ADHD (what it is this disease) and what are the symptoms and result of this disease. The paper also discusses the affects of ADHD on patients. In this paper the treatment of ADHD is also discussed and explained.
All the details relating to this condition and its symptoms and treatments are explained and supported by the use of literature review.
ADHD in Children
ADHD (attention deficit hyperactivity syndrome) is a chronic condition that affects the children and continues till their adulthood in many cases. This disease results in the combination of a number of problems such as difficulty in focusing on something and paying attention, ‘hyperactivity and impulsive behavior’. (Mayo Clinic, 2013)
In the children, the children suffering from ADHD also experience lack of confidence and self-esteem, trouble in relationships and bad performance in school. The disease is usually preceded by behavioral and learning problems and lack of attention in children. This condition has particularly received a lot of attention in the last decade because of increased diagnosis in children. (Mayo Clinic, 2013)
Symptoms of the ADHD include:
Symptoms showing inattention and lack of attention:
Failure to focus on things and pay close attention, difficulty in maintaining constant attention on one task or even playing, (APS, 2013)
Easily distracted from a given task, (APS, 2013)
Problems in managing and organizing tasks, stuff, etc., (APS, 2013)
Difficulty in following or understanding instructions / guidelines, (APS, 2013)
Avoiding the tasks and chores that require mental efforts and thinking (also dislike and get irritated if pushed to do something that is difficult), (APS, 2013) and Do not listen when spoken to (because of lack of attention and slow senses etc.). (APS, 2013)
Symptoms showing hyperactivity
Fidgeting with hands and feet, restlessness, constantly move in the seats, etc., (APS, 2013)
Not able to sit constantly during class or lectures and leaving the seat often, (APS, 2013)
Excessively running and climbing, (APS, 2013)
Difficulty in playing one game and constantly moves about, (APS, 2013)
Giving answers without hearing the complete questions, speaking long sentences and at fast speed, (APS, 2013) and Usually interrupting others to speak their minds. (APS, 2013)
ADHD is usually diagnosed by the pediatrician along with a psychologist who uses different methods to identify the extent of the disease. The methods include rating on the basis of different tests, questionnaires and observation of a child’s behavior at home and at school. These specialists also measure the extent of the disease and its effect on learning and understanding abilities of children. Further, psychologists also recommend and advise methods to improve this condition. (APS, 2013)
The disease is usually treated using psychological methods including training of teachers, educators and parents to deal with and educate the suffering children, training and counseling of the affected child, and medication also helps in curing this condition. (APS, 2013)
Key terms: ADHD, lack of attention, symptoms, hyperactivity, diagnosed, treated, psychological methods, medication
The key terms mentioned above has been explained in the introduction preceding phase. Where ADHD is a chronic disease characterized by either lack of attention or hyperactivity. The preceding pages also discuss the symptoms (pertaining to both lack of attention and hyperactivity), the diagnosis and the treatment methods of ADHD.
Literature Review
Symptoms and Effects of ADHD
ADHD is a chronic situation that is characterized by the combination of many psychological conditions in the children including lack of attention, concentration, inability to focus, etc. Kaplan in his article quoted the following information ‘research over the past 2 decades has demonstrated that ADHD occurs frequently and causes considerable suffering in patients and their families. ADHD begins in early childhood and persists through adolescence and into adulthood in 70% of those affected. Two large epidemiological studies in the U.S. have placed its prevalence at 8.7% in children and 4.4% in adult.’ (Kaplan, 2012)
In the Pediatrics journal it was explained that 4.4 million children in the United States have been diagnosed with ADHD. (Scheffler et al., 2013)
Wall et al., in their research, considered the responses and stimuli of patients of ADHD and compared those with non-patients. They identified that in order to efficiently perform any task the essential requirement are to attend ‘to target stimuli and not be distracted by irrelevant signals is an efficient way to perform a task. It also helps to be aware of mistakes so that one can correct them and maintain efficiency.’ (Wall et al., 2009)
Wall et al., concluded in their research that ‘children suffering from ADHD typically have difficulties with maintaining the focus of attention, are often distracted by unimportant stimuli, have problems with inhibiting premature responses and are claimed to monitor their performance for errors less well than those without ADHD. Thus it is not surprising that these children perform poorly on tasks requiring effort and control both in the laboratory and at school.’ (Wall et al., 2009)
Wall et Al. In their research ‘examined the ability of adolescents with ADHD, their healthy siblings and healthy controls to suppress proponent response tendencies and identified that performance did not show major differences between groups, although No-go errors were numerically increased for the patients. Processing of the target was reduced in the ADHD group especially at frontal electrode positions and response on error trials was not significantly different between groups.’ (Wall et al., 2009)
