Raising a child with Attention Deficit Hyperactivity Disorder (ADHD) ADHD) not easy. You may be angry and frustrated by your child's behavior and poor academic performance, and you may get the impression that you are a bad parent. These feelings are understandable, but unjustified. ADHD is a disease and is not the result of bad parenting. ADHD can be effectively treated, and by understanding your child's condition, you can help them!

What is ADHD in children: a brief description

Children with ADHD have difficulty concentrating and, as a result, cannot always cope with educational tasks. They make mistakes due to inattention, do not pay attention and do not listen to explanations. Sometimes they may be overly mobile, fidgeting, standing up, doing a lot of unnecessary activities, instead of sitting still and focusing on their studies or other activities. This behavior is sometimes unacceptable in the classroom and creates problems both at school and at home. Such children often have poor academic performance and are often considered mischievous, rebellious, "terrorizing" family and peers at school. At the same time, they themselves may suffer from low self-esteem, it is difficult for them to make friends and make friends with other children.

In fact, the cause of the above behavior is the lack of certain biologically active substances in certain parts of the brain.

How common is ADHD?

According to the American Psychiatric Association, ADHD is a common disorder that affects 3-7% of children. school age.

How is the behavior of children with ADHD different from the behavior of other children?

Features of behavior in ADHD - the characteristic is divided into three categories:

1. Symptoms inattention. Such children are easily distracted, forgetful, and have difficulty focusing their attention. They have trouble completing assignments, getting organized, and following instructions. One gets the impression that they do not listen when they are told something. They often make mistakes due to inattention, lose their school supplies and other things.

2. Symptoms hyperactivity. Children seem impatient, overly sociable, fussy, cannot sit still for a long time. In the classroom, they tend to take off at the wrong time. Figuratively speaking, they are constantly on the move, as if wound up.

3. Symptoms impulsiveness. Very often in the classroom, teenagers and children with ADHD shout out the answer before the teacher finishes their question, constantly interrupting when others are talking, it is difficult for them to wait for their turn. They are incapable of postponing pleasure. If they want something, then they must get it at the same moment, without succumbing to various persuasions.

Your healthcare provider has all the information you need about ADHD and can make the correct diagnosis based on the diagnostic criteria at their disposal.

How is ADHD diagnosed?

All children can be inattentive or hyperactive at times, so what makes children with ADHD different?

ADHD is detected when a child's behavior differs from that of other children of the same age and developmental level for a sufficiently long time, at least 6 months. These features of behavior occur before the age of 7, later they manifest themselves in various social situations and adversely affect intra-family relations. If the symptoms of ADHD are significant, this leads to social exclusion of the child at school and at home. The child should be carefully examined by a doctor to rule out other diseases that may also cause these behavioral disorders.

Depending on the underlying disorders, doctors may diagnose ADHD with a predominance of inattention, hyperactivity, and impulsivity, or a combination type.

What diseases can accompany ADHD?

Some children have other diseases that accompany this disorder. These include:

• A developmental learning disorder that causes a child to perform significantly less than their peers.
• Defiant oppositional disorder, which is manifested by deliberate disobedience, hostile and even violent behavior.
• Emotional disorders, when the child feels a breakdown, becomes nervous, tearful. A restless child may lose the desire to play with other children. Such a child may be too dependent.
• Tics can also coexist with ADHD. The manifestation of tics is varied: twitching of the muscles of the face, prolonged sniffing or twitching of the head, etc. Sometimes, with strong tics, sudden shouting may occur, which disrupts the social adaptation of the child.
• Also, the child may have a delay in psychoverbal development or mental development(ZPRR or ZPR)

What are the causes of ADHD?

The exact cause of ADHD is still not clear. However, experts believe that the symptoms of ADHD may be due to a complex of factors. Here are some of them:

ADHD tends to be inherited, which indicates the genetic nature of this disease.
- There is evidence to suggest that alcohol and smoking during pregnancy, preterm birth and prematurity may also increase the chance of a child developing ADHD (4, 5).
- Brain injuries and infectious diseases of the brain in early childhood also create a predisposition to develop ADHD.

The mechanism of development of ADHD is based on the deficiency of certain chemical substances(dopamine and norepinephrine) in some areas of the brain. These data highlight the fact that ADHD is a disease that requires appropriate diagnosis and proper treatment.

Does ADHD get better with time?

Symptoms of hyperactivity and impulsivity in adults fade into the background. In adulthood, ADHD can be manifested by a lack of rational planning of one's time, poor memory, poor academic performance and, as a result, low level achievements in the professional field. Adults with ADHD may have problems with substance dependence, drug addiction, and depression.

I am very tired of the way my child behaves. It's my fault?

The behavior of a child with ADHD can be extremely unbearable. It often makes parents feel guilty and ashamed. Having a child with ADHD doesn't mean you didn't raise them well. ADHD is a disease that requires proper diagnosis and proper treatment. With effective treatment, it is possible to normalize behavior at school and at home, increase the child's self-esteem, facilitate his social interaction with other children and adults, that is, help the child reach his potential and return him to a full life.

How can I help my child with ADHD?

Arm yourself with the knowledge and proper understanding of ADHD! There are many sources from which you can draw useful information. A child with ADHD needs appropriate medical supervision, including a psychologist. One of the aspects of treatment is psychological help and support for the child.

Talk to your child's teachers about his behavior. Make sure they understand what's going on so you can help your child.

How to treat ADHD?

The most optimal is combined treatment, which consists in a combination of drug therapy and psychological correction.

My child has been diagnosed with ADHD. What does this mean?

Not all people understand that ADHD is a disease, and some see it as an unreasonable "label". At times, parents find it difficult to accept that their child is sick and resent the diagnosis. Sometimes parents believe that they themselves are to blame for this diagnosis, as they were bad or inattentive parents. It is important to understand that ADHD is a disease. Treatment can improve a child's learning, social adjustment, and ability to make friends and maintain friendships. Proper treatment can reduce tension in the family, normalize life at home and make it enjoyable for all family members. Most importantly, treating a child with ADHD effectively increases their chances of having a healthy, happy, and productive future without any problems. If you are concerned about this disease and its consequences for your family, talk to a specialist who will tell you about this disease. Delaying treatment because of a lack of understanding of the problem is definitely not right for your child.

How should I behave at home if my child has ADHD?

1. Develop a positive attitude.

Children and adolescents with ADHD are sensitive to criticism. Instead of criticizing the child and telling him what he should NOT do, turn your remarks in a more positive way and tell the child what he SHOULD do. For example, instead of "Don't throw your clothes on the floor," try saying, "Let me help you put your clothes away."
Help your child develop the habit of positive thoughts. For example, instead of thinking, “I can’t do this,” help him tune in to what he can do: “I can do it!”

2. Be generous with praise.

Children thrive when their parents praise them. For example: "What did you do today? homework good and fast,” or “I’m proud of you.”
We all make mistakes and small missteps from time to time. Instead of getting angry when your child messes something up, say something like, "Don't worry, it can be fixed."

3. Help your child not to worry.

Activities such as quiet games, listening to pleasant music, taking a bath will help your child calm down when he is irritated or frustrated.

4. Make simple and clear rules for the child. Children need a certain routine. With its help, they know when and what they need to do, and feel calmer. Do your daily tasks at the same time of the day.

Have lunch and dinner at the same time.
- Help your child not put off things that must be done.
- Keep a to-do list.
- Teach your child to plan their day. Start by collecting school supplies ahead of time.

5. Communicate more.

Talk to your child. Discuss different topics with him - what happened at school, what he saw in the movies or on TV. Find out what the child is thinking. Ask open-ended questions that suggest a story rather than a one word answer. When you ask a child a question, give him time to think and answer. Don't answer for him! Listen when he speaks to you and make positive comments. Let your child feel that he and his affairs are interesting to you.

6. Limit distractions and supervise your child's work. When your child needs to focus on completing a task, he needs special conditions. Reducing distractions will help you concentrate better.

Make sure your child has enough opportunity to blow off steam. Children often need a break between school and homework.
- Make sure that the child understands what is required of him when completing the task.
- Some tasks need to be broken into several parts to make them doable.
- If necessary, supervise classes and household chores.
- Regular breaks will allow the child to rest and then focus again.

7. Respond appropriately to bad behavior.

Explain what exactly made you angry in his behavior.
- Avoid generalizations (for example, instead of: "You never listen to me," say: "I'm angry because you didn't listen to me now").
- The punishment must be fair and correspond in severity to the offense committed.
- Do not get into arguments with the child.
- Be firm in your decisions, but don't resort to threat tactics.

Clear rules and a definite daily routine will make it easier for the child to accept the norms of behavior.

8. Rest yourself. Sometimes you need rest and time for yourself too. Invite someone to babysit or send the baby to a trusted friend.

9. If you feel that you are not coping, talk to your doctor who will give you the necessary advice.

Parents need to remember that effective treatment for ADHD requires a thorough examination of the child by a specialist, as symptoms of ADHD can occur secondary to another condition. In these cases, treating only the symptoms of ADHD will be ineffective.

Material provided by Eli Lilly.

Attention deficit hyperactivity disorder (ADHD is the most commonly used abbreviation in Russian neurology) is a chronic behavior disorder, the first manifestations of which occur in childhood. Traditionally, the disease is considered within the framework of childhood diseases, although the pathology also occurs among people over 18 years of age.

The first description of the phenomenon of excessive children's activity and inattention dates back to the end of the 18th century. However, the term “ADHD” itself only came into use in the early 1980s.

Attention deficit hyperactivity disorder in children is considered as a medical and social problem affecting neurological, psychological and pedagogical issues.

The prevalence of ADHD worldwide reaches 5-20%. The urgency of the problem is reinforced by the polymorphism of the clinical manifestations of the disorder, the likelihood of undesirable consequences of the disease in adulthood, as well as the ambiguity of diagnosis and treatment.

Definition

The essence of the disease lies in the term itself - the characteristic disorders are a decrease in attention and hyperactivity in a child. Subsequently, such manifestations are dangerous in terms of the development of learning disorders, deviant behavior, and a decrease in the quality of life. Pathology refers to the etiologically heterogeneous pathology, that is, the causes of ADHD may be different.

ADHD stands for Attention Deficit Hyperactivity Disorder. In this regard, the term "ADHD syndrome" is not applicable.

The first signs of ADHD usually appear in children older than 5 years. Although initially there may be a subclinical stage of the disease with manifestation at a later age. There is a theory according to which ADHD, debuting in childhood, does not stop later, but only undergoes a series of changes. Correction of the state can only affect the quantitative and qualitative transformation. Indeed, there are some differences in the objective manifestations of ADHD in children of different age groups. For preschoolers and students elementary school hyperactivity and aggressiveness in communication with others predominate. For adolescents, attention deficit, anxiety-phobic disorders, and defiant behavior are considered more characteristic.

Causes

ADHD is based on processes of impaired processing of external and internal information, which leads to clinically pronounced attention disorders and hyperactivity. However, clear positions regarding the causes of such changes have not yet been formulated. It is believed that the syndrome has a polyetiological nature.

Initially, the syndrome of hyperactivity and attention deficit in children was considered as a consequence of an organic lesion of cerebral formations as a result of perinatal pathology of the nervous system. However, cases of distracted attention syndrome were later described in children who did not have structural changes in the brain.

The neurotransmitter theory of the development of ADHD is also considered justified. According to her, the causes of hyperactivity and attention deficit in children are hidden in the dysfunction of the metabolic processes of neurotransmitters (mostly dopamine and norepinephrine).

There is also a hereditary model for the development of ADHD. Its proponents point to a higher incidence of the disorder among relatives. To date, it has been established that a fairly large number of genes are involved in the formation of ADHD, a different combination of which ensures the variability of the clinic.

In addition, the social conditioning of violations should not be overlooked. Unfavorable family environment, conflicts with relatives and peers do not act as a direct cause of ADHD, but are often a triggering factor in the development of the disorder.

Classification and diagnosis

The polymorphism of the clinical manifestations of attention deficit disorder in children explains the difficulties in formulating clinical diagnostic criteria. Childhood hyperactivity, impulsivity and attention deficit are considered mandatory manifestations of the disorder. The predominant manifestation of one of these three symptoms classifies the pathology into:

• ADHD with a predominance of attention disorders;
• ADHD with predominant manifestations of hyperactivity and impulsivity;
• a combined form of the disorder, which combines the clinical manifestations of the two previous options.

At the same time, in the Russian Federation, for the diagnosis of ADHD, it is required to confirm the presence of all three groups of symptoms. In other words, a comprehensive diagnosis of hyperactivity, impulsivity and attention deficit should be carried out. In this case, only a combined form of pathology can be detected. Therefore, this classification has not found wide application in domestic neurology.

In addition, the necessary characteristics for the diagnosis of ADHD are:

• the duration of clinical manifestations is at least six months;
• persistence of symptoms;
• the impact of manifestations of the disease on all spheres of life;
• severity of violations;
• problems in learning and social contacts of the child;
• exclusion of other disorders that explain the existing clinic.

Specific tests and laboratory and instrumental diagnostics of ADHD have not been developed.

Clinical picture

The main clinical symptoms of ADHD are reduced to attention disorders, hyperactivity in children and impulsivity. Such disorders entail learning disabilities in children with intact intelligence. First of all, speech, writing, reading and counting skills are affected. The child does not cope with school assignments, makes many mistakes due to inattention, is not able to independently build priority tasks, refuses the help and advice of adults. Extremely indicative is the commitment of hyperactive children to films and computer games with fast turnaround.

In addition, the child becomes a source of constant concern for others. He is able to interfere in the conversations of adults, interrupt the interlocutor, take other people's things without permission, behave inappropriately in society. Difficulties arise when communicating with peers, aggressiveness is often manifested, conflicts arise. The child cannot adequately analyze his actions and predict their consequences. In the future (more often in adolescence), this can provoke antisocial behavior.

Attention deficit disorder in a child is expressed mainly in the inconsistency of his actions, lack of active listening when addressing him, difficulties in organizing the educational process or games, and forgetfulness. Children with ADHD are usually willing to take on new tasks, but rarely complete them to the end, try to avoid boring tasks, often lose things, and are absent-minded.

Hyperactivity in children is manifested by various forms of motor disinhibition.. The child constantly fidgets, climbs on furniture, trees, stamps his feet, drums his fingers. Sleep disturbances can be additional signs of hyperactivity. As a rule, children with ADHD sleep much less than their peers and are extremely impulsive. Hyperactivity is more often detected in school-age children and preschoolers and sometimes requires serious treatment.

A characteristic feature of the neurological status in this case is the absence of a pronounced focal deficit.

Treatment

Therapy of patients with attention deficit hyperactivity disorder should be complex and individual. An isolated treatment of hyperactivity in children is impossible without affecting the symptoms of lack of attention or without normalizing the function of controlling actions. Neurologists, psychologists, teachers and parents must take part in the program for the correction of existing disorders.

The main assistance to the child is reduced to the modification of behavior by the methods of psychotherapy, pedagogical and neuropsychological correction. Drug treatment of ADHD in both children and adults is considered inappropriate. It can be justified only in cases where there is no effect from the ongoing non-pharmacological therapy or the presence of an organic nature of the disorder. In this case, they resort to neuroprotectors, vasoactive agents, antioxidants, nootropics. All drugs used to eliminate the symptoms of ADHD are selected individually exclusively by the attending physician.

Primary assistance provides for the correction of ADHD in the following areas:

• work with attention disorders, behavior control and excessive motor activity;
• optimization of social relations with adults and peers;
• dealing with aggressive behavior, anger and addictions (if any).

Before treating attention deficit hyperactivity disorder, it is necessary to find out the social factors of the pathology and try to neutralize the negative psychological influences in the child's environment.

Neuropsychological work is primarily directed to increased distractibility and insufficient organization of activities. Parents and educators are advised to ignore the child's challenging actions as much as possible, to limit distractions during class as much as possible. A system of rewards for good behavior should be thought out separately. The daily routine is drawn up in accordance with the age and employment of the child and is clearly followed. In many ways, this is facilitated by the maintenance of a special diary or calendar, where completed plans are noted. A prerequisite should be a proportionate combination of mental stress with physical activity.

