Hyperactivity unmasked: revealing the potential behind ADHD

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Attention Deficit Hyperactivity Disorder (ADHD) often manifests itself as an energetic, constant whirlwind, disrupting the tranquility of classrooms and homes. But beyond the apparent squalls lies unexplored potential, often masked by the tumultuous symptoms of the disorder itself.

Armed with knowledge, teachers, parents and carers can uncover hidden talents and foster an environment conducive to the development of the individuals concerned. A few points of light to illuminate this sometimes tumultuous journey.

A mosaic of symptoms

Distinguishing ADHD is not simply a matter of identifying physical hyperactivity. It involves a diversity of behavioral, emotional and cognitive manifestations that can vary widely from one individual to another.

Attention deficit disorder and hyperactivity are the tip of the iceberg for these children,” says the teacher. Other difficulties include poor time management, executive function problems, learning disabilities, low frustration tolerance, poor control of emotions, particularly anger – “I think, so I say! –problems getting started on tasks.. Chris Foster, American teacher

Classic symptoms such as impatience, frequent interruptions or the inability to sit still can be found alongside less noticeable but equally disruptive signs, such as fluctuating attention, increased distractibility or poor organization.

Why are we talking about this now?

  1. Improved Diagnostic Techniques:
    • Diagnostic methods and criteria have evolved and improved over time.
    • Health professionals are better trained to recognize the symptoms of ADHD.
  2. Awareness and destigmatization:
    • Greater awareness of ADHD has contributed to greater acceptance and understanding.
    • Efforts to destigmatize mental health disorders encourage more parents and teachers to seek help.
  3. Information accessibility :
    • Online informationand resources have made knowledge of ADHD more accessible.
    • Social networks and other digital platforms facilitate the sharing of experiences and knowledge about ADHD.
  4. Research and development :
    • Ongoing research provides new insights and up-to-date data on ADHD.
    • New treatment approaches and coping strategies are more widely disseminated.

Distinguishing ADHD from the absence of limits: understanding behavioral variations in children

Children with ADHD

  • ADHD is a neurodevelopmental disorder with biological and genetic components.
  • Symptoms, such as inattention, hyperactivity and impulsivity, persist in a variety of contexts (school, home, recreational activities).
  • These behaviours occur regardless of setting and expectations, and are often inappropriate for the child’s age.
  • ADHD affects children in spite of an appropriate upbringing and structuring framework .

Children without a structured environment

  • Disruptive or non-compliant behavior may be a response to a lack of clear rules or limits.
  • In general, when placed in an environment with clear rules and expectations, behaviors tend to adjust.
  • Behavioral challenges can often be mitigated or resolved through positive and consistent parenting strategies.
  • Behaviors are more contextual and may not occur as consistently or ubiquitously as in ADHD.

It’s crucial to remember that only a qualified healthcare professional can make a diagnosis of ADHD, using precise clinical criteria and carrying out a thorough assessment.

A child who displays unruly or authority-defying behavior does not necessarily have ADHD, and may simply be responding to his or her environment or going through a normal developmental phase.

The diagnosis of neurodevelopmental disorders, as identified by ADHD, does not include all children who might be affected, and some of them do manage their condition well. However, when a child fails to develop as expected , and significant impacts are observed in various aspects of his or her daily life, it becomes essential to consider identifying the underlying cause.

The road to diagnosis

The diagnostic process, essential to understanding and structuring appropriate care, involves a range of healthcare professionals.

The diagnosis of ADHD, generally established on the basis of precise DSM-5 criteria, involves professionals such as neuropsychologists, pediatricians, psychiatrists and psychologists. The latter will carry out an in-depth assessment that takes into account the manifestations of the disorder in the various contexts of the individual’s life.

The diagnosis of neurodevelopmental disorders is not restricted to expert hospital consultations. Your child psychiatrist or psychiatrist can do it for you Nantes University Hospital website

Several health professionals have specialized in the disorder.

