe behavioral impairment, combined with minimal abnormalities in the central nervous system, which can be characterized by various combinations of speech, memory, attention control, and motor functions. In his opinion, individual differences in children may be the result of genetic abnormalities, biochemical disorders, strokes in the perinatal period, diseases or injuries during periods of critical development of the central nervous system, or other organic causes of unknown origin.

In 1968, another term appeared: "hyperdynamic syndrome of childhood." The term was adopted in the International Classification of Diseases, however, it was soon replaced by others: “attention impairment syndrome”, “impaired activity and attention” and, finally, “attention impairment syndrome with hyperactivity (ADHD), or "Attention Deficit Hyperactivity Disorder"(ADHD)." The latter, as the most fully covering the problem, is used by domestic medicine at the present time. Although there are and may be found in some authors such definitions as "minimal brain dysfunction" (MMD).

In any case, no matter how we call the problem, it is very acute and needs to be addressed. The number of such children is growing. Parents give up, kindergarten teachers and teachers in schools sound the alarm and lose their temper. The very environment in which children grow up and are brought up today creates exceptionally favorable conditions for the increase in their various neuroses and mental deviations.

There are some differences in the interpretation of the hyperactivity syndrome in the activities of people with different professional orientations: pediatricians, neuropathologists, psychologists and teachers. Psychologists, fixing the main attention on violations of spatial orientation and motor skills, use the term "children's dyspraxia" or "apraxia (dyspraxia) of development"

Unfortunately, there are still many unexplored and inexplicable facts regarding the nature and manifestations of hyperactivity. Nevertheless, all specialists working with children of this category have common goals and objectives: to identify this syndrome as early as possible, to observe the child for many years, to adapt it to modern society and give him a good suitable education. This is also the goal of parents who turn to professionals for help.

Attention deficit / hyperactivity disorder is a dysfunction of the central nervous system (mainly the reticular formation of the brain), manifested by difficulties in concentrating and maintaining attention, learning and memory disorders, as well as difficulties in processing exogenous and endogenous information and stimuli.

Syndrome (from the Greek syndrome - accumulation, confluence). The syndrome is defined as a combined, complex disorder of mental functions that occurs when certain areas of the brain are damaged and naturally due to the removal of one or another component from the normal functioning. It is important to note that the disorder naturally combines disorders of various mental functions that are internally interconnected. Also, the syndrome is a natural, typical combination of symptoms, the occurrence of which is based on a violation of the factor due to a deficiency in the work of certain brain areas in case of local brain damage or brain dysfunction caused by other causes that do not have a local focal nature.

Hyperactivity - "Hyper ..." (from the Greek. Hyper - above, above) - component compound words indicating an excess. The word "active" came into Russian from the Latin "activus" and means "effective, active." External manifestations of hyperactivity include inattention, distractibility, impulsivity, increased motor activity. Often hyperactivity is accompanied by problems in relationships with others, learning difficulties, low self-esteem. At the same time, the level intellectual development in children does not depend on the degree of hyperactivity and may exceed the age norm. The first manifestations of hyperactivity are observed before the age of 7 years and are more common in boys than in girls. Hyperactivity occurring in childhood is a set of symptoms associated with excessive mental and motor activity. It is difficult to draw clear boundaries for this syndrome (i.e., the totality of symptoms), but it is usually diagnosed in children who are characterized by increased impulsivity and inattention; such children are quickly distracted, they are equally easy to please and upset. Often they are characterized by aggressive behavior and negativism. Due to such personality traits, hyperactive children find it difficult to concentrate on performing any tasks, for example, in school activities. Parents and teachers often face considerable difficulties in dealing with such children.

The main difference between hyperactivity and just an active temperament is that this is not a trait of the child's character, but a consequence of impaired mental development of children. The risk group includes children born as a result of caesarean section, severe pathological childbirth, artificial babies born with low birth weight, premature babies.

Attention deficit hyperactivity disorder, also called hyperkinetic disorder, occurs in children between the ages of 3 and 15, but most often manifests itself in preschool and primary school age. This disorder is a form of minimal brain dysfunction in children. It is pathologically low scores attention, memory, weakness of thought processes in general with a normal level of intelligence. Arbitrary regulation is poorly developed, performance in the classroom is low, fatigue is increased. Deviations in behavior are also noted: motor disinhibition, increased impulsivity and excitability, anxiety, negative reactions, aggressiveness. At the beginning of systematic training, difficulties arise in mastering writing, reading and counting. Against the background of educational difficulties and, often, a lag in the development of social skills, school maladaptation and various neurotic disorders occur.

1.2 Causes and signs of hyperdynamic syndrome

In this section, we consider the causes of the hyperdynamic syndrome.

The experience accumulated by researchers indicates not only the lack of a single name for this pathological syndrome, but also the lack of a consensus on the factors leading to the occurrence of attention deficit hyperactivity disorder. Analysis scientific and methodological literature allows you to identify a number of causes of the ADHD syndrome. However, the significance of each of these risk factors has not yet been studied enough and needs to be clarified.

The occurrence of ADHD may be due to the influence of various etiological factors during the period of brain development up to 6 years. An immature, developing organism is most sensitive to harmful influences and least able to resist them.

Many authors (Badalyan L.O., Zhurba L.T., Vsevolozhskaya N.M., 1980; Veltishchev Yu.E., 1995; Khaletskaya O.V., 1998) consider the late stages of pregnancy and childbirth to be the most critical period. M. Haddres - Algra, H.J. Huisjes and B.C. Touwen (1988) divided all factors that cause brain damage in children into biological (hereditary and perinatal), acting before childbirth, at the time of childbirth and after childbirth, and social, due to the influence of the immediate environment. These studies confirm the relative difference in the influence of biological and social factors: from an early age (up to two years), biological factors of brain damage are of greater importance - the primary defect (Vygotsky L.S.). In the later (from 2 to 6 years) - social factors - a secondary defect (Vygotsky L.S.), and with a combination of both, the risk of attention deficit hyperactivity disorder is significantly increased.

A large number of works are devoted to studies proving the occurrence of attention deficit hyperactivity disorder due to minor brain damage in the early stages of development, i.e. in the pre- and intranatal periods.

Yu.I. Barashnev (1994) and E.M. Belousova (1994) consider “small” disorders or injuries of the brain tissue in the prenatal, perinatal and less often postnatal periods to be primary in the disease. Considering high percent premature babies and an increase in the number of intrauterine infections, as well as the fact that in Russia in most cases childbirth proceeds with injuries, the number of children with encephalopathies after childbirth is large.

A special place among neurological diseases in children is occupied by prenatal and intranatal lesions. Currently, the frequency of perinatal pathology in the population is 15-25% and continues to grow steadily.

O.I. Maslova (1992) provides data on the unequal frequency of individual syndromes when characterizing the structure of organic lesions of the nervous system in children. These disorders were distributed as follows: in the form of motor disorders - 84.8%, mental disorders - 68.8%, speech disorders - 69.2% and convulsive seizures - 29.6%. Long-term rehabilitation of children with organic lesions of the nervous system in the first years of life in 50.5% of cases reduces the severity of motor disorders, speech development and the psyche in general.

Neonatal asphyxia, threatened miscarriage, anemia in pregnancy, postmaturity, maternal alcohol and drug use during pregnancy, and smoking are thought to contribute to ADHD. A psychological follow-up study of children who underwent hypoxia revealed a decrease in learning ability in 67%, a decrease in the development of motor skills in 38% of children, and deviations in emotional development in 58%. Conversational activity was reduced in 32.8%, and in 36.2% of cases, children had deviations in articulation.

