Category: ADHD

Introduction

The patient is a Caucasian 8-year-old girl referred for treatment by their primary care provider after her teacher feared she could have ADHD. According to Katie’s teacher’s “Conner’s Teacher Rating Scale-Revised” score, she is inattentive, easily distracted, forgets what she has previously learned, and does poorly in spelling, reading, and arithmetic. She is known to only pay attention to things that attract her, and her attention span is short. Her teacher claims she appears bored in her studies and frequently sidetracked. Another trait of Katie is that she frequently disobeys instructions, starts things but never finishes them, and neglects to do her studies.

The patient states that she frequently feels “lost.” she finds her other lessons dull and occasionally challenging. Katie admits that she does get distracted during class by more exciting things. When the teacher calls her name, Katie continues that she occasionally has nothing on her mind and has no idea what is being discussed. Katie claims that her home life is fulfilling and rejects the harassment and bullying she has experienced at school.

After the mental status examination, Katie, a Caucasian 8-year-old girl, appears to be developing in line with her age. She speaks persuasively, coherently, and logically. She has the proper sense of person, place, time, and occasion. She is also dressed correctly for the season and the weather. She does not have any apparent motions, tics, or body language. She describes her mood as euthymic and her affect as bright. Katie denies having visual or aural hallucinations and freely admits to having neither delusional nor paranoid thought processes. Katie’s ability to pay attention throughout the clinical interview and count backward from 100 using successive 2s and 5s show that she is mostly in control of her attention and focus. Discrimination and comprehension appear age-appropriate.

Katie denies any ideas of suicide or murder. After assessing Katie’s status and development, the matter was evaluated in three stages and resolved. The pertinent conclusions influenced the decision-making process and the information acquired from each step. In this case, the consumer requires a prescription for Ritalin. This medication treats attention deficit hyperactivity disorder, a form of ADHD. It works by changing the brain’s concentrations of specific chemical molecules. Methylphenidate belongs to the subclass of stimulant medications. It can enhance a patient’s ability to pay attention, help them stay focused during an activity, and help them deal with behavioral problems. Additionally, it could promote the development of listening skills and job organization (Conners et al., 1998). This medication also treats narcolepsy, a particular kind of sleep disorder.

Decision Point One

Katie has reached the required age to get Ritalin at eight years old. By maintaining optimal levels of dopamine and norepinephrine throughout the body and brain, the stimulant medicine Ritalin boosts activity in the brain and body (Bélanger, 2018). IR Ritalin must be divided into smaller doses for the total daily intake for the initial dose. Given the girl’s young age, it would be prudent to begin the therapy with low dosages of the medication in order to reduce the likelihood of side effects.

The other two options were sticking with the current dosage, reassessing to see if any significant changes have occurred, and giving Ritalin LA (Pakdaman, 2018). Due to a successful outcome from the tiny initial dosages, the re-evaluation was chosen for the second point. It was necessary to keep an eye on Katie to see whether the symptoms would improve. As it requires proof of tolerance or inefficacy from the frequent administration of the preceding medicine, the third alternative, which entails providing Ritalin LA, would not be acceptable for the first decision.

The primary goal of giving IR Ritalin is to lessen ADHD symptoms. The particular objective was to assist Katie in becoming more focused and capable of finishing her chores. This should lead to improved interactions with her classmates and academic success. Ethical concerns and disagreements may be lessened if the restoration of Quality of Life for ADHD patients and their families was recognized as the goal of treatment options. Children with ADHD appear to have a high rate of prescription non-adherence; as a result, it is ethically essential for the doctor to enhance compliance throughout the diagnostic and therapy phases (Conners et al., 1998). Because of this, Katie must always participate as fully as she can in the informed consent process. The girl’s parents would have to keep an eye on her development and let the hospital know if they noticed any strange behaviors. This choice was made based on the circumstances, the patient’s condition, and the potential for more therapy.

Decision Point Two

The patient received the same amount of IR Ritalin and was required to continue taking it for an additional four weeks after the results of the first four weeks were evaluated. The dose given during the first four weeks, which had contentious effects on the patient, impacted this choice. Katie’s disorder symptoms had also not been sufficiently managed to stop taking her medication (Conners et al., 1998). She had to continue the therapy as a result. The medicine selection would have been altered if the medication had not been successful (Sayal, 2018). Ritalin LA would not be a suitable substitute for IR Ritalin because it remained effective beyond the first four weeks of use. Ritalin LA was mainly used when ADHD symptoms worsened; there was no clinical need for it.

As it had been noted before in the therapy, the sustained IR Ritalin dose delivery was intended to reduce the symptoms of ADHD further. It was anticipated that Katie’s ability to focus and complete tasks would advance even farther from her current state (Conners et al., 1998). As a result, she will be a better student and make even more friends because she does not find people to be uninteresting. There is a moral requirement to enhance group decision-making in ADHD. The ethical proposal of shared decision-making (SDM) is widespread. However, there is a considerable danger of conflict and misunderstanding in situations when there are several evidence-based therapies available and parents, patients, and physicians evaluate the potential options differently. The elevated heart rate will persist as long as the medication is taken, and the parents will be informed (Conners et al., 1998). They will be given instructions on regularly checking the patient for unfavorable arrhythmias that might lead to potentially fatal heart problems.

Decision Point Three

For eight weeks, the patient had IR Ritalin therapy. It impacted the first four weeks, but the symptoms worsened during the following four. The medicine had to be altered despite the improvement in focus since the patient’s condition had worsened. Ritalin LA 20 mg was recommended because it has a longer duration of action on the patient after delivery than IR Ritalin since IR Ritalin proved ineffective at staying effective throughout the school day (Childress, 2021). This choice was anticipated to prolong the symptom relief while attending school and keep the healing process. Since Katie’s tachycardia was not abnormal, a STAT EKG was ruled out as being necessary.

