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  • Print publication year: 2006
  • Online publication date: August 2009

17 - Hyperkinetic disorders

Summary

Introduction

Many children show traits of behaving in an impulsive, inattentive and restless fashion. These behaviours, when not severe, need not constitute a problem. When extreme, however, they present a risk for the psychological development of the individual. Severe levels of ‘hyperactivity’ (the combination of impulsiveness, restlessness and overactivity) make children more likely to develop an antisocial adjustment, and more likely to show various aspects of personality dysfunction in later adolescence and adult life. Children's hyperactivity can also be very unpleasant for the caregivers. Both teachers and parents can find it hard to live with a hyperactive child, and their tolerance and ability to cope may determine whether it is presented as a problem. Children with hyperactivity rarely ask for help themselves, and are often not aware of a problem. The presentation to the clinician is therefore a complex blend of the skills and tolerance of adults surrounding the child and the qualities of the children themselves. They constitute the commonest reason for referral to child mental health or behavioural paediatric services in many countries. Effective physical and psychological treatments are available, and the management needs to be long term. Hyperactive behaviour problems therefore make up a large part of the work of most community mental health services for children.

Definition and classification

ICD 10 criteria

The ICD-10 definition of hyperkinetic disorder is based upon the simultaneous presence of all three main behavioural problems: attention deficit, overactivity and impulsiveness.

