Mechanisms of motor disinhibition and their specific types of corrective work

Adaptation disorders, manifested in the form motor disinhibition, according to experts, have a variety of reasons: organic, mental, social. However, most authors dealing with the problems of the so-called attention deficit hyperactivity disorder regard it mainly as a result of certain problems of an organic, neurological nature. Motor disinhibition as a disturbed behavior has many similarities with other types of deviant development, but at the moment there are criteria for distinguishing a group of disorders in which hyperactivity is the main problem.

Data on the prevalence of such behavioral disorders vary widely (from 2% to 20% in the pediatric population). It is well known that in girls such problems are 4-5 times less common than in boys.

Although the hypothesis of the identity of the hyperkinetic syndrome and minimal brain dysfunction is often criticized, the causes of the disease (or condition) are usually considered complications during the entire perinatal period, diseases of the nervous system during the first year of life, as well as injuries and diseases that occurred during the first three years. child's life. In the future, most children with similar behavioral problems are diagnosed with "mild brain dysfunction" or "minimal brain dysfunction" (Z. Trzhesoglava, 1986; T.N. Osipenko, 1996; A.O. Drobinskaya 1999; N.N. Zavadenko , 2000; B. R. Yaremenko, A. B. Yaremenko, 2002; I. P. Bryazgunov, E. V. Kasatikova, 2003).

For the first time, detailed clinical descriptions of functional brain failure appeared in the literature in the 30-40s of the last century. The concept of “minimal brain damage” was formulated, which began to denote “non-progressive residual conditions resulting from early local lesions of the central nervous system in the pathology of pregnancy and childbirth (pre- and perinatal), as well as craniocerebral injuries or neuroinfections. Later, the term “minimal brain dysfunction” became widespread, which began to be used “... in relation to a group of conditions that are different in their causes and mechanisms of development (etiology and pathogenesis), accompanied by behavioral disorders and learning difficulties not associated with severe intellectual development disorders” ( N.N. Zavadenko, 2000). Further comprehensive study of minimal brain dysfunctions showed that it is difficult to consider them as a single clinical form. In this regard, for the latest revision of the International Classification of Diseases ICD-10, diagnostic criteria have been developed for a number of conditions previously classified as minimal brain dysfunctions. With regard to the problems of motor disinhibition, these are the headings R90-R98: "Behavioral and emotional disorders of childhood and adolescence"; heading P90: "Hyperkinetic disorders" (Yu.V. Popov, V.D. Vid, 1997).

The positive effect of psychostimulants in the medical treatment of children with such disorders is explained by the hypothesis that children with hyperkinetic syndrome are “underexcited” in terms of brain activation, and therefore excite and stimulate themselves with their hyperactivity to compensate for this sensory deficiency. Lowe et al. found an insufficient activity of metabolic processes in the forebrain in children with signs of disinhibition.

In addition, the period from 4 to 10 years of age is considered the period of the so-called psychomotor response (V.V. Kovalev, 1995). It is in this age period that more mature subordinate relationships are established between the hierarchically subordinate structures of the motor analyzer. And violations of these, "... still unstable subordinate relations, are an important mechanism for the emergence of disorders of the psychomotor level of response" (cited by V.V. Kovalev, 1995).

Thus, if hyperexcitability, motor disinhibition, motor clumsiness, absent-mindedness, increased fatigue, infantilism, impulsivity predominate among children with signs of minimal brain dysfunctions at preschool age, then schoolchildren's difficulties in organizing their behavior and academic difficulties come to the fore.

However, as our research and counseling experience show, children with similar behavioral problems also have a variety of emotional and affective characteristics. Moreover, in children with behavioral problems of the type of motor disinhibition, as a rule, attributed by most authors to a single "hyperactivity syndrome", fundamentally different, opposite "in sign" features of the development of the affective sphere as a whole are often found.

The specifics of our study is that the problems of motor disinhibition were considered not only from the point of view of features and differences in the neurological status, but also affective status. And the analysis of the behavioral problems and characteristics of the child was based on identifying not only the causes, but also the psychological mechanisms underlying them.

In our opinion, the analysis of the affective status of children with behavioral problems according to the type of motor disinhibition can be carried out in terms of the model of basic affective regulation proposed in the school of K.S. Lebedinskaya - O.S. Nikolskaya (1990, 2000). In accordance with this model, the mechanisms of formation of the affective-emotional sphere of a child can be assessed by the degree of formation of the four levels of the basic affective regulation system (BAR levels), each of which can be in a state of increased sensitivity or increased endurance (hypo- or hyperfunctioning).

Working hypothesis was that motor disinhibition itself, so similar in its manifestation in most children, may have a different "nature". Moreover, the latter is determined not only by the problems of the neurological status, but also by the peculiarities of the tonic support of the child's life activity - the level of the child's mental activity and the parameters of his performance, that is, first of all, it depends on the specifics of the functioning of the levels of basic affective regulation.

Materials and methods of research

The analyzed group included 119 children aged 4.5-7.5 years, whose parents complained about motor and speech disinhibition, uncontrollability children, significantly complicating their adaptation in preschool and school educational institutions. Often, children came with pre-existing diagnoses, such as attention deficit hyperactivity disorder, hyperexcitability syndrome, and minimal brain dysfunction.

It should be noted that children whose symptoms of motor disinhibition were included in some more "general" psychological syndrome (total underdevelopment, distorted development, including Asperger's syndrome, etc.) were not included in the analyzed group.

In accordance with the objectives of the study, a diagnostic block of methods was developed, which included:

1. A detailed and specifically oriented psychological history taking, where the following were assessed:

features of early psychomotor development;

features of early emotional development, including the nature of interaction in the "mother-child" dyad (the main anxieties and anxieties of the mother regarding her interaction with the child in the first year of life were analyzed);

the presence of indirect signs of neurological distress.