This choice is anticipated to maintain Katie’s focus throughout her academic days. IR Adderall was an option when switching from IR Ritalin as a medicine. However, it does not work long enough to reduce symptoms (Conners et al., 1998). The duration of action for IR Ritalin and IR Adderall is three to six hours (Childress, 2021). Ritalin LA has some potentially serious adverse effects, but treating ADHD in children diagnosed with it is acceptable and morally right.

With this strategy, Katie might have a fulfilling relationship and elevate her performance (Fleischmann, 2022). The evidence would be presented to Katie’s parents, who would then be told that their daughter would receive stimulant medicine as part of a multimodal treatment plan (Conners et al., 1998). They should be aware that the disease has negatively impacted the child’s life; as a result, when the advantages outweigh the possible hazards, as they do in this instance, it is worthwhile. When the physician, instructors, and family collaborate closely to support the treatment program for success, these dangers might be promptly addressed.

Conclusion

The client is a Caucasian 8-year-old kid diagnosed with ADHD by her teacher. In order to assist the patient focus better and finishing her chores, it was determined following the mental state examination that giving IR Ritalin in tiny doses would be the best course of action. This would result in improved interactions with her classmates and academic success. The patient received the same amount of IR Ritalin after four weeks and was required to continue taking it for an additional four weeks. The excellent results of the dose demonstrated in the first four weeks had an impact on this choice.

In addition, the disorder’s symptoms persisted. Her medicine had to be kept up, so. If the medicine had turned out to be unsuccessful, the pharmaceutical option would have been altered. As shown before, in the course of treatment, the goal of the continuing IR Ritalin dose delivery was to reduce the symptoms of ADHD even further (Conners et al., 1998). It was anticipated that Katie’s ability to focus and finish tasks would advance above the current level. However, the symptoms got worse after eight weeks of therapy. Therefore, Ritalin LA had to be substituted for the original medicine. This choice is anticipated to maintain Katie’s focus throughout her academic day.

When used, the medicine Ritalin may have unwanted consequences. However, in this instance, the patient met the medication’s requirements, and its anticipated benefits outweighed any adverse effects. Involving Katie in any decision-making in this circumstance would be morally right (Conners et al., 1998). She should be aware of the hazards and procedures performed on her body, regardless of age. The fact that the medicine is morally acceptable and that the physician would collaborate with them to reduce Katie’s ADHD symptoms should also be made clear to Katie and her parents.

References

Bélanger, S. A., Andrews, D., Gray, C., & Korczak, D. (2018). ADHD in children and youth: Part 1—Etiology, diagnosis, and comorbidity. Paediatrics &Amp; Child Health, 23(7), 447–453.

Childress, A. C. (2021). Novel Formulations of ADHD Medications: Stimulant Selection and Management.FOCUS, 19(1), 31–38.

Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998). Revision and restandardization of the Conners teacher rating scale (CTRS-R): Factor structure, reliability, and criterion validity.Journal of Abnormal Child Psychology, 26(4), 279–291.

Fleischmann, A., & Gavish, B. (2022). Pharmacological treatment of children with ADHD: how educators persuade parents to use it.European Journal of Special Needs Education, 1–15.

Pakdaman, F., Irani, F., Tajikzadeh, F., & Jabalkandi, S. A. (2018). The efficacy of Ritalin in ADHD children under neurofeedback training. Neurological Sciences, 39(12), 2071–2078.

Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D. (2018). ADHD in children and young people: prevalence, care pathways, and service provision. The Lancet Psychiatry, 5(2), 175–186.

Faraone, & Larson. (2019). Genetics of attention deficit hyperactivity disorder. PubMed. Web.

Summary & Validity: This article features an in-depth look at a chronic medical problem of attention deficit. It discusses the manifestations, nursing interventions, and pathophysiology of the disorder in an attempt to manage the increased cases of the disorder. This report is essential as it discusses my medical journey to recover from hyperactivity disorder. This article is based on a medical journal whose strength and validity are a tribute to Library databases.

Xu, G., Snetselaar, L. G., Strathestn, L., Ryckman, K., Nothwehr, F., & Torner, J. (2022) Association between the history attention-deficit/hyperactivity disorder diagnosis and cardiovascular disease in the U.S. adults. Health Psychology, 41(10), 693- 700. Web.

Summary & Validity: This account is a history of attention deficit, consequently known as hyperactivity disorder. It clearly outlines the origin and early symptoms of the disorder and the scientist who discovered attention deficit hyperactivity disorder. In addition, the article exhibits the remedies for hyperactivity disorder. I can employ this reference in the preface writing of Anthropology and the mode section and analysis. The proficiency of this article is undisputed because it is competently analyzed and explored from the relevant medical websites.

ADHD—what causes attention-deficit/ hyperactivity disorder and how is it treated? (2021). Pediatric Patient Education. Web.

Summary & Validity: This article describes the causes of hyperactivity disorder and the potential factors of a medical condition. It outlines how environmental factors and genetic factors are associated with attention deficit. Equally, the article outlines how brain development and brain injuries are linked with the disorder. This article clearly outlines the signs and symptoms of ADHD in both early and later stages. Similarly, the article describes the nursing process involved in the formation of an efficient healthcare plan.

Sharma, M. (2018). Conservative therapy through adequate doctor-patient interaction improves outcomes in patients suffering from attention deficit. International Journal of Healthcare Education & Medical Informatics, 04 (04), 1-2. Web.

