In recent years, there has been achieved a great progress in studying one of the most pressing problems of neuropediatrics – Attention-Deficit Hyperactivity Disorder in children (ADHD). The urgency of the problem is determined by a high frequency of this syndrome in the child population and its great social significance. Currently, according to Haggerty (2014) “two to three percent of children have ADHD”. There is no coincidence that the attention to ADHD has emerged and strengthened simultaneously with a sharp decrease in the average number of children per family and the equally sharp decline in child mortality. Moreover, such factors as the relative complexity of modern life and the practice of universal secondary education played their specific role in the development of the disorder. It can be stated that ADHD is primarily a “school sickness”. Thus, the main aim of the assignment is to present a thorough overview of the chosen disorder for the purpose of exploring its main features and possible ways to cope with it.
First of all, it is necessary to give a definition to the disorder because it will help us to explore ADHD better in further discussion. According to Delfos (2009), ADHD is primarily a problem of maintaining focus, concentration and persistence in achieving results. A child with ADHD is often impulsive and overly active. Preschool children with attention deficit hyperactivity disorder are usually restless, finding it difficult to communicate and interact with other children of their age; very often they behave themselves badly. Restlessness is also typical for older children; they continuously move their feet, hands, and talk incessantly. Moreover, they are forgetful and disorganized, although they are not aggressive. The parents, regarding this definition are apt to consider that all their children can be diagnosed with ADHD, but Wender (2010) mentioned that “the characteristics listed are not abnormal in themselves; they are only abnormal when they are excessive. What characterizes ADHD children is the intensity, the persistence, and the patterning of these symptoms”.
Children with attention deficit hyperactivity disorder have normal or high intelligence, however, tend to fail at school. In addition to studying difficulties, attention deficit hyperactivity disorder is manifested by motor hyperactivity, concentration defects, distractibility, impulsive behavior, problems in relationships with others. It should be noted that attention deficit hyperactivity disorder is observed in both children and adults. In recent years its genetic nature was proved. It is quite obvious that in the focus of scientific problems of ADHD the interests of various specialists are concentrated – pediatricians, educators, neuropsychologists, speech pathologists, neurologists.
Using statistical data to explore the scales of the problem, according to Nylund (2011), it can be noted that approximately 20% ADHD children are marked with learning difficulties and about 90% do not do well in school. 40% ADHD children, when they reach the age of puberty, are identified with depression, anxiety and a tendency to act “out of spite.” Approximately 60% of little children have such violations as temper tantrums; while older children are unstable to the difficulties of life. Although impulsivity and hyperactivity tend to decrease with the age, inattention and associated symptoms can persist even in the adult.
In summary of the main symptoms, we can say that attention deficit hyperactivity disorder is characterized by hyperactive behavior and inability to concentrate. Many children have difficulties in concentrating, but some of them have this volition accompanied by increased activity. It is worth noting that, although seemingly at the forefront there is an excessive mobility of the child, the primary defect in the structure of this disease is the lack of attention: a child can not concentrate on anything for long. Children with ADHD are characterized by restlessness, inattention, hyperactivity and impulsivity, seem unable to hold still, often interrupt others and exhibit dysfunction in their social adaptation.
According to Smith & Segal (2014), in children, attention deficit hyperactivity disorder is one of the most encountered mental disorders. There is evidence that up to 5% of children are suffering ADHD, and this disorder occurs in boys 4-5 times more often than in girls. It turns out that almost every class has one child who is in need of treatment of this disease.
As it was previously mentioned, children with ADHD often have problems both at home and at school. If the parents decide to leave ADHD untreated, in the future this disease will not only interfere with school and work, but it also will disrupt social and emotional development of the person and will increase susceptibility to drug use and the risk of various injuries. It is hard to say that the number of children with ADHD has dramatically increased nowadays. However, such a diagnosis has become increasingly common as awareness about the disease is very well developed and it becomes easier to identify ADHD by parents and teachers.