The reference website is the HyperSupers association , which has contacts in every region. Members of the association have priority.

In January 2024, an online training course is offered to members.

This training includes “Plongez En Nos Troubles” (PENT), a webdocumentary that looks at the school career of children suffering from Attention Deficit Disorder with or without Hyperactivity (ADHD).

The project is carried out in collaboration with HyperSupers TDAH France.

Way of life The Barkley method in practice: how to implement a points system encouraging positive behaviour in ADHD children?

Over an 8-week period, the team closely followed elementary, middle and high school students, to better understand their educational experience.

An immersive journey into the world of ADHD, where children, parents and education professionals unite their voices to shed light on daily realities and coping strategies
An immersive journey into the world of ADHD, where children, parents and education professionals unite their voices to shed light on daily realities and coping strategies

This webdocumentary takes an interactive approach to answer key questions such as:

  • What are the characteristic signs of ADHD in the school environment?
  • What challenges do these children face as a result of their inattention?
  • What solutions exist to help them succeed at school despite these obstacles?

Immerse yourself in this fascinating and instructive exploration that sheds light on the reality of students with ADHD and how to support them towards an education better adapted to their needs.

Recognized professionals in the Alpes-Maritimes

  • Docteur Hervé Caci, Nice child psychiatrist 04 92 03 08 49 . Highly sought-after, with a waiting list of around 2 years. To be confirmed with his secretariat;
  • Docteur Isabelle Delattre, Vence, pediatrician specializing in ADHD 06 65 10 29 93. Appointments via Doctolib. Having worked at the MDPH, she has many contacts with professionals in the region;
  • Docteur Fleur Acroute, general practitioner working at the Centre Référent des Troubles du Langage et des Apprentissages (CRTLA), the CRTLA only accepts children with severe learning disabilities. The center is for children aged 3 to 18 with severe, complex and long-lasting language and learning disorders, requiring level 3 expertise. A file must be completed to identify whether your child falls within the scope of this center of expertise.

Recognized professionals in Pays de la Loire

DSM-V, the Diagnostic and Statistical Manual of Mental Disorders (5th edition)

The DSM-V is a major reference in the field of psychiatry, covering a multitude of criteria and points concerning the diagnosis of various mental disorders, including Attention Deficit Disorder with or without Hyperactivity (ADHD). Here are some of the key elements he explores concerning the latter:

  • Significant presence of symptoms: The DSM-V requires that several inattentive or hyperactive/impulsive symptoms be observed before the age of 12.
  • Duration and persistence of symptoms: Symptoms, whether inattentive or hyperactive/impulsive, must persist for at least six months for a valid diagnosis.
  • Involvement in two different environments: Symptoms must be present and have an impact in at least two living contexts, such as home and school.
  • Presence of significant difficulties: Symptoms must cause significant social, academic or occupational difficulties.
  • Other mental disorders: The importance of excluding other mental disorders to ensure that symptoms are not caused by another psychological problem.
  • Distinguishing types of ADHD: The DSM-V specifies different types of ADHD (predominantly inattentive, predominantly hyperactive/impulsive, or combined) and details the criteria for each.
  • Age and developmental considerations: The diagnosis must take into account the individual’s developmental level, and ensure that symptoms are not simply a manifestation of typical developmental phases.
  • Exclusion of organic causes: The manual emphasizes the need to exclude other medical causes of the presenting symptoms.
  • Identification of comorbidities: Addresses the possibility and management of comorbidities frequently associated with ADHD, such as oppositional defiant disorder or anxiety disorder.

These criteria, among other nuances and points addressed by the DSM-V, aim to ensure an accurate and comprehensive diagnosis of ADHD, taking into account the complexity and variability of the disorder’s manifestations across different contexts and stages of life.

Multidimensional care

The care proposed for ADHD is intended to be a balanced and personalized mix of medicated and non-medicated interventions.

