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ADHD (attention deficit hyperactivity disorder) je poremećaj pozornosti s hiperaktivnošću. Radi se o vrlo čestom poremećaju koji se javlja u ranim godinama, a traje kroz razdoblje adolescencije i, vrlo rijetko, odrasle životne dobi.
Da bi se djetetu dijagnosticirao ADHD poremećaj, simptomi moraju biti prisutni najmanje šest mjeseci i izraženiji nego u djece iste dobi. Dr. Vlatka Novak pobliže je objasnila simptome ADHD sindroma. Što se tiče deficita pažnje, započinje dr. Novak, djeca nisu u stanju posvetiti dovoljno pažnje nekim detaljima, mogu raditi pogreške u domaćim i školskim zadaćama jer nisu dovoljno koncentrirana, mogu biti neuredna, brzopleta i teško im je ustrajati do kraja u obavljanju nekog zadataka. Često mijenjaju jednu nedovršenu aktivnost drugom, imaju teškoća s organiziranjem zadaća i aktivnosti, a zadaće koje zahtijevaju mentalni napor doživljavaju kao neugodne i nastoje ih izbjegavati.
– Zbog hiperaktivnosti djeca ne mogu biti na miru, vrpolje se na sjedalu. Uvijek izgledaju kao da su u ubrzanom filmu i ili u velikoj brzini. Imaju teškoća u grupnim sjedilačkim aktivnostima, a školska djeca imaju teškoća sa sjedenjem u školi cijeli sat. Često ustaju, ili se ljuljaju i tresu nogama, rukama, pretjerano pričaju, rade buku i prilikom nekih tihih aktivnosti, nestrpljivi su, upadaju drugima u riječ i ne mogu saslušati neku priču do kraja. Oko 30 posto djece s ADHD-om ima teškoće u postizanju školskog uspjeha – priča dr. Novak. Problem je, kaže, što takva djeca često teško nalaze prijatelje u školi, zbog hiperaktivnosti budu etiketirana i stigmatizirana, te se u njima onda generira revolt i ljutnja iz čega može proizići nasilničko ponašanje. Istovremeno, pojašnjava dr. Novak, takva djeca mogu biti vrlo kreativna, inventivna, nalaziti rješenja za neke probleme koja druga djeca ne vide.

PROBLEMI S DIJAGNOZOM

ADHD poremećaj nije lako dijagnosticirati.
– Da bi se postavila dijagnoza ADHD sindroma, smetnje moraju biti upadljive, biti prisutne u kući i u školi ili u društvu, i u znatnoj mjeri narušavati socijalno i školsko funkcioniranje te trajati najmanje šest mjeseci. Treba dobiti uvid u situaciju u obitelji i psihologijskim testiranjima utvrditi radi li se o mentalnoj retardaciji. Također, treba razlučiti radi li se samo o prkosnom djetetu koje hiperaktivnošću i nedostatkom pažnje reagira na nepovoljne obiteljske ili školske okolnosti. Nažalost, nemamo podatke o tome koliko djece ima ADHD jer ne vodimo statističke evidencije. Osim toga, neku djecu roditelji vode psiholozima ili neuropedijatru, a ne samo psihijatru. Neku djecu nikad ni ne dovedu po pomoć. Ovaj sindrom se javlja u tri do pet posto djece školske dobi, obično tri puta više kod dječaka. Obično se poremećaj prvi put dijagnosticira kad dijete krene u školu, jer je ugrožena njegova prilagodba u školi – zaključila je dr. Novak.
Za sve poremećaje koji se javljaju u dječjoj dobi, pa tako i za ADHD sindrom, najvažnija je uloga roditelja u tretmanu poremećaja, kaže dr. Novak.
– Stručne osobe s djecom su kratko vrijeme, a roditelji su s njima 24 sata. Treba educirati roditelje i dati im upute da vikom, galamom, kažnjavanjem i prijekorima neće postići ništa. Roditelji se trebaju naoružati strpljenjem, naučiti tolerirati hiperkinetsko ponašanje, djetetu davati kratke, jezgrovite i jednostavne upute umjesto kompliciranih. Upute trebaju biti samo za kratki period, a ne dugoročne. Treba slijediti neke rutinske svakodnevne obrasce ponašanja, na način da se svari uvijek drže na istom mjestu i da se radnje uvijek obavljaju u isto vrijeme. Ako dijete uči ili piše zadaću, treba maknuti sve potencijalne predmete koji bi mu odvukli pažnju: ugasiti televizor, radio i računalo, maknuti igračke i slično. Također, treba biti određeno i vrijeme za zabavu i igru. Komunikacija s djecom s ADHD sindromom mora biti jasna, nagrade i kazne također. Sa stručnog stajališta, bihevioralne psihoterapijske tehnike koje rade na principu usvajanja novih obrazaca ponašanja i mijenjanja starih imaju dobar učinak – priča dr. Vlatka Novak.

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