Prematurity, morpho-functional immaturity, hypoxic encephalopathy, maternal physical and emotional trauma during pregnancy, preterm birth, and underweight babies are at risk for behavioral problems, learning difficulties, and emotional state, increased activity.

Research Zavadenko N.N., 2000; Mamedaliyeva N.M., Elizarova I.P., Razumovskoy I.N. in 1990, it was found that the neuropsychic development of children born with insufficient body weight is much more often accompanied by various deviations: delayed psychomotor and speech development and convulsive syndrome.

The research results show that intensive medical, psychological and pedagogical impact at the age of up to 3 years leads to an increase in the level of cognitive development and a decrease in the risk of developing behavioral disorders. These data prove that overt neurological disorders in the neonatal period and factors recorded in the intranatal period are of prognostic value in the development of ADHD in older age.

A great contribution to the study of the problem was made by works that put forward an assumption about the role of genetic factors in the occurrence of ADHD, the proof of which was the existence of familial forms of ADHD.

To confirm the genetic etiology of the ADHD syndrome, follow-up observations by E.L. Grigorenko (1996). According to the author, hyperactivity is an innate characteristic along with temperament, biochemical parameters, and low reactivity of the central nervous system. Low excitability of the central nervous system E.L. Grigorenko explains the violation in the reticular formation of the brain stem, inhibitors of the cerebral cortex, which causes motor anxiety. A fact proving the genetic predisposition of ADHD was the presence of symptoms in childhood in parents of children suffering from this disease.

The search for genes of predisposition to ADHD was carried out by M. Dekkeg et al. (2000) in a genetically isolated population in the Netherlands, which was founded 300 years ago (150 people) and currently includes 20 thousand people. In this population, 60 patients with ADHD were found, the pedigrees of many of them were traced back to the fifteenth generation and were reduced to a common ancestor.

Studies by J. Stevenson (1992) prove that the heritability of attention deficit hyperactivity disorder in 91 pairs of identical and 105 pairs of fraternal twins is 0.76%.

The works of Canadian scientists (Barr С.L., 2000) speak of the influence of the SNAP 25 gene on the occurrence of increased activity and lack of attention in patients. The analysis of the structure of the SNAP 25 gene encoding the synaptosome protein in 97 nuclear families with increased activity and lack of attention showed an association of some polymorphic sites in the SNAP 25 gene with the risk of developing ADHD.

There are also gender and age differences in the development of ADHD. According to V.R. Kuchma, I.P. Bryazgunov (1994) and V.R. Kuchma and A. G. Platonov, (1997) among boys of 7-12 years old, signs of the syndrome occur 2-3 times more often than among girls. In their opinion, the high frequency of symptoms of the disease in boys may be due to the higher vulnerability of the male fetus to pathogenetic influences during pregnancy and childbirth. In girls, the cerebral hemispheres are less specialized, so they have a greater reserve of compensatory functions in case of damage to the central nervous system compared to boys.

Along with the biological risk factors for ADHD, social factors are analyzed, such as educational neglect leading to ADHD. Psychologists I. Langmeyer and Z. Mateychik (1984) distinguish between social factors of trouble, on the one hand, deprivation - mainly sensory and cognitive, on the other - social and cognitive. They refer to unfavorable social factors as insufficient education of parents, incomplete family, deprivation or deformation of maternal care.

J.V. Hunt, V. A Sooreg (1988) prove that the severity of motor and visual-motor disorders, deviations in the development of speech and cognitive activity in the development of children depends on the education of the parents, and the frequency of such deviations depends on the presence of diseases in the neonatal period.

O.V. Efimenko (1991) great importance in the occurrence of ADHD gives the conditions for the development of the child in infancy and preschool age. Children brought up in orphanages or in an atmosphere of conflict and cold relationships between parents are more prone to neurotic breakdowns than children from families with a benevolent atmosphere. The number of children with disharmonious and sharply disharmonious development among children from orphanages is 1.7 times higher than the number of similar children from families. It is also believed that the occurrence of ADHD contributes to the delinquent behavior of parents - alcoholism and smoking. 3. Trzhesoglava showed that in 15% of children with ADHD, parents suffered from chronic alcoholism.

Thus, on present stage approaches developed by researchers to the study of the etiology and pathogenesis of ADHD, for the most part, affect only certain aspects of the problem. Three main groups of factors that determine the development of ADHD are considered: early damage to the central nervous system associated with the negative impact on the developing brain of various forms of pathology during pregnancy and childbirth, genetic factors and social factors.

Researchers do not yet have convincing evidence of the priority of physiological, biological or social factors in the formation of such changes in the higher parts of the brain, which are the basis of attention deficit hyperactivity disorder.

In addition to the above reasons, there are some other points of view on the nature of this disease. In particular, it is assumed that eating habits and the presence of artificial food additives in foods can also influence the behavior of the child.

This problem has become relevant in our country due to significant imports. food products, including baby food, which have not passed due certification. It is known that most of them contain various preservatives and food additives.

Abroad, the hypothesis of a possible relationship between food additives and hyperactivity was popular in the mid-70s. Message from Dr. B.F. Feingolda (1975) from San Francisco that 35-50% of hyperactive children showed a significant improvement in behavior after eliminating foods containing nutritional supplements from their diet caused a real sensation. However, subsequent studies have not confirmed these data.

For some time, refined sugar was also “under suspicion”. But careful research has not confirmed these "charges". Currently, scientists have come to the final conclusion that the role of food additives and sugar in the origin of attention deficit hyperactivity disorder is exaggerated.

However, if the parents suspect any connection between the change in the child's behavior and the consumption of a certain food, then it can be excluded from the diet.

Information has appeared in the press that the exclusion from the diet of foods containing a large amount of salicylates reduces the hyperactivity of the child.

Salicylates are found in the bark, leaves of plants and trees (olives, jasmine, coffee, etc.), and in small quantities - in fruits (oranges, strawberries, apples, plums, cherries, raspberries, grapes). However, this information also needs to be carefully checked.

It can be assumed that the environmental troubles that all countries are now experiencing make a certain contribution to the increase in the number of neuropsychiatric diseases, including ADHD. For example, dioxins are super-toxic substances that occur during the production, processing and combustion of chlorinated hydrocarbons. They are often used in industry and households and can lead to carcinogenic and psychotropic effects, as well as severe congenital anomalies in children. Salt pollution heavy metals, such as molybdenum, cadmium, leads to a disorder of the central nervous system. Compounds of zinc and chromium play the role of carcinogens.

An increase in the content of lead - the strongest neurotoxin - in environment may be the cause of behavioral disorders in children. It is known that the content of lead in the atmosphere is now 2000 times higher than during the industrial revolution.

There are many more factors that can be potential causes of the disorder. Usually, during the diagnosis, a whole group of possible causes is revealed, i.e. the nature of this disease is combined.

1.3 Psychological characteristics of children with hyperdynamic syndrome

In this paragraph, we highlight the psychological characteristics of children with hyperdynamic syndrome.

The lag in the biological maturation of the CNS in children with ADHD and, as a result, the higher brain functions (mainly the regulatory component), does not allow the child to adapt to new conditions of existence and normally endure intellectual stress.