Medications such as methylphenidate are commonly prescribed. At the same time, complementary approaches such as psychoeducation, psychotherapy and behavioral and cognitive therapies are often used to manage the various aspects of the disorder.

Cognitive-behavioural therapy (CBT)

Recognized for its effectiveness in the treatment of a variety of psychological disorders, CBT has also proved invaluable in supporting people suffering from Attention Deficit Disorder with or without Hyperactivity (ADHD).

The benefits of CBT on ADHD are all the more relevant as they provide undeniable support in managing the daily symptoms and challenges inherent in this disorder.

By targeting individuals’ thought processes and behaviors, CBT aims to modify dysfunctional cognitive patterns, as well as teach and reinforce positive skills.

As a result, people with ADHD learn to manage their symptoms of inattention, hyperactivity and impulsivity more effectively , leading to improvements in various areas of their daily lives.

For example, positive reinforcement and self-monitoring, two key components of CBT, can help improve self-esteem and self-control, which are often impaired in individuals with ADHD.

Family whirlwind: when motor agitation transforms parental life
Family whirlwind: when motor agitation transforms parental life

CBT sessions address, among other things, organization, planning and social skills, through practical methods and everyday scenarios.

Not only do they help shape behavior and structure the individual’s environment to minimize distractions, they also offer strategies for dealing with frequently encountered stress and frustration.

This is particularly useful for children and teenagers navigating the structured world of education, but also for adults facing professional and social demands.

It should be noted, however, that the success of CBT also depends on the overall context of ADHD management, in which pharmacotherapy and other interventions (such as school or work accommodations) also play a crucial role.

However, the versatility and adaptability of CBT provide a solid framework, offering a rich therapeutic complement and providing concrete, applicable support in the day-to-day lives of people affected by ADHD.

Focus on leading treatments

The management of ADHD (Attention Deficit Disorder with or without Hyperactivity) encompasses a variety of approaches, including the administration of specific medications.

Prior to treatment by a pediatrician or child psychiatrist, your child will undergo an ECG, or electrocardiogram, to ensure that he or she is not at cardiovascular risk.

The ECG as a safeguard before starting ADHD treatment
The ECG as a safeguard before starting ADHD treatment

Let’s take a look at the most commonly prescribed medications on the French market, along with their potential effects and side-effects.

MedicationAction / Use / CommentsDuration of efficacy / BenefitsSide effects
MedikinetAlters the quantities of certain substances in the brain, increasing attention and reducing impulses.Up to 8 hoursHeadaches, difficulty falling asleep, reduced appetite.
ConcertaExtended-release, manages symptoms throughout the school day.approximately 12hMay include increased blood pressure and mood disorders.
QuasymImmediate release of active ingredient followed by prolonged release.Shorter duration than ConcertaSimilar to other methylphenidate-based medications, such as reduced appetite or mood swings.
Ritalin
Available in immediate-release and extended-release forms.Immediate release about 4h00Headaches, abdominal pain, sleep disorders, and sometimes effects on growth.
The main molecule in this treatment is methylphenidate. What will change between the different formulas are the excipients, which will release methylphenidate differently in the body.

Methylphenidate, or MPH, as ritalin is known, has historically been very rarely prescribed in France. We have the lowest use in the world. only 1 in 8 patients with ADHD benefit from this drug, which is genuinely effective over a short period (with no risk of dependence). So there is no overconsumption. Professor Olivier BONNOT, Head of Pharmacology and Professor of Child Psychiatry at Nantes University Hospital

Response to treatment varies according to each person’s individual metabolism . It may be necessary to explore various therapeutic options in order to determine which is most effective

Deciphering the duration of action of the main ADHD medications, shared by Arthur Jasinki on the blog eveildutdah.fr
Deciphering the duration of action of the main ADHD medications, shared by Arthur Jasinki on the blog eveildutdah.fr

Psychostimulants are often combined, if need be, with a treatment to induce sleep:

MedicationAction / UseDosageSide effectsPrecautions
Slenyto (Melatonin)Regulates sleep-wake cycles and helps children with ADHD fall asleep.It is usual to start with the lowest dosage, 1mg, and adjust to 2mg as needed.Generally well tolerated.Use under medical supervision and with precise evaluation before prescription . Beware of overdosing, which can have the opposite effect and prevent sleep.
Focus on Melatonin: a hormone naturally secreted by the body, used to manage sleep disorders in ADHD children.

