Category: ADHD

Abstract

ADHD known as attention deficit/hyperactivity disorder may affect all aspect of a youngster’s life. Excessive activity and distraction in children is one of the most common problems for parents, especially when accompanied by erroneous behaviors that affect their efficiency and scientific achievement. When is this diagnosed as satisfactory? Without a doubt, it impacts on the kid, as well as on guardians and kin, making unsettling influences on family and conjugal working. The antagonistic impacts of ADHD upon youngsters and their families changes from the preschool years to elementary school and puberty, with shifting parts of the confusion being progressively unmistakable at various stages. ADHD may continue into adulthood making disturbances. Also, ADHD has been related with expanded human services costs for patients and their relatives.

As kids with ADHD get more established, the manner in which it impact them their families changes .This fluctuates with family and school, and also with age, subjective capacity, and understanding of the children. The optimal medical is gone for supporting the person with ADHD and enabling them to accomplish their maximum capacity while limiting unfavorable impacts on themselves and society.

Introduction

ADHD is a cerebrum issue set apart by a progressing example of heedlessness and additionally hyperactivity-impulsivity that meddles with working or improvement.

• Heedlessness: implies an individual experiences issues supporting center and is complicated; and these issues are not because of absence of understanding.
• Hyperactivity: implies an individual appears to move about continually, incorporating into circumstances in which it isn’t proper; or unreasonably squirms, taps, or talks.
• Impulsivity: implies an individual makes rushed activities that happen at the time without first reasoning about them and that may have high potential for damage; or a longing for prompt prizes or powerlessness to postpone delight. A hasty individual might be socially meddling and exorbitantly intrude on others or settle on vital choices without thinking about the long term outcomes.

What causes ADHD?

Specialists at the National Institute of Mental Health (NIMH), National Institutes of Health (NIH), and the nation over are examining the reasons for ADHD. Recent studies shows that ADHD might be caused by connections among qualities and natural or non-hereditary elements. In the same way as other different diseases, various components may add to ADHD, for example:

• Genes
• Tobacco, alcohol abuse, or medication consumed during pregnancy
• Exposure to ecological poisons, for instance a large amount of lead at a young age
• Low birth weight
• Mind wounds

The preschool child

Poor focus, elevated amounts of movement, and lack of caution are visible qualities of ordinary preschool youngsters. Kids with ADHD may at present emerge. Associated challenges, for example, deferred improvement, oppositional conduct, and poor social abilities, may appear. In the event that ADHD is a probability, it is essential to offer focused on child rearing guidance and support. Indeed, even at this beginning period parental pressure might be gigantic when a youngster does not react to conventional parental decisions and conduct advice. Targeted work with preschool kids and their careers has been appeared to be powerful in enhancing kids’ communication and decreasing parental stress.

Primary school years

Kids with ADHD at the primary school start to be viewed as being distinctive as classmates build up the aptitudes and development that empower them to learn effectively in school. In spite of the fact that a delicate instructor might have the capacity to adjust the classroom to enable a capable youngster with ADHD to succeed, he may experience scholastic disappointment, rejection by colleagues, and low confidence. They also face problems in learning the program that affect them as well. Parents may find that relatives decline to think about the kid, and that other youngsters don’t welcome them to parties or out to play. Subsequently, parents have brief period to themselves; at whatever point the kid is wakeful they must watch them. As anyone might expect, family connections might be seriously stressed, and at times separate, bringing extra social and money related difficulties. This may make kids feel down and have aggressive behavior.

ADHD in young people

Adolescence may realize a decrease in the over activity; however distraction, rashness, and internal eagerness stay significant challenges. A misshaped feeling of self and an interruption of the ordinary improvement of self has been accounted by teenagers with ADHD. Furthermore, offensive and aggressive behavior may exist and develop more issues. Youngsters with ADHD are at expanded danger of scholastic disappointment, dropping out of school or school, high school pregnancy, and criminal conduct. Driving represents an extra hazard. People with ADHD are effectively diverted from focusing on driving while going gradually, however while driving quick may likewise be unsafe. It has been appeared, contrasted and age coordinated controls, drivers with ADHD are at expanded danger of petty criminal offenses, particularly speeding, and are viewed as to blame in more car crashes, including deadly ones.

Adult life

60% of people with ADHD in youth keep on experiencing issues in grown-up life. Adults with ADHD are bound to be rejected from business and have regularly attempted various occupations previously having the capacity to discover one at which they can succeed. They may need to pick explicit sorts of work and are now again independently employed. In the work environment, grown-ups with ADHD encounter progressively relational troubles with managers and partners.

Discussion

Treating ADHD

Despite the fact that there is no remedy for ADHD, at present accessible medicines may help decrease side effects and enhance working. ADHD is generally treated with medication, education, treatment and training.

Behavioral and pharmacological therapy

When the period of the case is more than six months it is necessary to resort to a specialist to ascertain whether the child’s condition is satisfactory or a passing mental state, especially that the child can be infected with hyperactivity for a certain period only. After the child behavior is diagnosed with the psychiatrist, accordingly a treatment is prescribed for him.

However, during this period the hyperactivity does not stop at him, but the treatment is mitigated by describing some ways to improve his actions. Parents should note that treatment does not cure the child completely because it is classified as a disorder, and the disorder persists throughout his life.

In detail, the treatment focuses on giving the patient some ways and plans to alleviate his excessive movement. The most important of these is the order of the objects, his guidance about adapting in his place for a long time, and a number of strategies followed by the parents and focused on how to deal with their child in this situation to help overcome them. It is also important to follow the strategies of stopping ,to teach him how to stop thinking about what to do and avoid rushing to do the work required of him or even in answer to the questions asked to him.

Treatment varies from one case to another and from one degree to another. In addition to psychological and behavioral treatments, the doctor may prescribe some medications especially stimulants like Ritalin, Concerta, Adderall, Focalin and others to manage hyperactivity or concentration.

I think that the most vital component in a fruitful treatment program for ADHD is to be sure, to think positive. You need to ensure that the expert who is helping you and your kid is available to you, adaptable, can disclose to you anything you desire. The treatment of ADHD is for a long time so we need to manage somebody we trust and who thinks about you and your kids. We have to develop the positive qualities and to limit the negative ones to have a good cure with the treatment of the specialist.

Treatments can have several problems such as drug addiction due to stimulant, and affecting children’s growth. The healthcare cost of ADHD is expensive and is approximately $4306.

Conclusion

To sum up, it is important to know that it is no possible to talk about a final solution to the problem of hyperactivity, but to manage and control it, and to not neglect the child situation. It is also crucial to tell the parents and the child about his condition, and interpreted well to have a succeed treatment, and help him to adhere to the behavioral treatments described by the specialist.

References

1. David Rettew,M.D. New Thinking About the Boundary Between Traits and Illness and a child psychiatrist in the psychiatry and pediatrics departments at the University of Vermont College ofMedicine.Retrieved from: https://www.psychologytoday.com/us/blog/abcs-child-psychiatry/201401/the-adhd-debate
2. Dr Hallowell, Live better life. Retrieved from: http://www.drhallowell.com/add-adhd/top10questions/
3. DuPaul GJ, McGoey KE, Eckert TL, et al. Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioural, social, and school functioning.Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2
4. Krueger M, Kendall J. Descriptions of self: an exploratory study of adolescents with ADHD. Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2
5. Leibson CL, Katusic SK, Barbaresi WJ, et al. Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2
6. Mattes JA, Gittelman R. Growth of hyperactive children on maintenance regimen of methylphenidate. Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2
7. Poulton A, Cowell CT. Slowing of growth in height and weight on stimulants: a characteristic pattern. Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2
8. The National Institute of Mental Health Information Resource Center.Retrieved from: https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml
9. Weiss G, Hechtman L, Milroy T, et al. Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. Retrieved from: https://adc.bmj.com/content/90/suppl_1/i2

ADHD is defined as Attention Defect/ Hyperactivity Disorder. It is a chronic condition that cannot be cured but can be treated and managed by medication and behaver intervention. ADHD affects 5% of Australian population which is equivlant to 1 in 20 people. 85% of people with ADHD is not diagnosed yet and boy are 4 times more likely to have ADHD that girls. Symptoms of ADHD include difficulty sustaining attention, hyperactivity, impulsive behaviour and is often accompanied with difficulty regulating emotions. All children experience these symptoms time to time but for those with ADHD it is 10 times worse, affecting them in many areas of life and much more suver . Think of the most distracted kid you know, someone who is never listening, looking everywhere except where they are suppose to unless fascinated by their task. Someone who gets so distracted you can’t help but wonder if they are deaf. That is what I am like without my tablet. But times it by 5 and 100% of the time. Children with ADHD have little control over their behaviour as they are symptoms of their disorder. They arise from an impaired ability to inhibit and regulate attention, behaviour and emotions; to reliably recall information in the moment; to plan and problem solve; to self-reflect and self monitor; and to self-soothe.

These stem from neurological differences and a resultant developmental delay, which reduces a child’s ability to exert age-appropriate self-control.