O.V. Khaletskaya (1999) analyzed the state of higher brain functions in healthy and sick children with ADHD at the age of 5-7 years and concluded that there were no pronounced differences between them. At the age of 6-7 years, the differences are especially pronounced in such functions as auditory-motor coordination and speech; therefore, it is advisable to conduct dynamic neuropsychological monitoring of children with ADHD from the age of 5 using individual rehabilitation techniques. This will make it possible to overcome the delay in the maturation of higher brain functions in this group of children and prevent the formation and development of a maladaptive school syndrome.

There is a discrepancy between the actual level of development and the performance that can be expected based on the IQ. Quite often, hyperactive children are quick-witted and quickly "grasp" information, have extraordinary abilities. Among children with ADHD there are really talented children, but cases of mental retardation in this category of children are not uncommon. The most important thing is that the intelligence of children is preserved, but the features that characterize ADHD - restlessness, restlessness, a lot of unnecessary movements, lack of focus, impulsive actions and increased excitability, are often combined with difficulties in acquiring learning skills (reading, counting, writing). This leads to pronounced school maladjustment.

Severe disorders in the field of cognitive processes are associated with disorders of auditory gnosis. Changes in auditory gnosis are manifested in the inability to correctly assess sound complexes consisting of a series of consecutive sounds, the inability to reproduce them, and shortcomings. visual perception, difficulties in the formation of concepts, infantilism and vagueness of thinking, which are constantly influenced by momentary impulses. Motor discordance is associated with poor eye-hand coordination and negatively affects the ability to write easily and correctly.

Research L.A. Yasyukova (2000) show the specifics of the intellectual activity of a child with ADHD, which consists of cyclicity: arbitrary productive work does not exceed 5-15 minutes, after which the children lose control of mental activity further, within 3-7 minutes the brain accumulates energy and strength for the next work cycle.

It should be noted that fatigue has a dual biological effect: on the one hand, it is a protective protective reaction against extreme exhaustion of the body, on the other hand, fatigue stimulates recovery processes, pushes the boundaries of functionality. The longer the child works, the shorter

productive periods become longer and the rest time is longer - until complete exhaustion occurs. Then sleep is necessary to restore mental performance. During the period of "rest" of the brain, the child ceases to understand, comprehend and process incoming information. It is not fixed anywhere and does not linger, therefore

the child does not remember what he was doing at that time, does not notice that there were some breaks in his work.

Mental fatigue is more characteristic of girls, and in boys it manifests itself by the age of 7. Girls also have a reduced level of verbal-logical thinking.

Memory in children with ADHD may be normal, but due to the exceptional instability of attention, there are "gaps in well-learned" material.

Disorders short term memory can be detected in a decrease in the amount of memorization, increased inhibition by extraneous stimuli, and delayed memorization. At the same time, an increase in motivation or organization of the material gives a compensatory effect, which indicates the preservation of the cortical function in relation to memory.

At this age, speech disorders begin to attract attention. It should be noted that the maximum severity of ADHD coincides with the critical periods of psychoverbal development in children.

If the regulatory function of speech is impaired, the adult's speech does little to correct the child's activity. This leads to difficulties in the sequential execution of certain intellectual operations. The child does not notice his mistakes, forgets the final task, easily switches to side or non-existent stimuli, cannot stop side associations.

These are especially common in children with ADHD. speech disorders, as a delay in the development of speech, insufficiency of the motor function of the articulatory apparatus, excessively slow speech, or, conversely, explosiveness, voice and speech breathing disorders. All these violations determine the inferiority of the sound-producing side of speech, its phonation, the limited vocabulary and syntax, and the lack of semantics.

There are also other disorders, such as stuttering. Stuttering does not have clear age trends, however, it is most often observed at 5 and 7 years of age. Stuttering is more characteristic of boys and occurs in them much earlier than in girls, and is equally present in all age groups. In addition to stuttering, the authors also highlight the talkativeness of this category of children.

Increased switching from one activity to another occurs involuntarily, without adjustment to the activity and subsequent control. The child is distracted by minor auditory and visual stimuli that are ignored by other peers.

A tendency to a pronounced decrease in attention is observed in unusual situations, especially when it is necessary to act independently. Children do not show perseverance either during classes or in games, they cannot watch their favorite TV show to the end. At the same time, there is no switching of attention, therefore, types of activities that quickly replace each other are carried out in a reduced, poor quality and fragmentary way, however, when pointing out mistakes, children try to correct them.

Attention impairment in girls reaches its maximum severity by the age of 6 and becomes the leading disorder in this age period.

The main manifestations of hyperexcitability are observed in various forms of motor disinhibition, which is aimless, not motivated by anything, situationless and usually not controlled by either adults or peers.

Such increased motor activity, turning into motor disinhibition, is one of the many symptoms that accompany developmental disorders in a child. Purposeful motor behavior is less active than in healthy children of the same age.

Coordinating disturbances are found in the field of motor abilities. Research results show that motor problems begin as early as preschool age. In addition, there are general difficulties in perception, which affects the mental abilities of children, and, consequently, the quality of education. The most commonly affected are fine motor skills, sensorimotor coordination, and manual dexterity. Difficulties associated with maintaining balance (when standing, skating, rollerblading, bicycling), visual-spatial coordination disorders (inability to play sports, especially with the ball) are the causes of motor awkwardness and an increased risk of injury.

Impulsivity manifests itself in sloppy performance of the task (despite the effort, do everything right), in restraint in words, deeds and actions (for example, shouting from a place during class, inability to wait for your turn in games or other activities), inability to lose, excessive perseverance in defending their interests (despite the requirements of an adult). With age, the manifestations of impulsivity change: the older the child, the more pronounced impulsivity and more noticeable to others.

One of the characteristic features of children with ADHD is violations of social adaptation. These children typically have a lower level of social maturity than is usually the case for their age. Affective tension, a significant amplitude of emotional experience, difficulties in communicating with peers and adults lead to the fact that a child easily develops and fixes negative self-esteem, hostility to others, and neurosis-like and psychopathological disorders occur. These secondary disorders aggravate the clinical picture of the condition, increase maladjustment and lead to the formation of a negative "I-concept".

Children with the syndrome have impaired relationships with peers and adults. In mental development, these children lag behind their peers, but they strive to lead, behave aggressively and demandingly. Impulsive hyperactive children quickly react to a ban or a sharp remark, respond with harshness, disobedience. Attempts to contain them lead to actions on the principle of a "released spring". Not only others suffer from this, but also the child himself, who wants to fulfill a promise, but does not keep it. Interest in the game in such children quickly disappears. Children with ADHD love to play destructive games, during the game they cannot concentrate, they conflict with their comrades, despite the fact that they love the team. The ambivalence of forms of behavior is most often manifested in aggressiveness, cruelty, tearfulness, hysteria, and even sensual dullness. In view of this, children with attention deficit hyperactivity disorder have few friends, although these children are extroverts: they look for friends, but quickly lose them.

The social immaturity of such children is manifested in the preference for building play relationships with children. younger age. Relationships with adults are difficult. It is difficult for children to listen to the explanation to the end, they are constantly distracted, especially in the absence of interest. These children ignore both adult rewards and punishment. Praise does not stimulate good behavior, in view of this encouragement must be very reasonable, otherwise the child will behave worse. However, it must be remembered that a hyperactive child needs praise and approval from an adult to strengthen self-confidence.

A child with the syndrome is not able to master his role and cannot understand how he should behave. Such children behave familiarly, do not take into account specific circumstances, cannot adapt and accept the rules of behavior in a particular situation.