Frazier et al., in their research on ADHD identified that one of the most crucial and ‘prominent feature associated with ADHD’ is poor performance at school. And children suffering from ADHD are at a ‘risk of facing numerous academic complications’ including bad results and failing grades. Their research also presented the fact that all the researchers conducted on ADHD conclude that ‘not all individuals associated with ADHD experience academic deficits’. (Frazier et al., 2007)
These studies, conducted to identify the effect on academic aspects of the children suffering from ADHD, were based on results identified through tests, parent teacher interviews and observing children and their behavior at school and home. (Frazier et al., 2007)
Frazier and his colleagues in their research also discussed that ADHD symptoms (in the form of academic in capabilities) identified in children continue beyond childhood and are also witnessed when the children reach adulthood and if not properly treated this leads to the continuation of these conditions even in adulthood. (Frazier et al., 2007)
According to their research academic complications usually arise mostly in the reading ability, followed by mathematical capabilities and then in spellings. That is ADHD makes the children weak in the compartments of reading, mathematics and spellings most then other academic aspects. (Frazier et al., 2007)
Another research conducted by McConaughy and colleagues highlighted that ‘parent and teacher ratings showed significantly lower academic performance and lower social functioning for children with ADHD compared to other referred children without ADHD and controls.’ (McConaughy et al., 2011)
McConaughy et al., conducted their research by comparing the results of children suffering from ADHD with those not suffering from the condition in tests (maths, reading, writing, spellings etc.) to establish an association between ADHD and academic complications.
They reported that the students and children with ADHD show lower academic achievement. They also identified that the most affected academic aspect was reading, then mathematics, followed by spellings. (McConaughy et al., 2011)
Further the study also concluded significantly lower scores on tests of reading, mathematics, and written language for children with ADHD vs. controls, but mixed results for children with ADHD vs. referred children without ADHD. (McConaughy et al., 2011)
The research conducted by McConaughy et al., also highlighted and discussed the fact that the children suffering from ADHD face a lot of social complications as well and face problems in building and maintaining social relationships. Studies on social factors were based on ‘a variety of measures, including positive and negative peer ratings, parent and teacher ratings of children’s social competence and social skills, number and quality of peer friendships, and measures of children’s self-control and problem-solving skills.’ (McConaughy et al., 2011)
The research and studies gathered evidences resulting in the conclusion that children with ADHD are more rejected by their peers than children without ADHD. This research also explains that the extent of the rejection varies with the extent and sub-types of ADHD and with the increase in aggressive behavior of the child suffering from ADHD the rate of rejection from peers and friends increase. (McConaughy et al., 2011)
As far as the sub-types of ADHD and aggressive attitude of the sufferers is considered, McConaughy et al., explained in their paper that ‘children with ADHD-Combined type tended to be more aggressive and less popular, whereas children with ADHD-Predominantly Inattentive type tended to be more passive and more neglected by peers.’ (McConaughy et al., 2011)
The paper also concluded that ‘children with ADHD are more likely than children without ADHD to be victims of bullying and to bully others, have difficulty making or keeping friends, and show lower levels of social competence and social knowledge.’ (McConaughy et al., 2011)
The research paper also compared the results of children suffering from ADHD and children not suffering from this condition and came upon the results that ‘showed significant academic and social impairments in children with ADHD compared to other referred children without ADHD, which has seldom been assessed in previous studies. Children with ADHD scored significantly lower than other referred children without ADHD on three measures of academic performance: teacher ratings of their grade level performance in academic subjects (TRF Academic Performance); teacher ratings of their academic skills, effort, and motivation (SSRS Academic Competence); and the WIAT-II mathematics composite score.’ (McConaughy et al., 2011)
The study found that in ‘children with ADHD, 15 — 55% showed clinically significant impairment in academic performance and 85% showed clinically significant impairment in social behavior.’ (McConaughy et al., 2011)
The research emphasized on the ‘importance of assessing academic and social functioning and developing multifaceted interventions that target these key peripheral features of ADHD along with efforts to reduce core symptoms.’ (McConaughy et al., 2011)
Maria Re and Colleagues conducted a research and explained in their paper that the children suffering from ADHD suffer difficulties in writing and expressing their thoughts and ideas via writing. (Maria Re et al., 2007)
Maria Re and colleagues conducted three studies to find out the extent of inabilities of children suffering from ADHD in expressive writing by giving two expressive writing tasks to all the children (participants). The results show that there was no link between the grade of the participants and their task results. And the overall performance was not good. The lower performance was also because of spelling errors, use of less qualitative adjectives and use of less subordinate phrases. (Maria Re et al., 2007)
