Attention Deficit Hyperactivity Disorder
ADHD was first brought up in 1902 by British pediatrician Sir George Still. He described it as “an abnormal defect of moral control in children”, he discovered that affected children had a hard time controlling their behavior the way a non-affected child would, however they were still very smart. Originally ADHD was called hyperkinetic impulse disorder, until 1980 when the third edition of the DSM (DSM-III) was released, then it was called attention deficit disorder (ADD). ADD had two types; ADD with hyperactivity, and ADD without hyperactivity. Finally, when the DSM-III was updated again in 1987, hyperactivity distinction was removed and replaced to Attention Deficit Hyperactivity Disorder (ADHD) which it still is called today. In fourth edition of the DSM which was released in 2000, there were three types of ADHD released: combined type, predominantly inattentive type, and predominantly hyperactive-impulsive type ADHD, which are still used by doctors today. In the 1990’s diagnoses of ADHD began to rise: doctors could diagnose ADHD more efficiently, parents were becoming more aware of the symptoms, and more children were developing ADHD. (Krucik G., 2015, pg. 1). According to Baren (2000), “There are no laboratory test available to help the diagnoses of ADHD” (pg. 14).
The cause of ADHD is unknown, however according to Baren (2000), “specialist agree that 30% to 40% of children diagnosed with ADHD have relatives with the same disorder” (pg. 6). Some natural factors also may have an effect in the cause (Health, 2016, pg. 1). “A study held in 2010 by Pediatrics found that children with higher levels of organophosphate, which is a pesticide used on produce, had increased ADHD rates. Another study also in 2010 showed that women with increased levels of organophosphate were likely to have children with ADHD” (Health, 2016, pg. 2). According to Wolraich, M.L. “Fetuses exposed to alcohol can develop fetal alcohol effects or syndrome, which are both symptoms seen in ADHD” (Wolraich, Health, 2016, pg. 3). In 2009 studies found that children with higher blood-lead levels tend to have ADHD than kids with lower blood-lead levels. Leavitt (2009) said “lead can be toxic to developing brain tissue, and may have effects on children exposed to lead at young ages” (Health, 2016, pg. 4).
ADHD is a common behavioral disorder that affects about 10% of school children, usually diagnosed at age seven, it’s three times more common in boys than it is girls, (Kids Health, 1995-2016, pg. 1). According to Baren (2000), “Between 40% and 60% of children with ADHD will have academic problems in school, some will have trouble doing time test, or large amounts of writing (pg. 16). ADHD is a highly genetic brain disorder that affects a precise act of brain functions and similar behaviors called the “executive functioning skills”, that consist of attention, concentration, memory, effort, motivation, wisdom from mistakes, energized activity, precise order and communication skills. There are many factors that affect these challenges like structure and chemical differences in the brain as well as genetics (Frank M., 1998, ¶1).
When is, ADHD considered ADHD? To be ADHD the symptoms and behaviors must occur before age seven and repeatedly occur for at least six months. The symptoms must also hinder at least two daily activities like on the playground, in social settings, and in the classroom (AACAP, 2016, ¶4).
Symptoms of ADHD in children are categorized in three groups: Inattention, Hyperactivity, and Impulsivity. Inattention symptoms can consist of; being distracted easily, not following directions, not completing tasks, appears to be not listening, makes careless mistakes, forgets about daily routine, struggles to stay organized, struggling to sit still, loses things easily, and daydreams a lot. Symptoms of hyperactivity can include; fidgeting, bouncing and squirming while sitting, having a hard time staying seated, playing loudly, talking too much, and is always on the go (restlessness). Impulsivity can consist of; trouble waiting their turn, blurting out answers, and interrupting others (WebMD, 2005-2016, pg.1) According to Baren (2000), “A child's environment can affect the child’s behavior.” (pg. 6).
Symptoms of ADHD in adults can vary as they age. Some symptoms in adults include: forgetfulness, anxiety, low self-motivation, issues at work, uncontrollable anger, substance addiction or abuse, procrastination, not very well organized, getting easily frustrated, getting bored easily, having a hard time concentrating when reading, mood swings, and relationship problems.
Faulty social skills in children with ADHD can affect their future. Faulty social skills have been associated with higher cases of dropping out in school, loss of jobs, disorderly conduct, and contacts with law enforcement officials (Krucik G., 2015, pg. 5). Studies in 1991 show that students with ADHD are less involved in extracurricular activities and often experience emotions of sadness, and feelings of loneliness when compared to a student without ADHD. Students with hyperactivity are more likely of being declined by their fellow aged classmates (Krucik G., 2015, pg. 6).
