One of the most common diagnoses made by child psychiatrists in the preschool period is Attention Deficit Hyperactivity Disorder (ADHD). The prevalence of ADHD in preschool children is approximately 2-6%. 60-80% of children with ADHD before school continue to experience the same disorder in later periods. In this period, hyperactivity and impulsivity are most prevalent. Therefore, children diagnosed with ADHD in this age group are mostly male.
What is the Importance of Pre-School ADHD Diagnosis and Treatment?
Children with ADHD symptoms in the preschool period may experience failure in classes and social relations in the future. problems, behavioral problems and additional psychiatric disorders are more likely to occur. Therefore, early diagnosis and intervention of ADHD can improve the child's relationship with his family and peers, prevent labeling/stigma, and prevent the development of other mental problems (loss of self-confidence, anxiety, depression). Children with ADHD in this period may be removed from school or nursery due to their disruptive behavior. In this case, they are deprived of pre-school education, which is very important for children's spiritual, social and academic development. Even if they attend school, they experience losses in the academic, social and spiritual gains expected to be achieved at school due to ADHD symptoms.
What are the Symptoms of Pre-School ADHD?
Families often experience aggressive behavior and tantrums in the preschool period. People bring their children with ADHD to a child psychiatrist due to problems such as stubbornness, having problems with peers, and mobility. The most common ADHD symptoms in the preschool period are; inability to postpone one's wishes, getting bored of games quickly - frequent game changes, talking a lot, clumsiness, frequent accidents and injuries, difficulty in following rules, difficulty in completing activities that require attention, pushing and hitting other children, damaging objects, mobility, difficulty in waiting one's turn, in inappropriate places running-climbing, resistance to sleep.
How is ADHD diagnosed in preschool children?
The symptoms of ADHD are lack of attention, hyperactivity and impulsivity. Preschool child without ADHD The fact that these symptoms can be seen to a certain extent in children requires more caution when making a diagnosis in this age group. Therefore, during psychiatric evaluation, it is necessary to obtain information from as many different sources as possible (family, child, teacher, guidance service, even previous teacher). Detailed data is collected about the difficulties encountered in the process from the womb to the moment of application to us, the course of the symptoms of the disorder, and the family's efforts to solve it. During the psychiatric examination of the child, a good clinical observation is made to get an idea about the symptoms of ADHD, mutual conversation about home-school-friends-daily life issues, playing games and age-appropriate activities are performed to evaluate the cognitive status. It is evaluated whether ADHD symptoms are due to physical (such as thyroid disease, anemia) or another mental disorder (depression, anxiety, sleep disorder). When we suspect a physical disease, we may request the necessary medical examinations or be referred to the relevant specialist physician. There is no physical examination (such as blood test, EEG) required to diagnose ADHD.
When diagnosing ADHD, forms and scales are given that family members, caregivers and teachers must fill out. Through these forms and scales, it is aimed to reach different people's observations and thoughts about the child. In addition, the change in ADHD symptoms and response to treatment are evaluated by having the same forms and scales filled out again during follow-ups. If it will contribute to diagnosis, treatment and follow-up, psychological tests (providing information about intelligence-development-attention level) can be applied. There is no need to have a psychological test to diagnose ADHD.
The diagnosis of ADHD is made by evaluating the information received from the family and school, psychiatric examination findings, psychological test results, and data obtained from forms and scales related to ADHD. .
How is ADHD treated in preschool children?
Non-drug approaches are recommended as the first treatment option for preschool children diagnosed with ADHD. The family is given psychoeducation about ADHD symptoms and possible causes, treatment options, side effects and the course of the disorder. The family should be encouraged to communicate with the child in a healthy way, to encourage correct behavior, to Counseling is provided on issues such as coping with work, positive behavior and skill acquisition, academic coaching, and anger management. During the therapy process, behavioral treatment methods are applied to children for problem solving, anger-behavior control, coping with negative emotions and experiences, and establishing healthy communication. Since school is one of the areas where children with ADHD experience the most problems, the school is contacted, arrangements are made at school and in the classroom, the teacher and guidance service are informed, and cooperation is made on the appropriate approach and attitude.
In what cases is medication recommended for preschool children with ADHD?
If ADHD symptoms are moderate or severe, if behavioral treatment methods alone are not sufficient to solve the problem, if the child is injured or injures someone else, If there is a risk, if the patient has serious adaptation problems at school and in the environment of friends, if there is an attention problem that negatively affects language and cognitive development, if the parents have serious coping and control difficulties, the drug option is considered. Before starting drug treatment, it is necessary to give detailed information to the family. This information; It should include headings such as the reason for recommending the drug, which symptoms are targeted with the drug, the expected benefit, possible side effects related to the drug, what to do in case of side effects, and the duration of drug treatment.
As a result; Children diagnosed with ADHD before school have a high risk of experiencing academic, social and psychological problems in the future. Regular follow-up and treatment of these children by a child psychiatrist (with priority given to non-drug approaches) ensures that ADHD symptoms are controlled and possible losses are minimized.
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