In the visible Kiki (4) the same as any other normal child. But people who know him or frequent contact with him will feel how difficult it is to deal with these children. Kiki notorious bully their peers, they interfere with learning, running to and fro, or quarrel. However Dewi (32), mother Kiki did not feel worried about her son. He considers the activity of Kiki is still fairly reasonable.
Dewi believes, at the age of children is being actively exploring what was in the vicinity, and always wanted to try a lot of things, as long as Kiki would listen prohibition, injunction, and advice from parents, teachers, and others who are worthy of respect, Dewi did not have to worry about their children's behavior.
But what if the child turned out to be very difficult to manage. Prohibitions and commands of parents and teachers, only a powerful few minutes even seconds. The rest, he does not want to cooperate, did not want to be silent, and various other forms of obstinacy that already threaten "stability" class, home, or even a public place?
Child psychiatrist, Dr. Tjhin Wiguna, SpKJ (K), from the Division of Child and Adolescent Psychiatry, Department of Psychiatry Faculty of medicine / RSCM said, many parents do not feel worried if their children are as young as toddlers seem very active. Although sometimes exhausting and cause resentment, but that was the act of a healthy toddler. They were in full swing explore the surrounding neighborhood. Touching, holding, kissing, even eat anything that caught his attention, is a necessary part of the process that he went through in its life cycle.
But if the activity is already beyond the limits of reasonableness, and can not be controlled, need to be aware if the child suffers Hiperactive Attention Deficit Disorder (ADHD) or Attention Concentration and Hyperactivity Disorder (GPPH). Children with a tendency to excessive activity (hyperactivity) and difficulty concentrating it, typically beginning to look at the age of 2 years.
Although that trend can already be detected earlier, but many parents are still reasonably assume that his doings for others may seem unnatural.
ADHD or GPPH is a neurobehavioural disorder or physical disorder in the brain. "So it was not caused by misguided," said Tjhin. Manifestations, children with this GPPH unable to concentrate and very impulsive or frequently move suddenly.
In general, characteristics that can be seen in people with ADHD / GPPH is difficult to concentrate on an activity, and tend to keep moving. He was always moved from one activity to another, and can not finish the job, even the most simple, completely.
In general there are three GPPH symptoms are quite striking. First, attention deficit disorder (inattention) with less characteristic can be zeroed. So frequently make mistakes due to carelessness, it is difficult to accept the lesson, and attention began to be diverted.
The second is hyperactivity. Some characteristics of hyperactivity is difficult to sit still, always in a hurry, often moving his legs and arms, difficulty playing quietly, and excessive talking. The latter is the impulsivity (easily aroused). Character is difficult to wait their turn, answer questions before the question is finished posed, often interfere with a friend, and often interrupted the speech of others.
While its main symptom-based GPPH divided into dominant type hyperactivity or impulsivity, lack of attention dominant type, and mixed type between the two types. GPPH therapy can be done in several ways, namely pharmacological therapy or medication to control substances that exist in the brain, behavior therapy, education of patients and families, as well as combination therapy.
Brain cells are disrupted
Although no official figures for the study of children with GPPH, but in the world suffering figure range 3-10 per cent of the child population. While the Indonesian research in 2002 on a number of primary schools in central Jakarta, produces the magnitude that of 100 elementary school children there are 4 children who are likely to suffer GPPH. Speaking about the causes GPPH, despite much research done even since many years ago, but there is no research that says certain factors that cause a person can suffer GPPH.
But Tjhin ensure that genetic factors play a major role in GPPH. Pregnant mothers who consume drugs, cigarettes, and alcohol can also be a factor GPPH in the suffering of children in lahirkannya later. "In addition to pregnant women who experience difficulties during childbirth and premature birth can be a factor, the factor sehinggan not just one but many factors," said Tjhin.
GPPH sufferers often experience problems with executive function, namely the ability to design, expensive, and carry out an action. This is due to abnormalities in the structure of the front part of the brain of the patient. Therefore, if a child with GPPH have low academic achievement, in fact it is not because of the development of cognition that is problematic. Low academic achievement is due to their inability to concentrate in following the teaching and learning activities in the classroom.
Quoting an expert psychiatrist from the United States, Russell Barkley, Tjhin added, difficulty concentrating on GPPH afflictions due to dysfunction in the brain cells that are affected by the hormone dopamine, which serves as a neurotransmitter. Children with impaired GPPH transport between the dopamine transporter and dopamine receptors in the reception of dopamine in the brain cells.
"The brain is composed of many cells and tissues. Well, in children with this GPPH pump that regulates the balance of spending and withdrawal of dopamine is not properly distributed. Because of this disruption emotions become uncontrollable child, "said Tjhin.
