Attention deficit disorder: what can the family do?

There are three basic conditions that would allow us to talk about an attention deficit hyperactivity disorder (ADHD) in a child. These are the scattered attention, restlessness, and impulsiveness. They are the primary symptoms.

The children evaluated are divided into those who only have scattered attention and those who also have hyperactivity and impulsivity.

Dr. Catina Solano Mosquera, a physician and child and adolescent psychiatrist, explains that the timely diagnosis of the disorder occurs from the time the child enters the school stagein which it has already passed through its first stage of growth and development.

And if it is already detected in adolescence, a fourth symptom is added: changes in mood.

The diagnosis, says Dr. Solano, is interdisciplinary. “Not from a single point of view. is requested psychological, psychiatric and neurological evaluation. According to that, the needs of the child are determined, which must be worked on”. This is how decisions are made, for example, drug therapy.

Is there a genetic factor in ADHD?

In this neurodevelopmental condition we speak of genetic and environmental factors. “When one does the clinical history, one investigates if there is a history within the family with these types of symptoms, in the parents or direct relatives. And, of course, comorbidities are also being investigated, such as emotional symptoms”, says Solano.

The most frequent comorbidities in children with pure attention disorder are Learning problems. Here pedagogical intervention is necessary. And if a child has attention disorder associated with motor hyperactivity or impulsivity, then it is also thought that there is a conduct disorder.

“When we reach adolescence, hyperactivity subsides, but impulsivity remains and the emotional symptoms”, adds the specialist. This happens when the children have gone through situations of great repression and calls for attention, of a management that has not been the most successful.

Alternatives must be sought as opposed to repression and punishment. “The most appropriate thing is for children to see a firm and clear discipline, never with shouting or mistreatment”, warns the psychiatrist, because they, not having adequate self-regulation, constantly try to do what they want.

Strong discipline begins with regulated physical exercise. “This helps a lot to give it a good containment system.” The use of medicines also enters this section. “It is very sad to see children who have not been handled correctly when they reach the stage of adolescence. They do not have proper social relationships and are not accepted by peers; they do not obey, despite receiving recurrent calls for attention, both at home and at school”.

The sum of pharmacology (if required), structured sport, sustained discipline and a good family environment gives the child a good prognosis. “If we subtract these interventions, the prognosis becomes a little more complex.”

Symptoms that appear in preadolescence

A very current topic is that some children may have symptoms of ADD or ADHD starting at age 11, in pre-adolescence. They have been able to sustain a stable attention span during school, but then there are many changes in thinking.

“The thought also grows, not only the physical; there are changes from the emotional and cognitive point of view”, indicates the doctor. “When we find this, it is necessary to evaluate and confirm or rule out if the child has any condition of an attention deficit.”

This also involves the school. When children have some cognitive difficulty, they benefit from coordinated work and supervision. Solano does not speak of specialized care, since he says that this is not what it is about, but about proper management, in which professionals give guidelines to teachers and they give feedback to those who are working with the child, so that he can continue advancing .

What else can the school do?

The school can make sure the child has been tested, so the teachers know what’s going on. This way they can give the children a little more time to complete assignments and tasks. “You have to give them guidelines and signals so that they start working.” For example, do not give them a task for tomorrow, but extend the deadline to two days, and make sure that the commitment is fulfilled.

“Sometimes children with attention disorders do not persevere; they get bored easily. They are given time, they are placed in the front of the room so that they are more attentive”. And they are not stigmatized, warns Solano. They do not need a different attention, but a guide and conversations that guide them.

A powerful element is the example. “Perseverance is taught by parents. Learning the sport also gives it. Unfortunately, we are in a complacent society. A child entered a sport and after a month he didn’t want to, he didn’t like it, he got tired or the parents don’t have time to take him. But when one is persevering, the achievements are wonderful”.

Discipline is a great structuring of the nervous system, according to Dr. Solano. “A child with a good family structure regulates himself, matures and gets ahead with his own resources.”

This discipline must be direct and face to face. Try to make your child understand what he is telling you. Once communication and visualization between parents and children is established, the expected behavior is explained to them, as well as the rewards or losses if this is not met. This way, if there is misbehavior, the father does not have to devise or improvise ways to punish, because according to the agreement they reached, it is the children who lose the privileges.

The importance of medication in ADHD

The drug used in certain cases of attention deficit disorder is described by Solano as one of the longest on the market, unchanged. Its about methylphenidatewhich was approved in 1937. It is still the main drug, and the adverse results, says the doctor, are due to non-prescription uses.

“The methylphenidate does not generate dependency; it can be withdrawn at any time,” says the psychiatrist. “When the child has required the medication and has not received it, he has been very hurt. It is the child who receives the recurring calls for attention at home, at school, with friends, the sports team. Arriving like this at adolescence, he is emotionally fragile and does not have self-confidence, as he has been questioned for incorrect behavior that he could not control. (F)