Attention Deficit Hyperactivity Disorder: Signs and Symptoms

Introduction

The ‘Lot in Life’ chosen for this case is a 6-year-old who has just been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). There is no known cure for this condition. This section covers key issues related to the scenario.

Overview

ADHD is a brain disorder characterized by a continuing order of inattention and/or hyperactivity-impulsivity, which affects normal functioning or development (National Institute of Mental Health, 2017). Three major areas of interest are inattention (difficulty in maintaining focus, persistence, or organization), hyperactivity (constant movement, talk, tap, or extreme restlessness), and impulsivity (hasty behaviors and actions) (Verkuijl, Perkins, & Fazel, 2015).

According to Verkuijl et al. (2015), ADHD is the second common mental disorder of childhood, and it was determined that the prevalence rates of childhood were 2.2% in boys and 0.7% in girls. Further, research shows that the condition may be found in 5% of children and 2.5% of adults (Anand et al., 2017). It affects academic, social, and occupational functions throughout a lifespan. Symptoms are often observed in children across different settings before they attain the age of 12 (Anand et al., 2017).

Signs and Symptoms

The major behaviors observed in individuals with ADHD are inattention and hyperactivity/impulsivity (National Institute of Mental Health, 2017). Majorities of children tend to have a combination of inattention and hyperactivity-impulsivity. At the age of six, hyperactivity is the most noted behavior (Sciberras et al., 2014). Although other persons may display these signs and symptoms, individuals with ADHD usually show excessive severity, frequencies, and interference with other life processes.

ADHD diagnosis requires thorough processes conducted by a multidisciplinary team consisting of a psychologist, pediatrician, and/or psychiatrist with the necessary competencies. Diagnosis is usually considered when symptoms have been observed for a longer period, when they are chronic, and when normal functioning is disrupted. Symptoms can be noted as early as at the age of three and can extend to adolescence through adulthood. In some instances, it is possible to mistake these signs for other emotional issues or completely miss them. Such occurrence causes delays in diagnosis. Undiagnosed cases in adults could be characterized by low performances in academic, work-related challenges, and poor social activities (Fleming et al., 2017).

Symptoms may vary through an individual’s lifespan. For instance, in early childhood, hyperactivity and impulsivity are the most observed, while later periods may be characterized by inattention, particularly in classroom and poor academic performance. Fidgeting or restlessness may be experienced in adolescence as hyperactivity diminishes while impulsivity and inattention persist. Adolescents with ADHD may struggle to cope with the condition and other normal functions, such as antisocial behaviors.

Risk Factors

Researchers have not precisely determined the causes of ADHD, but some potential risk factors have been identified, specifically genetic and environmental ones (Anand et al., 2017). Evidence suggests that inflammation-related genes could cause ADHD, and cytokines associated with tryptophan metabolism and dopaminergic brain pathways are critical for understanding pathogenesis of the condition(Anand et al., 2017). Additionally, preterm birth, low birth weight, and perinatal infections, which are characterized by neuroinflammation noticed through microglia actions, could also be linked to the condition (Thapar & Cooper, 2016; Rand, Austin, Inder, Bora, & Woodward, 2016). Other potential causes of ADHD could be alcohol use, cigarette smoking, use of certain drugs, exposure to environmental pollutants during pregnancy, or brain insults. More cases of ADHD are reported in males than in females.

Treatment of Attention Deficit Hyperactivity Disorder

No known cure is currently available for ADHD. Nonetheless, many therapy options have been used to manage the condition by helping to limit symptoms and enhancing functioning. The treatment has also become progressively more complex as new interventions emerge in clinical practice, and they include pharmacological interventions, psychological interventions, and complementary and alternative medicine, as well as education and training (Catalá-López et al., 2017).

Pharmacological interventions

Pharmacological interventions involve the use of medication to manage ADHD under the administration of a physician. Some known therapeutic drugs include stimulants, such as amphetamine and methylphenidate, as well as non-stimulants like guanfacine and atomoxetine. Antidepressants like venlafaxine, bupropion, and imipramine, and antipsychotics drugs, such as thioridazine and aripiprazole are also administered to patients (Catalá-López, et al., 2017).

Psychological interventions

Children and adolescents can benefit from many psychological therapies available for managing ADHD. Behavioral therapy aims to transform the behaviors of an individual. They are based on the cognitive theories and social learning principles, which strive to enhance desired behaviors and curtail undesired ones. Practitioners may apply behavior therapy (teachers or parents may mediate), contingency management, and cognitive behavior therapy, which may involve social skills training and others. Psychological therapies may last for several days, months, or years.

