Whether Philip wants to sit quietly at the table today? (Hoffmann, 1848)
Lively children are part of your everyday life and that’s a good thing too! As a rule, it is quite normal at this age for children sometimes to be very restless and fidgety or easily distracted, and it is difficult, especially with younger children, to distinguish normal from restless and borderline d.h. "expansive" behavior to be distinguished. In many children such problems decrease in the course of a few months. Therefore, it is also particularly difficult to make an AD(H)S diagnosis at this age and caution should be exercised in making a diagnosis. However, if the behavior continues for a longer period of time, the question arises whether the child could be "hyperactive" or has ADHD.
Perhaps you sometimes reach your limits due to the problem behavior of one or more children, because they constantly demand attention. In order to get to the bottom of the everyday problems that arise from this, it is important to better understand and be able to classify the problems of these children.
ADHD is a behavioral disorder in children, adolescents or adults characterized by abnormalities in the core areas of attention and concentration disorders, impulsivity and marked physical restlessness (hyperactivity).
In kindergarten, children affected by ADHD are conspicuous for their inability to engage in quiet activities and often for their pronounced hyperactivity. Unable to concentrate and constantly on the move. In general, conspicuousness can be distinguished in the following core areas:
Further, comprehensive Information on causes, symptoms and course of ADHD can be found in General information on ADHD.
Attention and concentration disorders
- Abortion of activities/games just started, v.a. in the activities that require a gradual, planned action.
- The inattention can be observed during other people’s occupations at the table (e.g., in the evening, in the evening, in the evening, in the evening).B. This can be observed in painting and handicrafts) and also in structured group situations (circle of chairs).
- The affected children often lose interest quickly even in self-selected play (painting and handicrafts).
- Sudden and rash actions, without considering the consequences.
- No patience; hardly able to wait for their turn to be diagnosed.
- Disruption of other children’s play. Children with ADHD burst into adult conversations and out with answers before the question is finished.
- They show restlessness and fidgetiness, especially in situations where quietness is required: The children get up from the table while eating, they cannot sit still in a sitting circle.
- Difficulty playing quietly. Excessive climbing.
- This restlessness seems to be difficult to influence permanently by the environment or by prompts. Children respond to admonishments at first, but after a few seconds or minutes the restlessness returns.
The conspicuities are usually observed in different areas of life – so not only in kindergarten, but also in the family or during leisure activities. When children devote themselves to their favorite activity, these symptoms hardly show, even if this activity requires a high level of attention (z.B. in building a railroad). Also, not all core symptoms need to occur equally. For example, some children have predominantly attention difficulties, and impulsivity and hyperactivity are much less present or not present at all. Furthermore, there is a wide variation in the severity of these problems.
What other problems often occur?
Probably the most common problem that occurs in addition to ADHD in kindergarten age are oppositional and aggressive behavioral problems. Children with these problems have difficulty following rules. They often get into fights with their parents and educators but also with other children. They get angry easily, provoke others and blame others for their own mistakes. In addition, they are irritable, react quickly in anger, and get into physical fights. To some extent, oppositional and aggressive behavior problems are part of normal development; however, there are children who exhibit these problems more than others.
In preschool, other problems may also occur as a side effect of ADHD:
- in physical dexterity, the children often have greater problems than others their age (z.B. in painting, handicrafts, climbing).
- In speech and language, children usually find it more difficult to form sounds correctly. They are difficult to understand or have a small vocabulary.
- Some children also have even greater difficulty recognizing patterns with their eyes or remembering faces (z.B. puzzles; memory games).
Another problem can be the rejection by peers, because they disturb other children by their impulsiveness and hyperactivity during play or because they sometimes also show aggressive behavior. Relationships with adults are also strained. Educators often have arguments with the child and reach their limits and feel they can no longer control the child.
Due to negative experiences and feedback, many children with ADHD increasingly suffer from insecurity and lack of self-confidence. These ‘quiet’ emotional difficulties are often less noticeable at first, because the other problems are more obvious and more disturbing.
How do the children develop?
When they start school, there is usually a marked increase in behavioral problems because the children are suddenly confronted with demands for calmness, perseverance and concentration that they are not yet able to cope with. In the family, coping with homework in particular becomes a problem. Although most ADHD children do not differ in their talents from other children, many children with ADHD have poorer academic performance and therefore have to repeat a class. Because of these difficulties, many children quickly lose interest in learning.
