Hyperkinetic Conduct Disorder is a collection of complex behavioral disorders characterized by the presence of certain features from three categories: impulsivity, inattention and hyperactivity, in the presence of specific criteria for conduct disorder in society.
Basic terminology
There are several terms that describe these behavioral disorders in children: ADD (Attention Deficit Disorder), ADHD (Attention Deficit Hyperactivity Disorder), Hyperkinetic Disorder proper, and Children's Hyperactivity.
All these concepts are somewhat different from each other. However, they are based on concentration problems and hyperactive behavior.
Hyperkinetic disorder is a behavioral disorder that worries parents at an early age. At the same time, the baby is extremely inattentive, impulsive and overly active.
However, do not think that many children, for example, a five-year-oldage (which is characterized by anxiety and inattention) suffer from a similar disorder. Such behaviors become a problem when they are significantly hypertrophied compared to their peers, this negatively affects academic performance, communication with friends and family.
Only 5% of schoolchildren have hyperkinetic conduct disorder, with boys slightly more likely.
Causes of occurrence
The causes of such disorders are not known for certain, but there is a clear connection between the disease and traumatic experiences and hereditary (family) factors.
The following factors can provoke the development of hyperkinetic behavioral disorders:
- insufficient/unbalanced nutrition (including improper introduction of complementary foods);
- severe intoxication, such as chemical compounds;
- constant stress, unfavorable environment in a team or family;
- use of certain drugs;
- damages or failures in the development of the brain, especially its right hemisphere);
- pregnancy problems (oligohydramnios, fetal hypoxia, etc.).
Varieties of disease
Classify such disorders according to severity: mild and severe.
In addition, there are several types of deviations according to the age of the child:
Kids 3-6 years old are emotionally unstable and too mobile. They do not sleep well at night, often wake up and refuse tosleep during the day, which further exacerbates the situation. Such children show disobedience in every possible way, ignoring the prohibitions and rules that educators or parents require
- Younger students do poorly in school and do not follow the rules of school behavior. Such a student cannot concentrate on the lesson, and independent tasks are given to him very hard. It is difficult for a child to maintain attention and perseverance, because of this, he is distracted, makes ridiculous mistakes and does not learn the material.
- High school students with hyperkinetic conduct disorder are prone to antisocial behavior, smoke or drink alcohol, start sexual activity early, especially without thinking about choosing a partner.
Main symptoms of pathology
Do not think that hyperkinetic conduct disorder (F 90.1) is just a feature of temperament. This condition is included in the ICD-10 as a pathology requiring medical correction.
Some parents attribute this to over-controlling the child, but there is no evidence that harsh or poor parenting leads to such disorders.
Hyperkinetic disorders in children can be expressed in a number of different ways according to age, motivations and environment in the classroom, kindergarten and at home. There are three main groups of symptoms: impaired attention, impulsivity and hyperactivity.
So, for some children, attention problems come to the fore, while the child is often distracted, forgets importantthings, interrupts the dialogue started, disorganized, starts a lot of things and does not finish any of them.
Hyperactive babies are overly fidgety, noisy and restless, their energy is literally in full swing, and their actions are almost always accompanied by incessant chatter.
When the symptom of impulsivity prevails, the child does things without thinking, it is extremely difficult to endure waiting (for example, queues at the game) and is very impatient.
In addition, other symptoms are often present: neurological manifestations (epilepsy, tic, Tourette syndrome), impaired coordination, social adaptation, problems with learning and organization of activities, depression, autism, anxiety.
In one out of three cases, children with a similar problem "outgrow" the pathology and do not need special treatment or support.
Parents often wonder why hyperkinetic disorder is dangerous.
This condition is fraught (but, fortunately, not always) with problems not only in childhood (poor academic performance, problems with classmates, teachers, etc.), but also in adult life (at work, in relationships and addictions to alcohol or drugs).
Where to contact
If parents suspect that the baby has a similar condition, a psychiatric consultation is necessary.
Only a specialist, observing the behavior of the child and his character, can establish an accurate diagnosis.
Signs,indicating the presence of an ailment cannot be single, that is, symptoms that periodically recur for at least 6 months are considered diagnostically significant.