2. Analysis of the features of the operational characteristics of the child's activities,

3. An assessment of the level of mental tone (for these purposes, together with Candidate of Medical Sciences O.Yu. Chirkova, a special thematic questionnaire for parents was developed and tested).

4. The study of the features of the formation of various levels of arbitrary regulation of activity:

simple movements;

motor programs;

arbitrary possession of mental functions;

keeping the activity algorithm;

voluntary regulation of emotional expression.

5. Study of the features of the development of various aspects of the cognitive sphere.

6. Analysis of the emotional and affective characteristics of the child. It should be emphasized that special attention was paid to assessing the general level of mental activity and mental tone of the child.

7. In addition, the type of assistance needed by the child when working with certain tasks was necessarily assessed. The following types of assistance were used:

stimulating;

help "toning" the child and his activities;

organizing assistance (i.e., building an activity algorithm “instead of” a child, programming this activity and controlling it by an adult).

Indicators of the level of the child's general mental activity, the pace of activity, and other performance parameters were correlated with the assessment of the child's emotional and affective characteristics. For this, an integral assessment of the bipolar disorder profile as a whole was carried out, and the states of individual levels of basic affective regulation were assessed according to O.S. Nikolskaya. In this case, it was assessed which of the BAR levels (1-4) is in a state of increased sensitivity or increased endurance (hypo- or hyperfunctioning).

Research results and discussion

In the course of the study, significant differences were revealed between the manifestations of the studied developmental features. These results made it possible to divide 119 examined children into three groups:

We assigned 70 children to the first group (20 girls, 50 boys);

the second group consisted of 36 children (respectively, 15 girls and 21 boys);

13 children made up the third group.

Specific for children, referred to by us as first group, there was a history of indirect or explicit (objectified in medical documents) signs of neurological distress, usually sufficiently expressed. In the early stages, this, first of all, was manifested in changes in muscle tone: muscle hypertonicity or muscle dystonia, uneven muscle tone, was noted much more often. Quite often, already in the early stages of development, the child was diagnosed with perinatal encephalopathy (PEP). Indirect signs of neurological trouble were manifested during this period by fountain regurgitation, sleep disturbances (sometimes inversion of the sleep-wake mode), piercing, "heart-rending" screams. The increased muscle tone of the lower extremities - sometimes even the inability to relax the muscles of the legs - led to the fact that, having risen to his feet early, the child stood "till you drop." Sometimes the child began to walk early, and walking itself was more like an uncontrollable run. Children, as a rule, did not take well any "solid" complementary foods (sometimes up to 3-3.5 years they hardly took solid food).

In the stories of mothers about their anxieties (in 62 out of 70 cases), the most common recollection was that the child was very difficult to calm down, he screamed a lot, was in his arms all the time, demanded motion sickness, the constant presence of his mother.

Specific for this developmental variant was the presence of a significant number of signs of neurological trouble in the anamnesis, a change (as a rule, acceleration and less often - a violation of the sequence) of early motor development. All this, according to the totality of signs, can be qualified as minimal brain dysfunctions, the result of which was the insufficient formation of the voluntary (regulatory) component of activity in general (N.Ya. Semago, M.M. Semago, 2000).

Thus, the motor disinhibition observed in children of the first group can in essence be considered "primary" and only intensifies in its manifestations when the child is tired.

Children second group demonstrated deficiency in the regulation of their own activity already at the most elementary levels - the level of performing simple motor tests according to the model (up to the age of 5.5 years) and the level of performing simple motor programs according to the model (for older children). It is quite obvious that hierarchically higher and later forming levels of behavior regulation as a whole turned out to be clearly deficient in children of this group.

The following features of development were specific for the children that we referred to the second group (36 cases).

In the picture of the early development of children, there were no signs of pronounced neurological distress, and in terms of timing and pace, early psychomotor and emotional development basically corresponded to the average normative indicators. However, somewhat more often than the average for the population, there was a change not in the timing, but in the very sequence of motor development. Doctors identified problems associated with minor disorders of autonomic regulation, minor eating disorders, and sleep. Children of this group were sick more often, including, more often than the average for the population, in the first year of life, there were dysbacteriosis, variants of allergic manifestations.

The mothers of most of these children (27 out of 36) recalled their anxiety about relationships with children in the first year of life as uncertainty about their actions. Often they did not know how to calm the child, how to feed or swaddle him properly. Some mothers recalled that they often fed the baby not in their arms, but in the crib, simply supporting the bottle. Mothers were afraid to spoil their children and did not accustom them to "handling". In some cases, such behavior was dictated by the grandparents, less often by the father of the child (“You can’t spoil, accustom to motion sickness, to hands”).

When examining the children of this group, first of all, a reduced background of mood and, most often, low indicators of general mental activity attracted attention. Children often needed encouragement and a kind of “toning” from an adult. It was this type of assistance that turned out to be the most effective for the child.

The formation of the regulatory sphere of these children (according to age) turned out to be sufficient. These children before fatigue(this is of fundamental importance) coped well with special tests for the level of regulatory maturity, kept the algorithm of activity. But the possibility of regulating emotional expression was most often insufficient. (Although it should be noted that before the age of 7-8 years, healthy children may show difficulties in emotion regulation even in expert situations).

Thus, in general, we can talk about a sufficient level of voluntary regulation of children belonging to the second group. At the same time, the level of voluntary regulation of the emotional state often turned out to be insufficiently formed, which shows a clear relationship between the formation of the regulation of emotions and emotional expression and the specifics of the formation of the actual affective regulation of behavior.