Increased excitability is the cause of difficulties in acquiring ordinary social skills. Children do not fall asleep well even if the regimen is observed, they eat slowly, dropping and spilling everything, as a result of which the process of eating becomes a source of daily conflicts in the family.

Harmonization of the development of the personality of children with ADHD depends on the micro_and macrocircle. If mutual understanding, patience and a warm attitude towards the child are preserved in the family, then after the treatment of ADHD, all the negative aspects of behavior disappear. Otherwise, even after the cure, the pathology of the character will remain, and perhaps even intensify.

The behavior of such children is characterized by a lack of self-control. Committed to independent action(“I so want”) turns out to be a stronger motive than any rules. Knowing the rules is not a significant motive for one's own actions. The rule remains known but subjectively meaningless.

It is important to emphasize that the rejection of hyperactive children by society leads to the development of a sense of rejection in them, alienates them from the team, increases imbalance, irascibility and intolerance of failure. Psychological examination children with the syndrome in most of them reveals increased anxiety, anxiety, internal tension, a sense of fear. Children with ADHD are more prone to depression than others, easily upset by failure.

The emotional development of the child lags behind the normal indicators of this age group. Mood changes rapidly from elated to depressed. Sometimes there are unreasonable bouts of anger, rage, anger, not only in relation to others, but also to oneself. The child is characterized by low self-esteem, low self-control and arbitrary regulation, as well as elevated level anxiety.

A calm environment, guidance from adults lead to the fact that the activity of hyperactive children becomes successful. Emotions have an exceptionally strong influence on the activities of these children. Emotions of medium intensity can activate it, however, with a further increase in the emotional background, activity can be completely disorganized, and everything that has just been learned can be destroyed.

Thus, older preschoolers with ADHD demonstrate a decrease in the voluntariness of their own activity as one of the main components of a child's development, which causes a decrease and immaturity in the formation of the following functions in development: attention, praxis, orientation, weakness of the nervous system.

Ignorance that a child has functional deviations in the work of brain structures, and the inability to create an appropriate mode of learning and life in general for him at preschool age, give rise to many problems in elementary school.

1.4 Organization of corrective work with preschool children with hyperdynamic syndrome

It is generally accepted that the treatment of ADHD should be complex, that is, it should include both drug therapy and psychotherapeutic methods. The psychotherapeutic treatment of ADHD will be discussed in more detail in the next chapter.

Pharmacotherapy for ADHD. Currently, the following groups of drugs are most often used in drug treatment: psychostimulants, antidepressants, as well as nootropic drugs.

in the USA and European countries The most widely used in the treatment of ADHD are psychostimulants. In our country, these drugs are not yet registered. These drugs have been used to treat ADHD since 1937, when C. Bradley discovered that the central nervous system stimulant benzedrine can significantly improve the condition of children with this pathology. The main mechanism of action of psychostimulants is the release of the excitatory mediator dopamine. Most often applied methyl-phenidate(ritalin, concerta). In recent years, a psychostimulant drug has been developed concert, the use of which is characterized by a longer duration of action and fewer side effects. In our country, these funds are not used. Under the influence of these drugs, the mechanisms of regulation of motor activity are improved, the activity of the cerebral cortex increases.

The use of psychostimulants makes it possible to achieve improvement in 70-80% of cases. As a rule, the use of psychostimulants is started with low doses, gradually increasing them until a therapeutic effect is achieved or side effects develop. Physical dependence with the use of these drugs usually does not develop. Treatment with psychostimulants usually lasts for many years and should be accompanied by dispensary observation of such a patient.

The use of psychostimulants can be complicated by the development of side effects. The most common of these are insomnia, irritability, abdominal pain, loss of appetite, headaches, nausea. Despite a large number of studies on the use of psychostimulants in the treatment of ADHD, this issue is still subject to debate.

A new drug proposed for the treatment of ADHD -- atomoxetine(Strattera), a selective inhibitor of presynaptic norepinephrine transporters. This drug is used to treat ADHD in children over 6 years of age, teenagers and adults. Atomoxetine is especially effective in cases of ADHD combined with anxiety disorders, depression, ODD, tics, enuresis.

In Russia, for the treatment of ADHD, traditionally used nootropic funds. Nootropic drugs are drugs that positively affect the higher integrative functions of the brain; the main manifestation of their action is the improvement of learning and memory processes in case of their violations. Nootropic and cerebroprotective drugs used in the treatment of ADHD include encephabol, pantogam, phenibut, picamilon, cerebrolysin, nootropil, gliatilin, instenon.

The search for new pharmacological agents led scientists to the discovery of a class of low molecular weight peptide bioregulators called cytomedins; they carry out the transfer of information necessary for the normal functioning, development and interaction of cell populations (Morozov V. G., Khavinson V. X., 1996). One of the most effective drugs of this class is cortexin, isolated from the cerebral cortex of animals.

In pediatric practice, the drug is used in the rehabilitation of various forms of cerebral palsy, the consequences of traumatic brain injuries, epileptic syndrome, psychomotor and speech development delays (Ryzhak G.A. et al., 2003).

Often used in the treatment of ADHD pantogam. According to its chemical structure, it is a calcium salt of 0 (+) - pantoyl-gamma-aminobutyric acid (GABA). The use of pantogam can reduce hyperactivity, the severity of tics.

Transcranial micropolarization (TCMP) -- therapeutic application of permanent (galvanic) electric current little force on the brain tissue. The method of transcranial micropolarization (TCMP) was developed at the Research Institute of Experimental Medicine of the Russian Academy of Medical Sciences (G. A. Vartanyan et al., 1981). According to D. Yu. Pinchuk (1997), the most likely mechanism of TCMP is the directed activation of non-specific activating systems of the brain (non-specific thalamic nuclei, mesencephalic reticular formation), which leads to the activation of the existing, but not effectively functioning, synaptic apparatus of neurons, and to the intensification of the processes of morpho-functional development of immature elements of the cortex due to the normalization of neurodynamics. This method activates the functional reserves of the brain, has no undesirable side effects and complications.

The TCMP method is effective method treatment of various forms of ADHD, which allows, in the absence of undesirable side effects, to change the functional state of the brain in a targeted manner.

biological Feedback in the treatment of ADHD. Biocommunication is actively used to change the functional state of the central nervous system based on rearrangements of the spectral characteristics of electroencephalograms (EEG-BFB). As a result of ECG training, leading to the normalization of the central regulatory mechanisms, the restoration of hemodynamic, metabolic and neurotransmitter functions, a new functional system is formed in the brain, which has its own endogenous resistance mechanism (Shtark M.B., 1998).

N. P. Bekhtereva (1988) emphasizes that biological feedback does not have undesirable effects, because effects are used that are as close as possible to physiological ones. These methods provide targeted activation of the structural and functional reserves of the brain in order to overcome the effects of factors of a stable pathological state.

Since the EEG of patients suffering from ADHD is characterized by an increase in the representation of theta activity and a decrease in the power of beta activity, biofeedback training is usually aimed at increasing rapid activity in the beta rhythm range while simultaneously suppressing theta activity (Grin-Yatsenko V. A., 1991).

As a rule, in the EEG-BFB procedure, visual, less often acoustic signals are used as reinforcement. Visual feedback is provided by changing the size, color, brightness of the image and other parameters of the object on the display screen depending on the power, amplitude, percentage of occurrence in the EEG of controlled activity. The visual signal is in some cases supplemented by an acoustic feedback signal. It can be a beautiful melody that turns on if the amplitude of the current wave exceeds a given threshold (or, conversely, did not reach it if the task is to suppress activity), or a change in sound volume or pitch depending on the amplitude of the waves of the range selected for training.

