Attention-Deficit Hyperactivity Disorder (ADHD)

Introduction

According to (Schachter, 2001), ADHD mostly affects children with an average age of below seven years which results in impairment of those children’s functionalism. It is a developmental disorder that is neurobehavioral whose characteristics include patterns of inattention and impulsiveness which may be accompanied by hyperactivity. Young boys are mostly affected by this disorder with their number being twice that of affected girls. ADHD is chronic since most of those diagnosed to suffer from it at childhood have those symptoms persisting even to adulthood. However, in the process of growing up coping mechanisms are developed so that the disorder is compensated for to some level.

Symptoms

Various symptoms are noticed in someone suffering from ADHD which include, impulsiveness where patients act without a prior thought of the outcome of their actions. It also involves disorganization, where patients may leave activities halfway finished and the go-ahead to start others as well as interrupting conversations. Hyperactivity is another symptom that is manifested through restlessness with patients being unable to sleep peacefully as they might even walk and change beds at night. Children with ADHD may be seen climbing on trees and anything else they find on their way which can be very dangerous. This restlessness is caused by difficulties in sitting down which make them be always on their toes. ADHD is also characterized by limited attention where patients get distracted easily; find themselves daydreaming as well as listening difficulties. These symptoms are categorized into three subtypes that include; hyperactive which are also referred to as impulsive, inattentive, and lastly combined. (Losier, 1996)

(Steinhausen, 2003), argues that, behaviors of ADHD are experienced by quite a several people though they might not affect them so much to the level that they interfere with their studies, work, or how they relate with other people as it’s possible to apply coping mechanisms. The symptom that is most common in children is hyperactivity through which degree reduces as they grow up where inattention seems to persist forever. However, only a small portion of those children diagnosed with ADHD are found to suffer from the disorder alone as other conditions are experienced in conjunction with ADHD. Those conditions must receive separate diagnoses and treatments since they are different from pure ADHD. They include; conduct disorder representing twenty-six percentage of its association with ADHD while the other is a disorder of defiant opposition taking thirty-five percent of association. These two are associated with anti-social behaviors which include signs of aggression, stealing, tempers, and stubbornness in children. The other percentage of association is taken up by several conditions which are vigilance disorder, mood disorder, anxiety disorder as well as a disorder of compulsion and obsession.

Etiology

ADHD’s specific causes are yet to be known but various factors are contributing to this disorder among them being social, genetics, physical, and diet-related factors. The genetic factor shows that children mostly inherit this disorder from their parents with hyperactivity being the most inherited condition though it’s also associated with other causes. According to researchers, ADHD is mostly caused by various genes combined. These genes impact transporters of polyamine through the traditional model through which a genetic disease is caused is not followed. Therefore, ADHD should be seen as an interaction of genetic factors with other factors in the environment as there has not been found a gene that independently causes ADHD. (Guevara, 2001)

Environmental factors also contribute to ADHD causing signs of impulsive behavior, hyperactivity as well as inattentive behavior in children who were exposed to tobacco and alcohol during pregnancy. Nicotine which is found in tobacco causes a condition of hypoxia where the fetus lacks enough oxygen leading to ADHD. A diet that is a factor contributing to ADHD can be divided into additives and supplementation of Omega 3. Additives are harmful to children causing hyperactivity in children and they should therefore be eliminated in the production of their foodstuffs. Research has shown that the supplementation of omega 3 could show effectiveness in ADHD treatment but some of these studies have been contradicted by conflicting results on the same. (Breuer, 2004)

According to (Coghill, 2004), Social factors do not independently cause ADHD but work in association with other factors. Children’s attention as well as their ability to regulate themselves is sometimes influenced by how they relate with those people taking care of them. Symptoms of this disorder have been found in foster children and those who have been emotionally and physically abused in form of violence. However though not classified in any of the four factors, head injury has also been found to contribute to ADHD since a high number of patients suffering from the disorder had at one time or another suffered from such injuries.

