Category: ADHD

What is ADHD?

The controversy surrounding overmedication of children diagnosed with Attention Deficit Hyperactivity Disorder or ADHD is an ongoing contemporary issue. There are three categories of ADHD, Hyperactivity/Impulse (ADHD-HI), Inattentive (ADHD-I), and Combined inattentive and hyperactive impulsive (ADHD-C). Symptoms are usually identified by age four. Overall, I have found significant studies that confirm ADHD is under diagnosed. I was baffled to find this out as common as it is to hear the acronym ADHD. Working for Modesto City School for 20 years now, I thought ADHD was over diagnosed but after doing some research for my ADHD presentation I found that a lot of kids go under the radar and are never diagnosed much less treated in any way. Students with ADHD rather go as labeled “trouble maker” or the “day dreamer”. Now thinking back I can specifically think of a few students that I wonder now if they were in the category of overlooked students. ADHD affects the brain and so to no surprise it is common that students with ADHD have learning disabilities or other disabilities. The most common co-occurring with ADHD disorder is autism spectrum disorder, other co-occurring disorders are speech and language difficulties, learning disabilities, tourette’s syndrome and other tic disorders, as well as epilepsy.

Are Stimulants Overprescribed?

An article that I am going to discuss is titled: Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities. The study done examined epidemiological survey data obtained from 1,285 children and their parents across four communities. Analyses examined the frequency the children’s ADHD diagnosis the extent to which medications were prescribed as well as the provisions of other services such as: psychosocial treatments, school-based educational interventions. Some children who had been prescribed stimulants did not meet full ADHD diagnostic criteria, but these children manifested high levels of ADHD symptoms, suggesting that the medication had been appropriately prescribed. Children with ADHD were generally more likely to receive mental health counseling and/or school-based interventions than medication.This study showed both the prevalence of the diagnosis within nonreferred populations and the extent to which various treatments such as: stimulant medication, mental health treatment, and educational interventions are used. The findings of this study were that 5.1% of children met the DSM full criteria across the pooled sampled. Only 12.5% of children meeting ADHD criteria have been treated with stimulants during the previous 12 months.

What was found was that medications are often not used in treating ADHD children identified in the community. This suggests the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments. On the basis of the data collected it cannot be concluded that substantial `overtreatment` with stimulants is occurring across communities in general. In fact, per this study ADHD is undermedicated. The lack of knowledge regarding treatment for ADHD can be keeping these children from the help they desperately need.

Prevalence of Medication Treatment for ADHD

Another article that I found interesting was Prevalence of Medication Treatment for Attention Deficit-Hyperactivity Disorder Among Elementary School Children In Johnston County, North Carolina. This was a study done to determine the prevalence of medication treatment for Attention Deficit-Hyperactivity Disorder (ADHD) among elementary school children in the North Carolina county. Parents of 7333 children from 1st grade through 5th grades in 17 public elementary schools were asked whether their child had ever been given a diagnosis of ADHD by a psychologist or physician and whether their child was currently taking medication to treat ADHD. Parens of 6099 children (83%) responded.

In this article they state the findings were 607 (10%) of children were given an ADHD diagnosis by a professional, boys were diagnosed 3:1 to girls. Of those diagnosed, 434 (71%) were receiving ADHD medication treatment. Treatment rates varied by sex, race/ethnicity, and grade. Per this study, if treatment patterns observed in this study are representative, the medication of ADHD is prevelent.

