From the author: Published in the journal Psychotherapy number 2 for 2005, Professional Psychotherapeutic League, publishing house "Genius", pp. 21-25. entitled: Children with attention deficit syndrome in the general child mode kindergarten" (Recommendations for methodologists, educators, psychologists) This article provides recommendations on how to support the development of a preschool child with hyperactivity (F 90 according to ICD-10). The recommendations are intended for the administration of kindergartens, educators, and psychologists. In this article We will talk about children who often turn out to be the most difficult for kindergarten teachers. They create the greatest number of problems, both for themselves and for their parents, for the children in the group and for the teachers. As a rule, there is 1 in each kindergarten group. -2 such children, but there are several others whose problems are milder, but also require attention. These are children with a history of birth trauma, the consequences of which are called differently by Russian authors: this is encephalopathy, and minimal brain dysfunction, and attention deficit disorder and hyperexcitability. In accordance with ICD-10, this group of disorders is called “Hyperkinetic disorders” (F90) (5), although in our domestic literature the term minimal cerebral dysfunctions is most often used. According to the diagnostic criteria developed by the American Psychiatric Association and published in the Diagnostic and Statistical Manual of Mental Disorders (DSM-1V), the diagnosis of this syndrome is carried out in two dimensions: attention disorders and hyperactivity-impulsivity. The article was written based on the author’s experience working with this category of children and their parents in kindergarten. According to Russian researchers, such children in the population are at least 30 percent [5], according to various foreign researchers - from 1 to 20% [2]. Such differences may be associated both with the lack of a unified system for assessing symptoms and with differences in the quality of medical care for women and children during childbirth and in the first year of the child’s life. Why are these children difficult for adults? They are less obedient, make noise and run around, often fall and hurt themselves, drop something, and hurt others, since their movements are less coordinated [2, 5], and their attention is distracted. They are more aggressive and often become participants in conflicts in which they act physically. In addition, children with a higher level of self-control can easily provoke them into behavior that is not approved by adults, while they themselves will “get away with it.” Children with attention deficit disorder have an increased need for physical activity. Therefore, they often organize noisy games in the group, and become negative leaders in the group, demonstrating to others not the best examples of behavior. They also have difficulty sleeping during the day and create problems during quiet times. It is difficult for them to sit through the entire duration of classes taught by kindergarten teachers; it is difficult for them to concentrate on a lesson for a long time if it does not involve them very emotionally. They create a number of problems in learning, especially in preparing for reading and writing. [9]. They are often sent to speech therapy kindergartens because they often have some kind of speech problems (stuttering, general underdevelopment of speech, disturbances in sound pronunciation, both of an articulatory nature and those associated with the inability to distinguish certain sounds)[8]. All these children suffered during birth, or in the first few days of life, or during the intrauterine period of life, some difficulties that were accompanied by oxygen starvation of brain cells. And this oxygen starvation (hypoxia) led to the so-called biochemical injury. One of the consequences of this biochemical injury is an increase in intracranial pressure and/or chronic cerebral vascular tone in any area of ​​the brain (as a reaction to injury). As a resultAll these consequences, the study of which falls within the competence of neuropathologists, neuropsychologists and physiologists, the state of the central nervous system in these children changes, and they acquire characteristics that are externally expressed in the behavior already described. These changes in behavior and in the development of the child can be corrected, compensated, and the child can, over time, enter the normal course of development according to age. And for this it is necessary that parents consult doctors and treat the child, and also that the adults around him treat him in accordance with his individual characteristics [9]. One of the most important methods of correction is the creation of the necessary external conditions for the child, including through properly organized conditions for his stay in a preschool institution. These conditions are organized in accordance with the characteristics of the functioning of the child’s central nervous system. And the first feature of such children is that the processes of excitation in their central nervous system prevail over the processes of inhibition. The predominance of excitation over inhibition in children of this age is a physiological norm. But in children who have suffered hypoxia, excitement is more pronounced than in other children. Moreover, this excitement begins to grow if this child is in a group. If he is alone, he is calmer. The more children around him, the more excited he is. The problem especially increases if there are two or even three such children in a children’s