How to help my child with adhd without medication

Can You Treat It Without Drugs?

Written by Marisa Cohen

"Your child has ADHD."

For most families, that means the beginning of a long trek through the world of pharmaceuticals. Medications are the top treatment for ADHD, and they're effective for 80% of kids with the disorder.

But many parents worry about side effects and want to exhaust every other option before they put their child on medicine.

No matter what your decision is, you can help your child live a calmer, more successful life.

To Medicate, or Not to Medicate?

For some, like Sonia, it was a matter of age. "My son was just 5 years old when he was diagnosed with ADHD, and I thought that was too young for medication," she says.

In fact, the American Academy of Pediatrics agrees. They almost always recommend that, before age 6, you start with behavior therapy.

"Parents often ask if they can try other treatments first before they turn to medication, and there are several methods that are effective," says Richard Gallagher, PhD, of the Institute for Attention Deficit Hyperactivity and Behavior Disorders at the NYU Child Study Center. He encourages parents to try other things while they look into the risks and benefits of medications.

Gallagher says that behavior changes alone are most effective with kids who are only inattentive and unfocused, rather than those who are also impulsive and hyperactive. The most successful treatment for ADHD combines both meds and behavior management.

Parent and Teacher Help

Parents and classroom teachers play a starring role in helping a child learn to recognize and adjust their behavior, Gallagher says.

For parents, this means creating small, manageable goals for their child, such as sitting for 10 minutes at the dinner table, and then giving rewards for achieving them. It's also helpful for the teacher to send home a daily "report card," letting the parents know whether the child met their behavior goals at school that day.

From a young age, Sonia's son was graded in school every 20 minutes on three goals: staying seated, staying on task, and being respectful of others. His reward for meeting the goals were more time shooting hoops later in the day - a more effective strategy than punishing him for misbehaving, his mom says.

A coach or tutor can work with older children to come up with a system for keeping track of their books, papers, and assignments, says Edward Hallowell, MD, the author of Delivered from Distraction. "This is more helpful than Mom or Dad trying to help organize, because with a parent, it can come across as nagging," he says.

Sleep

Getting enough shut-eye can be a game-changer for kids with ADHD. Research shows that just an extra half-hour of sleep can help with restlessness and impulsivity.

"A lot of kids with ADHD also have sleep disorders, and each condition makes the other one worse," says Mark Stein, PhD, an ADHD specialist at the Seattle Children's Hospital.

One of the most common sleep issues for kids with ADHD is that they can't settle down and fall asleep; then their exhaustion the next day makes their symptoms worse. While some doctors recommend sleep aids such as melatonin, you should start by practicing good sleep habits:

Have a consistent bedtime, even on the weekend.
Keep the bedroom cool and dark.
Create a soothing winding-down ritual.

"We have bedtime broken down into 10 specific tasks, like taking a bath, putting on pajamas, reading for a half-hour," Sonia says. "He had trouble falling asleep before, but the routine really helps him settle down."

That also means no screens of any kind before bedtime. Take computers, TVs, phones, and video games out of the bedroom so your child isn't distracted or tempted.

Exercise

Make sure your child has plenty of opportunities to run and play (at appropriate times). Some recent studies found that after about 30 minutes of exercise, kids with ADHD can focus and organize their thoughts better.

Elise can confirm these results. "Like a lot of kids with ADHD, my son doesn't have very good coordination, but he's fallen in love with swimming," she says. "He enjoys the feel of the water and always feels calmer when he gets out of the pool."

If your child wants to play organized sports that require focus and concentration, like baseball or tennis, there's more to the equation. "Before they started medication, many of my patients were stuck playing the outfield, where they would just wander around chasing daisies," Stein says. "But the medication helped them play better and be part of the team."

Meditation and Mindfulness

A new line of research is exploring how mindfulness -- learning how to sharpen focus, raise awareness, and practice self-control through breathing and meditation -- may help manage the symptoms of ADHD.

One small study found that when both children and their parents completed an 8-week mindfulness-training program, the kids had fewer symptoms. And their parents felt less of the stress that typically comes with their role.

This is promising news, but Gallagher points out there isn't yet enough solid evidence to fully recommend the strategy.

Elise's son has tried a few different meditation techniques over the years to control his anxiety and impulsivity. While they were helpful at the moment, she says he hasn't been able to stick with them.

Music Therapy

It can hone attention and strengthen social skills. It's rhythmic and structured. And playing music requires different parts of your brain to work together, as well as learning how to be a part of a group.

There's very little hard research specifically connecting music with ADHD symptoms, but scientists do know that when children play an instrument -- taking piano lessons at home, say, or playing cello with a school orchestra -- they do much better on tests of executive function than children who don't study music. That's the ability of the brain to organize and easily switch between tasks.

