Hyperkinetic is just another word for Hyperactive.
Hyperactivitydescribes children who show numerous amounts of inappropriate behaviors insituations that require sustained attention and orderly responding to fairlystructured tasks. Humans who are hyperactive tend to be easily distracted,impulsive, inattentive, and easily excited or upset. Hyperactivity in childrenis manifested by gross motor activity, such as excessive running or climbing. The child is often described as being on the go or “running like a motor”, andhaving difficulty sitting still. Older children and adolescents may beextremely restless or fidgety. They may also demonstrate aggressive and verynegative behavior.
Other features include obstinacy, stubbornness, bossiness,bullying, increased mood lability, low frustration tolerance, temper outbursts,low self-esteem, and lack of response to discipline. Very rarely would a childbe considered hyperactive in every situation, just because restraint andsustained attentiveness are not necessary for acceptable performance in manylow-structure situations. Many parents rate the onset of abnormal activity intheir child when it is and infant or toddler. Abnormal sleep patterns arefrequently mentioned, the child objects to taking naps, he also seems to needless sleep, and becomes very stubborn at bedtime. Then, when the child isseemingly exhausted, hyperactive behavior may increase.
Family history studiesshow that hyperactivity, which is more common in boys than in girls, may be ahereditary trait, as are some other traits (reading disabilities or enuresis-bedwetting). Certain predisposing factors affect the mother, and therefore thechild, at the time of conception or gestation or during delivery. Included areradiation, infection, hemorrhage, jaundice, toxemia, trauma, medications,alcohol, tobacco, and caffeine. The course of the syndrome typically spans the6-year to 12-year age range. In many classrooms, children who displayinappropriate overactivity (restlessness, moving around without permission) ,attention deficits (distractible by task-irrelevant events, inability to sustainattention to the task) , and impulsivity (making decisions and responses hastilyand inaccurately, interrupting and interfering with classmates and the teachers)are likely to be identified as hyperactive. The diagnosis of hyperactivity isusually suggested when parents and teachers complains that a child isexcessively active, behaves poorly, or has learning difficulties.
However,there is no specific definition or precise test to confirm that a child ishyperactive. This syndrome is most frequently recognized when the child cannotbehave appropriately in the classroom. There are three characteristic courses. In the first, all of the symptoms persist into adolescence or adult life. Inthe second, the disorder is self-limited and all of the symptoms disappearcompletely at puberty.
In the third, the hyperactivity disappears, but theattentional difficulties and impulsivity persist into adolescence or adult life. The relative frequency of the courses is unknown. The individual, accordingly,does not grow out of the disorder. As the child passes through puberty,aggression and restlessness may decrease, but most symptoms persist and may leadthe adolescent to develop a low self-esteem and a tendency to withdraw. Theadolescent may also manifest anti-social tendencies, for instance, lieing,stealing, and violence, which frequently lead to delinquency. Similarly,symptoms persist into adult life and account for social maladjustment (behaviorthat violates laws or unwritten standards of the school or community, yetconforms to the standards of some social subgroup).
Attention-deficitHyperactivity Disorder (ADHD), also called attention deficit disorder (ADD), ispresently the most common condition diagnosed in hyperactive children. Thisspecific syndrome focuses on the child’s inability to pay attention. Thissyndrome occurs early in life (in infancy or by the age of 2 or 3 years ) ismore common in boys and may occur as many as 3 percent of prepubertal children. A small proportion of hyperactive children have a definite history of injury to,or disease of, the brain that preceded a change to abnormal behavior.
Thesechildren show relatively minor disabilities of coordination, reflexes,perception, problem solving, and other behaviors often referred to as”softsigns” of neurological disorder (brain-injured). It has not beenestablished, however, that brain damage or malfunction is a factor in most casesof hyperactivity. Studies of many children who had difficulties at birth showno connection between such difficulties and later hyperactivity. In these otherwise, normal children, hyperactivity, impulsivity, and distractibility arevariable.
