Psychological correction of ADHD. Neuropsychological correction of children with ADHD. The difference between hyperactivity and activity

The goal of therapy is to reduce behavioral problems and learning difficulties. To do this, first of all, it is necessary to change the child’s environment 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 set of techniques, 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 stages:

§ educational conversations with the child, parents, teachers;

§ training parents and teachers in behavioral programs;

§ expanding the child’s social circle through visiting various clubs and sections;

§ special training in case of learning difficulties;

§ drug therapy;

§ autogenic training and suggestive therapy Suggestive therapy - hypnosis. .

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

Adults often do not understand what is happening to the child, but his behavior irritates them. Not knowing about the hereditary nature of ADHD, they explain the behavior of their son (daughter) as “wrong” upbringing and blame each other. Specialists should help parents understand the child’s behavior, explain what they can realistically hope 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 disorders. The psychologist (doctor) must explain to parents that improvement in 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 referred for treatment only after a comprehensive examination.

Drug therapy

Abroad, drug therapy for ADHD is used more than widely; for example, in the USA, the use of drugs is a key aspect of treatment. But there is still no consensus on the effectiveness of treatment with drugs, and there is no single regimen for taking them. Some doctors believe that the prescribed drugs bring only a short-term effect, others deny this.

For 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) improvement is observed in 75%. cases. This group of drugs includes methylphenidate (commercial name Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cylert).

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

The high effectiveness of psychostimulants is explained by their wide range of neurochemical actions, which are aimed primarily at 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 terminals. It is assumed that they have a general “irritating” effect on these systems, which leads to the normalization of their functions. There has been a proven direct correlation between improved catecholamine metabolism and a reduction in ADHD symptoms.

In our country, these drugs have not yet been registered and are not used. No other highly effective medications have yet been created. Our psychoneurologists continue to prescribe aminalon, sidnocarb and other neuroleptics with a hyperinhibitory effect that does not improve the condition of these children. In addition, aminalone has adverse effects 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 of the drug. And they can be observed. These include loss of appetite, insomnia, increased heart rate and blood pressure, and drug addiction. Less common are abdominal pain, dizziness, headaches, drowsiness, dry mouth, constipation, irritability, euphoria, bad mood, anxiety, nightmares. There are hypersensitive reactions in the form of skin rashes and swelling. Parents should immediately pay attention to these signs and notify their doctor as soon as possible.

In the early 70s. There have been reports in medical periodicals that long-term use of methylphenidate or dextroamphetamine leads to child growth retardation. However, further repeated studies have not confirmed the connection between growth retardation and the effect of these drugs. 3. Trzhesoglava sees the reason for growth retardation not in the action of stimulants, but in the general developmental lag 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.

There are several treatment strategies for the disease. Drug therapy can be carried out continuously, or the “drug holiday” method is used, i.e. The medicine is not taken on weekends and during holidays.

However, you cannot rely only on medications, because:

* not all patients experience the expected effect;

* psychostimulants, like any medications, have a number of side effects;

* the use of medications alone does not always improve a child’s behavior.

Numerous studies have shown that psychological and pedagogical methods can successfully and longer-term correct behavior disorders and learning difficulties than the use of medications. Medicines are prescribed no earlier than 6 years of age and only for individual indications: in cases where impaired cognitive functions and deviations in the child’s behavior cannot be overcome with the help of psychological, pedagogical and psychotherapeutic correction methods.

Effective use CNS stimulants abroad for decades have made them “magic pills”, but a serious drawback remains the short duration of their action. Long-term studies have shown that children with the syndrome who underwent courses of psychostimulants for several years did not differ in academic performance from sick children who did not receive any therapy. And this despite the fact that clear positive dynamics were observed directly during treatment.

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

In 1990, the American Academy of Pediatrics opposed the unilateral use of medications 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 for correcting attention deficit disorder, the main role is given to behavioral psychotherapy. There are psychological assistance centers abroad that provide special training for parents, teachers and children's doctors in these techniques.

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

The home correction program includes:

* changes in the behavior of an adult and his attitude towards the child(demonstrate calm behavior, avoid words “no” and “no”, 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, and spend leisure time with the whole family);

* organization of the daily routine and place for classes;

*special behavioral program, providing for the predominance of methods of support and reward.

While the home program is behaviorally focused, the school program focuses on cognitive therapy to help children cope with learning difficulties.

The school correction program includes:

* change of environment(the child’s place in the classroom is next to the teacher, changing the lesson mode to include minutes of active recreation, regulating relationships with classmates);

* creating positive motivation and situations of success;

* correction of negative behaviors, in particular unmotivated aggression;

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

Behavioral programs require significant skill; adults have to use all their imagination and experience in communicating with children in order to maintain the motivation of a constantly distracted child during classes.

Corrective methods will be effective only if there is close cooperation between family and 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 provided that common principles are maintained in relation to the child at home and at school: a “reward” system, help and support from adults, participation in joint activities. Continuity of therapeutic therapy at school and at home is the main key to success.

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

Correctional programs should be aimed at the age of 5-8 years, when the compensatory capabilities of the brain are great and a 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 parenting methods are ineffective for these children. Features of them 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.

A home rewards and rewards program includes the following:

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

2. The child’s efforts in achieving this goal are encouraged in every possible way.

3. At the end of the day, the child’s behavior is assessed in accordance with 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: doing homework well, helping a weaker classmate with homework, exemplary behavior, cleaning his room, preparing lunch, shopping, and others.

In a conversation with a child, and especially when you give him tasks, avoid directive instructions, turn the situation in such a way that the child feels: he will do something useful for the whole family, they completely trust him, they rely on him. When communicating with your son or daughter, avoid constant taunts such as “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: allow your child to watch TV in the evening for half an hour longer than the allotted time, treat him to a special dessert, give him the opportunity to participate in games with adults (lotto, chess), allow him to go to a disco one more time, buy that thing he has been wanting for a long time dreams.

If a child behaves exemplary during the week, he should receive an additional reward at the end of the week. This could be some kind of trip with parents out of town, an excursion to the zoo, to the theater and others.

The above version of behavioral training is ideal and its use is not always possible in our country at present. But parents and teachers can use individual elements of this program, taking its basic idea: rewarding the child for achieving set goals. Moreover, it does not matter in what form it will be presented: material reward or simply an encouraging smile, a kind 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 this, everything written is strictly observed, and the child is rewarded for success in completing it. Physical punishment must be avoided.

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

Special training

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 may benefit from learning in special settings that suit his or her abilities. The main reasons for poor performance in this pathology are inattention and lack of proper motivation and determination, 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 out with intensive training. If there are partial delays, a correction class is recommended, and if intelligence is normal, a catch-up class is recommended.

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

At the same time, as experience shows, organizing a class exclusively for children with ADHD is inappropriate, 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.

Recently, due to insufficient funding, the organization of correction classes has been irrational. Schools are not able to provide these classes with everything necessary, and also 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, and therefore to 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, where, along with training, therapeutic measures will also be carried out.

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

Physical activity

Treatment of children with ADHD must 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 physical exercise, especially on the cardiovascular and respiratory systems of the body, is well known to all doctors.

The muscular system responds by increasing working capillaries, while the supply of oxygen to tissues increases, resulting in improved metabolism between muscle cells and capillaries. Lactic acid is easily removed, so muscle fatigue is prevented.

Subsequently, the training effect affects the increase in the number of main enzymes that affect the kinetics of biochemical reactions. Myoglobin content 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 former is steady running, and the latter is barbell training. Anaerobic physical exercise increases muscle strength and mass, while aerobic exercise improves the cardiovascular and respiratory systems and increases endurance.

Most of the experiments conducted 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 a person’s mental state.

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 alleviate the course of the disease and make the child “virtually” 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 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.

An “imbalance” in the innervation of the cardiovascular system was also identified 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 body weight) with a minute break before the next load. It has been shown that during physical activity of submaximal intensity, the heart rate in children with the syndrome is more pronounced compared to the control group. At maximum loads, the functionality of the circulatory system was leveled and the maximum oxygen transport corresponded to the level in the control group.

* Since the physical performance of these children during the research practically did not differ from the level of the control group, physical activity can be prescribed to them in the same volume as healthy children.

* It is important to keep in mind that not all types of physical activity may be beneficial for hyperactive children. Games where the emotional component is strongly expressed (competitions, demonstration performances) are not shown for them. Physical exercises that are aerobic in nature are recommended in the form of long, uniform training of light and medium intensity: long walks, jogging, swimming, skiing, cycling and others.

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

Before a child begins to engage in physical 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 must 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 normal development of the body in childhood, and children with the syndrome, due to general developmental delay, often lag behind healthy peers in height and body weight.

