Hyperkinetic disorder, also known as Attention Deficit Hyperactivity Disorder (ADHD), is characterized by inattention and hyperactivity that is more frequent and severe than typical for a child's age. It has been linked to both genetic and environmental factors such as prenatal exposure, head injuries, and psychosocial stress. Children with ADHD often have short attention spans, act impulsively, and struggle to finish tasks in school. Treatment involves medication, behavior modification, and cognitive behavioral therapy to help patients develop coping strategies. Nurses play an important role in ensuring a safe environment and using positive reinforcement to support patients.
Hyperkinetic disorder, also known as Attention Deficit Hyperactivity Disorder (ADHD), is characterized by inattention and hyperactivity that is more frequent and severe than typical for a child's age. It has been linked to both genetic and environmental factors such as prenatal exposure, head injuries, and psychosocial stress. Children with ADHD often have short attention spans, act impulsively, and struggle to finish tasks in school. Treatment involves medication, behavior modification, and cognitive behavioral therapy to help patients develop coping strategies. Nurses play an important role in ensuring a safe environment and using positive reinforcement to support patients.
Hyperkinetic disorder, also known as Attention Deficit Hyperactivity Disorder (ADHD), is characterized by inattention and hyperactivity that is more frequent and severe than typical for a child's age. It has been linked to both genetic and environmental factors such as prenatal exposure, head injuries, and psychosocial stress. Children with ADHD often have short attention spans, act impulsively, and struggle to finish tasks in school. Treatment involves medication, behavior modification, and cognitive behavioral therapy to help patients develop coping strategies. Nurses play an important role in ensuring a safe environment and using positive reinforcement to support patients.
Hyperkinetic disorder, also known as Attention Deficit Hyperactivity Disorder (ADHD), is characterized by inattention and hyperactivity that is more frequent and severe than typical for a child's age. It has been linked to both genetic and environmental factors such as prenatal exposure, head injuries, and psychosocial stress. Children with ADHD often have short attention spans, act impulsively, and struggle to finish tasks in school. Treatment involves medication, behavior modification, and cognitive behavioral therapy to help patients develop coping strategies. Nurses play an important role in ensuring a safe environment and using positive reinforcement to support patients.
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HYPERKINETIC DISORDER
ATTENTION DIFICIT HYPERACTIVE
DISORDER(ADHD) Definitions • Hyperkinetic disorder (Attention-Deficit Hyperactivity Disorder or ADHD in DSMIV) is a persistent pattern of inattention and or hyperactivity more frequent and severe than is typical of children at a similar level of development. Etiology Biological influences Genetic factors Siblings of hyperactive children have about twice the risk of having the disorder as does the general population Biological parents of children with the disorder have a higher incidence of ADHD than do adoptive parent Biochemical theory o A deficit of dopamine and norepinephrine has been attributed in the overactivity seen in ADHD. o This deficit of neurotransmitters is believed to lower the threshold for stimuli input Pre, peri and postnatal factors Prenatal toxic exposure, prenatal mechanical insult to the fetal nervous system Prematurity, fetal distress, precipitated or prolonged labor, perinatal asphyxia and low Apgar scores Postnatal infections, CNS abnormalities resulting from trauma, etc Environmental influences Environmental lead Food additives, coloring preservatives and sugar have also been suggested as possible causes of hyperactive behavior but there is no definite evidence Psychosocial factors • Prolonged emotional deprivation
• Stressful psychic events
• Disruption of family equilibrium
Clinical Features
• Sensitive to stimuli, easily upset by
noise, light, temperature and other env’tal changes. • At times the reverse occurs and the chn are flaccid and limp, sleep more and the growth and dev’t is slow in the first month of life. More commonly active in crib, sleep little. General coordination deficit. Short attention span, easily distractible. Failure to finish tasks. Impulsivity. Memory and thinking deficits . Specific learning disabilities In school o Often fidgets with hands or feet or squirms in seat. o Answers only the first two questions ; often blurts out answers to questions before they ' have been completed. o Unable to wait to be called on in school and may respond before everyone else. o Has difficulty awaiting turn in games or group situations. o Often loses things necessary for tasks or activities at school. Home o Explosive or irritable. o Emotionally labile and easily set off to laughter or tears. o Mood is unpredictable. o Impulsiveness and an inability to delay gratification. o Often talks excessively. o Often engages in physically dangerous activities without considering possible consequences (for example, runs into street without looking).
Diagnosis o Detailed prenatal history and early developmental history. o Direct observation, teacher's school report (often the most reliable), parent's report. Treatment Pharmacotherapy CNS stimulants: Dextroamphetamine, methylphenidate, pemoline Tricyclic antidepressants Antipsychotics Serotonin specific re-uptake inhibitors Clonidine Psychological therapies
Behavior modification techniques
Cognitive behavior therapy
Social skills training
Nursing Intervention Develop a trusting relationship with the child. Convey acceptance of the child separate from the unacceptable behavior. Ensure that patient has a safe environment. • Remove harmful objects from immediate • Identify deliberate behaviors that put the child at risk for injury. • Institute consequences for repetition of this behavior • Provide supervision for potentially dangerous situations. Since there is non-compliance with task expectations, • provide an environment that is as free of distractions as possible. Ensure the child's attention by calling his name and establishing eye contact, before giving instructions.
Ask the patient to repeat instructions before
beginning a task.
Establish goals that allow patient to complete a part
of the task, rewarding each step completion with a break for physical activity.
Provide assistance on a one-to-one basis, beginning
with simple concrete instructions. Gradually decrease the amount of assistance given to task performance, while assuring the pt that assistance is still available if deemed necessary. Offer recognition of successful attempts and positive reinforcement for attempts made. - Give immediate positive feedback for acceptable behavior. Provide quiet environment, self-contained classrooms, and small group activities. -Avoid over stimulating places such as cinema halls, bus stops and other crowded places.