group, since they mutually reinforce each other’s hyperexcitation with their behavior [3]. This excitement has two components: external motor, behavioral hyperactivity and internal, overexcitation at the level of mental processes, overexcitation of the central nervous system (internal plane). One of the recommendations here is that such children should be separated into different groups (usually in kindergarten there are two parallel groups of children of the same age). In some cases, if the child’s agitation is very pronounced (and as a rule, it is accompanied by other behavioral features described below), it may even be recommended to wait before placing the child in kindergarten. Or he should attend some special kindergarten, with a small group size, or simply attend clubs, development groups, where he comes for 1-2 hours a day. And, of course, such a child should receive treatment. This is the parents' concern. Unfortunately, parents often do not know that the child needs to be treated by a neurologist, neuropsychiatrist, or homeopath, since, unfortunately, there are often cases when the child is not diagnosed due to the ease of manifestations, or for some other reason. It is also not uncommon for a child to be intensively observed and treated by a neurologist for the first year of life. When his minimal cerebral dysfunction was compensated, he was removed from the neurologist's follow-up. The problem is often discovered again when the child enters a preschool institution or school (if he did not go to kindergarten), since in the new tasks of development, learning and communication, the child’s characteristics begin to appear, imposed by traumatic experiences (both physical and emotional) on his central nervous system. In addition, often these new conditions and the increased load on the child’s central nervous system (compared to home conditions) in preschool and school institutions become the cause of decompensation of those functions that were previously compensated. These more subtle disorders, less significant for doctors, turn out to be extremely significant for the family, for educators and teachers working with the child, and for the development of the child himself, including social development. Thus, it often happens that it is the teacher or other kindergarten employee (psychologist, valeologist, methodologist) who discovers peculiarities in the behavior and development of the child and reports them to the parents, and therefore it is he whobecomes the initiator of individual support for the development and upbringing of the child. However, there is a group of parents who find it difficult to invest additional efforts in the treatment and development of the child [4]. Sometimes it is simply difficult for them to overcome this barrier and admit that the child needs at least medical advice. Or the reason for the inattention of adult family members to the child may simply be their fatigue from a lot of work, from internal family problems, from a lack of money in the family, etc. Also, parents may not sufficiently understand the importance of treatment and other forms of help for the child, since they are not familiar with the consequences in adult life of not helping the child now. These include increasing problems at school, problems with controlling behavior, aggressiveness that increases during puberty, and the risk of drug addiction [6]. Therefore, the task of the teacher, psychologist, methodologist, and other kindergarten employees is to establish a trusting relationship with parents and help them understand that their child needs medical advice, individual treatment at home and in kindergarten, and an individual pedagogical approach. Another way to help children with hyperexcitability is to give them a relaxation of the kindergarten routine. The relaxation of the regime is expressed in the fact that the child is in kindergarten for fewer hours during the week than other children. Either he leaves the group earlier, or has an “extra day off” during the week, by individual agreement with the parents. Easing the regime is necessary to prevent overfatigue of the child’s central nervous system, which is caused by overexcitation, as well as its insufficient resources caused by injury. At home, the child’s need for rest should be supported by an appropriate environment in which his own physical and psychological space is allocated, in which he can be safe, alone, or in the presence of a small number of close relatives (instead of another large group of guests, adults or small). And this break from a large group of children is necessary not only for those children who clearly, outwardly demonstrate overexcitement. There are children with a strong social orientation who, due to this motivation, control their behavior in kindergarten, but then spend all their psychological resources on it. In kindergarten they look “pretty decent,” but since the resources are spent in kindergarten, the breakdown begins at home. When such a child comes to kindergarten for the first time, his behavior may look like this: in kindergarten he behaves like everyone else, and when he comes home, the parents see a violent reaction in the form of protest, or crying, or unusual running around, whims. A child may hide in a corner and cry; he cannot restrain himself, etc.. Ie. The child's behavior changed dramatically after he began attending kindergarten. Sometimes parents say: “He has become insane.” Why does this reaction occur? Because the resources of this child's nervous system are limited. To us adults, it often seems that everything in a child’s life is so simple: say hello to the teacher, wash your