Psychotherapy

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

Doctors have long noticed that the mother of such a child is overly irritable, impulsive, and often has a low mood. 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 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 experience an asthenoneurotic condition that requires psychotherapeutic treatment.

There are many psychotherapeutic techniques that can benefit both mother and child. Let's look at some of them.

Visualization

Experts have proven 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 constantly create images in our imagination.

Visualization refers to relaxation, mental merging with an imaginary object, picture or process. It has been shown that visualization of a certain symbol, picture, or process has a beneficial effect and 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, slow down the pulse, etc. .

Meditation

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

Meditation reduces the activity of the sympathetic nervous system, helps reduce anxiety and relaxation. At the same time, the heart rate and breathing slow down, the need for oxygen decreases, the pattern of brain tension changes, and 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 lately. Meditation techniques are 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 through 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 decreases slightly, the heart rate slows down, breathing becomes rare and shallow, and peripheral vasodilation decreases. Vasodilation is the dilation of blood vessels - the so-called “relaxation response.”

Self-regulation of emotional and vegetative functions achieved with the help of AT, optimization of the state of rest and activity, increasing the ability to realize the psychophysiological reserves of the body allow this method to be used in clinical practice to enhance behavioral therapy, in particular for children with ADHD.

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

Experience has shown that the use of autogenic training for ADHD helps reduce motor disinhibition, emotional excitability, improves spatial coordination, 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 4-9 years old and psychomuscular training for children 8-12 years old, proposed by psychotherapist A.V. Alekseev.

The relaxation training model is an AT model revised 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 will help them relieve general tension.

Relaxation training can be carried out during individual and group psychological work, in gyms or in a regular classroom. Once children learn to relax, they will be able to 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.

To teach children to relax different muscle groups, it is not necessary that they know where and how these muscles are located. It is necessary to use children's imagination: include certain images in the instructions so that, when reproducing them, children automatically activate certain muscles. The use of fantasy images also helps to attract and maintain children's interest.

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

Of all the psychotherapeutic techniques, autogenic training is the most accessible to master and can be used independently. It has no contraindications for children with attention deficit hyperactivity disorder.

Hypnosis and self-hypnosis

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

The literature provides a lot of data on complications during pop hypnosis sessions, in particular in 1981, Kleinhouse and Beran described the case of a teenage girl who felt “unwell” after a session of mass pop hypnosis. 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 between objects and people. There was urinary retention. Clinical and laboratory examinations revealed no abnormalities. The variety hypnotist who was called was unable to provide effective assistance. She was 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. Relapse is a return of the disease, an exacerbation of the disease. diseases. It took 6 months of weekly sessions to get her back to normal. It should be said that earlier, before the variety hypnosis session, the girl had not observed any disturbances.

No such cases were observed during hypnosis sessions in a clinical setting by professional hypnotherapists.

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, before hypnotherapy, it is necessary to carefully select patients for treatment, find out the anamnestic data, previous diseases, as well as the mental state of the patient at the time of treatment and obtain his consent to conduct a hypnosis session. Risk factors on the part of the hypnotherapist include 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 to the patient.

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

Most psychotherapists believe that all types of hypnosis are nothing more than self-hypnosis. Self-hypnosis has been proven to have a beneficial effect on any person.

The use of the guided imagination method 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 the book Self-Hypnosis by Brian M. Alman and Peter T. Lambrou.

We have described many techniques that can be used to correct 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 severe form of the disease, medications.

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

Children with attention deficit hyperactivity disorder (ADHD) have certain neuropsychological developmental characteristics. Children with this syndrome experience disturbances in the formation of higher mental functions, difficulties in developing school skills and social adaptation.

There are several theories about the occurrence of ADHD in children. The most common include:

• genetic;
• socio-psychological (improper upbringing, living conditions in the family, alcoholism of relatives);
• biological (trauma during childbirth, organic brain damage during pregnancy).

Children with ADHD are hyperactive, inattentive, restless, and impulsive. To solve these problems, it is effective to use neuropsychological correction.

Neuropsychological correction technique

The methodology of neuropsychological correction is based on the teachings of the Soviet psychologist Alexander Romanovich Luria about the patterns of development and the hierarchical structure of the brain organization of higher mental functions. During mental activity, three main blocks of the human brain interact. Underdevelopment or damage to zones or areas of any of the listed blocks leads to various violations.

First block is energetic. It is responsible for maintaining tone, which is necessary for the normal functioning of the subcortical hemispheres of the brain.

To harmonize the neurodynamic support of activity, they use a series of exercises, aimed at activating the subcortical formations of the brain. These include:

• breathing exercises and stretches;
• various types of massage and self-massage (fingers and ears are very effective);
• bodily exercises and relaxation techniques;
• oculomotor exercises.

Second block carries out reception, processing and storage of sensory information. The brain structures responsible for the activity of this block are located in the posterior parts of the brain hemispheres. Each area is responsible for a certain type of information (temporal - auditory, occipital - visual, parietal - general sensitive).

The second block includes three cortical zones built on top of each other. Initially, the primary zones receive nerve impulses. Secondary zones then process the received information. Tertiary zones carry out logical and grammatical operations that require the participation of abstract thinking and are responsible for human memory.

To optimize this block, exercises are used aimed at:

• improvement of memory properties, attention;
• formation of spatial ideas and relationships;
• development of dexterity and smoothness of voluntary movements.

Third block is responsible for programming, regulation and control of activities. It is located in the anterior parts of the cerebral hemispheres. These departments organize conscious and active activities. In children with ADHD, the processes are not balanced, so the following is recommended:

• role-playing games;
• communication exercises with verbal and non-verbal emphasis;
• exercises aimed at increasing self-regulation, variability and rationality of behavior.

Classes for children with ADHD are held once or twice a week for seven to nine months. In the future, the acquired skills are consolidated at home. The need for cycle duration is due to the fact that the work of cerebral blocks is carried out anew and the formed abnormal interactions of brain systems are corrected.

Our clinic has many years of experience in treating hyperactivity syndrome in children. We, like no one else, make sure that the treatment process is safe and as effective as possible. In addition to neuropsychological correction, we also use other non-drug methods, including cognitive behavioral therapy and biofeedback sessions. It should not be forgotten that timely consultation with a competent specialist will help prevent serious complications in the future.

CORRECTIONAL WORK WITH CHILDREN WITH ATTENTION DEFICIT SYNDROME AND HYPERACTIVITY

Introduction

The need to study children with attention deficit hyperactivity disorder (ADHD) before school 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 G.N. Monina. in his book on working with children suffering from attention deficit: “A complex of deviations in child development: inattention, distractibility, impulsiveness 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 disturbances in the regulation of active attention and inhibitory control.”
According to various authors, hyperactive behavior is quite common: from 2 to 20% of children are characterized by excessive mobility and disinhibition. Among children with conduct disorder, doctors identify 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 their increased activity. However, gradually deviations of individual mental functions increase, which leads to pathology, which is most often called “mild brain dysfunction.” There are other designations: “hyperkinetic syndrome”, “motor disinhibition” and so on. A 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 surrounding children and adults, but the possible consequences of this disease for the child himself. Two features of ADHD should be emphasized. Firstly, it manifests itself most clearly 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) also name the causes of hyperactive behavior as characteristics of temperament, 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 a class, now there are up to five or more.
Long-term manifestations of inattention, impulsiveness 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; Grigorenko E.L., 1996; Zakharov A.I., 1986, 1998;) . Cognitive and behavioral impairment continues to persist in nearly 70% of adolescents and more than 50% of adults diagnosed with ADHD in childhood). In adolescence, hyperactive children early develop a craving for alcohol and drugs, which contributes to the development of delinquent behavior (Bryazgunov I.P., Kasatikova E.V., 2001). They, to a greater extent than their peers, are characterized by a tendency to commit crimes (Mendelevich V.D., 1998).
Attention is also drawn to the fact that attention deficit hyperactivity disorder is given the main attention only when a child enters school, when school maladaptation and academic failure are evident (Zavadenko N.N., Uspenskaya T.Yu., 1994; Kasatikova E.B. , Bryazgunov I.P., 2001).
The study of children with this syndrome and the development of deficit functions has great importance for psychological and pedagogical practice specifically in 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.,).
Modern directions of developmental and correctional work (Semenovich A.V., 2002; 1998; Semago N.Ya., 2000; Sirotyuk A.L., 2002) are based on the principle of replacement development. There are no programs that consider the multimorbidity of developmental problems of a child with ADHD in combination with problems in the family, peer group and adults accompanying the child’s development, based on a multimodal approach.
An analysis of the literature on this issue showed that in most studies, observations were carried out on school-age children, i.e. during the period when the signs appear most clearly, and the conditions of development in early and preschool age remain, basically, 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 multimorbidity of problems in children, is becoming increasingly important, which makes it possible to make a favorable prognosis for treatment and organize corrective action.