Nowadays, children with Attention Deficit Hyperactivity Disorder are not uncommon. This is facilitated by the high requirements for modern education, and intensively developing technological advances, and frequent social conflicts in families. With timely competent correction of ADHD, the course of the pathology is favorable. However, the delay in treatment and diagnostic measures can modify the symptoms of the disease, making them more pronounced and rough. Such manifestations significantly disrupt the daily life of a person, interfere with his social contacts and significantly reduce the quality of life.

Usually, symptoms of ADHD people around the child notice at the moment when he starts to go to school, that is, at about 7 years old. However, the symptoms characteristic of this disease appear much earlier.

Some sources report that they can be observed from the birth of a child. However, in the first period of life, the diagnosis cannot be made due to the impossibility of assessing disorders in all groups and performing all diagnostic studies.

Who usually suffers from ADHD

ADHD affects about 5% of children in primary school age, and it is estimated that this figure could be even higher. It is the most common developmental disorder and occurs regardless of culture.

According to various sources, it is diagnosed 2-4 times more often in boys than in girls. Appears early, mostly within the first five years of a child's life, although it is usually difficult to identify the onset of symptoms.

Children with ADHD can not find a place for themselves!

Parents often seek help when it becomes clear that characteristic features of hyperactivity interfere with the child's schooling.

For this reason, many children at the age of seven go to a specialist, although interviews with parents often show that symptoms of attention deficit hyperactivity disorder were visible before.

Hyperactivity in ADHD

• ADHD with dominant signs of impulsivity and hyperactivity;
• ADHD with a predominance of attention disorders;
• Mixed subtype (most common).

Which symptoms are dominant to a certain extent depends on gender and age. This follows from long-term observations, which led to the following conclusions:

• boys are more likely to have a mixed subtype, while girls tend to be dominated by attention-related symptoms;
• with age, the picture of the disease, and, consequently, the type of dominant symptoms, changes. It is estimated that in about 30% of people diagnosed with ADHD in childhood, symptoms disappear altogether during puberty, and for the majority, hyperactivity and impulsivity give way to attention deficits.

Additional criteria for ADHD

It must be remembered that the mere presence of several symptoms corresponding to those listed above is not enough to make a definite diagnosis.

Some classification systems report that diagnosis requires, for example, confirmation of 6 symptoms from the hyperactivity group and 6 from the attention disorder group. In addition, additional conditions must also be met. They were collected into a group of additional diagnostic criteria.

These include:

• onset of symptoms before the age of 7 years;
• symptoms must be observed in at least two places, that is, for example, both at home and at school;
• problems must lead to suffering or disruption of social functioning;
• the symptoms cannot be part of any other disorder, which means that the child should not be diagnosed with other behavioral disorders.

Behavioral symptoms of ADHD

Behavioral symptoms of ADHD- it's repetitive aggressive behavior, rebelliousness and antisocial behavior. Diagnostic criteria suggest persistence of symptoms for at least 12 months.

In practice, behavioral symptoms take the form of non-compliance with rules, use of profanity, outbursts of anger, getting into conflicts. acute form behavioral disorders include lying for no reason, fornication, theft, running away from home, bullying others, arson.

The coexistence of ADHD and conduct disorders is estimated at 50-80%, and in the case of severe conduct disorders, a few percent. On the one hand, impulsiveness and inability to foresee the consequences of one's actions, and on the other hand, difficulties in establishing social contacts. Children with ADHD are often rebellious and aggressive.

An additional risk factor is the ease of falling into “bad company”, which is often the only environment where a young person with hyperactivity can take root. As with other complications of ADHD, prevention is essential. The only chance to avoid the complex and risky behavior of the child is timely prescribed therapy.

What to look for in a child's behavior

Already in early childhood, a child may experience certain signs that are harbingers of the development of ADHD:

• rapid speech or delayed speech development;
• colic;
• inability to learn from their mistakes;
• significantly increased time to perform normal daily activities;
• excessive mobility at the time of the beginning of bipedalism;
• frequent injuries caused by the mobility of the child.

It must be borne in mind that the listed symptoms can be observed in many other diseases, therefore, if they occur, immediately think about ADHD. can be divided into the following steps:

• Stage 1: A conversation with parents during which the doctor tries to identify possible risk factors associated with the period of intrauterine development of the fetus. The questions asked should also concern the development of the child, his relationship with other people in the environment, as well as possible problems that arise in everyday life.
• Stage 2: Conversation with the child's teacher. It is aimed at collecting information about his behavior at school, about relationships with peers, possible problems learning. It is important that the teacher has known the child for more than six months.
• Stage 3: Child observation. This is a difficult phase of the study due to the instability of ADHD symptoms and their variability depending on the environment in which the child is located.
• Stage 4: Talking to a child. It is important to remember that it should be carried out during the absence of parents in order to see how the child behaves without their supervision.
• Stage 5: Diagnostic tests and questionnaires containing questions for parents and teachers.
• Stage 6: Psychological tests to assess intelligence, fine motor skills, speech and problem solving ability. They are of some value in excluding other diseases that have symptoms of ADHD.
• Stage 7 In: Pediatric and Neurological Research. It is important that vision and hearing are tested during these tests.
• Stage 8: In addition, electronic measurement of the frequency and speed of movement of the eyeballs can be carried out to assess hyperactivity or a computer test of continuous attention to assess impaired concentration. However, these methods are not used regularly and are not available everywhere.

It is normal for children to sometimes forget to do their homework, daydream during class, act without thinking, or get nervous about dining table. But inattention, impulsivity and hyperactivity are signs of Attention Deficit Hyperactivity Disorder (ADHD, ADD). ADHD leads to problems at home, school, affects the ability to learn, get along with others. The first step to solving a problem is to provide the help the person needs.

We all know kids who can't sit back, who never seem to listen, who don't follow instructions no matter how clearly you present them, or make inappropriate comments at the wrong time. Sometimes these children are called troublemakers, criticized for being lazy, undisciplined. However, it could be Attention Deficit Hyperactivity Disorder (ADHD), formerly known as Attention Deficit Disorder, ADD.

Is this normal behavior or ADHD?

Signs and symptoms of ADHD usually appear before the age of seven. However, it can be difficult to distinguish ADHD from normal "child behavior".

If only a few signs are noticed, or symptoms appear only in certain situations, it is probably not ADHD. On the other hand, if a child is showing a range of signs and symptoms of ADHD that are present in all situations - at home, at school, at play - it's time to take a closer look at the problem.

Once you understand the challenges your child is facing, e.g. forgetfulness, difficulties at school, work together to find creative solutions to capitalize on strengths.

Myths and facts about attention deficit disorder

Myth: All children with ADHD are hyperactive.

Fact: Some are hyperactive, but many others with attention problems are not. Not too active, seem dreamy, unmotivated.

Myth: They can never concentrate.

Fact: They often focus on their activities. But no matter how hard they try, they cannot concentrate if the task is boring or repetitive.

Myth: They can do better if they want to.

Fact: They do their best to be good, but still they cannot sit still, remain calm, concentrate. They may seem naughty, but this does not mean that they act on purpose.

Myth: children will eventually outgrow ADHD.

Fact: ADHD often continues into adulthood, so don't wait for your child to outgrow the problem.

Treatment will help you learn how to minimize symptoms.

Myth: medicine - the best option treatment.

Fact: medication is often prescribed for attention deficit disorder, but this may not be the best option.

Effective ADHD treatment includes education, behavioral therapy, support at home, school, exercise, and proper nutrition.

Key Features of ADHD

When many people think of Attention Deficit Disorder, they imagine an out-of-control child in constant motion, destroying everything around them. But this is not the only possible picture.

Some children sit quietly - their attention is scattered for several tens of kilometers. Some people pay too much attention to the task, they cannot switch to something else. Others are only slightly inattentive, but overly impulsive.

Three main

The three main characteristics of ADHD are inattention, hyperactivity, and impulsivity. The signs and symptoms of a child with attention deficit disorder depend on which characteristics predominate.

Which of these boys might have ADHD?

• A. A hyperactive boy who talks non-stop cannot sit still.
• B. Calm dreamer, sitting at the table, looking into space.
• C. Both
  Correct answer: "C"

Children with ADHD are:

• Inattentive, but not hyperactive or impulsive.
• Hyperactive and impulsive, but able to pay attention.
• Inattentive, hyperactive, impulsive (the most common form of ADHD).
• Children who only have attention deficit symptoms are often overlooked as they are not destructive. However, the symptoms of inattention have consequences: falling behind in school; conflicts with others, games without rules.

MINISTRY OF EDUCATION OF THE RUSSIAN FEDERATION

BARNAUL STATE PEDAGOGICAL UNIVERSITY

PEDAGOGICAL FACULTY

COURSE WORK

"PECULIARITIES OF MENTAL DEVELOPMENT OF CHILDREN WITH ATTENTION DEFICIENCY AND HYPERACTIVITY SYNDROME"

Barnaul - 2008

Plan

Introduction

1. Attention deficit hyperactivity disorder in childhood

1.1 Theoretical rationale for the concept of ADHD

1.2 Understanding Hyperactivity Disorder and Attention Deficit Disorder

1.3 Views and theories of domestic and foreign psychologists in ADHD research

2. Etiology, mechanisms of development of ADHD. Clinical signs of ADHD. Psychological characteristics of children with ADHD. Treatment and correction of ADHD

2.1 Etiology of ADHD

2.2 Mechanisms of development of ADHD

2.3 Clinical features of ADHD

2.4 Psychological characteristics of children with ADHD

2.5 Treatment and management of ADHD

3. Experimental study of the mental processes of children with ADHD and with the norm of development

3.1 Attention research

3.2 Mind research

3.3 Memory research

3.4 Perception research

3.5 Exploration of emotional manifestations

Conclusion

Bibliography

Applications

Introduction

The need to study children with attention deficit hyperactivity disorder (ADHD) in preschool age due to the fact that this syndrome is one of the most common reasons for seeking psychological help in childhood.

The most complete definition of hyperactivity is given by Monina G.N. in his book on working with children with attention deficit: “A complex of deviations in the development of the child: inattention, distractibility, impulsivity in social behavior and intellectual activity, increased activity with a normal level of intellectual development. The first signs of hyperactivity can be observed before the age of 7 years. The causes of hyperactivity may be organic lesions of the central nervous system (neuroinfections, intoxications, traumatic brain injuries), genetic factors leading to dysfunction of the neurotransmitter systems of the brain and dysregulation of active attention and inhibitory control.

According to various authors, hyperactive behavior is quite common: from 2 to 20% of students are characterized by excessive mobility, disinhibition. Among children with conduct disorder, physicians distinguish a special group of children suffering from minor functional disorders of the central nervous system. These children are not much different from healthy ones, except for increased activity. However, gradually the deviations of individual mental functions increase, which leads to a pathology, which is most often called "mild brain dysfunction". There are other designations: "hyperkinetic syndrome", "motor disinhibition" and so on. The disease characterized by these indicators is called "attention deficit hyperactivity disorder" (ADHD). And the most important thing is not that a hyperactive child creates problems for the surrounding children and adults, but in the possible consequences of this disease for the child himself. Two features of ADHD should be emphasized. Firstly, it is most pronounced in children aged 6 to 12 years and, secondly, it occurs 7–9 times more often in boys than in girls.

In addition to mild brain dysfunction and minimal brain dysfunction, some researchers (I.P. Bryazgunov, E.V. Kasatikova, A.D. Kosheleva, L.S. Alekseeva) also name the causes of hyperactive behavior as temperamental features, as well as defects in family upbringing . Interest in this problem does not decrease, because if 8–10 years ago there were one or two such children in the class, now there are up to five people or more. I.P. Bryazgunov notes that if at the end of the 50s there were about 30 publications on this topic, then in 1990 their number increased to 7000.

Prolonged manifestations of inattention, impulsivity and hyperactivity, the leading signs of ADHD, often lead to the formation of deviant forms of behavior (Kondrashenko V.T., 1988; Egorova M.S., 1995; Kovalev V.V., 1995; Gorkovaya I.A., 1994; Grigorenko E.L., 1996; Zakharov A.I., 1986, 1998; Fischer M., 1993). Cognitive and behavioral disorders continue to persist in almost 70% of adolescents and more than 50% of adults who were diagnosed with ADHD in childhood (Zavadenko N.N., 2000). In adolescence, hyperactive children develop early cravings for alcohol and drugs, which contributes to the development of delinquent behavior (Bryazgunov I.P., Kasatikova E.V., 2001). For them, to a greater extent than for their peers, a tendency to delinquency is characteristic (Mendelevich V.D., 1998) .

Attention is also drawn to the fact that attention is paid to attention deficit hyperactivity disorder only when a child enters school, when there is school maladaptation and poor progress (Zavadenko N.N., Uspenskaya T.Yu., 1994; Kuchma V.R. , Platonova A.G., 1997; Razumnikova O.M., Golosheikin S.A., 1997; Kasatikova E.B., Bryazgunov I.P., 2001) .

The study of children with this syndrome and the development of deficient functions is of great importance for psychological and pedagogical practice precisely at preschool age. Early diagnosis and correction should be focused on preschool age (5 years), when the compensatory capabilities of the brain are great, and it is still possible to prevent the formation of persistent pathological manifestations (Osipenko T.N., 1996; Litsev A.E., 1995; Khaletskaya O. IN 1999) .

Modern directions of developing and corrective work(Semenovich A.V., 2002; Pylaeva N.M., Akhutina T.V., 1997; Obukhov Ya.L., 1998; Semago N.Ya., 2000; Sirotyuk A.L., 2002) are based on the principle replacement development. There are no programs that consider the multimorbidity of the developmental problems of a child with ADHD in combination with problems in the family, peer group and adults accompanying the development of the child, based on a multimodal approach.

An analysis of the literature on this issue showed that in most studies, observations were made on children of school age, i.e. during the period when the signs are most pronounced, and the conditions for development at an early and preschool age remain, for the most part, outside the field of view of the psychological service. Right now, the problem of early detection of attention deficit hyperactivity disorder, prevention of risk factors, its medical, psychological and pedagogical correction, covering the multimorbidity of problems in children, is becoming increasingly important, which makes it possible to make a favorable treatment prognosis and organize a corrective impact.

In this work, an experimental study was conducted, the purpose of which was to study the characteristics of the cognitive development of children with attention deficit hyperactivity disorder.

Object of study is the cognitive development of children with attention deficit hyperactivity disorder in preschool age.

Subject of study is a manifestation of hyperactivity and the effect of the symptom on the personality of the child.

Target this study: to study the features of cognitive development of children with attention deficit hyperactivity disorder.

Research hypothesis. Very often, children with hyperactive behavior have difficulties in mastering educational material, and many educators tend to attribute this to lack of intelligence. Psychological examination of children makes it possible to determine the level of intellectual development of the child, and in addition, possible violations of perception, memory, attention, emotional-volitional sphere. Usually, the results of psychological research prove that the level of intelligence of such children corresponds to the age norm. Knowledge of the specific features of the mental development of children with ADHD allows us to develop a model of corrective assistance to such children.

Taking into account the purpose of the study, its object and subject, as well as the formulated hypothesis, the following tasks:

1. Analysis of literary sources on this topic in the process of theoretical research.

2. Experimental study of the level of development of mental (cognitive) processes in preschool children with ADHD, such as attention, thinking, memory, perception.

3. Study of emotional manifestations in children with hyperactivity syndrome and attention deficit.

To solve the tasks set, the following methods were used: literature analysis (works of domestic and foreign authors in the field of psychology, pedagogy, defectology and physiology on the research problem); theoretical analysis of the problem of hyperactivity; questioning teachers and educators; methods for diagnosing perception: the technique “What is missing in these pictures?”, the technique “Find out who it is”, the technique “What objects are hidden in the pictures?”; methods for diagnosing attention: the “Find and cross out” technique, the “Put down the marks” technique, the “Remember and dot” technique; methods for diagnosing memory: the “Learn the words” technique, the “Memorizing 10 pictures” technique, the “How to patch the rug?” technique; methods for diagnosing thinking: a technique for identifying the ability to classify, the technique “What is superfluous here?”; evaluation scale of emotional manifestations.

Theoretical basis our work was largely determined under the influence of fundamental research by domestic psychologists and speech pathologists: the cultural-historical theory of L.S. Vygotsky, his research on the nature of primary and secondary deviations in the mental development of children, the systemic structure of functions, their compensatory development in the process of specially organized activity, the theory of the correlation of psychological development in normal and with disorders (T.A. Vlasova, Yu.A. Kulagina , A.R. Luria, V.I. Lubovsky, L.I. Solntseva, etc.).