hands, go to the cafeteria (if there is one), then play, draw, etc. In fact, in kindergarten, a child encounters many new rules of behavior that he must learn and follow, and many new people with whom he must build relationships, with whom he must take into account. In the presence, in relationships with these other people, the child exhausts his resource to inhibit himself, and at home there is an emotional outburst on his parents. Parents sometimes talk about this in kindergarten, and sometimes not. If they trust the teacher, they can tell. Therefore, it is important to have this trusting relationship with parents and it is important to ask how the child behaves at home after kindergarten. If the child is this wayreacts during the adaptation period or a little later, then his parents should be advised to attend kindergarten for a while (and for some children permanently) only for half a day. Sometimes he needs to take a day off in the middle of the week and not take him to kindergarten. This day must be pre-agreed with the teacher so that the child does not have the impression that the requirements for him are chaotic. The next feature of children who have suffered hypoxia in utero or at birth is the so-called “disinhibition” [2]. This quality means that these children have a harder time than others stopping an activity they have started, especially in response to an adult's command to stop. It is recommended not to stop such children with a command with the particle “not” at the beginning, but to switch them to another activity using a positively formulated command. If parents and caregivers “stop” the child too often, this may ultimately cause him to have a nervous breakdown. Often the punishments used in kindergarten cause tension in the inhibition processes. For example: if you get into a fight, sit on a chair; If you broke a toy, stand in the corner. Or: the teacher left the group during quiet time, the children were playing around and throwing pillows. As punishment, children lie down after quiet time, when others have already gotten up. Psychologists conducted an interesting study that showed that if a child’s motor activity is slowed down, forcing him, for example, to sit, then he will still behave more actively at another period of time during the day and thus “gain” the characteristic and necessary for him the amount of motor activity. Therefore, punishments with deprivation of physical activity can cause unwanted physical activity in the child at other times of the day. It is preferable when the measures and sanctions applied include the child in physical activity aimed at correcting the mistake he has made, or the negative consequences of the action he has committed. For example: if you dropped a flower pot, sweep up the soil and replant the flower; broke a toy - fix it together with the teacher or parents; got into a fight - draw a picture for the offended person. The third feature of children who have suffered hypoxia is increased aggressiveness. It does not occur in all children with the consequences of hypoxia, but in general it is typical for them. That is, these children are more pugnacious than others, and this often creates special problems in the group. Their pugnacity and anger are biologically determined, since during hypoxia precisely those areas of the brain that are responsible for aggressive behavior were affected. The tendency of these children to get into conflicts and problematic situations is also supported by their feature, which is called “field behavior” [4]. This means that their behavior is determined by external stimuli (compared to internal stimuli) to a greater extent than other children. Simply put, they are easier to provoke than others, and they become victims of voluntary or involuntary “tricks.” How to work with this quality of a child? First of all, it is necessary to keep in mind that aggressiveness gradually decreases with age. But a lot depends on the atmosphere in the family and garden where the child is. There is a biological mechanism of aggressiveness, but if it is used often, it is trained, and something like a “knurled rut” is created. The child should be in an atmosphere in which he: A) would not receive negative examples of angry, aggressive behavior from adults, B) would not have reasons to react aggressively, C) would receive incentives for the harmonious development of the sphere of feelings. Namely, all the diversity of the child’s feelings should be accepted and encouraged (sadness, fear, joy, interest, admiration, gratitude, etc.). Otherwise, anger begins to grow as the only possible way to express feelings. D) so that the child feels safe, both physical and psychological, so that he does not have the need to defend himself(for example, from insults from an older brother). For the family, this means that there should be a calm atmosphere in the family, without angry manifestations between family members. This needs to be explained to parents and told them that it now depends on them what their child will be like at 12, 14, 30 and 50 years old, and how his life will turn out in the future. An untreated and improperly raised child will have problems with aggressive behavior during puberty and further into adulthood. It is especially important that such a child is not physically punished in the family. This traditional measure of “education” has not yet been eliminated in our culture, and is especially common in problem families, including in families where there is a hyperactive child. It is a hyperactive child who often becomes the object of aggression from adults, due to his increased physical activity, chaotic behavior and requiring