As for the features of the formation of level affective regulation, according to the results of an integral assessment of the child's behavior and the responses of parents, a distortion of the proportions of the system was usually observed, as a rule, due to hyperfunction of the 3rd level of affective regulation, and in rough cases - of the 2nd and 4th levels. .

From the point of view of the analysis of the affective status, one often had to talk about insufficient affective toning, already starting from the 2nd level of affective regulation (that is, its hypofunction) and, as a result, about a change in proportions in the toning of the 3rd and 4th levels.

In this case, especially when fatigue sets in, the affective toning necessary for solving behavioral problems can be compensatory manifested in an increase in the protective mechanisms of the 2nd level of affective regulation.

This kind of “tonization” is specific for the hypofunction of the second level of affective regulation (the level of affective stereotypes), and the “unjustified fearlessness” that appears in situations of fatigue and the game “with risk” characterize the features of the third level of affective regulation - the level of affective expansion.

Perhaps, precisely because in children with early childhood autism (3rd group RDA according to O.S. Nikolskaya) there is a “breakdown” of the entire system of affective regulation or a gross distortion of the interaction of this particular level, such children quite often, especially in early and preschool age, ADHD is erroneously diagnosed.

The emergence in children of stereotyped motor reactions, manifesting themselves as motor disinhibition, has in this case fundamentally different mental mechanisms.

Thus, for children of the second group, various manifestations of motor and speech disinhibition do not indicate hyperactivity, but a decrease in mental tone against the background of fatigue and a compensatory need for activation and “toning of various levels of affective regulation” through motor activity - jumping, stupid running around, even elements stereotypical movements.

That is, for this category of children, motor disinhibition is a compensatory reaction to mental exhaustion; motor excitation occurring in children of this group can be considered compensatory or reactive.

In the future, such behavioral problems lead to developmental deviation towards disharmony of the extrapunitive type (in accordance with our typology (2005) diagnosis code: A11 -x).

An analysis of the condition of children in the first and second groups allows us to conclude that there are significant differences between them in terms of parameters:

specifics of early psychomotor development;

subjective difficulties of mothers and the style of their interaction with the child;

level of mental tone and mental activity;

level of maturity of regulatory functions;

features of the development of the cognitive sphere (in most children by subgroups);

the type of assistance needed (organizing for children of the first group and stimulating for children of the second group).

According to the characteristics of the pace of activity, the following patterns were revealed:

in children of the first group, as a rule, the pace of activity was uneven or accelerated due to impulsivity;

in children of the second group, the pace of activity before the onset of fatigue might not have been slowed down, but after the onset of fatigue, it most often became uneven, slowed down or, less often, accelerated, which negatively affected the results of the child’s activity and criticality;

there were no significant differences between children in terms of working capacity - the latter was most often insufficient in children of both groups.

At the same time, a profile of basic affective regulation specific for each group of children was revealed:

increasing the endurance of individual levels (hyperfunction) for children of the first group;

increasing their sensitivity (hypofunction) for children of the second group.

Similar differences in the affective status of children in the first and second groups are considered by us as the leading mechanisms of the revealed behavioral features in both cases.

Such an understanding of the fundamentally different mechanisms of behavioral maladjustment makes it possible to develop specific, fundamentally different approaches and methods of psychological correction for the two discussed variants of behavioral problems.

Children referred to by us third group(13 people), demonstrated both signs of neurological distress and a fairly pronounced regulatory immaturity, as well as a low level of mental tone, uneven tempo characteristics of activity, problems of insufficient formation of the cognitive sphere. Apparently, the symptoms of motor disinhibition in these children were only one of the manifestations of the lack of formation of both the regulatory and cognitive link of mental functions - in our typology of deviant development (M.M. Semago, N.Ya. Semago, 2005), such a state is determined as "Partial misformation of mixed type", (diagnosis code: NZZ's). The fate of these children (6 people) indicators of the level of mental tone were unstable (which may also indicate the possible neurodynamic features of these children), and the integral assessment of the level of mental tone was difficult.

Further, based on an understanding of the psychological mechanisms underlying such types of deviant development, on the basis of the idea of ​​general and specific patterns of development, we substantiated the need for an adequate direction of corrective work with children of the categories under study, taking into account the understanding of the mechanisms of impaired adaptation.

Correctional work

The technologies of correctional and developmental work for children with problems in the formation of an arbitrary component of activity are described in our previous articles, which set out the principles and sequence of work on the formation of an arbitrary component of activity (N.Ya. Semago, M.M. Semago 2000, 2005).

Technologies of correctional and developmental work for children with a reduced level of mental tone are presented for the first time.

Since such behavioral problems, from our point of view, are due to a reduced level of mental tone and mental activity in general (increased sensitivity of the 1st and 2nd levels of basic affective regulation), signs of disinhibition in this case act as compensatory mechanisms, "toning" that increase the overall level of mental tone of the child. They can be considered as an increase in the protective mechanisms of the 2nd level of affective regulation. Consequently, correctional technologies in this case should be oriented, first of all, to the harmonization of the system of affective regulation. Speaking about the methodological foundations of building correctional programs, it is necessary to rely on the theory of K.S. Lebedinskaya -O.S. Nikolskaya (1990, 2000) on the structure and mechanisms of basic affective regulation (tonization) in normal and pathological conditions (4-level model of the structure of the affective sphere).

The proposed correctional and developmental approaches are based on two main principles: the principle of toning and “rhythmization” by the child’s environment (including through distant sensory systems: vision, hearing) and the actual methods aimed at increasing the level of mental toning, for example, the method of bodily -oriented therapy and related techniques adapted to work with children.