Without proper diagnosis and evidence based treatment a child’s ADHD can have may profound negative effects on day to day life. Effecting their family life, academic achievement, ability to navigate school and stress, friendships, social standing and self-esteem. If treated properly they can live a fulfilling life thriving reaching their full potential and goals.

There are many reasons for ADHD such as genetics. My Mothers brother has ADHD they never found a treatment that worked he is bad with money and can’t secure a job. I have rarely meet him though. My Grandfather on mums side is also believed to have ADHD. ADHD is sometimes thought to be caused by things such as lead and smoke. But there are some crazy myths out there like how to much sugar or screen time can cause it. Or even bad parenting! Before starting my quest and researching scientifically about ADHD I had never heard of such nonsense but I now see others must have. I just thought ADHD is caused by a lack of Diphoton which is scientifically correct, no one gene causes ADHD but a interaction between many. But when I hear these myths my blood boils, some myths are totally ridicules . I am insulted that that people could believe these lies. Calling those with ADHD lazy, or immature. It’s NOT their fault. Or that it is overdiagnoses or a boys only condition. Leaving those females to suffer in the dark. If people took the time to even understand the basics of ADHD and how it affects people just basic knowledge would allow them to easily tell the truth from lies. It was early in my exploration into ADHD when I learnt about these myths, using just my common sense I could easily decipher truth.

Some may outgrow it with age or lesion but children with ADHD may also struggle with low self esteem and self worth, sustaining relationships and poor performance at school and other academic areas. Even with a bright mind it may be hard to get there ideas on paper and can become frustrated, overwhelmed and feel they are fighting a losing battle. Early diagnosis and treatment can make all the difference. I was Diagnosed in grade 3-4 with combined type of ADHD. It meant due to my late(ish) diagnose some things I will always be behind. Like I missed my first 4 years of schooling and essentials in that. In class they expect everyone to know timetables, I never learnt this I don’t even remember learning that they exist until grade 3. I have never managed to completely memorise them even after YEARS of painful learning, reciting in the car, flashcards, and Sing A Long CD’s I still have not learnt them all. I am not treated with behaviour intervention only in the making of this book did I even learn that existed. I don’t think it would work for me anyway, I could not concentrate long enough to learn any other way. Instead I take Conserta otherwise known as Ritalin every single day, I used to take drug holidays but I will tell you more about it latter on. I am currently on the largest dose there is 12 hours. This may sound lake a lot. But when you take into account the packed curriculum and outside school activities sometimes it’s not enough. I will try and try and try bust after a hour long study session I only ever manage to remember 1-2 points or 2-3 questions. These days I am stunned by my classmates approach to tests. Such as CRAM where basically you do all your studying on the night before to keep it fresh in your mind. For me this would be a disaster resulting in terrible grades.

I strongly believe with things like this one size does not fit all. It is so important for me when talking about ADHD to achelly learn how it affects someone. For me there always seems to be something more interesting going on whether it be in my mind daydreaming, people walking past, noise, different conversations, screens, games, window ext. I am constantly fighting a losing battle in my mind forcing myself to try and stay on topic. Wenching myself back, and yelling at myself inside horrified by my level of self control. I will often perch a book 2cm from my face trying to block everything else out. But today there is so much going on. Recently in class I had a substitute teacher. I don’t mean to be rude but he was the worst teacher for me ever. Everyone loved him, he let them play games and put on a video to try and distract us! The typing on keys, the window, conversations even on my tablet I was finding it torture. I knew I let myself look for even a second I would be hooked. Close to tears I listened to my classmates ooh and ahh at the stunts on screen, as I screamed quietly in my mind. “NO Hannah Just a little bit longer.” Using one hand to block my view of the screen and plug my ears I sat 1cm from my computer my fingers trembling with the strain. Shouting, trying in my mind a war was on the teacher oblivious to my struggle. As I cried silently, I didn’t want to do the work as homework but I was horrified by the teachers approach. He said if 20 people did the work we didn’t have to do more. No one except me was working, expecting to have others do it and miss out. My mind begged to ask the teacher to sit outside. But I didn’t want to look like I was in trouble or that something was wrong. Gritting my teeth and digging my nails into the soft flesh of my hand I continued on. Worse for wear I finished early, my hand and wrist red and sore. My attention is like a greased bull. I lose things easerly and 1minite latter I will forget what I was talking about. For me especially at school concentrating on one conversation and to shut out the other is very hard. I tend to sit at the front not because I want to answer questions but because at the front you can’t see others computer screens. Today just a class is a battle of focus between class and a video game. I rarely get tempted to play them, worried what to do if I was caught but I can’t help watching. I easly cry and get scared, just the simple problem of asking a teacher and getting neglected even if only by a misunderstanding is enough to bring tears. Even when I lock myself in my room there are so many distractions. My ADHD makes it easy to get frustrated, stressed and overwhelmed. Feeling like I am in a ball of never-ending emotions. In grade 3-4 I started to learn to read. With small books I would sit in the car and very slowly and very loudly read each word. When my mother and brother tried to talk I would get louder and louder, every time they disturbed me I would start all over agen.

Becoming incedingly frustrated. Until one of two things happened, 1) I would blow having a full out screaming crying match. Or 2) They would be quiet. When I first got my tablet the results were spontaneous, Suddenly for the first time I could sit quietly and read in my head. For the first time EVER. At school I would never behave that badly, instead I sat quietly and wouldn’t follow instructions instead I got distracted.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects a number of brain functions. Although there are no known causes, several factors may contribute to this disorder. Such factors may include genetics, exposure of fetus to tobacco, alcohol or other drugs, illnesses or a history of a head injury. The general core characteristics are impulsive behaviour, hyperactivity and inattention, which ultimately interferes with one’s ability to appropriately control their behaviour and cognition. It is a highly prevalent disorder in childhood, in which most symptoms may persist into adulthood, resulting in poor academic and social outcomes (Rubia, 2018). ADHD is associated with possible functional impairment, as well as significant social and medical implications in children and adults. Children with ADHD often exhibit working memory difficulties along with executive function problems that include response inhibition, attentional switching, planning and sustained attention (Holmes et al., 2014). It is therefore essential to consider all aspects of a child’s disorder and life, in order to develop an approach to effectively treat them (Wilens & Spencer, 2010).

A multimodal approach that combines medication with behavioural management, psychological counselling and family support is essential for an effective treatment (Martinez-Raga, Ferreros, Knecht, de Alvaro, & Carabal, 2017). However, implementing stimulant medications is considered a widely used treatment for children with ADHD (Gold, Blum, Oscar-Berman, & Braverman, 2014). It also plays a significant role in the long-term management and treatment of children with ADHD (Wilens & Spencer, 2010). Stimulants can be effective in improving symptoms, additionally leading to possible favourable outcomes such as improved academic or work performance, or reduced criminality. There is some evidence that the use of medication can reduce the risk of criminality among patients with ADHD (Lichtenstein et al., 2012) and is therefore, effective in relieving symptoms. In addition, medications are considered cost-effective in comparison with a combination of medications and behavioural treatment (Wu et al., 2012). However, there are side effects and risks associated with this treatment and is therefore considered a debatable treatment, which often requires a comprehensive evaluation and consideration during usage. Stimulant medications are therefore an effective treatment with a well-established efficacy, but is associated with potential risks and side effects (Martinez-Raga et al., 2017).

Stimulants are the most widespread medications approved by the Food and Drug Administration (FDA) (De Sousa & Kalra, 2012) and is associated with potential risks and adverse effects, which prompts people to investigate its’ effectiveness in treating children. Stimulant medications, including amphetamine and methylphenidate can have a paradoxical effect on children with ADHD, by calming and possibly improving both their cognitive and non-cognitive symptoms. The release of stimulants in the pre-frontal cortex can subsequently increase the levels of dopamine, which are neurotransmitters that regulates emotional responses such as attention and pleasure (De Sousa & Kalra, 2012). However, the specific mechanisms of these stimulants may differ, in which some stimulants may either increase dopamine by blocking the presynaptic dopamine transporter or may stimulate the release of vesicular dopamine stores in the presynaptic terminals (Bidwell, McClernon, & Kollins, 2011), using the dopamine transporter as a carrier (Lakhan & Kirchgessner, 2012). As children with ADHD exhibits lower levels of dopamine, this is an effective method of gradually increasing its’ levels and in turn, regulate the child’s motivation, attention and memory formation. Although stimulants are associated with an exceptional response rate, some children with ADHD may exhibit a poor toleration or a lack of response to this treatment (Martinez-Raga et al., 2017). Therefore, the effectiveness of stimulant medications can vary depending on the individual with ADHD.

