Sempre più sentiamo parlare di difficoltà di attenzione nei bambini, negli adolescenti ma anche negli adulti. In ambito scolastico gli insegnanti conoscono bene le difficoltà di attenzione e le ripercussioni sull’apprendimento. Ma le difficoltà di attenzione colpiscono anche gli adulti che spesso non sono stati riconosciuti durante il periodo d’infanzia e per tale ragione hanno dovuto affrontare tutto da soli.
Cosa è l’ADHD o il DDAI?
- Il DDAI (Disturbo dell’attenzione e/o iperattività) o ADHD ( Attention deficit hyperactivity disorder), è un disturbo del neurosviluppo caratterizzato fenomenicamente da livelli invalidanti di disattenzione, disorganizzazione e/o iperattività-impulsività.
- La disattenzione e la disorganizzazione (disattention) comportano l’incapacità di mantenere l’attenzione su un compito che richiede concentrazione, l’apparente mancanza di ascolto e la perdita di oggetti , a livelli inadeguati all’età o al livello di sviluppo.
- L’iperattività (hyperactivity) comporta un’eccessiva attività motoria. I bambini, possono avere difficoltà a sedere tranquillamente quando dovrebbero ( es., a scuola), incapacità di aspettare, intromissione nelle attività altrui. I pazienti più adulti mostrano segni di irrequietezza, agitazione e loquacità, a volte al punto che gli altri si sentono esausti al solo guardarli
- L’impulsività (impulsivity) si riferisce ad azioni affrettate che hanno il potenziale per un esito negativo (p. es., nei bambini, che attraversano una strada senza guardare, negli adolescenti e negli adulti, che improvvisamente interrompono la scuola o lasciano un posto di lavoro senza pensare alle conseguenze).
- Durante il periodo infantile, l’ADHD si sovrappone frequentemente a disturbi spesso ritenuti “esternalizzanti”, come il disturbo oppositivo-provocatorio e/o il disturbo della condotta.
Si ha una maggior rappresentazione nei maschi rispetto alle femmine, con differenze nelle varie aree geografiche spesso attribuite alle diverse pratiche metodologiche e diagnostiche. L’ADHD può essere associato ad altri disturbi del neuro sviluppo: apprendimento, comportamento motorio ripetitivo, tic.
L’ADHD spesso persiste nell’età adulta, con conseguente compromissione del funzionamento sociale, scolastico, e lavorativo.
A causa delle difficoltà che si evidenziano nel soggetto è sempre necessario un percorso di riabilitazione, poiché la compromissione può compromettere tutti i campi della vita relazionale, sociale, scolastica e lavorativa dell’individuo.
Come si diagnostica l’ADHD?
L’ADHD è un disturbo che necessita di test specifici e osservazione clinica affinché si possa arrivare ad una diagnosi precisa nel soggetto.
- Esistono test specifici a seconda della fascia di età, sia per l’infanzia e l’adolescenza ma anche per gli adulti.
- I test sono indispensabili anche per capire la compromissione del soggetto e l’eventuale percorso riabilitativo da perseguire.
Quali tipi di interventi sono indispensabili per aiutare il soggetto e la famiglia?
- Gli interventi riabilitativi tendono a cogliere queste caratteristiche e afferiscono a tecniche cognitivo-comportamentali, prevalentemente individuali ma anche di un gruppo; a volte può essere scelta, in affiancamento, una terapia farmacologica monitorata.
- Dal modello neuropsicologico si può estrarre, ad esempio un “allenamento” delle funzioni esecutive (autoregolazione dell’attenzione), con una metodologica centrata sui tempi e sulla qualità del compito: il classico potenziamento dell’attenzione selettiva è quello dei barrage di stimoli, ordinati o casuali, spaziali o sequenziali, etc (esistono anche software specifici).
- Frequentemente in associazione ai trattamenti individuali assistiamo all’utilizzo di tecniche gruppali rivolte ai genitori con lo scopo formativo di cambiare modalità disfunzionali di relazione genitore-figlio.
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