میتوان گفت تا اندازهای همه کودکان احساس عصبانیت را تجربه کنند، و در بعضی از موارد هم ممکن است حتی پرخاشگر، عصبانی و یا نافرمان شوند. اما در این موارد جای نگرانی نیست، چرا که این رفتارها با وجود این گه گاهی چالش برانگیز هستند، اما میتوان گفت بخشی از رشد طبیعی کودکان نیز میباشند.
اما در خصوص موضوع اختلالات رفتاری باید گفت که چیزی فراتر از این مساله بوده و با آن دسته از رفتارهای چالشی که گاهی ممکن است در کودکان بروز پیدا کند، متفاوت خواهد بود. در همین ابتدا بگوییم که این دسته از رفتارات در بین کودکانی بد سرپرست یا بیسرپرست بسیار شایع بوده و همین دلیل مناسبی است تا موسسات خیریه در مشهد، رفع اختلالات روانی در کودکان را الویت کاری خود قرار دهند.
اختلالات رفتاری کودکان به رفتارهایی گفته میشود که خارج از محدوده سنی و رفتار طبیعی و بهنجار میباشند. به عنوان مثال از شایعترین انواع این رفتارها میتوان به اختلال بیش فعالی و نقص توجه، اختلال سلوک و … نیز اشاره کرد که در ادامه به آن پرداخته خواهد شد.
لازم به ذکر است که این اختلالات و رفتارها گاهی علائمی مشابه هم داشته و تشخیص اختلال کودک بدون تخصص، امری سخت به شمار خواهد رفت، و به قطع نیاز به نظر متخصص کودک خواهد داشت. از همین رو جهت تشخیص دقیق آن، میبایست حتما به مشاوره کودک مراجعه نمود.
اختلالات رفتاری کودکان میتواند به دلایل متعددی پدیدار شوند، که عبارتند از:
- شرایط ژنتیکی و ارثی
- عوامل مختل کننده پیش از تولد
- نارساییها در بدو تولد
- مشکلات زایمان مادر
- آسیب جسمانی به مغز
- فقر و وضعیت نامساعد اقتصادی
- شرایط محیطی
- شرایط خانوادگی نامناسب و پراسترس
- شرایط اجتماعی و فرهنگی نامناسب
- شکستهای پی در پی و تجربه ناکامی
- بدرفتاری با کودک
- نادیده گرفتن نیازهای کودک
- روابط ناسالم
- روابط ضعیف با دوست و همسالان
- الگوهای تربیتی غلط
- بیماریهای مزمن جسمانی
- جنسیت
- رشد ناکافی مغز
- مشکلات یادگیری
شایعترین اختلالات رفتاری در کودکان
مشکلات رفتاری کودکان، از انواع مختلفی برخوردار بوده که هر کدام از آنها با نشانهها و دلایل مخصص به خود پدیدار میشوند. در این بخش برخی از شایعترین مشکلات رفتاری کودکان را مورد بررسی قرار خواهیم داد.
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اختلال لجبازی از شایعترین اختلالات کودکان
کودکانی که دارای اختلال رفتاری لجبازی هستند، به صورتی خصمانه و یا حتی انتقام جویانه سعی در مخالفت و نافرمانی با والدین و اطرافیان خود داشته و با این رفتار سعی دارند تا قدرت خود را نشان دهند.
از علائم تشخیص این اختلال رفتاری در کودکان، عبارتند از جر و بحث زیاد با بزرگسالان، بیتوجهی به دستورات، رفتارهای کینه توزانه، خشم و پرخاش و سرزنش اطرافیان.
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اختلال سلوک
این نوع اختلال، از دسته رفتارهای پرخاشگرانه در کودکان میباشد. در خصوص این اختلال باید گفت که نسبت به اختلال لجبازی و نافرمانی، بسیار شدیدتر است و ممکن است پیامدهای سنگینتری برای خود کودک و یا خانواده و اطرافیان او داشته باشد.
کودکانی که اختلال رفتاری سلوک دارند، نسبت به قوانین موجود کاملا بی اعتنا بوده و ممکن است کارهایی را انجام دهند که از لحاظ هنجارهای اجتماعی، برای سن او اصلا مناسب نباشد.
رفتارهایی از قبیل دعوا و درگیری در داخل و خارج از خانه، در برخی موارد دزدی، رفتارهای جنسی از سنین پایین، دروغ گویی، بزهکاری و … را میتوان به عنوان رفتارهای هنجارشکن در کودکان مبتلا به این اختلال رفتاری برشمرد.
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اختلال بیش فعالی و نقص توجه
بیش فعالی را میتوان به عنوان شایعترین اختلالات رفتاری در کودکان محسوب نمود. این رفتار معمولا در دوران دبستان تشخیص داده میشود.