If your child would rather kick a soccer ball than pick up a flute, or can't sit still for lessons or practice, simply listening to their favorite playlist may calm them down long enough to finish their homework. When you listen to music you like, your brain releases dopamine, a chemical that also helps with focus.

More work needs to be done to connect ADHD to music, but it's certainly an area worth exploring, especially for music-loving families.

Omega-3 Fatty Acids

Over the years, several "ADHD diets" have been proposed and then dismissed by science.

A study found that kids with ADHD have lower levels of omega-3s in their blood, which suggests bumping up the amount in their diet might reduce ADHD symptoms. But research on this topic is limited, and whether omega-3 supplements might help is not clear.

Although omega-3 supplements aren't widely recommended as a treatment, Hallowell points out that eating a balanced diet -- including fish, whole grains, and plenty of fruits and vegetables -- and cutting down on sugar and processed foods can certainly help your child live a healthier life.

Easing ADHD without meds

Because of his attention-deficit/hyperactivity disorder (ADHD), the 10-year-old boy rarely even tried to answer the questions on the math and language arts worksheets his fourth-grade teacher asked students to complete during class. Not only that, he often bothered the students who did.

Then the teacher made an important change to the boy's worksheets: She wrote the correct answers on them with invisible markers so that the boy could reveal the correct answer by coloring over the space as soon as he finished a question. The teacher also randomly inserted stars he could uncover by coloring and told him he would earn a reward for collecting four stars. The strategy paid off: The boy was soon answering every question and getting 84 percent of them correct.

Giving immediate feedback is just one of many simple and effective behavioral approaches to improving children's attention, says psychologist Nancy A. Neef, PhD, who described the invisible marker experiment in a chapter on treating ADHD she co-authored in the 2012 "APA Handbook of Behavior Analysis." With ADHD affecting an estimated 7 percent of American children ages 3 to 17, psychologists are developing behavioral interventions that parents, teachers and others can use to help kids focus and control their impulses. Others are conducting research that demonstrates that more exercise and longer sleep can help.

That's good news for kids, says Neef, who believes that parents, teachers and pediatricians are sometimes too quick to jump to prescribing medication for ADHD.

"Particularly in the case of stimulant medications, which are the most common treatment for ADHD, we don't know an awful lot about the long-term side effects," says Neef, a professor of special education at The Ohio State University.

And medication doesn't address problems related to children's academic performance and relationships with family members, peers and others. "Even though medication can be effective and very helpful, it's not a panacea," Neef says.

Behavioral interventions

Surprisingly, nonpharmacological approaches are also controversial, especially among the medical community.

"If you read the professional guidelines for psychiatrists or sometimes pediatricians, the treatment that is emphasized for kids with ADHD is a pharmacological one," says Gregory A. Fabiano, PhD, an associate professor of counseling, school and educational psychology at the State University of New York at Buffalo.

That bias toward pharmacological approaches has its roots in a large study by the Multimodal Treatment of ADHD (MTA) Cooperative Group, published in 1999 in the Archives of Psychiatry. The study, which compared medication, intensive behavioral treatment, a combined approach and standard community care, concluded that medication worked best. "The field took that result and ran with it," says Fabiano.

But since then, a number of papers have followed up on the original study participants. "They have found that some of those conclusions may have been if you just looked at the immediate post-treatment results," he says. "If you look at how well they work over time, any differences seem to subside."

He points as an example to a 2007 article in the Journal of the Academy of Child and Adolescent Psychiatry. A three-year follow-up of the MTA study, the paper found that while medication and the combined approach had a significant advantage at the 14- and 24-month follow-up, that advantage faded over time. At the 36-month point, the treatment groups didn't differ significantly on any measure.

Fabiano's own work, a meta-analysis published in 2009 in Clinical Psychology Review, found that behavioral treatments for ADHD are highly effective. Fabiano and his co-authors examined 174 studies of behavioral treatments in 114 papers. These treatments fell into three broad categories:

Parent programs. These interventions focus on teaching parents strategies for helping their children succeed. One such approach is to catch children being good. "If you think about the typical child with ADHD, they're always noticed when they're messing up," says Fabiano. "One of the things we try to teach adults to do is to also notice them when they're doing the right thing and then label and comment on it so they're getting attention for good behavior."
Teacher programs. Like the invisible marker example, these interventions offer teachers behavioral strategies for the classroom. They include giving straightforward, one-step-at-a-time instructions to children and announcing the consequences of not paying attention ahead of time. Another effective approach is contingency management. With this strategy, children receive daily report cards that outline how well they have met such goals as speaking in turn or bringing their homework back to class. When they meet those goals, they receive awards.
Therapeutic recreational programs. In these programs, children with ADHD interact with each other at summer camps and similar venues. The programs offer crafts, sports and traditional camp activities in addition to behavioral interventions. In contrast to the usual ADHD treatment, these interventions last all day long for several weeks at a time. Programming typically includes brief social skills training sessions plus coached group play incorporating contingency management strategies. In addition to learning social skills, participants also learn sports and team membership skills.

