Attention Deficit and Hyperactive(ADHD) Conduct and Autism Disorder

Attention Deficit and Hyperactive Disorder (ADHD)

Attention Deficit and Hyperactive Disorder is commonly associated with mental retardation. The cardinal features of the disorder are 

   Extreme persistent restlessness

2.     Sustained and prolonged motor activity and difficulty in maintaining attention

3.     Children with this disorder are often impulsive, restless and prone for accidents.

4.     Others are learning difficulties, which result in part from poor attention and lack of persistence with tasks.

5.     Mood fluctuates but low self-esteem and depressive mood are common.

6.     Restlessness over activity and related symptoms often start before school age.

7.     Sometimes the child may be over active as a baby, but more often significant problems begin, when the child begins to walk

8.     He or she is consistently on the move inferring with objects and exhausting his or her parents with over activity. This will usually gradually reduce, as the child grows older, especially when it is mild and not present in every situation.

It usually ceases by puberty. Remedial teaching and behaviour modification may help to reduce the inadvertent over activity. It is best to reserve drug treatment for severe cases, which have not responded to other treatment. The common drugs used are stimulants and antipsychotics.

Conduct disorder:

The essential feature of conduct disorder is persistent abnormal conduct, which is more serious than ordinarily childhood mischief. In the preschool period, the disorder usually manifests as aggressive behaviour in the home often with over activity. In later childhood it usually first begins in the home as stealing, lying and disobedience together with verbal or physical aggression.

Later the disturbances often become evident as truanting, delinquency reckless behaviour or alcohol or drug abuse. Mild conduct disorders often subside without treatment. For severity, treatment is mainly directed to the family. It usually takes the form of social casework or family therapy.

Autism or other pervasive development disorders:

The term pervasive developmental disorder refers to a group of disorders characterised by abnormalities in communication, social interaction and restricted repetitive activities and interest. Autistic children do not respond to their parent' s affectionate behaviour by smiling, cuddling.

There is little difference in their behaviour towards people and inanimate objects. The characteristic signs are gaze avoidance that is the absence of eye-to-eye contact, sameness, not in touch with reality. The ratio of male and female are 1 : 4.

Speech may develop later or never appear. If it develops serious impairments usually remain such as the misuse of pronouns, inappropriate use of words spoken by others. (echolalia).

Obsessive desire for it, which means resisting change in the routine. Repetitive and sustained odd play is noted. Sound making or spinning toys often fascinates them. Bizarre behaviour and mannerisms are common. Some autistics may engage in odd motor behaviour such as whirling round and round clapping their hands or socking.

Treatment:

Management of the abnormal behaviour is through social and educational services by the nurse. Behavioural methods, special schooling family parental training, group therapy are found useful.