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ADHD stands for Attention-Deficit/Hyperactivity Disorder, which is a neurodevelopmental disorder that affects both children and adults. It is characterized by persistent patterns of inattention, impulsivity, and hyperactivity that can interfere with daily functioning and development. If the disorder is characterized by difficulties in sustaining attention, being easily distracted, and having trouble organizing and completing tasks but does not involves hyperactivity and impusivity, the disorder is sometimes also called ADD (Attention-Deficit Disorder)

According to Dr. Malá from the Child Psychiatry Clinic at the Motol University Hospital in Prague, ADHD is a disorder characterized by neurodevelopmental delay with deviations in the development of the central nervous system and impaired regulation at the level of neurotransmitter systems (noradrenergic and dopaminergic). This, in turn, affects all cognitive functions. MRI examinations demonstrate reduced brain volume, cerebellum, basal ganglia primarily on the right side, and the corpus callosum (Malá, 2005)

A typical manifestation of this disorder is weak attention, easily getting tired, and the child's inability to sustain longer and higher-quality focus. These children cannot endure anything for long and get bored quickly. Children with ADHD struggle with maintaining attention to complete assigned tasks within a specific time limit. Among the symptoms of inattention in these children are situations where they don't listen even when spoken to directly. They have difficulties with task and activity organization and can be easily distracted by external stimuli. In social situations, they often shift from one conversational topic to another.

Hyperactivity refers to an excessive urge for movement, activity that is purposeless and even senseless, and is not easily controlled or regulated. The child is unable to coordinate and control it. This is associated with a tendency for impulsive reactions. Typical characteristics are aimless and unnecessary movements. In school, these children often leave their seats, play with objects unrelated to the lesson, frequently interrupt others, and exhibit excessive speech. They produce atypical sounds that accompany their actions or extensively comment on their own activities. Excessive and unnecessary activity requires a significant amount of energy. It involves not only an increase in the frequency of various activities but also an increase in their intensity. For example, the child tends to run rather than walk. Their activity is clearly disproportionate to the situation. Restless children, however, do not have an excess of energy and, furthermore, are unable to channel it effectively (Vágnerová, 2002).

Under the symptom of impulsivity, we include, for example, the tendency of children to react without thinking, suddenly, and often inappropriately to stimuli. Impulsivity also means an inability to anticipate the consequences of their actions or to regulate their behavior. Engaging in risky activities that endanger their health is common. The child does whatever comes to mind, unable to control their expressions and unable to wait for anything. Impulsive children are unable to plan and control their behavior. They often exhibit immaturity in their personality. Frequent fluctuations in their performance and emotional state can be observed. These children are socially disruptive, unpleasant, and elicit negative reactions from their surroundings. The uncontrollable fluctuations in CNS function are often mistakenly interpreted as a motivational disorder (Vágnerová, 1999).

It is important to determine the cause of ADHD or ADD symptoms. As mentioned before, one possibility is that changes in the brain are evident. Medications such as Ritalin can be helpful for these children. However, it is also possible that primary reflexes, often in combination with poor sensory integration, have caused the symptoms of ADHD/ADD.

If the cause of the symtoms are not integrated primary reflexes, the therapy is relatively straightforward: we inhibit primary reflexes through exercises and improve sensory integration (medication often doesn't help these children). However, sometimes children have brain changes and primary reflexes persist alongside them. In such cases, it is important to address everything that can be done. By inhibiting primary reflexes and improving sensory integration, the manifestations improve, although they may not completely disappear.

How is it possible for primary reflexes to cause ADD/ADHD symptoms? Primary reflexes influence a child's psychomotor development. They affect the foundation of everything, which is why persisting primary reflexes can have such diverse symptoms.

Let's take an example: every time the Moro reflex is triggered, adrenaline and cortisol are released into the bloodstream. The release of adrenaline is part of the "fight or flight" response, preparing the body for combat or escape. Increased levels of adrenaline cause hyperactivity, aggression, and the need to influence the environment. Cortisol affects blood sugar levels. Low blood sugar levels lead to irrational behavior.

The Moro reflex causes:

  • increased sensitivity to sensory stimuli, which tires the child and makes them even more prone to triggering the Moro reflex (and the release of additional adrenaline and cortisol). In school, these children are often reprimanded to focus only on their work and not pay attention to others.

The Asymmetrical Tonic Neck Reflex (ATNR):

  • hinders the proper development of the corpus callosum (the connection between the two hemispheres, which normally develops by the age of six and a half to seven years in a child). Optimal development of specialized brain centers cannot occur if the corpus callosum is not properly formed. Children with poorly developed connections tend to favor right hemisphere activities. They may be impulsive, have difficulty understanding cause and effect, and not learn from previous experiences. They struggle to grasp relationships and sequence, negatively affecting their perception of time. Children with poorly developed corpus callosum have difficulty waiting (like young children) and understanding the duration of one minute or the concept of tomorrow or next month.

The Tonic Labyrinthine Reflex (TLR) causes:

  • difficulty for the child to relax.

  • poorer body posture. Muscles and ligaments on the front side of the body may shorten, which can hinder breathing and reduce oxygen levels in the blood. This can lead to improper brain functioning since the brain requires sufficient oxygen for proper operation.

  • difficulty for the child to sit still for extended periods.

The Symmetrical Tonic Neck Reflex (STNR) causes:

  • worse focus.

  • children to constantly engage in physical activities that other children do unconsciously.

  • that, while sitting, children "wrap" their legs around the chair legs, sit on their heels, or do anything else just to fix their legs. In response to reflexive stretching of the lower limbs, they often balance on the back legs of the chair - "rocking on the chair."

The Galant Spinal Reflex causes:

  • the child's inability to sit still in a chair.

  • discomfort when wearing tight pants or belts because they stimulate the lumbar area of the back.

  • problems with bedwetting. Older children who no longer wet the bed are unable to concentrate sufficiently on their work because they constantly think about whether they need to go to the bathroom.

Due to persistent primary reflexes, optimal neural connections in the brainstem are not formed. Suboptimal neural connections in the brainstem can lead to improper functioning of the reticular formation. The reticular formation is a functionally important integration system and part of the brainstem. Its malfunction can result in brain overload, causing confusion and irritability. The inability to control impulses from the brain to the body can also contribute to poorer behavior. Behavior becomes impulsive, coarse, and lacking self-control.

Article author: PhDr. Marja Volemanová, PhD.

Used sources:

  • Vágnerová, Marie (2002).Úvod do psychologie, 2. vydání. Praha: Univerzita Karlova v Praze. ISBN 80-246-0015-3

  • Vágnerová, Marie (1999). Vývojová psychologie. Praha: Portál. ISBN 978-80-7178-308-4

  • Volemanová, Marja. 2019. Primární reflexy, opomíjený faktor problémů učení a chování u dětí. 2. rozšířené vydání. Statenice : INVTS, 2019. 978-80-907369-0-0


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