1. Hyperactivity and attention deficit disorder in childhood

Attention-deficit/hyperactivity disorder is a dysfunction of the central nervous system (mainly the reticular formation of the brain), manifested by difficulties concentrating and maintaining attention, learning and memory disorders, as well as difficulties 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 damaged and is naturally caused by the removal of one or another component from 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 natural, typical combination of symptoms, the occurrence of which is based on a disturbance of a factor caused by a deficiency in the functioning of certain brain areas in the case of local brain lesions or brain dysfunction caused by other causes that do not have a local focal nature.
Hyperactivity - “Hyper...” (from the Greek Hyper - above, from above) is an integral part of complex words, indicating excess of the norm. The word “active” came into Russian from the Latin “activus” and means “effective, active.” External manifestations of hyperactivity include inattention, distractibility, impulsiveness, and increased motor activity. Hyperactivity is often accompanied by problems in relationships with others, learning difficulties, and low self-esteem. At the same time, the level of intellectual development in children does not depend on the degree of hyperactivity and can 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, which occurs 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., a set of symptoms), but it is usually diagnosed in children who are characterized by increased impulsiveness and inattention; Such children are quickly distracted, they are equally easy to please and upset. They are often characterized by aggressive behavior and negativism. Due to such personality characteristics, hyperactive children find it difficult to concentrate on completing 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 simply active temperament is that this is not a character trait of the child, but a consequence of mental development disorders in children. The risk group includes children born as a result of cesarean section, severe pathological births, artificial babies born with low birth weight, and premature babies.
Attention deficit hyperactivity disorder, also called hyperkinetic disorder, is observed in children aged 3 to 15 years, 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, and weakness of thought processes in general with a normal level of intelligence. Voluntary regulation is poorly developed, performance in classes is low, and fatigue is increased. Deviations in behavior are also noted: motor disinhibition, increased impulsivity and excitability, anxiety, negativism reactions, and aggressiveness. When starting systematic learning, 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 arise.

2. Psychological characteristics of children with attention deficit/hyperactivity disorder (ADHD)

The lag in the biological maturation of the central nervous system in children with ADHD and, as a consequence, in higher brain functions (mainly the regulatory component), does not allow the child to adapt to new living conditions and tolerate intellectual stress normally.
O.V. Khaletskaya (1999) analyzed the state of higher brain functions in healthy and sick children with ADHD aged 5-7 years and came to the conclusion that there were no pronounced differences in them. At 6-7 years of age, differences are especially pronounced in such functions as auditory-motor coordination and speech, so it is advisable from the age of 5 to conduct dynamic neuropsychological monitoring of children with ADHD, using individual rehabilitation techniques. This will overcome the delay in maturation of higher brain functions in this group of children and prevent the formation and development of maladaptive school syndrome.
There is a discrepancy between the actual level of development and the performance that can be expected based on IQ. Quite often, hyperactive children are smart and quickly “grab” information and have extraordinary abilities. Among children with ADHD there are truly talented children, but cases of mental development delays in this category of children are not uncommon. The most significant thing is that children’s intelligence is preserved, but the features that characterize ADHD - restlessness, restlessness, many unnecessary movements, lack of focus, impulsiveness of actions and increased excitability - are often combined with difficulties in acquiring educational skills (reading, counting, writing). This leads to pronounced school maladjustment.
Severe impairments in cognitive processes are associated with disorders of auditory gnosis. Changes in auditory gnosis are manifested in the inability to correctly evaluate sound complexes consisting of a series of sequential sounds, the inability to reproduce them and deficiencies in visual perception, difficulties in the formation of concepts, infantility 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.
L.A. Research Yasyukova (2000) show the specifics of the intellectual activity of a child with ADHD, consisting of cyclicality: voluntary productive work does not exceed 5-15 minutes, after which children lose control over mental activity; then within 3-7 minutes the brain accumulates energy and strength for the next duty cycle.
It should be noted that fatigue has a double 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 and pushes the boundaries of functional capabilities. The longer the child works, the shorter
Productive periods and longer rest periods become possible 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, so the child does not remember what he was doing at that time, does not notice that there were any breaks in his work.
Mental fatigue is more common in girls, and in boys it manifests itself by the age of 7. Girls also have a reduced level of verbal and logical thinking.
Memory in children with ADHD may be normal, but due to exceptional instability of attention, “gaps in well-learned” material are observed.
Disorders of short-term memory can be detected in a decrease in the volume of memorization, increased inhibition by extraneous stimuli, and delayed memorization. At the same time, increased motivation or organization of material gives a compensatory effect, which indicates the preservation of 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 critical periods of psychospeech 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 consistently performing certain intellectual operations. The child does not notice his mistakes, forgets the final task, easily switches to side or non-existent stimuli, and cannot stop side associations.
Particularly common in children with ADHD are speech disorders such as delayed speech development, insufficient motor function of the articulatory apparatus, excessively slow speech, or, conversely, explosiveness, voice and speech breathing disorders. All these violations cause defects in the sound-pronunciation side of speech, its phonation, limited vocabulary and syntax, and insufficient semantics.
A tendency towards a pronounced decrease in attention is observed in unusual situations, especially when it is necessary to act independently. Children do not show persistence either during classes or in games, and cannot watch their favorite TV show to the end. In this case, there is no switching of attention, so activities that quickly replace each other are carried out in a reduced, poor quality and fragmentary manner, however, when errors are pointed out, children try to correct them.
Attention disturbance 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, unmotivated, 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 child developmental disorders. Purposeful motor behavior is less active than in healthy children of the same age.
Coordinating disorders are found in the area of ​​motor abilities. In addition, general difficulties in perception are noted, which affects the mental abilities of children, and, consequently, the quality of learning. Fine motor skills, sensorimotor coordination, and manual dexterity are most commonly affected. Difficulties associated with maintaining balance (while standing, skating, roller skating, biking), impaired visual-spatial coordination (inability to play sports, especially with a ball) are the causes of motor clumsiness and an increased risk of injury.
Impulsivity is manifested in sloppy performance of a task (despite effort, doing everything correctly), incontinence in words, deeds and actions (for example, shouting from the seat during class, inability to wait for one’s turn in games or other activities), inability to lose, excessive persistence in defending one’s interests (despite the demands of an adult). With age, the manifestations of impulsivity change: the older the child, the more pronounced the impulsiveness is and the more noticeable to others.
One of the characteristic features of children with ADHD is impairment of social adaptation. These children typically have a lower level of social maturity than is typical for their age. Affective tension, a significant amplitude of emotional experience, difficulties arising in communication with peers and adults lead to the fact that the child easily forms and fixes negative self-esteem, hostility towards others, and neurosis-like and psychopathological disorders arise. 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 strive to lead, behave aggressively and demandingly. Impulsive hyperactive children quickly react to a prohibition or harsh remark, responding with harshness and disobedience. Attempts to restrain them lead to actions based on the “released spring” principle. Not only those around him suffer from this, but also the child himself, who wants to fulfill his promise, but does not keep it. Such children's interest in playing quickly disappears. Children with ADHD love to play destructive games, cannot concentrate during play, and conflict with their friends, despite the fact that they love the team. Ambivalent forms of behavior most often manifest themselves in aggressiveness, cruelty, tearfulness, hysteria and even sensory dullness. Because 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 a preference for building play relationships with younger children. Relationships with adults are difficult. It is difficult for children to listen to an explanation to the end; they are constantly distracted, especially if they are not interested. These children ignore both encouragement from adults and punishment. Praise does not stimulate good behavior; therefore, rewards must be very justified, otherwise the child will behave worse. However, it must be remembered that a hyperactive child needs praise and approval from an adult to strengthen his self-confidence.
Harmonization of the personality development of children with ADHD depends on the micro and macro environment. If mutual understanding, patience and a warm attitude towards the child are maintained in the family, then after ADHD is cured, all negative aspects of behavior disappear. Otherwise, even after treatment, the character pathology 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 this way”) turns out to be a stronger motive than any rules. Knowledge of the rules does not act as a significant motive for one’s own actions. The rule remains known, but subjectively meaningless.
It is important to emphasize that society’s rejection of hyperactive children leads to the development of a sense of rejection in them, alienates them from the team, and increases instability, temper and intolerance to failure. A psychological examination of children with the syndrome reveals increased anxiety, restlessness, internal tension, and a sense of fear in most of them. Children with ADHD are more prone to depression than others and are easily upset by failures.
The emotional development of the child lags behind the normal indicators for this age group. The mood quickly changes from elated to depressed. Sometimes there are causeless attacks of anger, rage, anger, not only in relation to others, but also towards oneself. Ignorance that a child has functional abnormalities in the functioning of brain structures and the inability to create an appropriate mode of education and life in general in preschool age give rise to many problems in elementary school.