کودکانی که به این اختلال مبتلا هستند، علائمی مانند بیقراری و توجه و تمرکز بسیار پایین داشته، که موجب میشوند تا نتوانسته به درستی در کلاس درس متمرکز شده و یا تکالیف خود را به درستی انجام دهند. همچنین در اکثر کودکان بیش فعال دیده شده که حتی نمیتوانند به خاطر بیاورند که میبایست چه کاری را انجام دهند.
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اختلال تیك از دیگر اختلالات شایع کودکان
تیک، به یک حرکت یا صدایی گفته میشود که کودکان به طور ناگهانی، غیر موزون و کلیشهای آن را انجام میدهند. کودکانی که به اختلال تیک مبتلا هستند، معمولا کنترلی در مقابل آن ندارند، اگرچه در برخی موارد زمان آن به تاخیر میافتد.
این نوع اختلال یا تیکهای عصبی، عموما زمانی اتفاق میافتد که فشار روانی زیادی روی کودک باشد. ضمن این که تیکهای حرکتی و صوتی دو دسته هستند، تیک ساده و تیک مرکب.
البته باید گفت جای نگرانی زیادی نیست، چرا که انواع اختلال تیک در کودکان موقتی بوده و با درمان دارویی و گذر زمان نیز قابل درمان خواهد بود.
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اختلال اوتیسم
در خصوص اختلال اوتیسم باید گفت که تعریف آن بسیار وسیع و گسترده میباشد، اما در حالت کلی کودکانی که دارای اختلال اوتیسم هستند معمولا دارای رفتارهایی مانند انزوای اجتماعی هستند و از تماسهای اجتماعی کناره گیری کنند، همچنین ممکن است عقب ماندگی ذهنی و نقایص زبانی داشته باشند و رفتارهای کلیشهای از خود بروز دهند.
البته لازم به ذکر است که اختلال اوتیسم از طبقههای مختلفی برخوردار است، که هر کدام از آنها دارای درمانهای خاص و متعددی نیز میباشد.
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انواع فوبیاها
از ویژگیها و نشانههای اصلی فوبیا در کودکان، میتوان به وجود یک ترس دائمی و آشکار از اشیا و یا شرایط خاصی اشاره کرد، که این موضوع را ممکن است با گریه، بیقراری، سفت کردن اعضای بدن یا محکم چسبیدن به اطرافیان بروز دهد. ترس در کودکان به دلایل مختلفی اتفاق میوفتد و اگر در همان سنین درمان نشود تا آخر عمر گریبانگیر فرد خواهد بود. موسسات خیریه در تهران ارائه خدمات روانشناسی به منظور رفع این دسته از اختلالات را در الویت خدمات خود قرار میدهند.
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عادت کودک به دزدی
کودکانی که مبتلا به این اختلال هستند، معمولا عادت به دزدیدن چیزهایی دارند که حتی ممکن آن را لازم نداشته باشند، و یا دارای ارزش مالی پایینی باشد.
عموما کودکان دارای این اختلال، پیش از انجام دزدی دچار یک تنش شدید میشوند، اما بعد از انجام آن این تنش جای خودش را به یک لذت و رضایت زیادی خواهد داد.
درمان مشکلات رفتاری کودکان
درمان مشکلات رفتاری در کودکان، بهتر است در سنین پایین انجام شود و هرچه زودتر این روش های درمانی استفاده شود، نتیجه ی بهتری در کاهش اثرات منفی آن در بزرگسالی کودک خواهد داشت.
درمان اختلالات رفتاری کودکان معمولا چند جانبه است. بنابراین باتوجه به نوع اختلال و عوامل زمینه ساز آن، برخی از درمانها توصیه میشود که در ادامه به آن خواهیم پرداخت.
- آموزش والدین برا درمان مشکلات رفتاری کودکان، که حوه ارتباط برقرار کردن و کنترل کودک در شرایط بحران را توضیح می دهد.
- خانواده درمانی، که به افراد خانواده کمک میکند در شرایط موجود چطور کودک را کنترل کرده و یا با آن برخورد کنند.
- درمان شناختی رفتاری CBT ، که کمک میکند کودک با شناسایی رفتارهای آسیبزا آن را کنترل کند.
- حمایت تخصصی، به این معنی که کودک را در موضوعاتی که با آن دچار مشکل است حمایت کرده، که میتواند روشی مناسب برای درمان اختلالات رفتاری آن باشد.
- کنترل خشم، که با حضور در کلاسهای آموزشی برای کودک به او آموزش داده میشود که چگونه خشم و رفتارهای پرخاشگرانه خود را کنترل کنند.
- آموزش اجتماعی، که در کنار دیگر درمانها به کودکان آموزش داده میشود تا چگونه به راحتی با اطرافیان ارتباط برقرار کنند.
- دارو درمانی، که این روش هم معمولا علاوه بر دیگر روشها و در کنار آنها، میتواند برای کنترل کوتاه مدت رفتارهای تکانشی در کودکان استفاده شود.
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