Imagine that you are invited to spend a whole morning in a class of three or four year olds.
I am sure that no one will be surprised to see minors on the move, restless, with emotions on the surface and not focused on the task that their teacher has ordered them to do.
No one will be surprised to see this behavior in the little ones.
What's more, perhaps they would be more surprised to see them still, silent and concentrated like an adult studying for some oppositions.
Now that would be weird and probably a clear indication that something is wrong... because they are children.
There are many characteristics that can define students in Early Childhood Education: motor restlessness, difficulty paying attention, impulsiveness, difficulties managing their emotions and impulses, conflicts with their peers... Wow!
What a coincidence!
If these characteristics coincide with the most common symptoms of a disorder known as ADHD -attention deficit hyperactivity disorder-.
Sure, but they are also typical of a fundamental stage of life called childhood.
So how can you tell if it is normal or a disorder?
More information
Keys to avoid diagnosing false positives for ADHD
Better to start at the beginning.
ADHD is one of the most diagnosed pathologies in childhood and adolescence.
Around 5-7% of the child and adolescent population have it.
As already mentioned, ADHD is characterized by a difficulty paying attention, impulsivity and hyperactivity.
These are the nuclear symptoms —the main ones—, but there are other secondary ones that should not be lost sight of: difficulties in managing your emotions and controlling your impulses, low tolerance for frustration, little patience, need for external reinforcement... In addition, it is very difficult for them to organize themselves, they tend to have conflicts with their peers, they do not like to abide by rules and respect limits, and they have little perseverance.
Many mothers and fathers tell me in consultation: “My son can spend hours concentrating on a task that he likes and motivates him;
Now, if it is a demotivating task, it is very difficult for him to attend ”.
This is very common in younger children, since attractive tasks capture their attention, being able to spend hours on said activity with great performance.
On the other hand, when the task is monotonous and boring, their focus of attention can last a few seconds.
I repeat that this is normative in all children.
In adults, things are quite different.
Adults have the ability, thanks to their already developed brain, to face tasks that they don't like, but that they have to do.
They know that in this life you can't always do what you want, but sometimes you have to do demotivating, monotonous and boring things.
They just run.
The problem is that young children, especially those under the age of six, have a hard time doing what they don't want to do and don't like.
They have a still very immature brain that pushes them to do what they want, not what they have to do.
That is why it is so difficult for them to abide by the rules and respect the limits that adults impose on them.
Six years is a very important age for children, at all levels, but above all in terms of brain development.
What happen?
At this age approximately (in some minors earlier and in others a little later) they already have a minimally developed prefrontal cortex.
And what does this imply?
Well, they already have, in a basic way, executive functions.
Executive functions are, as Lewis Goldberg, an American personality psychologist and professor emeritus at the University of Oregon, put it, "the conductor of our lives."
Executive functions, located in the prefrontal cortex, allow concentration, impulse control, planning, managing emotions, self-motivation, being aware of what one feels and thinks, making decisions consciously and is also located in the prefrontal cortex. a very important function for the human being: ethical awareness.
Therefore, everything that differentiates humans from other animals is located in this brain area.
Children with six or seven years old already have these brain applications minimally active to be able to start them, something that did not happen a couple of years before, around the age of four.
The truth is that ADHD is a neurodevelopmental disorder.
What does this mean?
Which is a pathology that involves slower and different brain development than normal.
It is understood normal as usual, please.
If ADHD and childhood have identical symptoms, experts are forced to wait until that age to see if a specific child has the disorder or not.
I always say that no child under this age should be diagnosed with this disorder and I know that there are (and many, unfortunately).
Faced with this situation, health professionals have the responsibility to train, qualify and make good diagnoses so as not to fall into the error of diagnosing a four-year-old child who simply manifests the symptoms of something known as CHILDHOOD.
How is ADHD currently diagnosed?
From my point of view, currently the diagnosis of ADHD is identified with three characteristics: overdiagnosis, underdiagnosis and misdiagnosis.
Regarding the first, overdiagnosis, health professionals diagnose more cases than there really are.
Scientific studies conclude that 5-7% of children and adolescents have it, but we currently have many more children than what these investigations reflect.
Something is going wrong.
Although this is a reality in recent years, it is true that the number of diagnoses has increased after the pandemic, which does not mean that there are more children or adolescents with ADHD, but rather more diagnoses.
Myths such as that technological devices cause ADHD favor this trigger in diagnoses.
Fetal Alcohol Spectrum Disorder (TEAF), Autism Spectrum Disorder (ASD), anxiety disorders, insecure attachments, and childhood itself are some examples that are commonly diagnosed as ADHD.
For this reason, I am convinced that this disorder serves as a mixed bag for many other disorders and even for normative circumstances of children's development.
Secondly, in addition to an overdiagnosis, there is also an underdiagnosis, since many minors with ADHD of the inattentive subtype are not being detected or diagnosed, which implies that they are not intervened with either.
This subtype is more difficult to detect, since it usually occurs exclusively with difficulties to attend, but not with excessive movement or behavior problems.
And lastly, unfortunately, there is a bad diagnosis, since, on occasions, the professionals who can evaluate, diagnose and intervene in disorders such as ADHD carry out express evaluations, where in a few minutes and superficially they are based exclusively on on the symptoms and diagnose minors with this disorder without having carried out a thorough evaluation.
In conclusion, ADHD should not be a mixed bag where disorders and circumstances that have nothing to do with this neurodevelopmental disorder come together.
One of the keys is that professionals take the evaluation of each minor individually very seriously, dedicating enough time, affection and being well trained in this disorder.
Rafa Guerrero
is a psychologist and Doctor of Education.
Director of Darwin Psychologists, author of the books 'ADHD.
Between pathology and normality' (2021) and 'Stories for emotional development from attachment theory' (2019).
You can follow Mamas & Papas on
,
or sign up here to receive
our biweekly newsletter
.
Subscribe to continue reading
Read without limits
Keep reading
I'm already a subscriber
