TDAH
ADHD stands for Attention deficit disorder and hyperactivity7. It's about a neurobiological disorder character originated in childhoodinvolving a pattern of attention deficit, hyperactivity and / or impulsivity, and that often is associated with other comorbid.1-2
It is essential for the ADHD diagnosis evaluate these core symptoms we have discussed (attention deficit, hyperactivity and impulsivity) submitted:
1. from an early age: before 12 years1.
2. with a intensity and frequency above normal for age and stage of child development.
3. what impair or interfere significantly in performance child in two or more areas of your life: school or work, family and social. 1-2
4. not caused by another medical problem, toxic, a drug or another psychiatric problem.3
Although there may be clinical suspicion in children under 6 years the diagnosis of ADHD must have passed this age. further, It is often recognize ADHD in children when primary education begins, coinciding with difficulties in school performance and presentation of social dysfunctions.
Attention deficit
hyperactivity
Impulsiveness
He Attention deficit disorder and hyperactivity (TDAH) has 3 nuclear symptoms (main):
– lack of tiención
– hyperactivity
– impulsiveness
These symptoms can occur with varying intensity in each patient and can occur independently. Thus, the symptomatic profile of those affected will vary in intensity and presentation (based on the predominant symptoms)1.
Not everything that looks like what is ADHD
You will often see these characteristics of inattention, hyperactivity or impulsivity own behavior in childhood, since it is natural that children are very active, pay little attention, listen little ... But it is important to differentiate between a "normal" behavior and one that is not.
PSo that a possible diagnosis of ADHD can be considered, the following criteria set by the DSM-5 must be met (Diagnostic and Statistical Manual of Disorders M23entales, Fifth edition):
– manifest these behaviors or some of them disproportionately compared to other children of age and about their level of development.
– present from an early age (before 12 years).
– it affects at least two different environments of life of the child: school, social and / or family.
– significantly impairs their quality of life.
– It not caused by a medical problem, toxic or other psychiatric problem.
It is important to see a health professional who specializes in ADHD so that you can make a proper clinical diagnosis and thus avoid misdiagnosis.
A correct diagnosis is essential for an effective treatment, so that parents and teachers can fundamentally help the child with Attention Deficit Hyperactivity Disorder (TDAH) to develop its full potential.
Early diagnosis is also essential for early intervention, thus avoiding possible comorbidity and adequately addressing the different problems that may arise throughout its development.
The age to attend the professional depend on the characteristics of each case, although there are more suspicions of diagnosis in the preschool stage, Today, In most cases, the age at which treatment begins is school age. (primary school) since we have a great qualitative and quantitative change environmental demands of the child / a, increase social and academic demands and require greater attention and control over themselves, which produces greater difficulties and clearer symptoms.
The diagnosis of this disorder must be based on a thorough assessment to exclude other possible causes of the child's difficulties, including information about your family, of teachers and evaluation by health professionals from different areas: child psychiatrists, Child psychologists, pediatricians, neuropsiquiatras, neuropsicólogos, etc.
The evaluation of this complex disorder should be performed from a multidisciplinary perspective addressing both the psychological evaluation, educational and medical.
ADHD assessment protocol
There is no single reliable test that alone allows make an exclusive diagnosis and.
To establish the final diagnosis judgment is necessary to collect information from different sources around and intervene in the child and make systematic observations of their behavior and retrospective assessment of their behavior from the earliest ages.
ADHD evaluation should include:
- A full medical examination to assess the overall health of children and discard problems visual type, auditory, anemias or lack of vital components for health.
- A professional psychological evaluation to have a clear idea of the emotional condition of the child, including tests of intellectual ability and cognitive development.
- A family assessment for which behavior scales are used.
- A school evaluation including academic and behavioral history of the child in the classroom.
- Diagnosis is based on the compliance with the criteria of DSM-V, which they are the diagnostic criteria established by the American Academy of Psychiatry (1994) or the criteria of the CIE-10 (1992) recognized and established by WHO.
ADHD should be multimodal and individualized, taking into account the patient and his family. The goal of treatment is multimodaldecrease symptoms while complications from the disorder and reduce the negative impact it can have on the lives of patients and their environment.
The multimodal treatment of ADHD involves three approaches:
– tratamiento farmacológico
- Cognitive behavioral therapy
- Treatment psicoeducativo (parents and teachers)2526
Hence the multimodal treatment is also known as combination therapy, because it requires multiple approaches and the involvement of different professionals.
According to the results of studies, drug treatment would be the method more effective in reducing nuclear symptoms of ADHD5 (attention deficit, hyperactivity and impulsivity)1, and psychological treatment (behavioral and psychoeducational) mainly to helpimprovement of executive functions2 (cognitive skills like starting tasks, get organized, plan things ...).
And it has been shown that educating the patient and family about the disorder, adapt the environment to the needs of each person and improve skills approach to patients, Parents and educators, They can help get good results in the treatment of ADHD, when it combined with a pharmacological intervention.