Summary & Validity: It unravels the medical procedures, patient treatments, and development of a favorable health system. The article’s attention to detail manicures the understandability of the concepts of the modern healthcare system. The emphasis on public relations between the nurses and patients or caregivers flavors the report. Ethical considerations in the healthcare sector, such as confidentiality, are perfectly addressed in this report. Ultimately, programs such as fostering patients’ physical exercise and behavioral management techniques are addressed in this article.

Genetics and Neurotransmitters

Attention deficit hyperactivity disorder (ADHD) is a genetic condition passed from parent to child through inherited genes. The fathers who had attention deficit hyperactivity during their youth have children affected by this disease (Liu et al., 2021). Mothers with identical twins share this ADHD trait since they share common characteristics. Patients with this condition seem to be restless and have difficulties in concentration. The symptoms are mostly noticed at an early age and may develop when the circumstances of a child change, for instance, when they begin going to school. Norepinephrine and dopamine are two neurotransmitters that play a role in ADHD (Xiong et al., 2021).Since dopamine plays a role in focusing and rewarding the brain after completing specific tasks, lower levels indicate a deficiency.

Neuroanatomical Changes and Therapy

ADHD disorder affects the brain in various ways by altering its normal functioning.

The condition affects the motivational functioning and abnormal cognitive and behavioural components of the brain. The regulation of the brain cell connections, emotions and moods are affected. Critical communications between different brain areas through the nerve impulses are also hindered. Dysfunction of the prefrontal cortex contributed to a lack of alertness and shortened attention in the brain’s short-term memory. Behaviour therapy is the most suitable for controlling ADHD disorder. It is crucial since it equips patients with tools to monitor their behaviours and adapt to change.

Current Theories of Causation and Cultural factors

A dynamic developmental theory indicates that the interplay between the environment and individuals influences behaviour. Genetic factors linked to the neurotransmitter dopamine may play a critical role in developing ADHD (Chuang et al., 2022). Some cultural myths depict that if a person with ADHD is hyperactive and impulsive during childhood, they are likely to continue that way into adulthood. The culture that trains children on the importance of socializing through speech has more minor victims.

References

Chuang, Y., Wang, C., Huang, W., Wang, L., Kuo, H., Chen, Y., & Huang, Y. (2022). Two meta-analyses of the association between atopic diseases and attention deficit hyperactivity disorder core symptoms.Scientific Reports, 12(1). Web.

Liu, Y., Chang, X., Qu, H., Tian, L., Glessner, J., & Qu, J. et al. (2021). Rare recurrent variants in noncoding regions impact attention-deficit hyperactivity disorder (ADHD) Gene networks in African American and European American ancestry children.Genes, 12(2), 310. Web.

Xiong, Z., Yan, J., & Shi, S. (2021). Val158Met polymorphisms of COMT gene and serum concentrations of catecholaminergic neurotransmitters of ADHD in Chinese children and adolescents.Medicine, 100(49), e27867. Web.

Introduction

The independent variable in this study is the presence of diagnosed ADHD, a problematic condition in many children which makes concentration difficult. The major problem with this variable is that it cannot really be accurately measured as yet. The dependent variables are the boys being tested, including the control group. Because the ADHD half of the independent variable cannot be accurately quantified, there is a problem with the dependent variables. Even though the ADHD group was separated into types, the research has no broad application, since the results can only be quantified for small groups with very narrow definitions. The other variables are the videogames, matching exercise and the zoo navigation exercise used to test the performance of the boys.

Difficulties of Sample Selection

The difficulties in testing this group must have been a prime consideration for the researchers, as they took great care in their selections and in documenting them. The researchers made a concerted effort to set up a viable experiment by testing the participants and separating the types of ADHD, in case this was an extra variable and applying other measures designed to isolate the desired independent variable: the presence of ADHD. They were careful to take all boys from the same age groups and located within the same geographical area and part of the same socio-economic group. Testing of IQ and skills further assured some homogeneity among the participants. The ADHD group had even been diagnosed by the same pediatrician. Children with any other conditions diagnosed or suspected were eliminated from the control group in an effort to attain a high level of matching. This was confirmed by interviewing the school principal and psychologist. Girls were excluded because there were few in the ADHD group and even fewer played video games. Participants from the test and the control group were closely matched for age, IQ and skills. Finally, data was only used for those pairs who completed the video games and the matching and zoo navigation exercises. There was even care taken to match the boys for familiarity and skill with the video games and the Zoo.

Application

Even though the nature of ADHD makes this study not applicable on a broad scale, because the results cannot be quantified statistically for the overall group, except as anecdotal evidence, extreme care is taken in creating the sample and in documenting all segments of the tests, especially since each ADHD participant’s particular types and levels of difficulty were also included, makes the results of this research very valuable in identifying stressors and resulting cognitive deficits. This data is not only valuable to practitioners in the field but provides much comparison data for other studies. The measuring methods and their applications and analyses were very carefully done and described completely for the readers. Procedures for testing and analysis of the tests were described in great detail. Then the resulting analyses were applied to the proper areas of cognitive functioning, according to established research.

Conclusions

Considering the nature of the problems being investigated and the difficulty in creating a homogenous group for testing, this research study was extremely well done. If enough projects are completed with as much attention to detail and as careful documentation, the body of work could soon grow to a quantifiable size for many types of ADHD. For this reason, this research study stands as an excellent example of research design and execution. Any research involving human subjects is problematic and studies involving children must be carefully controlled. Therefore, the level of care taken here should be replicated.

References

Lawrence, Vivienne; Houghton, Stephen; Tannock, Rosemary; Douglas, Graham; et al. 2002.

ADHD outside the laboratory: Boys’ executive function performance on tasks i.

Journal of Abnormal Child Psychology. 2002; ProQuest Social Science Journals.pg. 447.