Stimulant medications may effectively treat or improve attention deficit in individuals with ADHD. In particular, methylphenidate can significantly increase dopamine levels in the ventral striatum, a region of the brain associated with decision making and reward-related behaviours (Lakhan & Kirchgessner, 2012). Moreover, this increase in the ventral striatum may enhance the saliency of the task and thus, improve attention in ADHD (Lakhan & Kirchgessner, 2012). Although stimulants may improve sustained, focused attention, selective attention and distractibility may worsen due to an increase in impulsivity (Lakhan & Kirchgessner, 2012). As children with ADHD exhibit decreased activity in ventral striatum during reward anticipation (van Hulst et al., 2017), stimulant medications will therefore improve those cognitive deficits. Particularly, in the medial prefrontal cortex, impaired reward anticipation behaviours often correlates with impaired decision making and learning in children with ADHD (Hauser et al., 2014). However, there are minimal evidence that supports the effectiveness of stimulant medications on decision-making, with some suggesting that stimulants do not ameliorate the decision-making deficits (DeVito et al., 2008). In addition to this, many studies still fail to indicate that stimulant medications can alter a child’s academic performance or learning (Neef, Bicard, Endo, Coury, & Aman, 2005). However, according to Felt’s study, it may improve their learning and academic perfomrnace, as they are less likely to be held back a grade (Felt, Biermann, Christner, Kochhar, & Harrison, 2014). Therefore, its effectiveness in treating children with ADHD remains controversial and thus, further research is required.

Similarly, the release of stimulants may also boost the levels of norepinephrine, which is a neurotransmitter related to arousal and attentiveness. A release of stimulant, methylphenidate will inhibit norepinephrine transporters, which reuptake norepinephrine and thereby, increase the catecholamines levels (Rubia et al., 2014). Therefore, increasing norepinephrine activity, which impacts on executive and attentional function (Faraone, 2018). Norepinephrine can alter the network activity in the higher-order processing areas of attention and working memory and by increasing its’ levels, modulate sustained attention and increase frontoparietal network activation (O’Donnell, Zeppenfeld, McConnell, Pena, & Nedergaard, 2012). Stimulants are therefore effective in treating the cognitive deficits in children with ADHD by increasing levels of dopamine and norepinephrine activity.

There are beneficial effects associated with the use of stimulant medications on working memory performance in children with ADHD. Stimulant medications can help strengthen and enhance the functional connectivity of some frontoparietal brain regions that are engaged for working memory (Wong & Stevens, 2012). Such enhancement is achieved through better coordination of information processing across the specialised nodes of connected networks. Therefore, activating the network engagement, as well as changing the regional functional connectivity. Evidence has shown that an increased activation of regional functional connectivity in the frontoparietal regions was correlated with improved working memory performance (Burgess et al., as cited in Wong & Stevens, 2012). In particular, the ability to store and manipulate visual-spatial information is improved but with no beneficial effects on the storage of auditory-verbal information (Bedard, Jain, Johnson, & Tannock, 2007). Therefore, the effects of stimulants are selective, as it will vary depending on the working memory component or task used. However, it is ultimately recommended to have a synergistic approach for treating children with ADHD to achieve optimal results (Holmes et al., 2014).

As there are structural abnormalities in the basal ganglia of children with ADHD, it is therefore important to investigate the effectiveness of stimulant medications in treating those associated cognitive deficits. Children with ADHD often have changes or a reduction in grey matter, which can be modulated by medication (Ellison-Wright, Ellison-Wright, & Bullmore, 2008). They present with abnormal volume and cortical thickness in the corpus callosum, prefrontal regions, basal ganglia and the temporal and parietal cortices (Nakao, Radua, Rubia, & Mataix-Cols, 2011). Possible expansion of the gray matter volumes and cortical thickness can be associated with the use of stimulant medications on ADHD, which has a normalizing effect on the brain structure (Nakao et al., 2011; Sobel et al., 2010). As medications are known to block dopamine transporters in the basal ganglia, it can enhance and normalize the activation in the basal ganglia (Rubia K, as cited in Nakao et al., 2011) and thereby, repair abnormal basal ganglia structure and elicit morphological changes in children with ADHD. It is further emphasised that medicated patients experience an increase in normal brain structure in comparison with unmedicated patients of ADHD. However, there are inconsistent evidences supporting this, which suggests that further research is required to investigate the changes in brain or basal ganglia volume (Nakao et al., 2011).

As children with ADHD often demonstrate executive function difficulties, one must evaluate the effectiveness of stimulant medication in treating those cognitive deficits. There is an absence of consistent evidence that stimulant medications enhance or alleviate executive function deficits (Bidwell et al., 2011). Therefore, its effectiveness in treatment is still undetermined. Stimulants, however, have varying effects depending on the dose and the domain of function, with high doses producing a greater improvement on some (e.g. attention, memory, working memory) but not others (e.g. planning, cognitive flexibility) (Bidwell et al., 2011). However, a randomised clinical trial has concluded that stimulants do not moderate or consistently improve those executive function deficits (Biederman et al., 2011). Therefore, additional intervention alternatives for executive function should be further explored, in which stimulant medications are used in conjunction with other strategies/management.

Stimulant medications, however, have both benefits and harms on behavioural effects which has elicited much discussion and concerns. Using stimulants without a prescription or using frequent doses of stimulants than prescribed, has been a prevalent and growing problem among populations of children transitioning to adolescents (Martinez-Raga et al., 2017). There are persistent concerns with the increased risk of substance abuse among individuals prescribed with stimulant ADHD medications. There are no indications of increased risk of substance abuse but instead, suggestions of long-term protective effect on substance abuse (Chang et al., 2014). However, evidences have also suggested that there is a dramatic increase in the misuse of stimulants by ADHD individuals, which may be a result of misconceptions (Lakhan & Kirchgessner, 2012). Moreover, stimulants may reduce emotional reactions to frustration and increase effortful behaviour. Although stimulants may or may not provoke substance abuse, it is essential to remain alert to the potential problem of stimulant misuse in children with ADHD (Chang et al., 2014). On the contrary, possible promotion of “risky behaviour”, as well as an increased susceptibility to environmental distractions can be a result of using these drugs (Advokat & Scheithauer, 2013). Other potential behavioural effects may include mood changes, anxiety and depression. Due to these “psychological side effects”, treatment discontinuation is considered significantly high in children (Advokat & Scheithauer, 2013). Therefore, despite its effectiveness in reducing symptoms, patients will often discontinue the use of stimulant medications. Aside from these side effects, inappropriate use could harm children by stigmatising them or by preventing possible advantageous treatments (Currie, Stabile, & Jones, 2014). Furthermore, long-term benefits of stimulant medications in treating children with ADHD remains controversial (Currie et al., 2014). Such stimulants are often prescribed to potentially improve a child’s academic performance to be successful in school. As there is little evidence associated with this, subjecting children to stimulant medications with potential side effects is weakened (Currie et al., 2014). Therefore, prompting one to debate about the moral implications of using drugs to effectively treat children with ADHD.

It is essential for further research on the effectiveness of stimulants, as there are several limitations to each evidence. One inherent limitation is that the peak-based meta-analyses are generally based on summarised rather than raw statistical brain maps and as a result, produce less accurate results (Nakao et al., 2011). Each study included in this essay used different statistical thresholds which can still be statically correct (Nakao et al., 2011). However, it is still unknown whether these differences can affect the validity of those researches. Furthermore, often the results for substance abuse are interpreted through the medical and legal records of substance-related hospitalisations, deaths and convictions, which are mainly severe cases of drug abuse (Chang et al., 2014). Therefore, further research is required to investigate whether these findings generalize to less severe cases. According to Van Hulst, his study involved primarily boys to preserve statistical power and therefore, will only apply to boys with ADHD. Moreover, the reward tasks were designed to detect differences in anticipatory activity rather than reward processing and as a result of collinearity, the brain activity could not be analysed separately (van Hulst et al., 2017).

Ultimately, future research is required to investigate the effectiveness of stimulant medications in treating children with ADHD. It is however, recommended to implement a multimodal approach, in which medications are combined with behavioural therapy and family support to effectively treat children with ADHD. In addition to this, early intervention is ideal, as it may reduce the negative outcomes associated with ADHD (Dopheide & Pliszka, 2009). Generally, there are benefits and harms associated with the use of stimulant medications and such controversies may include possibility of substance abuse, “risky” behaviour and inconsistent improvement of those executive function deficits. On the contrary, stimulant medications may modulate and alter working memory function, sustained attention and planning by increasing the dopamine and norepinephrine levels and enhancing the functional connectivity in the frontoparietal regions of the basal ganglia and ventral striatum.

ADHD can either go by these names Hyperactivity Disorder or ADD. ADHD affects both dopaminergic and serotonergic gene systems , including the genes DRD4, SLC6A3 and DBH.

What are the symptoms of ADHD?

• Impulsiveness
• Disorganization and problems prioritizing
• Poor time management skills
• Problems focusing on a task
• Trouble multitasking
• Excessive activity or restlessness
• Poor planning
• Low frustration tolerance
• Frequent mood swings
• Problems following through and completing tasks
• Hot temper
• Trouble coping with stress

ADHD is diagnosed by specially trained mental health professional like psychiatrists, psychologists or neurologists in which they go through both observational and vocal testing. Though a neuropsychological test can help diagnose a patient with ADHD, an MRI or a PET still can’t be used to diagnose a patient. So in the end, a clinical test would be most effective in the diagnosis process. (a patient must show symptoms of ADHD for 6 months or longer yo go through the tests)

What treatments are there for ADHD?