"A lot of this isn't rocket science," Fabiano admits. "The hard part is keeping these interventions going."

But the key is early intervention, says psychologist George J. DuPaul, PhD, co-author of the 2011 book "Young Children with ADHD: Early Identification and Intervention." Even the American Academy of Pediatricians' 2011 treatment guidelines say that behavioral strategies should be the first line of treatment for young children with ADHD.

"These are students who enter kindergarten and first grade already behind academically and behaviorally and never quite catch up," says DuPaul, who chairs the department of education and human services at Lehigh University's College of Education. "Early intervention in the preschool years offers the opportunity to get a head start on trying to bridge the gap between students with attention problems and their peers."

As a result, says DuPaul, behavioral interventions should begin even before children start school. Parents can introduce preschoolers to early literacy and numeracy activities to give them the extra head start they need, he suggests. Psychologists can also teach families how to identify the real reason children with ADHD engage in problematic behavior and what to do about it. A child who ignores directions when asked to put away his toys and come to dinner, for example, may be trying to communicate that he wants to keep playing. Parents can learn to redirect such behavior by teaching the child to communicate his desires verbally, warning him about upcoming transitions and invoking consequences when he fails to follow directions — techniques that can also benefit children who don't have ADHD.

Psychologists can also teach others in children's lives how to use such techniques, DuPaul says. A preschool teacher reading a story to preschoolers, for instance, can praise children who are not talking to neighbors. Once the chattering child notices that praise and stops talking, says DuPaul, the teacher can "pivot" to praising that child.

Lifestyle changes

Healthy living may also help children with ADHD — as well as everyone else — maintain their focus. And unlike medication, it's free.

Exercise is one powerful intervention, says Matthew B. Pontifex, PhD, an assistant professor of kinesiology at Michigan State University. His research suggests that even a few minutes of physical activity a day can help children with ADHD ignore distractions, stay focused on tasks and boost their academic performance.

In a study published last year in the Journal of Pediatrics, Pontifex and his co-authors had 40 elementary school-age children — half with ADHD — spend 20 minutes striding on a treadmill or quietly reading. Whether they had ADHD or not, the children performed better on math and reading comprehension tests after exercising. The exercisers with ADHD were better able to slow down and avoid repeat mistakes while playing a computer game.

For psychologists, says Pontifex, the implications are clear. "At the very least, exercise might be a frontline thing to consider in treatment," he says.

There are policy implications as well, he adds. Schools are under pressure to cut recess and physical education to make way for subjects that will help children perform better on standardized tests, he explains. "This research provides some empirical basis to suggest there would be a potential benefit for having those physical exercise opportunities during the school day," he says.

Sleep may be another no-cost intervention, says psychologist Reut Gruber, PhD, an assistant professor of psychiatry and director of the Attention, Behavior, and Sleep Lab at McGill University. Her research with typically developing children without ADHD suggests that even just a half-hour of extra sleep can keep kids from being restless at school and improve their behavior. Conversely, cutting back on sleep can result in tears, tantrums and frustration.

In a paper published in 2012 in Pediatrics, she and her colleagues studied sleep's impact on 34 children ages 7 to 11. The parents of half the kids were told to give their children an extra hour of sleep; the others were told to cut sleep time by an hour. While wristwatch-like devices called actigraphs that the children wore revealed that the extra-sleep group ended up sleeping only an extra half-hour on average, that small increase was enough to produce noticeable results. According to teacher ratings, behavior improved among the kids who got more sleep and deteriorated among those who got less.

Past studies have shown that children with ADHD tend to be hypoaroused, says Gruber. Unlike adults, who typically slow down when they're tired, children with or without ADHD often manifest fatigue by getting hyperactive.

"From the outside, they make look very energetic, but really it's the opposite," says Gruber. "It has been proposed that one reason for hyperactivity is that it helps children stay awake."

Rebecca A. Clay is a writer in Washington, D.C.

13 tips for parents and teachers on how to properly teach hyperactive children

The child cannot do the same thing for a long time and is often distracted. Abruptly takes off and starts running around the room or school. These can all be signs of Attention Deficit Hyperactivity Disorder (ADHD). Panic early! Such children can also be successfully taught if you know how to work with them. Psychologist, psychotherapist GMS Clinic Inna Pasechnik compiled a memo on working with hyperactive children.

The physiological characteristics of children with ADHD are the following manifestations:

1. The child needs to constantly move, it is difficult for him to sit straight during the lessons: such children are distracted, talk in the lessons, "spin", sway, sit with their legs under the buttocks, when tired, their motor activity increases.