Introduction

ADHD stands for Attention-Deficit Hyperactivity disorder which is a mental disorder that results into a mixture of behaviors that are disruptive. It is common in children at their early stages of growth. Usually, these behaviors result into a child’s difficulty in development, social life, family relationship and performance in any activity it engages in. Major symptoms for this disorder include inattentiveness, hyperactivity and impulsiveness.

At times, hyperactivity is not present and at this juncture the disorder is referred to as DH or HD inattentive where the child has some abnormal behaviors such as not thinking before acting, fearless, impatience, inability to sit or stick in a job for a long time, problem in paying attention, inability to control emotions and difficulty in following instructions, as such the child has problems in his/her social life.

Although these characters are common to all children, the intensity and extent in child’s life development is what raises concern. Many factors contribute to these disorders such as failure in child’s attempt to do something like in education, desperation from death of a parent or divorce and such like circumstances that might adversely affect the child’s mentality.

Medication is not an adequate solution for such disorders and the environment in which the child is exposed has a big role to play in improving these disorders (Holowenko, 1999). ADHD is a disorder that is real but does not necessarily require medical attention for its correction.

ADHD is real

Diagnosis has shown that this disorder is real and it is caused by neurological and biochemical processes which are responsible for attention payment and right reasoning due to brain functioning problems.

The maturation period for the child’s neurons, level of lead poisoning and genetic inheritance are all factors contributing to how a child behaves. This behavior can either cease at a certain age or continue up to childhood. Though the disorders are common with all children, one can be right to conclude that ADHD does not exist but the level of their exaggeration makes the disorder real.

In some cases this order can be inherited from parents and it is possible for more than one kid in a family to have to have it. In this case, the child’s behavior is determined by the biological make up of the brain and the neurons. Such disorders are humiliating not only to the victims but also to the close relatives. It is good to diagnosis for this disorder immediately the symptoms are noticed. Diagnosis is supposed to be done by a qualified psychiatrist.

In as much as the child behavior is not at free will, parents have a big role to play so as to improve the conditions. Exposure to the right type of environment at both home and school can play a great role in treating such kind of disorder. Encouragement and counseling cannot be left unmentioned as this will help the child understand the situation he/she is at and this can yield positive results.

Free will is a situation where by one freely chooses on what to do. It is an important factor in psychology because the brain functions to choose on what to do without any external force. If ADHD was a free will situation then no one could have chosen on either of the symptoms but because it relays on determinism, the state becomes more natural and real (Kalat 2010).

Effect of western culture on ADHDs

According to statistics, more boys are vulnerable to this disorder than girls although, at the current, large number of children has been diagnosed with this disorder. There various cultural factors that determine the development of a child’s brain in the western culture such as lack of support from the parents and this leads to mental torture.

In child development, a child requires a lot of attention from his/her parents who give directions and advise on how things should be done. Also in school, the children are put into a lot of pressure in order to perform excellently in academics.

This may be a negative impact in that the child feels inadequate as she/he struggles to achieve the required requirements. Currently, the society is too busy to take care of the children and to give them guidance on how to live. Competitiveness and individualism is highly encouraged and this means the child is left alone to carryout his/her own activities even at an early stage. There is also a failure on the side of mothers who fail to take their responsibility of teaching the children morals.

Moral decay in the society is also a contributing factor towards these disorders. These cultural practices have been proved to contribute towards ADHD through various researches carried out. This can be true though on the contrary, these disorders are said to have been caused by biological factors in such a way that they can be passed from parents to their children. The frontal hemisphere of the brain is concerned with coordination and a delay in development in this part of the brain can lead to such kind of disorder.

Side effects of the used drugs

In western culture, once a child is diagnosed with this disorder, medication is prescribed in form of stimulant such as Ratlin which acts to improve the impulsiveness and the inattention in a child.

This drug is to be taken for 7 to 8 years and in the begging the drug seems effective but with time, the disorder symptom reoccurs. The drug is not meant to improve the child’s knowledge or activeness but it helps improve the conditions for this improvement for a short duration of time.

To most psychiatrics, this behavior can be corrected by use of either depressant or stimulants. These drugs are believed to activate the brain functioning incase of stimulant while the depressants are used to reduce the rate of brain functioning thus keeping the child’s brain at par with those of other children of the same age.

However, this is not true as such practices will eventually lead to some kind of resistance to the drugs thus leaving the condition the same or worst. Instead of concentrating on the child’s abilities, a lot of reliability has been laid on doctors who give prescription; this has led to pharmaceutical making abnormal profits.

Many are the side effects associated with these drugs such as mood swings, weight loss, appetite loss, irritability, insomnia, uncontrolled emotions, dizziness, retarded growth, lack of creativity, headaches, problem in body movement , stomachs’ and many more (Litchblau 2010). This is contrary to what has been published indicating that the drugs used have no known side effects.

Conclusion

ADHD is a type of disorder that can be caused by either biological or environmental factors, although all children have these characters at their early developmental stages, their degree of persistence in a child’s life and level of exaggerations as compared to those of other children of the same age calls for concern for such disorders.

Diagnosis for this disorder is of great value though use of drugs cannot have a long lasting solution. It is therefore advisable to look for other ways of treating or avoiding such cases that may lead to these disorders. Use of drugs is dangerous due to the side effects they lead to. ADHD is real and it exists.

Reference List

Holowenko H. (1999). Attention deficit/hyperactivity disorder: a multidisciplinary approach. London: Jessica Kingsley Publishers.

Kalat, J. (2010). Introduction to Psychology. Wudsworth: Cengage Learning.

Litchblau, L. (2010). Psychopharmacology Demystified. Wudsworth: Cengage Learning.