3. Correction of ADHD

The goal of therapy is to reduce behavioral problems and learning difficulties. To do this, first of all, it is necessary to change the child’s environment 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 set of techniques, or, as experts say, be “multimodal.” This means that a pediatrician, psychologist, 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 stages:
educational conversations with the child, parents, teachers;
training parents and teachers in behavioral programs;
expanding the child’s social circle through visiting various clubs and sections;
special training in case of learning difficulties;
drug therapy;
At the beginning of treatment, the doctor and psychologist must carry out educational work. The meaning of the upcoming treatment must be explained to parents and the child.
Adults often do not understand what is happening to the child, but his behavior irritates them. Not knowing about the hereditary nature of ADHD, they explain the behavior of their son (daughter) as “wrong” upbringing and blame each other. Specialists should help parents understand the child’s behavior, explain what they can realistically hope for and how to behave with the child.
Behavioral psychotherapy
Among the psychological and pedagogical methods for correcting attention deficit disorder, the main role is given to behavioral psychotherapy. The key point of the behavioral correction program is changing the child’s environment at home in order to create favorable conditions for overcoming the lag in the development of mental functions.
The home correction program includes:
* changing the behavior of an adult and his attitude towards the child (demonstrate calm behavior, avoid the words “no” and “no”, build relationships with the child on trust and mutual understanding);
* changing the psychological microclimate in the family (adults should quarrel less, spend more time with the child, and spend leisure time with the whole family);
* organization of the daily routine and place for classes;
*special behavioral program that provides for the predominance of support and reward methods.
The environmental (kindergarten) correction program includes:
* changing the environment (the child’s place in the group is next to the teacher, changing the lesson mode with the inclusion of minutes of active rest);
* creating positive motivation, situations of success;
* correction of negative forms of behavior, in particular unmotivated aggression;
* regulation of expectations (this also applies to parents), since positive changes in the child’s behavior do not appear as quickly as others would like.
Behavioral programs require significant skill; adults have to use all their imagination and experience in communicating with children in order to maintain the motivation of a constantly distracted child during classes.
Success in treatment will be guaranteed provided that common principles are maintained in relation to the child at home and in the garden: a “reward” system, help and support from adults, participation in joint activities. Continuity of treatment therapy is the main key to success.
Correctional programs should be aimed at the age of 5-7 years, when the compensatory capabilities of the brain are great and a pathological stereotype has not yet formed.
Based on literature data, we have developed specific recommendations for parents and teachers on working with hyperactive children.
It must be remembered that negative parenting methods are ineffective for 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.
A home rewards and rewards program includes the following:
1. Every day the child is given a specific goal that he must achieve.
2. The child’s efforts in achieving this goal are encouraged in every possible way.
3. At the end of the day, the child’s behavior is assessed in accordance with the results achieved.
4. When a significant improvement in behavior is achieved, the child receives a long-promised reward.
Examples of goals set for a child could be: doing homework well, being exemplary, cleaning your room, preparing lunch, shopping, and others.
In a conversation with a child, and especially when you give him tasks, avoid directive instructions, turn the situation in such a way that the child feels: he will do something useful for the whole family, they completely trust him, they rely on him. When communicating with your son or daughter, avoid constant taunts such as “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: allow your child to watch TV in the evening for half an hour longer than expected, treat him to a special dessert, give him the opportunity to participate in games with adults (lotto, chess).
If a child behaves exemplary during the week, he should receive an additional reward at the end of the week. This could be some kind of trip with parents out of town, an excursion to the zoo, to the theater and others.
For unsatisfactory behavior, a light punishment is recommended, which should be immediate and inevitable. This could be simply verbal disapproval, temporary isolation from other children, or deprivation of “privileges.”
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 this, everything written is strictly observed, and the child is rewarded for success in completing it. Physical punishment must be avoided.
Physical activity
Treatment of children with ADHD must include physical rehabilitation. These are special exercises aimed at restoring behavioral reactions, developing coordinated movements with voluntary relaxation of the skeletal and respiratory muscles.
Most of the experiments conducted 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 a person’s mental state.
These data make it possible to develop recommendations for physical education for children with attention deficit hyperactivity disorder.
* Physical activity can be prescribed in the same volume as for healthy children.
* It is important to keep in mind that not all types of physical activity may be beneficial for hyperactive children. Games where the emotional component is strongly expressed (competitions, demonstration performances) are not shown for them. Physical exercises that are aerobic in nature are recommended in the form of long, uniform training of light and medium intensity: long walks, jogging, swimming, skiing, cycling and others.
Particular preference should be given to long, steady running, which has a beneficial effect on the mental state, relieves tension, and improves well-being.
Before a child begins to engage in physical exercise, he must undergo a medical examination in order to exclude diseases, primarily of the cardiovascular system.
Psychotherapy
Attention deficit hyperactivity disorder is a disease not only of the child, but also of adults, especially the mother, who most often comes into contact with it.
Doctors have long noticed that the mother of such a child is overly irritable, impulsive, and often has a low mood. 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 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 experience an asthenoneurotic condition that requires psychotherapeutic treatment.
There are many psychotherapeutic techniques that can benefit both mother and child. Let's look at some of them.

Visualization

Experts have proven 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 constantly create images in our imagination.
Visualization refers to relaxation, mental merging with an imaginary object, picture or process. It has been shown that visualization of a certain symbol, picture, or process has a beneficial effect and 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, slow down the pulse, etc. .

Meditation

Meditation is one of the three main elements of yoga. This is a conscious fixation of attention on a moment in time. During meditation, a state of passive concentration occurs, which is sometimes called the alpha state, because at this time the brain generates predominantly alpha waves, just like before falling asleep.
Meditation reduces the activity of the sympathetic nervous system, helps reduce anxiety and relaxation. At the same time, the heart rate and breathing slow down, the need for oxygen decreases, the pattern of brain tension changes, and the reaction to a stressful situation is balanced.
Autogenic training
AT includes a series of exercises through 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.
Self-regulation of emotional and vegetative functions achieved with the help of AT, optimization of the state of rest and activity, increasing the ability to realize the psychophysiological reserves of the body allow this method to be used in clinical practice to enhance behavioral therapy, in particular for children with ADHD.
Hyperactive children are often tense and internally withdrawn, so relaxation exercises must be included in the correction program. This helps them relax, reduces psychological discomfort in unfamiliar situations, and helps them cope with various tasks more successfully.
The relaxation training model is an AT model revised 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 will help them relieve general tension.
Relaxation training can be carried out during individual and group psychological work, in gyms or in a regular classroom. Once children learn to relax, they will be able to 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.
Of all the psychotherapeutic techniques, autogenic training is the most accessible to master and can be used independently. It has no contraindications for children with attention deficit hyperactivity disorder.
We have described many techniques that can be used to correct 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 severe form of the disease, medications.
It must be emphasized that improvement in the child’s behavior will not appear immediately, however, with constant classes and following the recommendations, the efforts of parents and teachers will be rewarded.

4. Correctional program for children with attention deficit/hyperactivity disorder

The purpose of the correction program: psychological correction of the components of hyperactivity: voluntary attention, communication skills, development of the child’s personal qualities.
Objectives of psychocorrectional work:
1. Development of the child’s attention (formation of its properties: concentration, switchability, distribution);
2. Training of psychomotor functions;
3. Reducing emotional stress;
4. Training in recognizing emotions from external signals;
5. Behavior correction using role-playing games;
6. Relieving anxiety;
7. Development of communication skills.
Correction means:
games for the development of psychomotor functions and correction of behavior in a team.
Exercises and games aimed at developing a child’s stability, concentration, switching and distribution of attention.
Exercises and games aimed at overcoming motor automatism.
A set of psychogymnastics classes.
The program is intended for children of middle and senior preschool age.
Principles of program construction:
1. Availability of the proposed material, compliance with the age characteristics of children;
2. Systematicity and consistency in carrying out correctional work;
3. Personality-oriented approach to children.
The program provides for the possibility of implementing an individual approach to the child, working with various subgroups of children, taking into account their age characteristics.
Classes are held once every 2 days.

Thematic planning of correctional and developmental work with children:

Lesson No. 1

Lesson objectives:
Acquaintance.
Correction of key components of ADHD
Tasks:

Familiarization with the rules of behavior in the group;
Developing interest in joint activities.

Formation of self-control skills.