Summarizing the risk factors for this disorder, it can be stated that ADHD is a family disease. Every child suffering from this disease has at least one relative with the same problem. An evidence of the genetic nature of the disease is that the presence of the disease in one of the twins indicates the presence of this disorder in the second twin. Using more detailed explanation, it can be added that there are functional immaturities or disruption of subcortical brain structures and frontal regions of the cerebral cortex at the core of ADHD. Recent studies have shown that children with ADHD are predisposed to abnormal functioning (dysregulation) of certain brain chemicals, called neurotransmitters, and abnormal functioning of neural pathways that regulate behavior. Moreover, some children with ADHD have certain parts of the brain smaller or less active than children without this disorder do.
It is possible to suggest that violations of neurotransmitter metabolism, leading to hyperactivity, are associated with mutations in genes that regulate the function of dopamine receptors. Separate biochemical studies in children with attention deficit hyperactivity disorder suggest that there is not only dopamine metabolic disturbance in the brain but also other neurotransmitters – serotonin and norepinephrine.
Diagnostics of ADHD is not as easy as it seems for the first glance. Taking into account the fact that ADHD involves several symptoms, it is quite difficult to diagnose the disease properly. It is necessary to remember that some manifestations of this syndrome may be just a phase in the development of the child.
Children can be diagnosed with ADHD only after a detailed discussion of all symptoms with parents and children, and after a thorough observation of the behavior of children in different situations. It is also necessary to explore the family of the child who is going to be diagnosed with ADHD for the purpose of ascertaining a presence of relatives with the same problem. The physician must distinguish ADHD from a mental or physical illness. Unfortunately, there is no a special test for the diagnosis of ADHD.
Even teachers can discover and express suspicion about the possibility of ADHD in some children. In order to assess the neurological and psychological status, the physician should carefully examine the medical records of children. Children must also assign a series of studies: assess vision, hearing, verbal and motor skills, intellectual abilities, personality traits, and other characteristics. To avoid mistake, it is also necessary to go through a consultation in allergist.
Basing on the above stated information about ADHD, we can make some conclusions about the ways how the disease should be treated. It is a truth that the system of treatment and monitoring children with ADHD is not developed enough, and it has a place due to the uncertainty of the pathogenesis of the disease. We are going to present non-drug and drug methods of correction in further discussion.
Beginning with non-pharmacological correction methods, it is good to mention that they include methods of behavior modification, psychotherapy, educational and neuropsychological correction. For instance, one of the most effective methods of ADHD is Davis technique. It does not suppress particular perception of the child and his unusual ability. With the help of the “points of orientation” a child masters the mechanism of “focus.” So, due to this technique, the child will avoid accusations of backwardness, slowness and can unleash the roots of the own creativity.
Moreover, the child is encouraged to “gentle training mode” – the minimum number of children in the classroom (ideally no more than 12 people), a shorter duration of training (30 min), child stays in the front row (eye contact of the teacher and child improves concentration). An important thing in terms of social adaptation is also a purposeful and long-term education of the child’s socially promoted standards of conduct, since the behavior of some children has antisocial traits.
The psychotherapeutic work with parents is also necessary so that they did not regard the child’s behavior as a “hooligan” and were more understanding and patient in their school activities. Parents should monitor the regime of the day of a “hyperactive” child (taking meals, doing homework, sleeping), provide him the opportunity to spend excess energy in physical exercises, long walks, running. Fatigue should also be avoided when performing tasks, as this can increase hyperactivity. “Hyperactive” children are extremely high-strung, so it is necessary to exclude or limit their participation in activities associated with the accumulation of large numbers of people. Since the child has difficulties in concentrating, it is necessary to give him only one task for a certain period of time.
As we have mentioned, the treatment of ADHD is multifaceted and includes methods of behavior modification, educational, and neuro-psychological adjustment. Medical therapy is prescribed in severe cases, when problems of conduct and violations of the cognitive functions in children with ADHD can not be overcame only by means of psychological interventions. The first-line treatment of mild and severe ADHD is parent training. In severe cases, the first-line treatment is pharmacotherapy. The first-line drug of choice for treating ADHD is methylphenidate which is a mild, central nervous system stimulant. In the US, the drug is sold under the brand name Ritalin. Of course, it is necessary to remember that the therapy can be started only after the accurate diagnosis.