With the onset of adolescence, physical restlessness in particular decreases, while attention problems and impulsive actions often remain. Even into adulthood, these problems can continue and lead to difficulties in various areas of life (z.B. at work, in relationships). For others, the symptoms diminish as they enter adulthood.
What can help you and the child?
There are a number of proven therapies and support options that can help parents of easily distracted, impulsive, and/or restless children manage the problems. Those methods that are based on strengthening the relationship and the basic principles of behavior modification can of course be used in any context of pedagogical work, i.e. also for you. They have also proven their worth in daytime settings in various studies. The aim of any support should be to (re-)guide the child’s everyday life in the day care center and later on in school, in addition to family life, in a harmonious way. So it is not a matter of hoping that the child will "see something", or of "changing it from the ground up". This is not possible at all, and with such an approach educators can only fail.
To reduce the core problems of ADHD
- attempt to develop a more comprehensive understanding of the child’s problems and improve the sometimes strained relationship with the child,
- anticipate more often how the child might react through greater knowledge and close observation, and in this way be better "prepared" for difficult situations,
- to adapt the environment in the day care facility to the needs of the child within the scope of the possibilities, and
- Reconsidering and, if necessary, optimizing your strategies for dealing with the child.
As described above, many children with ADHD also have other problems. These additional problems sometimes decrease with the treatment of hyperkinetic disorders, which is why it makes sense to treat these disorders first. This treatment can be low-threshold, as z.B. through a guided self-help program, or, if the problem is more intense, by child and adolescent psychotherapists or child and adolescent psychiatrists. The Youth Welfare Office can provide help for families and for children if the families as a whole are overburdened in their upbringing or are severely impaired by other stresses or if the child is very severely psychologically impaired.
For children with additional problems, subordinate and supplementary have proven effective:
- Occupational therapy (occupational therapy) or Mototherapy for children with impairments in body coordination or fine motor skills;
- complementary psychological (or in individual cases pharmacological) Therapies to treat additional psychological problems of the child.
The basic rule when selecting support measures for children with ADHD is that the measures should start where the problems occur: in the child itself, in the family or in the daycare facility or in the home. later at school.
Further information on effective therapy approaches can also be found under Diagnostics, therapy and other aids.
What can be done in the daycare facility/daycare center?
In changing the behavioral problems in the day care center you are especially challenged. Through clear structures for spatial and temporal orientation, the development of a positive relationship with the child in question, through targeted and immediate reinforcement through praise and positive consequences, but also through the use of clear negative consequences for problematic behavior, educators can support easily distractible, impulsive and/or restless children and help them limit their behavioral problems. strive for a close exchange with the parents. Of course, as an educator, you have knowledge and attitudes that, unlike many parents, make it easier for you to successfully manage difficult parenting situations. It is only in everyday life often difficult to implement them consistently.
For more information and materials on intervention options, reinforcement plans, and structuring aids, see Helpful Concepts and Materials.
What advice can you give to parents?
If a child shows multiple behavioral abnormalities, then it is advisable to do something in the family and change it. As a pedagogical specialist, you can support parents by drawing their attention to problems and pointing out various offers of help (counseling centers, youth welfare office, child and adolescent psychotherapist, child and adolescent psychiatrist, social pediatric centers, early intervention centers).
Among psychotherapeutic methods, behavioral therapy has proven especially effective for inattentive, impulsive and/or restless children, some of which are offered by counseling centers (z.B. Family counseling centers), by social pediatric centers and by early intervention centers, but above all by practicing psychological psychotherapists, psychotherapy outpatient clinics, medical psychotherapists and special child and adolescent psychotherapists or in practices for child and adolescent psychiatry. Behavioral therapy is a term used to describe various forms of psychological treatment aimed at families, day care centers (or. later the schools) or the children themselves can direct. Often, these different forms of treatment are combined to improve the effects of therapy in the different areas of the child’s life (day care/school, family, recreational area. In comprehensive national and international studies investigating the effectiveness of these treatment methods in children with ADHD (including specifically those of preschool age), interventions in the family and day care center were found to be particularly effective. Treatment components that address the child himself have not been well studied in preschool children. However, there are, for example, also initial studies in Germany that suggest that so-called "play training", in which preschool children learn to play more persistently and intensively, can be effective.
To prepare and conduct a meeting with parents, please also refer to our recommendations under Consultation and Cooperation with Parents.