So far there are two ways to treat ADHD, either medication or therapy. As far as medication goes, there are stimulant medications, like Dexmethylphenidate, and non-stimulant medication, like Atomoxetine. The main difference being that non-stimulant medication takes longer to activate when compared with stimulant medication, but can last up to 24 hours and can often act as a back up to stimulant medication in case there are unwanted side effects. But what if he/she is 6 years old or younger? Well it is recommended that medication should be avoided and rather go through behavior therapy, as it can help kids cope with the hyperactivity and eventually work just as good as medicine, without the side effects.

Life expectancy with ADHD?

Life expectancy can be affected by ADHD, not because of a health-related issue but because of the “high-risk” activities ADHD can make one do. Drug abuse, for example, can be caused by the anti-social behavior that is caused by ADHD. Partaking in criminal activity that could prove fatal can be another example since it’s proven that one with ADHD may find it harder to find employment, so in the end, one could find it easier to rob a liquor store rather than go through their thousandth job application. Furthermore, ADHD can be extremely dangerous for kids as it can exponentially increase their hyperactivity and eventually lead to serious injury.

Overall, ADHD can complicate a person’s life from childhood to adulthood. First off, there will be academic problems as confusion and consistent sidetracking in school will lead to being a slower-paced learner. also, in some cases, ADHD can affect social skills which means that one would have a harder time making friends and could potentially lead to slight depression from the thought of being alone. lastly, employment can be exceptionally hard for someone with ADHD as employers can get the idea that one won’t be “up to speed” to the other co-workers.

ADHD, overall, has an even greater impact on Quality of life when compared to other mental health conditions. Increased symptoms and impairment, like difficulty to focus or work on a task, contribute to the lower quality of life that ADHD provides. There is evidence that, with enough treatment like therapy and medicine, Quality of life may improve. Overall, ADHD can hold one back from a good quality of life, which can be noticed especially when seen from an outsiders’ perspective, like a mother or father.

Professionals on ADHD altered the name of the disorder from ‘hyperkinetic “impulse disorder” to attention “deficit disorder” (ADD). Scientists and professionals alike believed hyperactivity was not overly common in the disorder. As a result of this realization, two subtypes of ADD were created: ADD with hyperactivity and ADD without hyperactivity.

Citations

1. Hulvershorn, leslie. “How Is ADHD Diagnosed?” Brain & Behavior Research Foundation, Bbrfoundation, 5 Sept. 2019, https://www.bbrfoundation.org/ask-an-expert/how-is-adhd-diagnosed.
2. “Adult Attention-Deficit/Hyperactivity Disorder (ADHD).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 22 June 2019, https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878.
3. Berlin, Mark. “ADHD and Its Impact on Longevity.” Psychology Today, Sussex Publishers, 26 Nov. 2018, https://www.psychologytoday.com/us/blog/child-development-central/201811/adhd-and-its-impact-longevity.
4. https://www.google.com/url?q=https://www.bbrfoundation.org/ask-an-expert/how-is-adhd-diagnosed&sa=D&ust=1574659537791000&usg=AFQjCNEGY3XsXUSyMmbLrRiNSbnCL4jErg
5. https://www.google.com/url?q=https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878&sa=D&ust=1574659537791000&usg=AFQjCNHexhuVcFKGq7acnVKgXl3nOvJQew
6. https://www.google.com/url?q=https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878&sa=D&ust=1574659537792000&usg=AFQjCNFoSu0kBoYb7kmXPUmQiUxa8ZPx4w
7. https://www.google.com/url?q=https://www.psychologytoday.com/us/blog/child-development-central/201811/adhd-and-its-impact-longevity&sa=D&ust=1574659537792000&usg=AFQjCNFz6kDgnDmgpClRBqk5T-agqy7mpg
8. https://www.google.com/url?q=https://www.psychologytoday.com/us/blog/child-development-central/201811/adhd-and-its-impact-longevity&sa=D&ust=1574659537792000&usg=AFQjCNFz6kDgnDmgpClRBqk5T-agqy7mpg

Adam is one of four children who live at home with mum. Adam has ADHD but has no other medical conditions. When Adam was in year 4, he was one of a few children in his class achieving a greater depth of understanding academically especially in mathematics. Since joining year 5 Adam has shown a decline in the work he is completing in class and refusing to sit the end-of-term assessments has resulted in him falling to a below-average academic level. The observer has known Adam since the start of year 4. The observation was made from part of the room which did not disturb the lesson taking place or interfere with the interactions between Adam and the class teacher (Mrs P). Adam was sat at his own table which is next to Mrs P’s desk. The lesson was mathematics, the teacher had just finished explaining the task, using examples from the previous day and had given the children the appropriate level of work to suit their ability. The children appeared to be engaged, listening to and following the teacher’s instructions. Adam had not shown an interest in the lesson opener, instead looking around the classroom, attempting to catch the attention of his peers. Mrs P saw Adam was not listening but ignored this.

Observation

‘Come on Adam’, said Mrs P, ‘open your workbook and get started. Adam sat at his table, arms tightly crossed, avoiding eye contact by looking down at the floor. He did not respond to these initial instructions. Some of the children who had already started their work were distracted by Mrs P talking to Adam and began chatting amongst themselves. Mrs P shushed the talking children and tried engaging with Adam again, ‘Come on mate, I know you can do this work’, she said, ‘all you have to do is open your book and work through the questions’. I noticed that Mrs P had folded her arms as she spoke to Adam. A few of the children were looking up from their work and whispering to themselves. Adam continued to ignore the teacher. Mrs P looked over to me, raised her arms in frustration and shook her head. I was beginning to feel a mix of emotions. I felt that things could escalate and was anxious others would become distracted from their work. I was disappointed with Adam as I know that the work set should be easy for him to complete. Surprisingly, it really annoyed me that Mrs P had used the term ‘mate’ when trying to win him round.

Mrs P’s attention was then drawn away by another child asking for help. As soon as Mrs P turned her attention to this other child, Adam raised his head and turned to the two girls sitting behind him. He whispered something to them both and all three began giggling. Mrs P had not noticed this and continued working with the child needing support. Adam began tapping his ruler and pencil on the table as if he was playing the drums making the two girls giggle even louder. Adam’s actions distracted some of the children near to where Adam was sitting. One of the children to shouted out ‘Adam stop banging, Mrs P I can’t concentrate!’. This caused Mrs P to react by calling out to Adam. ‘Adam, why haven’t you started you work yet, your book isn’t even open’, she now sounded angry. Adam shouted back at her, ‘I don’t know how to do it, I don’t know what to do!’. ‘Yes, you do as it the same as the work we all did yesterday’, she replied while she walked over to Adam, opened his book and pushed it nearer to him. At last, I thought, Mrs P has become Adams teacher again, he needed to be told. Adam smiled, not so much of a happy smile, it was nothing like the smile he gave when he and the other two girls where giggling earlier. It was more of a smarmy, victorious smile, a smile which said Adam had got Mrs P attention. Not only that, she had opened his book for him.

Mrs P left Adam to see how some of the other children were getting on. Immediately the smile disappeared from Adams face, he closed his book and pushed it, so it fell to the floor. He folded his arms and slouched back onto his chair and began kicking one of the tables legs. I really wanted to call over to Adam, telling him to sit up and get on with his work, but I didn’t. I was feeling so angry with Adam that I felt like stopping the observation, I mean, he is refusing to do his work so why should I bother. I took a few deep breaths and continued.

Adam slouched in his chair for another 5 minutes before disappearing under the table, arms still crossed. Mrs P returned to her desk and noticed Adam under his table. ‘If you want me to work with you, you must come out from under the table and sit on your chair’, she said while picking up his book. Immediately climbing out from under the table, Adam sat on his chair with a huge smile on his face. Mrs P sat with Adam for the next 13 minutes, working through the questions with him. I could see that Adam was fully absorbing the one-to-one attention yet still not doing very much of his own work. Mrs P was pretty much doing all the work for him. She was prompting, pointing, giving him clues to what the answers should be and even writing down the answers for him, Adam look very happy. The other children were becoming more and more disruptive, talking, moving around the classroom and throwing objects such as pencils and erasers at one another. Mrs P seemed to have sacrificed control of every other child in the classroom by giving Adam her sole attention. Each time the noise levels increased, Mrs P told the class to quieten down. Some of the children were out of their seats wandering around the classroom.

It was now time for morning break and Mrs P sent the children out of the class. Adam refused to leave the classroom completely, hugging the doorframe as if he was glued to it. Mrs P asked why he had not joined his friends outside and Adam replied it was because he had not finished all the questions. Mrs P then agreed to sit with him during the break time so he could finish his work.

According to the Centers for Disease Control and Prevention (CDC) 6.1 million children aged 2-17 years have been diagnosed with ADHD in the United States, (CDC, 2021). ADHD stands for attention-deficit/hyperactivity disorder, there is a large number of people in the US who have this disorder, and not a lot of Americans are informed about what ADHD is what it means to have this disorder, and other factors that can come with it. In this report, I will be discussing the prevalence of ADHD in the US, mortality rates, risk factors for complications, and methods of treatment.