The syndrome has been described for many years, and these childrenwere previously said to have minimal brain dysfunction (MBD). In the MBDsyndrome, the behaviors of ADHD (attention deficit disorder with hyperactivity)were combined with poor coordination, emotional instability, immaturedevelopment, perceptual difficulties, learning disabilities, language disorders,and minor neurological abnormalities observed through medical examinations. Inmost cases it is not possible to find a specific cause for hyperactivity and maynot be appropriate to try. Since hyperactivity behavior is common, starts earlyand persists at least into adolescence, has hereditary determinants, and also isrelatively hard to change by psychological means, it may represent a type oftemperament rather than a psychological or medical disorder.
Most authoritiesfeel that factors that interfere with the normal development of a child’s brainduring pregnancy, labor, delivery, and early infancy are most significant. These include infections, injuries, prematurity, and difficult births. Otherpossible causes include environmental conditions such as maternal drug addiction,lead poisoning, malnutrition, and emotional deprivation. In some, hyperactivityseems to be an inherited trait. Only in rare circumstances is there a precisehistory of previous injury or disease of the brain, or an ongoing neurologicalor psychiatric disorder that can be diagnosed.
Although, it’s usuallyassociated with normal intelligence, it may accompany mental retardation oremotional disturbances. Target-behavior recording is commonly used to measurehyperactivity, especially the inappropriate overactivity component, but alsoinattention and impulsivity. Behavior-rating scales often include hyperactivityitems; some such as the Conners Parent-teacher Questionnaire, are especiallydesigned for measuring hyperactivity. Other behavior patterns indicative ofhyperactivity may be measured with objective tests, such as “selectiveattention” (ability to concentrate on task-relevant aspects of a situationrather than in cendental, task-irrelevant features) and “impulsive cognitivetempo” (tendency to decide and act hastily without fully considering alternativeresponses, which often leads to mistakes in problem solving and decision making).
These measures of actual functioning in an artificial situation do resembleimportant learning situations for students, and are useful and are usefulresearch tools, but are not yet well developed enough for educationalapplications. Because, it is not possible in most cases to find a specificcause for hyperactivity, there is little agreement as to how much medical orpsychological investigation is needed for every child. Most parents begin bydiscussing their child’s problem with their family doctor or pediatrician. Based upon that evaluation, referral is sometimes made for neurological,psychological, psychiatric, and educational evaluations for consideration ofpossible related disorders and to place the child in the most appropriate schoolenvironment. Researchers must understand a disorder before they can attempt totreat it. There are a variety of theories on the etiology of ADHD, but mostresearchers now believe that there are multiple factors that influence it’sdevelopment.
It appears that many children may have a greater likelihood ofdeveloping ADHD as a result of genetic factors. This predisposition isexacerbated by a variety of factors. Although a very popular belief is thatfood additives or sugar can cause ADHD, there has been almost no scientificsupport for these claims. Since so many factors have been found to beassociated with the development of ADHD, it is not surprising that numeroustreatments have been developed for the amelioration of ADHD symptoms. Although,numerous treatment methods have been developed and studied, ADHD remains adifficult disorder to treat effectively. Treatments of hyperactivity can be broken down into roughly twocategories: medication, and behavioral or cognitive-behavioral treatment withthe individual ADHD child, parents, or teachers.
Stimulant medications havebeen used in the treatment of ADHD since 1937. The most commonly prescribedstimulant medications are methylphenidate (Ritalin), premoline (Cylert) anddextroamphetamine (Dexedrine). Ritalin corrects the neurochemical imbalances inthe brain, and it is the most widely used stimulant drug. Until the 1960’shyperactive children were thought to be suffering from anxiety resulting fromconflict between their parents, and together with their families they weretreated by psychotherapy. Since then, stimulant drugs have come into wide useto calm hyperactive children.
