When children suffer from a disease called "attention deficit and hyperactivity disorder" (hereinafter referred to as "ADHD"), many parents are still in the dark. On the surface, children are just active, unable to sit still, and even appear smarter than other children. Isn’t this the "nature" of children in the traditional concept?
In medicine, behind hyperactivity is that attention can’t be concentrated normally. Hyperactivity may decrease with the increase of age and self-control, but it is difficult to alleviate the defect of attention, which may affect children’s life in study, work and life.
The Second People’s Hospital of Guizhou Province (Guizhou Mental Health Center) opened a special outpatient clinic for children and adolescents with learning difficulties on March 6th this year. Over the past six months, it has received hundreds of cases of "ADHD" among adolescents, and carried out professional intervention treatment under the guidance of the expert team of attention deficit hyperactivity disorder in the Sixth Hospital of Peking University.
"ADHD" can’t be equated with mischief.
Medical "attention deficit and hyperactivity disorder" is often just hyperactivity or mischief in the cognition of many parents. "There are many sick boys, and children are often smarter and have high IQ." Xiong Jie, deputy director of the Women and Children Psychiatry Department of the Second People’s Hospital of Guizhou Province, said, "Many parents didn’t notice ‘ Move around ’ The attention deficit problem behind it. "
Many details in children’s life can be used to judge whether they have attention problems: whether children in kindergarten can concentrate on listening to a story told by their parents; When children draw, will they unconsciously turn their eyes from drawing paper to pen tip? Is it always a drag to finish the exercises … …
Other children will provoke their classmates lightly, and may draw a picture on their classmates when sharpening pencils; Can’t stand the constraints of classroom discipline and get along well with teachers and classmates; Parents who often fight are invited … … Qian Ying, deputy director of Peking University Sixth Hospital and Peking University Clinical Psychology Center, explained that "hyperactivity" is a dimension of attention deficit, and there are many subtle manifestations in patients’ study and life.
"There is something called dopamine in their brains that is not enough." Qian Ying made an analogy: "There seems to be a battle in the brain. When dopamine secretion is normal, the marshal in the brain can direct everything. When it is time to move, it should be quiet. If the dopamine secretion is less, the marshal may fall asleep and the soldiers will start to move uncontrollably. "
An article published in the Chinese Journal of Epidemiology in 2018 showed that the total prevalence rate of attention deficit and hyperactivity disorder among children in China was 5.6%, and subgroup analysis showed that the prevalence rate of boys was 7.7% and that of girls was 3.4%. Qian Ying said that less than 1/3 of the patients were formally treated, and the proportion of patients receiving formal treatment after treatment was even lower.
The reason why children fall behind in their grades may be the lack of concentration.
The reason why some teenagers really go to the hospital is that there is a problem in their learning status. After analyzing a large number of cases, it is found that the first and third grades of primary school are the peak periods for children to suffer from ADHD.
Xiong Jie’s children have just entered the first grade this year, and the teacher will ask Xiong Jie for advice: Why can’t some children in the class concentrate on the lecture anyway? This directly leads to their inability to keep up with their studies. "If six or seven-year-old children can only concentrate for a few minutes, they will definitely not be able to study normally." Xiong Jie said.
The study found that some sick children have high IQ, and they can not concentrate on each class for a long time in the first and second grades, but they can also learn some knowledge, and they can barely keep up with the learning progress by being smart. Generally, in the third grade, academic performance will drop significantly. At this time, if you don’t see a doctor again, by the sixth grade and junior high school, your child will face more serious problems. "It is often that academic performance is not good and interpersonal communication is not good. How do children find themselves unloved?" Qian Ying said that children will feel inferior because of this, and with the advent of adolescence, many children have a stiff relationship with their parents.
Qian Ying opposes that some parents often say that their children are too rebellious in adolescence. "In fact, the child is wronged in his heart. He can’t control himself, but there is something wrong with dopamine in his brain." Through contact with a large number of patients, Qian Ying found that if children at this time did not feel the warmth of teachers, classmates and relatives, and did not see a doctor in time, they were most likely to get into bad habits, such as indulging in the Internet, smoking, drinking and even committing crimes.