Diagnosis

There is no specific test that is used in ADHD’s diagnosis which makes the diagnosis a clinical one. Different kinds of criteria are applied in its diagnosis with North America using the criteria of DSM-IV while a different one known as ICD-10 is used by European countries. When diagnosing this disorder in children, it’s considered that the child has to show multiple impairments to be regarded as one suffering from ADHD. The criteria of DSM-IV classifies ADHD into three types which include a type of combined signs of this disorder, a predominantly inattentive ADHD type, and lastly, is the predominant impulsive as well as hyperactive type. The three ADHD types are classified based on a particular criterion that has parts A and B which are observed for six months. (Leimkuhler, 1994)

However, while performing ADHD diagnoses; some conditions should be excluded which are psychological as well as medical conditions. The various medical conditions that need exclusion include anemia, chronic illness, hypothyroidism, and substance abuse. Others are side effects of medication, lead poisoning, and vision impairment among others. Sleep is a major psychological condition that has a very complex relationship with ADHD caused by an overlap in the centers regulating sleep in children with those regulating arousal and attention. Disorders of sleep have been found to present signs that are almost similar to those of ADHD in terms of dysregulation of behavior as well as inattention resulting in different levels of relationships between the two disorders. (Grcevich, 2001)

Management

The process of treating ADHD involves putting together lifestyle changes, medication, behavior modifications as well as counseling. There is a support group that offers information and gives assistance to ADHD patients to enable them to cope with this disorder. Behavioral interventions that would otherwise help manage ADHD involve some psychological therapies that include family therapy, interventions in schools, parent management, and input in psychological education among others. Instances, where parents have been advised and educated to help deal with children suffering from ADHD, have not brought long-term benefits. Therapies offered to families of those children with this disorder have not given good results since it has been found that most of these children have parents who divorce when the ailing children are young.

However, there is an alternative pharmacological treatment where stimulant medications may be given. These are very effective showing a 70% improvement in children given the stimulant, though it does not help them improve in their academic achievement. The results of stimulant treatment have only been observed in the first few years of its administration leaving safety in the long term unknown. However, before a child is given these stimulants, they must get tested for problematic conditions related to the heart. Stimulants users have also been warned against the possibilities of depending on the drugs for a very long time without which the child may experience low moods, drug abuse as well as sudden death. ADHD can also be managed by changing the lifestyles of children suffering from the disorder which might include the incorporation of aerobic fitness in the lifestyle of a child. This may improve the rate at which the child’s mind functions as well as the neural organization that shows controlled behavior in developments taking place before adolescence. However, there are contradictory results of athletic boys suffering from ADHD that show signs of increased acceptance of peer pressure as well as some negative behavior. (Jadad, 1999)

Prevalence

According to (Wilens, 2002), the Prevalence of ADHD in children is globally estimated at 5% though studies on this vary locally and geographically. In terms of geographical variation, more children are suffering from ADHD in North America than they are in the Middle East. On the USA’s eastern coast, there are more ADHD management and diagnosis practices than on the western coast of the same continent. The frequency at which these diagnoses are done differs with the female children taking 4% of the total while male children take 10%. This difference may be as a result of susceptibility differences between the two genders or a lower likelihood of female children being diagnosed compared to male children. The rates at which children are diagnosed with ADHD have risen in the USA and UK compared to rates experienced in the 1970s. Another study carried out in 2003 has shown that about 4.4 million children have been found to suffer from ADHD with 2.5 million of them being treated.

Conclusion

There have risen some controversies about ADHD which have involved teachers, the media, policymakers, clinicians as well as parents of children suffering from ADHD. These different people argue based on opinions that support the existence of this disorder while others deny that it exists. However, researchers from an evidence-based practice center argue that several features cause ADHD’s controversial nature which includes changes in its diagnostic criteria, lack of cure but therapies, and lack of a specific laboratory confirmatory test. Another reason is the variation of management as well as diagnosis rates across countries and continents all over the world which give different results of prevalence rates. (Marsden, 2000)

References

Breuer D. (2004): An Adaptive multimodal Treatment in children with ADHD: Springer pp 33-35. Web.

Coghill D. (2004): Stimulants for ADHD: Br Med Assoc pp14-16. Web.

Grcevich S. (2001): Preparation for the treatment of ADHD: Expert Opinion pp5-10. Web.

Guevara J. (2001): Evidence based management of ADHD: Br Med Assoc pp 26-29. Web.

Jadad A. (1999): Management of Attention Deficit Hyperactivity Disorder: Can J Psychiatry pp 15-19. Web.

Leimkuhler M. (1994): ADHD in Children: American Psychiatric Publishing Inc pp 13-15. Web.

Losier B. (1996): Test in samples of children with and without ADHD: Blackwell Synergy pp 22-27. Web.

Marsden C. (2000): Psychotherapeutics: Expert Opinion pp11-13. Web.

Schachter H. (2001): Methylphenidate for the treatment of attention –deficit disorder: Can Med Assoc pp2-8

Steinhausen H. (2003): Attention –Deficit hyperactivity disorder in a life perspective: Blackwell Synergy pp17-19. Web.

Wilens T. (2002): Attention –deficit Hyperactivity Disorder Across The lifespan: Annual Reviews pp 29-31. Web.