ADHD 過度活躍症

Understanding Attention Deficit Hyperactivity Disorder (ADHD)

The term “hyperactive child” is widely used in society. In the minds of the general public, any child who cannot sit still, loves to run and jump around, and is constantly touching everything is labeled a hyperactive child. Because of this, parents often anxiously ask in clinical settings: Is my child really hyperactive?

Clinically, there is no official diagnosis called “hyperactive child.” The correct terminology is Attention Deficit Hyperactivity Disorder (ADHD). It is defined as a child exhibiting developmentally inappropriate levels of inattention, impulsivity, and hyperactivity relative to their intelligence and age. These children are usually identified before school age (under 7 years old).

The Three Core Dimensions of Diagnosis

1. Inattention (Poor Attention)

a. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

b. Often has difficulty sustaining attention in tasks or play activities.

c. Often does not seem to listen when spoken to directly.

d. Often does not follow through on instructions and fails to finish schoolwork, chores, or workplace duties (not due to oppositional behavior or failure to understand instructions).

e. Often has difficulty organizing tasks and activities.

f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).

g. Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils).

h. Is often easily distracted by extraneous stimuli.

i. Is often forgetful in daily activities.

2. Hyperactivity

a. Often fidgets with hands or feet or squirms in seat.

b. Often leaves seat in classroom or in other situations in which remaining seated is expected.

c. Often runs about or climbs excessively in situations where it is inappropriate.

d. Often has difficulty playing or engaging in leisure activities quietly.

e. Is often “on the go,” acting as if “driven by a motor.”

f. Often talks excessively.

3. Impulsivity

a. Often blurts out answers before questions have been completed.

b. Often has difficulty waiting their turn.

c. Often interrupts or intrudes on others (e.g., butts into conversations or games).

Causes of Hyperactivity

The definitive cause of hyperactivity and inattention in children has not yet been found. Generally, factors are divided into congenital (innate) and acquired:

• Congenital: Genetics, maternal medication use during pregnancy, or abnormalities at birth.
• Acquired: Sensory integration issues, brain injury, or psychological factors.

How Parents Can Identify the Problem

Parents can observe their child’s behavior across six different daily scenarios:

1. During Meals

a. Refuses to sit properly; often leaves the seat and runs around.

b. Disrupts family dining at will.

c. Cannot sit quietly; constantly shifts or moves their body.

d. Fidgets or plays with utensils.

e. Talks excessively.

2. Watching TV

a. Cannot sit and watch properly during a program; frequently runs around.

b. Cannot sit quietly; constantly moves their body.

c. Fidgets with their hands or other objects.

d. Talks excessively.

e. Constantly flips through channels or presses buttons on the remote control.

3. Doing Homework

a. Cannot stay seated; frequently gets up to walk around.

b. Cannot sit quietly; constantly shifts their body.

c. Cannot focus; plays with objects or their own body.

d. Talks excessively.

e. Requires continuous adult supervision.

4. During Play

a. Cannot settle down to play quiet games.

b. Cannot continuously play with the same toy or game.

c. Makes strange movements or odd noises.

d. Talks excessively.

e. Interrupts other people’s ongoing games or activities.

5. During Sleep

a. Difficult to soothe or get them to go to bed.

b. Sleep duration is too short.

c. Remains restless after falling asleep, tossing and turning.

6. Behavior Outside of School and Home

a. Restless during travel, keeping the family on edge.

b. Frequently touches or grabs things randomly while shopping.

c. Restless/noisy when watching movies.

d. Fidgety and restless when visiting relatives and friends.

Core Challenges & Impact

The primary difficulties for these children lie in communication obstacles, emotional disorders, and behavioral problems.

• Communication: Due to the child’s inattention, they cannot fully receive messages sent by others, making it difficult to engage in meaningful interactions.
• Emotions: These children lack patience and find it hard to control their emotional impulses, frequently leading to conflicts with others.

Reports indicate that these children may experience low academic achievement or learning disabilities, which can lead to social adaptation issues. Furthermore, if parents cannot treat the child with patience, it often causes parent-child conflicts, potentially leading to personality deviations and antisocial behavior.

Treatment and Therapy

In terms of treatment, occupational therapists will provide appropriate therapy based on the child’s specific condition. For example:

• Using gross motor activities to burn off excess physical energy.
• Utilizing calming sensory stimulation to soothe the child’s emotions.
• Progressing to activities that require focus—such as stacking blocks—to train the child to be more attentive.

If a child is overly hyperactive, inattentive, or cannot calm down through therapeutic techniques alone, they may require medication from a child psychiatrist or assistance from a physical therapist.

8 Guidelines for Parents at Home

Parents should pay close attention to the following points when interacting with their child at home:

1. Give clear instructions that are not too long.
2. Avoid using negative language (phrasings).
3. Speak clearly, calmly, and slowly to the child.
4. Maintain eye contact as much as possible when speaking with the child.
5. Praise more than you punish.
6. Simplify the environment where the child does activities or homework; keep it neat and clean to avoid unnecessary distractions.
7. Co-create a daily routine and house rules together with the child.
8. Provide regularly scheduled opportunities for the child to burn off energy.

Source: Taipei Tian-Yi United Clinic (http://www.scrc.com.tw/tene/showedu.asp?id=1094928640)