"Carousel"
Purpose: group unity exercise.
The adult takes the child by the hand and begins to collect all the children in one chain, forming a circle.
The adult says the words:
Words of the Movement
Now we will ride the carousel. Repeat the words after me and move together in a circle so that the carousel does not break. Words: “The carousel spun, ate, ate, ate. And then they ran, ran, ran. Hush, hush, don't rush, stop the carousel. One-two. One-two (pause). The game is over. The carousel is slowly moving to the right. The pace of speech and movements gradually accelerates. When the words “run” are heard, the carousel changes direction. The pace of movement gradually slows down and at the words “one or two” everyone stops.

"Catch - don't catch"
The rules of this game are similar to the well-known way to play “Edible - Inedible”. Only the condition of when the child catches the ball and when not can change in each game. For example, now you agree with him that if the driver throws the ball, saying a word related to plants, then the player catches it. If the word is not a plant, then it hits the ball. For example, one game con might be called "Furniture is not furniture." Similarly, you can play such variants as “Fish is not a fish”, “Transport is not transport”, “Flies - does not fly” and many others. The number of selectable game conditions depends only on your imagination. If it suddenly runs out, invite the child to choose the conditions of the game himself, that is, the category of words that he will catch. Children sometimes come up with completely fresh and creative ideas!
Note. As you probably noticed, this game develops not only attention, but also the ability to generalize, as well as the speed of processing heard information. Therefore, for the purpose of the child’s intellectual development, try to ensure that the categories of these generalized concepts are diverse and affect different areas, and not limited to everyday and frequently used words.
"Golovoball"
In this game, in order to be successful, the child will have to take into account the pace and nature of the other person's movements. In general, his usual impulsiveness will not help matters.
It's good if you involve a few more children in this game. Firstly, it is with peers that the child most of all needs to learn to get along well, and secondly, it is, of course, possible to carry out these game tasks with an adult, but it is not very convenient. So, let your child, together with his partner, stand at the line called “start.” Place a pencil on this line. The players' task is to take this pencil from both sides so that each of them touches its tip with only their index finger. Using these two fingers between them, they should be able to pick up a pencil, carry it to the end of the room and return back. If during this time they did not drop what they were carrying and did not help themselves with the other hand, then the couple can be congratulated on successfully completing the task. This means that they are capable of being friends since they have shown such good cooperation skills with each other.
As a next task, you can take a piece of paper, which the players must carry by holding it with their shoulders. Then offer them a soft toy to carry using only their ears and cheeks.
And finally, offer a more difficult task - a ball that they must carry using only their heads (literally and figuratively). This is not as easy as it might seem at first glance, because the ball, due to its shape, will tend to slip. If you are playing a game with more than two children, then after this round offer them the same task, which they will now all do together (that is, three or five of them). This really brings children together and creates a friendly, joyful atmosphere. When trying to complete a task, they usually realize quite quickly that they can do it better if they hug each other's shoulders and walk together in small steps, discussing when to turn or stop.
Note. If your child is not immediately able to cooperate with other children, then (when his peers begin to complete the task) pay attention to how a pair of players coordinate their actions: talking to each other, the quick one adjusting to the slower one, holding hands to better feel the movements of the other , and so on.
"Freeze"

Lesson No. 2

Lesson objectives:
Group cohesion;

Tasks:
Uniting participants into a group;

Development of voluntary attention;

Development of social communication skills.
“Whose voice?”
Children sit in a semicircle. The presenter has his back to the players. One of the children calls out the name of the leader, who, without turning around, must name the one whose voice he heard. First, the children call out to the leader in their usual voice, and then you can change the intonation.

"The dragon bites its tail."

"Sharp Eye"
In order to become a winner in this game, a child needs to be very attentive and be able not to be distracted by foreign objects.
Choose a small toy or object for your child to find. Give him a chance to remember what it is, especially if it's a new thing in the house. Ask your child to leave the room. When he fulfills this request, place the selected item in a visible place, but so that it is not immediately noticeable. In this game, you cannot hide objects in desk drawers, behind closets, or similar places. The toy should be positioned so that the player can find it without touching the objects in the room, but simply looking at them carefully.
Note. If your son or daughter managed to find a toy, then they deserve praise. You can even tell them that if they were born into an Indian tribe, they might have been called a proud name like Sharp Eye.

Lesson No. 3

Lesson objectives:

Correction of key components of ADHD.
Tasks:
Uniting participants into a group;
Developing interest in joint activities;
Development of voluntary attention;
Formation of self-control skills;
Development of social communication skills.
"It's the other way around"
This game will surely appeal to stubborn little ones who like to do everything the other way around. Try to “legalize” their passion to contradict. The adult will be the leader in this game. He must demonstrate a variety of movements, and the child must also perform movements, only completely opposite to those shown to him. So, if an adult raised his hands, the child should lower them, if he jumped, he should sit down, if he stretched his leg forward, he should move it back, etc.
Note. As you probably noticed, the player will need not only the desire to argue, but also the ability to think quickly, choosing the opposite movement. Draw the child's attention to the fact that the opposite is not just different, but somewhat similar, but different in direction. This game can be supplemented with periodic statements by the presenter, for which the player will select antonyms. For example, the presenter will say “warm”, the player must immediately answer “cold” (you can use words from different parts of speech that have opposite meanings: run - stand, dry - wet, good - evil, fast - slow, much - little, etc.).
"Revived Elements"
The players sit in a circle. The presenter agrees with them that if he says the word “earth”, everyone should lower their hands down, if the word “Water” - stretch their arms forward, if the word “air” - raise their hands up, the word “fire” - rotate their arms. Whoever makes a mistake is considered a loser.
"Pump and Ball"

Lesson No. 4

Lesson objectives:
Formation of voluntary behavior;
Correction of key components of ADHD.
Tasks:
Uniting participants into a group;
Developing interest in joint activities;
Development of voluntary attention;
Formation of self-control skills;
Development of social communication skills.
"Magic word"
Children usually love this game very much, since it puts an adult in the position of a child who is taught to be polite.
Ask your child what “magic” words he knows and why they are called that. If he has already mastered enough etiquette norms, he will be able to answer that without these words, requests can look like a rude order, so people will not want to fulfill them. “Magic” words show respect for a person and endear him to the speaker. Now you will play the role of such a speaker, trying to achieve the fulfillment of your wishes. And the child will be an attentive interlocutor, sensitive to whether you said the word “please”. If you say it in a phrase (for example, say: “Please raise your hands up!”), then the child fulfills your request. If you simply say your request (for example, “Clap your hands three times!”), then the child teaching you politeness should never perform this action.
Note. This game develops not only attention, but also children’s ability to be voluntarily (performing actions not impulsively, simply because they want it now, but in connection with certain rules and goals). This important characteristic is considered by many psychologists to be one of the leading ones in determining whether a child is ready for school.
"Princess Nesmeyana"
Everyone is familiar with children's complaints that someone else is disturbing their concentration and making them laugh. In this game they will have to overcome precisely this unfortunate circumstance.
Remember such a cartoon character as Princess Nesmeyana. It was almost impossible to cheer her up; she paid no attention to anyone and shed tears day and night. Now the child will be such a princess. Of course, he shouldn’t cry, but he is strictly forbidden to laugh (otherwise, what kind of Nesmeyana is this?). In the same cartoon, as you know, there was a worried father who promised the princess as a wife and half a kingdom in addition to the one who would cheer her up. Such potential suitors, eager for the royal treasury, can be other children or, initially, adults in the family. They surround the princess (who can be played by either a boy or a girl) and try with all their might to make her smile. The one who is so successful in this matter that he makes Nesmeyana smile broadly (his teeth will be visible) is considered to have won this competition of grooms. In the next round, this person changes places with the princess.
Note. It is better to set some restrictions among the “suitors” (they do not have the right to touch the princess) and for Nesmeyana (she should not turn away or close her eyes or ears).
Communication games
"I'm silent - I whisper - I scream"