Depending on the degree of insufficiency of mental tone and the age of the child (the younger the child, the more importance is attached to contact, bodily methods that are more natural for the child), the volume of the necessary rhythmic organization of the environment and the actual tactile rhythmic influences that increase the tone of the child due to direct contact with him were developed. - bodily and tactile, leading, in turn, to an increase in the overall mental tone.

The distant methods of rhythmic organization of the environment included:

Establishment of a clear repeating with affective consolidation (pleasure) mode (rhythm) of the child's life. The very rhythm and events of the day should be experienced by the child together with the mother, giving pleasure to both.

Selection of adequate rhythmically organized musical and poetic works that are presented to the child in a situation before the onset of obvious fatigue, thereby preventing, to a certain extent, compensatory chaotic movements (aimed at autotonization of the child, but destructive in their behavioral manifestations). The same tasks were often solved in the family with the help of a child drawing to a particular melody. In this case, the toning mechanisms specific to the second level were connected to polymodal toning methods (movement rhythm, color changes, musical accompaniment). In the activities of specialists of educational institutions (PPMS centers), such work can be carried out as part of art therapy.

Actually, the system of tactile toning, accompanied by specific intonationally designed "chants" (like folklore refrains).

Playing simple folklore games and ball games that have a stereotypical, repetitive character.

The methods of distant toning include the methods of mental toning by the mechanisms of the first level of affective toning: the creation of sensory comfort and the search for the optimal intensity of certain influences, which fit well into such a type of psychotherapy as "landscape therapy", a specific organization of the "living" environment: comfort, safety , sensory comfort. This kind of "distant" toning can be carried out both by a specialist when working with children, and at home in the family when implementing the system of filial therapy.

If such methods are not enough to organize the correct behavior of the child and increase his mental tone, special methods of tactile toning are used directly for the tasks of normalizing behavior. These techniques, first of all, are taught by the mother of the child (the person replacing her). An appropriate technology for teaching the mother (filial therapy) and the corresponding sequence of the tonic methods of work themselves were developed. This correctional program was called "Increasing mental tone (PWP program)".

The system of work to increase the level of mental tone of the child was to be carried out by the mother daily, for 5-10 minutes, according to a certain scheme and in a certain sequence. The scheme of work included the obligatory consideration of the main laws of development (primarily cephalocaudal, proximodistal laws, the law of the main axis), following the principle of sufficiency of impact.

The toning techniques themselves were variants of stroking, patting, tapping of various frequencies and strengths (certainly pleasant for the child), performed first from the top of the head to the shoulders, then from the shoulders through the arms and from the chest to the tips of the legs. All these "touches" of the mother were necessarily accompanied by sentences and "conspiracies" corresponding to the rhythm of the touches. To solve these problems, the mothers were familiarized with a sufficient amount of folklore materials (chants, sentences, chants, etc.). It should be noted that the effect of this type of “conversational” communication with children (in a certain rhythm and intonation) is noted by psychologists and other specialists working with children with early childhood autism of the O.S. group. Nikolskaya.

Our observations have shown that for older children (7-8 years old) the actual tactile influences are not adequate either to age or to the patterns of mother-child dyadic relations. In this case, a fairly effective technology of work, in addition to the rhythmically organized and predictable life of the child, which makes it possible to increase his mental tone, is his inclusion in the so-called folklore group.

The inclusion of the mother in the work with the child also had a tactical task proper. As preliminary studies have shown (Semago N.Ya., 2004), it was the mothers of children with insufficient mental tone who turned out to be insolvent in their parental position in the first year of a child's life. Hence, one of our assumptions was that the low level of the mental tone of the child may be the result of, among other things, insufficient tactile, bodily, rhythmic maternal behavior proper. In this regard, it is precisely such full-fledged maternal behavior in early age child is one of the main factors in the formation of a harmonious system of affective regulation in children.

Another direction of our work to harmonize the affective sphere and increase the level of the mental tone of the child is a specially selected range of games (having a large volume of the motor component), with the help of which the child could also receive affective saturation and, thereby, increase his tonic mental resource. These included games that have a repetitive stereotypical character (from infantile games like “We drove, we went, into the hole boo”, “Ladushki”, etc. to a number of ritual folklore games and stereotypical ball games that have a high affective charge for the child ).

At the moment, monitoring of a number of children included in such correctional work continues. Work continues on the analysis of the criteria for the effectiveness of corrective work. Of the positive changes obtained as a result of this comprehensive program with children of different ages, the following can be distinguished:

in most cases, there is a significant decrease in the number of complaints about the motor disinhibition of children, both from the parents and from the specialists of the educational institutions in which they are;

the periods of active working capacity of the child, the overall productivity of his activity increase;

the relationship in the mother-child dyad, mutual understanding between mother and child is significantly improved;

as a result of involving mothers in work with their own child, most of them have acquired the ability to "read" and more sensitively assess the emotional and physical well-being of the child.

Emphasizing that classes on “toning” the mental sphere of the child in this case were combined with elements of psychotherapeutic work, it should be noted that no correctional program can be effective outside of such a context. But in this case, the work to increase the mental tone of the child was the main "backbone" element of correctional work.

References

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Zavadenko N.N., Petrukhin A.S., Solovyov, O.I. Minimal brain dysfunction in children. Cerebrolysin for minimal brain dysfunction. - M.: EBEVE, 1997.

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SDR, movement disorder syndrome, movement disorder syndrome, movement disorder syndrome in children

What is SDR?

Motor disinhibition syndrome (SDR) is a form of neuropsychiatric disorders in children, characterized by increased motor activity and excitability. They say about such children: "Hyper active children." Synonyms for SDR are movement disorder syndrome , movement disorder syndrome , motor activity syndrome , motor disinhibition syndrome, neonatal sdr, children sdr .motor disinhibition syndrome occurs in 20-35% of children. In most cases HAPPY BIRTHDAY is a consequence of the lung of the brain, especially in the prenatal period and during childbirth.

