ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) Homework Help

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

Attention deficit hyperactivity disorder (ADHD) can be said to be a development disorder that is exhibited through impulsivity, hyperactivity and inattention (Raishevich and Jensen, 2007). There are many other behavioral disorders that can be diagnosed in children but ADHD is most common having 8 – 12% of school aged children being affected by it (Kim et al, 2009). Impulsivity, hyperactivity and inattention are not uncommon in people but in people with ADHD these symptoms are found to greatly interfere with their daily life. The symptoms mostly start to show before 7 years of age and pose problems mostly at school and at home (Brown, 2006). The symptoms continue to show in majority of children with ADHD as they grow up. Because of the lack of an objective way that can measure the behavior of a child and the lack of lab tests for ADHD, controversy can arise in the diagnosis. Disagreement can also be found among experts on the best approach to treat the disorder. However, it is generally agreed that early action would improve the social and educational development of the child.
Signs and Symptoms
The symptoms of ADHD can be categorized into three; inattentiveness, hyperactivity and impulsivity (Raishevich and Jensen, 2007). One type can be very prevalent in a child or the child may have a combination of the types. Children exhibiting Inattentiveness are often less disruptive hence hard to realize their problem early enough. In the symptom of inattentiveness the child is unable to pay close attention to details and their school work is full of careless mistakes. During tasks or play the individual has a hard time keeping attention. When spoken to directly, the child seems to not listen and behaves as if he or she is not being addressed. The person lacks to follow through on instructions and does not complete assigned duties in the workplace, school work or chores. Organizing duties, activities and tasks poses a problem to him or her. Tasks that require sustained mental efforts are very challenging to them therefore they dislike or avoid them. The person is also likely to lose tools needed for activities and tasks such as pencils, books, spanners, rakes and the likes. Distraction comes easily and forgetfulness is also more frequent in their daily activities (Raishevich and Jensen, 2007).
Hyperactivity symptoms include fidgeting with hands and feet or squirming in the seat. When required to seat the person leaves the seat. In children running around and climbing in inappropriate situations is seen. The individual also has difficulty in doing their activities quietly. Often he or she acts as if “driven by a motor” and doesn’t seem to stay at one place concentrating on one thing (Akhondzadeh and Noorbala, 2006).
Very impulsive behavior is present in a person with ADHD. A good example is blurting out of answers even before the complete question has been asked. During group activities the person has a hard time waiting for their turn and often engages in the activity before their turn. Interruption and intrusion into other people’s affairs is common for instance the individual can butt into their colleagues’ conversation.
Causes and incidences
Causes of ADHD are not known specifically and research continues into the factors leading to this disorder. However, there are some factors that are considered to cause or exacerbate the problem such as genetics, physical and social environments and diet. The disorder is highly inheritable with 75 percent of the cases having a genetic factor (Farone and Mick, 2010). Exposure to particular toxins during childhood or maternally is a factor. ADHD develops in children born by women who were exposed to smoking, drinking and Polychlorinated Biphenyls (PCBs) during their time of pregnancy (Kim et al, 2009). Exposure to lead, phthalates or PCBs increases the likelihood of developing the disorder. The brains of ADHD children and those of non ADHD children are different as evidenced by brain scans. An example is the altered brain activity observed in the prefrontal cortex in ADHD children. This part of the brain is thought to be the command centre therefore the altered brain activity in this part may affect the child or individual’s ability to control their hyperactive or impulsive behaviors (Heinrich et al, 2007). According to researchers, excessively slow wave or theta activity in particular regions of the brain can cause hyperactivity in children.
Risk Factors
Gender is one factor considered in the diagnosis of ADHD with boys developing the disorder 4 – 9 times more than girls (Farone and Mick, 2010). There are experts who believe that ADHD is undiagnosed in girls. However, recent research opposes the idea and considers there to be no association between the sex of a child and ADHD. Children with ADHD commonly have a relative of the first degree suffering from the same disorder hence heredity is another risk factor. Prenatal and early postnatal health is also factors that pose risk to the child. Use of drugs, alcohol and cigarettes in pregnant women, as well as exposing infants or the fetus to toxic substances and deficiencies in nutrition can lead to the development of ADHD (Nigg et al, 2010). Other behavioral disorders such as conduct disorder should also be taken seriously as they might be initial signs of the development of ADHD.
Signs and Tests
Incorrect labeling is very common in ADHD. Also, ADHD children sometimes remain undiagnosed. In order to clarify the test and diagnosis of ADHD, the American Academy of Pediatrics (AAP) has some guidelines to be used (Radar et al, 2009. During diagnosis, specific symptoms are investigated in different settings. At least six attention, hyperactivity or impulsivity symptoms should be present and some of these are supposed to be observed before age 7. The symptoms must be seen in the individual for at least six months, in more than one setting and not be caused by any other problem. The level of difficulty caused by the symptoms in different settings should be high. As a result of the symptoms being severe, school, home and relations with peers will be difficult (Brown, 2006). Partial remission is observed in older children who have the symptoms still but the disorder is not fully defined. Evaluation of a child is required once suspicion of the disorder sets in. In the evaluation parent and teacher questionnaires may be used. This is because school and home are the settings where the symptoms and effects of the disorder are observed most. Psychological evaluation of both the child and the family is also carried out. In the psychological evaluation IQ tests and other psychological tests are performed. Examination of the psychosocial, physical, mental, nutritional and developmental aspects of the patient will be carried out too (Radar et al, 2009).