Since September 13, 2021, the initiation of methylphenidate treatment or its annual renewal can be done in private practice. Nantes University Hospital website

Renewal of the treatment, which is classified as a psychostimulant, must be carried out every 28 days by your child’s GP, who will weigh and take your child’s blood pressure.

The treatment chosen depends on the child’s weight and response to treatment. We always start with a low dose , then work upwards.

However, it should be remembered that medication, while essential in many cases, is part of a broader therapeutic strategy and should always be approached with caution and a sense of personalization.

Collaboration with specialized healthcare professionals, a thorough understanding of the different options and their implications, and regular follow-up are key to optimizing ADHD management.

The therapeutic pathway for ADHD management is as diverse as the individuals it aims to help. Each treatment requires ongoing evaluation of its efficacy and safety, to ensure balanced and appropriate care for each unique case.

School adaptations: a necessity

School, as a place of learning and socialization, can sometimes be a challenging environment for a child with ADHD.

Adaptations, such as frequent rest periods, clear and concise instructions, or the use of visual and interactive teaching methods, can be significant in optimizing the student’s school career.

The role of the MDPH

The Maison Départementale des Personnes Handicapées (MDPH) is a reception, information and supportcenter for people with disabilities and their families.

In France, ADHD is recognized as a disability by the MDPH. This opens access to a range ofaids and accommodations, notably within the school curriculum, to enable children and teenagers to navigate with ease through the various challenges they may encounter.

When a child is diagnosed with Attention Deficit Disorder with or without Hyperactivity (ADHD), parents can apply to the Maison Départementale des Personnes Handicapées (MDPH) for various forms of assistance to ensure appropriate support.

Adaptations to help children

On the one hand, as far as accommodations are concerned, the Plan Personnalisé de Scolarisation (PPS ) is a valuable tool designed to ensure successful and fulfilling schooling by adapting learning conditions to the child’s specific needs.

It includes various adaptations such as :

  • adjusting schooling times ;
  • the use of specific teaching aids;
  • the support of a school life assistant, where appropriate.

This information is recorded in the Gevasco (Guide d’Évaluation des besoins de compensation en matière de scolarisation).

Key points concerning GEVASCO

Objective

  • Assessing needs: The GEVASCO aims to identify and assess the student’s specific needs, taking into account his or her abilities, limitations and the obstacles he or she may face in the school context;
  • Developing the PPS: The information gathered through GEVASCO contributes to the development of the student’s Personalized Schooling Project (PPS).

Players involved

  • Educational team: The evaluation process mobilizes the educational team, which knows the student well;
  • Parents: Parents are also involved , and their observations and contributions are taken into account.

Main elements analyzed

  • Functionality: Assessment of the student’s abilities and limitations in various areas (motor, cognitive, sensory, etc.);
  • Compensation: Identification of the aids and adaptations needed to compensate for limitations and encourage the student’s active participation;
  • School environment: Analysis of the school environment and its suitability for the student’s needs.
Page from a Gevasco shared by Audrey on lecoindesmaitresses.fr
Page from a Gevasco shared by Audrey on lecoindesmaitresses.fr

Action Plan

  • Recommendations: Development of recommendations and guidelines to ensure optimal schooling adapted to the student’s needs;
  • Follow-up: GEVASCO can be used to monitor the student’s needs over time, and can be reviewed and adjusted as the situation evolves.

Use in the schooling process

  • Orientation: It contributes to orientation decisions made by the Maison Départementale des Personnes Handicapées (MDPH);
  • Schooling: Helps define the type and location of schooling best suited to the student.