Scientific novelty is determined by the methodological level of solving the problem, which provides the scientific basis for the development of the psychological foundations for the formation of the mental development of preschool children with hyperactivity and attention deficit, as a means of their personal development, a qualitative restructuring of their behavior in the process of correctional and developmental work in line with solving the problem posed.

The following provisions are put forward for defense:

1. Attention Deficit Hyperactivity Disorder (ADHD) is a composite group of various etiology, pathogenesis and clinical manifestations pathological conditions. Its characteristic features are increased excitability, emotional lability, diffuse mild neurological symptoms, moderately pronounced sensorimotor and speech disorders, perception disorder, increased distractibility, behavioral difficulties, insufficient formation of intellectual activity skills, and specific learning difficulties.

2. This syndrome occurs in about 20 percent of preschool children, with boys four times more likely than girls. Such children are characterized by constant restlessness, problems with concentration, impulsivity, "uncontrollable" behavior.

3. Level of formation cognitive processes(attention, memory, thinking, perception) of children with ADHD does not correspond to the age norm.

4. In providing psychological assistance to hyperactive children, work with their parents and teachers is of decisive importance. It is necessary to explain the problems of the child to adults, to make it clear that his actions are not intentional, to show that without the help and support of adults, such a child will not be able to cope with his difficulties.

5. In working with such children, three main directions should be used: 1) on the development of deficient functions (attention, behavior control, motor control); 2) to develop specific skills of interaction with adults and peers; 3) if necessary, work with anger should be carried out.

Theoretical and practical significance research is determined by the need to study the characteristics of the mental development of preschoolers with hyperactivity and attention deficit, on the basis of which recommendations are developed for parents and educators. These studies can be used when working with hyperactive children.

Structure and volume of research work. The research work consists of an introduction, three chapters, a conclusion set out in 63 pages of typewritten text. The list of references has 39 items. Research work contains 9 drawings, 4 charts, 5 applications.

1. Attention deficit hyperactivity disorder in childhood

1.1 Theoretical substantiation of the concept of ADHD

The first mention of hyperactive children appeared in special literature about 150 years ago. The German physician Hoffman described the extremely active child as "Fidget Phil". The problem became more and more obvious and by the beginning of the 20th century caused serious concern among specialists - neuropathologists, psychiatrists.

In 1902, a rather large article was devoted to her in the Lancet magazine. Information about a large number of children whose behavior goes beyond the usual norms began to appear after the epidemic of Economo lethargic encephalitis. This is probably what led to a closer study of the connection: the behavior of the child in the environment and the functions of his brain. Since then, many attempts have been made to explain the cause, and various methods have been proposed for treating children who have observed impulsiveness and motor disinhibition, lack of attention, excitability, and uncontrollable behavior.

So, in 1938, Dr. Levin, after long-term observations, came to the unexpected conclusion that the cause of severe forms of motor restlessness is organic damage to the brain, and the basis of mild forms is the incorrect behavior of parents, their insensitivity and violation of mutual understanding with children. By the mid-1950s, the term “hyperdynamic syndrome” appeared, and doctors began to say with increasing confidence that the main cause of the disease was the consequences of early organic brain lesions.

In the Anglo-American literature in the 1970s, the definition of “minimal brain dysfunction” is already clear. It is applied to children with learning or behavioral problems, attention disorders, who have a normal level of intelligence and mild neurological disorders that are not detected by standard neurological examination, or with a sign of immaturity and delayed maturation of certain mental functions. To clarify the boundaries of this pathology in the United States, a special commission was created that proposed the following definition of minimal brain dysfunction: this term refers to children with an average level of intelligence, with learning or behavioral disorders that are combined with pathology of the central nervous system.

Despite the efforts of the commission, there was still no consensus on concepts.

After some time, children with such disorders began to be divided into two diagnostic categories:

1) children with impaired activity and attention;

2) children with specific learning disabilities.

The latter include dysgraphia(isolated spelling disorder), dyslexia(isolated reading disorder), dyscalculia(counting disorder), as well as a mixed disorder of school skills.

In 1966 S.D. Clements defined this disease in children as follows: “A disease with an average or near average intellectual level, with mild to severe behavioral impairment, combined with minimal abnormalities in the central nervous system, which can be characterized by various combinations of speech, memory, attention control disorders , motor functions. In his opinion, individual differences in children may be the result of genetic abnormalities, biochemical disorders, strokes in the perinatal period, diseases or injuries during periods of critical development of the central nervous system, or other organic causes of unknown origin.

In 1968, another term appeared: "hyperdynamic syndrome of childhood." The term was adopted in the International Classification of Diseases, however, it was soon replaced by others: "attention impairment syndrome", "impaired activity and attention" and, finally, Attention Disorder with Hyperactivity Disorder (ADHD), or "Attention Deficit Hyperactivity Disorder" (ADHD)". The latter, as the most fully covering the problem, is used by domestic medicine at the present time. Although there are and may be found in some authors such definitions as "minimal brain dysfunction" (MMD).

In any case, no matter how we call the problem, it is very acute and needs to be addressed. The number of such children is growing. Parents give up, kindergarten teachers and teachers in schools sound the alarm and lose their temper. The very environment in which children grow up and are brought up today creates exceptionally favorable conditions for the increase in their various neuroses and mental deviations.

1.2 Understanding Hyperactivity Disorder and Attention Deficit Disorder

Attention Deficit Disorder / hyperactivity- this is a dysfunction of the central nervous system (mainly the reticular formation of the brain), manifested by difficulties in concentrating and maintaining attention, learning and memory disorders, as well as difficulties in processing exogenous and endogenous information and stimuli.

Syndrome(from the Greek syndrome - accumulation, confluence). The syndrome is defined as a combined, complex disorder of mental functions that occurs when certain areas of the brain are affected and naturally due to the removal of one or another component from the normal functioning. It is important to note that the disorder naturally combines disorders of various mental functions that are internally interconnected. Also, the syndrome is a regular, typical combination of symptoms, the occurrence of which is based on a violation of the factor due to a deficiency in the work of certain brain areas in case of local brain damage or brain dysfunction caused by other causes that do not have a local focal nature.

Hyperactivity -"Hyper ..." (from the Greek. Hyper - above, above) - an integral part compound words indicating an excess. The word "active" came into Russian from the Latin "activus" and means "effective, active." External manifestations of hyperactivity include inattention, distractibility, impulsivity, increased motor activity. Often hyperactivity is accompanied by problems in relationships with others, learning difficulties, low self-esteem. At the same time, the level of intellectual development in children does not depend on the degree of hyperactivity and may exceed the age norm. The first manifestations of hyperactivity are observed before the age of 7 years and are more common in boys than in girls. Hyperactivity , occurring in childhood is a set of symptoms associated with excessive mental and motor activity. It is difficult to draw clear boundaries for this syndrome (i.e., the totality of symptoms), but it is usually diagnosed in children who are characterized by increased impulsivity and inattention; such children are quickly distracted, they are equally easy to please and upset. Often they are characterized by aggressive behavior and negativism. Due to such personality traits, it is difficult for hyperactive children to concentrate on performing any tasks, for example, in school activities. Parents and teachers often face considerable difficulties in dealing with such children.

The main difference between hyperactivity and just an active temperament is that this is not a trait of the child's character, but a consequence of impaired mental development of children. The risk group includes children born as a result of caesarean section, severe pathological childbirth, artificial babies born with low birth weight, premature babies.

Attention deficit hyperactivity disorder, also called hyperkinetic disorder, occurs in children between the ages of 3 and 15, but most often manifests itself in preschool and primary school age. This disorder is a form of minimal brain dysfunction in children. It is characterized by pathologically low levels of attention, memory, weakness of thought processes in general, with a normal level of intelligence. Arbitrary regulation is poorly developed, performance in the classroom is low, fatigue is increased. Deviations in behavior are also noted: motor disinhibition, increased impulsivity and excitability, anxiety, negative reactions, aggressiveness. At the beginning of systematic training, difficulties arise in mastering writing, reading and counting. Against the background of educational difficulties and, often, a lag in the development of social skills, school maladaptation and various neurotic disorders occur.

Attention- this is a property or feature of a person's mental activity, providing the best reflection of some objects and phenomena of reality while simultaneously abstracting from others.

Main functions of attention:

- activation of necessary and inhibition of currently unnecessary psychological and physiological processes;

– facilitating an organized and targeted selection of incoming information in accordance with current needs;

- ensuring selective and long-term concentration of mental activity on the same object or type of activity. Human attention has five main properties: stability, concentration, switchability, distribution and volume.

1. Sustainability of attention manifests itself in the ability for a long time to concentrate on any object, subject of activity, without being distracted.

2. attention span(opposite quality - absent-mindedness) is manifested in the differences that exist when attention is concentrated on some objects and distracted from others.

3. Switching attention is understood as its transfer from one object to another, from one type of activity to another. Two multidirectional processes are functionally connected with the switching of attention: inclusion and distraction of attention.

4. Distribution of attention consists in the ability to disperse it over a significant space, in parallel to perform several types of activities.

5. attention span is determined by the amount of information that can simultaneously be stored in the sphere of increased attention (consciousness) of a person.

attention deficit- the inability to keep attention on something that needs to be learned for a certain period of time.

1.3 Views and theories of domestic and foreign psychologists in the study of attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder is considered one of the main clinical variants of minimal brain dysfunction. For a long time, there was no single term for deviations in personality development. A large number of works reflected different concepts of the authors; the most common signs of the disease were used in the name of the syndrome: hyperactivity, inattention, staticomotor insufficiency.

The term "minimal brain dysfunction" (MMD) was officially introduced in 1962 at a special international conference in Oxford and has been used in the medical literature ever since. Since that time, the term MMD has been used to define conditions such as behavioral disorders and learning difficulties that are not associated with severe intellectual disabilities. IN domestic literature the term "minimal brain dysfunction" is now used quite often.

L.T. Zhurba and E.M. Mastyukova (1980) in their studies used the term MMD to denote conditions of a non-progradient nature with the presence of mild, minimal brain damage in the early stages of development (up to 3 years) and manifested in partial or general disorders of mental activity, with the exception of general intellectual underdevelopment. The authors identified the most characteristic disorders in the form of a kind of motor failure, speech disorders, perception, behavior, and specific learning difficulties.

In the USSR, the term “mental retardation” was used (Pevzner M.S., 1972), since 1975, publications have appeared using the terms “partial brain dysfunction”, “mild brain dysfunction” (Zhurba L.T. et al., 1977) and "hyperactive child" (Isaev D.N. et al., 1978), "developmental disorder", "improper maturation" (Kovalev V.V., 1981), "motor disinhibition syndrome", and later - "hyperdynamic syndrome" ( Lichko A.E., 1985; Kovalev V.V., 1995). Most psychologists used the term "motor disturbance of perception" (Zaporozhets A.V., 1986).

Author 3. Trzhesoglava (1986) proposes to consider MMD from the side of organic and functional disorders. He uses the terms "mild infantile encephalopathy", "mild brain damage" from the standpoint of an organic approach, and the terms "hyperkinetic child", "excitability syndrome", "attention deficit disorder" and others - from the standpoint of clinical, taking into account the manifestations of MMD or the most pronounced functional deficit.

Thus, in the study of MMD, there is an increasingly clear trend towards their differentiation into separate forms. Given that minimal brain dysfunction is still being studied, different authors describe this pathological condition using different terms.

In the domestic psychological and pedagogical science of hyperactivity, attention was also paid, however, not paramount. So, V.P. Kashchenko singled out a wide range of character disorders, to which, in particular, he attributed "painfully pronounced activity." In his posthumously published book Pedagogical Correction, we read: thoughts, desires, aspirations. This is his psychophysical property, we recognize as normal, desirable, extremely sympathetic. A strange impression is produced by the child being lethargic, inactive, apathetic. On the other hand, excessive thirst for movement and activity (morbid activity), brought to unnatural limits, also attracts our attention. We then note that the child is constantly on the move, cannot sit still for a single minute, fidgets in place, dangles his arms and legs, looks around, laughs, is amused, always chatting about something, does not pay attention to comments. The most fleeting phenomenon escapes his ear and eye: he sees everything, hears everything, but superficially ... At school, such painful mobility creates great difficulties: the child is inattentive, naughty a lot, talks a lot, laughs endlessly at every trifle. He is extremely scattered. He cannot or with the greatest difficulty brings the work he has begun to the end. Such a child has no brakes, no proper self-control. All this is caused by abnormal muscular mobility, painful mental and general mental activity. This psychomotor increased activity then finds its extreme expression in a mental illness called manic-depressive psychosis.

In our opinion, Kashchenko attributed the described phenomenon to “character flaws, due mainly to active-volitional elements”, also singling out the absence of a specific goal, absent-mindedness, and impulsiveness of actions as independent shortcomings. Recognizing the painful conditionality of these phenomena, he offered mainly pedagogical methods of their management - from specially organized physical exercises to the rational dosing of educational information to be mastered. It is difficult to argue with Kashchenko's recommendations, but their vagueness and generality raise doubts about their practical usefulness. “It is necessary to teach the child to desire and to fulfill his desires, to insist on them, in a word, to fulfill them. To do this, it is useful to give him tasks of varying difficulty. These tasks should be available to the child for a long time and become more difficult only as his strength develops. This is undeniable, but hardly sufficient. It is quite obvious that it is not possible to solve the problem at this level.

Over the years, the impotence of pedagogical methods for the correction of hyperactivity has become more and more obvious. After all, explicitly or implicitly, these methods relied on the old idea of ​​the flaws in education as the source of this problem, while its psychopathological nature required a different approach. Experience has shown that the school failure of hyperactive children is unfairly attributed to their intellectual disability, and their indiscipline cannot be corrected by purely disciplinary methods. Sources of hyperactivity should be sought in disorders of the nervous system and, in accordance with this, corrective measures should be planned.

Research in this area led scientists to the conclusion that in this case, the cause of behavioral disorders is an imbalance in the processes of excitation and inhibition in the nervous system. The "responsibility area" for this problem was also localized - the reticular formation. This section of the central nervous system is "responsible" for human energy, motor activity and the expression of emotions, influencing the cerebral cortex and other overlying structures. Due to various organic disorders, the reticular formation may be in an overexcited state, and therefore the child becomes disinhibited.

The immediate cause of the disorder was called minimal brain dysfunction, i.e. many microdamages of brain structures (arising from birth trauma, asphyxia of newborns and many similar reasons). At the same time, there are no gross focal lesions of the brain. Depending on the degree of damage to the reticular formation and disturbances in the nearby parts of the brain, more or less pronounced manifestations of motor disinhibition occur. It was on the motor component of this disorder that domestic researchers focused their attention, calling it hyperdynamic syndrome.

In foreign science, mainly American, special attention was also paid to the cognitive component - attention disorders. A special syndrome was identified - attention deficit hyperactivity disorder (ADHD). A long-term study of this syndrome made it possible to identify its extremely widespread prevalence (according to some reports, it affects from 2 to 9.5% of school-age children worldwide), as well as to clarify the data on the causes of its occurrence.

Various authors have tried to link childhood hyperactivity with specific morphological changes. Since the 1970s the reticular formation and the limbic system are of particular interest to researchers. Modern theories consider the frontal lobe and, above all, the prefrontal region as an area of ​​anatomical defect in ADHD.

Concepts of involvement of the frontal lobe in ADHD are based on the similarity of clinical symptoms observed in ADHD and in patients with lesions of the frontal lobe. Patients in both groups have marked variability and impaired regulation of behavior, distractibility, weakness of active attention, motor disinhibition, increased excitability, and lack of impulse control.