Summary

Bright not broken: Gifted Kids, ADHD, and autism, the book by Kennedy, Banks, and Grandin (2011) focuses on the issues about the identification and education of twice-exceptional children (2e children). These are the children who simultaneously have exceptional gifts such as academic, physical, or intellectual abilities, and a developmental or learning impairment such as the autism spectrum disorder or the attention deficit hyperactivity disorder.

The book is divided into three parts. The first one discusses nuances related to the identification of 2e children. It is stated that such kids are often perceived as lazy, unintelligent, or defiant by their teachers, which leads to severe problems with the child’s development; therefore, it is paramount to efficaciously identify these children to be able to properly address their needs.

The second part deals with the nature of the issues that 2e children are faced with. The authors discuss the flaws that exist in the American mental health and educational systems. In particular, it is stressed that many children are labeled with numerous disorders and are treated accordingly, often with strong medications, whereas in the reality they do not have these disorders, but may have other disabilities that remain unaddressed; also, the currently existing educational system lacks methods to properly deal with the 2e children.

Finally, the third part focuses on the methods that can be employed to help 2e children. Here, the importance of building a culture that would define these kids as bright rather than broken is emphasized.

Reflection

It is possible to state that the book provides rather a high-quality review of the issues about the identification, education, and upbringing of the 2e children. The authors approach the problem systematically, beginning with the difficulties related to telling apart the 2e children from the rest of the kids. For instance, several characteristics typical of such kids are provided; the common views of adults on these children are also exposed and criticized, which, undoubtedly, can come in handy for both educators and parents whose children are 2e kids.

It is also paramount that the authors emphasize that diagnosing kids with such disorders as e.g. the Oppositional Defiant Disorder (ODD) or the Conduct Disorder (CD) is often done erroneously, and the strong medications, which may not always be good even for children with ODD or CD, may significantly harm the 2e kids who have been falsely diagnosed with these disabilities, and hinder the identification of their true condition, significantly worsening their health, academic, social, and personal outcomes.

The authors state that the system currently used for diagnosing these (that is, the Diagnostic and Statistical Manual of Mental Disorders) has significant faults that cause the professionals to err frequently; this also leads the parents to blame the specialists who were “simply following the rules of their profession“ (Kennedy et al., 2011, p. 82). The fact that the authors point out this problem is of the essence because only voicing such issues publicly can lead to positive changes in the existing system.

Also, the authors of the book discuss the issues related not only to the mental health system but also to the educational system existing in the U.S. and explain what manner of difficulties parents and their 2e children are forced to face to provide the kids with proper education and safeguard them from “falling through the cracks” of the existing educational system. Importantly, the authors scrutinize the current education system, which is stated to be influenced by the No Child Left Behind act, and is supposed to make “all students, regardless of ability or disability, meet proficiency standards” (Kennedy et al., 2011, p. 140); it means using a unified approach to all the children, with disregard to their peculiarities, which entails non-properly addressed needs of both the disabled children and the gifted children; clearly, 2e kids might face even more serious aftermath.

The very fact that this problem is being raised and discussed in the book, drawing the attention of the readers to the issue, is an essential aspect that will undoubtedly help advocate on the multiple levels of society for the rights not only of 2e children but also for the rights of the other kids who do not fit the existing educational system well.

Another point that is worth noting is that the authors not only raise the organizational issues in the book but also provide the readers with certain practical recommendations about raising the 2e children. The first two authors, being mothers of several 2e children, have much practical experience to share with their audience; the fact that the third author has autism herself and has been able to successfully cope with it also gives the book more weight.

Therefore, it should be emphasized that the book by Kennedy et al. (2011) provides a systematic overview and several valuable insights about the situation that the 2e children and their parents face; these will undoubtedly be helpful not only for parents and educators directly dealing with 2e children but also for individuals participating in child advocacy.

Reference

Kennedy, D. M., Banks, R. S., & Grandin, T. (2011). Bright not broken: Gifted kids, ADHD, and autism: Why twice-exceptional kids are stuck and how to help them. San Francisco, CA: Jossey-Bass. Web.

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral developmental disorder that is associated with hyperactivity, inattentiveness, impulsivity, excessive motor activity and distraction. It affects people of all ages. ADHD is diagnosed in childhood from the age of seven and adolescents and most adults with the disorder link it to their childhood where it was either noticed or ignored.

The causes of ADHD are not established concretely in research studies although it is linked to genetic, hereditary or biological factors as well as environmental and social factors to a certain extent. Addressing ADHD in children is significant since early diagnosis and treatment of the condition during childhood can alleviate it.

The prevalence rates of ADHD are high in children and if not dealt with during childhood it usually creates more problems in adolescent stage. Sufferers of ADHD are at risk of engaging in negative behaviors such as substance abuse as well as the onset of depression.

The use of behavior modification in addressing ADHD is very important since the medication alone cannot transform the sufferers whereas monitoring it is very difficult. This research project establishes the use of behavior modification in dealing with ADHD in children.

Summary of Articles Relevant to the Research Project

Chang, H., Chang, C., & Shin, Y. (2007). The Process of Assisting Behavior Modification in a Child with Attention-Deficit Hyperactivity Disorder. Journal of Nursing Research, 15(2), 147-154.

The authors of the article are Chang Hsin and Chang Ching of the National Cheng Kung University as well as Shin of the nursing department in Kaohsiung Medical University Hospital. The objective of the article is to offer a description of the process of behavior modification for a child diagnosed with ADHD. The research involved a child who had not reported positive effects despite undergoing treatment of ADHD using medication.

The child was subjected to behavior modification together with medication for the next year with the medication based on the prescription of the doctor. The behavior treatment was based on the drafts of the doctors and experts with major techniques being punishment and skillful reinforcement. The information was collected from interviews with parents and teachers and other observation. The results from the research were:

1. The child improved in self discipline in his daily life.
2. His social interactions with friends improved.
3. He finished his school work and games on time.