Valko et al. Conducted a study to research the ‘temporal processing and response inhibition defects’ in the ADHD patients. The research concluded that the ‘performance of ADHD patients was poorer, and Cue CNV and NoGo P300 were weaker. Moreover, it was also concluded that ADHD-related ERP differences in children were more prominent at posterior scalp sites but more pronounced at anterior scalp sites in adults, paralleling the prominent topographic changes of both ERP markers with development.’ (Valko et al., 2013)
The study also discussed the fact that most of the problems and deficiencies faced in ADHD are caused by impaired temporal information processing. Valko et al. identified that ‘impaired temporal information processing may play an important role in the deficits observed in ADHD, given that attention, inhibition, and working memory are crucial for temporal processing and involve similar frontal cortex networks.’ (Valko et al., 2013)
Treatment by Medicines
The research conducted by Scheffler et al., show that children suffering with ADHD and receiving proper medication ‘scored higher on the ECLS-K standardized mathematics and reading achievement tests’ as compare to children who did not receive any medication. (Scheffler et al., 2013)
The research conducted by Scheffler and peers also found that ‘60% of diagnosed children taking prescription medications to treat the disorder, at a cost of $2.2 billion in the year 2003’ they also identified that the medicated children perform better and there is a need to conduct more simulation and trials in order to identify the in depth relationship between medication and performance (academic performance) of children suffering from ADHD. (Scheffler et al., 2013)
Using medicines to treat ADHD patient’s results in other side effects including an increase in blood pressure and heart rate, etc. The researchers also considered a relationship between the ADHD medications and sudden and unexplained death in children and teenagers. However, it was concluded that in the absence of cardiovascular illness, ADHD agents are safe. Moreover presence or a history of cardiovascular problems in any patient requires proper consultation before taking any step. (Kaplan, 2012)
Kaplan recommended that a detailed family and medical history of patients should be taken and analyzed before prescribing any ADHD medicine to those patients. (Kaplan, 2012)
Kaplan also discussed in his paper that if children are not treated properly and ADHD continues in their adulthood too, then there are occasions which may cause anxiety for the patients and their parents. Like acquiring driving license might cause anxiety for the parents as ADHD patients may not properly operate motor vehicles. (Kaplan, 2012)
He discussed two researches in his paper in which simulated driving tests of ADHD patients were conducted. In one scenario the patients were given lisdexamfetamine (LDX) while in the other the patients were given methylphenidate. It was observed that in both the cases patients ‘had fewer video recorded collisions and other problematic driving events.’ (Kaplan, 2012)
ADHD and Diet
Kaplan also discussed in his paper that ADHD is directly affected by the diet of the patient and discussed that ‘omega-3 fatty acid supplementation, particularly with higher doses of eicosapentaenoic acid, was modestly effective for treating. (Kaplan, 2012)
He further explained in his paper that ‘the role of diet and food colors and found that restriction diets reduced ADHD symptoms and that an estimated 8% of children who have ADHD may have symptoms related to synthetic food colors.’ (Kaplan, 2012)
Psychological Treatment of Children with ADHD
Another important method of treating ADHD patients apart from use of medicines is psychological methods. DuPaul et al. In their research paper discussed and highlighted the importance and results of consultations and academic interventions (by school) on the performance of children with ADHD. (DuPaul et al., 2006)
DuPont et al., also explained that ‘the most effective treatments for ADHD include psycho stimulant medication (e.g., methylphenidate) and contingency management strategies. They also concluded that positive effects were observed in children suffering from ADHD by using Class Wide Peer Tutoring (CWPT) and Computer Assisted instructions to help them. The results show moderate to large effects on children’s weekly math and spelling test scores were obtained with CWPT. (DuPaul et al., 2006)
DuPont et al., discussed in their paper that the studies are based on small sample size and have not been conducted on big samples, but studies on effects of academic interventions on the achievement of children with ADHD usually conclude that academic intervention in the form of teachers intervention plans with school psychologists and consultants, CWPT, computer assisted instructions, etc. help yield positive results for the patients. (DuPaul et al., 2006)
DuPont and colleagues also discussed the importance and results of behavioral consultation model in which ‘classroom teachers’ work with consultants to develop individualized interventions based on baseline data regarding a student’s academic strengths and weaknesses as well as important contextual variables (e.g., antecedent and consequent events prompting and maintaining academic behaviors). In addition, consultants monitor treatment implementation and teachers are provided with feedback designed to enhance intervention fidelity.’ (DuPaul et al., 2006)