Prevalence

ADHD is not contagious, and no one can really decide whether they can or cannot get ADHD. ADHD diagnosed in children is more prevalent in boys than in girls, (Danielson et al., 2016). It is not something that can be prevented since it is genetic, even then it is not 100% certain that a person who has someone in their family with ADHD can inherit it themselves, or it could have been caused by possible drug use or alcohol consumption during pregnancy as that can increase the chances of developing ADHD. If it is by genetics it will be in their bloodline and can be passed down to their offspring but it does not mean they themselves will have ADHD. However, it does mean they have a higher chance of being diagnosed with ADHD or their offspring. There is no way to prevent this disorder other than decreasing the risk of children developing ADHD when they are in the womb by not using drugs or drinking alcohol. Many people have different types of ADHD and not everyone who is diagnosed with ADHD looks or behaves the same.

Mortality Rates

There is more to ADHD than what most people know about, people who are diagnosed with ADHD are at risk when they have limited education as this plays a role in life expectancy. People who are diagnosed with ADHD are increased when diagnosed in adulthood rather than in adolescence, but women still had a higher mortality rate when diagnosed in adulthood and childhood compared to men which was lower, (Dalsgaard et al. 2015). Also, those who are diagnosed with ADHD are more likely to use nicotine, alcohol, and marijuana. The use of these stimulants makes people who are diagnosed with ADHD feel more at ease or gives them a calming sensation since many people who have ADHD have trouble concentrating and focusing or if they have behavioral issues. With this they have an increased chance to use nicotine, drugs, and alcohol that can lead to health complications such as liver failure, lung cancer, etc., and that increases the risk of disease and it shortens their life expectancy.

Risk factors for complications

Although it may not occur to some people that having ADHD comes with more complications than behavioral issues. People who are diagnosed with ADHD face risk factors such as “antisocial behavior, learning disabilities, drug abuse, impaired academic performance, impaired executive functions, communication disorders, speech problems, and comorbid psychiatric disorders”, (Javad et al., 2013). These risk factors contribute to complications that people with ADHD can face for instance having speech problems. Having speech problems at an early age can have complications for them as they are not able to communicate what they want or express their needs clearly to their parent. Behavior issues can actually lead to drug use which can turn into drug abuse, which can lead to health complications later on in their life.

Method of Treatment

Treatment that is being used for ADHD is behavior training and medications. Behavior training includes training for the parents as well, which helps children control their behavior, (Healy, 2016). One treatment for ADHD includes therapy, medications are not the only way to treat ADHD. One type of treatment for ADHD is behavioral therapy, which focuses on unhealthy behaviors to help with mental discomfort. There is also behavioral parent training that involves the parents being provided with instructions on how they should interact with their child but mostly used with children and may not be effective on teenagers. They are taught how to praise the child, help them learn skills, give them dedicated attention set appropriate behaviors, and focus on relationship-building skills. Different treatments for ADHD involve medications such as Adderall and Ritalin which are the most common medications for ADHD.

Conclusion

Overall, ADHD in the US should not be ignored since many children in the US have been diagnosed with this disorder and many people know one person or know of a person who has ADHD. Being diagnosed with ADHD can lead to complications in a person’s life and it is better to be informed about ADHD and how to interact with people with this disorder rather than treating them as if they are different when they are not. It is important for parents to seek therapy for their children who are diagnosed with ADHD and to also have therapy for themselves so they can learn how to interact with their children and give them the attention they need. Adults can also seek therapy and/or take medications if they wish to do so. The complications that can come with ADHD are alarming so I think it is important for there to be resources to help people with ADHD to help overcome possible complications and work with them.

References

1. Dalsgaard S,Østergaard SD,Leckman JF,Mortensen PB,Pedersen MG. (2015, May 30). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet (London, England). https://pubmed.ncbi.nlm.nih.gov/25726514/.

This combined with the fact that the companies that provide these types of medication, essentially that they all have a significant amount of resources to invest into research, both meaning that the information around medication is very clear and well understood universally. Therefore, people can make educated decisions with the breadth of knowledge that is available to them and there is not going to be any confusion that could cause patients to experience any problems. Another positive of medication in treating ADHD is that it usually does have the desired effect, just combined with the side-effects as well. There is no doubt as to whether these different types of drugs reduce the symptoms of ADHD and over the many years of being studied, they have been almost perfected in the way that they do help people deal with some of the more negative aspects of living with ADHD. Therefore, they do ultimately do what they are intended to do, very efficiently, the issue simply lies in the side effects that will come as a result, but if they can be managed, medication is a trusted and effective solution. A final strength of medication in treating ADHD is that it is now highly accessible due to the amount of research that has gone into it as well as the fact that medication can be replicated on a much larger scale than some other treatments. Due to this fact people that need quick treatment for their ADHD symptoms can get a very quick solution that will be able to solve the main issues almost immediately. This is a strength of medication when treating ADHD because of the fact that it can be treated universally with drug therapy and in most cases this treatment is good enough for this to be the most efficient plan going forward. However, this extreme accessibility can also produce a quite serious negative because the treatment is so available for people that think they may need it, it can lead to some people being prescribed medication when they do not actually need it, but because the medication is so accessible, there does not have to be many barriers that block whether someone can be prescribed it or not. If a person that does not actually need the medication, gets prescribed it, this could cause much more harm than good and thus practitioners need to be careful to make sure that this does not happen.

It is now relevant to look at the number of weaknesses that comes with using medication as the main way of treating people with ADHD. The first weakness of note comes from the multitude of side-effects that the drugs used to treat ADHD come with. Some of the common side effects that are seen from medication used to treat ADHD include, but are not limited to: decreased appetite CITATION NHS2018 l 2057 (NHS, 2018) (which can negatively affect healthy weight gain and physical development, especially in children), mood swings CITATION NHS2018 l 2057 (NHS, 2018) (which can negatively affect the mental health of the individual), increased aggression CITATION NHS2018 l 2057 (NHS, 2018) (can further damage a person’s mental health, as well as potentially affecting their personal relationships) and a combination of nauseaheadachesvomitingdiarrhoea CITATION NHS2018 l 2057 (NHS, 2018) (all obviously being detrimental to someone’s health). These side effects may not harm everyone, but for the people that they do harm, they can be very damaging to a person’s life and the people around them as they are all quite serious side-effects that someone may have to deal with almost everyday (if they are taking the medication regularly).Therefore, this is a weakness of using medication as the primary treatment for ADHD because for some people taking the medication, the side-effects actually end up causing more harm than the positives of taking the medication in the first place and so suitable alternatives must be pursued. Another side-effect of using medication to treat ADHD is that it is more expensive method of treatment than the potential alternatives. While being accessible, medication is still a relatively expensive way of treating ADHD when there may potentially be treatments that are either completely free or considerably cheaper. This could be taxing on certain people that cannot afford regular treatment and thus have decide whether to get medication or other necessities that they require. It is also just unfortunate that people must pay in order to treat an illness that is out of their control and so if there can be better alternatives found, they should be looked at. This is a smaller weakness than that of the side-effects but if a cheaper alternative can be found then there is no reason why it should not be pursued and so it is still a weakness, nevertheless. A final weakness comes mainly from one of the types of drugs used to treat ADHD, namely stimulants. The issue with stimulants is that they have the potential to be abused. This is because stimulants can increase dopamine levels and can cause feelings of euphoria when taken in high doses. Addiction is described as being caused when “your reward center mistakes drugs for a viable source of chemical reward and works to encourage you to use stimulants repeatedly.” CITATION Vis21 l 2057 (Vista Pines Health, 2021). This is obviously problematic for stimulants, which also happen to be the most commonly prescribed drug for the treatment of ADHD CITATION Rya11 l 2057 (Ryan, 2011), and therefore alternatives where this could not be the case are much more desirable because abuse of stimulant can potentially ruin lives if it gets out of hand. While there definitely there are some strengths to using medication to treat ADHD, mainly the plethora of research and its wide availability, there are still many weaknesses including the potentially severe side-effects as well as the cost and the potential for abuse. Due to these weaknesses, a natural alternative to treating ADHD is definitely desirable and research does show positive signs, it is just whether there is enough to completely replace ADHD treatment from medication to more natural methods.

Overview and evaluation of new, potential natural treatments for ADHDA natural treatment is one that does not occur artificially, in the same sense that medication does, and thus does not have artificial effects on the body. These treatments avoid do not share the same shortcomings as medication and potentially provide a much more sustainable solution in dealing with ADHD in the long-term. Interest in these natural alternatives has been steadily increasing in recent years and there is now some substantial research that points towards natural treatments being very beneficial for people with ADHD. This essay will look at dietary control with multi-nutrients, the effects of physical activity, therapy and exposure to nature.