Prevention
There are no stipulated preventive measures in ADHD since the specific causes of the disorder are not known. However, the condition can be managed with behavioral therapy, changes in lifestyle and medication. Early identification and treatment of the condition is also beneficial as it helps to prevent most of the problems that are associated with the disorder.
Treatment
Treatment of ADHD especially in children is a controversial matter. Currently, therapy, medication or both are used in treatment (Radar et al, 2009). Some studies show that using medication to treat the disorder without some sort of therapy reduces the long term outcomes of the child. Therapy includes family and behavioral therapy as well as training in social and parental skills. Most parents investigate nutritional therapies but the effectiveness of the nutritional therapies has so far not been proven. Homeopathy and mind/body techniques may help improve behavior in ADHD children as shown by preliminary evidence (Frei et al, 2006).
Lifestyle
In order to manage the child’s behavior, skilled clinicians offer parental skills training which equip the parents with tools and techniques. Rewarding of appropriate behavior and discouraging destructive behavior is taught. Parents and teachers in conjunction with doctors and therapists perform this technique. Written behavioral contracts, tokens and points are examples of rewards that can be used by parents on older children with ADHD (Brown, 2006). Charts with stars for good behavior can be created for younger children. Undesirable behavior can be discouraged through the use of timeouts. There are other techniques that can be used, such as rules that are understandable, suitable in development progress and not that harsh. Repeated commands need to be avoided after reminding the child of the repercussions that will follow. Discipline should come before anger and frustration sets in. it is also encouraged for praise to be given to the child after he or she follows the rules and behaves in an appropriate manner.
Additionally, changes in the workplace or classroom play a significant role in the treatment plan. Highly structured settings should be created for hyperactive children by the teacher who should be qualified in handling behavior that is disruptive and one who easily adapts to the distinctive cognitive style of hyperactive children (Frei et al, 2006). As a result of the challenges faced by an ADHD child in interacting, social skills training, appropriate placement in the classroom and elaborate engagement rules with peers are important. Family, couple and behavioral therapies would benefit ADHD adults.
Therapy through medication
The most commonly prescribed and most widely researched medications in the treatment of ADHD are stimulants. The principle behind their improvement of ADHD symptoms is not yet fully understood by researchers. However, studies indicate that the level of concentration of serotonin and dopamine in the brain is increased by taking these drugs. Serotonin is associated with mood and well being whereas dopamine is associated with activity (Akhondzadeh and Noorbala, 2006). Atomoxetine is the first drug that is a non stimulant medication approved to treat ADHD. This drug increases dopamine and norepinephrine levels in the brain. Since it was first developed as an antidepressant, it carries a warning indicating its possible effect of causing suicide thoughts in teenagers and children. Methylphenidate, Lisdexamfetamine dimesylate, Amphetamine and Dextroamphetamine are the most common stimulants prescribed for ADHD (Radar et al, 2009). Trouble sleeping, nervousness and decreased appetite are some common side effects of these medications.
Alternative Therapies
Recent survey shows that alternative treatments are being used by parents of children with ADHD. The most commonly used alternative treatment is nutritional therapy. Despite the conflicting results shown by studies, elimination of foods that the child is sensitive to should be considered after consulting with the doctor in order to see if the symptoms will improve (Brown, 2006). The doctor’s supervision is necessary when a parent decides to undertake alternative treatment.
Diets
Benjamin Feingold developed the Feingold diet in 1970s in his belief that hyperactivity and learning disabilities in children were influenced majorly by flavors, artificial colors, naturally occurring salicylates and preservatives (Weber and Newmark, 2007). Mixed results have been found in studies with some showing no benefits of diet while others finding a little improvement in the symptoms. The Feingold diet is complex, difficult to follow and changes the lifestyle of the family hence consultation with the doctor before trying it is important.
The other dietary therapies focus on more consumption of foods rich in protein and complex carbohydrates and minimal consumption of foods with sugar and artificial sweeteners. Hyperactivity in a certain study was found to increase among children after consumption of foods with additives and food coloring. There is however no study that has proved any relation between sugar and ADHD. There is also another study that found no difference in behavior between the children whose diets were high in artificial sweeteners and sugar and those whose diet was free of them (Weber and Newmark, 2007). This result was obtained even in parents who considered their children were sensitive to sugar. The doctors who concentrate on nutrition express their confidence as they have experienced positive results from food allergies testing and the use of an elimination diet. Parents that consider food allergy testing and elimination diet to be beneficial are encouraged to talk to a doctor experienced in nutrition for ADHD children. Magnesium is one mineral that is believed to cause symptoms of ADHD when deficient. Magnesium supplements offered to magnesium deficient ADHD children may improve behavior. Vitamin B6 is required in the manufacture of brain chemicals such as dopamine and serotonin which are thought to cause ADHD (Weber and Newmark, 2007). The doctor’s supervision is critical before administering B6 to a child due to its dangerous effects when taken in high doses. Zinc, essential fatty acids and L – Carnitine are the other vitamins and minerals that are believed to improve behavior in ADHD children. All of these mineral and vitamins have dangerous side effects when taken in high doses therefore they should not be administered before talking to a doctor.