Syndrome of movement disorders, SDR, symptoms, signs, manifestations

What are the main symptoms, signs and manifestations of the syndrome of movement disorders, disorders, disinhibition? Manifested motor disinhibition syndrome (SDR) clumsiness, motor disinhibition, absent-mindedness, aggressiveness, distractibility, impulsiveness. Mildly expressed arrhythmic and uncoordinated choreiform character is often detected, especially during emotional stress and physical activity. Hyperkinesias are predominantly localized in the distal extremities, less pronounced in the proximal extremities, and usually do not lead to impaired self-care. Children are restless, too mobile, emotionally labile, often change activities. They are constantly on the move, everyone wants to see, touch. They react to the parents' comments with crying, shouting, refusing to fulfill their requirements. Their development in the first year is often accelerated, they start walking early, are very active, mobile, give the impression of being well developed mentally.

Bad study, poor academic performance? Is your child doing poorly in school? Restlessness? Violation of discipline?

However, in the first years of schooling, an average or low level of their mental development is revealed, sometimes a child does not study well at school, a gymnasium, a lyceum, it turns out deuces at school (a child is a double student, a double student, a triple student). Difficulties in study and conflict situations are frequent. Parents often ask the question: "How to improve school performance?" Insufficient concentration of attention, restlessness, frequent distractibility give them a reputation as violators of discipline. At the same time, children may have increased abilities for a certain type of activity, some love physical education (physical education). SDR is especially pronounced in preschool and early school age, with treatment at the Sarclinic, the symptoms disappear. Motor disinhibition and usually manifest at home. In a new environment, such children at first are often shy and timid, with peers.

SDR, movement disorders syndrome diagnostics

Movement Disorder Syndrome, Movement Disorder Syndrome, motor disinhibition syndrome, SDR characterized by a number of signs: neurological microorganism is noted in the form of asymmetry of cranial innervation, tendon-periosteal reflexes, i. Neurologist, pediatric neuropathologist reveals pathological pyramidal or extrapyramidal reflexes. According to the private medical practice of Sarclinic, electroencephalography (EEG) in 39.7% shows various changes, usually of a diffuse nature, characterized by a certain constancy. Sometimes interhemispheric asymmetry and local predominance of pathological activity are revealed.

SDR, movement disorders syndrome - treatment in Saratov

Sarclinic provides treatment of SDR, treatment of movement disorder syndrome in children, treatment of movement disorder syndrome in Saratov. Sarclinic successfully uses complex methods of treatment of motor disinhibition syndrome. The effectiveness of the complex treatment of SDR, which may include a variety of reflexotherapy, acupuncture, microacupuncture, moxatherapy, non-traditional and other methods, reaches 95% and depends on the severity of the pathology. Treatment of the syndrome of movement disorders is carried out on an outpatient basis and individually. All treatments are safe. The Sarclinic has been operating for many years, during which time hundreds of patients aged from 1 to 18 years have been cured of motor disinhibition syndrome. If you have a disinhibited, very active child, an overly active child, contact the Sarclinic, at the first consultation the doctor will examine the child and, if necessary, treat SDR. Sarclinic knows what to do, how to treat and cure SDR, motor disinhibition syndrome! Hyperactive children become calm and adequate.

Hyperactivity in children, treatment

Sarclinic conducts treatment of hyperactivity in children. Children's hyperactivity, hyperactivity syndrome in children, including those with attention deficit, attention deficit hyperactivity disorder are successfully treated. Correction of hyperactivity in children, infants, infants, toddlers, preschoolers, schoolchildren, adolescents, adults (men and women, boys and girls) must be carried out. Sarclinic has developed a hyperactivity correction program. As a result of the treatment of children, the symptoms of hyperactivity disappear completely. Sarclinic knows how to treat hyperactivity in children.

. There are contraindications. Specialist consultation is required.
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In the process of maturation, the child goes through certain stages, which gradually differentiate and become more complex. In an infant, the psyche is almost not developed, and he has a reaction to all influences in the form of vegetative and somatic symptoms (fever, vomiting, malnutrition, etc.). Growing up, the child reaches another stage of development - psychomotor, and all the adverse effects that occur at the age of 4 to 7 years can cause various disorders of the motor sphere, in the form of impaired coordination of movement (tics, stuttering), the child becomes either inhibited or disinhibited. At the onset of the third level of development, typical disorders disappear and movement disorders are no longer characteristic, because the age stage has passed. What are the causes of excessive fussiness? There are a lot of them, starting from the perinatal age (mother's pregnancy, birth trauma, various infectious diseases, head bruises at an early age, etc.). As soon as the child has reached the psychomotor level of development, he begins to have excessive motor activity.

The causes of disinhibition act on the reticular formation, this is a specific part of the brain that is responsible for motor activity and the expression of emotions, for human energy, activates the cerebral cortex and other structures. The child becomes motorally disinhibited when the reticular formation is in an excited state. Motor disinhibition is of varying degrees, it depends on the violations of the nearby parts of the brain and on the degree of damage to the reticular formation itself. It combines in different ways with other deviations: for example, with mental immaturity, when a ten-year-old child behaves like a six-year-old. Such children are lagging behind in their emotional and volitional development and they are dominated by reactions of a younger age - harmonic infantilism. They are overly mobile, restless, constantly fussing, careless, superficial in their affections, cheerful. Any games and activities they will soon get bored. Classes at school are difficult for them, since they need to concentrate, but on the contrary, they want to run, jump, play. In rare cases, it is necessary to resort to medication, harmonic infantilism gradually disappears on its own, but this requires the help of teachers and parents. Harmonic infantilism is basically a pedagogical problem. Teachers and parents should form in children the desire for independence, a sense of responsibility, discipline, they should have constant control over the children. These kids shouldn't be punished. It is necessary that they themselves learn to repent for their behavior. To do this, it is imperative to praise, encourage children for good behavior, and deprive them of rewards for bad behavior, show their resentment towards them, ignore their countless whims. This is a very long and painstaking work that requires endurance and patience.