Firstly, dietary control with multi-nutrients is an area that could potentially have a great effect on symptoms of ADHD. A study conducted a trial titled “Multinutrients for ADHD Youth (MADDY) Trial: Preliminary Trends for Treatment” CITATION Ste19 l 2057 (Stern, 2019) which investigated the effects of a change in nutrition through the use of supplements. They study was a “fully funded, multi-site, randomized double-blinded clinical trial for adolescents ages 6-12 years,” CITATION Ste19 l 2057 (Stern, 2019). This study found that after the 16-week study, there was a significant decrease in the symptom count found for inattention and hyperactivity, which was assessed through the use of validated questionnaires in 27 families CITATION Ste19 l 2057 (Stern, 2019). This study is obviously very recent, showing that this avenue of potential alternative treatments for ADHD is still very much in its infancy. That does not mean that the results are any less valuable and they do definitely suggest that dietary control could massively aid people in controlling their symptoms of ADHD. The main issue with this research is that it is a such a small amount of research to go of off and while the trends are definitely encouraging, they by no means confirm anything. Another issue is also presented due to the fact that diet is almost impossible to fully control and so it is very hard to ever say conclusively that only one change caused a certain result. Overall, while the results of this study are encouraging for the future and people looking for alternative treatment methods could definitely try adjusting their diet, this is still an area that will require substantial research to even reach any sort of conclusion and so at least for now cannot be strongly considered as a key aspect for that argument that natural treatments could replace drug treatment, at present.

Another area of natural treatment that could potentially reduce the symptoms of ADHD significantly is physical activity. While it is widely known that physical activity is beneficial for both physical and mental health universally, there is an increasing amount of interest about the specific positives it may offer for reducing the symptoms of ADHD that people have to deal with. A study was done that found physical activity before working reduced the symptoms of ADHD exhibited, as long as there was a wind down period CITATION Sum12 l 2057 (Summerell, 2012). It found out that physical activity can also be more detrimental for ADHD symptoms if there is not a suitable wind down period after the physical activity, but if this wind down time is given, then the symptoms of ADHD are significantly reduced. This study reached the conclusion that physical activity is definitely an effective measure for people to take when they are trying to look for more natural methods to treat symptoms of ADHD CITATION Sum12 l 2057 (Summerell, 2012). While this is just one study that definitely did not have a universal scope, it is of a much wider consensus that physical activity is a very real way to, naturally, reduce the symptoms of ADHD that someone exhibits. This natural treatment can be much confidently given to patients as a why to help them with their ADHD. It is still at the stage in research, however, where it would most likely be prescribed with medication as well to try and get optimal results but as the research gets more refined, it could definitely be a key aspect of an eventual natural treatment plan for ADHD.

Cognitive behaviour therapy is another area of potentially natural treatments that has been explored quite significantly. It would be a very significant part of a potentially completely natural treatment for ADHD because of the key findings that studies have found of its effects. One of these pieces of key research was done at Massachusetts general hospital in 2006 and found the significant effects that CBT can have on patients with ADHD CITATION Saf06 l 2057 (Safren, 2006). This study looked at 11 individuals (9 men and 2 women) who had all not responded to medication treatment, then treating them with CBT and measuring the results CITATION Saf06 l 2057 (Safren, 2006). This study acknowledged that psychotherapy is usually used with medication in treatment of ADHD, but only used psychotherapy without the use of medication and found that the results were still very positive for the reductio of visible symptoms CITATION Saf06 l 2057 (Safren, 2006). It also suggests that this approach could be very useful for adults with ADHD because the organised nature of the sessions can help people declutter their often more unorganised lives, that have come into fruition because of their ADHD CITATION Saf06 l 2057 (Safren, 2006). This is study is good evidence for the benefits of using CBT as a natural treatment for ADHD because it was used in isolation without medication to show its isolated effects. The problem with a lot of studies on CBT is that it is combined with the use of medication and so the researchers cannot be certain that it was the therapy itself having the effect on the participant. With this study it can only be the therapy and so that is a strength of this study. A weakness of this study is that it was only done on 11 participants and so the results cannot be easily extrapolated. Due to the fact that there were so few participants, it cannot confidently be known that they all weren’t just abnormal results because there are not enough participants to make a good comparison. However, other studies have gone on to replicate similar findings and so in using them with this study, the weakness is no longer relevant. Overall, CBT has been shown to significantly reduce the symptoms of ADHD and would definitely be a crucial part to a natural approach to treatment for ADHD. Even in the current treatment of ADHD with medication, CBT is still very commonly used to improve the results and so it is a definitely a key part of treatment and would aid a fully natural approach in replacing the current medication approach to treatment.

A final natural treatment that could potentially be a part of a fully natural treatment for ADHD is exposure to nature. This treatment is similar to the physical exercise one in the sense that it is known to be very healthy for both the physical body and the mind, but it has also been found, as well, to massively aid people in dealing with symptoms of ADHD. A study looked at children with ADHD across the United States and got their parents to rate the aftereffects of 49 common after-school and weekend activities on the child’s symptoms, some involving greenery and some not CITATION Kuo04 l 2057 (Kuo, 2004). They found that green, outdoor activities significantly reduced symptoms more than activities that were conducted in other settings even when the activity was matched CITATION Kuo04 l 2057 (Kuo, 2004). The findings are easily extrapolated as well because they were described as being “consistent across age, gender, and income groups; community types; geographic regions; and diagnoses” CITATION Kuo04 l 2057 (Kuo, 2004). This research is incredibly useful in the sense that it empirically shows that exposure to nature does reduce ADHD symptoms regardless of many other factors that could come into effect and so this proof here is another to say that exposure to nature would be very significant. Therefore, although exposure to nature is a part of a healthy lifestyle for anyone, it is even more important for people with ADHD and would certainly be a part of a natural treatment for ADHD.

ConclusionIn conclusion, medication for ADHD does have its relative positives and is definitely a sufficient solution for many people at present. However, it is not without its fair share of weaknesses and so pursuit for a more natural alternative would definitely be beneficial for society. This essay has outlined evidence for a number of natural treatments that could potentially increase in significance in treating ADHD. The current answer is that natural treatments cannot fully replace medication because there simply hasn’t been enough research and investment into these natural treatments to put them in a position to become the main form of treatment. However, all the initial signs from the research outlined are positive and if the research done in the future follows these trends, then there is a very realistic future when people can be fully treated using only natural methods which would eradicate all of the negatives that medication bring along.

ADHD (attention deficit/ hyperactivity disorder) is a common brain disorder. It occurs in childhood and may continue in adulthood. In this, children have difficulty in concentrating in a task and remaining still. Children suffering from this disorder find it difficult to learn. Condition becomes apparent when children are in early school years. And it is generally diagnosed by the teachers. These behaviours of children suffering from this disease affect their social and personal life.It has severe effects in particular parts of the brain and it’s caused due to various reasons. If not treated properly and earlier, this disorder can become chronic and can stay even after entering into adulthood.

ADHD can be very disruptive of a child’s education and that of children of the same classroom. This disorder is marked by various signs and symptoms but, the key behaviours of ADHD includes inattention, hyperactivity and impulsivity. Speaking of which, it is normal to have inattention (being unfocused in class or in some other activity) and impulsivity, but for people with ADHD, these behaviours are very much more severe, secondly prevalence is much higher and thirdly, it severely affects their social and personal life.

1. INATTENTION: Difficulty keeping their minds on a task and is easily distracted and hence, miss details and make some careless mistakes in school/job work. Also, they don’t listen to people, don’t follow rules and hence, they keep forgetting or losing things that one needs to complete a task.these people generally don’t like those activities which requires mental effort. They aren’t able to manage time.
2. HYPERACTIVITY: A child who cannot sit still and who is constantly moving, roaming, touching/ tapping and fidgeting about things. They leave their seat when expected to staying seated. They aren’t able to stay quiet and that’s why talk non-stop, cannot wait for anyone or anything, gets irritated very easily. They are completely restlessness.
3. IMPULSIVITY: It refers to when a person makes hasty actions (that may even harm a person), or speaks and acts without thinking of the consequences of that act (e.g. butts into conversations or games). It resembles the actions done win hyper activeness.

Diagnosis of ADHD includes 6 or more of 9 symptoms of inattention, hyperactivity or impulsivity.

Symptoms in children may vary, i.e., some may only have inattention, while some may suffer from hyperactivity or impulsivity while some may show mixed symptoms. The most common symptom of children (with ADHD) is hyper activeness or hyperactivity. Prevalence of boys having this disorder is much more compared with girls. In adulthood, the ratio is approximately 2:1 which suggests that many females are failed to be diagnose.

Adults with ADHD have trouble managing their time, being organised or giving their best in their respective jobs. They may even have problems with their aggression, conduct disorder, learning disabilities, can have problems in their relationships, and may also suffer from low self-esteem and therefore depression. About half of the children may show symptoms in adulthood during which these people get diagnosed with substance abuse disorder.

One of the major causes of ADHD is heritability. It plays an important role in determining the possibility of a person to have ADHD.Estimated heritability of ADHD ranges from 75%-90%. So, youngsters having ADHD have taken it form their parent or one of their relatives.

Dopamine is the neurotransmitter which is responsible for cognitive functions. Dysregulation of it is mainly associated with ADHD. COMT (catechol-O-methyltransferase) is the enzyme (in frontal lobes) responsible for inactivation of dopamine in brains and hence causing ADHD. It cleaves catecholamines (including dopamine and norepinephrine) in the extracellular fluid. Though, reuptake is the primary method of removing catecholamine from the synapse.

Other reasons of ADHD include: brain injuries, exposure to environmental toxins, smoking, drug and alcohol consumption during pregnancy increases risk factor of having ADHD.