The research establishes that behavior modification when carried out together with drug treatment improves the daily lives of children with ADHD. Good communication with parents and the psychological preparation are important in behavior modification while the overall support of the teachers and other social interactions are necessary for such children.

Coles, E., Pelham, W., Gnagy, E., Burrows-Maclean, L., Fabiano, G., et al. (2005). A Controlled Evaluation of Behavioral Treatment with Children with ADHD Attending a Summer Treatment Program. Journal of Emotional and Behavioral Disorders, 13(2), 99-112.

This study was done by ten authors identified above. The purpose was to evaluate the effectiveness of behavioral treatment for children suffering from ADHD. The research study involved the manipulation of the presence of behavioral treatment for four children of ages 11 to 12 years.

The children involved in the research were enrolled at the Center for Children and Families located at the State University of New York in Buffalo for the summer treatment program of 2001 for duration of eight weeks.

The behavior treatment conditions were varied and changes in the behaviors in and out of the classroom assessed together with the levels of productivity in their academic work. The behaviors recorded included: obedience to activity rules, daily rates of compliance, interruptions, conduct problems, complaining, negative verbalizations and violation of rules. The findings were:

1. John showed a low rate of complaining during treatment which increased with withdrawal.
2. Anne’s classroom seatwork and rule violations worsened with the withdrawals but stabilized during the last three weeks of the project.
3. Trevor reduced negative behavior but never returned to his initial treatment level of functioning after the withdrawals.
4. Jeremy’s classroom rule violations were also low initially when behavior modification was being used, but the rate rose when it was withdrawn.

The study demonstrates the positive impact of behavior modification on children with ADHD but it is limited in terms of the sample size and the individual differences.

DuPaul, G., & White, G. (2006). ADHD: Behavioral, Educational and Medication Interventions. Education Digest, 71(7), 57-60.

The study was done by DuPaul of Lehigh University Pennsylvania and White of Education Leadership program. The purpose of the report is to provide a guideline to educators on ways of dealing with children with ADHD. They report that educators spend much time dealing with students with special needs such as children with ADHD.

The article suggests that medical and psychosocial treatments help but responses to medication vary with individual differences hence requiring monitoring.

They suggest the need for staff to be updated with medical research with behavioral interventions in the classroom of antecedent based strategies such as modified lengths of assignments, posting of rules and peer tutoring among others, and consequent strategies based on reward systems and reinforcements as well as academic interventions.

They suggest the establishment of a support system for children with ADHD which includes increased time during testing, preferential seating in class, choice of a quiet place for testing purposes and increased length of assignments.

Ibrahim, E. (2002). Rates of adherence to pharmacological treatment among children and adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology, 17(2), 225-231.

The author of the article is Ibrahim El-Sheikh, a psychiatrist based at the King Fahad National Guard Hospital in Riyadh in Saudi Arabia. He asserts that although the pharmacological interventions for children and adolescents with ADHD are effective, the failure to comply with prescribed medication poses a great challenge to children and adolescents.

The objective of the research was to investigate the rate at which the children and adolescents diagnosed with ADHD and involved in the research were able to adhere to prescribed medication. The research involved a total of 51 children and adolescents of ages 7 to 16.6 years diagnosed with ADHD. The research entailed interviews and the checklists provided to the parents and teachers for compliance. The results of the research were:

1. There were high rates of adherence to treatment reported by the patients for the one week and three months period.
2. After the three months period, the reports of the parents showed stability in the adherence of the children and adolescents to the medication.

The implications of the findings were that the characteristics and functioning of the families played a key role in the adherence and the behavior modification therapy lessons attended by the participants. The whole research establishes the need for behavioral modification when coupled with medication. However, the study was limited to participants from intact family structure while the duration of three months was short and did not allow long term evaluation.

Logan, A. (2007). Controlling ADHD. Canadian Journal of Health and Nutrition, 9(229), 86-88.

The author of the article is Logan, a lecturer on depression, learning, nutrition and behavior at the Harvard medical school. The purpose of the study was to evaluate the alternative care that is given to children suffering from ADHD. The author asserts that the alternative care provides relief in the long term compared to the remedy of pharmaceutical medication.

The alternative care includes behavioral modification in the form of reinforcements and rewards systems which can be used by teachers and parents. According to the author, the alternative care not only enables children with ADHD acquire coping skills but also adaptive thinking, improved communication skills and management of emotions. The author also suggests that adherence to proper diet and nutrition serves as a form of treatment for children suffering from ADHD.

Conclusion

The research project under consideration involves children suffering from ADHD due to the complexity of the condition that results from a lack of clear cause, mixed symptoms and high prevalence. ADHD is treatable in childhood but failure to be diagnosed and treated earlier in life causes more adverse effects especially as the sufferers advance to the adolescent stage.

This paper has provided the summary of the relevant scholarly articles for more in depth analysis and evaluation of the condition. The general consensus from the articles is that behavioral modification program is an effective way of managing ADHD in children especially if the program is coupled with medication.

Introduction

As research studies show, Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent disorders in most learning institutions. As a result of these most learners who suffer from this condition are nowadays under medication aimed at reducing any signs of hyperactivity, impulsivity, and inattentiveness. Most ADHD medicines are stimulants meant to rectify the biochemical condition in the human brain, which has been cited as the primary cause of the attention and impulse control problem.

Over a long time, these medicines have proved to be beneficial to this class of learners, as most researches show that, as compared to un-medicated learners, most learners under the ADHD medication have shown improved academic performance. As a result of these, there has been an increase in the number of pharmacological treatments of learners with ADHD.

Although such is the case, ADHD treating medicines have also been associated with abuse and some side effects, which to a larger extent can impair learning. Most regular users of ADHD drugs are prone to addiction and numerous side effects, in case of an overdose or withdraw.