Food for Thought

Although I personally do not have a child that suffers from ADHD, I do work with and care for quite a few children who are diagnosed or may possibly suffer from this disorder. I personally feel that medicating young children for ADHD is wrong. The Centers for Disease Control and Prevention (CDC) agrees with me. They suggest parents of young children try behavior therapy first. The CDC states that 75% of young children with ADHD are receiving drugs as treatment. There are many other forms of treatment that in my opinion should be tried before medications are introduced. Other types of treatment include changing the child’s diet, sugary foods are not recommended. Foods rich in protein such as lean beef, pork, poultry, fish, eggs, beans, nuts, soy, and low-fat dairy products can have beneficial effects on ADHD symptoms. Protein-rich foods are used by the body to make neurotransmitters, the chemicals released by brain cells to communicate with each other. Protein can prevent surges in blood sugar, which increase hyperactivity. Increasing physical activity can help improve attention and focus in children with ADHD. Exercise also produces endorphins, the ‘feel good’ chemical in the brain. Exercise also helps children get rid of restless energy, which is a symptom of ADHD. Also behavioral therapy with parents and children is a way to better deal with ADHD. Behavior therapy is an effective treatment for attention deficit-hyperactivity disorder (ADHD) that can improve a child’s behavior, self-control, and self-esteem. It is most effective in young children when it is delivered by parents. Experts recommend that doctors refer parents of children under 6 years old for training in behavior therapy before prescribing ADHD medicine. When parents become trained in behavior therapy, they learn skills and strategies to help their child with ADHD succeed at school, at home, and in relationships. This is also a way to educate parents of the disorder itself and help them better understand their child and what is going on internally with them. Parents will learn to understand how their child works rather than get upset at them because they are not like everyone else. Children with ADHD may exhibit one or many symptoms, however there is much more to ADHD than being hyper, impulsive, unorganized, fidgeter, talkative, dreamer or clumsy, children with ADHD are also creative, flexible, enthusiastic, spontaneous, energetic and are driven. Having ADHD is stigmatized as a “bad thing” but it is simply just not understood.

I use to think I knew what ADHD was however, I was wrong. Unless one really spends time and researches this disorder there are too many components to completely understand. Even though I feel much more knowledgeable about ADHD now, I am sure I have but scratched the surface of what ADHD is.

References

1. Jensen, P., Kettle, L., Roper, M.. Sloan, M.T., Dulcan,M. K.,Hoven, C., Bird, H.R., Bauermeister, J.J., Payne, J.D. (1999) Journal of the American Academy of Child & Adolescent Psychiatry. Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities, Vol#38 (Issue 7), 797-804.
2. Rowland, A.S., Umbach, D.M., Stallone,L., Naftel, J.A., Bohlig, M.B., Sandler D.P. (2002) American Journal of Public Health. Prevalence of Medication Treatment for Attention Deficit-Hyperactivity Disorder Among Elementary School Children in Johnston County, North Carolina https://ajph.aphapublications.org/doi/full/10.2105/AJPH.92.2.231

Adderall is a medication in the class of CNS energizers used to treat consideration deficiency hyperactivity issue (ADHD) and narcolepsy. In any case, it might cause genuine weight reduction, which is very much reported on the web. Weight reduction is one of the conceivable symptoms of taking solution Adderall, a medication regularly recommended for ADHD and narcolepsy in the two kids and grown-ups. The medication smothers hunger and accelerates digestion, the two of which can advance weight reduction.

The undeniably mainstream “study tranquilize”.

Adderall is a pharmaceutical substance endorsed to patients with consideration shortfall hyperactivity issue (ADHD). The medication is a blend of amphetamine and dextroamphetamine, which are both focal sensory system energizers. In any case, in the ongoing years, Adderall is getting progressively well known among those without ADHD, as the medication can assist individuals with centering and focus, making it a mainstream “study sedate” for understudies packing for tests or chipping away at requesting ventures. This is what’s really going on in the mind and body while on Adderall.

What is Adderall?

Adderall is a physician endorsed medicine that contains two medications: amphetamine and dextroamphetamine. It has a place with a class of meds called energizers. It’s most ordinarily used to treat consideration shortfall hyperactivity issue (ADHD). It’s additionally used to treat narcolepsy. Adderall is viewed as a first-decision treatment choice for ADHD. Studies show that it improves consideration and center, and diminishes hasty practices. Between 75 percent and 80 percent of kids with ADHD will see improved indications with the utilization of energizers, for example, Adderall. Adderall is additionally successful for expanding daytime alertness in individuals with narcolepsy, in spite of the fact that there is minimal related research accessible. Adderall comes in two structures:

• Adderall oral tablet
• Adderall XR expanded discharge oral case

How Extended Adderall Use Affects the Brain

Energizers increment focus and vitality levels while diminishing the requirement for rest and stifling the hunger. Adderall expands the action of a few synapses, for example, serotonin, norepinephrine, and particularly dopamine. After some time, the adjustments in dopamine movement can affect our mind’s prize place, and modify our capacity to encounter delight without the synthetic help of proceeded with amphetamine use.. The more regularly Adderall is taken, the more instilled these progressions become. A resistance to the medication may frame, and more Adderall might be required at each portion so as to feel the equivalent wanted impacts.