Disharmonious infantilism is a medical and pedagogical problem. Here, in addition to the symptoms characteristic of harmonic infantilism, there is excitability, instability, a tendency to deceive, which is accompanied by motor disinhibition.

Motor disinhibition is combined with cerebrovascular syndrome and infantilism. In combination with cerebrosthenic syndrome, children quickly become exhausted, tired, and become less enduring. This is accompanied by headaches, vomiting, decreased memory and attention, dizziness, bad mood. Such children quickly get tired of a small load, from various activities and from the hustle and bustle. They become lethargic, irritable, need rest. This is manifested by the promotion of motor disinhibition and increased exhaustion. Others, on the contrary, become fussy, restless, disinhibited, who are difficult to calm down and put to bed for rest. In combination with motor disinhibition with cerebration and infantilism, its treatment is very long and difficult.

Psychopathic syndrome occurs when the frontal lobes of the brain are bruised. Children become foolish, fussy, careless, do not respond to comments, laugh, look stupid, some have to be transferred to individual education, as they can create a danger to other children, bring disorganization.

There are cases when a psychopathic syndrome is combined with motor disinhibition and a violation of drives. In such cases, children run away from home, steal, drink alcohol, smoke, lead an antisocial lifestyle, become insensitive. This is where medication is needed. Parents and teachers should form submission to discipline, the ability to repent. Responsibility is required on the part of parents, teachers and doctors. The work should be joint, in close cooperation.

Motor disinhibition is a very prominent and noticeable symptom, violations of which can be quickly and completely cured. The main thing is to educate the child in patience, perseverance and discipline, as well as to patiently heal.

Children's hyperactivity is a condition in which the activity and excitability of the child significantly exceeds the norm. This causes a lot of trouble for parents, caregivers and teachers. Yes, and the child himself suffers from emerging difficulties in communicating with peers and adults, which is fraught with the formation of negative psychological characteristics of the individual in the future.

How to identify and treat hyperactivity, which specialists should be contacted for diagnosis, how to build communication with a child? All this is necessary to know in order to raise a healthy baby.

It is a neurological-behavioral disorder often referred to in the medical literature as hyperactive child syndrome.

It is characterized by the following violations:

• impulsive behavior;
• significantly increased speech and motor activity;
• attention deficit.

The disease leads to poor relationships with parents, peers, poor school performance. According to statistics, this disorder occurs in 4% of schoolchildren, in boys it is diagnosed 5-6 times more often.

The difference between hyperactivity and activity

Hyperactivity syndrome differs from the active state in that the behavior of the baby creates problems for parents, others and himself.

It is necessary to contact a pediatrician, neurologist or child psychologist in the following cases: motor disinhibition and lack of attention appear constantly, behavior makes it difficult to communicate with people, school performance is poor. You also need to consult a doctor if the child shows aggressiveness towards others.

The reasons

The causes of hyperactivity can be different:

• premature or;
• intrauterine infections;
• the influence of harmful factors at work during a woman's pregnancy;
• bad ecology;
• and physical overload of a woman during the period of gestation;
• hereditary predisposition;
• unbalanced diet during pregnancy;
• immaturity of the central nervous system of the newborn;
• metabolic disorders of dopamine and other neurotransmitters in the infant's central nervous system;
• excessive demands on the child of parents and teachers;
• disorders of purine metabolism in the baby.

Provoking factors

This condition can be provoked by the use of drugs during pregnancy without the consent of the doctor. Possible exposure, drugs, smoking during the period of gestation.

Conflict relations in the family, family violence can contribute to the appearance of hyperactivity. Poor academic performance, due to which the child is subjected to criticism from teachers and punishment from parents, is another predisposing factor.

Symptoms

Signs of hyperactivity are similar at any age:

• anxiety;
• restlessness;
• irritability and tearfulness;
• bad sleep;
• stubbornness;
• inattention;
• impulsiveness.

In newborns

Hyperactivity in children under one year old - infants is indicated by anxiety and increased motor activity in the crib, the brightest toys cause them a short interest. On examination, these children often reveal dysembryogenesis stigmas, including epicanthal folds, abnormal structure of the auricles and their low position, gothic palate, cleft lip, and cleft palate.

In children aged 2-3 years

Most often, parents begin to notice manifestations of this condition from the age of 2 or from an even earlier age. The child is characterized by increased capriciousness.

Already at the age of 2, mom and dad see that it is difficult to interest the baby in something, he is distracted from the game, spins in a chair, is in constant motion. Usually such a child is very restless, noisy, but sometimes a 2-year-old baby surprises with his silence, lack of desire to make contact with parents or peers.

Child psychologists believe that sometimes such behavior precedes the appearance of motor and speech disinhibition. At two years old, parents can observe signs of aggression in the baby and unwillingness to obey adults, ignoring their requests and demands.

From the age of 3, manifestations of egoistic traits become noticeable. The child seeks to dominate his peers in collective games, provokes conflict situations, interferes with everyone.

Preschoolers

Hyperactivity of a preschooler is often manifested by impulsive behavior. Such children interfere in the conversations and affairs of adults, do not know how to play collective games. Especially painful for parents are the tantrums and whims of a 5-6-year-old baby in crowded places, his violent expression of emotions in the most inappropriate environment.