The choice of methods of psychocorrection depends on the needs of the child, the goals that adults set for the psychologist (psychotherapist), and, finally, the capabilities of the specialist working with the child. Before deciding which type of psychotherapy is the most effective in each particular case, it is necessary to collect information about the child: find out his medical diagnosis, methods of drug treatment, and, if possible, recommendations from specialists who have worked with the child before and are currently working (doctor, psychologist, teachers etc.).

After that, the psychotherapist (psychologist) invites the family (or one of the parents) to obtain additional information about the child and draw up a contract. The specialist gives parents the opportunity to tell about the child everything that they see fit: his positive features character, weaknesses, favorite and unloved activities, problems and difficulties in education, etc. After this, a circle of problems is outlined that parents would like to resolve in the course of psychotherapeutic activities.

When drawing up a contract with parents, a psychotherapist (psychologist) talks about the general principles of working with a child, one of which is confidentiality. It is very important to discuss with parents what information the therapist will communicate to them and what information he should keep secret, how feedback will be provided to parents, and what information and to what extent the psychotherapist (psychologist) can communicate to specialists of other profiles working with the child ( e.g. a speech pathologist class teacher etc.), etc.

Taking into account the interests of the child, the request of the parents and their professional capabilities, the specialist chooses the most appropriate, in his opinion, form of work with the child.

...

decluttering

Much has been written about how important it is to be able to let go, to complete the old, obsolete. Otherwise, they say, the new will not come (the place is occupied), and there will be no energy. Why do we nod when we read such cleaning-motivating articles, but everything still remains in place? We find thousands of reasons to postpone what is deferred for throwing away. Or not to start sorting out rubble and storerooms at all. And we already habitually scold ourselves: “I’m completely cluttered up, we need to pull ourselves together.”
To be able to easily and confidently throw away unnecessary things becomes a mandatory program of a “good housewife”. And often - a source of another neurosis for those who for some reason cannot do this. After all, the less we do “the right way” - and the better we can hear ourselves, the happier we live. And the more right it is for us. So, let's see if it's really necessary for you personally to declutter.

The art of communicating with parents

Parents often like to teach their children, even when they are old enough. They interfere in their personal lives, advise, condemn ... It comes to the point that children do not want to see their parents, because they are tired of their moralizing.

What to do?

Acceptance of shortcomings. Children must understand that it will not be possible to re-educate their parents, they will not change, no matter how much you would like it. When you come to terms with their shortcomings, it will be easier for you to communicate with them. You just stop expecting a different relationship than before.

How to prevent change

When people create a family, no one, with rare exceptions, even thinks about starting relationships on the side. And yet, according to statistics, families most often break up precisely because of infidelity. Approximately half of men and women cheat on their partners in a legal relationship. In a word, the number of faithful and unfaithful people is distributed 50 to 50.

Before talking about how to save a marriage from cheating, it is important to understand

Hyperdynamic syndrome (attention deficit disorder).

Every year more and more children are diagnosed with minimal brain dysfunction (MBD). Hyperdynamic syndrome (attention deficit disorder) is one of the manifestations of MMD. Let's take a look at what these terms mean.

Minimal cerebral dysfunction (MMD) is the outcome of mild organic brain damage. Characteristic features MMD is irritability, emotional instability, moderately pronounced sensorimotor and speech disorders, perception disorder, increased distractibility, behavioral difficulties, insufficient formation of intellectual skills, specific learning difficulties.

Hyperdynamic syndrome in children is mainly expressed in impaired concentration and increased unstructured activity. The onset of developmental disorders in such children occurs in the first 5 years of life. The causes of violations are damage to the central nervous system of the child as a result of exposure to harmful factors during pregnancy, childbirth and in the first three years of life. Acute and chronic diseases suffered by the mother during pregnancy and childbirth, infections, severe toxicosis (preeclampsia) in the 1st and 2nd half of pregnancy, as well as bad habits of parents and even psychological stress - all these are harmful factors that lead to impaired development of the child in utero.

During childbirth, damage to the central nervous system (CNS) may occur as a result of mechanical trauma or hypoxia (lack of oxygen) due to the weakness of the mother's labor activity, improper passage of the child through the birth canal or surgical delivery (caesarean section, obstetric care). In such children, the medical record often includes a diagnosis of PTCNS - perinatal encephalopathy (damage to the central nervous system), made by a neurologist.

In the first few years after birth, the child is defenseless and easily susceptible to unfavorable factors(mechanical injuries, infections, malnutrition, and others). The severity of the injury can vary. Mild disorders may improve during the first year of a child's life, more severe ones persist and may then appear as:

Increased excitability;

Violations of the activity of attention;

mild neurological syndromes;

Speech disorders;

Difficulties in schooling.

Hyperdynamic syndrome is observed in children from birth to 15 years, but most often manifests itself in preschool and primary school age. The highest percentage of hyperactive children is observed in 5-10 years. The peak of manifestations falls on 6-7 years, and by the age of 14-15 hyperactivity gradually decreases. From the point of view of age physiology, periods of 6-7 and 9-10 years are critical for the maturation of brain structures. The second peak symptom of hyperdynamic syndrome coincides with the period of sexual development - 13-15 years. In children with signs of hyperdynamic syndrome after 14-15 years, there is a significant improvement in their condition: hyperactivity decreases, self-control and regulation of behavior increase, but approximately 6% of children have complications in the form of early alcoholism, drug addiction, and deviant behavior. Therefore, the sooner the treatment of a child with hyperdynamic syndrome is started, the more favorable the outcome will be.

So what really happens to a child who is diagnosed with hyperdynamic syndrome?

Let's try to explain:

For one reason or another, the brain of a child (usually a newborn) received minor damage, that is, part of the brain cells simply does not function.

Nerve cells, as you know, do not recover, but immediately after an injury, other, healthy nerve cells begin to gradually take over the functions of the injured, that is, the recovery process immediately begins.

At the same time, the process of normal age development child. He learns to sit, walk, talk, etc. Both the recovery process and the process of normal age-related development require energy. Consequently, from the very beginning, the nervous system of a child with hyperdynamic syndrome works with a double load.

When stressful situations, prolonged stress (for example, testing at a prestigious gymnasium) or after somatic diseases, a hyperdynamic child may experience deterioration of the neurological condition, increased behavioral disturbance and learning problems. All of the above also need energy, and the nervous system cannot cope with this increased load.

There are two main processes in the nervous system - excitation and inhibition. In hyperdynamic syndrome, structures that provide the process of inhibition are affected. That is why these children have difficulties with concentration, voluntary attention and regulation of their activity.

With a successful development of events, sooner or later the functions of all the affected cells will be “taken apart” by other, healthy cells, the necessary connections will be restored (usually this happens by the age of 14-15) and the child (teenager) no longer differs from his healthy peers.

The earlier the diagnosis is established - hyperdynamic syndrome, the better for the child and his parents.

Portrait of a child with hyperdynamic syndrome

Such a child is often called a "give", "perpetual motion machine", tireless. The first thing that catches the eye when meeting a hyperdynamic child is his excessive in relation to the calendar age and some kind of "stupid" mobility. As a baby, such a child in the most incredible way gets out of the diapers. It is impossible to leave such a baby on the changing table even for a minute from the very first days and weeks of his life.