The decisive role in the formation of the modern concept of ADHD was played by the work of the Canadian researcher of the cognitivist orientation V. Douglas, who for the first time in 1972 considered the attention deficit with an abnormally short period of its retention on any object or action as a primary defect in ADHD. In clarifying the key characteristics of ADHD, Douglas, in her subsequent work, along with such typical manifestations of this syndrome as attention deficit, impulsivity of motor and verbal reactions, and hyperactivity, noted the need for significantly more than normal reinforcement for the development of behavioral skills in children with ADHD. She was one of the first to come to the conclusion that ADHD is caused by general disturbances in the processes of self-control and inhibition at the highest level of the reaction of mental activity, but by no means by elementary disorders of perception, attention and motor reactions. The work of Douglas served as the basis for the introduction in 1980 in the classification of the American Psychiatric Association and then in the ICD-10 classification (1994) of the diagnostic term "attention deficit hyperactivity disorder". According to the most modern theory, dysfunction of the frontal structures may be due to disorders at the level of neurotransmitter systems. It is becoming more and more obvious that the main research in this area belongs to the competence of neurophysiology and neuropsychology. This, in turn, dictates the appropriate specifics of corrective measures, which, to this day, alas, remain insufficiently effective.

2. Etiology, mechanisms of development of ADHD. Clinical signs of ADHD. Psychological characteristics of children with ADHD. Treatment and correction of ADHD

2.1 Etiology of ADHD

The experience accumulated by researchers indicates not only the lack of a single name for this pathological syndrome, but also the lack of a consensus on the factors leading to the occurrence of attention deficit hyperactivity disorder. An analysis of available sources of information allows us to identify a number of reasons for the occurrence ADHD syndrome. However, the significance of each of these risk factors has not yet been studied enough and needs to be clarified.

The occurrence of ADHD may be due to the influence of various etiological factors during the period of brain development up to 6 years. An immature, developing organism is most sensitive to harmful influences and least able to resist them.

Many authors (Badalyan L.O., Zhurba L.T., Vsevolozhskaya N.M., 1980; Veltishchev Yu.E., 1995; Khaletskaya O.V., 1998) consider the late stages of pregnancy and childbirth to be the most critical period. M. Haddres-Algra, H.J. Huisjes and B.C. Touwen (1988) divided all factors that cause brain damage in children into biological (hereditary and perinatal), acting before childbirth, at the time of childbirth and after childbirth, and social, due to the influence of the immediate environment. These studies confirm the relative difference in the influence of biological and social factors: from an early age (up to two years) greater value have biological factors of brain damage - a primary defect (Vygotsky L.S.). In the later (from 2 to 6 years) - social factors - a secondary defect (Vygotsky L.S.), and with a combination of both, the risk of attention deficit hyperactivity disorder significantly increases.

A large number of works are devoted to studies proving the occurrence of attention deficit hyperactivity disorder due to minor brain damage in the early stages of development, i.e. in the pre- and intranatal periods.

Yu.I. Barashnev (1994) and E.M. Belousova (1994) consider “small” disorders or injuries of the brain tissue in the prenatal, perinatal and less often postnatal periods to be primary in the disease. Given the high percentage of premature babies and the increase in the number of intrauterine infections, as well as the fact that in Russia in most cases childbirth proceeds with injuries, the number of children with encephalopathies after childbirth is high.

A special place among neurological diseases in children is occupied by prenatal and intranatal lesions. Currently, the frequency of perinatal pathology in the population is 15–25% and continues to grow steadily.

O.I. Maslova (1992) provides data on the unequal frequency of individual syndromes when characterizing the structure of organic lesions of the nervous system in children. These disorders were distributed as follows: in the form of motor disorders - 84.8%, mental disorders - 68.8%, speech disorders - 69.2% and convulsive seizures - 29.6%. Long-term rehabilitation of children with organic lesions of the nervous system in the first years of life in 50.5% of cases reduces the severity of motor disorders, speech development and the psyche in general.

Neonatal asphyxia, threatened miscarriage, anemia in pregnancy, postmaturity, maternal alcohol and drug use during pregnancy, and smoking are thought to contribute to ADHD. A psychological follow-up study of children who underwent hypoxia revealed a decrease in learning ability in 67%, a decrease in the development of motor skills in 38% of children, and deviations in emotional development in 58%. Conversational activity was reduced in 32.8%, and in 36.2% of cases, children had deviations in articulation.

Prematurity, morpho-functional immaturity, hypoxic encephalopathy, physical and emotional trauma of the mother during pregnancy, premature birth, and underweight of the child cause the risk of behavioral problems, learning difficulties and emotional disorders, increased activity.

Research Zavadenko N.N., 2000; Mamedaliyeva N.M., Elizarova I.P., Razumovskoy I.N. in 1990, it was found that the neuropsychic development of children born with insufficient body weight is much more often accompanied by various deviations: delayed psychomotor and speech development and convulsive syndrome.

The research results show that intensive medical, psychological and pedagogical impact at the age of up to 3 years leads to an increase in the level of cognitive development and a decrease in the risk of developing behavioral disorders. These data prove that overt neurological disorders in the neonatal period and factors recorded in the intranatal period are of prognostic value in the development of ADHD in older age.

A great contribution to the study of the problem was made by works that put forward an assumption about the role of genetic factors in the occurrence of ADHD, the proof of which was the existence of familial forms of ADHD.

To confirm the genetic etiology of the ADHD syndrome, follow-up observations by E.L. Grigorenko (1996). According to the author, hyperactivity is an innate characteristic along with temperament, biochemical parameters, and low reactivity of the central nervous system. Low excitability of the central nervous system E.L. Grigorenko explains the violation in the reticular formation of the brain stem, inhibitors of the cerebral cortex, which causes motor anxiety. A fact proving the genetic predisposition of ADHD was the presence of symptoms in childhood in parents of children suffering from this disease.

The search for genes of predisposition to ADHD was carried out by M. Dekkeg et al. (2000) in a genetically isolated population in the Netherlands, which was founded 300 years ago (150 people) and currently includes 20 thousand people. In this population, 60 patients with ADHD were found, the pedigrees of many of them were traced back to the fifteenth generation and were reduced to a common ancestor.

Studies by J. Stevenson (1992) prove that the heritability of attention deficit hyperactivity disorder in 91 pairs of identical and 105 pairs of fraternal twins is 0.76%.

The works of Canadian scientists (Barr С.L., 2000) talk about the influence of the SNAP-25 gene on the occurrence of increased activity and lack of attention in patients. The analysis of the structure of the SNAP-25 gene encoding the synaptosome protein in 97 nuclear families with increased activity and lack of attention showed an association of some polymorphic sites in the SNAP-25 gene with the risk of developing ADHD.

There are also gender and age differences in the development of ADHD. According to V.R. Kuchma, I.P. Bryazgunov (1994) and V.R. Kuchma and A. G. Platonov, (1997) among boys of 7–12 years old, signs of the syndrome occur 2–3 times more often than among girls. In their opinion, the high frequency of symptoms of the disease in boys may be due to the higher vulnerability of the male fetus to pathogenic influences during pregnancy and childbirth. In girls, the cerebral hemispheres are less specialized, so they have a greater reserve of compensatory functions in case of damage to the central nervous system compared to boys.

Along with the biological risk factors for ADHD, social factors are analyzed, such as educational neglect leading to ADHD. Psychologists I. Langmeyer and Z. Mateychik (1984) distinguish between social factors of trouble, on the one hand, deprivation - mainly sensory and cognitive, on the other - social and cognitive. They refer to unfavorable social factors as insufficient education of parents, incomplete family, deprivation or deformation of maternal care.

J.V. Hunt, V. A Sooreg (1988) prove that the severity of motor and visual-motor disorders, deviations in the development of speech and cognitive activity in the development of children depends on the education of the parents, and the frequency of such deviations depends on the presence of diseases in the neonatal period.

O.V. Efimenko (1991) attaches great importance to the development of the child in infancy and preschool age in the occurrence of ADHD. Children brought up in orphanages or in an atmosphere of conflict and cold relationships between parents are more prone to neurotic breakdowns than children from families with a benevolent atmosphere. The number of children with disharmonious and sharply disharmonious development among children from orphanages is 1.7 times higher than the number of similar children from families. It is also believed that the occurrence of ADHD contributes to the delinquent behavior of parents - alcoholism and smoking. 3. Trzhesoglava showed that in 15% of children with ADHD, parents suffered from chronic alcoholism.

Thus, at the present stage, approaches developed by researchers to the study of the etiology and pathogenesis of ADHD, for the most part, affect only certain aspects of the problem. Three main groups of factors that determine the development of ADHD are considered: early damage to the central nervous system associated with the negative impact on the developing brain of various forms of pathology during pregnancy and childbirth, genetic factors and social factors.

Researchers do not yet have convincing evidence of the priority of physiological, biological or social factors in the formation of such changes in the higher parts of the brain, which are the basis of attention deficit hyperactivity disorder.

In addition to the above reasons, there are some other points of view on the nature this disease. In particular, it is assumed that eating habits and the presence of artificial food additives in foods can also influence the behavior of the child.

This problem has become urgent in our country due to the significant import of food products, including baby food, that have not passed proper certification. It is known that most of them contain various preservatives and food additives.

Abroad, the hypothesis of a possible relationship between food additives and hyperactivity was popular in the mid-70s. Message from Dr. B.F. Feingolda (1975) from San Francisco that 35-50% of hyperactive children showed a significant improvement in behavior after the elimination of foods containing nutritional supplements from their diet caused a real sensation. However, subsequent studies have not confirmed these data.

For some time, refined sugar was also “under suspicion”. But careful research has not confirmed these "charges". Currently, scientists have come to the final conclusion that the role of food additives and sugar in the origin of attention deficit hyperactivity disorder is exaggerated.

However, if parents suspect any connection between a change in a child's behavior and the consumption of a particular food, then it can be excluded from the diet.

Information has appeared in the press that the exclusion from the diet of foods containing a large amount of salicylates reduces the hyperactivity of the child.

Salicylates are found in the bark, leaves of plants and trees (olives, jasmine, coffee, etc.), and in small quantities - in fruits (oranges, strawberries, apples, plums, cherries, raspberries, grapes). However, this information also needs to be carefully checked.

It can be assumed that the environmental troubles that all countries are now experiencing makes a certain contribution to the increase in the number of neuropsychiatric diseases, including ADHD. For example, dioxins are super-toxic substances that occur during the production, processing and combustion of chlorinated hydrocarbons. They are often used in industry and households and can lead to carcinogenic and psychotropic effects, as well as severe congenital anomalies in children. Pollution environment salts of heavy metals, such as molybdenum, cadmium, leads to a disorder of the central nervous system. Compounds of zinc and chromium play the role of carcinogens.

An increase in the content of lead, the strongest neurotoxin, in the environment can cause behavioral disorders in children. It is known that the content of lead in the atmosphere is now 2000 times higher than during the industrial revolution.

There are many more factors that can be potential causes of the disorder. Usually, during the diagnosis, a whole group of possible causes is revealed, i.e. the nature of this disease is combined.

2.2 Mechanisms of development of ADHD

Due to the variety of causes of the disease, there are a number of concepts that describe the proposed mechanisms of its development.

Proponents of the genetic concept suggest the presence of a congenital inferiority of the functional systems of the brain responsible for attention and motor control, in particular in the frontal cortex and basal ganglia. The role of the neurotransmitter in these structures is performed by dopamine. As a result of molecular genetic studies in children with severe hyperactivity and attention disorders, anomalies in the structure of the dopamine receptor and dopamine transporter genes were revealed.

However, there is still not enough clear experimental evidence to explain the mechanism of development (pathogenesis) of the syndrome from the standpoint of molecular genetics.

In addition to the genetic theory, neuropsychological theory is also distinguished. In children with the syndrome, deviations in the development of higher mental functions are noted, which are responsible for motor control, self-regulation, inner speech, attention and working memory. Violation of these "executive" functions responsible for the organization of activities can lead to the development of attention deficit hyperactivity disorder, according to R.A. Barkley (1990) in his Unified Theory of ADHD.

As a result of the neurophysiological studies carried out - nuclear magnetic resonance, positron emission and computed tomography - scientists have identified deviations in the development of the frontal cortex, as well as the basal ganglia and cerebellum, in these children. It is assumed that these disorders lead to a delay in the maturation of the functional systems of the brain responsible for motor control, self-regulation of behavior and attention.

One of the latest hypotheses of the origin of the disease is a violation of the metabolism of dopamine and norepinephrine, which act as neurotransmitters of the central nervous system.

These compounds affect the activity of the main centers of higher nervous activity: the center of control and inhibition of motor and emotional activity, the center of activity programming, the system of attention and working memory. In addition, these neurotransmitters perform the functions of positive stimulation and are involved in the formation of the stress response.

Thus, dopamine and norepinephrine are involved in the modulation of the main higher mental functions, which causes the occurrence of various neuropsychiatric disorders in violation of their metabolism.

Direct measurements of dopamine and its metabolites in the cerebrospinal fluid revealed a decrease in their content in patients with the syndrome. The content of norepinephrine, on the contrary, was increased.

In addition to direct biochemical measurements, the evidence for the validity of the neurochemical hypothesis is the beneficial effect in the treatment of sick children with psychostimulants, which, in particular, affect the release of dopamine and norepinephrine from nerve endings.

There are other hypotheses describing the mechanisms of ADHD: the concept of diffuse cerebral dysregulation by O.V. Khaletskaya and V.M. Troshin, generator theory G.N. Kryzhanovsky (1997), theory of neurodevelopmental delay 3. Trzhesoglavy. But the final answer to the question of the pathogenesis of the disease has not yet been found.

2.3 Clinical features of ADHD

Most researchers note three main blocks of ADHD manifestation: hyperactivity, attention disorders, impulsivity.
Signs of Attention Deficit Hyperactivity Disorder (ADHD) can be detected in very young children. Literally from the first days of life, the child may have increased muscle tone. Such children struggle to free themselves from diapers and do not calm down if they are trying to swaddle tightly or even put on tight clothes. They may suffer from frequent, repeated, unmotivated vomiting from early childhood. Not by regurgitation, characteristic of infancy, but by vomiting, when everything that he ate is immediately back like a fountain. Such spasms are a sign of a disorder of the nervous system. (And here it is important not to confuse them with pyloric stenosis).

Hyperactive children throughout the first year of life sleep poorly and little, especially at night. Difficulty falling asleep, easily excited, crying loudly. They are extremely sensitive to all external stimuli: light, noise, stuffiness, heat, cold, etc. A little older, at two or four years old, they develop dyspraxia, the so-called clumsiness, the inability to focus on some object or phenomenon that is even interesting to him is more clearly visible: he throws toys, cannot calmly listen to a fairy tale, watch a cartoon.

But hyperactivity and attention problems become most noticeable by the time the child enters kindergarten, and become quite menacing in elementary school.

Any mental process can be fully developed only if attention is formed. L.S. Vygotsky wrote that directed attention plays a huge role in the processes of abstraction, thinking, motivation, directed activity.

concept "hyperactivity" includes the following features:

The child is fussy, never sits still. You can often see how he moves his hands and feet for no reason, crawls on a chair, constantly turns around.

The child is not able to sit still for a long time, jumps up without permission, walks around the classroom, etc.

The motor activity of the child, as a rule, does not have a specific goal. He just runs, spins, climbs, tries to climb somewhere, although sometimes this is far from safe.

The child cannot play quiet games, relax, sit quietly and calmly, do something specific.

The child is always aimed at movement.

Often talkative.

concept "carelessness" is made up of the following features:

Usually a child is not able to hold (focus) attention on details, which is why he makes mistakes when performing any tasks (at school, kindergarten).

The child is not able to listen to the speech addressed to him, which gives the impression that he generally ignores the words and comments of others.

The child does not know how to complete the work performed. It often seems that he is thus expressing his protest, because he does not like this work. But the thing is that the child is simply not able to learn the rules of work offered to him by the instruction, and adhere to them.

The child experiences great difficulties in the process of organizing his own activities (it does not matter whether to build a house out of cubes or write a school essay).

The child avoids tasks that require prolonged mental stress.

The child often loses his things, items needed at school and at home: in kindergarten he can never find his hat, in the classroom - a pen or diary, although previously the mother collected everything and put it in one place.

The child is easily distracted by extraneous stimuli.

In order for a child to be diagnosed with inattention, he must have at least six of the listed signs that persist for at least six months and are constantly expressed, which does not allow the child to adapt to a normal age environment.

Impulsiveness It is expressed in the fact that the child often acts without thinking, interrupts others, can get up and leave the classroom without permission. In addition, such children do not know how to regulate their actions and obey the rules, wait, often raise their voices, and are emotionally labile (the mood often changes).

concept "impulsiveness" includes the following features:

The child often answers questions without thinking, without listening to them to the end, sometimes just shouting out the answers.