In children of preschool age, restlessness is clearly manifested, they do not pay attention to the comments made, interrupt, shout over their peers. It is completely useless to reprimand and scold a 5-6-year-old baby for hyperactivity, he simply ignores information and does not learn the rules of behavior well. Any occupation captivates him for a short time, he is easily distracted.

Varieties

Behavioral disorder, which often has a neurological background, can proceed in different ways.

Attention deficit disorder without hyperactivity

This behavior is characterized by the following:

• listened to the task, but could not repeat it, immediately forgetting the meaning of what was said;
• cannot concentrate and complete the assignment, although he understands what his task is;
• does not listen to the interlocutor;
• does not respond to comments.

Hyperactivity without Attention Deficit

This disorder is characterized by such signs: fussiness, verbosity, increased motor activity, the desire to be in the center of events. It is also characterized by frivolity of behavior, a tendency to take risks and adventures, which often creates life-threatening situations.

Hyperactivity with Attention Deficit Disorder

It is abbreviated in the medical literature as ADHD. We can talk about such a syndrome if the child has the following behavioral features:

• cannot concentrate on a specific task;
• abandons the work he has begun without finishing it to the end;
• attention is selective, unstable;
• negligence, inattention in everything;
• does not pay attention to the addressed speech, ignores offers of help in completing the task, if it causes difficulties for him.

Violation of attention and hyperactivity at any age make it difficult to organize their work, accurately and correctly complete the task, without being distracted by external interference. In everyday life, hyperactivity and attention deficit lead to forgetfulness, frequent loss of their belongings.

Attention disorders with hyperactivity are fraught with difficulties in following even the simplest instructions. Such children are often in a hurry, commit rash acts that can harm themselves or others.

Possible consequences

At any age, this behavioral disorder interferes with social contacts. Due to hyperactivity in preschool children attending kindergarten, it is difficult to participate in collective games with peers, communicate with them and educators. Therefore, visiting the kindergarten becomes a daily psychotrauma, which can adversely affect the further development of the individual.

Schoolchildren suffer from academic performance, attending school causes only negative emotions. The desire to learn, to learn new things disappears, teachers and classmates are annoying, contact with them has only a negative connotation. The child withdraws into himself or becomes aggressive.

The impulsive behavior of a child sometimes poses a threat to his health. This is especially true for children who break toys, conflict, fight with other children and adults.

If you do not seek help from a specialist, a person with age can develop a psychopathic personality type. Hyperactivity in adults usually begins in childhood. One in five children with this disorder continue to have symptoms into adulthood.

Often there are such features of the manifestation of hyperactivity:

• tendency to aggression towards others (including parents);
• suicidal tendencies;
• inability to participate in a dialogue, to make a constructive joint decision;
• lack of skills in planning and organizing their own work;
• forgetfulness, frequent loss of necessary things;
• refusal to solve problems that require mental stress;
• fussiness, verbosity, irritability;
• fatigue, tearfulness.

Diagnostics

Violation of attention and hyperactivity of the baby become noticeable to parents from an early age, but the diagnosis is made by a neurologist or psychologist. Usually, hyperactivity in a child of 3 years, if it occurs, is no longer in doubt.

Diagnosis of hyperactivity is a multi-step process. Anamnesis data are collected and analyzed (the course of pregnancy, childbirth, the dynamics of physical and psychomotor development, diseases suffered by the child). The opinion of the parents themselves about the development of the baby, the assessment of his behavior at 2 years old, at 5 years old is important to the specialist.

The doctor needs to find out how the adaptation to kindergarten went. During the reception, parents should not pull the child, make comments to him. It is important for the doctor to see his natural behavior. If the baby has reached the age of 5, a child psychologist will conduct tests to determine mindfulness.

The final diagnosis is made by a neuropathologist and a child psychologist after receiving the results of electroencephalography and MRI of the brain. These examinations are necessary to exclude neurological diseases, the consequence of which may be impaired attention and hyperactivity.

Laboratory methods are also important:

• determination of the presence of lead in the blood to exclude intoxication;
• biochemical blood test for thyroid hormones;
• complete blood count to rule out anemia.

Special methods can be used: consultations of an ophthalmologist and audiologist, psychological testing.

Treatment

If the diagnosis of "hyperactivity" is made, complex therapy is necessary. It includes medical and pedagogical activities.

Educational work

Specialists in child neurology and psychology will explain to parents how to deal with hyperactivity in their child. Educators also need to have relevant knowledge. kindergarten and teachers in schools. They should teach parents the right behavior with the child, help overcome difficulties in communicating with him. Specialists will help the student to master the techniques of relaxation and self-control.

Change of conditions

It is necessary to praise and encourage the baby for any successes and good deeds. Emphasize the positive qualities of character, support any positive undertakings. You can keep a diary with your child, where to record all his achievements. In a calm and friendly tone, talk about the rules of behavior and communication with others.

Already from the age of 2, the baby should get used to the daily routine, sleep, eat and play at a certain time.

From the age of 5, it is desirable that he has his own living space: a separate room or a corner fenced off from the common room. There should be a calm atmosphere in the house, quarrels of parents and scandals are unacceptable. It is advisable to transfer the student to a class with a smaller number of students.

To reduce hyperactivity at 2-3 years old, children need a sports corner (Swedish wall, children's bars, rings, rope). Physical exercise and games will help relieve stress and expend energy.