Lesson No. 5

Lesson No. 6

Lesson objectives:
Formation of voluntary behavior;
Correction of key components of ADHD.
Tasks:
Uniting participants into a group;
Developing interest in joint activities;
Development of voluntary attention;
Formation of self-control skills;
Development of social communication skills.
"The Soldier and the Rag Doll"
The easiest and most reliable way to teach children to relax is to teach them to alternate between strong muscle tension and subsequent relaxation. Therefore, this and the following game will help you do this in a playful way.
So, invite your child to imagine that he is a soldier. Remember with him how to stand on the parade ground - standing at attention and standing still. Have the player pretend to be such a military man as soon as you say the word "soldier". After the child stands in such a tense position, say another command - “rag doll”. When performing it, a boy or girl should relax as much as possible, lean forward slightly so that their arms dangle as if they were made of fabric and cotton wool. Help them imagine that their whole body is soft and pliable. The player must then become a soldier again, etc.
Note. Such games should be completed at the relaxation stage, when you feel that the child has had enough rest.
"Pump and Ball"
If a child has at least once seen a deflated ball being inflated with a pump, then it will be easy for him to enter into the image and depict the changes occurring at that moment with the ball. So, stand opposite each other. The player representing the ball should stand with his head down, his arms hanging limply, his knees bent (that is, look like an uninflated shell of the ball). The adult, meanwhile, is going to correct this situation and begins to make movements as if he were holding a pump in his hands. As the intensity of the pump movements increases, the “ball” becomes more and more inflated. When the child’s cheeks are already puffed out and his arms are stretched out to the sides with tension, pretend that you are looking critically at your work. Touch his muscles and complain that you overdid it and now you have to deflate the ball. After this, pretend to pull out the pump hose. When you do this, the “ball” will deflate so much that it will even fall to the floor.
Note. To show your child an example of how to play an inflating ball, it is better to first invite him to play the role of a pump. You will tense and relax, which will help you relax, and at the same time understand how this method works.
"Speak on signal"
Now you will simply communicate with the child, asking him any questions. But he should not answer you right away, but only when he sees a conditioned signal, for example, arms folded on his chest or scratching the back of his head. If you asked your question, but did not make the agreed-upon movement, the child should remain silent, as if he were not being addressed, even if the answer is on his tongue.
Note. During this conversation game, you can achieve additional goals depending on the nature of the questions asked. So, by asking your child with interest about his desires, inclinations, interests, and affections, you increase your son’s (daughter’s) self-esteem and help him pay attention to his “I.” By asking questions about the content of a topic covered at school (you can rely on a textbook), you will, in parallel with the development of volitional regulation, consolidate certain knowledge.

Lesson No. 7

Lesson objectives:
Formation of voluntary behavior;
Correction of key components of ADHD.
Tasks:
Uniting participants into a group;
Developing interest in joint activities;
Development of voluntary attention;
Formation of self-control skills;
Development of social communication skills.
"Humpty Dumpty"
The character of this game will surely appeal to a hyperactive child, since their behavior is very similar. To help children get into the role better, remember if they read S. Marshak’s poem about Humpty Dumpty. Or maybe he saw a cartoon about him? If so, then let the children talk about who Humpty Dumpty is, why he is called that and how he behaves. Now you can start the game. You will read an excerpt from Marshak’s poem, and the child will begin to portray the hero. To do this, he will turn his torso to the right and left, swinging his soft, relaxed arms freely. For those who are not satisfied with this, they may also turn their heads.
So, an adult in this game must read a poem:
Humpty Dumpty
Sat on the wall.
Humpty Dumpty
Fell in his sleep.
When you say the last line, the child should sharply tilt his body forward and down, stop swinging his arms and relax. You can let the child fall on the floor to illustrate this part of the poem, however, then you should take care of its cleanliness and carpeting.
Note. Alternating fast, energetic movements with relaxation and rest is very useful for a hyperactive child, since in this game he gets a certain pleasure from a relaxed fall to the floor, and therefore from rest. To achieve maximum relaxation, repeat the game several times in a row. To avoid getting bored, you can read the poem at a different pace, and the child will slow down or speed up his movements accordingly.
Games that develop volitional regulation
"The dragon bites its tail."
The players stand behind each other, holding the waist of the person in front. The first child is the head of the dragon, the last is the tail. The “Head” is trying to catch its “Tail”, the rest of the children are tenaciously holding on to each other.

Lesson No. 8

Lesson objectives:
Formation of voluntary behavior;
Correction of key components of ADHD.
Tasks:
Uniting participants into a group;
Developing interest in joint activities;
Development of voluntary attention;
Formation of self-control skills;
Development of social communication skills.
"I'm silent - I whisper - I scream"
As you have probably noticed, hyperactive children have difficulty regulating their speech - they often speak in a raised voice. This game develops the ability to consciously regulate the volume of one’s statements, stimulating the child to speak either quietly, then loudly, or be completely silent. He will have to choose one of these actions, focusing on the sign that you show him. Agree on these signs in advance. For example, when you put your finger to your lips, the child should speak in a whisper and move very slowly. If you put your hands under your head, as you would during sleep, your child should shut up and freeze in place. And when you raise your hands up, you can talk loudly, scream and run.
Note. It is better to end this game at the “silent” or “whisper” stage in order to reduce gaming excitement when moving on to other activities.
"Toys Alive"
Ask your child what he thinks happens at night in a toy store. Listen to his versions and ask him to imagine that at night, when there are no buyers, the toys come to life. They begin to move, but very quietly, without saying a word, so as not to wake up the watchman. Now imagine some toy yourself, for example a teddy bear. Let the child try to guess who it is. But he should not shout out the answer, but write it down (or draw it) on a piece of paper, so as not to give away the toys by noise. Then let the child show any toy himself, and you try to guess its name. Please note that the entire game must be played in absolute silence. When you sense a decline in your child’s interest, announce that it is getting light. Then the toys should fall back into place, thus the game will be over.
Note. In this game, the child acquires the skills of non-verbal (without the use of speech) communication, and also develops self-control, because when he guessed what kind of toy you are depicting, he so wants to immediately say about it (or better yet, shout), but the rules of the game do not allow do this. When he himself pretends to be a toy, you also need to make an effort not to make sounds and not to prompt the adult.
"Freeze"
In this game, the child needs to be attentive and be able to overcome motor automatism by controlling his actions.
Play some dance music. While it sounds, the child can jump, spin, and dance. But as soon as you turn off the sound, the player must freeze in place in the position in which the silence caught him.
Note. This game is especially fun to play at a children's party. Take advantage of this to train your child and at the same time create an atmosphere of relaxedness, since children are often embarrassed to dance seriously, and you invite them to do it in a game, as if as a joke. You can also introduce a competitive motive: those who did not have time to freeze after the end of the music are eliminated from the game or are subject to some kind of comic punishment (for example, saying a toast to the birthday boy or helping to set the table).

List of used literature

1.. Badalyan L.O., Zavadenko N.N., Uspenskaya T.Yu. Attention deficit syndromes in children // Review of Psychiatry and Medical Psychology named after. V.M. Bekhterev. St. Petersburg: 1993. - No. 3. - 95 s.
2. Bryazgunov I.P., Kasatikova E.V. A restless child, or everything about hyperactive children. - M.: Publishing House of the Institute of Psychotherapy, - 2001. - 96 p.
3. Bryazgunov I.P., Kuchma V.R. Attention deficit hyperactivity disorder in children (issues of epidemiology, etiology, diagnosis, treatment, prevention and prognosis). - M. - 1994. - 49 p.
4. Burlachuk L.F., Morozov S.M. Dictionary-reference book on psychodiagnostics. - St. Petersburg: Publishing House "Peter", - 2000. - 528 p..
5. Age characteristics mental development of children / Ed. I.V. Dubrovina, M.I. Lisina. - M., 1982. - 101 p.
6. Vygotsky L.S. Development of higher mental functions. - M.: APN RSFSR, - 1960. - 500 p.
7. Drobinskaya A.O. Attention deficit hyperactivity disorder // Defectology. - No. 1. - 1999. - 86 p.
8. Zhurba L.T., Mastyukova E.M. Minimal brain dysfunction in children. Scientific review. M.: VNINMI, - 1980. - 50 p.
9. Zavadenko N.N. Hyperactivity and attention deficit in childhood. M.: "Academy", - 2005. - 256 p.
10. Zavadenko N.N. How to understand a child: children with hyperactivity and attention deficit disorder // Curative pedagogy and psychology. Supplement to the journal "Defectology". Issue 5. M.: Shkola-Press, - 2000. - 112 p. Lesson summary on “Development of speech and communication” in grade 0 of a correctional school

Maybe someone will be interested.
Variants of the syndrome
According to the American classification of diseases DSM-IV, there are 3 variants of this disorder:

syndrome combining attention deficit and hyperactivity;
attention deficit disorder without hyperactivity;
hyperactivity disorder without attention deficit.

Alarm Signals
If, at the age of 4-5, parents and kindergarten teachers notice that the child cannot play quiet games, is unable to concentrate on a task and finish it, if he quits one activity and starts another, without finishing it, moves on to the next, then such a child needs a thorough psychological examination.
First, the child’s behavior is observed for a certain time at home and in kindergarten. Only after this, by comparing observations, psychologists and teachers can talk about the specific difficulties that the child is experiencing.

Many parents and educators believe that the main problem is the child’s hypermobility. There is no doubt, but the fact is that hyperactivity is not the key problem. As brain structures mature, by about 13-15 years of age, hyperactivity decreases significantly or disappears completely. There may only be fussy movements in the adult and/or an inability to fixate in one position for a long time.

The main symptoms of ADHD are: impaired concentration and impulsive, thoughtless behavior.