DuPont et al., based their study on two approaches, ‘one approach involved “consultation as usual” wherein teachers selected academic interventions proposed by a school psychologist or special educator based on perceived effectiveness and feasibility, with minimal follow-up once interventions had been implemented. The other approach to consultation involved the selection and development of academic interventions based on data collected by the consultant regarding individual student skills and present classroom conditions.’ (DuPaul et al., 2006)
On the basis of their study DuPont et al. concluded that these findings appear to support academic consultation; however, the type of consultation model did not appear to make a difference, suggesting that the less time-consuming consultation approach may be sufficient. Positive growth trajectories were obtained for math and reading skills as well as teacher ratings of academic enablers (e.g., motivation, study skills) across a 15-month period. (DuPaul et al., 2006)
Duvall et al., discussed and studied the impact of home school environment provided by parents on the performance of children suffering from ADHD. They also considered whether the parents can provide effective home school environment to such children. (Duvall et al., 2004)
In their research paper they explained that home schools are difficult to operate because of lack of training of teachers and parents. However, students from home school socialize equally and participate in school too. In their research they also concluded that parents, although, can give effective tutoring to children with ADHD and improve their performance, even without any professional training and help. (Duvall et al., 2004)
They found out that when ‘academic gains and instructional environments of 4 (four) home school students were compared to that of 4 (four) public school students who were taught in special classes. The home school students in this study made more gains, which appeared related to higher level of engagement on key instructional behaviors including writing, task participation, reading aloud and silently, and academic talks.’ (Duvall et al., 2004)
They concluded in their research that ‘homeschooling may have certain advantages over public schooling for some children with ADHD.’ (Duvall et al., 2004)
Conclusion
The above paper explains in details the symptoms and treatment of ADHD on children and its implications on them. It is evident that the children suffering from ADHD are low performers in academics. These children have difficulty in understanding, focusing, writing, reading, solving mathematical problems and other academic aspects.
These children also face difficulties in maintaining attention on one thing for a constant time period. Further they also face a lot of difficulties in memorizing texts and spellings.
The paper also explains that sometimes the effects and the condition prevail in adulthood too.
The condition can be treated using medications that have shown to improve the results and conditions, however, there are certain side effects attached to them. The condition can also be treated using psychological methods of homeschooling, academic interventions and consultations. All of the psychological methods have proved to yield positive results.
References
Australian Psychological Society (APS). (2013). Attention deficit hyperactivity disorder (ADHD) in children. APS Webpage. Retrieved from http://www.psychology.org.au/community/adhd/
DuPaul, G.J., Jitendra, A.K., Volpe, R.J., Tresco, K.E., Lutz, J.G., Junod, R.E., Cleary, K.S., Flammer, L.M., & Mannella, M.C. (2006). Consultation-based Academic Interventions for Children with ADHD: Effects on Reading and Mathematics Achievement. J Abnorm Child Psychol. 34 (2006), 635-648.
Duvall, S.F., Delquadri, J.C., & Ward, D.L. (2004). A Preliminary Investigation of the Effectiveness of Homeschool Instructional Environments for Students with Attention Deficit Hyperactivity Disorder. School Psychology Review. 33(1). 140-158
Frazier, T.W., Youngstrom, E.A., Glutting, J.J., & Watkins, M.W. (2007). ADHD and Achievement: Meta-Analysis of the Child, Adolescent, and Adult Literature and a Concomitant Study with College Students. Journal of Learning Disabilities. 40(1), 49-65.
Kaplan, G. (2012, November). What’s new in ADHD .Psychiatric Times. 9-11
Maria Re, A., Pedron, M. & Cornoldi, C. (2007). Expressive Writing Difficulties in Children Described as Exhibiting ADHD Symptoms. Journal of Learning Disabilities. 40(3), 242-255.
Mayo Clinic Staff (2013). Attention deficit hyperactivity disorder (ADHD) in children. Mayo Clinic Webpage. Retrieved from http://www.mayoclinic.com/health/adhd/DS00275
McConaughy, S.H., Volpe, R.J., Antshel, K.M., Gordon, M., & Eiraldi, R.B. (2011). Academic and Social Impairments of Elementary School Children with Attention Deficit Hyperactivity Disorder. School Psychology Review. 40(2), 200-225.
Scheffler, R.M., Brown, T.T., Fulton, B.D., Hinshaw, S.P., Levine, P. & Stone, S. (2013). Positive Association between Attention Deficit Hyperactivity Disorder Medication Use and Academic Achievement during Elementary School. Pediatrics. 2009 (123), 1273-1280.
Valko, L., Doehnert, M., Muller, U.C., Schneider, G., Albrecht, B., Dreshler, R., Maechler, M., Steinhausen, H.C., & Brandeis, D. (2009). Differences in Neurophysiological Markers of Inhibitory and Temporal Processing Deficits in Children and Adults with ADHD. Journal of Psychophysiology. 23(4), 235-246.
Wild-Wall, N., Oades, R.D., Wessels, M.S., Christiansen, H., & Falkenstein, M. (2009). Neural activity associated with executive functions in adolescents with attention deficit hyperactivity disorder (ADHD). International Journal of Psychophysiology. 74 (2009), 19-27.
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