This is due to the peculiarities of the brain in children with ADHD, they need a constant supply of nutrients to the brain, which is possible only when moving. If a child with ADHD is persuaded to sit quietly, it will be more difficult for him to think.

In this regard, it is recommended to allow a certain level of motor activity to the child during the lesson. If the child gets tired, then allow him (find a legitimate reason) to walk around the class or do some active exercises (wipe off the board, distribute notebooks, go for water).

2. The child is very tired of the routine, it becomes unbearably boring for him to do the same type of tasks if he has already figured it out.

In this regard, in the world pedagogical practice, it is customary to reduce the number of tasks of the same type (including homework) for children with ADHD by 30%, not to require them to complete all the examples, if the child has already mastered the topic. The number of repetitions in children with ADHD does not affect the quality of information assimilation.

In addition, it is acceptable for a child with ADHD to be able to draw in a draft or twist something in his hands during the lesson. They tend to do several things at the same time, which does not affect the quality of perception of information in the lesson. Otherwise, the child begins to distract his neighbors by actively moving and talking to them.

3. A child with ADHD is most often not able to beautifully and neatly arrange his work, he allows corrections, blots, inaccurate design of assignments.

It is recommended to pay attention to the content of the work, and not to the quality of its design, since a regular decrease in the score for an incorrectly designed work will significantly reduce the motivation to study.

4. Children with ADHD are afraid of large volumes.

If a child with ADHD is immediately asked to complete 20 examples, he will be frightened and fall into a stupor or despair, as large amounts of work scare them. However, if a child is given the same 20 examples on separate cards 5 times 4 examples each, it will noticeably improve his performance. The child will be happy to complete all 20 examples, in addition, this will be a good opportunity to move between receiving the next card. Thus, children with ADHD need to divide large amounts of tasks into several small parts.

5. A child with ADHD may forget everyday things and some items when completing a task according to a plan, they may even forget the ultimate goal of the activity (poor working memory).

Often, children with ADHD get their grades lowered because they forget to do part of the tasks in the exercises. It is recommended to separately concentrate their attention on all the items of the task in the exercise. For example, asking this particular child what you need to remember to complete in the task.

In addition, these children tend to forget their things. Therefore, they can be reminded of them more often or separately encouraged for not forgetting to take everything with them. It is effective to use "reminders" - small notes, stickers in a pencil case or announcements on the wall, thanks to which the child can remember to take a thing with him, go somewhere or do something.

6. A child with ADHD is often distracted.

It is advisable to seat children with ADHD closer to the teacher so that it is easier for them to concentrate, and in case the child is distracted, lightly touch his hand so that he can concentrate again. It is possible to specifically discuss with the child the ways by which he can not be distracted in the lesson.

7. Children with ADHD have poor time orientation.

It has nothing to do with the intellectual development of the child. However, a child with ADHD often does not notice that more time has passed than he intended. As a result, the children are late, I don’t have time to finish something. In such cases, it is recommended to either remind the time yourself, or teach the child to set a timer, or set a timer or an hourglass so that children can see them and be able to navigate on their own.

8. A child with ADHD can be very interested in something, this is his strength, so if the child is unsuccessful in something, then you can restore his authority in the eyes of classmates by involving him in activities in which he showed interest and showed your awareness.

9. Children with ADHD are impulsive.

It is difficult for a child with ADHD to restrain himself from shouting out in class if he knows the answer, it is difficult for him not to interfere in the activity if something interesting happens to him.

In the lessons, it is possible to introduce special tablets on which children can fix the answer to the teacher's question so that they do not have to endure if another student answers. It is also possible to introduce a special encouragement for the child, if he did not cry out, showed patience. For example, if the child refrained from impulsive action, allow him to distribute notebooks.

10. Children with ADHD are emotional.

In this regard, they can be very offended if something does not work out for them or classmates do not communicate with them (children with ADHD are very sociable: they like to talk, chat with everyone). In this case, the child needs support or help in building relationships with classmates, you can intervene in the children's play and assign roles, showing the child how he can participate in the game. Otherwise, conflicts may arise between a child with ADHD and other children.

11. A child with ADHD can be taught to do those things that are difficult for him for physiological reasons, but for this he needs to create external motivation.

For this, an incentive system (bonus system) is used. It can be used in conjunction with parents. For example, several rules (3 rules) are introduced that the child must follow at school, for the fulfillment of which the child receives “pluses” from the teacher in a special diary (the child prepares such a diary himself at home, beautifully arranging it). Rules should be short and specific. For example, “wait for the teacher to ask you, do not shout out”, “do all the tasks in the class”, “write all the examples in a notebook”, etc. At the same time, for the implementation of the rules at each lesson, the child receives plus signs, a plus sign is put every time when the child follows the rule. Next, parents reward the child for a certain number of “pluses”. For this house, a list of rewards is compiled: each "bonus" is worth a certain number of "pluses".