This scenario results mostly due to the fact that, most ADHD suffers under medication have a tendency of developing a dependency syndrome, in their endeavour to maintain their academic performance (DeFrates-Densch and Smith 677-689). Therefore, although ADHD medicines can help to promote academic performance of learners with ADHD, sometimes if not well used, they can greatly affect the achievement standards of learners with ADHD.

Positive Effects of ADHD Medication on Education

The primarily problem that faces most learners with ADHD is concentrating in the classroom because of the neurological deficits, which make it hard for teachers to teach them in a traditional classroom setting. In the past, because of this, most learning institutions were forced to have “special” classes for this group of learners.

However, with the introduction of ADHD drugs, nowadays ADHD sufferers can learn normally under normal leaning conditions with learners who are not suffering from ADHD. As research studies show, ADHD drugs have an activating and energising effect on learners with the ADHD anomaly; hence, most learners who are under medication, can afford to concentrate and attend to their academic needs (McClure 1-2).

In addition, as Rabiner (1) argues, because of the hyperactivity and impulsivity reducing effect of ADHD drugs, most ADHD suffers are nowadays able to learn in an indistinguishable class setting, because of the reduced instances of disruptive behaviours; hence, reducing the level of discrimination from other learners.

On the other hand, because of the suppressing effect of these drugs on impulsive behaviour, ADHD drugs play an integral role of promoting positive relationships between sufferers and their siblings, parents, and fellow learners.

This is very essential in the learning process of learners with ADHD, because these learners can seek assistance and guidance from fellow learners, siblings, and parents with minimal express. It is important for parents and educators to note that, the effects of ADHD drugs are normally short term; hence, from time to time, learners should be reminded of need to take their medicine.

Negative Effects of ADHD Medications

Although ADHD medications are of great significance to learners with the ADHD disorder, majority of this stimulants are very addictive, as they have to be taken from time to time by the suffers. In addition, as research studies show, majority of learners with this condition have a tendency of overdosing themselves, without considering any side effects that may result from such overdoses. Depending on the type stimulant, different ADHD drugs have different effects on individuals.

For example, Ritalin, one of the most common ADHD stimulants can make learners to fall asleep even during class time, be nervous, and experience high levels of nervousness. In addition, ADHD stimulants can cause headaches, abdominal pains, and depression. Although research findings show that, these effects are short-term, they can greatly affect a learner’s performance standards, as they are likely to disturb the normal learning process.

On the other hand, some ADHD medications can also cause dysphoria; a condition characterised by a bland and emotionless appearance of learners. This condition mostly caused when a learner takes an overdose of the prescribed ADHD drug. As research studies show, some of these side effects can be very detrimental on the normal learning process (Austin, Staats, and Burgdorf 19-22).

Conclusion

In conclusion, although ADHD drugs have some associated negative effects on the general performance of a learner, their contributions are immense not only to the education of the learner, but also to the development of positive relationships between learners and other concerned parties.

Therefore, it is important for parents to encourage their children who are suffering from this condition to use these drugs, are they greatly help to minimise any ADHD symptoms, which may affect their smooth learning. It is important for parents and educators to note that, these drugs cannot work on their own without the help of instructors and parents. Hence, it is the duty of parents and educators to provide favourable learning conditions and any required academic guidance to these learners.

Works Cited

Austin, Margaret, Staats, Natalie, and Burgdorf, Laura. ADHD: Attention Deficit Hyperactivity Disorder. 2007. Web.

DeFrates-Densch, Nancy and Smith, Cecil. Handbook of research on adult learning and development. Web.

McClure, Thomas. Interventions for students with ADHD. 2008. Web.

Rabiner, David. ADHD medications. ADHD News. 2010. Web.

Some students require special educational and behavioral attention due to the wide range of behavioral characteristics that they display. These include students suffering from Attention Deficit Hyperactivity Disorder and Asperger syndrome. These students are often difficult to deal with in class because they exhibit a wide range of disruptive behaviors that may derail the delivery and performance in a normal classroom setting.

Students with ADHD are usually loud and try to seek attention from the rest and even the teachers. They are also hyperactive and want to be involved in everything and they will throw tantrums if they are denied a chance to show themselves off (Green 1994).

They can easily disrupt a class by using their fidgety behaviors. The students with Attention Deficit Hyperactive Disorders also squirm very much and their squirming can be very disruptive to a classroom setting (Woodbury, 2008). They are also very oppositional and do not follow orders and instructions easily mainly because they are always inattentive. Their behaviors can be a big source of agony to the fellow students and the teachers because they are easily distractible, they always blurt out and they keep on moving here and there in a way that disrupts others (Hanna, 2006).

On the other hand students with Asperger syndrome usually have difficulties in social interactions and are usually withdrawn (Faraone 2003). Unlike the ones with ADHD, these students do not have attention-seeking or obnoxiously disruptive behaviors but can also be can also disrupt class due to their weird asocial behaviors. They have weird obsessions that can be a source of disruptions and their speech behaviors are usually one-sided meaning that they can easily disrupt the class with their awkwardness in speech. These students are also very insensitive to the feelings of others and this may cause friction in the classroom setting. Their clumsiness is the main source of disruption in the classroom.

However, ADHD and Asperger syndrome are mild behavioral challenges that do not require the students to be separated from the others (Bogadshina, 2003). These are students that do not need special classes because their behavioral challenges can be easily dealt with by the teachers. This means that principles of inclusion can be applied to be able to handle these students (Hartman, 2006).