Are Belviq And Adderall The Same Thing?

Belviq (lorcaserin hydrochloride) and Adderall (amphetamine and dextroamphetamine salts) are utilized for weight reduction. Belviq is shown for the treatment of interminable weight the board in grown-ups with a weight list (BMI) of 30 or more prominent (corpulent) as an expansion to a diminished calorie diet and exercise. Belviq is likewise endorsed for use by grown-ups with a BMI of 27 or more noteworthy (overweight) and who have in any event one weight-related condition, for example, (hypertension), type 2 diabetes, or elevated cholesterol (dyslipidemia).

Adderall might be utilized off-name for weight reduction, however the Food and Drug Administration (FDA) has not endorsed it for this sign. Adderall is utilized for treating consideration shortage hyperactivity issue (ADHD) and narcolepsy. Belviq and Adderall have a place with various medication classes. Belviq is a serotonin 2C receptor agonist and Adderall is an amphetamine.

An Effective ADHD Drug

Adderall is a viable medication for its proposed employments of treating ADHD and narcolepsy and furnishes alleviation to individuals with these conditions. These clients may see weight reduction as an accidental symptom of taking Adderall; this can be an aftereffect of the diminished craving, convincing clients to eat far less since they aren’t ravenous.

Dangers of Amphetamine Use for Weight Loss

The issue with utilizing Adderall for weight reduction reasons for existing is the odds of experiencing antagonistic reactions and building up a dependence on the medication..Is Adderall is an opiate – it isn’t, be that as it may, it is an exceptionally addictive energizer and may cause reliance and resilience which could prompt overdose side effects and confusions. Getting high on amphetamines produces sentiments of happiness and it is this experience which is addictive a can be the main inspiration for utilizing the medication.

When an individual begins to utilize Adderall for weight reduction purposes a few people may begin to take higher does than suggested. After some time, this prompts resilience and the body will begin to require an a lot higher portion to accomplish the ideal impacts thus this will build the danger of overdose.

It causes you to pine for more Adderall:

As clarified previously, Adderall prompts an arrival of dopamine, however it additionally keeps the concoction from renewing itself. Accordingly, when the Adderall wears off, it can leave clients desiring more so as to feel that dopamine surge once more.

It can give you dry mouth:

Adderall restrains the creation of spit, which can realize the upsetting sentiment of dry mouth, frequently alluded to as ‘cotton mouth.’

It triggers the body’s “battle or flight” reactions:

Since the medication to a great extent invigorates the thoughtful sensory system, the body’s battle or flight reactions are activated from taking Adderall, including expanded perspiring and enlarged understudies in the eyes.

Introduction

The critical issue looks at the use of stimulants in the treatment of attention deficit hyperactivity disorder (ADHD). Children with ADHD exhibit hyperactivity, hostility, inattentiveness, defiance, inattentiveness and resistance. The stimulants in question affect the behavior of the children, making them more docile. The use of these drugs has repercussions, both physical and psychological. However, the companies manufacturing and marketing the drugs seem to disagree (Breggin, 2002).

Facts presented by each side of the critical issue

The yes side of the critical issue makes it clear that the drugs being used to control ADHD are harmful as they affect the normal growth patterns of children. This is because they interfere with the hormones that regulate growth. The children have been observed to gain less weight and even height that they are supposed to.

This side of the critical issue also brings out the fact that the drugs are addictive and may cause dependence in children. This is shown by the fact that a child’s behavior worsens when he misses his medication. The child then exhibits withdrawal symptoms similar to those of a person abusing a drug like cocaine (Breggin, 2002)

The no side of the critical issue brings out the fact that the stimulants in deed affect the brain functions. They act on the brain regions whose under activity brings about ADHD. This side also shows the fact that the effect of stimulants in the patient is short term, hence the need to keep using more of the stimulant. This is exemplified by the use of insulin for the treatment of diabetes (Barkley, 2000).