This system is exclusively a system of rewards, that is, “minuses” are not set and “pluses” do not burn out. This is due to the fact that the behavior of a child with ADHD is so restless that he will lose “pluses” faster than he accumulates them, and thus the system will stop working, the child will lose interest in it and, as a result, it will be impossible to motivate the child with something .

Children with ADHD need to be led only on a reward system, the punishment system either does not work or quickly leads children with ADHD to depression, which also worsens their behavior.

12. The system for developing the skill of desirable behavior can also be used for the entire class as a whole (B. Furman's system "Kid's skills" - there is such a book).

In this case, one skill is selected, which the whole class learns. For example, be ready for the lesson on time. This means that as soon as the bell rings, the children should stand exactly near their desks, the things needed for the lesson should be on the table. If all the children were able to do this, then the teacher praises them and puts the ball in a special jar. When the jar is full, it means the class has mastered the skill. For this, children are rewarded with what they love: tea drinking, a diploma from the director, going to the zoo.

The experience of using such a program has shown that when developing one skill, children become generally more successful in all areas and their behavior becomes better in general.

13. In general, the child can be involved in helping the teacher, this will greatly inspire him, cheer him up and motivate him to cooperate.

How to help a child with ADHD?

Attention deficit hyperactivity disorder (ADHD) is a behavioral developmental disorder. How as a rule, it is diagnosed in children. Child with ADHD has difficulty concentrating, he becomes hyperactive, poorly controlled and impulsive. Unfortunately, many parents and educators in schools do not take this disorder seriously and associate child's behavior with pampering and bad manners. Children with ADHD are often subjected to pressure from both parents and from other children. All this is fertile ground for further mental illness and the formation of criminogenic behavior in adulthood. How to determine in time Does your child need professional help? What are the reasons for the appearance syndrome? And what if your child is diagnosed with ADHD? Says the leading researcher of the Ural Federal University Sergey Kiselev.

Sergey Yurievich Kiselev – Candidate in Psychology, Leading Researcher at the Ural Federal University, Head of the Laboratory of the Brain and neurocognitive development.

— I remember how 13 years ago my cousin brother was diagnosed with Attention Deficit Disorder and hyperactivity. Then in Russia, almost no one knew about it. diagnosis. Tell us what is known today?

In fact, we still don't fully know what it is. disorder. There is a definition in the International classification of diseases, where deficiency syndrome is separately distinguished attention and separately - hyperactivity syndrome. However, often we We are faced with two sets of symptoms. Such a manifestation commonly referred to as Attention Deficit Hyperactivity Disorder or ADHD.

However, there is still no generally accepted concept of causes of ADHD, about the mechanisms that cause syndrome symptoms. We have at our disposal only a number of different models that attempt to explain externally observed symptoms. I view this disorder from a neuropsychological point of view in within the framework of the Lurie approach. Russian psychologist and neuropathologist Alexander Romanovich Luria created a national neuropsychology, which is known throughout the world precisely as Luriev neuropsychology. His followers and students developed their own concept of the nature of behavioral disorders and mental health in children with ADHD.

It's not just about attention problems or hyperactivity. These children have a range of symptoms associated with a disorder. different mental functions, for example, they often have specific memory impairment, increased exhaustion, difficulties of inclusion in tasks, activity fluctuation, etc. Before modern specialists are faced with the task of explaining the causes and mechanisms of this set of symptoms.

Why is it important? If we know the mechanism of disorder, then we can more effectively help children deal with them. it will allow us to correctly build a correction for the development of children with ADHD diagnosis, which will work with the mechanism of the disorder, not outward symptoms. Suppression or withdrawal of symptoms often does not mean that we act on the mechanism of disorder, Therefore, such a correction has a short-term effect. For example, if a person has a cough that is associated with tuberculosis, then cough pills, of course, will not cure this disease. AT In this case, it is necessary to treat tuberculosis, then cough, as one of the symptoms of this disease will disappear. Also with behavioral disorders. It is necessary to influence the mechanism of the disorder, and not "remove symptoms".

Unfortunately, there is still no generally accepted understanding what the variants of ADHD might be. Most likely, There are different kinds and types of this syndrome. For example, modern research shows that under such a disorder How does ASD (Autism Spectrum Disorder) fall under the plethora of different variants of this disorder, including Asperger's syndrome, Kanner syndrome, RDA (early childhood autism), etc. It is obvious that ADHD also includes different varieties.

It is also important to understand that there are individual differences course of this disease.

Professionals should not just diagnose ADHD, thereby putting a label on the child. They must clearly understand which variant of ADHD you need to work with in a particular situation. It is necessary to understand the individual characteristics of the course of ADHD every child.

One of the serious tasks of modern child neuropsychology and neurology — development of an algorithm for helping children with ADHD, taking into account type of disorder, age, sex, individual and typological features of the child.