The child hardly waits for his turn, regardless of the situation and environment.

The child usually interferes with others, interferes in conversations, games, sticks to others.

It is possible to speak of hyperactivity and impulsivity only if at least six of the above signs are present and they persist for at least six months.

By adolescence, increased motor activity in most cases disappears, and impulsivity and attention deficit persist. According to the results of N.N. Zavadenko, behavioral disorders persist in almost 70% of adolescents and 50% of adults who had an attention deficit diagnosis in childhood. characteristic feature mental activity of hyperactive children is cyclical. Children can work productively for 5–15 minutes, then the brain rests for 3–7 minutes, accumulating energy for the next cycle. At this point, the child is distracted and does not respond to the teacher. Then mental activity is restored, and the child is ready for work within 5-15 minutes. Children with ADHD have a “flickering” consciousness, they can “fall in” and “fall out” of it, especially in the absence of motor stimulation. If the vestibular apparatus is damaged, they need to move, spin and constantly turn their heads in order to remain “conscious”. In order to maintain concentration of attention, children use an adaptive strategy: they activate the centers of balance with the help of physical activity. For example, leaning back on a chair so that only its back legs touch the floor. The teacher requires the students to "sit up straight and not be distracted." But for such children, these two requirements come into conflict. If their head and body are immobile, the level of brain activity decreases.

As a result of correction with reciprocal movement exercises, damaged tissue in the vestibular apparatus can be replaced with new tissue as new nerve networks develop and myelinate. It has now been established that motor stimulation of the corpus callosum, cerebellum and vestibular apparatus of children with ADHD leads to the development of the function of consciousness, self-control and self-regulation.

These violations lead to difficulties in mastering reading, writing, counting. N.N. Zavadenko notes that 66% of children diagnosed with ADHD are characterized by dyslexia and dysgraphia, for 61% of children - signs of dyscalculia. In mental development, delays of 1.5–1.7 years are observed.

In addition, hyperactivity is characterized by a weak development of fine motor coordination and constant, erratic, awkward movements caused by an unformed interhemispheric interaction and a high level of adrenaline in the blood. Hyperactive children are also characterized by constant chatter, indicating

on the lack of development of inner speech, which should control social behavior.

At the same time, hyperactive children often have extraordinary abilities in different areas, are quick-witted and show a keen interest in their surroundings. The results of numerous studies show a good general intelligence of such children, but the listed features of their status do not contribute to its development. Among hyperactive children there may be gifted ones. So, D. Edison and W. Churchill were hyperactive children and were considered difficult teenagers.

An analysis of the age dynamics of ADHD showed two bursts of the manifestation of the syndrome. The first is celebrated at the age of 5–10 years and falls on the period of preparation for school and the beginning of education, the second - at 12–15 years. This is due to the dynamics of the development of higher nervous activity. The age of 5.5–7 and 9–10 years are critical periods for the formation of brain systems responsible for mental activity, attention, and memory. YES. Farber notes that by the age of 7 there is a change in the stages of intellectual development, conditions are formed for the formation of abstract thinking and arbitrary regulation of activity. The activation of ADHD at 12-15 years of age coincides with the period of puberty. A hormonal surge is reflected in the characteristics of behavior and attitudes towards learning.

According to modern scientific data, among boys of 7–12 years old, signs of the syndrome are diagnosed 2–3 times more often than among girls. Among adolescents, this ratio is 1:1, and among 20-25-year-olds it is 1:2, with a predominance of girls. In the clinic, the ratio of boys and girls varies from 6:1 to 9:1. Girls have more pronounced social maladaptation, learning difficulties, and personality disorders.

According to the severity of symptoms, doctors classify the disease into three groups: mild, moderate and severe. With a mild form, the symptoms, the presence of which is necessary for the diagnosis, are minimally expressed, there are no violations in school and social life. In a severe form of the disease, many symptoms are revealed to a large extent, there are serious learning difficulties, problems in social life. The average degree is a symptomatology between mild and severe forms of the disease.

Thus, hyperactivity syndrome often includes cerebrasthenic, neurosis-like, intellectual-mnestic disorders, as well as such psychopathic manifestations as increased motor activity, impulsivity, attention deficit, aggressiveness.

2.4 Psychological characteristics of children with ADHD

The lag in the biological maturation of the CNS in children with ADHD and, as a result, the higher brain functions (mainly the regulatory component), does not allow the child to adapt to new conditions of existence and normally endure intellectual stress.

O.V. Khaletskaya (1999) analyzed the state of higher brain functions in healthy and sick children with ADHD at the age of 5–7 years and came to the conclusion that there were no pronounced differences between them. At the age of 6–7 years, the differences are especially pronounced in such functions as auditory-motor coordination and speech; therefore, it is advisable to conduct dynamic neuropsychological monitoring of children with ADHD from the age of 5 using individual rehabilitation techniques. This will make it possible to overcome the delay in the maturation of higher brain functions in this group of children and prevent the formation and development of a maladaptive school syndrome.

There is a discrepancy between the actual level of development and the performance that can be expected based on the IQ. Quite often, hyperactive children are quick-witted and quickly "grasp" information, have extraordinary abilities. Among children with ADHD there are really talented children, but cases of mental retardation in this category of children are not uncommon. The most important thing is that the intelligence of children is preserved, but the features that characterize ADHD - restlessness, restlessness, a lot of unnecessary movements, lack of focus, impulsive actions and increased excitability, are often combined with difficulties in acquiring learning skills (reading, counting, writing). This leads to pronounced school maladjustment.

Severe disorders in the field of cognitive processes are associated with disorders of auditory gnosis. Changes in auditory gnosis are manifested in the inability to correctly assess sound complexes consisting of a series of successive sounds, the inability to reproduce them and the shortcomings of visual perception, difficulties in the formation of concepts, infantilism and vagueness of thinking, which are constantly influenced by momentary impulses. Motor discordance is associated with poor eye-hand coordination and negatively affects the ability to write easily and correctly.

Research L.A. Yasyukova (2000) show the specifics of the intellectual activity of a child with ADHD, consisting of cyclicity: arbitrary productive work does not exceed 5–15 minutes, after which the children lose control of mental activity further, within 3–7 minutes the brain accumulates energy and strength for the next work cycle.

It should be noted that fatigue has a dual biological effect: on the one hand, it is a protective protective reaction against extreme exhaustion of the body, on the other hand, fatigue stimulates recovery processes, pushes the boundaries of functionality. The longer the child works, the shorter
productive periods become longer and the rest time is longer - until complete exhaustion occurs. Then sleep is necessary to restore mental performance. During the period of "rest" of the brain, the child ceases to understand, comprehend and process incoming information. It is not fixed anywhere and does not linger, therefore
the child does not remember what he was doing at that time, does not notice that there were some breaks in his work.

Mental fatigue is more characteristic of girls, and in boys it manifests itself by the age of 7. Girls also have a reduced level of verbal-logical thinking.

Memory in children with ADHD may be normal, but due to the exceptional instability of attention, there are "gaps in well-learned" material.

Disorders of short-term memory can be found in a decrease in the amount of memorization, increased inhibition by extraneous stimuli, and slow memorization. At the same time, an increase in motivation or organization of the material gives a compensatory effect, which indicates the preservation of the cortical function in relation to memory.

At this age, speech disorders begin to attract attention. It should be noted that the maximum severity of ADHD coincides with the critical periods of psychoverbal development in children.

If the regulatory function of speech is impaired, the adult's speech does little to correct the child's activity. This leads to difficulties in the sequential execution of certain intellectual operations. The child does not notice his mistakes, forgets the final task, easily switches to side or non-existent stimuli, cannot stop side associations.

Especially frequent in children with ADHD are such speech disorders as delayed speech development, lack of motor function of the articulatory apparatus, excessively slow speech, or, conversely, explosiveness, voice and speech breathing disorders. All these violations determine the inferiority of the sound-producing side of speech, its phonation, the limited vocabulary and syntax, and the lack of semantics.

There are also other disorders, such as stuttering. Stuttering does not have clear age trends, however, it is most often observed at 5 and 7 years of age. Stuttering is more characteristic of boys and occurs in them much earlier than in girls, and is equally present in all age groups. In addition to stuttering, the authors also highlight the talkativeness of this category of children.

Increased switching from one activity to another occurs involuntarily, without adjustment to the activity and subsequent control. The child is distracted by minor auditory and visual stimuli that are ignored by other peers.

A tendency to a pronounced decrease in attention is observed in unusual situations, especially when it is necessary to act independently. Children do not show perseverance either during classes or in games, they cannot watch their favorite TV show to the end. At the same time, there is no switching of attention, therefore, types of activities that quickly replace each other are carried out in a reduced, poor quality and fragmentary way, however, when pointing out mistakes, children try to correct them.

Attention impairment in girls reaches its maximum severity by the age of 6 and becomes the leading disorder in this age period.

The main manifestations of hyperexcitability are observed in various forms of motor disinhibition, which is aimless, not motivated by anything, situationless and usually not controlled by either adults or peers.

Such increased motor activity, turning into motor disinhibition, is one of the many symptoms that accompany developmental disorders in a child. Purposeful motor behavior is less active than in healthy children of the same age.

Coordinating disturbances are found in the field of motor abilities. Research results show that motor problems begin as early as preschool age. In addition, there are general difficulties in perception, which affects the mental abilities of children, and, consequently, the quality of education. The most commonly affected are fine motor skills, sensorimotor coordination, and manual dexterity. Difficulties associated with maintaining balance (when standing, skating, rollerblading, bicycling), impaired visual-spatial coordination (inability to sports games especially with the ball) - the causes of motor awkwardness and an increased risk of injury.

Impulsivity manifests itself in sloppy performance of a task (despite the effort, do everything right), intemperance in words, deeds and actions (for example, shouting from a place during class, inability to wait for your turn in games or other activities), inability to lose, excessive perseverance in defending their interests (despite the requirements of an adult). With age, the manifestations of impulsivity change: the older the child, the more pronounced impulsivity and more noticeable to others.

One of characteristic features children with ADHD are disorders of social adaptation. These children typically have a lower level of social maturity than is usually the case for their age. Affective tension, a significant amplitude of emotional experience, difficulties that arise in communicating with peers and adults lead to the fact that a child easily forms and fixes negative self-esteem, hostility to others, neurosis-like and psychopathological disorders occur. These secondary disorders aggravate the clinical picture of the condition, increase maladjustment and lead to the formation of a negative "I-concept".

Children with the syndrome have impaired relationships with peers and adults. In mental development, these children lag behind their peers, but they strive to lead, behave aggressively and demandingly. Impulsive hyperactive children quickly react to a ban or a sharp remark, respond with harshness, disobedience. Attempts to contain them lead to actions on the principle of a "released spring". Not only others suffer from this, but also the child himself, who wants to fulfill a promise, but does not keep it. Interest in the game in such children quickly disappears. Children with ADHD love to play destructive games, during the game they cannot concentrate, they conflict with their comrades, despite the fact that they love the team. The ambivalence of forms of behavior is most often manifested in aggressiveness, cruelty, tearfulness, hysteria, and even sensual dullness. In view of this, children with attention deficit hyperactivity disorder have few friends, although these children are extroverts: they look for friends, but quickly lose them.

The social immaturity of such children is manifested in the preference for building play relationships with younger children. Relationships with adults are difficult. It is difficult for children to listen to the explanation to the end, they are constantly distracted, especially in the absence of interest. These children ignore both adult rewards and punishment. Praise does not stimulate good behavior, in view of this encouragement must be very reasonable, otherwise the child will behave worse. However, it must be remembered that a hyperactive child needs praise and approval from an adult to strengthen self-confidence.

A child with the syndrome is not able to master his role and cannot understand how he should behave. Such children behave familiarly, do not take into account specific circumstances, cannot adapt and accept the rules of behavior in a particular situation.

Increased excitability is the cause of difficulties in acquiring ordinary social skills. Children do not fall asleep well even if the regimen is observed, they eat slowly, dropping and spilling everything, as a result of which the process of eating becomes a source of daily conflicts in the family.

Harmonization of personality development in children with ADHD depends on micro- and macrocirculation. If mutual understanding, patience and a warm attitude towards the child are preserved in the family, then after curing ADHD, everything negative sides behaviors disappear. Otherwise, even after the cure, the pathology of the character will remain, and perhaps even intensify.

The behavior of such children is characterized by a lack of self-control. The desire for independent action (“I want it that way”) turns out to be a stronger motive than any rules. Knowing the rules is not a significant motive for one's own actions. The rule remains known but subjectively meaningless.

It is important to emphasize that the rejection of hyperactive children by society leads to the development of a sense of rejection in them, alienates them from the team, increases imbalance, irascibility and intolerance of failure. Psychological examination of children with the syndrome in most of them reveals increased anxiety, anxiety, internal tension, a sense of fear. Children with ADHD are more prone to depression than others, easily upset by failure.

The emotional development of the child lags behind the normal indicators of this age group. Mood changes rapidly from elated to depressed. Sometimes there are unreasonable bouts of anger, rage, anger, not only in relation to others, but also to oneself. The child is characterized by low self-esteem, low self-control and arbitrary regulation, as well as an increased level of anxiety.

A calm environment, guidance from adults lead to the fact that the activity of hyperactive children becomes successful. Emotions have an exceptionally strong influence on the activities of these children. Emotions of medium intensity can activate it, however, with a further increase in the emotional background, activity can be completely disorganized, and everything that has just been learned can be destroyed.

Thus, older preschoolers with ADHD demonstrate a decrease in the voluntariness of their own activity as one of the main components of a child's development, which causes a decrease and immaturity in the formation of the following functions in development: attention, praxis, orientation, weakness of the nervous system.

Ignorance that a child has functional deviations in the work of brain structures, and the inability to create an appropriate mode of learning and life in general for him at preschool age, give rise to many problems in elementary school.

2.5 Treatment and management of ADHD

The goal of therapy is to reduce behavioral disturbances and learning difficulties. To do this, first of all, it is necessary to change the environment of the child in the family, school and create favorable conditions for correcting the symptoms of the disorder and overcoming the lag in the development of higher mental functions.

Treatment of children with Attention Deficit Hyperactivity Disorder should include a complex of methods, or, as experts say, be “multimodal”. This means that a pediatrician, a psychologist (and if this is not the case, then the pediatrician must have certain knowledge in the field of clinical psychology), teachers and parents should participate in it. Only the collective work of the above-mentioned specialists will achieve a good result.

"Multimodal" treatment includes the following steps:

Educational conversations with the child, parents, teachers;

Teaching parents and teachers about behavioral programs;

Expansion of the child's social circle through visiting various circles and sections;

Special education in case of learning difficulties;

drug therapy;

Autogenic training and suggestive therapy.

At the beginning of treatment, the doctor and psychologist must carry out educational work. Parents (preferably also a class teacher) and the child must be explained the meaning of the upcoming treatment.

Adults often do not understand what is happening to the child, but his behavior annoys them. Not knowing about the hereditary nature of ADHD, they explain the behavior of their son (daughter) with “wrong” upbringing and blame each other. Specialists should help parents understand the behavior of the child, explain what can really be hoped for and how to behave with the child. It is necessary to try all the variety of methods and choose the most effective for these violations. The psychologist (doctor) should explain to parents that the improvement of the child's condition depends not only on the prescribed treatment, but to a large extent on a kind, calm and consistent attitude towards him.

Children are sent for treatment only after a comprehensive examination.

Medical therapy

Abroad, drug therapy for ADHD is used more than widely, for example, in the United States, the use of drugs is a key point in treatment. But there is still no consensus on the effectiveness of drug treatment, and there is no single scheme for their administration. Some doctors believe that the prescribed drugs bring only a short-term effect, others deny this.

In case of behavioral disorders (increased motor activity, aggression, excitability), psychostimulants are most often prescribed, less often - antidepressants and antipsychotics.

Psychostimulants have been used to treat motor disinhibition and attention disorders since 1937 and are still the most effective drugs with this disease: in all age groups (children, adolescents, adults), an improvement is observed in 75%. cases. This group of drugs includes methylphenidate (commercial name Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cilert).

When taken in hyperactive children, behavior, cognitive and social functions improve: they become more attentive, successfully complete tasks in the classroom, their academic performance increases, and relationships with others improve.