There are some treatments for ADHD in both adults and children. However ADHD is not curable. Some individuals can experience mental health management, there are two main outcomes of mental health management: living a “meaning life” and growing to one’s “full potential” which can be achievable goals for a person with ADHD (CHADD, 2016, ¶3). Treatments for ADHD include: medicine, therapy, counseling, skills training, and depending on the age of the child parental training. Behavior therapy is counselling where children and adults with ADHD can learn behavior-changing techniques and skills for dealing with situations. Parenting skills training helps parents come up with ways to help their child’s behavior. Social skills training helps children learn new ways to socially interact with their peers (Marks. L., 2016, pg1). Medicine stimulants for ADHD can help children focus, and ignore distractions. Stimulants work for 70-80 percent of people. Stimulants are used for moderate and severe ADHD. Some stimulants are capable to be used for children ages three and up. Other can be used for children over the age of six. The medications can come in different forms, short-acting, intermediate-acting and long-acting. Short-acting medications take effect quickly, however can wear off in a short period as well, resulting the person taking the medication many times a day. Intermediate-acting medications last longer than the short-acting medications but may need to be taken a few times a day. Long-acting medications can last an entire day, so the person may only have to take the medication one time a day. Some stimulant medications for ADHD include: Eveko, ProCentra, Adderall, Focalin, Vyvanse, Concerta, and Ritalin, Methylin, QuilliChew, Quillivant, Daytrana, Aptensio XR, Metadate ER, and Metadate CD. Stimulants are the most used medicines for ADHD. Stimulants increase the amount of dopamine and norepinephrine in brain, this helps increase concentration and lower the sleepiness that’s frequent with ADHD. Adderall is used mostly for ADHD, some of the side effects for a person taking Adderall may include: headache, stomach ache, lower appetite, trouble sleeping, dry mouth, and increase heartbeat. (Health line, 2014, part 2). Non-stimulant medications for ADHD include: Strattera, Kapvay, and Intuniv. Non-stimulants affect the neurotransmitters, however don’t increase dopamine levels. The drug takes longer to respond after taken. Doctors only prescribe non-stimulants when stimulants are not safe, don’t work, or the patient wants to stay away from the possible side effects of the stimulant. Strattera can cause liver damage, however has only caused liver damage in a small amount of people. Kapvay is also used to treat high blood pressure, which can cause a person taking the medication with ADHD to get lightheaded. Intuniv is commonly provided to adults with high blood pressure. Taking intuniv for ADHD may increase memory and help behavioral problems, aggression and hyperactivity. (Health line, 2014, part 3). The most commonly prescribed medications used for ADHD include: Adderall, Ritalin, Concerta, Focalin, Dexedrine, and Vyvanse. Side effects for a person taking any of the commonly prescribed ADHD medications may include: headache, stomach ache, lower appetite, trouble sleeping, dry mouth, and increase heart beat (Marks. L., 2016, pg1).
According to Wender (1987), “Children with ADHD have a “my way or the highway” attitude when interacting or playing with siblings, or friends” (pg. 38). For instance, a child with ADHD wants make a fort in the woods with his brother. The child without ADHD insist that they build the fort between several pine trees, so all they have to do is make a door, however the brother with ADHD insist on building a fort out of sticks from the ground up between four trees, they get into an argument and both go off and build their own fort. According to Wender (1987), “In a family with more than one child, the child with ADHD sometimes views his or her siblings as the “good children” being favored, where the child with ADHD views there self as the “bad child” who is always getting in trouble and constantly told what to do. The child with ADHD gets more blame and the siblings without ADHD get more praise, the child with ADHD is jealous of his or her siblings” (pg. 38)
According to Wender (1987), “The most common parental complaint is the struggle in disciplining the child with ADHD. The child forgets what their parent just told them, or sometime just doesn't even listen to them” (pg. 39). For example, the child was told to clean their room, they get about half way done and decide to do something else. Another example could be that the child was told to stop jumping down the stairs, they stop for a while and then begin to do it again. According to Wender (1987), “Some children with ADHD tend to act four or five years younger than their actual age. It’s often easier for a parent to deal with their child if they view their child as if they were four or five years younger than their child’s age” (pg.23)
According to Barren (2000), “Children with ADHD cannot outgrow the disorder, however as the child transitions into an adult they can become more familiar with their behavior and learn to ignore the things that distract them to get things done. Adults with ADHD can accomplish anything that an adult without ADHD can do, or at least get by” (pg. 28-29).