increased attention from adults. Therefore, it is important to ask parents questions and clarify what punishments are used in the family. Often, in families with physical punishment, a vicious circle is created: a child has behavior problems - he is punished with a belt, or simply hit with a hand - he behaves even worse - he is punished again - he behaves even worse, etc. Requirements for In this case, the demands placed on the child, as a rule, go beyond his psychophysiological capabilities, that is, he cannot fulfill them in any way. The consequences of these punishments “fall” on the teacher, since he has no right to beat the child, and the behavior of this child in the group gets out of control. Here it is important to convince parents to abolish physical punishment and agree on a unified approach to education in the family and at home. The illusion of the effectiveness of physical punishment is supported by the fact that after physical punishment, many children actually “calm down” for a few days, and behave “good” from the parents’ point of view. This fact serves as a rational explanation for some parents for the correctness of their pedagogical “policy.” Meanwhile, after a few days the problem repeats itself. A certain cyclical pattern develops in the behavior of parents and children, with a gradual progression towards worsening the problem. Our observations of this category of children, as well as an analysis of the personality of adult clients with a history of physical punishment in childhood, reveal that physical punishment is often the pathogenetic cause of difficulties in the formation of the Parent’s ego-state or even leads to his “exclusion” (transactional analysis ) [7]. This pathology in the ego state is a form of psychological defense against the image of a “destructive parent” and negative emotions. Meanwhile, it is the Parent’s Ego state that is the “storage place” for the ethical norms and values ​​of the individual. Thus, we can conclude that physical punishment cannot serve as a method of education, since it does not form, but rather destroys, the necessary internal ethical regulators of behavior. Another feature of children who have suffered hypoxia is that their perseverance suffers, which is a common form of hyperexcitability and disinhibition. It is difficult for such a child to sit on a chair for the entire lesson, especially when the lesson does not include elements of physical activity, and when the limits of age norms regarding the duration of classes are not observed in the lessons. Such a child will “misbehave” in class. For example, he can spin around, stand up, get distracted, or touch those sitting next to him, or talk. Others will simply get up and start running, or go play. It is very important to monitor compliance with time limits in the activities of teachers with children. If the teacher has greatly developed the control function, his children will quietly sit through two classes in a row. But the teacher who comes to replace him will receive an emotional outburst not only from difficult children, but from the entire group as a whole. There are also very responsible teachers who strive to pass on as much as possible to children.knowledge and skills that do not know how to positively evaluate the results of their work. The job of a psychologist in a kindergarten, or a manager if there is no psychologist, is to give them the opportunity to relax, to help them reduce the excessive demands that they place on themselves and on the children, and thus help the children. A somewhat similar problem occurs during quiet time. Some children who have suffered from hypoxia cannot fall asleep for a very long time, or cannot fall asleep at all during the day. Moreover, it is difficult for them to lie still during the entire quiet hour (if they have not fallen asleep), and the quiet hour turns into torture for both the teacher and the child. Here the issue must be resolved individually: if the child can lie still during quiet time, he can be left in the group. If he cannot lie down, then he must be removed from the group. Some kindergartens organize special rooms for children who do not sleep during quiet hours. Usually there are several such children per kindergarten. If there is no such room in the kindergarten, then the parents' responsibility is to pick up the child from the kindergarten at midday or during quiet time. Perhaps this solution to the problem may seem too bold to some. But here it is necessary to develop an understanding that this is necessary in the interests of the mental and physical health of the child, and that the main responsibility for the life, health and development of the child lies with his parents, and not with a government agency or educator, which is reflected in the Declaration of the Rights of the Child. Among hyperexcitable children, there are also those in whom hyperexcitability leads to nocturnal and daytime enuresis [2]. Daytime and nocturnal enuresis differ from other urinary disorders in that the child falls asleep so deeply during night or daytime sleep that the bladder sphincter relaxes and the child does not notice how he pees. True, some children wake up immediately after they pee, but because they are lying in a wet bed. Daytime and nocturnal enuresis cannot be controlled by the child and cannot be stopped by suggestions, persuasion, punishment or psychotherapy. Daytime and nocturnal enuresis are not re-educated, but treated by a neurologist or psychotherapist. In any case, it is necessary to visit a doctor to clarify whether enuresis in this case is a neurotic symptom, a neurological symptom, or signals a complex