Student-centered approach

  • Student-centered: Instead of focusing solely on limitations or diagnosis, it focuses on how the student interacts with his or her school environment;
  • Adaptability: GEVASCO seeks to develop a schooling pathway that is flexible and adaptable to the student’s evolving needs.

The life assistant can be an AESH-i or an AESH-m

AESHi (Accompanying a student with an individual disability)

  • The AESHi accompanies a specific pupil, supporting his/her integration and participation in school activities;
  • This support is personalized and adapted to the student’s specific needs, whether educational, physical or social.

AESHm (Mutualized support for students with disabilities)

  • The AESHm is dedicated to assisting several students with disabilities, either simultaneously or successively, without requiring sustained and continuous attention for each one;
  • The AESHm is dedicated to assisting several pupils with disabilities, either simultaneously or successively, without sustained and continuous attention being required for each one;
  • Intervention is carried out strictly in accordance with the guidelines laid down by the Commission des Droits et de l’Autonomie des Personnes Handicapées (CDAPH).

Recourse if the AESH fails to turn up

In the absence of your child’s AESH, if he or she is able to attend school on his or her own, you will need to send a registered letter with acknowledgement of receipt to the DASEN ( Directeur Académique des Services de l’Education Nationale) of the DSDEN in your area, indicating the non-attendance of the human assistant on the date indicated .

The balance of justice tilts in favor of children: an asserted right to an adapted education, ensuring the continuity of ordinary schooling for all
The balance of justice tilts in favor of children: an asserted right to an adapted education, ensuring the continuity of ordinary schooling for all

If your child is unable to attend school without his or her AESH for physiological or psychological reasons (harassment, depression, etc.), you can lodge a “référé liberté” application, in which you will need to file 2 procedures via the Télérecours citoyen website:

  • a request for summary suspension;
  • an appeal for excess of power.

These documents are available on the Toupi.fr website.

Financial aid for care and equipment

From a financial point of view, several forms of assistance can be requested to help alleviate the costs inherent in the disorder.

The Allocation d’Éducation de l’Enfant Handicapé(AEEH) is designed to offset the costs of raising and caring for a disabled child.

The Allocation Journalière de Présence Parentale(AJPP) may be paid if the child is forced to miss school for care. If one of the parents has to stop or limit his or her professional activity, this aid can be granted for a period of 310 days’ absence over a maximum of 3 years.

The Prestation de Compensation du Handicap ( PCH ), on the other hand, makes a larger contribution to covering various disability-related expenses.

The PCH includes 5 forms of assistance:

  • human;
  • technical;
  • home adaptation or transport;
  • specific assistance;
  • or, exceptionally, animal assistance.

If granted, these schemes can help manage the costs and organization involved in ADHD care, making daily life easier for the families concerned.

Please note, however, that not all forms of assistance can be combined.

Potential and prospects

While ADHD has its challenges, it is also, from some perspectives, associated with boundless creativity , inexhaustible energy and the ability to think outside the box.

These traits, if properly channeled and supported, can turn into valuable assets, propelling these individuals towards flourishing and, perhaps, unexpected horizons.

Nevertheless, we must remain vigilant when accompanying our different children:

In all the studies examined for the report, learners with disabilities were found to be just as likely, if not more likely, than their non-disabled peers to be victims of school violence and harassment, in some cases much more so. This is true at all levels of education, but particularly between the ages of 13 and 15, during the transition from late childhood to early adolescence. UNESCO report in 2021

In the final analysis, unmasking hyperactivity means revealing, recognizing and valorizing the potential that lies dormant in each individual.

It means adopting an approach that not only alleviates torment, but also celebrates singularities and talents.

For, as the African saying goes: “The tree that sees far has deep roots”. So, the future of those living with ADHD needs to be seen with a depth of approach and a vision far ahead, where present obstacles become milestones of a fulfilling trajectory.

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