The high efficiency of psychostimulants is explained by the wide spectrum of their neurochemical action, which is directed primarily to the dopamine and noradrenergic systems of the brain. It is not completely known whether these drugs increase or decrease the content of dopamine and norepinephrine in synaptic endings. It is assumed that they have a general "irritating" effect on these systems, which leads to the normalization of their functions. A direct correlation has been proven between improved catecholamine metabolism and reduced symptoms of ADHD.

In our country, these drugs are not yet registered and are not used. No other highly effective drugs have yet been created. Our neuropsychiatrists continue to prescribe Aminalon, Sydnocarb and other antipsychotics with hyperinhibitory action, which do not improve the condition of these children. In addition, aminalon has an adverse effect on the liver. Several studies have been conducted to study the effect of cerebrolysin and other nootropics on ADHD symptoms, but these drugs have not yet been introduced into widespread practice.

Only a doctor who knows the child's condition, the presence or absence of certain somatic diseases, can prescribe the drug in the appropriate dosage, and will monitor the child, identifying possible side effects drug. And they can be seen. Among them are loss of appetite, insomnia, increased heart rate and blood pressure, and drug dependence. Less common are abdominal pain, dizziness, headaches, drowsiness, dry mouth, constipation, irritability, euphoria, bad mood, anxiety, nightmares. There are hypersensitivity reactions in the form of skin rashes, edema. Parents should immediately pay attention to these signs and inform the attending physician as soon as possible.

In the early 70s. reports have appeared in the medical press that long-term use of methylphenidate or dextroamphetamine leads to a delay in the growth of the child. However, further repeated studies have not confirmed the relationship between stunting and the effects of these drugs. 3. Trzhesoglava sees the cause of growth retardation not in the action of stimulants, but in the general lag in the development of these children, which can be eliminated with timely correction.

In one of the latest studies conducted by American specialists in a group of children from 6 to 13 years old, it was shown that methylphenidate is most effective in young children. Therefore, the authors recommend prescribing this drug as early as possible, from 6–7 years of age.

There are several strategies for treating the disease. Drug therapy can be carried out continuously, or the method of "drug holidays" is used, i.e. on weekends and during holidays, the medicine is not taken.

However, you can not rely only on drugs, because:

Not all patients have the expected effect;

Psychostimulants, like any medication, have a number of side effects;

The use of drugs alone does not always improve the behavior of the child.

In the course of numerous studies, it has been shown that psychological and pedagogical methods allow correcting behavioral disorders and learning difficulties quite successfully and for a longer time than the use of drugs. Medications are prescribed no earlier than 6 years and only according to individual indications: in cases where cognitive impairments and deviations in the child's behavior cannot be overcome with the help of psychological, pedagogical and psychotherapeutic methods of correction.

The effective use of CNS stimulants abroad for decades has made them "magic pills", but their short duration of action remains a serious drawback. Long-term studies have shown that children with the syndrome, who took courses of psychostimulants for several years, did not differ in academic performance from sick children who did not receive any therapy. And this is despite the fact that a clear positive trend was observed directly in the course of treatment.

short duration of action and side effects the use of psychostimulants led to the fact that their excessive prescription in 1970-1980. already in the early 90s, it was replaced by an individual appointment with an analysis of each specific case and a periodic assessment of the success of treatment.

In 1990, the American Academy of Pediatrics opposed the one-sided use of drugs in the treatment of attention deficit hyperactivity disorder. The following resolution was passed: “Drug therapy should be preceded by pedagogical and behavioral correction…”. In accordance with this, cognitive-behavioral therapy has become a priority, and medications are used only in combination with psychological and pedagogical methods.

Behavioral Psychotherapy

Among the psychological and pedagogical methods of correction of attention deficit disorder, the main role is given to behavioral psychotherapy. Abroad, there are centers for psychological assistance, which provide special training for parents, teachers and children's doctors in these techniques.

The key point of the behavioral correction program is to change the environment of the child at school and at home in order to create favorable conditions for overcoming the lag in the development of mental functions.

Home correction program includes:

change in the behavior of an adult and his attitude towards a child(demonstrate calm behavior, avoid the words “no” and “impossible”, build relationships with the child on trust and mutual understanding);

change in the psychological microclimate in the family(adults should quarrel less, devote more time to the child, spend leisure time with the whole family);

organization of the daily routine and places for classes ;

special behavioral program, providing for the prevalence of methods of support and rewards .

The home program is dominated by the behavioral aspect, while at school the main focus is on cognitive therapy to help children cope with learning difficulties.

The school correction program includes:

environment change(the place of the child in the classroom is next to the teacher, changing the lesson mode with the inclusion of minutes of active rest, regulating relationships with classmates);

creation of positive motivation, situations of success ;

correction of negative forms of behavior, in particular unmotivated aggression;

regulation of expectations(applies to parents as well), since positive changes in the behavior of the child do not appear as quickly as others would like.

Behavioral programs require considerable skill, adults have to use all their imagination and experience with children in order to keep the constantly distracted child motivated during classes.

Corrective methods will be effective only under the condition of close cooperation between the family and the school, which must necessarily include the exchange of information between parents and teachers through joint seminars, training courses, etc. Success in treatment will be guaranteed if uniform principles are maintained in relation to the child at home and at school: the “reward” system, help and support from adults, participation in joint activities. Continuity of treatment therapy at school and at home is the main guarantee of success.

In addition to parents and teachers, doctors, psychologists, social pedagogues, those who can provide professional assistance in individual work with such a child, should provide great assistance in organizing a correction program.

Correctional programs should be focused on the age of 5–8 years, when the compensatory capabilities of the brain are great and the pathological stereotype has not yet formed.

Based on literature data and our own observations, we have developed specific recommendations for parents and teachers on working with hyperactive children (see paragraph 3.6).

It must be remembered that negative methods education is ineffective in these children. The peculiarities of their nervous system are such that the threshold of sensitivity to negative stimuli is very low, so they are not susceptible to reprimands and punishment, and do not easily respond to the slightest praise. Although the methods of rewarding and encouraging the child must be constantly changed.

The home reward and promotion program includes the following points:

1. Every day, the child is given a specific goal that he must achieve.

2. The efforts of the child in achieving this goal are encouraged in every possible way.

3. At the end of the day, the child's behavior is evaluated according to the results achieved.

4. Parents periodically inform the attending physician about changes in the child's behavior.

5. When a significant improvement in behavior is achieved, the child receives a long-promised reward.

Examples of goals set for a child can be: good homework, helping a weaker classmate with homework, exemplary behavior, cleaning his room, cooking dinner, shopping, and others.

In a conversation with a child, and especially when you give him tasks, avoid directives, turn the situation in such a way that the child feels: he will do a useful thing for the whole family, he is completely trusted, hoped for. When communicating with your son or daughter, avoid constant pulling like "sit still" or "don't talk when I'm talking to you" and other things that are unpleasant for him.

A few examples of incentives and rewards: let your child watch TV in the evening for half an hour longer than the allotted time, treat him with a special dessert, give him the opportunity to participate in games with adults (lotto, chess), let him go to the disco once again, buy the thing that he has been talking about for a long time dreams.

If the child behaves approximately during the week, at the end of the week he should receive an additional reward. It can be some kind of trip with your parents out of town, an excursion to the zoo, to the theater and others.

The given version of behavioral training is ideal and it is not always possible to use it with us at the present time. But parents and teachers can use individual elements of this program, taking its main idea: encouraging the child for achieving the set goals. And it does not matter in what form it will be presented: material reward or just an encouraging smile, an affectionate word, increased attention to the child, physical contact (stroking).

Parents are encouraged to write a list of what they expect from their child in terms of behavior. This list is explained to the child in an accessible manner. After that, everything written is strictly observed, and the child is encouraged for success in its implementation. Physical punishment must be refrained from.

It is believed that drug therapy in combination with behavioral techniques is most effective.

Special education

If it is difficult for a child to study in a regular class, then by decision of the medical-psychological-pedagogical commission, he is transferred to a specialized class.

A child with ADHD can benefit from learning in special settings appropriate to their abilities. The main reasons for poor academic performance in this pathology are inattention and lack of proper motivation and purposefulness, sometimes combined with partial delays in the development of school skills. Unlike the usual "mental retardation", they are a temporary phenomenon and can be successfully leveled with intensive training. In the presence of partial delays, a correction class is recommended, and with normal intelligence, a class for catching up.

A prerequisite for teaching children with ADHD in correctional classes is the creation of favorable conditions for development: the occupancy of no more than 10 people in the class, training in special programs, the availability of appropriate textbooks and educational materials, individual sessions with a psychologist, speech therapist and other specialists. It is desirable to isolate the class from external sound stimuli, it should contain a minimum number of distracting and stimulating objects (pictures, mirrors, etc.); students should sit separately from each other, students with more pronounced physical activity should be seated at the subject tables closer to the teacher in order to exclude their influence on other children. The duration of classes is reduced to 30-35 minutes. During the day, autogenic training classes are mandatory.

At the same time, as experience shows, it is not advisable to organize a class exclusively for children with ADHD, since in their development they must rely on successful students. This is especially true for first-graders, who develop mainly through imitation and following authorities.

IN Lately due to insufficient funding, the organization of correction classes is irrational. Schools are not able to provide these classes with everything necessary, as well as to allocate specialists to work with children. Therefore, there is a controversial point of view on the organization of specialized classes for hyperactive children who have a normal level of intelligence and are only slightly behind their peers in development.

At the same time, it must be remembered that the absence of any correction at all can lead to the development of a chronic form of the disease, which means problems in the lives of these children and those around them.

Children with the syndrome require constant medical and pedagogical assistance (“advisory support”). In some cases, for 1-2 quarters, they should be transferred to a sanatorium department, in which, along with training, therapeutic measures will also be carried out.

After treatment, the average duration of which, according to 3. Trzhesoglavy, is 17-20 months, children can return to regular classes.

Physical activity

Treatment of children with ADHD must necessarily include physical rehabilitation. These are special exercises aimed at restoring behavioral reactions, developing coordinated movements with voluntary relaxation of the skeletal and respiratory muscles.

The positive effect of exercise, especially on the cardiovascular and respiratory systems of the body, is well known to all physicians.

The muscular system responds with an increase in working capillaries, while the supply of oxygen to tissues increases, as a result of which the metabolism between muscle cells and capillaries improves. Lactic acid is easily removed, so muscle fatigue is prevented.

In the future, the training effect affects the increase in the number of basic enzymes that affect the kinetics of biochemical reactions. The content of myoglobin increases. It is not only responsible for storing oxygen, but also serves as a catalyst, increasing the rate of biochemical reactions in muscle cells.

Physical exercise can be divided into two types - aerobic and anaerobic. An example of the first is uniform running, and the second is barbell exercises. Anaerobic physical exercises increase strength and muscle mass, while aerobic exercises improve the cardiovascular and respiratory systems, increase endurance.

Most of the experiments performed have shown that the mechanism for improving well-being is associated with increased production during prolonged muscle activity of special substances - endorphins, which have a beneficial effect on the mental state of a person.

There is compelling evidence that exercise is beneficial for a range of health conditions. They can not only prevent the occurrence of acute attacks of the disease, but also facilitate the course of the disease, make the child "practically" healthy.

Countless articles and books have been written about the benefits of exercise. But there is not much evidence-based research on this topic.

Czech and Russian scientists conducted a series of studies on the state of the cardiovascular system in 30 sick and 17 healthy children.

An orthoclinostatic study revealed a higher lability of the autonomic nervous system in 65% of sick children compared to the control group, which suggests a decrease in orthostatic adaptation in children with the syndrome.

The “imbalance” of the innervation of the cardiovascular system was also revealed when determining physical performance using a bicycle ergometer. The child pedaled for 6 minutes at three types of submaximal load (1–1.5 watts/kg of body weight) with a minute break before the next load. It was shown that at physical activity submaximal intensity, the heart rate in children with the syndrome is more pronounced than in the control group. At maximum loads, the functionality of the circulatory system leveled out and the maximum oxygen transport corresponded to the level in the control group.

Since the physical performance of these children in the course of the studies practically did not differ from the level of the control group, they can be prescribed motor activity in the same amount as healthy children.

It must be borne in mind that not all types of physical activity may be beneficial for hyperactive children. For them, games where the emotional component is strongly expressed (competitions, demonstration performances) are not shown. Recommended physical exercises that are aerobic in nature, in the form of a long, uniform training of light and medium intensity: long walks, jogging, swimming, skiing, cycling and others.

Particular preference should be given to a long, even run, which has a beneficial effect on the mental state, relieves tension, and improves well-being.

Before a child begins to exercise, he must undergo a medical examination in order to exclude diseases, primarily of the cardiovascular system.

When giving recommendations on a rational motor regimen for children with attention deficit hyperactivity disorder, the doctor should take into account not only the characteristics of this disease, but also the height and weight data of the child's body, as well as the presence of physical inactivity. It is known that only muscle activity creates the prerequisites for the normal development of the body in childhood, and children with the syndrome, due to a general developmental delay, often lag behind their healthy peers in height and body weight.

Psychotherapy

Attention deficit hyperactivity disorder is a disease not only of a child, but also of adults, especially the mother, who is most often in contact with him.

Doctors have long noticed that the mother of such a child is overly irritable, impulsive, her mood is often lowered. To prove that this is not just a coincidence, but a pattern, special studies were conducted, the results of which were published in 1995 in the journal Family Medicine. It turned out that the frequency of the so-called major and minor depression occurs among ordinary mothers in 4–6% and 6–14% of cases, respectively, and among mothers who had hyperactive children, in 18 and 20% of cases, respectively. Based on these data, scientists concluded that mothers of hyperactive children must undergo a psychological examination.

Often, mothers with children with the syndrome have an asthenoneurotic condition that requires psychotherapeutic treatment.

There are many psychotherapeutic techniques that can benefit both the mother and the child. Let's dwell on some of them.

Visualization

Experts have proved that the reaction to the mental reproduction of an image is always stronger and more stable than to the verbal designation of this image. Consciously or not, we are constantly creating images in our imagination.

Visualization is understood as relaxation, mental fusion with an imaginary object, picture or process. It is shown that the visualization of a certain symbol, picture, process has a beneficial effect, creates conditions for restoring mental and physical balance.

Visualization is used to relax and enter a hypnotic state. It is also used to stimulate the body's defense system, increase blood circulation in a certain area of ​​the body, to slow down the pulse, etc. .

Meditation

Meditation is one of the three main elements of yoga. This is a conscious fixation of attention at a moment in time. During meditation, a state of passive concentration occurs, which is sometimes called the alpha state, since at this time the brain generates predominantly alpha waves, just like before falling asleep.

Meditation reduces the activity of the sympathetic nervous system, promotes anxiety reduction and relaxation. At the same time, the heart rate and breathing slow down, the need for oxygen decreases, the picture of brain tension changes, the reaction to a stressful situation is balanced.

There are many ways to meditate. You can read about them in books that have been published in large numbers in recent times. The meditation technique is taught under the guidance of an instructor, in special courses.

Autogenic training

Autogenic training (AT) as an independent method of psychotherapy was proposed by Schulze in 1932. AT combines several techniques, in particular, the visualization method.

AT includes a series of exercises with which a person consciously controls the functions of the body. You can master this technique under the guidance of a doctor.

Muscle relaxation achieved with AT affects the functions of the central and peripheral nervous systems, stimulates the reserve capabilities of the cerebral cortex, and increases the level of voluntary regulation of various body systems.

During relaxation, blood pressure slightly decreases, heart rate slows down, breathing becomes rare and shallow, peripheral vasodilation decreases - the so-called "relaxation response".

The self-regulation of emotional-vegetative functions achieved with the help of AT, optimization of the state of rest and activity, increasing the possibilities for the implementation of the psychophysiological reserves of the body make it possible to use this method in clinical practice to enhance behavioral therapy, in particular for children with ADHD.

Hyperactive children are often tense, internally closed, so relaxation exercises must be included in the correction program. This helps them to relax, reduces psychological discomfort in unfamiliar situations, and helps them to cope with various tasks more successfully.

Experience has shown that the use of autogenic training for ADHD helps to reduce motor disinhibition, emotional excitability, improves coordination in space, motor control, and enhances concentration.