Not always, but quite often, hyperdynamic children have some kind of sleep disturbance.

Sometimes the presence of hyperdynamic syndrome can be assumed in an infant by observing its activity in relation to toys and other objects. The study of objects in a hyperdynamic infant is intense, but extremely undirected. That is, the child discards the toy before exploring its properties, immediately grabs another, only to discard it after a few seconds. The attention of such an infant is very easy to attract, but absolutely impossible to keep.

Motor skills in hyperdynamic children develop in accordance with age, often even ahead of age. Hyperdynamic children earlier than others begin to hold their heads, roll over on their stomachs, sit, stand up, walk, etc. Standing on its feet, the baby will immediately run ahead of itself.

As a rule, no attempts at admonition work on hyperdynamic children. They are fine with memory and understanding of speech. They just can't resist.

Quite often, hyperdynamic children have various speech disorders, it seems that they have "porridge in their mouths." Most often, only parents understand them.

Hyperdynamic children from the very beginning do not walk, but run. When they speak, they wave their arms a lot and stupidly, shift from foot to foot or jump on the spot.

Another feature of hyperdynamic children is that they do not learn not only from the mistakes of others, but even from their own.

It is the hyperdynamic children who are the children who get lost. Just something caught the attention of the hyperdynamic child, and he immediately forgot about his parents, about the fact that he was told to stand here and not leave this place, and went, went, drawn like a magnet by his short-term but all-consuming interest.

If we talk about emotional characteristics, then hyperdynamic children, as a rule, are not evil. They are not able to bear a grudge or plans for revenge for a long time, they are not prone to calculated, purposeful aggression. They quickly forget all grievances, yesterday's offender or offended today is their best friend. But in the heat of a fight, when the already weak inhibitory mechanisms fail, such children can be unaccountably cruel and unstoppable. When communicating with hyperdynamic children, one must take into account that all their feelings are quite superficial, lacking volume and depth. Cognition, assessment of the feelings and state of other people is a complex analytical work that requires a lot of tension and concentration on another person. But with concentration, a hyperdynamic child has big problems! Therefore, one should not expect miracles of understanding from such a child - it is better to just tell him what exactly you are experiencing right now.

Relationships with peers in hyperdynamic children can develop in different ways, depending on the degree of manifestation of the syndrome. Almost always, such children are very sociable, they easily get acquainted with both children and adults. However, despite the sociability, the hyperdynamic child rarely manages to build long-term and deep friendships. Sometimes hyperdynamic children shun the company of their peers and enjoy messing around with younger children.

A hyperdynamic child loves noisy, outdoor games. In complex, quiet, role-playing games or games with rules, the hyperdynamic child does not like to play.

Almost all people surrounding a hyperdynamic child (parents, teachers, even classmates) are in inescapable confidence that the child can get rid of all problems and shortcomings by simply “pulling himself together”, “gathering”, etc. Unfortunately they are wrong. For some time, each hyperdynamic child will try to meet the expectations of the people around him, "exert his will", "take care of himself" and follow other equally valuable tips. Gradually, however, both he and others become convinced that all this does not bring any success. Moreover, the more a child is shamed and scolded, the worse things get for him. The nervous system of a hyperdynamic child, already working with overload, receives an additional load. The child lives in a state of constant stress. The main thing for a child with hyperdynamic syndrome is to find his place in society, and when it is found, the manifestations of the syndrome subside sharply.

Of course, not every child with a diagnosis of "hyperdynamic syndrome" has all of the above behavioral features. All this can be expressed weaker or stronger, and something may be absent altogether. The presented portrait is a pronounced hyperdynamic syndrome in all its glory. In this form, it occurs only in every fourth or fifth child diagnosed with hyperdynamic syndrome.

How can you tell if your child is hyperactive?

What should parents pay attention to when considering whether a child has hyperdynamic syndrome?

First, of course, for the presence of neurological diagnoses. First of all, this applies to the diagnoses of MMD, encephalopathy, and intracranial hypertension syndrome. If any of this is available (and even more so - all), then the likelihood of developing the syndrome is very high (up to 90%).

The presence of uncontrolled motor activity.

Very weak (relative to age norms) concentration of attention. The child constantly abandons one thing and immediately starts another. Even if he is busy with something, it costs nothing to distract him (especially if this activity is preparing lessons).

Any persistent manifestation of sleep disturbance.

The presence in the history of the child's development of speech therapy problems, delayed speech development or its general underdevelopment(even if today the child speaks absolutely normally).

Inability to adapt to the disciplinary requirements of a preschool institution.

Rapid "choking" speech.

Increased injuries and a tendency to "get stuck" in all sorts of stories and troubles.

The presence of one or more tics or motor stereotypes (blinking, coughing, rubbing nose, eyes, pulling his hair, stubbornly, "to the meat" bites his nails, breaks burrs, constantly twists or crumples something in his fingers, jumps in place, twists head, etc.).

Nocturnal or daytime enuresis (involuntary urination).

Superficial, sometimes excessive sociability. The child does not always feel social boundaries and distances, which, it seems, should already be aware (by age).

Prefers younger playmates.

Weather sensitivity. Condition, mood changes depending on the time of year, day.

Even with a little stress or tension, a breakdown can occur.

None of the above signs can serve as an absolute criterion for the reliability of the presence or absence of hyperdynamic syndrome. But, after reviewing the list again, you can write out on a piece of paper the numbers of those features that your child has. If you have accumulated 4-5 or more - most likely, there is a syndrome.

What should parents of a preschooler do if he has hyperdynamic syndrome (attention deficit disorder).

First of all, it is necessary to establish the cause of hyperactivity, consult with specialists. To do this, you need to visit a neurologist, psychoneurologist or psychologist. If a neurologist prescribes a course of medication, massage, a special regimen, you must strictly follow his recommendations.

Secondly, a hyperdynamic child, like air, needs a strict daily routine (for example, if every day at 8 pm a green night light is lit, a glass of kefir and cookies appear on the table, a shower is taken, a fairy tale is read, and then - everything, without options, just sleep , and no indulgences, no “guests have come” or “interesting movies”, then gradually the child’s brain develops something like a conditioned reflex, and then the child falls asleep calmly).

To maintain emotional balance, it is necessary to avoid crowds of people whenever possible. Staying in large stores, markets, restaurants, etc. has a stimulating effect on the child. It can be extremely difficult to “calm down” a child with hyperdynamic syndrome after visiting the above places.

In their relationship with the child, parents must adhere to the "positive model". Praise him in every case when he deserves it, emphasize his successes. This will help build your child's self-confidence.

Do not exceed loads. In recent years, it has become more and more fashionable to send very young children to educational centers where children are taught a little of everything.

If a hyperdynamic child grows in a family, then the correct policy in relation to preschool activities will be the following:

1. You should not send a child under six years old to groups where education is based on a “school” type, that is, children during classes should sit at their desks or tables, raise their hands, answer in turn, write in notebooks, perform tasks that require a large perseverance and concentration.

2. It is quite acceptable and appropriate to organize classes for a preschooler in groups where everything takes place in a playful environment, where during the lesson children can freely move around the room, stand, sit, jump, respond at will, etc.

3. If the manifestations of the hyperdynamic syndrome are very strong (the child is a “catastrophe”), then up to six years old you can do without additional training sessions, limiting yourself to what is given in the kindergarten. The nervous system of a child has so many worries. Somehow it will manage without additional loads.

