International Journal of Medical Sciences And Clinical Research
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VOLUME
Vol.05 Issue07 2025
PAGE NO.
24-28
10.37547/ijmscr/Volume05Issue07-06
To the Question of Determining the Cognitive Status and
Non-Specific School Maladaptation in Children with
Attention and Hyperactivity Syndrome
Zakirova Feruza Nodir qizi
Tashkent State Medical University, Uzbekistan
Madjidova Yakutkhon Nabiyevna
Tashkent State Medical University, Uzbekistan
Received:
31 May 2025;
Accepted:
29 June 2025;
Published:
31 July 2025
Abstract:
We conducted our own research to determine the cognitive status and non-specific school
maladaptation in children with attention and hyperactivity disorder.
Keywords:
Methods, corrections, children, status.
Introduction:
Determining the cognitive status and
specific school maladjustment in children with
attention deficit hyperactivity disorder (ADHD) involves
assessing various cognitive functions such as attention,
memory, executive functions, as well as examining the
problems the child encounters at school.
This allows us to identify the difficulties that the child
faces in learning and communication and to develop
appropriate methods of correction and support.
Despite the fairly large volume of research studies in
this area, the problems of the etiological and
pathogenetic factors of ADHD remain to this day not
fully disclosed, that is, the authors do not have a unified
opinion on them.
There are many scientists who suggest a genetic basis
for the syndrome, citing the frequent presence of
similar behavioral characteristics in close relatives in
such children, as well as the presence of a large number
of neuropsychiatric syndromes in the family of these
patients.
Hereditary components occupy a significant place
among the factors in the formation of attention deficit
hyperactivity disorder. In this situation, there is also a
lot of evidence demonstrating a fairly high degree of
correlation relationships for this syndrome in
monozygotic twins, amounting to 80 to 100%),
as well as higher rates of hyperactivity among relatives
of hyperactive children.
There are many authors who attribute the main and
most important influence on the processes of
etiopathogenesis to prenatal, perinatal and postnatal
risk factors, such as various pathological processes
during pregnancy, hypoxic-ischemic and infectious
manifestations that affect the activity not yet
ompletely the formed brain of the fetus and newborn,
various traumatic processes during the period of labor
and at the end of the child's illness in the first year of
life.
In addition, regarding these factors, there are opinions
that their outcomes largely depend on the socio-
psychological situation surrounding them. For example,
in children from families with high socio-economic
status, the functional consequences of prenatal, birth
and postnatal periods, by 6-7 years, have almost
complete recovery, whereas in patients from families
with a low socio-economic level, this is not observed
and, as a rule, functional deviations persist.
Currently, according to the majority of scientists, the
fundamental basis of pathogenetic processes in ADHD
is a failure in the activity of the activating system of the
limbic-reticular complex (LRC), since it is this complex
that plays the main role of regulating learning,
memory, attention, emotional experiences, as well as
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
in the processing of incoming endogenous and
exogenous information.
Patients in this category experience a certain
dysfunction in the system, which leads to incorrect
information processing, causing overload and chaos of
incoming information, with overload and overstrain of
the child, which in turn forms general anxiety,
irritability and aggressiveness.
The initial signs of the clinical picture of attention
deficit hyperactivity disorder in children can essentially
be observed already in the first months of life (the
importance of identifying diseases in the first year of
life) of the child. Such children are usually distinguished
by their high susceptibility and increased response to
stimuli.
In addition, the child may show his anxiety absolutely
groundlessly, in particular by very loud and frequent
crying, he has a sleep disorder and, most importantly, a
sleeping position, namely, with the div arched
backwards, such children do not fall asleep for a long
time and wake up at any insignificant sound.
In terms of motor skills, general lags from healthy peers
of 1.5-2 months may be detected. As a rule, in the
context of the formation of speech skills, these children
are inert, inhibited, and indifferent.
The first rather difficult period of a child’s development
occurs at the age of three, since this is the time of one
of the crisis stages of the development of the brain in
general and cognitive activity in particular.
It is during this period of time that the formation and
development of memory and attention functions
occurs, in addition, it is marked by the formation of
one’s own “I”, as well as excessive importance and
independence, along with increasing signs of
stubbornness, obstinacy and denial.
At this stage of development, clear signs of attention
deficit hyperactivity disorder are determined with
almost 100% certainty; here, the nervous system is no
longer able to optimally manage the flow of incoming
information, which, moreover, is aggravated by an
increase in both physical and emotional stress.
