The what, why and how of hyperkinesis: implications for nursing

Hyperkinesis refers to a combination of traits that typically include: overactivity; restlessness; short attention span; distractability; low frustration tolerance; impulsiveness. Its aetiology and prevalence have not been established but associating problems underscore the importance of early identification and treatment. Theories about aetiology relate to minimal brain damage, heredity, temperament variations, maturational lag, dysfunction of the reticular activating system, food sensitivity, and learned response to unorganized environment. Hyperkinesis may be distinguished only by its behavioural manifestations. Insightful analyses of behavioural problems require viewing the child from a development perspective, such as those advanced by Freud, Erikson, Berne and others. Sensitivity to the ramifications of labelling the child as deviant is critical. Multidimensional assessment is needed upon which management decisions are made. An eclectic approach merits consideration: medication, if it works; therapeutic counselling; parental counselling; intervention with school personnel; and above all, support for the child. The nurse plays a crucial role in providing the health team with key information basic to establishing accurate diagnosis and evaluating interventions. The problem of hyperkinesis bears many implications for nursing practice and research.