4. If the child ended up in a training center where he is clearly inappropriate, problems began, do not bring the situation to a critical point. Get him out of there quickly. And in no case do not swing the rights in front of the administration or parents (otherwise, later there will be a temptation to discharge on the child, as on immediate cause your troubles). Explain to the child that he may be too young for such activities and that you will look for what suits him best. Or go back to school next year when he's older.

How to behave with a hyperdynamic child if parents acutely feel the need to develop their child at home?

There are a few simple rules, which will help save a significant amount of parental and children's nerve cells:

1. Do not try to seat your child in a certain place. Almost any space is suitable for activities with a younger preschooler - a carpet in the nursery, a sofa in the living room, a kitchen table, a yard and a bathroom. If the child is very mobile, then during classes he can walk, crawl or even run (although in the latter case you will have to run next to him). It is in motion that a hyperdynamic child absorbs information more easily. Fixing the posture requires too much effort. There is simply no energy left for classes.

2. Classes should be very short (no more than 10 minutes). If the child's concentration time is two minutes, do not despair, but start with two minutes. These two minutes can be repeated every hour. After a while, the concentration will increase to three, and then to 5 minutes.

3. Decide in advance what exactly you will be doing today, prepare all the toys or other supplies that you will need for the lesson. Thinking "on the go" is unacceptable. The attention deficit is too great and the concentration of the child is weak.

4. If possible, accustom the child to the regularity of classes. Try not to skip them. Let them be very short (for example, five minutes), but every day three times. For a hyperdynamic child, this is much better than half an hour twice a week.

5. Don't get too caught up in cutting-edge systems. Play with your child ancient and wise “educational” games like: “What was loaded onto the ship?”, “Take whatever you want, don’t say yes and no, don’t name black and white, don’t remember red ... You are you going to the ball?" These games are good because they do not require the child to sit at the table at all. You can play them while washing dishes, washing clothes or on the way to the kindergarten and the store. In addition, they are complex, and for example, the last of these games develops immediately: a) voluntary attention; b) vocabulary; c) the skill of searching for synonyms and antonyms; d) the ability to build questions; e) logical thinking.

6. If the child does not listen at all when books are read to him, two ways are possible:

The first is a banal bribery. You set an alarm for a certain (very short) time, for example, 5 minutes, and tell the child: “Now we will read a fairy tale about Masha. I read, you listen. When the alarm goes off, it's all over." Most young children are very intrigued by a ringing alarm clock. The child is impatiently waiting for the alarm to ring, concentrating all available attention on it and trying not to miss this moment. You are reading a fairy tale. The alarm clock is ringing. You turn it off, and tell the child: “You're doing great. You listened well. You have cookies. Read more tonight." The time allotted for reading a book should be increased by two to three minutes a week. Fifteen minutes in a row listening to one book is very good time for a hyperdynamic preschooler who recently refused to listen to reading at all.

The second way is more difficult. Here you need a fair amount of imagination. First you need to take a sheet of paper and draw on it a little story. It is better if you draw everything in front of the child. The accompanying story is also born before his eyes. The child is certainly interested and eager to continue. After several drawn stories (say, a week later), the time comes for stories based on other people's pictures (comics). But the text is still yours. When the child is used to this, you can move on to real books. Only they should have a lot of pictures so that the child feels the continuity of the way information is transmitted.

7. Parents during classes need to focus on the condition of the child. Hyperdynamic children have "bad days" when they literally forget everything and seem to lose acquired skills and knowledge. Scolding or shaming the child at this time is at least inappropriate. Note, “You are not very good at it today. It's OK. Now we will play, and we will return to this next time. The child will be grateful for your understanding, and the next time he can, he will try to please you. If you "press", shame, force, then the result will be just the opposite. The child will “go into denial”, and all your activities will be imprinted with negativism.

Parents need to remember that all preschool children tend to move a lot. Preschoolers with hyperdynamic syndrome need movement like air. In no case should the child's mobility be restricted. A hyperdynamic child should not be punished by putting him in a corner or sitting on a sofa, saying: “Stay (sit) here and don’t move!” If punishment, from your point of view, is necessary, then think of some other way. It is highly desirable that in the apartment where a hyperdynamic child grows, there are some kind of projectiles on which you can climb, hang, and somersault. The simplest sports complex (you can hang a crossbar with retractable rings and a rope in the doorway) will not only allow the child to “discharge” in an accessible and non-destructive way for the family, but will also develop strength, agility, flexibility, coordination of movements and, ultimately, reduce the tendency to traumatism characteristic of a hyperdynamic child. If there is an opportunity and desire of the child, then classes in any circles or sections can be very useful. Those circles and sections are suitable, the structure of which includes movement in large numbers. A folk dance circle, a theater studio, gymnastics, running or swimming will be very constructive. The main thing is, no matter how good, prestigious and useful the circle is, so that your child likes the leader. A hyperdynamic child will not go to a circle because it is “necessary” or “useful”. Parents shouldn't force him.

Raising a hyperactive child, it is necessary to pay closer attention to his nutrition. A lot depends on it. In some cases, nutrition can cause the development of the syndrome, while in others it can aggravate the course of the disease. In particular, if the disease is caused by the use of food additives such as dyes and preservatives, then eliminating them from the diet leads to a significant improvement in the health of the child. Especially dangerous are the red artificial dye erythrosin and orange - tartracine. They are found in some types of juices, sauces, carbonated drinks. In any case, they should be excluded from the diet of a child with hyperdynamic syndrome, even if the cause of the disease has nothing to do with nutrition (for example, with birth injuries, etc.), just as preservatives, flavors, foods rich in carbohydrates should be excluded. In general, the nutrition of children with hyperdynamic syndrome should mainly consist of vegetables and salads prepared with vegetable oils. The following products are recommended:

vegetables - peas, carrots, soybeans, cauliflower, red and white cabbage, spinach, broccoli, cucumbers;
leaf lettuce;
fruits - apples, pears, bananas;
garnish - potatoes, coarse noodles, unpolished rice;
cereals - wheat, rye, barley, millet;
bread - wheat and rye;
fats - sour-milk oil, vegetable oils;
meat - beef, veal, poultry, fish, lamb (1-2 times a week);
drinks - unsweetened tea, still water with a sodium content of about 50 mg / kg;
seasonings - iodized salt.

How to prepare a hyperactive child for school?

In the life of every preschooler, a crucial moment comes - six years, Last year before school. What should parents of a hyperdynamic child do to positively pass this stage?

First of all, it is necessary to determine the goals and objectives. They are:

Do not develop in the child a persistent aversion to the learning process even before the start of the learning itself.
Find out what specific weak spots in the cognitive processes of the child (auditory memory, logical thinking, imaginative thinking, etc.).
Prepare your child for school and first grade.
To form in the child a positive self-esteem and a positive attitude towards future learning.

How can all this be done?

First, it is absolutely unacceptable to send a hyperdynamic child to school if he is not yet seven years old. A child can be very developed intellectually, but psychophysically he is not yet ready for the situation. schooling. Not immediately, but it will definitely show up.

Secondly, in the year before school (but not before), a hyperdynamic child definitely needs school preparation courses. The ideal option is courses at the same school where the child will go next year. By attending school during preparatory classes, the child gets acquainted with spatial organization school, with its locker room, floors, classrooms and corridors, with the practice of sitting at a desk, raising a hand when answering, etc. Coming to school the next year, the child enters a room already familiar to him. For a hyperdynamic child with this limited adaptive reserve, this is a very positive practice. If the school is not preparatory courses, then courses in any other places will do.