Cognitive therapies aim to improve memory through training designed to enhance ADHD-deficient neuropsychological activities and to increase cognitive function and attention. Additionally, neurofeedback, which involves the visualization techniques of brain processes using electroencephalography, is applied to help children to develop attention and to manage their impulses. In neurofeedback, sensors are put on the scalp to gauge processes, and results are captured through videos or sounds. This approach is based on the behavioral principle of operant conditioning to help individuals with ADHD to control various states and processes of their brains.

Complementary and alternative medicine interventions

Complementary and alternative medicine consists of various medical and other healthcare systems, products, and practices, which are not classified under the modern medicine (Catalá-López et al., 2017). Dietary therapies may include a controlled elimination diet or consumption of less amount of food that may trigger hypersensitivity (this diet is often referred to as oligoantigenic). Diet restriction also extends to the removal of artificial food materials. Treatments also include herbal therapy in which Ginseng, Valerian, and others are used. Finally, homeopathic medication and other interventions aimed to enhance physical and mental well-being have been adopted to promote body-mind balance (El-Nagger, Abo-Elmagd, & Ahmed, 2017).

Education and Training

Parents, family members, and teachers need to provide guidance and support to children with ADHD to allow them to attain their full potential and excel. Anger, blame, anxiety, and frustration should be managed through effective training and education, which health professionals should offer to both children and parents. Such training also assists children to acquire novel skills, attitudes, and social skills. Moreover, parents and other caregivers are trained on parenting skills, stress management techniques, and they get additional help from support groups.

Individuals with ADHD are encouraged to join research studies or clinical trials to help in detecting and managing the condition. New knowledge continues to emerge in areas of cognition, brain imaging, genetics, epidemiology, and advances in treatment, which are critical for improving the health and quality of life of persons with ADHD.

Action Plan for Attention Deficit Hyperactivity Disorder (ADHD)

This action plan aims to manage ADHD through behavior change. It recognizes that a child with ADHD exhibits some aspects of challenging behaviors. As such, it encourages parents to work with healthcare professionals to make the condition easier to control.

The Plan

Managing ADHD is based on attaining the balance between the expected behaviors of and actual behaviorsthe child. A daily routine, guideline, and consequences are established to manage the behavior. For the right balance on behavior, the plan include:

  • Effective behavior strategies for learning, better sleep, diet, and physical activity
  • The necessary support for learning, communication and language, physical and emotional challenges
  • Treatment

This plan is based on professional advice to meet specific needs of the child and family. Moreover, it accounts for various aspects of the child’s life, such as conditions at home, at school, and in different social environments. The plan is discussed with family members, caregivers, therapists, and teachers to ensure that realistic expectations are established.

Strategies for Behavior

This part of the plan ensures that the child acquires the right skills and behaviors while reducing challenging behaviors.

  • he child is given clear verbal instructions to allow them to have a better understanding of the parents’ expectations.
  • Use daily predictable routine for the child to feel safe and secure – this should account for the period between the wake-up time and bedtime. It should have periods for play, homework, rest, and any other indoor activities.
  • To develop better social skills, the child should be reward for good behaviors, be taught strategies how to handle social issues with others, and how they can watch their own behaviors not to offend others.
  • Get an individualized education program

An individualized education program for the childcan be obtained from the school district. The child requires additional support in the classroom. Therefore, the child’s teacher can apply strategies that meet their needs. For example, breaking down tasks into smaller units, offering specific learner-centered support (one-on-one), providing a ‘peer buddy’ who understands what to do in case of a problem, planning classroom for learners with such special needs, conducting task planning, and providing extra time for task completion are some of the strategies for improving a learning environment for a child with ADHD.

Parents are encouraged to ensure that the child receives all the support they require with regard to physical, learning, and language. They should engage the school directly for any special programs and related funding to support the child.

ADHD Medication

A specialist in child’s ADHD should prescribe the most effective medication for the child. These may include stimulants to improve mental coordination and to enhance attention, control and language and motor skills. Non-stimulant medication should be prescribed to manage anxiety in the child. Additionally, other therapies may be administered based on the recommendation of a pediatrician or a psychiatrist. All drugs administered may have side effects and, therefore, it is important that a doctor should closely monitor the child. This section also accounts for diet monitoring, for example, how to feed the child and control loss of appetite during treatment.