Handling
According Tjhin, children with this GPPH treatable. However, because the cause itself has not been revealed with certainty, many methods of therapy is carried out to cope with GPPH. One of them is medication therapy or pharmacology. This therapy is done with the use of drugs as a control against the possibility of uncontrolled impulsive hyperactivity.
Because it is clear that children with impaired GPPH on its dopamine, Tjhin said types of drugs that are usually used for children with GPPH is methylphenidate. "Methylphenidate can cause changes in the structure of brain cells that make the child be quiet," said the doctor from the Hospital Pantai Indah Kapuk this. Research has shown that the administration of drugs with methylphenidate can improve executive function. This drug works to increase the synthesis and release of dopamine and neropinehrine. "Kids need to have a drug GPPH to help improve learning ability and behavior control," Advanced Tjhin. With the increasing executive function, children can concentrate, can control and control emotions.
But although children with this GPPH can be cured, but it does not mean any therapy is carried out solely with medication alone. Other therapies are also required accompanying medication therapy. Therapy is applied should be comprehensive and involve physicians, psychiatrists, parents, teachers, and the environment that is around. This therapy is aimed at reducing disruptive behavior, improve school performance and relationships with the environment, as well as independent both at home and at school.
Tjhin continued suffering of children with this GPPH can continue until the child is growing up. So if at first the child does not receive good treatment, then when he was a teenager is likely to experience delinquency, even depression, but not up to the level of suicide.
Responding to the Hyperactive
It is difficult to have a child with Impaired Concentration
Attention and / Hyperactivity (GPPH) this. But no need to blame others, yourself, the environment, or even the patient. Rumondang Month Siregar, owner Schools Special Needs Image Bakrie said the first thing parents should do is to accept the child GPPH fully the situation of children when he was sentenced to GPPH. If parents understand that their children so he can do the parenting of the child in accordance with the circumstances. But if the parents themselves difficult to accept it and continue to press the child, then it would be more difficult to orient.
"Although more focused on the elderly, but it's worth a big family and the environment is also very necessary for parents in dealing with children GPPH," said Rumondang. Besides, he added, parents also need to have 'alarms' to the development of their children. Alarm in question is aware of the growth and development of children his age. "For example, a child two years of age must be able to speak, but why can not my child? Or other children can see, why my child can not or perhaps even excessive? The alarm is only as a signal for parents, "he added.
When parents have been able to see the 'alarm', he can immediately consult a psychiatrist, a doctor, or a psychologist.
By monitoring the 'alarm' early parents will be able to help children to pursue GPPH delay. "Parents can make a normal child as a benchmark. So he can see what has not and should have done her child at that age, "said Rumondang.
Tjhin also added that although the child's brain cells GPPH disorder as has been mentioned, but the parents of the child should not be treated differently to other children, let alone insulting or abusing it. The important thing is parents should not be favors them. It is better in this case the parents make the rules that have been agreed with the child. Eg bath at 5 pm schedule, give him tolerance 15 minutes. Then tell him 'if you do not shower at 5:15 then you should not be watching television'. "So in this case the parents also impose penalties on the things he likes. But do not give physical penalties or things that he hates, it will be useless, "said Tjhin.
However, children with GPPH can still attend public school like any other normal child. Because of the problems in children GPPH is a function of self-control, emotion and behavior are not well developed so that when the drug was given early then its dopamine function will be improved. Parents also need to be patient and supportive therapies currently in live child. So, not a wise thing to alternate therapy before completion.
"Sometimes parents are impatient, and want to get instant results, but this GPPH child therapy takes a long time. If the therapy is great, parents can already see the changes in the first three months, for example, the child is able to talk, "he continued, but most importantly the involvement of a large family and teachers are also needed so that therapy can be more effective and efficient.
It would be better if parents also seek to gain support in "accompany" GPPH child. For example, join the community of parents with children with special needs. It is important to build the confidence of parents in educating children and get moral support.
What to do parents in children with ADHD:
As early as possible to familiarize their children to live in a rule. By applying the rules consistently, children can learn to control his emotions.
As early as possible provides trust and responsibility over what should be done son.
Identify yourself and psychological condition of children. By identifying, parents would not give excessive pressure, which can lead to rejection of the child to do what he should do.
Strive to provide a learning space away from distractions television, toys or noise.
As early as possible to monitor and evaluate on an ongoing basis, and consistent with the treatment that is being run by your child.
Familiarize children to express their emotions in the form of text or images.
Arrange the child's diet, avoid foods and beverages with sugar and high carbohydrate.
Invite your child to recreation beautiful places. This will help children to think positive.
Invite your child to practice calming yourself. For example by drawing a deep breath and remove it through the mouth. This exercise can be done repeatedly
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