In addition, in the pre-school year, a hyperdynamic child should be taught at home. No courses and preparatory classes will not exhaust the problem of the formation of school maturity in a hyperactive child. He certainly needs an individual approach. This is exactly what parents can do. For this you need:

First, determine when exactly the child has a period of greatest performance. It must be remembered that hyperdynamic children, due to the peculiarities of their nervous system, have not only “bad days”, but also “bad hours”. To force a child to do at this time what is already given to him with considerable difficulty (for example, to write words), means in vain to destroy him and his nerve cells.

Secondly, the ritual of classes. The hyperdynamic child needs the discipline of space. It is necessary to allocate a permanent place for the child to prepare "lessons" and to study with him. This place must be properly organized. The table and chair should be of adequate height - the legs are on the floor with the entire foot, the knees are bent at an angle of 90 degrees (otherwise the child will dangle his legs, spin and sit on the chair with one leg under his butt, which will lead to a curvature of the spine). The light should fall from the left and be moderately bright. There should be absolutely no extra things on the table or desk (otherwise the child will just play with them, forgetting about all the activities). You can not put the table of a hyperdynamic child so that he can look out the window directly from the table. All things necessary for classes (pen, notebooks, pencils, etc.) should be neatly laid out in their places, look beautiful and attractive. At first (it can stretch), parents will have to follow all this.

Thirdly, the correct sequence in the performance of tasks. You need to start working with a hyperdynamic child from the easiest task, from the one that he will definitely succeed. You can start by repeating what has already been passed and known. Then you need to move on to more complex tasks, reaching the maximum level of complexity approximately by the middle of the lesson. At this time, the child's concentration on the process is maximum, he can work in full force their intellectual capabilities. Further, attention and the ability to concentrate are on the decline. Together with them, the difficulty of the tasks offered to the child also declines. You need to finish again with something light, with which a tired child can handle. In the end, you can repeat something from what is already known. Then the child will have a feeling of success of the whole lesson as a whole.

Created: 03/12/2015
Update date: 03/12/2015

Hyperdynamic syndrome (synonyms: hyperkinetic disorder, attention deficit disorder (ADD),) is a persistent manifestation of inattention with general symptoms of hyperactivity and impulsivity. Such manifestations of states and emotions are normal if they are an appropriate, logical and adequate reaction to external stimuli. In the case of hyperdynamic syndrome, such phenomena are more frequent and vivid than they should be in persons with a comparable level of development.

The Tenth Revision of the International Classification of Diseases uses the term "hyperkinetic disorder" for a narrower diagnosis, in which all three symptoms must be present - attention deficit, hyperactivity and impulsivity.

Epidemiology and comorbidities

The prevalence of hyperdynamic syndrome is estimated to affect about 2.4% of children worldwide.
The disease is most often diagnosed in children aged 3-7 years. In older children and adults, the disease manifests itself much less frequently.
The syndrome is more often diagnosed in boys.
Hyperdynamic syndrome is more often inherited in the first degree of kinship. Twin studies suggest a significant genetic contribution. A number of genes have been identified that are considered to have little effect in the development of the disease, such as DRD4 and DRD5.
Hyperdynamic syndrome is a common disease among disabled children. Other risk factors include obstetric complications and.

In addition to the corresponding clinical picture, the syndrome is fraught with the following deviations in behavior and development:

Self-harm, susceptibility to traffic accidents and other accidents, substance abuse, crime, anxiety, and academic failure.
Hyperdynamic syndrome in children is part of a spectrum of disorders, 70% of which are reported as generalized or specific learning difficulties, such as dyslexia, language disorders, autism, dyspraxia, and the like. Oppositional thinking and behavioral disorders are present in most children with these disorders.

Clinical manifestation and diagnosis

Patients suffering from hyperdynamic syndrome are a constant pattern of inattention, hyperactivity and impulsivity, which hinders development and is characterized by:

Carelessness.

To qualify for inattention, six or more of the following symptoms must be present in children under the age of 16, or five or more in persons over the age of 17. Symptoms of inattention must be present for at least six months. These include:

The patient fails to pay close attention to detail, which causes him to make careless mistakes in school work, professional or other activities.
The patient is unable to maintain concentration on his task, including play activities.
It seems that the child does not hear what is being said to him.
The patient often does not follow instructions and does not complete school, housework, or work duties.
Often has problems organizing tasks and events.
Avoids, dislikes, or does not want to do tasks that require mental effort for a long period of time, such as school homework.
Often loses things needed for tasks and activities, such as schoolwork, pencils and pens, books, tools, wallets, keys, documents, glasses, mobile phones.
Easily distracted by all sorts of nonsense.
Often forgets about important little things in daily activities.

Hyperactivity and impulsivity.

Six or more of the following symptoms of hyperactivity and impulsivity in children under 16 years of age or five in adults must also be present for at least six months:

Often fidgets in place, makes illogical movements with arms or legs in any position of the body.
Often leaves situations where waiting is required.
Shows a feeling of increased anxiety when increased attention is required.
The child is unable to take part in recreational activities.
When observing a patient, one gets the feeling that this is a robot, endlessly acting from a wound key.
Often speaks excessively incessantly.
Blurts out the answer before the question is completed.
Interrupts others, abuses attention to himself in conversations or games.

In addition, for a diagnosis of hyperdynamic syndrome, the following conditions must be met:

Several of the above symptoms are present before the age of 12 years.
The main features are the same in different situations such as at home, at school, at work, with friends or relatives and so on.
There is clear evidence that the symptoms interfere with or diminish the quality of social or professional activity, school work.
The symptoms are not signs of schizophrenia or another psychotic disorder, such as mood, anxiety, or dissociative disorders.

Hyperdynamic syndrome should be considered in all age groups. Diagnosis should only be made by a specialist psychiatrist, pediatrician, or other physician with appropriate training and knowledge in diagnosing such behavioral disorders.

Diagnosis should be based on a complete clinical and psychosocial assessment. It is necessary to analyze the behavior and symptoms in different areas and find their reflection in the daily life of the patient. Also on an adequate assessment of the anamnesis, reports of observers and observation of the mental state.

Consideration should be given to the individual's needs, coexisting social, family, educational or professional circumstances, and physical health. Children especially benefit from the assessment of their parents or caregivers. Determining the severity and harm of behavioral disorders affecting the child and his parents. The needs of the patient and those around him must be taken into account.

If hyperdynamic syndrome is suspected, it is necessary to exclude:

A number of conditions such as thyroid disease, anxiety, and substance use disorders.
The use of steroids, antihistamines, anticonvulsants, beta-agonists, caffeine, nicotine.

Hyperdynamic syndrome - treatment

Pharmacological agents for children are prescribed in case of severe and persistent symptoms of hyperdynamic syndrome, when the diagnosis has been confirmed by a specialist. Children with mild symptoms may be treated with CNS stimulants if psychological interventions have been unsuccessful or unavailable. Treatment often needs to be continued into adolescence and may need to be continued into adulthood.

Medical treatment of the syndrome should be part of integrated program treatment. Pulse, blood pressure, psychiatric symptoms, appetite, weight and height should be recorded at the start of therapy, and reported after each dose adjustment and every six months of treatment.

The use of medications is generally not recommended for preschool children, for whom programs psychological support are first-line therapies. In school-age children with severe signs of hyperdynamic syndrome, drug treatment is the main method of therapy. It is important for parents to participate in the maintenance of treatment.