Listing some sources that can be helpful for individuals with this disorder, we need to mention that the first source that can be used to get more information about the disease is Medline Plus. This website provides the readers with short descriptions of the disease, its main symptoms, giving short recommendations on the treatment. To continue, Emmons & Anderson (2005) also gave a description of the disease for those who need to be aware of its main characteristics. But the authors also give important recommendation for overcoming the disorder and it can be helpful even for health care professionals. Jacobelli & Watson (2009) in their book “ADD/ADHD Drug Free: Natural Alternatives and Practical Exercises to Help Your Child Focus” mentioned that the drug use is rather controversial because sometimes pills can only temporarily improve symptoms. For the purpose of helping children to cope with the disorder they recommend to use behavioral therapy and techniques of strengthening brain functioning. Neven, Godber & Anderson (2010), also made a specific emphasis on the use of behavioral therapy, while they also provide an integrated exploration of the causes of ADHD. Such an approach which is presented in the book can help parents to understand the disease better. Langher, et al (2009), in the article about the disease, stated that ADHD children can often experience loneliness and relational problems with peers, and it can provoke severe problems in social and educational spheres. So, not only ADHD children should improve their behavior, but their close environment should also take into account the problems of these children.
To make a conclusion, it should be said that social adaptation of children with ADHD can be achieved only at the interest and cooperation of family, school and society because only joint efforts of all people who are interested in coping the disease may help children to battle this disorder. Moreover, making a thorough research of ADHD and learning much new information throughout the course, I have realized that our society needs changes because nowadays only a few people take responsibility for their actions, while others are still waiting that somebody will help their children to struggle against various diseases, including ADHD. It becomes evident that parents, teachers and health care professionals should work together over overcoming the negative consequences of various diseases, and there should be also implemented preventive measures. I strongly believe that these new knowledge gained in the course will help me to be more successful in my career because only knowing all the symptoms of different disorders and possible ways of their treatment it is possible to make the right decision in helping sick people in coping with their problems.
References
Delfos, M. (2009). Children and Behavioural Problems: Anxiety, Aggression, Depression and ADHD – A Biopsychological Model with Guidelines for Diagnostics and Treatment. Jessica Kingsley.
Emmons, P. & Anderson, L. (2005). Understanding Sensory Dysfunction: Learning, Development and Sensory Dysfunction in Autism Spectrum Disorders, ADHD, Learning Disabilities and Bipolar Disorder. Jessica Kingsley.
Haggerty, H. (2014). Treatment of ADHD in Children. PsychCentral. Retrieved from http://psychcentral.com/lib/treatment-of-adhd-in-children/00014482.
Jacobelli, F. & Watson, L. A. (2009). ADD/ADHD Drug Free: Natural Alternatives and Practical Exercises to Help Your Child Focus. AMACOM.
Langher, V. et al (2009). Adhd and Loneliness Social Dissatisfaction in Inclusive School from an Individual-Context Paradigm. The Journal of Special Education and Rehabilitation, 10 (3/4).
Medline Plus. Trusted Health Information for You. (2014). Attention deficit hyperactivity disorder. A service of the U.S. National Library of Medicine National Institutes of Health. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001551.htm.
Neven, R., Godber, T. & Anderson, V. (2010). Rethinking ADHD: Integrated Approaches to Helping Children at Home and at School. Allen & Unwin.
Nylund, D. (2011). Treating Huckleberry Finn: A New Narrative Approach to Working with Kids Diagnosed ADD/ADHD. Jossey Bass.
Smith, M. & Segal, R. (2014). ADD / ADHD in Children: Signs and Symptoms of Attention Deficit Disorder in Kids. Helpguide.org. A trusted non-profit resource. Retrieved from http://www.helpguide.org/mental/adhd_add_signs_symptoms.htm.
Wender, P. (2010). ADHD: Attention-Deficit Hyperactivity Disorder in Children and Adults. Oxford Universit
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"The terms offer and acceptance." freeessays.club, 17 May 2016
"The terms offer and acceptance." freeessays.club, 17 May 2016
"The terms offer and acceptance." freeessays.club, 17 May 2016
"The terms offer and acceptance." freeessays.club, 17 May 2016