problem. If such a child appears in the group, then it is good if one of the kindergarten employees clarifies with the mother whether she is doing anything, whether she has consulted a doctor, or whether the child is undergoing treatment. One of the mistakes that parents and educators make in relation to these children is that they begin to wake up the child in the middle of sleep in order for him to visit the toilet [2]. This is wrong, as it worsens the child’s condition. Daytime and nocturnal enuresis are associated with the fact that during the day the child’s central nervous system is overexcited and, accordingly, gets tired. Compensation occurs due to deeper immersion in sleep than is the case with healthy people. During such super-deep sleep, the child relaxes more than other children, and even the sphincter of the bladder relaxes, which is why the child wets the bed. If the child is woken up in the middle of sleep, then he will not achieve the necessary immersion in sleep, his brain will not rest, which will increase daytime overstimulation and worsen the child’s condition. Children who have suffered hypoxia during childbirth often have peculiarities of intellectual, emotional and personal development. One of the options encountered is that the child’s intellectual development is normal, or even exceeds the age norm, and emotional and social development corresponds to a year or two less [2]. This means that this child’s behavior and emotional reactions to events will be similar to those of younger children. Therefore, he has problems playing with children his own age, but lessproblems with younger children. In some cases, this problem is successfully solved by transferring the child to a group 0.5 to 1 year younger. Another solution is to place such a child in a group where children are older than him and will treat him as a small child. The question of assigning a child to a group should not be decided solely on the basis of his intellectual data, but comprehensively based on the data of both intellectual and personal development. The second option encountered is a lag in intellectual development. This is a “mild” delay, which cannot be qualified as a developmental delay, but it is noticeable against the background of other children, and is manifested in particular in the fact that the child experiences difficulties in mastering material in classes to prepare for mathematics, reading, writing, etc. etc. Such a child will lag behind in group classes, and he will eventually become bored in classes where he does not understand what is being discussed. This child’s motive for learning and understanding the world around him suffers. In addition, he suffers emotionally and develops an inferiority complex, since he constantly sees that other children succeed, but he does not. As a result, he may even refuse to do something or not want to participate in activities at all. Here the recommendation may be to place such a child in a younger group, or in a mixed-age group. Both there and there he will feel more comfortable. But mixed-age (mixed) groups are rare in kindergartens, as they require very high qualifications and dedication to their work from teachers. In case of developmental delay, consultation with a doctor is also necessary. Often it is enough to start taking medications that improve cerebral circulation, or take a course of electrophoresis, or follow other doctor’s orders, and the child makes leaps in his intellectual development. A teacher cannot teach a child if he does not have enough physical resources for learning, which must be supported medically and by a general lifestyle. And the last recommendation. It consists in the fact that sometimes a child is so problematic that he should not attend kindergarten at all. And it is very important, in the interests of the child himself, to delicately but persistently convince the parents that it is necessary to leave such a child at home. Often parents have the false belief that “the child must be in a group in order for him to learn to communicate with other children.” However, team interaction skills in this case are not adequately developed, since the whole situation as a whole does not contribute to this. Wrong patterns of behavior and wrong ways of responding are reinforced. And redoing an incorrectly formed skill is much more difficult than developing the correct skill “on a blank sheet of paper.” From the point of view of a long-term prognosis for social success, it is better for such a child to be at home, until he is 4, until he is 5 years old, etc. In any case, the issue must be resolved individually, taking into account all medical, social circumstances and the characteristics of the child’s development. When counseling and psychological support for families with a hyperactive child, it is proposed to use ideas from transactional analysis about devaluations, since the consultant has to deal with adult family members devaluing the child’s physical symptoms, devaluing the role of the physical factor in his development, the limited resources of his central nervous system, devaluation of the importance of medical treatment and other devaluations that are means of protecting script beliefs. (In translated literature, sometimes “depreciation” is translated as “ignoring” [7]) [7, 10]. Literature1. Bryazgunov I.P., Kasatikova E.V. A restless child, or everything about hyperactive children. - M.: Publishing House of the Institute of Psychotherapy, 2001.-96 p.2. Buyanov M.I. Conversations about child psychiatry: A book for teachers. - M.: Education, 1986. - 208 pp. 3. Zakharov A.I. How to prevent developmental disorders in children:. 295-302