In this regard, the most important aspect on the part of
adults is the understanding that a child in most cases
cannot understand the consequences of his behavior;
there is a backlash to comments or scolding.
He becomes more confused, his self-esteem drops, he
stops recognizing the authority of adults, the
impulsiveness and aggressiveness of such children
comes out. All this further contributes to the
deterioration of the situation.
Signs of attention deficit hyperactivity disorder in
preschool children include difficulties in perception and
thinking, excessive activity in a new, unfamiliar
situation, and delays in development of fine motor
skills, spontaneous occurrence of various tic
hyperkinesis or nocturnal enuresis is possible in such
children; in 100% of cases, emotional lability and
manifestations of negativism are noted.
The manifestations of the above-mentioned signs
become clearly expressed with the arrival of the child
in a new group (kindergarten or school), where
completely new requirements and people await him. If
in the so-called comfortable conditions, that is, in the
familiar home environment, the rules by which he lived
worked, then in a new, stressful situation they do not
work at all. This leads to even more severe nervous
shocks for the child. Usually, children with ADHD can
disrupt classes with their bad behavior and attract
everyone's attention, and cannot find a common
language with their peers.
Because of which in most cases they are alone, in
addition to this the child does not react to the
comments of adults, they begin the process of forming
a new model of social and communicative relations and
their self-esteem decreases sharply. This situation,
which is obvious, only worsens their social isolation.
It is also natural that this situation has a negative
impact on school education itself. The child poorly
masters writing, counting, reading skills, there is a
marked decline in academic performance, even with a
high level of intelligence, the functions of memory,
attention and thinking suffer.
Thus, attention deficit hyperactivity disorder is
considered a psychoneurological pathology with a
rather complex etiopathogenesis. In most cases, this
syndrome is verified in preschool children.
In the presence of concomitant neurological disorders,
the manifestations of ADHD are sharply aggravated,
which significantly worsens social activity, ability to
work and quality of life of this category of children.
According to the above, the primary task of specialists
should be to identify disorders of cognitive and
emotional activity in patients with ADHD already at the
early stages of the disease, followed by mandatory
monitoring.
The aim of our study
was: to study the factors of non-
specific school maladaptation and the features of
cognitive status in children with ADHD.
METHODS
We conducted a detailed analysis of 95 children
diagnosed with attention deficit hyperactivity disorder.
Of these, boys accounted for 65.2% (n=62), girls 34.7%
(n=33). The age of the patients ranged from 5 to 10
years.
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
RESULTS
Of the total number of examined patients with ADHD,
31 (32.6%) children had a deficit of active attention, 46
(48.4%) had dominant motor disinhibition, and 18
(18.9%) had predominant impulsivity.
The data are presented in Table 1.
Table 1.
Distribution of examined children by clinical variants of the syndrome depending on
gender
Clinical variants of the syndrome
ADHD
(n=48)
ADHD
+ (n=47)
Абс. %
Абс. %
Attention deficit disorder (n=31)
16
33,3
15
31,9
Motor disinhibition (n=46)
22
45,8
24
51,0
Impulsivity (n=18)
10
20,8
8
17,02
Testing using the Raven's Colored Progressive Matrices
method demonstrated that children in both groups
completed the procedure relatively satisfactorily, with
25% of patients achieving level I success, 50% of
children achieving level II success, and 35% of children
achieving level III success.
The average indicator for the groups was 22.5 points.
Boys showed a result from 17 to 23 points, and girls, in
turn, from 18 to 26 points. After the final scoring of the
results, the patients' indicators were compared with
the level of testing success (Table 2).
Table 2.
Level of success in passing the Raven's matrix test.
Success rate
Points
Percentage
of
tasks
completed correctly
I
17 and less
less than 15%
II
17,5-22,5 б
50%
III
22,75-27,9 б
35%
IV
28 and more b
0%
* – differences in statistically significant indicators (p < 0.05).
As can be seen from the table, in both groups, most
children reached the second level of success in
completing the methodology, having solved 50% of the
proposed tasks correctly. Not a single child reached the
fourth level of success.
The results of the memory study for 10 pictures are
shown in Tables 3- 4.
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
Table 3.
Results of diagnostics using the visual memory study method
ADHD
(n=48)
ADHD
(n=47)
Average value
7,09
6,85
Standard Deviation
1,90
1,48
The levels of development of logical and mechanical
memory of the subjects were diagnosed individually for
each subject based on the mean value and standard
deviation.