Symptoms of ADHD is caused due to dysfunction or problem in the prefrontal cortex and striatum in brain, the area which is responsible for planning, decision making, personality expression, learning, memory and many more things and therefore dysfunction of it causes forgetfulness, impulsivity, distractibility, etc. Growth of the brain of children with ADHD is like the unaffected children, but the rate is much slower. Cortical thickness of the brain of children with ADHD at the age of 11 years is the same as the brain of unaffected children of the age 8 years.

There are some methods/ techniques available for the treatment of ADHD. One of them is consumption of some drugs/ medications like:

• Amphetamine: is the stimulant used to treat ADHD but, it has different affects on different people. Like, on some it increases positive mood and facilitates performance on cognitive tasks, but in other people it has the opposite effects. A scientist tested amphetamine of 2 different variants on a group of people.
• 1st variant was the “val-val” variant, having lower brain levels of catecholamines, performed better when they were given low doses of amphetamine.
• 2nd variant was the “met-met” variant of amphetamine having higher levels of catecholamine, which actually impaired the performance.
• Methylphenidate (Ritalin), another stimulant used to treat ADHD. It inhibits reuptake of dopamine and hence one of the most common treatment for ADHD. It increases both, the levels of dopamine as well as norepinephrine in the prefrontal cortex. Amphetamine (treatment for ADHD) is used less as compared with methylphenidate.
• Clinicians have found that doses for ADHD when low are ineffective but, when high produce increases in activity level that disrupt children’s attention and cognition.

There are some other treatments available as well, like:

• Behavioural therapy in which therapists help youngsters to develop social, emotional and planning skills.
• Teacher’s support in which teacher help students in their studies and enjoy school more.
• Parent coaching in which parents are taught to how to respond to their children suffering from ADHD.

ADHD in children (which gradually progresses in adulthood)impairs cognitive function of the person, hence lowering his/ her self-esteem to a great level, increasing problems in their relationships, affecting their social and personal life aggressively. So, it is very important and necessary to support that person emotionally and to treat this condition as soon as possible because if not treated, it can become chronic and stay with the person lifelong.

References

1. WebMD – What is Attention Deficit hyperactive disorder? https://www.webmd.com/add-adhd/childhood-adhd/attention-deficit-hyperactivity-disorder-adhd#1
2. NIH (National Institute of Mental Health) – Attention Deficit/ Hyperactivity Disorder https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
3. KidsHealth (from Nemours) – ADHD https://kidshealth.org/en/parents/adhd.html
4. PHYSIOLOGY OF BEHAVIOUR (11TH EDITION) BY Neil. R Carlson

Introduction:

For my SEN module, I will be discussing and analysing ADHD aimed towards children in both primary and secondary schools in London, United Kingdom. I have chosen to produce a resource for children who are diagnosed with ADHD and this resource will be used towards reducing the hyperactivity and help children calm down and refocus. This resource will also help teachers deal with children with ADHD. I will follow up by discussing a short literature review on ADHD for analysis using journals, articles and books. I will then discuss relevant policies, training and cultural attitudes towards ADHD. On the other hand, I will offer an explanation of the optimistic feature of ADHD and why it isn’t always a bad thing like it’s made out to seem. I will then go into explaining the help needed for children with ADHD and what children with that condition need in order to help them on a day to day basis that helps make it easier for them and list any evidence that I have paid attention to people with ADHD in the UK, such as newspaper articles, documentaries or interviews. To finalise my essay, I will come to a conclusion about my findings.

Literature Review:

In this chapter, I will begin by giving an overview about ADHD and the causes and treatments using academic references. I will then go further into discussing relevant literature on ADHD like exclusions from schools and stigma on ADHD.

Overview of ADHD:

ADHD is Attentive Deficit Hyperactive Disorder. ADHD is one of the most prevalent paediatric neurodevelopmental conditions. It is most commonly diagnosed in childhood and lasts far into adulthood. Children with ADHD may struggle to pay attention, regulate impulsive actions (doing without considering the consequences), or be too energetic. It is common for kids to have difficulty focusing and behaving at some point in their lives. Children with ADHD, on the other hand, do not just grow out of these tendencies. The symptoms persist and can be severe, causing problems at school, at home, and with friends. A kid diagnosed with ADHD may chatter too much, fidget, make careless missteps or take needless risks, have issues with getting along with others, contemplate, can be forgetful or lose stuff and have a difficult time avoiding temptation (National Centre on Birth Defects and Development Disabilities 2020). Although the cause and risk factors for ADHD are unclear, recent research indicates that heredity plays a significant influence. A medical evaluation, including hearing and vision testing, is one stage in the process to rule out other disorders with symptoms such as ADHD. A checklist for assessing ADHD symptoms and obtaining a history of the kid from parents, teachers, and, in certain cases, the child are used to diagnose ADHD. ADHD is usually best treated with a mix of behaviour therapy and medication. Behaviour therapy, particularly parent training, is suggested as the first line of treatment for preschool-aged children (ages 4-5) with ADHD before medication is taken. What works best for the child and family may vary (National Centre on Birth Defects and Development Disabilities 2021). The NHS England (2015:8) put out that ADHD affects about 3-5% of children and 2% of adults and is more common in males than females (4:1). Girls with ADHD may present with less hyperactivity than boys and subsequently may be less easily identified in primary care settings.

Exclusion from schools for children with ADHD:

Children who have ADHD tend to be given up on easily and exclusion is automatically seen as an easy option. O’Regan (2010:1) defined exclusion as an opportunity for full-time alternative education arrangements to be made. These can include transfer to another school managed by the local education authority (LEA), or in some cases, education outside of the school environment within a pupil referral unit. In most cases, ADHD symptoms aren’t reported to superiors or the individuals parentguardians and left undealt with. O’Regan (2010:7) relates that considering the relatively high prevalence of ADHD among school-age children in the United Kingdom, it is plausible that many children excluded from schools for disruptive behaviour are showing symptoms of unidentified, untreated, or poorly managed ADHD. As soon as teachers see any symptoms or alarming behaviour they must immediately communicate this with the superiors and parentguardians of the pupil so it can be identified and dealt with properly, instead of assuming the pupil is purposefully misbehaving or acting out. O’Regan (2010:5) mentioned that those with SEN with full statements (a legal document that sets out a child’s SEN and the type of support that the LEA considers necessary) and those with some SEN support without statements are over eight times more likely to be permanently excluded than pupils with no SEN. It is apparent that children SENADHD are treated unfairly compared to those without SEN, despite those with SEN having a reason for their disruptive behaviour or showing symptoms of ADHD. The children with SEN need to be recognised by teachers in order to avoid exclusion and teachers need to be appropriately trained on how to spot ADHD symptoms and how to deal with it.

ADHD on stigma and social rejection :

The word stigma has been used for years. Bellanca and Pote (2013:2) defined stigma as refers to any characteristic that marks a group or individual as different. ADHD is often perceived under a negative light and has been stigmatised over time. Bellanca and Pote (2013:3) stated that research has found that children with ADHD, depression and LD are stigmatised and have lower peer status than those without such difficulties. Low peer status can lead to peer rejection which can make it harder for the individual with ADHD to fit in and feel involved and perhaps intensify the externalising actions associated with ADHD. In addition, Bell, Garvan and Bussing (2011:3) mentioned that ADHD had the highest social rejection rate. With that being said, this supports the point that children with ADHD face social rejection which can deteriorate the individuals mental health and can possibly cause them to struggle to make friends or fit in. To elaborate, Nguyen and Hinshaw (2020:4) mentioned unsurprisingly, children with ADHD are also recipients of stigmatisation from their peers. For example, compared to children with normal issues and depression, children with ADHD were more stigmatised both explicitly (e.g., targets of anger, fear, and social distance) and implicitly (e.g., receivers of negative attitudes). In order to reduce the stigmatisation from peers, teachers need to enforce more lessons raising awareness of disorders like ADHD and educate them on the matter. Finally, schools need to encourage other peers to work with others, including peers with ADHD and ask them to work together, mix up and not stick to the usual groups. Nguyen and Hinshaw (2020:5) added peers of children with ADHD tended to make fun of them behind their back and were unwilling to work with them on school projects or even have lunch together. It can be seen that ADHD has been heavily stigmatised and although it isn’t visible at all times, peers still seem to have something against the idea of someone having ADHD and more needs to be done so those who have ADHD do not feel marginalised. Foucault’s concept of the clinical gaze meant that it could generate new disorders by simply telling them (diagnoses du jour: ADHD, dyslexia, Asperger’s syndrome, BESD) and those labelled in this way started to become the features of the condition. This is why it is important that teachers are properly trained to be able to correctly identify ADHD symptom and not anyone who is misbehaving and disruptive.