- Describe key symptoms that may indicate ADHD in its early stages?

- If we talk about the most rude version of ADHD, then there is a number of basic sets of symptoms.

The first set of symptoms is associated with behavioral characteristics. One of the key symptoms is increased exhaustion. Such children as a rule, they cannot engage in any one activity for a long time. At school, for example, children with ADHD cannot sit still 40 minutes of the lesson, listen to the teacher, complete assignments. They are fast exhausted and switched to other activities. Exhaustibility this kind of thing greatly interferes with successful learning, and in a broader sense, effectively adapt to the world.

The second key symptom is related to the inability to turn on quickly. into a certain activity. A simple example: the beginning of the lesson after change. The typical child quickly enters the appropriate learning activity pace of activity, begins to listen to the teacher, complete study assignments. A child with ADHD cannot change quickly level of brain activity. At recess, when he ran, jumped, played with other children, he had increased activity, but for it is not suitable for learning activities. Enhanced level brain activity can not decrease to a suitable level for educational activity. Hence the serious problems with success learning, frequent comments from the teacher, etc.

The third symptom manifests itself in the form of peculiar waves of activity. At in such children, there is an effect of either increased activity, or its sharp decline. Similar undulating activity also manifests itself in school during the lesson. Against the backdrop of these fluctuations in activity, a specific effect occurs - at the peaks hyper- and hypoactivity children with ADHD are not successful in performing educational tasks. At such moments, their brain activity is not corresponds to learning activities. But when for a short period of time, their brain activity stabilizes and enters agreement with learning activities, they easily respond to teacher's questions, can solve a difficult problem, etc.

That is why many teachers notice that children with ADHD often disobedient, chaotic, but at the same time they have a normal intelligence. Indeed, the cognitive resources of such children are often good enough. And against the background of an optimal level of activity brain they realize them to the maximum. When the activity level does not correspond to educational activities, they, of course, show poor results.

In fact, each of us has waves of activity. During We go through periods of growth and decline every day. This characterizes normal feature of our nervous system. She demands period of rest, rest and activity. But in children with ADHD, this feature manifests itself in a hypertrophied form. Waves activities change more often and more noticeably.

The fourth symptom is hyperactivity, which manifests itself in the form increased motor activity, restlessness, the number of unnecessary movements, speech incontinence, etc. There is such a thing as synkinesis - involuntary extra movements during the performance of some activity or motor activity. For example, a child writes something in notebooks, and at this time his tongue moves, his shoulders move or legs move.

According to such key symptoms in the behavior of the child, specialists identify the presence of attention deficit disorder and hyperactivity.

Although there are situations when the diagnosis is made when the presence of only one of these symptoms. And this is wrong. For example, increased exhaustion may not be in the context of ADHD, and manifest as a result of dystonia or another disease. Therefore, it must be clearly understood that ADHD is always set of symptoms.

In addition to the group of behavioral symptoms, there are a number of secondary manifestations. Children with ADHD often have cognitive Problems. For example, they do not solve problems well against the background of fluctuations. activity. An experienced diagnostician will immediately understand that the reason lies not in the cognitive abilities of the child, and in the presence of increased exhaustion during the task. Therefore, often such children, to Unfortunately, many unnecessary symptoms are attributed. In this case, you need clearly distinguish between primary and secondary symptoms.

Another interesting phenomenon has to do with memory. Often in children with ADHD there is an increased erasure of traces of memory in conditions interference, that is, interfering activity. Like this shows up? Imagine that you have to remember two text. First you read and, as you think, remember the first text. Then you are given a second text. Memorizing the second material, you forget the first one. This is a natural feature of our memory. But children with ADHD this manifests itself in an abnormal form. For example, we ask the child to remember first the first 3 words, and then the second 3 the words. He repeats the second group of words clearly, but the first 3 do not can remember. Similar memory problems also interfere with children's educational activity.

In addition, these children have problems with voluntary control. Within the framework of the Luriev model for arbitrary control answers the so-called "third functional block in operation brain."

— Tell us more about this model.

— According to Luriev's model, there are three blocks of the brain. The first functional block is responsible for the level of brain activity. Second the block is cognitive. It is associated with processing, perception and remembering information coming from the outside world. Third the block is called the “programming, regulation and control block for the course of mental activity.

Children with ADHD often have secondary developmental delays. frontal cortex. This leads to derivative control problems and derived attention. For example, these children cannot focus on the task, can't control their behavior. This symptomatology of ADHD is especially pronounced in preschool children. It is clear that due to age the level of derivative control in these children is very immature. AT older age, closer to 9 years, in children with ADHD due to improvement of voluntary control over one's behavior occurs a decrease in the symptoms of this disorder, that is, it begins have a compensatory effect. However, ADHD does not go away, but only goes into a latent (hidden) form.