Currently, there are a number of modifications of autogenic training according to Schulze. As an example, we will give two methods - a model of relaxation training for children aged 4–9 years and a psychomuscular training for children aged 8–12, proposed by a psychotherapist A.V. Alekseev.

The relaxation training model is an AT model redesigned specifically for children and used for adults. It can be used both in preschool and school educational institutions, and at home.

Teaching children to relax their muscles can help relieve general tension.

Relaxation training can be carried out during individual and group psychological work, in gyms or in the regular classroom. Once children learn to relax, they can do it on their own (without a teacher), which will increase their overall self-control. Successful mastery of relaxation techniques (like any success) can also increase their self-esteem.

Teaching children how to relax different muscle groups does not require them to know where and how these muscles are located. It is necessary to use children's imagination: to include certain images in the instructions so that, reproducing them, the children automatically include certain muscles in the work. The use of fantasy images also helps to attract and retain the interest of children.

It should be noted that although children are willing to learn to relax, they do not want to practice this under the supervision of teachers. Fortunately, some muscle groups can be trained quite discreetly. Children can do the exercises in the classroom and relax without attracting the attention of others.

Of all the psychotherapeutic techniques, autogenic training is the most accessible in mastering and can be used independently. It has no contraindications in children with Attention Deficit Hyperactivity Disorder.

Hypnosis and self-hypnosis

Hypnosis is indicated for a number of neuropsychiatric disorders, including attention deficit hyperactivity disorder.

There is a lot of data in the literature about complications during variety hypnosis sessions, in particular, in 1981, Kleinhaus and Beran described the case of a teenage girl who felt “not well” after a mass variety hypnosis session. At home, her tongue sunk into her throat, and she began to choke. In the hospital where she was hospitalized, she fell into a state of stupor, did not answer questions, did not distinguish objects, people. Urinary retention was observed. Clinical and laboratory examinations revealed no abnormalities. The called pop hypnotist could not provide effective assistance. She remained in this state for a week.

An attempt was made to put her into a hypnotic state by a psychiatrist well versed in hypnosis. Her condition improved after that and she returned to school. However, three months later she had a relapse of the disease. It took 6 months of weekly sessions to bring her back to normal. It should be said that earlier, before the pop hypnosis session, the girl had no violations.

When conducting hypnosis sessions in a clinic by professional hypnotherapists, such cases were not observed.

All risk factors for complications of hypnosis can be divided into three groups: risk factors on the part of the patient, on the part of the hypnotherapist, and on the part of the environment.

To avoid complications on the part of the patient, it is required before hypnotherapy to carefully select patients for treatment, to find out the anamnestic data, past illnesses, as well as the mental state of the patient at the time of treatment and obtain his consent to the hypnosis session. Risk factors on the part of a hypnotherapist include a lack of knowledge, training, abilities, experience, and personal characteristics (alcohol, drug addiction, various addictions) can also influence.

The environment where hypnosis is performed should provide physical comfort and emotional support for the patient.

Complications during the session can be avoided if the hypnotherapist avoids all of the above risk factors.

Most psychotherapists believe that all types of hypnosis are nothing but self-hypnosis. It has been proven that self-hypnosis has a beneficial effect on any person.

Using the method of controlled imagination to achieve a state of self-hypnosis can be used by the child's parents under the guidance of a hypnotherapist. An excellent guide to this technique is Self Hypnosis by Brian M. Alman and Peter T. Lambrou.

We have described many techniques that can be used in the treatment of attention deficit hyperactivity disorder. As a rule, these children have a variety of disorders, so in each case it is necessary to use a whole range of psychotherapeutic and pedagogical techniques, and in the case of a pronounced form of the disease, medications.

It must be emphasized that the improvement in the behavior of the child will not appear immediately, however, with constant training and following the recommendations, the efforts of parents and teachers will be rewarded.

3. E experimental study of the mental processes of children with ADHD and developmental norms

The experimental work was aimed at solving the following problems:

1. Pick up diagnostic tools.

2. To identify the level of formation of cognitive processes in children with ADHD in comparison with the developmental norm.

Stages of implementation of experimental research.

1. Examination of children with ADHD in order to identify the level of formation of cognitive processes.

2. Examination of children with a developmental norm, in order to identify the level of formation of cognitive processes.

3. Comparative analysis of the obtained data.

The study was conducted in MDOU No. 204 of the compensating type "Zvukovichok" and in MDOU No. 2 "Birch" of the Talmensky district of the Altai Territory from December 2007 to May 2008.

The experimental group consisted of pupils of MDOU No. 204 "Zvukovichok" of a compensating type, consisting of 10 people; children of MDOU No. 2 "Birch" r. n. Talmenka with a developmental norm of 10 people. For research on this topic, a group of children of senior preschool age (6–7 years) was selected. The direct examination included several stages:

1. Introduction of the child into the examination situation, establishing emotional contact with him.

2. Communication of the content of tasks, presentation of instructions.

3. Observation of the child in the course of his activities.

4. Registration of the survey protocol and evaluation of the results.

In the course of the study, we used such basic diagnostic methods as conversation, observation, experiment, as well as the method of quantitative and qualitative analysis of the data obtained.

The method of conversation was used by us in order to establish contact with children; determining how they understand the essence of tasks and questions, in which they experience difficulties; clarification of the content of completed tasks, as well as in the actual diagnostic aspect.

We used the method of observation in order to follow the behavior of children, their reactions to this or that influence; how they perform tasks, how they are treated.

Since children with ADHD have impaired attention, which in turn is combined with motor activity, when interpreting the results of the study, we used not only quantitative analysis, but also qualitative analysis, guided by the peculiarities of mental development and self-awareness, both in normal children and with ADHD.

Based on the characteristics of the object, subject and objectives of our study, we used the following diagnostic techniques.

3.1 Methods for diagnosing attention

The following set of techniques is intended to study the attention of children with an assessment of such qualities of attention as productivity, stability, switchability and volume. At the end of the examination of the child using all four methods of attention presented here, we deduced a general, integral assessment of the level of development of the attention of a preschooler.

Method "Find and cross out"

The choice of this technique is due to the fact that the task contained in this technique is intended to determine the productivity and stability of attention. We showed the child drawing 1.

Figure 1. Matrices with figures for the task "Find and cross out"

On it, images of simple figures are randomly given: a fungus, a house, a bucket, a ball, a flower, a flag. Before the start of the study, the child received the following instructions: “Now we will play the following game: I will show you a picture on which many different familiar objects are drawn. When I say the word “begin”, you will start looking for and crossing out those objects that I will name along the lines of this drawing. It is necessary to search and cross out the named objects until I say the word "stop". At this time, you must stop and show me the image of the object that you saw last. This completes the task." In this technique, the children worked for 2.5 minutes.

Method "Put down the badges"

The choice of this technique is due to the fact that the test task in this technique is intended to assess the switching and distribution of the child's attention. Before starting the task, we showed the child Figure 2 and explained how to work with it.

Figure 2. Matrix for the “Put down the badges” technique

Instruction: “This work consists in putting in each of the squares, triangles, circles and rhombuses the sign that is given at the top of the sample, i.e., respectively, a tick, a line, a plus or a dot.”

Children worked continuously, completing this task for two minutes, and the overall indicator of switching and distribution of attention of each child was determined by the formula:

where S is an indicator of switching and distribution of attention;

N - the number of geometric shapes viewed and marked with the appropriate signs within two minutes;

n is the number of errors made during the execution of the task. Mistakes were considered incorrectly affixed characters or missing, i.e. not marked with appropriate signs, geometric shapes. The results of the study are reflected in the diagram for diagnosing the attention of children with ADHD and with developmental norms (see Diagram 1).

Method "Remember and dot"

The choice of this technique is due to the fact that with the help of this technique the amount of attention of the child is estimated. For this, the stimulus material shown in Figure 3 was used.

Figure 3. Stimulus material for the task "Remember and dot"

The sheet with dots was preliminarily cut into 8 small squares, which were then stacked in such a way that at the top there was a square with two dots, and at the bottom - a square with nine dots (all the rest go from top to bottom in order with a successively increasing number of dots on them).

Before the start of the experiment, the child received the following instructions:

“Now we will play a game of attention with you. I will show you one by one the cards on which the dots are drawn, and then you yourself will draw these dots in empty cells in the places where you saw these dots on the cards.

Next, the child was sequentially shown, for 1–2 seconds, each of the eight cards with dots from top to bottom in the stack in turn, and after each next card, they were asked to reproduce the seen dots in an empty card in 15 seconds. This time was given to the child so that he could remember where the points he saw were and mark them on a blank card.

The results of the study are reflected in the diagram for diagnosing the attention of children with ADHD and with developmental norms (see Diagram 1).

Diagram 1. Diagnosis of the attention of children with ADHD and with the developmental norm

Thus, from the diagnosing the attention of children with ADHD and with a developmental norm, it can be seen that: two children with a developmental norm completed the task with a very high score; three children with normal development received a high score; four children with normal development and two children with ADHD showed average results; five children with ADHD and one child with developmental norms scored poorly, and three children with ADHD scored very poorly on tasks. Based on the conducted research, the following conclusions can be drawn:

1) the level of quantitative indicators of voluntary attention in children with ADHD is significantly lower than in children with developmental norms;

2) differences were found in the manifestation of voluntary attention in children with ADHD, depending on the modality of the stimulus (visual, auditory, motor): it is much more difficult for children with ADHD to focus on completing a task in verbal conditions than visual instructions, as a result of which in the first case there is a greater number of errors associated with a gross violation of differentiations;

3) the disorder of all the properties of attention in children with ADHD as the most important factor in the organization of activity leads to unformed or significant disruption of the structure of activity, while all the main links of activity suffer: a) the instruction was perceived by the children inaccurately, fragmentarily; it was extremely difficult for them to focus their attention on the analysis of the conditions of the assignment and the search for possible ways its implementation; b) the tasks were performed by children with ADHD with errors, the nature of the errors and their distribution in time qualitatively differs from the norm; c) all types of control over the activities of children with ADHD are unformed or significantly impaired;

4) a significant decrease in indicators in the main group is observed according to the "Remember and dot" test. The low result of the task indicates a decrease in the amount of short-term memory mediated by the concentration of attention. Findings are consistent with the “Put the Badges” results showing that attention spans are erratic in children with ADHD;

5) in the process of teaching children with ADHD an elementary method of mastering voluntary attention, much more help from a teacher, an adult, in comparison with the norm of development in quantitative and qualitative terms, is required.

3.2 Methods for diagnosing thinking

Methodology "What is superfluous here?"

Target: Evaluation of figurative-logical thinking, the level of formation of analysis and generalization in a child.

Examination progress: Each time, when trying to identify an extra object in a group, the child had to name aloud all the objects in the group under consideration in turn.

Working hours: the duration of the task is 3 minutes.

Instruction: “In each of these pictures, one of the 4 items depicted is superfluous, inappropriate. Determine what it is and why it is superfluous.

Method "Classification"

Target : identifying the ability to classify, the ability to find the signs by which the classification was made.

Task text : look at these two pictures (the pictures for the task are indicated (Figure 4)). On one of these drawings you need to draw a squirrel. Think about what picture you would draw it on. From the squirrel to this drawing, draw a line with a pencil.

Figure 4. Material for the method "Classification"

The results of the study are reflected in the diagram for diagnosing the thinking of children with ADHD and with developmental norms (see Diagram 2).

Diagram 2. Diagnostics of the thinking of children with ADHD and with the norm of development

Thus, from the diagram of diagnosing the thinking of children with ADHD and with a developmental norm, it can be seen that: eight children with a developmental norm and two children with ADHD completed the task with a very high score; two children with normal development and six children with ADHD scored high; one child with ADHD scored moderate and one child with ADHD scored very low on tasks. Based on the conducted research, the following conclusions can be drawn:

1) the level of quantitative indicators of the formation of thinking in children with ADHD is significantly lower than in children with a developmental norm;

2) tasks were performed by children with ADHD with errors, the nature of the errors and their distribution over time qualitatively differs from the norm;

3) all types of control over their activities of children with ADHD are unformed or significantly impaired;

4) data analysis shows that ADHD symptoms affect the decrease in test performance in all parameters, but proves that there is no organic impairment of intelligence, since the results vary within the average age indicators;

5) in the process of teaching children with ADHD an elementary method of mastering logical thinking, much more help from a teacher, an adult, in comparison with the norm of development in quantitative and qualitative terms, is required.

3.3 Methods for diagnosing memory

Method "Learn the words"

Target: determination of the dynamics of the learning process.

Stroke: the child received the task after several attempts to memorize and accurately reproduce a series of 12 words: tree, doll, fork, flower, telephone, glass, bird, light bulb, picture, man, book.

Each child tried to reproduce the series after each successive listening. Each time we noted the number of words that the child was able to name. And so they did 6 times. Thus, we got the results of six attempts.

Technique "Memorizing 10 pictures"

Target: The state of memory (mediated memorization), fatigue, active attention is analyzed.

Subject pictures of 10 x 15 cm in size were presented.

1 set: doll, chicken, scissors, book, butterfly, comb, drum, cow, bus, pear.

2 set: table, plane, shovel, cat, tram, sofa, key, goat, lamp, flower.

Instruction:

1. "I will show pictures, and you name what you see on them." After 30 seconds: "Remember what you saw?".

2. “Now I will show other pictures. Try to memorize them as much as possible, so that later I can repeat them.

The results of the study are reflected in the memory diagnostics diagram for children with ADHD and developmental norms (see Diagram 3).

Method "How to patch the rug?"

We used this technique in order to determine the extent to which the child is able, keeping the images of what he saw in short-term and operative memory, to practically use them, solving visual problems. In this technique, the pictures presented in Figure 5 were used.

Figure 5. Pictures for the technique “How to patch a rug?”

Before showing it to the child, we said that this picture shows two rugs, as well as pieces of matter that can be used to patch the holes on the rugs, so that the patterns of the rug and the patch do not differ. In order to solve the problem, from several pieces of matter presented in the lower part of the figure, it is necessary to choose one that is most suitable for the pattern of the rug.

The results of the study are reflected in the memory diagnostics diagram for children with ADHD and developmental norms (see Diagram 3).

Diagram 3. Diagnostics of the memory of children with ADHD and with the developmental norm

Thus, from the memory diagnostics diagram for children with ADHD and with developmental norms, it can be seen that: two children with developmental norms completed the task for a high score; seven children with normal development and two children with ADHD showed average results; six children with ADHD and one child with developmental norms scored poorly, and two children with ADHD scored very poorly on tasks. Based on the conducted research, the following conclusions can be drawn:

1) In the main group, the value of indicators is lower than the value of indicators in the control group;

2) memory disorders of varying severity are observed when learning words. More than half of children with ADHD violated the sequence of presentation of words, confused and rearranged words, replaced words with similar or even inappropriate words. After a certain period of time, about 75% of the children could not reproduce the memorized words;

3) this decrease makes it possible to judge the low volume of long-term memory, which is associated with a low level of the regulatory process, a narrowing of the amount of attention, involuntary switching due to impulsivity and hyperactivity, a lack of control over the quality of performance of activities and little interest in children with ADHD;

4) analysis of the data shown in Diagram 3 showed that the test results in the main group are significantly - 2 times - lower than in the control group. In the study of short-term memory, the functional state, attention activity, exhaustibility and dynamics of mnestic activity were assessed. The test results indicate that direct memorization is impaired, and short-term memory is reduced.

3.4 Methods for diagnosing perception

Technique "What is missing in these drawings?"

The essence of this technique is that the child was offered a series of drawings shown in Figure 5.

Figure 5. Material for the methodology “What is missing in these pictures?”

Each of the pictures in this series is missing some significant detail. The child received the task: Identify and name the missing part.

Using a stopwatch, we recorded the time spent by the child to complete the entire task. The time of work was evaluated in points, which then served as the basis for the conclusion about the level of development of perception of a child with ADHD and with the developmental norm.

Technique "Find out who it is"

Before applying this technique, we explained to the child that he would be shown parts, fragments of some drawing, according to which it would be necessary to determine the whole to which these parts belong, i.e. restore the whole drawing by part or fragment.