Opinions presented by each side of the critical issue

The Yes side has the opinion that the use of stimulants may result in psychological problems that the child did not have initially. They also hold the opinion that the companies manufacturing and marketing the drugs do not tell people the truth as it is supposed to be. They instead make the side effects appear inconsequential.

On the other hand, the no side has the opinion that the drugs are indeed necessary in regulation of the child’s behavior, academic performance and social relations. They also think that the claims of the stimulants affecting growth in children are just myths (Breggin, 2002).

Strengths and weaknesses of the pro and con sides

The pro side shows that use of stimulants affects how the brain functions and that the drugs may cause dependence. They use the documented cases as evidence that the drugs may result in psychological as well as physical problems. The weakness in their argument is that the symptoms which they claim are due to cessation of stimulant use may actually be symptoms of the problem itself (ADHD).

The no side shows that the drugs are essential for children with ADHD to live a normal life. This is because they correct the deficiencies in the brain. The major weakness is the claim that stunted growth as a result of the stimulant use is a myth (Barkley, 2000).

The author I agree with

I agree with the author of the yes side. The use of these drugs really does affect the functions of the brain and may result in psychosis. Parents should use natural methods like giving the children a balanced diet and mineral supplements as opposed to the drugs. The drugs may cause retardation in a child who would otherwise have grown into a healthy adult (Breggin, 2002).

The side of the critical issue that contemporary research supports

Contemporary research supports the no side. There were studies conducted in hospitals in Massachusetts and Detroit to show that the stimulant use did not cause dependence. Other tests revealed that symptoms like anxiousness, loss of appetite, insomnia and irritability are due to ADHD and not the drugs (Barkley, 2000).

Conclusion

Although yes and no sides do not seem to agree, it is clear that the stimulants affect the normal functioning of the body. This begins with the brain functions and may end up in malfunctions of the heart or even addiction. The growth of the child is interfered with and this influences the kind of person that child will grow up into (Breggin, 2002).

References

Barkley, R. A. (2000). Taking charge of ADHD: The complete, authoritative guide. Surrey, Guildford.

Breggin, P. R. (2002). The Ritalin fact book: What your doctor won’t tell you about ADHD and stimulant drugs. New York, Perseus.

Abstract

It has been widely reported by the parents of the ADHD children that the latter experience a poor sense of time in their behaviors. Therefore this study paper seeks to find out the sense of time in children with attention deficit hyperactivity disorder (ADHD). the study that was carried out found out that many children are affected by attention deficit hyperactivity disorder in their sense of time and therefore this matter should never be taken for granted.

It is advisable that parents should spend most of their time with their children in order to establish if they are free from this disorder. It is also important that children who suffer from ADHD should be taken to a psychiatrist in order to manage this disorder.

Introduction

Undoubtedly, attention-deficit hyperactivity disorder (ADHD) is the most common disorder found in children and adolescent and it is believed that it affects 5-10% of the children all over the world (Willcut, Doyle, Nigg, Faraone & Pennington 2005). This disorder is characterized by hyperactivity pervasive, impulsivity and lack of proper attention. ADHD is a complicated disorder since it is caused by several factors and also the disorder exhibits many clinical conditions.

According to the DSM-IV-R (American Psychiatric Association, 2000), it elaborates that there are three sub types of ADHD namely predominantly inattentive, predominantly hyperactive-impulsive and combined inattentive and hyperactive-impulsive.

However, it has been established by various authors (Amador-Campos, Forns-Santacana, Guardia-Olmos & Pero-Cebollero, 2006; Baldwin, Flake, Meaux, Chelonis, J.J., Edwards, M.C., Field, C.R. et al. 2004) that there are other individual differences which cause ADHD other than the symptoms mentioned above.

Literature review

It is known that ADHD is mainly diagnosed in school going children even though it emerges in the years before the children go to school. However other studies based on community sample have revealed that the problem in behavior which is experienced in early life will likely to be linked to future difficulties in behavior.

On the contrary few studies have highlighted the frequency with which children under the age of five years meet the criteria for ADHD (Barkley, 1990; Barkley 1997; Barkley, Koplowitz, Anderson & McMurray, 1997). Generally, the studies mentioned above found out that approximately half of the young preschool children and almost three quarter of the older preschool children had behavior problem associated to ADHD with the range of age being assessed lying between 2-10 years (Harvey, Youngworth, Thaka &Errazariz, 2009).