The leading component of this disorder is the inability of the child’s brain to adequately self-regulate. This applies to both initiation and inhibition of behavior and activity.

Features of brain function in ADHD children
Children with ADHD experience a wide range of behavioral, cognitive and communication difficulties that interfere with their daily functioning and well-being.
The brain of an ADHD child works cyclically: 10-15 minutes of work, and then for 5-7 minutes the child seems to switch off, he does not have enough energy to continue working and he needs to gain this energy. During these 5-7 minutes, in order for consciousness to be turned on, the child is forced to turn his head, move his limbs or his entire body.
Children with ADHD are curious, but not inquisitive. They look, listen, touch and try everything, but chaotic sensory and motor acts do not add up to the necessary actions. The knowledge, ideas and conclusions of such children are superficial. Understanding of objects and phenomena is also superficial, ideas about social and interpersonal relationships are quite simplified.

ADHD child does not delve into the essence of phenomena, does not notice details and does not take them into account in the perception of the whole object or phenomenon. Thus, such an important personality trait as attentiveness is not formed or is formed very slowly. An attentive person understands more deeply what is happening around him and feels and experiences his personal experience more deeply. Attentiveness must be developed from early childhood, and not hope that the child will outgrow it and everything will pass with age!!!

Executive dysfunction

Modern research makes it possible to assume that the primary component of the disorder is a violation of the executive functions of intelligence and working memory. This suggests a certain dysfunction of the frontal cortex and neurochemical systems projecting to the frontal cortex.

The frontal-subcortical pathways are rich in catecholamines (dopamine, adrenaline, norepinephrine). This may partly explain the positive results of treatment with stimulants.

Frontal cortex dysfunction
The reason for weak voluntary attention and self-control, unstable motivation is dysfunction of the frontal cortex of the brain.

Disruption of the activity of the frontal cortex and the neurochemical connections connecting it with the central structures leads to the disintegration of processes in the brain, impairment of the ability to anticipate upcoming events, and plan one’s activities.

The frontal cortex is responsible for setting goals and objectives, planning and executing activities. The frontal cortex is also responsible for the motivational side of behavior - the formation of intentions, impulses, motivations, as well as the ability to control these impulses.

The Importance of Positive Motivation
Hyperactive children are very poorly motivated. Interest and desire to do something develops slowly in them. But once such an interest has formed, it usually remains for a long time or for life.
That is why it is so important to have positive motivation in activities and games with such a child. The important element here is the pleasure element.

Disorders that cause ADHD

Energy supply

Deficiency of energy supply can be observed during encephalographic examination. The child sits with his eyes open and performs some actions in accordance with the doctor’s instructions. At this time, the “alpha rhythm” dominates the electrical activity of the brain, that is, the brain “sleeps.”
Normally, the “alpha rhythm” occurs if a person sits with his eyes closed, nothing happens around him, there are no stimuli and there is no reaction to anything from the outside. Naturally, a child, being in “alpha,” cannot perform any type of activity efficiently. In this way, the brain compensates for the lack of energy supply. This is an objective factor.

Archaic and immature connections

The formation of connections, which develop very intensively in the child’s brain in the first years of life, has a sensitive period. If the sensitive period has passed and synkinesis is not disinhibited, then the child will simultaneously write and move his tongue chaotically. This distracts attention and reduces the effectiveness of the task. Again, additional energy is needed to compensate for these archaic mechanisms, and there is not much of it in reserve.

Personal maturity issues

If a child with disabilities has matured personally, he makes efforts to meet the expectations of at least his parents and immediate environment. He tries to sit quietly with his hands folded, makes an effort to concentrate on the task or understand what is being said, and restrains himself from shouting, rash statements and actions.
However, in response to the child’s efforts to behave correctly, he develops various disorders in the somatic sphere. The child begins to get sick more often and allergies arise. In all these diseases there is much more compensation than primary manifestations.

Neurobiological factors

According to modern concepts, dysfunction of the neurotransmitter systems of the brain plays an important role in the pathogenesis of ADHD. The hypothesis that puts forward neurochemical disorders as the main dysfunction is based on the positive effects of various medications.
Neurotransmitters are the general name for biological substances that are secreted by nerve endings and ensure the conduction of nerve impulses at synapses. Depending on the effects they achieve, mediators are either excitatory or inhibitory. Important neurotransmitters include dopamine (or dopamine), norepinephrine, and serotonin. These chemicals help the brain send, conduct, and receive signals. With ADHD, certain parts of the brain may become deficient in these substances. As a result, some signals are not transmitted by nerve cells because they cannot travel the distance between them. In ADHD, neurotransmitter levels may change. This manifests itself in the fact that the characteristic symptoms either intensify or weaken.

Nutritional factor

It was found that the usual concentration of sugar in the body does not affect the behavior of children with ADHD. True, children with ADHD are prone to disobedience and often consume sweets in larger quantities than the body needs. The effects of increased sugar levels in the body are being studied.
After a breakfast rich in carbohydrates and eating sweets, attention weakened in both groups of children. Psychological tests showed this. Nothing like this happened after protein breakfasts. The effect of carbohydrate breakfasts along with the consumption of sweets on the quality of attention was explained by increased serotonin synthesis over a certain period of time.
Thus, the only useful conclusion from these studies is the importance of a balanced diet for school-age children (especially in the morning), which should include the required amount of protein.

Encouragement and motivation

The motivational side of activity in people with ADHD suffers. The child lacks motivation to start or continue an activity. The child must be very interested in something so that he can do it for a long time and productively.

Inattention

Very often, a child with ADHD behaves poorly and does not pay attention to others. He is inconsiderate to other people by nature. A hyperactive child may simply not understand what is pleasant to another person and what is unpleasant and may be indifferent to the experiences of other people.
Understanding other people and their experiences can take a long period of time. Parents should work purposefully in this direction. Sessions with a psychologist can also help.

Delay emotional development

The child lags behind in emotional development and matures slowly. This is manifested by short temper, irritability, and lack of restraint.
Children with ADHD very often lag behind in psycho-emotional development, but they, as a rule, strive to lead other children. This is one of the reasons for poor relationships with peers.
Such children grow up more slowly. This does not mean that they will never grow up at all. The process of growing up lasts for a longer time and it does not proceed linearly, but in leaps and bounds. Young people with ADHD need more time to become responsible and independent, more family support and professional help.

Developmental and intelligence discrepancy

Hyperactive children may have good general intelligence. There may be gifted people among them. But developmental disorders prevent the development of intelligence to the fullest extent. There is a certain uncompensated discrepancy between the level of development and intelligence. This manifests itself both in the somatic sphere and in behavioral characteristics. Due to the fact that the restraining centers are not perfect, various deviant behaviors can persist in adults. At the same time, adults no longer demonstrate disinhibition and are quite able to concentrate their attention.

System of interests

In ADHD, the area of ​​formation of interests and needs is negatively affected. In conditions where a child/teenager becomes an outcast in the family and is deprived of support, a person may grow up with incorrect moral guidelines.
A child with ADHD experiences certain difficulties in establishing emotional contact with environment. It is quite difficult for him to feel comfortable in everyday situations and to receive pleasure and positive emotions simply from what he sees or hears. This problem continues into adulthood.
A child with ADHD is interested in everything exciting and exciting. With such guidelines, interests in certain types of activities and hobbies are formed very slowly. But if this happens and interest in something is fixed, then it is fixed for a very long time, sometimes for life. Finding your interests, your own business is very important for any teenager; for a teenager with ADHD this is many times more important.

Irritants

Instead of selective emotional preferences, a child with ADHD responds to all stimuli in the same way. The world is full of different stimuli and they are all equally interesting. Naturally, it is difficult for a person with such a feature to direct his attention to one thing.
In all likelihood, in certain parts of the brain, a person with ADHD experiences a constant internal need for self-stimulation and stimulants. A person drinks a lot of coffee, Coca-Cola, eats a lot of chocolate, drives a fast car, drinks alcohol, etc.
The child finds sources of stimulation in various risky or exciting situations. There are quite a few children with ADHD who are stimulated by other people's emotions, especially negative ones. Some children deliberately show disobedience, tease, and cause negative reactions in people. This fuels them and gives them pleasure.
Such negative manifestations of ADHD characteristics are another good reason for actively searching for an interesting activity, something that will bring pleasure to the child.

Irritability and emotional lability

Overreacting

Children with ADHD are impulsive and find it very difficult to put off getting what they want or enjoy until later. They may have difficulty waiting their turn or being asked by the teacher. They answer from their seats or interrupt other people.
In school classes, they are most often the initiators of social relationships. But they have an excessive emotional response that does not correspond to the content of the situation. They demonstrate an insensitivity to social expectations and nuances of interpersonal relationships.
ADHD behavior fluctuates differently at different times of the day and in different situations, so the child's behavior is unpredictable. He cannot play for a long time, communicate successfully, or establish friendly relationships with peers.
This state of affairs is due to the inability or lack of proper skill to direct one’s attention and thinking in the right direction.
Training various qualities of attention could make it easier for a child to adapt socially and establish strong relationships with his peers.