There are various ways in which the teachers can manage to handle students with Asperger syndrome and attention deficit hyperactive disorder. To start with, a teacher needs to establish clear and straightforward rules that are supposed to be followed by anyone in the classroom setting. This will help in reducing the disruptiveness of these students with behavioral challenges because, with these rules, the teacher will be able to consistently enforce consequences for behaviors that are against the set rules (Asari, 2003). The teacher can also set a reward system where the ones that are good at observing the rules that have been set are rewarded. This will motivate the students with behavioral challenges to behave decently.

Secondly, students that have the two behavioral challenges should be made to sit near the teacher. This is because the teacher will be able to pay additional attention to the students and this will help in limiting distractions in the class. While teaching in a class that has students with ADHD and Asperger syndrome, the teacher should ensure that they give instructions that are simple and easy to follow (Faraone, 2005). The directions and the instructions should be one step and the students should be made to repeat the instructions after the teacher to enhance understanding.

The attention span of students with behavioral challenges is usually low as compared to other students. This means that when it comes to classwork, the teacher should break down assignments for the students that have attention problems. The students with ADHD and Asperger syndrome should be given enough time to finish their assignments. The teacher should also write down assignment instructions for these students if they have difficulty copying the instructions.

It is very hard for students with behavioral challenges to sit down for a very long period (Berthoz, 2003). This means that the teachers should create frequent breaks to let the students move physically. Without these breaks, the students will become disruptive because they will tend to move around the place disturbing the classroom setup. It is not a must that these breaks be created for all the students. The teacher can plan simple tasks for the student with ADHD and Asperger syndrome that will ensure that they have move frequently (Myles, 2003).

These simple tasks include taking books to the library or getting materials from the store. They can also be sent out to have a sip of water or to the water fountain to freshen up. These breaks are very important especially for the students with ADHD because they utilize the extra energy and help them to remain focused (Woodbury, 2008).

Finally, the teachers should also identify the strengths of these students and work on them. They should reward them for their efforts and also praise them in the presence of others. This will help in reducing attention-seeking behaviors in the students with ADHD and clumsiness in the students that have Asperger syndrome.

Bibliography

Asari C, 2005, “Current trends in psychological research on children with high-functioning autism and Asperger disorder”. Current Opinion Psychiatry 18 (5): 497–501.

Bogdashina, O, 2003, Sensory Perceptional Issues in Autism and Asperger Syndrome: Different Sensory Experiences, Different Perceptual Worlds. Jessica Kingsley, Boston.

Faraone, S. V., 2005, “The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder”. Euro- Child Adolescent Psychiatry 14, 1-10.

Faraone, S., V, 2003, Talk about Your Child’s Mental Health: What to Do When Something Seems Wrong, Guilford Press, New York.

Green, C., 1994. Understanding ADHD, Doubleday, London.

Hanna, M., 2006. Making the Connection: A Parent’s Guide to Medication in ADHD, Ladner-Drysdale, Washington.

Hartmann, T., 2003. The Edison gene: ADHD and the gift of the hunter child, Park Street Press, Rochester.

Berthoz, S., 2006. “Response”. J Autism Dev Disord 36 (8): 1143–5.

Myles B. S., 2003. “Behavioral forms of stress management for individuals with Asperger syndrome”. Child Adolescent Psychiatry 12 (1): 123–41.

Woodbury, S., 2008. “Asperger syndrome”. Euro- Child Adolescent Psychiatry 18 (1): 2–11.

ADHD

ADHD is not usually seen as a learning disability but it often leads to difficulties with studies. Children with this disorder are very active and cannot sit still, they have a short attention span and they have difficulties with concentrating. These students need special attention and specific strategies. Thus, a boy in the 3^rd grade may benefit from the use of the following strategies.

As for the content, this boy will get short texts. It is possible to give him several texts while others read only one text. The number of words read by children will be similar. This will enable the child to be interested in reading as he will read several different stories and may be interested in the content. The texts should be interesting and relevant for the boy (they must be about his favorite characters or familiar situations).

The student needs comprehensive instructions. The student will have written instructions at hand as lack of attention may result in his failure to do the task correctly. It can be a good idea to divide the task into particular bullet points to make it clearer for the child who is easily distracted.

Of course, the teacher should check whether the student completes the task correctly all the time. It is possible to ask some questions or simply observe the child’s work for a while.

As for the most appropriate setting, it is possible to seat the child near the teacher. Besides, if there is another hyperactive child, it is possible to group them and make them discuss the contents of the texts and their tasks.

Finally, it is important to praise the child and provide certain feedback. It is possible to make the student responsible for doing something during the next class, for example, cleaning the board, handing-out aids, and so on. This can be a good ‘controlled’ distraction for the child who needs these distractions to be able to focus on important tasks.

EBD

Students with EBD also require special attention and may cause certain troubles to educators. Notably, it is important to focus on academic performance as well as the development of social skills and self-esteem. The child in the 3^rd grade having EBD can benefit from the following set of measures.

When it comes to content, the child should get texts on norms of behavior and social interaction (friendship, politeness, and so on). This will meet all the goals mentioned above. As for the complexity of the text, since the child does not have a learning disability, he should not get easier or shorter texts but they do not have to be too difficult as it can set the stage for misbehavior.

This student (as any other in the class) should get detailed instructions. It is possible to provide instructions with the help of visual aids (pictures, photos, bullet points on the board).

It is crucial to check whether students understand instructions properly. It is possible to ask the child with EBD (after observing his work on the task) to repeat the instructions. This will increase his self-esteem as he will give the correct answers.

The setting is also very important. It can be beneficial to group students and it is essential to make sure that the child is in the group with students who he likes. The atmosphere in the group should be positive and friendly. This will help the child develop his social skills.

As has been mentioned above, the child needs encouragement whenever he is behaving properly and there must be punished when he misbehaves. The punishment can be a poor grade or a serious talk.