What not to do for parents:

• constantly pull and scold, especially in front of strangers;
• humiliate the baby with derisive or rude remarks;
• constantly speak strictly with the child, give instructions in an orderly tone;
• prohibit something without explaining to the child the motive for his decision;
• give too difficult tasks;
• demand exemplary behavior and only excellent grades at school;
• perform household chores that were assigned to the child, if he did not complete them;
• accustom to the idea that the main task is not to change behavior, but to receive a reward for obedience;
• apply methods of physical influence in case of disobedience.

Medical therapy

Drug treatment of hyperactivity syndrome in children plays only an auxiliary role. It is prescribed in the absence of the effect of behavioral therapy and special education.

To eliminate the symptoms of ADHD, the drug Atomoxetine is used, but its use is possible only as directed by a doctor, there are undesirable effects. Results appear after about 4 months of regular use.

If the baby is diagnosed with such a diagnosis, psychostimulants can also be prescribed to him. They are used in the morning. In severe cases, tricyclic antidepressants are used under medical supervision.

Games with hyperactive children

Even with board and quiet games, the hyperactivity of a 5-year-old child is noticeable. He constantly attracts the attention of adults with erratic and aimless body movements. Parents need to spend more time with the baby, communicate with him. Playing together is very helpful.

Effectively alternating calm board games - lotto, picking up puzzles, checkers, with outdoor games - badminton, football. Summer provides many opportunities to help a child with hyperactivity.

During this period, you need to strive to provide the baby with a country holiday, long hikes, and teach swimming. During walks, talk more with the child, tell him about plants, birds, natural phenomena.

Food

Parents need to make adjustments to their diet. The diagnosis made by specialists implies the need to observe the time of eating. The diet should be balanced, the amount of proteins, fats and carbohydrates should correspond to the age norm.

It is advisable to exclude fried, spicy and smoked foods, carbonated drinks. Eat less sweets, especially chocolate, increase the amount of fruits and vegetables consumed.

Hyperactivity at school age

Increased hyperactivity in school-age children makes parents seek medical help. After all, the school makes completely different demands on the growing person than preschool institutions. He must memorize a lot, gain new knowledge, solve complex problems. The child requires attention, perseverance, the ability to concentrate.

Problems with study

Attention deficits and hyperactivity are noticed by teachers. The child in the lesson is dispersed, motor active, does not respond to comments, interferes with the lesson. The hyperactivity of younger schoolchildren at the age of 6-7 leads to the fact that children do not master the material well, carelessly do their homework. Therefore, they constantly receive comments for poor academic performance and bad behavior.

Teaching children with hyperactivity is often a major challenge. A real struggle begins between such a child and the teacher, as the student does not want to fulfill the requirements of the teacher, and the teacher fights for discipline in the classroom.

Problems with classmates

Adaptation in the children's team is difficult, it is difficult to find a common language with peers. The student begins to withdraw into himself, becomes secretive. In collective games or discussions, he stubbornly defends his point of view, without listening to the opinions of others. At the same time, he often behaves rudely, aggressively, especially if they do not agree with his opinion.

Correction of hyperactivity is necessary for the successful adaptation of the baby in the children's team, good learning and further socialization. It is important to examine the baby at an early age and conduct timely professional treatment. But in any case, parents should be aware that most of all the child needs understanding and support.

Answers

Among psychomotor disorders psychomotor disinhibition syndrome occupies a large place in young children. Most often it is observed with early organic brain damage. The nature and degree of its severity may be different. Children are disinhibited, constantly on the move, breaking objects, tearing, scratching everything that comes to hand. With fatigue and before sleep, restlessness usually increases. Psychomotor disinhibition of organic origin is often accompanied by a tendency to rhythmic stereotypes. In some children, against the background of psychomotor disinhibition, the poverty of spontaneous activity prevails, in others - a constant need for changes in actions.

Psychomotor disinhibition usually combined with frequent mood swings towards irritable-gloomy, with increased affective excitability. Newly increased distractibility, sleep disturbance, and a number of pathological habits are also noted. Children long and persistently bite their nails, suck their fingers; sometimes there are pathological inclinations (elements of sadism, masturbation, etc.).

Peculiar psychomotor agitation syndrome It can also manifest itself in mental illness in children, in particular in schizophrenia. Psychomotor agitation in schizophrenia is called catatonic. This is an empty, ridiculous, unmotivated motor excitation, which is accompanied by pretentious stereotypical hand movements, incoherent speech, negative reactions, echolalia (echo-like repetition of heard words), echopraxia (echo-like repetition of visible movements). A child in a state of such excitement usually does not react to the environment, performs a number of impulsive actions. Schizophrenia is characterized by a change in such excitation by more or less prolonged episodes of freezing, stupor.

State of psychomotor agitation may be the equivalent of a seizure. In these cases, psychomotor agitation occurs suddenly, paroxysmal, against the background of depressed consciousness, sometimes accompanied by individual muscle twitches. After the attack, the child does not remember what happened. In some cases, for example, in deep cerebrasthenic conditions, there is a syndrome of motor inhibition.

Perceptual disorders- Violation of sensations and perception. Many symptoms and syndromes of neuropsychiatric diseases in children are associated with impaired perception. Perceptual disorders can be observed in children with early organic brain damage. They are especially pronounced in cerebral palsy, which are characterized by specific sensory disorders (visual, auditory, kinesthetic), as well as a violation of the joint activity of various analyzers. This, in turn, leads to the underdevelopment of gnostic functions, in particular, optical-spatial gnosis. Young children with cerebral palsy have difficulty distinguishing the shape, size of objects, their spatial arrangement. In the future, more clear spatio-temporal disturbances may be detected.

Perceptual disturbances are also characteristic of children with mental retardation, while the severity of impairments corresponds to the degree of intellectual decline.
Symptoms of Perceptual Disorders in young children, they can manifest themselves in the occurrence of false perception (illusions and hallucinations).