From early childhood, children spend most of their time between home and school, and it is often in the latter setting where the first difficulties or differences in academic performance are detected, which usually lead to examination by a specialist in Neuropsychology, who is the one who must make the diagnosis to the extent that the main symptom is a cognitive deficit: selective attention. In recent years the number of cases diagnosed with the so-called Attention Deficit Hyperactivity Disorder (ADHD) has increased, and in the vast majority, the great concern of parents and teachers lies in the evolution that the child will have once diagnosed the disorder, not only in the school environment, but at all levels where the child develops psycho-emotionally.
Causes of ADHD
ADHD is a disorder with a clear neurobiological basis that affects cognitive state (attention), emotions and behavior in 3-7% of children worldwide. Primarily, the diagnosis is established on the basis of selective and/or sustained attention deficit, with or without motor restlessness, without purpose, generalized or present in any environment, with present symptoms of impulsivity. Such symptomatology manifests with an intellectual capacity (intelligence) within the normal range and affects academic performance and other specific learning such as calculus and reading. Although there are different theories that could explain the origin, the neurobiological cause is considered the main responsible. Additionally, this disorder has a high genetic content, up to 80% of ADHD cases have a family member with similar characteristics.
Subtypes of ADHD
In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, three subtypes within ADHD are differentiated:
- Attention deficit hyperactivity disorder predominantly inattentive subtype.
- Attention deficit hyperactivity disorder with attention deficit hyperactivity predominant hyperactive-impulsive subtype
- Attention deficit hyperactivity disorder combined subtype (has symptoms of both inattention, hyperactivity and impulsivity).
Symptoms of ADHD
It should be noted that not all children with ADHD have the same symptoms or the same intensity. The most common symptoms include:
- Impulsivity.
- Motor restlessness without purpose and in any environment. Difficulties in maintaining selective attention and concentration.
- Difficulties in working memory.
- Cognitive rigidity.
- Difficulties in behavioral inhibition and self-regulation.
Due to the repercussion of these symptoms in their daily life, it can cause emotional and social consequences in the different areas where children develop, thus affecting their school, family and social adaptation capacity. Problems can be observed in the emotional aspect linked to low self-esteem and inadequate channeling and expression of their emotions. Therefore, its impact on social adaptation may be even greater than the severity of the symptoms of ADHD.
Treatment of ADHD
Although ADHD has a high genetic content, the environment has a great influence on the solution of the problems that arise in the child’s life. Due to the behavioral and emotional problems presented by children with ADHD, in recent decades there has been an increased interest in finding treatments that are effective in resolving the potential problems that arise in the social, academic and emotional domains. Pharmacological treatment, using medications such as methylphenidate, has been widely used with children with ADHD and has proven to be effective in reducing the symptoms of attention deficit and impulsivity. However, it should be noted that the effects of treatment rarely persist once the active effect of the dose has worn off, which temporarily suppresses behavioral difficulties, so that these difficulties resurface when the treatment is no longer active.
Pharmacological intervention should not only be based on diagnosis but also on detecting whether the clinical manifestations have a negative impact on the child’s academic and social performance. In parallel, neuropsychological rehabilitation and cognitive-behavioral psychological intervention is recommended, where the child will be provided with techniques and strategies to be applied in daily life. The hypothesis is that, thanks to the improvement of these general functions, the benefits are generalized to the general cognitive functioning.
It is important to bear in mind that treatment for ADHD should be planned from a comprehensive and multidisciplinary approach, adjusted to the personal characteristics of the child and to the stage of development of the disorder at the time the diagnosis is made. Psychopharmacological treatment is almost always necessary and almost never sufficient and will certainly require a multidisciplinary intervention between neuropsychologists, child and adolescent psychologists and speech therapists, among other professionals.