And, finally, another secondary symptom is connected precisely with involuntary attention disorder. It's a symptom for the most part. refers to biology and the so-called orienting reflex for new incentives. When we hear an unexpected loud sound, we involuntarily pay attention to the source of the sound. This one is pure biological response allows us to respond effectively to potentially dangerous external influences.

Children with ADHD have a peculiar heightened sensitivity to all external influences, for example, to various soft sounds. A child with ADHD has an effect orienting reflex to both strong stimuli and weak. Outwardly, this manifests itself as increased distractibility. child. It is important to note that the child is not in the least is to blame - it is the indicative reflexes.

Imagine that you are walking through a forest at night. Your nervous system is this situation will become very sensitive. You will pay attention to any rustles and sounds. However, under normal conditions, when there is no danger, we react only to strong incentives. A child with ADHD constantly feels like he or she is is, figuratively speaking, in such a "dark and terrible forest." it leads to big problems at school, in communication with teachers and classmates.

So the symptoms of ADHD are quite complex and complex. To understand how a child with ADHD feels, imagine this situation. You are at the railway station, around various events are unfolding, many sounds, people flash before you, you are pushed, etc. And in these conditions you are offered to solve some problem. It is clear that you everything will be distracting and you will not be able to quickly and efficiently To solve the task. Of course, if you were asked to solve the same task at home in a calm environment, then you would have coped with it much faster. So, a child with ADHD seems to be all the time is in the situation of a railway station where its all distracts.

In addition, orienting reflexes are accompanied by an increase child's anxiety.

The situation is aggravated by the fact that others react to the behavior of these children is inappropriate. Teachers shout at them parents, peers. Children with ADHD are under severe pressure from the outside world. And that just makes them bigger. anxiety.

These kids are really hard. In life they are constantly face adaptation problems, even when they become adults. With age, the syndrome does not disappear anywhere. He only passes into a latent form, in which external symptoms do not appear clearly, but at the same time it is difficult for such a person concentrate on some work, he is overcome by a swarm of thoughts, he constantly distracted by various external and internal events.

— Are the causes of the syndrome known in children?

Almost all behavioral disorders in children are related to genetics. However, we cannot say for sure whether a child with genetic predisposition will form ADHD. The fact, that any phenotypic trait, including behavior, develops under the influence of two factors - genotype and environment. AT certain environmental conditions, a genetic predisposition to ADHD can lead to the development of this disorder, and in others conditions are not.

As risk factors that may lead to the development Attention Deficit Hyperactivity Disorder (ADHD) is traditionally referred to as birth trauma, hypoxia during childbirth, prematurity. However not always these factors lead to the development of ADHD. Especially if you have the child is not genetically predisposed to it disorder.

ADHD is always associated with a combination of genetic factors. predisposition and external adverse influences, especially in the first year of life. At this time, actively formed mechanism of neurodynamics in the brain, and external risk factors may lead to the development of this disorder. For example, emotional negative experiences of the child associated with the absence of the mother, may be such a risk factor.

In addition, children in the first year of life should develop in conditions of adequate sensory load. Level violation sensory information leads to adverse effects on reticular formation of the brain, which can lead to impaired neurodynamics and formation of ADHD.

- If you do not pay due attention to the disorder, to what could this lead to in the future?

- Imagine the world in which a child with deficiency syndrome lives attention and hyperactivity. At school, he most often does not succeed, on he is pressured by teachers, parents. This kid is trying to defend himself. often due to aggressive reactions. This, after all, may escalate into criminal behavior. And increased anxiety further may provoke the development of serious mental diseases, such as pathological depression. That is, at such children are at risk of developing adverse scenarios in life.

Therefore, it is necessary to treat them correctly already in the early childhood, to build the right atmosphere around such children, adequately respond to the manifestation of certain features, be more tolerant of them. This will reduce the risk development of deviant behavior.

— What practices are used to help such children? Are there any medications?

- If we talk about attention deficit disorder and hyperactivity in its gross form, it is necessary here comprehensive support. It includes three elements intervention.

First, medical support is needed, especially when severe form of ADHD.

The second element is behavioral modification. There are many different techniques. But one of the most effective has to do with learning the so-called deep diaphragmatic breathing. A business is that the reticular formation, which is responsible for the general the level of activity of our brain, is sensitive to the lack of oxygen. Each of us has experienced severe exhaustion and inefficient work when in a stuffy room. If we improve the supply of oxygen to the reticular formation, the brain will work better. In a child with ADHD, breathing is often irregular and shallow. This impairs the supply of oxygen to the brain. situation can be improved if the child is taught the technique of correct diaphragmatic breathing.

By the way, children with ADHD are well helped by sports where deep breathing is practiced, for example, swimming. Michael Phelps, a 23-time Olympic swimming champion, is also in actually suffered from ADHD. Phelps dealt with this disorder thanks in large part to swimming.

