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In recent times, it is common to hear that such and such child suffers from or, more accurately, is an ADHD case. ADHD cases have multiplied by thirty in just over a decade in our country, especially in children aged 8 to 12, with overdiagnosis occurring.
In Spain, more than 250,000 minors take psychostimulants to combat ADHD, according to the latest prevalence studies of this disorder by the National Institute of Social Security. Having a “label” and medication that improves symptoms gives the patient and their family a break from their anguish and uncertainty. In a high percentage of cases, medical prescription depends on guidance and mental health services, which in turn receive a report from the school describing a possible case of ADHD.
The child’s context and situation are not always taken into consideration, and certain reactions are part of normality, whether it is adolescent rebellion, nervousness, sadness, reactivity, lack of attention and concentration in the face of grief and changes, a difficult or crisis-ridden family environment, various abuses, bullying, or, among other circumstances, the child is highly gifted and has not been identified.
Medication for the treatment of ADHD has side effects on health, in addition to a perception on the part of the affected person of loss of personal responsibility, since they quickly argue that it is a problem of their brain biochemistry.
The characteristics of inattention, hyperactivity, or impulsivity are typical behaviors of early childhood, with continuous movement, little attention, not listening well, wanting things for yesterday… However, it is necessary to carry out a convenient discrimination and an adjusted detection.
In a possible diagnosis of ADHD, the following criteria marked by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) must be met:
- Manifests behaviors of hyperactivity, impulsivity, lack of attention, or some of them disproportionately in reference to other children of their age and with respect to their degree of development.
- They have been present since an early age (before 12 years of age)
- Significantly impairs their quality of life
- It is not caused by a medical problem, toxic substance, or other psychiatric problem.
- It affects at least two different environments in the child’s life: school, social, and/or family.
It is important to go to a health professional specialized in ADHD so that they can make an appropriate clinical diagnosis and thus avoid an erroneous diagnosis.
There is a consensus among experts that the tendency to develop ADHD is present from birth, although the most obvious behaviors are not accurately discriminated until the academic demands of Primary school. The ratio of affected males vs females is three to one. Within the ADHD subtype, the percentage of girls is higher than that of boys.
For many parents, it is not easy to assume that the behaviors they observe in their children are a disorder with complex words such as those used by pediatricians and other professionals, instead of having problems with hyperactivity and impulsivity, they think something more usual such as “why can’t they ever stay still?” Others, on the other hand, not feeling capable of managing the behavior of their little ones and with a high probability thanks to the dissemination about ADHD, see in this diagnosis an answer to their difficulty. Whether it is a false positive or a false negative, early detection is necessary to take the appropriate measures for the best development of the minor.
The core symptoms of ADHD are hyperactivity, attention deficit, and impulsivity.
Hyperactivity is perhaps the easiest to recognize due to its evidence and being the most well-known by the general public.
The child who suffers from hyperactivity is characterized by:
- Movements at inappropriate times
- Difficulty staying still when necessary
- Talking excessively
- Constantly makes noises even in quiet activities
- Difficulty relaxing
- Changing tasks without finishing any
- Lack of perseverance.
The manifestation of hyperactivity can be diverse according to stages of life, but the symptomatology is the same for children and adults. A superficial use of the term hyperactivity has been extended to describe states of people who are nervous or who are very active.
Attention deficit is more difficult to identify adequately at an early age. It usually appears generally when the school stage begins, because a more complex cognitive activity is required. In general, it persists significantly during adolescence and adulthood. The characteristics are:
- Difficulty maintaining attention for a prolonged time
- Little attention to detail
- Problems finishing tasks
- Fatigue to listen, follow orders and instructions
- Disorganization in their activities and homework
- Habitually loses, forgets objects and belongings
- Avoidance of tasks that need a sustained level of attention
- Frequent changes of conversation
- Forgetfulness of rules or details of the games
- Rapid distraction.
Impulsivity is probably the least frequent symptom of the three base symptoms of ADHD. Impulsivity is fundamentally the difficulty in thinking things through before acting. This can generate numerous problems, since the patient can put themselves in danger and live conflictive situations mainly in adolescence and adulthood.
The characteristics of impulsivity are:
- Impatience
- Problems waiting for their turn
- Constant interruption
- Overbearing and dominant answers
- Tendency to touch everything
- Conflicts with adults
- Little control and irreflexivity.
Encountering a “pure” ADHD is unusual. By such a diagnosis it is understood that the disorder is present without any other associated disorder. It is estimated that 70% of patients with ADHD present some comorbidity or associated psychiatric disorder.
A symptom that is not usually mentioned regarding children with ADHD is problems controlling their emotions, since these play an important role in the difficulties they face daily. It is not that they have different emotions from most of their peers, what does mark the diversity in many children with ADHD is that these feelings seem to be more frequent and intense, they seem to last longer and are an obstacle to daily life. They get frustrated quickly by small inconveniences. They do not usually have the same capacity as children their age to control their emotions. They generally have problems with functional memory, in addition to other executive functions, this difficulty makes them lose sight of the global idea and they tend to remain detained in what they are feeling at the moment. The specific emotion takes control of their thoughts.
They worry too much or for a long time about things that may be insignificant. Difficulty calming down when they are upset or angry. They feel hurt or offended by the slightest criticism. Demand and a lot of urgency to immediately obtain something they want. It is frequent that they feel overwhelmed by discouragement, frustration or anger, they show themselves fearful and insecure to start activities, they give up quickly in what they do, oppose to carry out the tasks and even avoid interacting with others.
The best intervention and help for their needs that can be offered to a child with ADHD is early detection
The dìde tool offers in a simple way the possibility of specifying up to 35 indicators, starting from the age of two years, carrying out a pre-evaluation in which at least two of the main areas of the minor, family-educational, intervene through their questionnaires, and that in the case results with significant markers accurately guides towards the relevant professional to carry out the evaluation and diagnosis. Similarly, it helps to discriminate false positives.
There are associations that are dedicated to its scientific research, dissemination and social awareness, information, training, advice and group and individual support, putting within reach of those affected and their families all possible means to reduce the negative effects of ADHD, trying to improve their quality of life.
These are some examples:
ADHD Association Vallés
ADHD Association Bahía de Cádiz
ADHD Association Ceuta
ADHD Association Axarquía
ADHD Association +16 Valencia
ADHD Association Palencia
Association Niño Activo
Association ANFATHI
Therapeutic association La Tortuga
In the following link you will find the associations of Spain of ADHD.
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