ADHD Related Context:

The UK government introduced the SEND (special educational needs or disabilities) policy in 2014. The Department for Education introduced the SEND 2014 policy in order to offer an advanced support system for those with SEND by firstly, creating a corresponding evaluation procedure to determine a child’s necessities throughout education, health and care. Secondly, adding the option of customised budgets for people with an EHC plan, allowing them to pick which services are suitable for them and their household. Also, ensuring that local officials work closely in the interests of children and young people with SEND, as well as increasing communication between different agencies. Finally, to guarantee that children’s special educational needs are recognised, assessed, and met. The UK government has invested in over £42 million in funding has been extended for projects aimed at raising educational standards, improving services, and providing practical assistance to disadvantaged families and children with special educational needs and disabilities (SEND). Additionally, The multi-million pound package of help and support includes more than £27 million for the Family Fund, which assists low-income parents raising children with serious illnesses or disabilities with the cost of equipment, goods, or services ranging from washing machines and refrigerators to sensory and academic materials that they may not have been able to afford otherwise (GOV.UK 2021). The topic or discussion of ADHD is seen as taboo and this issue may often result in individuals placing themselves or children in another category of a disorder. Deenuka Kasinather (2018:1) agrees by adding the stigma of ADHD in adulthood has become so taboo, that patients rarely bring it up with their primary physicians and fit their presentation into another subsect of mental illness. The ADHD spectrum is so broad with overlapping symptoms, yet so poorly understood. ADHD needs to be more spoken about and that not all aspects of it are negative and that there are treatments and help available. ADHD has many positive aspects to it, despite it having a bad image. Some positive aspects involve individuals being clear at communicating themselves, quick to put what they study into practice, great at seeing the entire picture, exciting to be around, passionate, curious, entertaining, creative and spirited (Department of Education 2015:8).

Support Needs of ADHD:

ADDISS (The National Attention Deficit Disorder Information and Support Service) offers information and resources regarding ADHD and the various treatments available, involving behavioural therapy, medication, individual counselling, and special education. On the other hand, you have the Hyperactive Children’s Support Group. This support group aims to offer solutions and help to families who have children that are diagnosed with ADHD by offering important information specifically concerning hyperactivityADHD and regime. The ADHD Foundation Neurodiversity Charity is the national charity in the UK, and the most leading ADHD charity within Europe. The charity aims to support a neurodiverse standard for people with ADHD in health, employment and education. The ADHD Foundation Neurodiversity Charity (2020) added that they as a charity are working in partnership with individuals, families, doctors, teachers, government and other agencies, the ADHD Foundation actively promotes a strength-based approach to living successfully with ADHD and other neurodiverse minds, such as, dyslexia, dyspraxia, autism spectrum, dyscalculia and Tourette’s syndrome. The ADHD Foundation Neurodiversity Charity offer professional guidance and consultancy facilities within the UK and for international schools and agencies. And finally, in the North West of England area, they offer a special combined health and education lifespan multi-modal service, presenting NICESIGN guidelines, educational, psychological and medical interventions cross the duration (ADHD Foundation Neurodiversity Charity 2020).

Evidence of the voices people living with ADHD:

I watched an interview on YouTube on two children, one with ADHD and the other without. Both children were 6 years old and were in year 2. The child with ADHD mentioned she doesn’t like school, sometimes struggles with homework, doesn’t have a lot of friends (feels lonely), sometimes gets bullied and throughout the interview most of her answers were I don’t know and sometimes. The child with ADHD also mentioned how sometimes I’m bad and give attitude to my mum. The interviewer asked why do you think you give attitude and the girl replied I don’t know, sometimes I just get into moods, depends on how good the day is. Towards the end of the interview, the interviewer asked the child with ADHD what do you want other kids like your age to know about the kids who have ADHD. The girl replied people like me with ADHD are better at listening and that they could help them by telling them whatever you do it’s still right because you tried your best. To add on, the other child who was a boy without ADHD showed opposite answers to the girl with ADHD and was more confident with his responses.

Conclusion:

In conclusion, this essay has discussed three key areas of ADHD and reviewed relevant policies in the UK. When teachers are fully trained, they’ll be able to identify any ADHD or other SEND symptoms and know how to appropriately take action. On the other hand, the education system needs major improvement with exclusion and inclusion. The education system need to come up with a better solution to exclusion for dealing with students that have ADHD or need extra support, instead of seeing exclusion the first and only option. We also saw that ADHD has a negative stigma in the UK and many other countries. It is therefore recommended that schools and parents education the children and themselves on the positive aspects of ADHD and other SENDs. Finally, people need to be aware that not all disabilities are visible and to think twice about what they’re going to say to someone in case that individual has a disability.

Millions of US children are diagnosed with psychological disorders. ADHD is one of the most common out there. Children with ADHD have difficulty focusing and keeping themselves calm and controlled. This can be so severe that it interferes with their ability to reach their full potential. Even more detrimental is the inability for many adults to understand or properly interact with children with ADHD. ADHD is a very real condition.

ADHD is one of the most controversial topics in the psychiatric health world. Approximately 72% of people believe ADHD is real, while 28% think it isn’t (Debate: ADHD). ADHD is a complicated disorder to diagnose. People who believe ADHD isn’t real say there is nothing to prove the disease, that it is all just based off of a doctor’s opinion. ADHD can’t be seen with a brain scan or blood tests, so doctors have to rely on other methods to diagnose the disease. DSM requires a patient to exhibit only 5 out of the 18 symptoms in order to be diagnosed (Time). This causes some to say it is overdiagnosed.

On the contrary, ADHD diagnosis is not taken lightly. There are multiple steps taken to make an accurate diagnosis. Medical professionals review the patient’s history, and from many sources such as. For example, teachers, parents, coaches, etc. (Science-Based Medicine). According to a commenter on Debate, “Of course ADHD is real! It’s been proven time and time again. It is not caused by poor parenting, sugar, or too much TV or video games, contrary to popular belief. It doesn’t discriminate against gender, age, race, religion, or social class. It is a spectrum disorder. Some who have it may have it slightly while some have it severely”. More than ⅔ of children with ADHD also have another psychological condition. Anxiety, depression, behavioral disorders, and learning disorders are some examples (CHADD).

While it is true that all children can get bored easily at times, act impulsive, or have a lack of focus, children with ADHD exhibit severe versions of those symptoms. According to Figure 1 from The Washington Post, Girls will be withdrawn, have low self-esteem, and verbally aggressive. This causes them to get in trouble at school, home, and any other place they may be.

As you can see in Figure 2, boys will be affected differently. They will be extremely impulsive and act out, hoping to receive attention. They can be physically aggressive. These children don’t know how else to get attention and are so unfocused they act out.

ADHD is much more common than most people realize. Approximately 6.4 million American children aged 4-17 have been diagnosed with ADHD (ADHD Awareness Month). There are many people who believe that ADHD is overdiagnosed. To be exact, 62% think it is overdiagnosed, while 72% think doctors are too quick to diagnose (Huffington Post). Those people tend to back their beliefs up with the fact that ADHD numbers have skyrocketed over the years. Since 2002, the number of children aged 4-17 with ADHD has increased by over 2 million (CDC). The reasoning behind this is that our knowledge of ADHD has gotten larger and doctors now can differentiate between ADHD symptoms and kids just being kids and acting up (ADHD Awareness Month). More than two times the amount of boys are diagnosed compared to girls. 1 in 5 highschool boys are diagnosed, while 1 in 11 girls are (CDC).

Treatment of ADHD can be done with many different approaches. These include parent training, skills training, behavioral training, counseling, and medication. Medication has been proven to be the most effective. There is an 80% chance that medication will help (CHADD). Parents, on average, wait 2 years after their child starts to display symptoms of ADHD to seek professional help (Huffington Post). This is because the stigma against ADHD and treatment stops parents from getting their children help. Luanne Southern states, “Unless ADHD hits close to home, one may never totally understand it”. There have been countless studies on Ritalin, which is the most common medication taken for ADHD. Some think that taking medication is unsafe, but as Dr. Levin states, “We have countless scientific studies on the safety of Ritalin. In fact, some of the drugs children take routinely for asthma and cancer haven’t been studied nearly as much as Ritalin”. While that may be true, there are some possible side effects of the medications. For example, the patient could experience sleep deprivation or loss of appetite.

ADHD is a condition that should be taken seriously. It is essential that is is understood by everyone. Children with ADHD have trouble completing tasks that seem so simple to others. There are millions of US children that are diagnosed with this disorder and the number is just continuing to increase.

Works Cited

1. “Frequently Asked Questions.” CHADD – The National Resource on ADHD. “Is ADHD Real?” Debate.org.
2. Mustich, Emma. “What Is ADHD, and Why Do People Say It Doesn’t Exist?” The Huffington Post, TheHuffingtonPost.com, 9 May 2012.
3. Saul, Dr. Richard. “ADHD Does Not Exist, Writes Dr. Richard Saul.” Time, Time, 14 Mar. 2014.
4. Strauss, Valerie. “ADHD in Kids: What Many Parents and Teachers Don’t Understand but Need to Know.” The Washington Post, WP Company, 7 Feb. 2016,
5. “The ADHD Controversy.” Science-Based Medicine.
6. “Trends in the Parent-Report of Health Care Provider-Diagnosis and Medication Treatment for ADHD | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention.
7. “7 Facts You Need To Know About ADHD.” ADHD Awareness Month – October 2018.
8. Strauss, Valerie. “ADHD in Kids: What Many Parents and Teachers Don’t Understand but Need to Know.” The Washington Post, WP Company, 7 Feb. 2016,