In Barkley’s (1997) unifying theory, he examines that impairment to sense of time is one of the major difficulties presented to children with ADHD. He goes further by postulating that the primary deficiency in response led to secondary deficiencies. According to his theory, a working memory deficit leads to lack of proper attention and hinders the development of sense of time in ADHD children.

The children are influenced by the recent activities while they tend to forget the activities which happened long ago. Levine & Spivack (1959) reported that in a group of restless and emotionally disturbed boys there is conception of time constriction and longer estimation of time. Also Capul (1966) noted that children below the age of nine presented problem in estimation of time.

Many researches support the theory of time perception deficit in ADHD children; (Baldwin et al., 2004; Barkley, Koplowitz, Anderson & Mcmurray, 1997; Andreou, Agapitou & Karapetsas, 2005; West et al., 2000 among others). The above named studies show that children with ADHD have difficulty in estimating time and they also have a discrepancy in tasks related to time reproduction.

These children will tend to overestimate short time interval while underestimating long time intervals. Furthermore, it has been established that children with ADHD combined type varied greatly in their time reproduction errors compared to children with inattentive ADHD type (Barkley, 1990).

Experimentally, children with ADHD have an ability to judge time interval appropriately while they fail to do so during their daily activities since they lack attention (Zakay, 2005).

Piaget (1946) illustrated that time was not intuitive but it only resulted from the constructed thoughts. He defined time as “coordination of movements of different speeds” (p.269). Therefore time can never be studied alone from other factors such as causality and space. Examples are time invariance which is the ability to determine time through sequences and simultaneity, time metric operation which is the ability to measure time.

Methodology

The participants were 50 children with various ADHD symptoms (40 were boys while the rest were girls of age 6 to 13 years). This diagnosis was carried out by experienced child psychiatrists and the results were that 43 of the children suffered from combined hyperactive-impulsive and inattentive types while the remaining seven suffered from predominant inattentive type.

It was also revealed that 20 children suffered from other conditions; 4 dyslexia, 6 learning disorder, 3 anxiety disorder and 7 mood disorder. 42 of the children were continuing with their medication at the time of the study even though they discontinued with medication 24 hours prior to the study (Quartier, Zimmerman & Nashat 2010).

There was a control group consisting of 50 children selected from schools. There was no significant difference between the two groups since they had similar characteristics concerning their age and their socioeconomic status. However, there was a large effect size in socioeconomic status which designates that more children with ADHD comes from lower socioeconomic class while the reverse is true for those that come from the upper socioeconomic class (Andreou, Agapitou & Karapetsas, 2005).

The children who had ADHD were selected from an association of patients who had ADHD and also from hospitals that offer mental services. The study was carried out after obtaining the consent from both parties i.e. their parents, children who had ADHD and the control group. The children who participated in this study were rewarded with gifts while their parents received the results of the study after two months of the study.

The time concept questionnaire (TCQ) was used to evaluate the knowledge of time in children with ADHD. This questionnaire consisted of 50 questions to be answered by the children from both the control group and the group that had ADHD. The questions were about time sequence and the orientation in time.

There was a control grid which helped in rating the responses of the children towards the prompt of the question. For example, 1 for “right” and 0 for “wrong”. Then, the time that was taken to fill the questionnaire form completely was recorded in order to determine the level of attention between the two groups that were involved (Harvey, Youngworth, Thaka & Errazariz 2009).

Parents of these children were also asked to fill “Its About Time” questionnaire (IATQ) which intended to gauge the time perception. There were thirty items on the questionnaire which had to be responded according to a scale that ranged from “hardly” to “almost often”.

A coefficient of .82 was estimated for the samples that were analyzed in the study. The scores that were obtained indicated the relationship with time oriental behavior i.e. lower scores showed that there was a problem in time oriental behavior and vice versa (Harvey, Youngworth, Thaka & Errazariz 2009).

The results that were obtained after conducting interview on questionnaire were recorded in the table as follows.

The results showed that children with ADHD did not necessarily differ from children without ADHD in their abilities to remember a series of events at a given time. However if this is compared with the Piagetian time conservation task which has a medium effect size of 0.55, it reveals that there is a slight possibility of vulnerability of event order in children with ADHD (Piaget, 1946).