Psychodiagnostic examination using this technique was carried out as follows. The child was shown Figure 6, in which all fragments were covered with a piece of paper, with the exception of fragment “a”. Based on this fragment, the child was asked to say to which general drawing the depicted detail belongs. It took 10 seconds to solve this problem. If during this time the child was not able to correctly answer the question, then for the same time - 10 seconds. - he was shown the next, slightly more complete picture "b", and so on until the child finally guessed what was shown in this picture.

Figure 6. Pictures for the method "Find out who it is"

The total time spent by the child on solving the problem and the number of fragments of the drawing that he had to look through before making the final decision were taken into account.

The results of the study are reflected in the diagram for diagnosing the perception of children with ADHD and with developmental norms (see Diagram 4).

Method "What objects are hidden in the drawings?"

We explained to the child that he would be shown several contour drawings, in which, as it were, many objects known to him were “hidden”. Next, the child was presented with drawing 7 and asked to sequentially name the outlines of all the objects "hidden" in its three parts: 1, 2 and 3.

Figure 7. Pictures for the method "What objects are hidden in the pictures"

The time to complete the task was limited to one minute. If during this time the child was not able to complete the task, then he was interrupted. If the child completed the task in less than 1 minute, then the time spent on the task was recorded.

If we saw that the child began to rush and prematurely, not finding all the objects, moved from one drawing to another, then we stopped the child and asked him to look in the previous drawing. They were allowed to move on to the next drawing only when all the objects in the previous drawing were found. The total number of all items "hidden" in Figure 7 was 14 items.

The results of the study are reflected in the diagram for diagnosing the perception of children with ADHD and with developmental norms (see Diagram 4).

Diagram 4. Diagnosis of the perception of children with ADHD and with the norm of development

Thus, from the diagram of diagnosing the perception of children with ADHD and with a developmental norm, it can be seen that: six children with a developmental norm completed the task with a very high score; two children with normal development and one child with ADHD received a high score; two children with normal development and five children with ADHD showed average results; four children with ADHD scored poorly and two children with ADHD scored very poorly on tasks. Based on the conducted research, the following conclusions can be drawn:

1) test scores in the main group are significantly lower than in the control group;

2) a decrease in the value in this series indicates a narrowing of perception, holistic perceptual activity, insufficient accuracy in carrying out mental operations of comparing various images and differentiating details;

3) the results of the study of perception in children with ADHD are also lower than in the control group. A decrease in indicators indicates the child's lack of confidence in the ability to establish patterns depending on the organization of image elements.

General conclusions of the study of cognitive processes in children with ADHD in comparison with the developmental norm

In general, the analysis of the performance of tests by children with ADHD did not reveal gross disorders of higher mental functions. The most typical for the examined children were violations of such cognitive functions as attention and memory, as well as insufficient formation of the functions of organizing programming and control.

Compared to children with developmental norms, children with ADHD lagged behind in task completion time. This is due to impaired attention, increased distractibility, fatigue. Somatically, children are well, so this factor is not taken into account.

Compared to children with developmental norms, children with ADHD made many mistakes. The children were distracted by any noise, were in a hurry, tried to complete the task faster in order to return to the group and continue playing with other children. The number of mistakes made increases towards the middle and end of the task, which is due to the excessive fatigue of children, and sometimes unwillingness to complete the task.

Amount of assistance offered

Basically, a demonstration of the performance of tasks was required. Sometimes it was necessary to stimulate the actions of children. Two children had to demonstrate the final result in order to update the visual image. Children with ADHD responded well to help. Unlike children with ADHD, children with normal development did not require assistance with tasks. They understood the instructions without even listening to the end, and the demonstration was not required at all. It can be concluded that the gap between the help offered to children with ADHD is significant.

Thus, in order to advance a child with ADHD in general development, for the assimilation of knowledge, skills and abilities, for their systematization and practical application, it is important not ordinary, but specially organized training and education.

3.5 Evaluation scale of emotional manifestations of the child

To study the emotional manifestations of children with developmental norms and children with ADHD, we developed the "Scale of emotional manifestations of the child." The study was carried out according to the type of questioning of educators of MDOU, who had been in contact with the children of our experimental groups for a long time. The scale was based on the observation of the child's behavior in the kindergarten group. The results of the observations were presented by the educators in an evaluation scale, where the emotional manifestations of the child were listed vertically, and the degree of severity of each of them was noted horizontally.

Target: identifying signs of mental stress and neurotic tendencies in preschool children with developmental norms and children with ADHD.

We paid special attention to such emotional manifestations of children as hypersensitivity, excitability, capriciousness, timidity, tearfulness, stubbornness, spitefulness, cheerfulness, envy, jealousy, resentment, cruelty, affectionateness, sympathy, conceit, aggressiveness, impatience.

Analyzing the obtained results, we concluded that in children with ADHD, in comparison with normally developing peers, such emotional manifestations as excitability, stubbornness, cheerfulness, cruelty, impatience predominate. And such manifestations as hypersensitivity, timidity, jealousy, affection, sympathy for children with ADHD are less common. (Annex 4)

In the home correction program for children with attention deficit hyperactivity disorder, the behavioral aspect should prevail:

1. Changing the behavior of an adult and his attitude towards a child:

- show enough firmness and consistency in education;

- remember that excessive talkativeness, mobility and indiscipline are not intentional;

- control the child's behavior without imposing strict rules on him;

- do not give the child categorical instructions, avoid the words "no" and "no";

- build relationships with the child on mutual understanding and trust;

- avoid, on the one hand, excessive softness, and on the other, excessive demands on the child;

- react to the child's actions in an unexpected way (joke, repeat the child's actions, take a picture of him, leave him alone in the room, etc.);

- repeat your request with the same words many times;

- do not insist that the child must apologize for the misconduct;

- listen to what the child wants to say;

Use visual stimulation to reinforce verbal instructions.

2. Changing the psychological microclimate in the family:

- give the child enough attention;

- spend leisure time with the whole family;

- Do not quarrel in the presence of the child.

3. Organization of the daily routine and place for classes:

- establish a solid daily routine for the child and all family members;

Show your child more often how best to complete the task without being distracted;

- reduce the influence of distractions during the child's task;

- protect hyperactive children from prolonged computer use and television viewing;

- Avoid as much as possible large crowds of people;

- remember that overwork contributes to a decrease in self-control and an increase in hyperactivity;

– Organize support groups of parents who have children with similar problems.

4. Special behavioral program:

- Come up with a flexible system of rewards for a job well done and punishments for bad behavior. You can use a point or sign system, keep a diary of self-control;

- do not resort to physical punishment! If there is a need to resort to punishment, then it is advisable to use quiet sitting in a certain place after the act;

- Praise your child more often. The threshold of sensitivity to negative stimuli is very low, so hyperactive children do not perceive reprimands and punishments, but are sensitive to rewards;

- make a list of the child's duties and hang it on the wall, sign an agreement for certain types of work;

- educate children in the skills of managing anger and aggression;

- do not try to prevent the consequences of the child's forgetfulness;

- gradually expand the responsibilities, having previously discussed them with the child;

- do not allow to postpone the execution of the task for another time;

- do not give the child instructions that do not correspond to his level of development, age and abilities;

- help the child to start the task, as this is the most difficult stage;

Don't give multiple orders at the same time. The task that is given to a child with impaired attention should not have a complex structure and consist of several links;

- explain to a hyperactive child about his problems and teach how to cope with them.

Remember that verbal means of persuasion, appeals, conversations are rarely effective, since a hyperactive child is not yet ready for this form of work.

Remember that for a child with attention deficit hyperactivity disorder, the most effective means of persuasion "through the body" will be:

- deprivation of pleasure, treats, privileges;

- a ban on pleasant activities, telephone conversations;

- reception of "off time" (isolation, corner, penalty box, house arrest, early departure to bed);

– an ink dot on a child’s wrist (“black mark”), which can be exchanged for a 10-minute sitting on the “penalty box”;

- holding, or simply holding in an "iron embrace";

- extraordinary duty in the kitchen, etc.

Do not rush to interfere in the actions of a hyperactive child with directives, prohibitions and reprimands. Yu.S. Shevchenko gives the following examples: - if the parents of a primary school student are worried that every morning their child wakes up reluctantly, dresses slowly and is in no hurry to go to kindergarten, then you should not give him endless verbal instructions, rush and scold. You can give him the opportunity to receive a "lesson of life." Having been late for kindergarten for real, and having gained the experience of explaining with the teacher, the child will be more responsible for morning gatherings;

- if a child breaks the glass of a neighbor with a soccer ball, then you should not rush to take responsibility for solving the problem. Let the child explain himself to the neighbor and offer to atone for his guilt, for example by washing his car daily for a week. The next time, choosing a place to play football, the child will know that only he is responsible for his decision;

- if money has disappeared in the family, it is not useless to demand recognition of theft. Money should be removed and not left as a provocation. And the family will be forced to deprive itself of delicacies, entertainment and promised purchases, this will certainly have its educational effect;

- if a child has abandoned his thing and cannot find it, then you should not rush to help him. Let him search. Next time he will be more responsible with his things.

Remember that after the punishment incurred, positive emotional reinforcement, signs of "acceptance" are needed. In the correction of the child's behavior, the technique of the "positive model" plays an important role, which consists in the constant encouragement of the desired behavior of the child and ignoring the undesirable. A necessary condition for success is the understanding of the problems of their child by parents.

Remember that it is impossible to achieve the disappearance of hyperactivity, impulsivity and inattention in a few months and even in a few years. Signs of hyperactivity disappear as they grow older, and impulsivity and attention deficit may persist into adulthood.

Remember that attention deficit hyperactivity disorder is a pathology that requires timely diagnosis and complex correction: psychological, medical, pedagogical. Successful rehabilitation is possible provided that it is carried out at the age of 5-10 years.

The school program for the correction of hyperactive children should rely on cognitive correction to help children cope with learning difficulties:

1. Changing the environment:

– study the neuropsychological characteristics of children with attention deficit hyperactivity disorder;

– build work with a hyperactive child individually. hyperactive child should always be in front of the teacher's eyes, in the center of the class, right at the blackboard;

- the optimal place in the classroom for a hyperactive child is the first desk opposite the teacher's table or in the middle row;

- change the mode of the lesson with the inclusion of physical education minutes;

- allow a hyperactive child to get up and walk at the end of the class every 20 minutes;

- give the child the opportunity to quickly contact you for help in case of difficulty;

- direct the energy of hyperactive children in a useful direction: wash the board, distribute notebooks, etc.

2. Creating positive motivation for success:

– introduce a sign system of evaluation;

- Praise your child more often

– the schedule of lessons should be constant;

– avoid overestimating or underestimating the requirements for a student with ADHD;

– introduce problem-based learning;

- use elements of the game and competition in the lesson;

- give tasks in accordance with the abilities of the child;

- break large tasks into successive parts, controlling each of them;

– create situations in which a hyperactive child can show his strengths and become an expert in the class in some areas of knowledge;

- teach the child to compensate for impaired functions at the expense of intact ones;

- Ignore negative actions and encourage positive ones;

- build the learning process on positive emotions;

- remember that it is necessary to negotiate with the child, and not try to break him!

3. Correction of negative forms of behavior:

– contribute to the elimination of aggression;

– teach the necessary social norms and communication skills;

- Regulate his relationship with classmates.

4. Regulating expectations:

- explain to parents and others that positive changes will not come as quickly as we would like;

- explain to parents and others that the improvement of the child's condition depends not only on special treatment and correction, but also on a calm and consistent attitude.

Remember that touch is a powerful stimulant for shaping behavior and developing learning skills. Touch helps anchor positive experiences. An elementary school teacher in Canada conducted a touch experiment in his classroom in which the day the teacher would randomly meet these students and touch them on the shoulder encouragingly, saying in a friendly manner, "I approve of you." When they violated the rules of conduct, the teachers ignored it, as if not noticing. In all cases, during the first two weeks, all students began to behave well and turn in their homework notebooks.

Remember that hyperactivity is not a behavioral problem, not the result of bad parenting, but a medical and neuropsychological diagnosis that can only be made based on the results of special diagnostics. The problem of hyperactivity cannot be solved by strong-willed efforts, authoritarian instructions and beliefs. A hyperactive child has neurophysiological problems that he cannot cope with on his own. Disciplinary measures of influence in the form of constant punishments, remarks, shouts, lectures will not lead to an improvement in the child's behavior, but rather worsen it. Effective results in the correction of attention deficit hyperactivity disorder are achieved with the optimal combination of drug and non-drug methods, which include psychological and neuropsychological correction programs.

Conclusion

The problem of the prevalence of attention deficit hyperactivity disorder is relevant not only because it is one of the modern characteristics health status of the child. This is the most important psychological problem of the civilized world, as evidenced by the fact that:

– firstly, children with the syndrome do not learn well school curriculum;

- secondly, they do not obey the generally accepted rules of conduct and often take the path of crime. More than 80% of the criminal contingent are people with ADHD;

- thirdly, various accidents occur with them 3 times more often, in particular, they get into car accidents 7 times more often;

- fourthly, the probability of becoming a drug addict or an alcoholic in these children is 5-6 times higher than in children with normal ontogenesis;

- Fifthly, from 5% to 30% of all school-age children suffer from attention disorders, i.e. in each class of a regular school, 2-3 people are children with attention disorders and hyperactivity.

In the course of an experimental study, we confirmed the hypothesis and proved that the level of intelligence of children with ADHD does not correspond to the age norm. Psychological examination of children made it possible to determine the level of intellectual development of children with ADHD, and in addition, possible disturbances in perception, memory, attention, emotional-volitional sphere. Knowledge of the specific features of the mental development of children with ADHD makes it possible to develop a model of corrective care for such children, since preschool age is an important period in the development of a child's personality, when the compensatory capabilities of the brain are great, which helps prevent the formation of persistent pathological manifestations. This period is important in terms of preventing the development of behavioral disorders, as well as the maladjustment school syndrome. In this regard, the search for criteria for diagnosing and correcting ADHD in preschool age is extremely important for the timely detection and correction of deviations, and stimulation of the development of immature higher brain functions. At the same time, the bulk of the work deals with the study of school-age children, when learning and behavioral difficulties come to the fore. In view of this, the issues of organizing psychological and medical care for families of children with ADHD, focused on early and preschool age, are becoming of great practical importance today.

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Applications

Annex 1

List experimental group children of MDOU No. 204 "Zvukovichok" compensating type 2001-2002 birth

1. Roman Balakirov

2. Mikhail Bezuglov

3. Emelianenko Maxim

4. Zhivlyakova Maria

5. Zinchenko Daria

6. Otroshchenko Danil

7. Panova Angela

8. Foltz Jacob

9. Kharlamov Dmitry

10. Shlyapnikov Dmitry

List of the control group of children MDOU No. 2 "Birch" r. Talmenka village, Altai Territory 2001–2002 birth

1. Batsalova Anastasia

2. Glebova Alena

3. Julia Kuleva

4. Parshin Konstantin

5. Pushkarev Anton

6. Lisa Rassolova

7. Solovyova Alisa

8. Smirnova Anastasia

9. Trunova Marina

10. Shadrina Julia

Appendix 2

Point system for evaluating results

The quantitative evaluation of the results was carried out according to the point system, as a result of which we made conclusions about the cognitive development of children.

Conclusions about the level of development:

10 points - very high level

8-9 points - high level

6-7 points - average level

4-5 points - low level

0-3 points - very low level

Annex 3

Children's drawings

As an additional method for the comparative study of the mental processes of children with ADHD and children with developmental norms, we used the "Picture of a Person" test.

Based on the test, the following conclusions were drawn:

1. Drawings of children with ADHD have pronounced distinctive features.

2. The drawing of children is primitive, disproportionate.

3. The lines of the drawing are mutually uncoordinated and indistinctly connected to each other.

Pyloric stenosis is a problem of the stomach, unable to take a lot of food.

Reciprocal - cross, multidirectional.

Dyslexia is a partial disorder of the process of mastering reading, manifested in numerous repetitive errors of a persistent nature and due to the unformed mental functions involved in the process of mastering reading.

Dysgraphia is a partial impairment of writing skills due to focal lesions, underdevelopment or dysfunction of the cerebral cortex.

Dyscalculia is a violation of the formation of counting skills due to focal lesions, underdevelopment or dysfunction of the cerebral cortex.

Suggestive therapy - hypnosis.

Vasodilation - vasodilation

Relapse - return of the disease, exacerbation of the disease.