“Inconvenient” children
Up to 150,000 Ukrainian schoolchildren may have symptoms of hyperactivity. Help from psychologists and teachers is a must
Today’s children are meeting all the demands of the times. They are active, impulsive, and have rich imaginations. But there are increasingly more children who stand out from the crowd with their lively temperaments and lack of restraint.
Experts call this type of behavior attention-deficit hyperactivity disorder, and in 2004 WHO recognized ADHD as the number-one problem in child psychiatry. Parents of hyperactive children have no cause for worry. With proper attention, love, and understanding, such children eventually outgrow ADHD to become cheerful, creative, and outgoing people.
Experts say that out of five million schoolchildren in Ukraine, between 50,000 and 150,000 children suffer from ADHD.
UNDERSTANDING
Every teacher or educator who has ever worked in a kindergarten or school for a few years has encountered children who could be dubbed “Dennis the Menace.” They are lively, restless, extremely energetic, imaginative, and very impulsive, and they often create havoc in classrooms. While they are small, they are fun, but if their behavior does not change as they grow older, they become a problem for the people around them — parents, friends, teachers, and adults in general. They spell an end to everyone’s peaceful existence, including their own, because people begin hating them, and sometimes they are expelled from school.
Psychiatrists and psychologists call this condition attention-deficit hyperactivity disorder, which is caused by a malfunction of the brain.
In 2004 the World Health Organization recognized ADHD as the number-one problem in child psychiatry, and developed countries are as concerned about it as we are about the flu. Ukraine’s government is indifferent to the problem, however, even though between 50,000 and 150,000 schoolchildren in Ukraine have ADHD, psychiatrists say. This is a high rate given that Ukraine’s school population stands at five million.
Ihor Martsenkovsky, the coordinator of the national program Mental Health in Ukraine, explains that ADHD is the most widespread pathology, and its rate among our children is very high. “It causes a certain delay in emotional and volitional processes — the child lags behind in maturity. We come across children like that every day, but we pretend that they don’t exist. These children have an attention deficit and become easily tired and distracted in class. Because of their impulsivity and lack of restraint, they often become victims of aggression, which causes them a lot of suffering.
“If this condition is not treated, 70 to 80 percent of such children will continue to have problems in adulthood. Their impulsivity and poor control over their emotions, and hence actions, will persist,” Martsenkovsky said.
Problems can include quarrels with neighbors or conflicts at work, even though these are common occurrences. If a child constantly feels rejected and realizes that it is a holiday for the teacher when s/he is not in class, the child will feel ostracized in society and will pursue self-assertion.
Oleh Romanchuk, the head of the Dzherelo Educational and Rehabilitation Center in Lviv, explains what this may lead to. “If such children do not receive timely assistance, with every passing year their self-esteem will shrink, depression will deepen, and their behavior will become anti-social, research suggests. If they are not given enough attention, they may wreck their lives with drug addiction, alcohol abuse, or criminal activity. Incidentally, people with ADHD cause four times as many traffic accidents as other drivers.”
Semen Hluzman is the executive director of the Ukrainian Psychiatric Association, who frequently visits Ukrainian prisons. “I see the results of inattention and indifference to these people on the part of the state and society whenever I visit penal colonies: these people have committed atrocious crimes. Many of them are in such a state that they cannot be released any time soon. We can ignore the problem, but then we will be forced to imprison many people, who could otherwise be free.”
HELP
Three years ago Romanchuk and his colleagues founded Dzherelo in Lviv to help hyperactive children. They found them in schools and kindergartens, and worked with their parents. The experience of working with 300 hyperactive children has shown that their behavior changes when they sense they are being treated differently. Then they begin to get a better handle on their behavior.
Experts generally believe that hyperactive children can live normal and fulfilled lives, especially since many of them are gifted individuals. There are recorded cases of children with ADHD who have gone on to become painters, actors, musicians, and inventors.
“Parents say: we don’t know what to do; we have problems with people because they complain about our child; we yell at the child and then we feel ashamed. Teachers are often helpless. But these children can flourish if they are constantly occupied and if we focus on the positive — that is how we work with our children. These methods have stood the test of time.
“For example, behavioral psychotherapy (the family-centered model and the multidisciplinary command model) involves a team of specialists and trained parents who work with children. In order to implement this throughout the country, we need reforms in the system of psychiatry. Now we are thinking about offering mini-programs for hyperactive children in regular clinics. The sooner we identify the disorder, the more effective our intervention will be,” said Romanchuk.
Ukrainian experts say that nothing new needs to be invented because the assistance scheme was created in Europe in the 1960s. Treatment is divided into behavioral modifications and the administering of medications that inhibit hyperactivity. Most researchers insist that behavioral changes are preferable to drugs, which may be used only in acute cases.
“Everything has been researched and there is a lot of information out there. We need to implement the technology that has been around for decades. Perhaps we are hindered in a way by traditions, a certain disorganization, lack of information, or conservatism because there are no problems with diagnosing the disorder,” Martsenkovsky said.
POTENTIAL
Ukraine’s Ministry of Health is now working on a medical protocol for helping children with ADHD, which will be implemented in all schools. Professor Viacheslav Mishyiev, the head of the Department of Child and Forensic Psychiatry at the Kyiv Platon Shupyk Medical Academy of Post-Graduate Education, says that programs to identify and work with children with ADHD, are being developed by psychiatrists, pediatricians, and educators.
“The protocol is a scheme specifying the order of tasks in the work with hyperactive children and the indicators of treatment quality. Similar protocols exist all over the world, and specialists use them. Parents need to be aware of the problem, have a proper attitude to it, and not neglect the treatment that their children require. Otherwise the Ministry of Health will not solve this problem,” explained Raisa Moiseienko, the head of the ministry’s Childhood and Maternity Protection Department.
Foreign scholars, in particular the specialists from the Institute of Psychiatry at King’s College London, have promised to provide assistance and share their experience. This was the goal of their recent visit to Ukraine. The commitment of our doctors and their huge case loads were the two things that struck them most when they visited our hospitals.
“When we come to Ukraine, we are pleased to see many enthusiasts, who are very knowledgeable and eager to learn more. Second, Ukraine has an extensive network of institutions that can provide these kinds of services. This is very important because they are not available in all countries. All the doctors we have met work long hours. In Europe doctors do not work with patients so much. I believe that these resources that you have can and should be used. This combination makes me optimistic,” said Eric Taylor, professor of child and adolescent psychiatry at King’s College London.
Psychiatrists say that the problem of hyperactive children is, in the grand scheme of things, not a medical issue but a problem relating to how society treats children. They emphasize that this is a worldwide problem, and its solution is a “test of maturity” for a society and, of course, the parents of hyperactive children.
“Parents have to love the child and believe in him or her,” said Romanchuk. This is what will make the child believe in himself or herself; this goes for all children. One way to show this kind of interest is to set up an association of parents of hyperactive children that would lobby for their interests, similar to organizations that already exist all over the world.
Attention to the large numbers of hyperactive children in Ukraine means caring for their future and the future of our country: preventing conflicts in school, child abandonment, drug addiction, alcoholism, teenage pregnancy, as well as psychiatric disorders, dependence on psychostimulants, domestic problems, unemployment, crime, traffic accidents, and other problems experienced by adults. This is another argument in support of the dictum that children are our best investment.