Determination of the level of speech development of
preschool children according to the methods of O.A.
Bezrukov and O.N. Kalenkov revealed the coefficients
of speech development presented.
The best results of the speech development skills
coefficient were in children with ADHD - 34 points. At
the same time, in this group of patients, disorders of
grammatical, communicative function and internal
speech. In the second group of patients, the coefficient
of speech development skills was 32 points, which
indicates a greater severity of cerebral disorders of the
perinatal period of development.
The assessment of the child’s communication skills
according to M.A. Povalyaev is presented in Table 4.
Table 4.
The level of social and communication skills in children with ADHD.
Categories
Group
ADHD
(n=48)
ADHD
+ (n=47)
Level 1 - High
(0,0)
(0,0)
Level 2 - Intermediate
10 (20,8)
7(14,8)
Level 3 - low
38 (79,1)
40 (85,1)
Level 4 - very low
(0,0)
(0,0)
* – differences in indicators are statistically significant (p < 0.05).
The average level of development of social and
communication skills was noted in 20.8% of children in
the ADHD group and 14.8% of children with ADHD+.
Patients from the first group were more sociable, more
interested in the surrounding environment. But despite
this unstable attention, excessive impulsiveness
created some problems in the process of
communication. The maximum duration of interaction
was approximately equal to 10 to 15 minutes.
A low level of development of social and
communicative
abilities
was
found
in
the
overwhelming majority of patients with ADHD
–
79.1%,
and in the majority of children with ADHD+
–
85.1%.
These patients, on the contrary, had difficulty
interacting with adults and peers, were often
embarrassed, shy, and expressed anxiety. The
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
maximum duration of communication was no more
than 10 minutes.
Polymorphism of cognitive and psychoemotional
disorders Various deviations in higher cortical activity
in children with ADHD, unfortunately, are inherent
components of the disease. It is they that are the basis
and determine the children's capabilities for optimal
learning and social and communicative adaptation.
According to this, the primary task should be to identify
these disorders at the earliest stages of the disease
with subsequent monitoring. To achieve this, we
propose the above questionnaire, the features of which
are ease of use, reliability and a high degree of
specificity.
CONCLUSIONS
In conclusion, the definition of cognitive status and
specific school maladjustment in children with ADHD is
an important step in providing them with the necessary
help and support. A comprehensive approach,
including clinical assessment, neuropsychological
testing, observation and questionnaires, allows us to
identify the difficulties the child is experiencing and to
develop effective strategies of correction and support
aimed at improving his cognitive development and
school adaptation.
REFERENCES
Pushkareva D.V., Ivanova T.I. Attention deficit
hyperactivity disorder in adults: causes, main clinical
manifestations and comorbid mental disorders
(literature review) // Omsk Psychiatric Journal. - 2018.
- No. 4. - P. 8-13.
Leonova A.V., Raeva T.V. Speech development
disorders
in
children
with
attention
deficit
hyperactivity disorder // Mental disorders: from
understanding to correction and support / Proceedings
of the regional scientific conference. Rostov State
Medical University University of the Ministry of Health
of the Russian Federation, Faculty of Advanced Training
and PPS, Department of Psychiatry and Narcology.
2018. - P. 142-144.
Shevchenko I. A. Social and biological risk factors for
ADHD / I. A. Shevchenko // Luria's approach in world
psychological science: abstracts of reports of the V
International Congress in memory of A. R. Luria.
Ekaterinburg, Russia, October 13-16, 2017 -
Ekaterinburg, 2017. - P. 151.
Agnew-Blais J., Polanczyk G., Danese A., Wertz J.,
Moffitt T., Arseneault L. Young adult mental health and
functional outcomes among individuals with remitted,
persistent and late-onset ADHD. - The British Journal of
Psychiatry. - 2018. - 213(3).
–
P. 526-534.
Molina B.S.G., Howard A.L., Swanson J.M. et al.
Substance use through adolescence into early
adulthood after childhood-diagnosed ADHD: findings
from the MTA longitudinal study. J Child Psychol
Psychiatry.
2018;59(6):692
–
702.
DOI:
10.1111/jcpp.12855.
Catala-Lopez F., Hutton B., Nunez-Beltran A. et al. The
pharmacological and non- pharmacological treatment
of attention deficit hyperactivity disorder in children
and adolescents: a systematic review with network
meta-analyses of randomised trials. PLoS One.
2017;12(7):
e0180355.
DOI:
10.1371/journal.pone.0180355.