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SUGGESTED READING
, P. Hill & , E. Taylor, An auditable protocol for attention deficit/hyperactivity disorder. Archives of Diseases in Childhood, 84 (2001), 404–9.
MTA, A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Archives of General Psychiatry, 56 (1999), 1073–86.
, R. Schachar & , R. Tannock, Syndromes of hyperactivity and attention deficit. Child and Adolescent Psychiatry: Modern Approaches, 4th edn (Oxford: Blackwell Publishing, 2002), pp. 399–418.
, J. M. Swanson, , J. A. Sergeant, , E. Taylor, , E. J. S. Sonuga-Barke, , P. J. Jensen & , D. P. Cantwell, Attention-deficit hyperactivity disorder and hyperkinetic disorder. The Lancet, 351 (9100) (1998), 429–33.
, E. Taylor, Developmental neuropsychopatology of attention deficit and impulsiveness. Development and Psychopathology, 11 (1999), 607–28.
, E. Taylor, , J. Sergeant, , M. Doepfneret al., Clinical guidelines for hyperkinetic disorder. European Child and Adolescent Psychiatry, 7 (1998), 184–200.
Appendix
Some useful treatment manuals
, R. A. Barkley, Defiant Children. A Clinician's Manual for Parent Training. (New York: Guilford, 1987).
, M. A. Bash & , B. W. Camp, Think Aloud. Classroom Program Grades 3–4. (Champaign, Ill.: Research Press, 1985).
, L. Braswell & , M. L. Bloomquist, Cognitive Behavioral Therapy with ADHD Children. (New York: Guilford, 1991).
, M. Dopfner, , S. Schurmann & , J. Frolich, Das Therapieprogramm fur Kinder mit hyperkinetischem und oppositionellem Problemverhalten (THOP). (Weinheim: Psychologie-Verlags-Union, 1996).
, G. J. DuPaul & , G. Stoner, ADHD in the Schools. Assessment and Intervention Strategies. (New York: Guilford, 1994).
, P. C. Kendall & , L. Braswell, Cognitive-Behavioral Therapy for Impulsive Children. (New York: Guilford, 1985).
, G. W. Lauth & , P. F. Schlottke, Training mit aufmerksamkeitsgestorten Kindern. (Weinheim: Psychologie Verlagsunion, 1993).
, A. L. Robin & , S. L. Foster, Negotiating Parent–Adolescent Conflict. (New York: Guilford, 1989).
, J. Swanson, School-based Assessments and Interventions for ADD Students. (Irvine: K.C. Publishing, 1992).
Questionnaires
Clinical Checklist for Hyperkinetic Disorders/ADHD (CCHD)
, M. Doepfner, , S. Schuermann & , J. Froelich, Therapieprogramm für Kinder mit hyperkinetischen Störungen (THOP). (Weinheim: Psychologie Verlags Union (German version), 1997).
Conners' rating scales
, C. K. Conners, Conners' Rating Scales: Revised Technical Manual. (New York: Multi-Health Systems, 1997).
Home situations questionnaire
R. A. Barkley, Attention-deficit Hyperactivity Disorder. A Clinical Workbook. (New York: Guilford Press, 1991).
Inattention, hyperactivity and impulsivity checklist for adolescents (IHI/A-Checklist)
, M. Doepfner, , S. Schuermann & , J. Froelich, Therapieprogramm für Kinder mit hyperkinetischen Störungen (THOP). (Weinheim: Psychologie Verlags Union (German version), 1997).
Inattention, hyperactivity and impulsivity checklist for parents and teachers (IHI/PT-Checklist):
, M. Doepfner, , S. Schuermann & , J. Froelich, Therapieprogramm für Kinder mit hyperkinetischen Störungen (THOP). (Weinheim: Psychologie Verlags Union (German version), 1997).
Interviews
Clinical interview for attention deficit and disruptive behaviour disorders (CIAD)
, M. Doepfner, , S. Schuermann & , J. Froelich, Therapieprogramm für Kinder mit hyperkinetischen Störungen (THOP). (Weinheim: Psychologie Verlags Union (German version), 1997).
Diagnostic interview schedule for children–parent interview (DISC-P)
Shaffer, D., Fisher, P. & Dulcan, M. K., The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the epidemiology of child and adolescent mental disorders study. Journal of the American Academy of Child and Adolescent Psychiatry, 35 (1996), 865–77.
Parental account of children's symptoms (PACS)
Taylor, E. A., Schachar, R., Thorley, G. & Wieselberg, M., Conduct disorder and hyperactivity: I. Seperation of hyperactivity and antisocial conduct in British child psychiatric patients. British Journal of Psychiatry, 149 (1986), 760–7.
Observations
Observation in the clinic
Luk, S.-L., Thorley, G. & Taylor, E., Gross overactivity: a study by direct observation. Journal of Psychopathology and Behavioral Assessment, 9 (1987), 173–82.
Groeningen behaviour observation scale
, A. F. Kalverboer (ed.), Developmental Biopsychology. (Ann Arbor: University of Michigan Press, 1990).
Neuropsychological assessment
Continuous performance tests (CPT)
, C. K. Conners, Conners Continuous Performance Test II. (Hurstpierpoint, UK: International Psychology Services, 2000).
Matching familiar figures test (MFFT)
Cairns, E. & Cammock, T., Development of a more reliable version of the matching familiar figures test. Developmental Psychology, 11 (1978), 244–8.
Stroop
Cohen, J. D. & Servan-Schreiber, D., Psychological Review, 99 (1992), 45–77.
TEACH (Test of everyday attention for children)
Manly, T., Anderson, V., Nimmo-Smith, I., Turner, A., Watson, P. & Robertson, I. H., The differential assessment of children's attention: the Test of Everyday Attention for Children (TEA-Ch), normative sample and ADHD performance. Journal of Child Psychology and Psychiatry, 42 (2001), 1065–81.
Tower of Hanoi
Welsh, M. C., Pennington, S. Ozonoff, Rouse, B. & McCabe, E. R. B. (1990), Child Development, 61 (1990), 1697–713.
Tower of London
Shallice, T., Philosophical Transactions of the Royal Society of London, Biology, 298, 199–209.
Wisconsin Card Sort Test
, D. Grant & , E. Berg, The Wisconsin Card Sort Test: Directions for Administration and Scoring. (Odessa: Psychological Assessment Resources, 1948).