In order to identify the presence of pathology, the doctor uses the following methods:
- conversation (often the child does not recognize the presence of any of the symptoms, and adults, on the contrary, exaggerate them);
- assessment of behavior in a child's natural environment (kindergarten, family, school, etc.);
- simulation of life situations to assess the child's behavior in them.
Diagnostic criteria
There are a number of criteria, the presence of which confirms the presence of a hyperkinetic disorder in a baby:
- Attention problems. At least 6 manifestations (forgetfulness, distraction, inattention, inability to concentrate, etc.) within 6 months.
- Hyperactivity. Within six months, at least 3 symptoms from this group appear (children jump up, turn around, swing their legs or arms, run in cases that are not suitable for this, ignore prohibitions and rules, cannot play quietly).
- Impulsive. Presence of at least 1 sign (inability to wait and conduct a dialogue, excessive talkativeness, etc.) for 6 months.
- Onset of symptoms before the age of seven.
- Symptoms do not only occur at home or at school/kindergarten.
- The present signs significantly complicate the educational process and social adaptation.
- The criteria that are present are notcorrespond to those in other pathologies (anxiety disorders, etc.).
Ongoing therapy
Treatment of hyperkinetic disorder in children involves the following goals:
- ensuring social adaptation;
- correction of the neuropsychic state of the child;
- determination of the degree of the disease and the selection of methods of therapy.
Non-drug step
At this stage, specialists advise parents about the disorder, explain how to support such a baby, and talk about the features of drug treatment. In cases where a child has learning difficulties, he is transferred to a correctional (special) class.
In addition, non-drug treatment of hyperkinetic conduct disorder in children involves the use of certain methods. These include the following:
- Group LF.
- Cognitive psychotherapy.
- Training with a speech therapist.
- Physiotherapy.
- Pedagogical correction of hyperkinetic behavior disorder in children.
- Massages of the cervical-collar region.
- Conductive Pedagogy.
- Normalization of the daily routine.
- Classes with a psychologist.
- Creating a comfortable psychological atmosphere.
Drug therapy
- "Methylphenidate" is a stimulant that increases alertness and energy with a beneficial distribution. Depending on the form used, it is prescribed 1-3 times / day. Moreover, the medication should be taken in the morning, soas later use is fraught with sleep disturbances. The dosage is selected individually. Physical dependence, like drug tolerance, is not common.
- In case of intolerance to psychostimulants, nootropics are prescribed: Noofen, Glycine, etc.
- Antioxidants: Actovegin, Oksibal.
- Normothymic anticonvulsants: valproic acid, "Carbamazepine".
- Fortifying agents: folic acid, magnesium-containing agents, B-group vitamins.
- In cases of ineffectiveness of the above drugs, tranquilizers are used: Clorazepate, Grandaxin.
- In the presence of severe aggressiveness or hyperactivity - neuroleptics ("Thioridazine", "Chlorprothixen").
- In cases of secondary depression, antidepressants are indicated: Melipramine, Fluoxitin.
Help from parents
Important in the treatment of hyperkinetic conduct disorder is the correction of the child's behavior at home. Therefore, parents should follow some rules:
- optimize the diet, that is, exclude from the menu products that increase the excitability of the baby;
- occupy the child with active games and sports in order to spend excess energy;
- make a list of household chores for the day for the baby and place it in a conspicuous place;
- any request mustbe pronounced in a calm voice and in an understandable manner;
- in case of performing any task that requires perseverance, it is necessary to give the child 15 minutes to rest. and make sure he doesn't overwork;
- necessary to write detailed simple instructions for doing household chores, which contributes to self-organization.
Preventive measures
The following should be taken into account:
- pedagogical control;
- exclusion of side effects of anticonvulsants and psychostimulants;
- maintaining a normal psychological climate in the family;
- improving the quality of life;
- when taking medication, take periodic breaks in treatment to determine further tactics;
- daily communication with school staff;
- in case of ineffectiveness of drugs - the involvement of teachers and psychiatrists for corrective therapy.
Next steps
- D-registration at the neurologist.
- In the case of the appointment of psychostimulants - control of sleep and the appearance of side effects.
- In cases of taking antidepressants - control of ECT (with tachycardia), and when prescribing anticonvulsants - control of AST and ALT.
- Providing the most comfortable conditions for learning, self-organization and socialization of the baby.