Use of Herbs
Use of herbs is generally safer when strengthening and toning the body’s systems. Herbs can be used as dry extracts, tinctures or glycerites. A teaspoon of herb per cup of hot water is recommendable unless directed otherwise. Two to four cups of the herb can be taken per day. There are no scientific studies that have been carried out yet to establish whether the herbal remedies sold in Europe and the United States improve symptoms of the disorder. The common recommended calming herbs for ADHD include Valerian, Lemon balm, Roman Chamomile and Passionflower (Radar et al, 2009).
Other techniques:
Homeopathy
The physical, psychological and emotional make-up of an individual is first considered before a remedy is prescribed in homeopathy. Experienced homeopaths ensure all these factors are assessed in order to determine the most appropriate treatment for each individual. Cina, Stramonium and Hyoscyamus niger are among the homeopathic remedies that have been found to be most effective (Frei et al, 2006).
Massage
Massage can be used as a relaxation technique in reducing anxiety and activity levels in teens and children. Compared to muscle relaxation, massage is found to be more effective in improving behavior and concentration in children and teenagers (Weber and Newmark, 2007).
Biofeedback
Hypnotherapy, biofeedback and progressive relaxation are examples of mind/body techniques that can be used in treating teens and children (Holtmann and Stadler, 2006). These techniques teach the children copying skills which they can use the rest of their lives. The treatments give the children and teenagers a sense of control and mastery, decrease stress and increase their self- esteem. The principle behind biofeedback is that brain activity associated with ADHD can be modified in children through training as well as increasing the brain activity associated with attention and concentration (Holtmann and Stadler, 2006).
Conclusion
Attention deficit hyperactivity disorder (ADHD) is a term associated with developmental problem affecting children, teenagers and adults. The characteristics of the ailment include, being inattentive and impulsive as well as being hyperactive. The specific causes of the disorder are not known but there are some factors considered to lead to or increase symptoms of the problem (Brown, 2006). Since the specific causes of the disorder are not known, prevention measures are not available. The testing of the problem requires a series of tests, observations and interviews. Treatment can be administered through medication, therapy or both. Utilizing both therapy and medication in the treatment of ADHD reduces behavioral problems of patients as they grow up and ensures the disorder is effectively managed throughout the life of the individual.
References:
Brown, T. E. (2006). Attention Deficit Disorder: The Unfocused Mind in Children and Adults. London: Yale University Press.
Farone, S. & Mick, E. (2010). Molecular Genetics of Attention Deficit Hyperactivity Disorder. Psychiatric Clinics of North America 33(1).
Frei, H., von Ammon, K. & Thurneysen A. (2006). Treatment of hyperactive children: increased efficiency through modifications of homeopathic diagnostic procedure. Homeopathy. 95(3):163-70.
Heinrich, H., Gevensleben, H. & Strehl U. (2007). Annotation: neurofeedback – train your brain to train behaviour. J Child Psychol Psychiatry. 48(1):3-16.
Holtmann, M. & Stadler, C. (2006). Electroencephalographic biofeedback for the treatment of attention-deficit hyperactivity disorder in childhood and adolescence. Expert Rev Neurother. 6(4):533-40.
Kim, B.N. et al. (2009). Phthalates exposure and attention-deficit/hyperactivity disorder in school-age children. Biol Psych. 66(10):958-63.
Nigg, J.T., Nikolas, M., Knottnerus, M., Cavanaugh, K. & Friderici, K. (2010). Confirmation and extension of association of blood lead with attention deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical exposure levels. J Child Psychol Psychiatry. 51(1):58-65.
Noorbala, A.A. & Akhondzadeh, S. (2006). Attention-deficit/hyperactivity disorder: etiology and pharmacotherapy. Arch Iran Med. 9(4):374-80.
Rader, R., McCauley, L. & Callen, E. (2009). Current Strategies in the Diagnosis and Treatment of Childhood Attention Deficit Hyperactivity Disorder. Am Fam Phys. 79(8).
Raishevich, N., & Jensen, P. (2007). Attention-deficit hyperactivity disorder. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF , eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: W.B. Saunders Company; ch. 31.
Weber, W. &Newmark, S. (2007). Complementary and Alternative Medical Therapies for Attention Deficit Hyperactivity Disorder and Autism. Pediatric Clinics of North America 54(6).