Stories like these inspire parents who reach out to me. for advice on ADHD. Such children are helped not only swimming, and any other sport where breathing plays an important role - kayaking, canoeing, skiing, running and other rhythmic and aerobic sports. Proper breathing brought to automatism is one of the most important helpers for children with ADHD.

The third direction is aimed at working with the family. This is about family therapy and creating the right atmosphere in which he lives child. As a rule, children with ADHD show inadequate forms of behavior from the point of view of the parents themselves. Moms, dads, grandmothers, brothers and sisters can be aggressive, punish child for inappropriate behavior. And this, as I said above, only exacerbates the already problematic anxiety in these children. Therefore, it is important that within the family, a child with ADHD develops harmonious and tolerant relationships. Under these conditions, above the probability that he will form a mechanism of arbitrary regulation and control, and he will gradually get rid of bright manifestations of ADHD symptoms.

The most unfavorable parenting strategy that leads to aggravation of ADHD symptoms - this is an authoritarian upbringing. At preschool age, it gives rise to a child increased infantilism, shifting responsibility to adult. A mature parenting strategy is to mother gradually transferred responsibility to the child in conditions joint activities.

- Tell us what you're working on today?

— Our laboratory of brain and neurocognitive development operates in several directions. One of the important areas of research employees of our laboratory is associated with the influence parent-child interaction on the development of young children and preschool age. We're trying to figure out what strategies and styles upbringing has the most beneficial effect on the development of the child, and which ones can increase the risk of developing various disorders, for example, ADHD.

Another important area is devoted to the study of digitalization, influence of virtual space and computer addiction on children development. In the international classification of diseases has already been introduced diagnosis called digital addiction or digital addiction. Unfortunately, this is how the modern environment works - it provokes a situation in which the child is immersed early in the virtual space and becomes dependent on it. Some studies show that the child's early interaction with digital environment negatively affects the development of many basic brain mechanisms. It is clear that digitalization is a reality, from which is now nowhere to go. However, it is very important to correctly to introduce the child to the digital environment in a timely manner, to adapt him to this new reality.

The third aspect of research is devoted to the formation of a unified system diagnosis of preschool children, which in Russia so far no. Unfortunately, we do not have a generally accepted standard for which we can assess the development of children at preschool age, in order to timely detect atypical manifestations and the risk of deviant behavior. The fact is that preschool age is a period in which during which most of the basic brain cells are formed mechanisms. Therefore, any mistakes are fraught with serious consequences. in future. We must learn to quickly identify the causes deviant behavior and deviant development of children, which will basis for the development of effective methods of correction. Necessary time to change the environment of a child with the risk of developing deviant behavior, adjust the parameters of its development in order to mitigate the risks of various disorders. That's why we need a unified system of sensitive diagnostics that will allow to identify not only gross violations in development, but also minimal deviations in order to help the child in time.

Preschool age is a very important period in development, because the child's brain is sensitive both to adverse external influences as well as favorable ones. Quickly noticing the deviation the specialist can change the child's environment, which will lead to to the rapid restoration of development mechanisms.

Therefore, at this age it is so important to create for the child the most favorable environment for the development of basic brain mechanisms.

Today, unfortunately, many parents focus on the formation of school skills in preschool age - reading, letters, bills. It is not right. So the parents ahead of events. Figuratively speaking, they build the roof of the house, not completing the foundation and walls. We must strictly follow a certain sequence of brain development, take into account individual characteristics of the child, including psychological.

The basic mechanisms of the brain must be formed in preschool age with the help of a variety of motor activities: gymnastics, dancing, sports, drawing, classes music and so on. And only then, when the foundation has been created, can it is easy to switch to the formation of a variety of school skills - letters, readings, bills, etc.

Today, together with Tomsk State University, we we are working on creating a unified diagnostic system that is easy to fit into the system of preschool education. It is necessary that she allowed to effectively identify risks at an early stage and gave the ability to quickly correct the development of the child.

— What advice would you give to parents whose children Have you been diagnosed with ADHD?

- Unfortunately, sometimes it happens that a child is diagnosed ADHD, but he doesn't really have that syndrome. I often I am facing this kind of overdiagnosis.

Therefore, it is important not to rely on the opinion of only one specialist. It is necessary to re-diagnose with another doctor, to make sure if the child really has a syndrome attention deficit and hyperactivity.

If the syndrome is confirmed by at least two specialists, then the child comprehensive support is required. Unfortunately, parents often rely on drugs. Of course, the effect of drugs is, but it short-term. If the child stops using them, then symptoms will return, and in some cases even worsen. Therefore, it is important to solve the problem comprehensively. Together with right built medical support must be carried out behavioral therapy, in particular, using the technique diaphragmatic breathing.