Fears and anxiety
When starting to study systematically, a child experiences various learning difficulties. Against the background of these difficulties and delays in the development of social skills, neurotic disorders can occur.
A child with ADHD may be very anxious or aggressive. How anxious or aggressive a child is can be determined using special computer tests. The results of diagnostic testing can provide valuable information about the personality traits of a child, adolescent, as well as an adult.

Psychiatry

Diagnosis and correction of hyperactivity in children

Introduction

1. History of the study and statistics of childhood hyperactivity

2. Clinical picture and diagnosis of hyperactivity

3. Causes of hyperactivity

4. Correction of hyperactive behavior

4.1 Working with parents of a hyperactive child

4.2 Working with hyperactive children

4.3 The role of the teacher in the correction of hyperactivity

Conclusion

Bibliography

INconducting

The problem of hyperactivity is currently becoming particularly relevant, because The number of hyperactive children is increasing every year. According to various authors, from 2 to 20% of students exhibit hyperactive disorders, characterized by excessive mobility and disinhibition. Teachers say: “One disinhibited child is a problem, two are a disaster,” because There is no longer enough time for the rest of the children.

The relevance of the problem is that hyperactivity is a disorder that has many different aspects: neurological, psychiatric, motor, language, educational, social, psychological, etc.

Often, the path of a child with symptoms of hyperactivity at school begins with failures. Lack of a sense of success causes secondary emotional distress and decreased self-esteem. Even the most capable children, with a high level of intelligence, show low academic performance. Although some of them still achieve good results, they do not fully realize their high intellectual capabilities.

In adulthood, only about 30% of hyperactive people recover from this disorder, and most of them experience significant difficulties in adulthood. According to statistics, about 20% of hyperactive people lead an antisocial lifestyle, including breaking the law and addiction to alcohol and drugs.

Therefore, timely diagnosis of the manifestations and causes of hyperactivity in children is important, because, according to many psychologists and psychotherapists, correction of hyperactivity in childhood is more effective. When preparing correctional programs, it is necessary to take into account the child’s personality characteristics, the style of family relationships, the reasons for the development of hyperactive behavior, etc.

1. History of the study and statistics of childhood hyperactivity

The concept of HYPERACTIVITY is a set of symptoms associated with excessive mental and motor activity.

The word hyperactive comes from the merger of two parts: “hyper” - (from the Greek Hyper - above, from above) and “active”, meaning “active, active”.

S.D. Clemens gave the following definition of hyperactivity: “... a disease with an average or close to average intellectual level, with mild to severe behavioral disturbances, combined with minimal deviations in the central nervous system, which may be characterized by various combinations of disorders of speech, memory, attention control, motor functions".

The study of the problem of hyperactivity was started by the German psychoneurologist Heinrich Hoffman, who for the first time described an extremely active child who could not sit quietly in a chair for a second, giving him the nickname Fidget Phil. This was about 150 years ago.

French authors J. Philippe and P. Boncourt in the book “Psychological Anomalies Among Students” (translated into Russian, this book was published in 1911), along with epileptics, asthenics, and hysterics, also identified the so-called unstable students.

Since then, many scientists have studied the problem of neurotic behavior disorders and learning difficulties, but for a long time there was no scientific definition of such child conditions. In 1947, pediatricians attempted to provide a clear clinical description of hyperactivity disorder in children with learning difficulties.

When describing the same symptoms, researchers called hyperactivity syndrome differently, i.e., until recently there was no consensus on the name of this disease. Hyperactivity has been called “mild brain dysfunction”, “hyperkinetic chronic brain syndrome”, “mild brain damage”, “mild infantile encephalopathy”, “hyperkinesis”, etc.

At a meeting of international neurological experts held in Oxford in 1947, a description of “mild brain dysfunction” appeared in the medical literature, which was characterized by about 100 clinical manifestations, in particular dysgraphia (writing impairment), dysarthria (impaired speech articulation), dyscalculia ( violation of counting), lack of concentration, aggressiveness, clumsiness, infantile behavior, etc.

Domestic neurologists paid attention to the problem of hyperactivity much later. So in 1972, the famous pediatrician Yu.F. Dombrovskaya, in a speech at a symposium dedicated to the role of the psychogenic factor in the origin, course and treatment of somatic diseases, identified a group of “difficult to educate” children who cause the most problems for parents and teachers.

In 1987, when American specialists revised the Diagnostic and Statistical Manual of Mental Disorders, the name of the disease “attention deficit hyperactivity disorder (ADHD)” was introduced and its symptoms (criteria) were clarified. According to scientists, this name most accurately reflects the essence of the phenomenon of hyperactivity. Strict criteria make it possible to standardize the methodology for diagnosing children at risk of such a disease and make it possible to compare data obtained by researchers in different countries. .

Therefore, when speaking about hyperactive children, most researchers (Z. Trzhesoglava, V.M. Troshin, A.M. Radaev, Yu.S. Shevchenko, L.A. Yasyukova) mean children with attention deficit hyperactivity disorder (ADHD ).

IN last years This disease is beginning to receive more and more attention in all countries, including ours. This is evidenced by the growing number of publications on this topic. If in 1957-1960. there were 31 of them, then in 1960-1975. - 2000, and in 1977 -1980. - 7000. Currently, 2000 or more articles and books are published annually on this problem.

Data from a statistical study by Russell Barclay.

· On average, in each class of 30 students there are 1 - 3 hyperactive children.

· The rate of emotional development of hyperactive children is 30% lower than that of their peers. For example, a ten-year-old child with hyperactivity operates at the maturity level of approximately a 7-year-old; A 16-year-old novice driver uses the decision-making skills of an 11-year-old child.

· 65% of hyperactive children have problems obeying higher authorities, including verbally hostile expressions and outbursts of irritation.

· 25% of hyperactive students have other severe learning problems in one or more areas: verbal expression skills, listening skills, reading comprehension and mathematics.

· Half of all hyperactive students have problems understanding what they hear.

· Hyperactive students have two to three times more problems with expressive language than their peers.

· 40% of hyperactive children have at least one parent with hyperactivity disorder.

· 50% of hyperactive children also have sleep problems.

· Parents of a hyperactive child are three times more likely to divorce.

· 21% of hyperactive teenagers regularly miss school.

· 30% had poor academic performance or had to repeat a year.

Modern research suggests that hyperactivity syndrome can arise very early in development. Babies have increased muscle tone, are overly sensitive to stimuli (light, noise), sleep poorly, eat poorly, cry a lot, and are difficult to soothe. At 3-4 years old, the child’s inability to concentrate on anything becomes clear: he cannot calmly listen to a fairy tale, is not able to play games that require concentration, his activity is predominantly chaotic.

But most researchers of hyperactive behavior tend to think that signs of the disorder are most pronounced between the ages of 5 and 10 years, i.e. in senior preschool and primary school age. Thus, the peak manifestation of the syndrome occurs during the period of preparation for school and the beginning of education.

This is due to the dynamics of the development of higher nervous activity. By the age of 7, as D.A. writes. Farber, there is a change in the stages of intellectual development, the conditions for the formation of abstract thinking and voluntary regulation of activity are formed.

At 6-7 years old, children with the syndrome are not ready to study at school due to the slowdown in the rate of functional maturation of the cortex and subcortical structures. Systematic school stress can lead to disruption of the compensatory mechanisms of the central nervous system and the development of maladaptive school syndrome, aggravated by educational difficulties. Therefore, the question of readiness for school for hyperactive children should be decided on a case-by-case basis by a psychologist and the doctor observing the child.

Among boys aged 7-12 years, signs of the syndrome are diagnosed 2-3 times more often than among girls. Among teenagers this ratio is 1:1, and among 20-25 year olds it is 1:2 with a predominance of girls. In girls, the cerebral hemispheres are less specialized, so they have a greater reserve of compensatory functions compared to boys when the central nervous system is damaged (Kornev A.N., 1986).

The prognosis is relatively good, as in a significant proportion of children, symptoms disappear during adolescence. Gradually, as the child grows, disturbances in the neurotransmitter system of the brain are compensated, and some symptoms regress. However, in 30-70% of cases, clinical manifestations of attention deficit/hyperactivity disorder (excessive impulsiveness, short temper, absent-mindedness, forgetfulness, restlessness, impatience, unpredictable, rapid and frequent mood swings) can also be observed in adults.