Drug therapy, however, is only temporary ineffect and presents the danger that, if prolonged, the children may becomepsychologically dependent on the drugs. Behavioral improvements caused bystimulant medications include impulse control and improved attending behavior. Overall, approximately 75 percent of ADHD children on stimulant medication showbehavioral improvement, and 25 percent show either no improvement or decreasedbehavioral functioning. It appears that stimulant medications can help the ADHDchild with school productivity and accuracy, but not with overall academicachievement. Although ADHD children tend to show improvement while they are onstimulant medication, there are rarely any long-term benefits to the use ofstimulant medications.
In general, stimulant medication can be seen as only ashort-term management tool. Antidepressant medications (such as imipramine anddesipramine ) have also been used with ADHD children. These medications aresometimes used when stimulant medication is not appropriate. Antidepressantmedication, however, like stimulant medications, appear to provide only short-term improvement in ADHD symptoms.
The treatment program for hyperactivechildren must be individualized to meet their particular needs. Medication,used alone or in combination with educational and psychological interventions,are most commonly utilized. Overall, the use or nonuse of medications in thetreatment of ADHD should be carefully evaluated by a qualified physician. If achild is put on medication for ADHD, the safety and appropriateness of themedication must be monitored continuously throughout it’s use.
Behavioral andcognitive-behavioral treatments have been used with ADHD children themselves,with parents, and with teachers. Most of these techniques attempt to providethe child with a consistent environment in which on-task behavior is rewarded(for example, the teacher praises the child for raising his or her hand and notshouting out an answer) , and in which off-task behavior is either ignored orpunished (for example, the parent had the child sit alone in a chair near anempty wall, a “time-out chair” , after the child impulsively does somethingwrong) . In addition, cognitive-behavioral treatments try to teach ADHDchildren to internalize their own self-control by learning to “stop and think”before they act. One example of a cognitive-behavioral treatment, which wasdeveloped by Philip Kendall and Lauren Braswell, is intended to teach the childto learn five “steps” that can be applied to academic tasks as well as socialinteractions.
The five problem-solving steps that children are to repeat tothemselves each time they incounter a new situation are the following: Ask :Whatam I supposed to do?” , “What are my choices?” ; concentrate and focus in ; makea choice ; ask “How did I do?” (If I did well, I can congratulate myself ; If Idid poorly, I should try to go more slowly next time. ) In each therapy session,the child is given twenty plastic strips at the beginning. The child looses astrip every time he or she does not use one of the steps, does too fast, orgives an incorrect answer. At the end of the session, the child can use thechips to purchase a small prize. This treatment alone combines the use ofcognitive strategies ( the child learns self-instructional steps) and behavioraltechniques ( the child looses a desired object, a chip, for impulsive behavior). Overall, behavioral and cognitive-behavioral treatments have been found to berelatively effective in the settings in which they are used and at the time,they are being instituted.
There is some evidence to suggest that thecombination of medication and behavior therapy can increase the effectiveness ofthe treatment. Like the effects of medications, however, the effects ofbehavioral and cognitive-behavioral therapies tend not to be long-lasting. Apromising trend in treatment is to help the hyperactive child by teaching hisparents and teachers how to cope with his individual behavior. Hyperactivechildren need to have a relatively set routine that includes a maximum ofregularity and a minimum of surprises and interruptions.
The school setting mayneed to be altered in such a way as to make additional help and provisionsavailable. The children frequently need praise, encouragement, and specialattention so that experiences that previously only lead to failure may nowbecome successful and enjoyable. Unfortunately, some children may never make acomplete recovery from hyperactivity, and have a greater chance of developingalcoholism or mental health problems as adults. While the diagnostic definition and specific terminology of ADHD willundoubtedly change throughout the years, the interest in and commitment to thisdisorder will likely continue.
Children and adults with ADHD, as well as thepeople around them, have difficult lives to lead. The research community iscommitted to finding better explanations of the etiology and treatment of thiscommon disorder.Category: English