Community Agencies

One important community agency for individuals with ADHD is the Children and Adults with Attention-Deficit/Hyperactivity Disorder(CHADD). The organization offers education, advocacy, and support for persons with the condition (CHADD, 2017). It further provides programs and services through collaborative approaches. These include training for teachers and parents, conducting works, providing the latest evidence-based information on ADHD, and offering a list of specialists to support the community. Parents can also learn from regular publications on treatments, advances in research, and membership. Members of the public are encouraged to contact the organization throughout the week to talk an ADHD information specialist; to sign up for newsletter and magazines; to ask questions and connect with others for support; to search the library; and to listen to various audio files on social media platforms. No cost information is available on services offered by the organization.

Boston Children’s Hospital has developed a Learning Disabilities Program to provide a thorough assessment for children who experience challenges in thinking (cognitive), academic, and social aspects of development. The program is designed to ensure that parents, teachers, and physicians have a comprehensive understanding of the child’s learning needs, and it offers recommendations for improvements (Boston Children’s Hospital, 2017). A team of specialists is available to evaluate the child for about half a day. The multidisciplinary team then meets to share and discuss findings for the development of a well-rounded evaluation understanding and an intervention strategy. After some weeks, the case coordinator contacts the parent to share results during feedback sessions. The Hospital provides both local and international telephone numbers, an online platform on the Web site for scheduling an appointment, and an e-mail for reaching the program coordinator. It, however, does not provide the cost of the program (this is based on the findings following an assessment).

Obstacles or Challenges in Implementing the Plan of Action

The primary goal of this action plan is to change behavior. Behavior, however, is intricate. At home, the plan could be difficult to implement due to a possible lack of support from other family members and caregivers. With insufficient training on behavior and stress management skills, the family may not successfully increase good behaviors and discourage unwanted ones. Besides, other problematic family or underlying medical issues could undermine the implementation of the plan.

Challenges also exist within a school environment. All teachers may not consistently use the plan and even when implemented, its effectiveness may not be known because of behaviorcomplexity and classroom fit, particularly where teachers and peers have not been shown how to use any interventions. Teachers may not have sufficient time to evaluate the program and provide feedback. To the extreme, teachers may ignore the plan they are being asked to use as not important, and the lack of resources too could hamper any meaningful implementation.

These are expected challenges. Nonetheless, they require effective communication, collaboration, evaluation, and feedback. The program should also be simple and supported with sufficient resources, including training.

Reflection and Conclusion

This Lot in Life – ADHD is a condition with no known cure. Despite this drawback, the paper aims to demonstrate that ADHD is a condition that parents and their children can manage with different interventions. More importantly, it shows that parents should seek professional assistance when they are developing an action plan for behavior strategies, medication, and learning.

Parenting in this case requires support from family members and professionals, which is a critical element in managing the child’s ADHD. Parents need to engage family members, friends, teachers, and support groups for parents whose kids have similar conditions. Additionally, health professionals should review any difficulties and go further to address stress in parents.

References

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Boston Children’s Hospital. (2017). Learning disabilities program. Web.

Catalá-López, F., Hutton, B., Núñez-Beltrán, A., Page, M. J., Ridao, M., Saint-Gerons, D. M.,… Moher, D. (2017). The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PLoS ONE, 12(7), e0180355. Web.

CHADD. (2017). About Children and Adults with Attention-Deficit/Hyperactivity Disorder. Web.

El-Nagger, N. S., Abo-Elmagd, M. H., & Ahmed, H. I. (2017). Effect of applying play therapy on children with attention deficit hyperactivity disorder. Journal of Nursing Education and Practice, 7(5), 104-119.

Fleming, M., Fitton, C. A., Steiner, M. F., McLay, J. S., Clark, D., King, A.,… Pell, J. P. (2017). Educational and health outcomes of children treated for attention-deficit/hyperactivity disorder. JAMA Pediatrics, 171(7), e170691. Web.

National Institute of Mental Health. (2017). Attention Deficit Hyperactivity Disorder. Web.

Rand, K. M., Austin, N. C., Inder, T. E., Bora, S., & Woodward, L. J. (2016). Neonatal infection and later neurodevelopmental risk in the very preterm infant. Journal of Pediatric, 170, 97-104. Web.

Sciberras, E., Lycett, K., Efron, D., Mensah, F., Gerner, B., & Hiscock, H. (2014). Anxiety in children with attention-deficit/hyperactivity disorder. Pediatrics, 133(5), 801-808.

Thapar, A., & Cooper, M. (2016). Attention deficit hyperactivity disorder. Lancet, 387(10024), 1240-50. Web.

Verkuijl, N., Perkins, M., & Fazel, M. (2015). Childhood attention-deficit/hyperactivity disorder. BMJ, 350, Web.