Xiong Jie and experts from the Sixth Hospital of Peking University once went to a drug rehabilitation center for investigation, and found that the proportion of drug addicts with ADHD in childhood was very high, and they basically did not receive professional intervention. Many people’s life trajectories are also surprisingly similar: from poor academic performance to behavioral problems, they gradually affect their emotions and appear personality defects, and then they are misled by others to further develop drug addiction … …
Professional treatment should be promoted to preschool age.
"Attention deficit and hyperactivity disorder" has the same obvious influence on a person as an adult.
Among the cases studied in Peking University Sixth Hospital, lateness and procrastination are the most common problems. Some patients have never been able to go to work on time, and serious "starting difficulties" have made him often criticized by leaders; Some patients are seriously procrastinating and incompetent, and are considered irresponsible by colleagues; Some people have serious emotional problems because of self-blame, and their social status as adults is very low, and they can’t keep up with their peers.
Some patients will show "high function". A doctoral student in Peking University, whose research ability is not weak, has been unable to start writing a thesis; A 40-year-old university teacher completed his knowledge accumulation by amazing self-discipline, but he had to make a particularly strict time schedule to complete his work. After becoming a doctoral tutor, he had to rely on drugs to improve his attention to complete his teaching and research tasks.
Qian Ying believes that to prevent similar problems in adulthood, it is necessary to intervene from an early age. One of her important research directions is preschool intervention. At present, the internationally accepted cognition is "early judgment, early action and active treatment". Qian Ying explained that this means that it is not necessary to make a diagnosis for preschool children with ADHD, but it is necessary to carry out professional intervention, especially non-drug intervention, as soon as possible.
Qian Ying was particularly pleased that after the opening of the adolescent learning disability clinic in the Second People’s Hospital of Guizhou Province for half a year, she had the first preschool child to see a doctor. Although the final diagnosis showed that the child was not ADHD, Qian Ying believed that this showed that parents in the western region began to sprout their understanding of the disease.
Qian Ying explained that people’s brains will be more mature when they reach a certain age, but people’s executive skills will last longer, and some people will continue to develop into adulthood. Some professional methods can be used to promote the development level of children with slow development of executive skills.
At present, Peking University Sixth Hospital and Shenzhen Children’s Hospital are jointly trying to intervene on "attention deficit and hyperactivity disorder" before school, and foreign professional researchers are also involved. Qian Ying found that after several months of training, some children made obvious progress. "The exact conclusion may be studied in five years." Qian Ying said.
Going to a mental health hospital for treatment is a difficult psychological hurdle to overcome.
In order to let more families know about the treatment knowledge of preschool ADHD, Qian Ying wrote a book on how to carry out family group training of executive skills, so that more parents can find problems, pay attention to them and make some active interventions for their children.
She believes that it is more important to let parents and children really sit in front of professional doctors, but the current embarrassment is that professional doctors often take their children into these places in mental health research institutions or "mental hospitals" that people often express, which is still difficult for many people.
Qian Ying noticed that some private early education institutions have set up children’s concentration training courses, and the fees are ten times or even dozens of times that of public hospitals. Many parents are willing to sign up their children. She believes that on the one hand, it is necessary to see that these institutions are mixed and there are no teaching standards, and the professionalism of teachers may not be qualified for the curriculum requirements; On the other hand, in the future, professional medical institutions can cooperate with educational institutions to integrate professional knowledge into the curriculum of kindergartens and schools, which will be more acceptable to children and parents.
WU GANG, director of the Women and Children’s Department of the Second People’s Hospital of Guizhou Province, also said, "I hope that professional outpatient clinics can drive more people to pay attention to the psychological problems of teenagers, and treat them as a cold." WU GANG plans to get a batch of professional diagnosis and treatment equipment for departments, send more medical staff to participate in professional study, and build a platform for cooperation with educational institutions and non-profit organizations in the future, so as to drive away the "sense of shame" under old ideas and let more children with ADHD receive treatment happily.
China Youth Daily China Youth Network reporter Bai Hao Intern Pearl