The results obtained from TCQ showed an important difference in the two groups of study. Generally the results indicate that children with ADHD had a difficult time in evaluating time concepts and they seemed to be impaired in orientation of time.

Parents of the children with ADHD frequently reported that their children were disorganized about time conservation and this is especially true according to our findings. This is so because the mean difference between the two groups for IATQ total score was at effect size of 1.98 representing a percentage of 98% of the ADHD group.

Also it is worth to note that ADHD group were less prone to delay respect (large ES d =1.34), they are likely to think before acting (large ES d = 1.15) and more likely to be impulsive than the control group i.e. children without ADHD (Quartier, Zimmerman & Nashat 2010).

This study had an aim of investigating organization of behavior as compared to time management as well as time knowledge and time invariance in children with ADHD.

According to the study, the results failed to establish that there was a deficit on time conservation in children with ADHD since there was no difference in time interval between the two groups. However analysis on the effect size reveals that children with ADHD performed poorly in tasks involving time as compared to the children without ADHD (Quartier, Zimmerman & Nashat 2010).

In conclusion, the study that was carried out found out that many children are affected by attention deficit hyperactivity disorder in their sense of time and therefore this matter should never be taken for granted. It is advisable that parents should spend most of their time with their children in order to establish if they are free from this disorder.

It is also important that children who suffer from ADHD should be taken to a psychiatrist in order to manage this disorder. If the children with ADHD are looked after properly, the level of the disorder will go down. However it is a challenge to various stakeholders to educate people about the menace of ADHD.

Reference List

Amador-Campos, J.A., Forns-Santacana, M., Guardia-Olmos,J., & Pero-Cebollero, M. (2006). DSM-IV attention deficit hyperactivity disorder symptoms: agreement between informants in prevalence and factor structure at different ages. Journal of the Psychopathology and Behavioral Assessment, 28, 23-32.

American Psychiatric Association. (2000). Diagnostic and statiscal manual of mental disorders DSM-IV-TR (4^th ed., text revision). Washington, DC: Author.

Andreou, G., Agapitou, P., & Karapetsas, A. (2005). Verbal skills in children with ADHD. European Journal of Special Needs Education, 20, 231-238.

Baldwin, R.L., Flake, R.A., Meaux, J.B., Chelonis, J.J., Edwards, M.C., Field, C.R. et al. (2004). Effect of methylphenidate on time perception in children with attention deficit/ hyperactivity disorder. Experimental and Clinical Pharmacology,12, 57-64.

Barkley, R.A (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65-94.

Barkley, R.A. (1990). Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. New York: Guilford.

Barkley, R.A., Koplowitz, S., Anderson, T & McMurray, M.B. (1997). Sense of time in children with ADHD: Effects of duration, distraction and stimulant medication. Journal of International Neuropsychological Society, 3, 359-369.

Bauermeister, J.J., Barkley, R.A., Martinez, J.V., Cumba, E., Ramirez, R.R., Reina, G. et al. (2005). Time estimation and performance on reproduction tasks in subtype of children with ADHD journal of clinical child and adolescent psychology ,34, 151-162.

Capul, M. (1966). Étude des difficultés temporelles chez des enfants inadaptés [A study of temporal difficulties in maladjusted children]. Revue de Neuropsychiatrie Infantile et d’Hygiène Mentale de l’Enfance, 14, 19–39.

Harvey E.A., Youngworth S.D., Thaka D.A & Errazariz P.A. (2009). Predicting Attention – Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder from preschool diagnostic assessments. Journal of consulting and clinical psychology, 77, 349- 354.

Levine, M., & Spivack, G. (1959). Incentive, time conception, and self-control in a group of emotionally disturbed boys. Journal of Clinical Psychology, 8, 110–113.

Mullins, C., Bellgrove, M.A., Gill, M., & Robertson, I.H. (2005). Variability in time reproduction: Difference in ADHD combined and inattentive subtypes. Journal of American Academy of Child and Adolescent Psychiatry, 44, 169–176.

Piaget, J. (1946). Le developpement de la notion de temps chez l’enfant. [The child conception of time]. Paris: PUF.

Quartier V., Zimmerman G. & Nashat S. (2010). Sense of time in children with Attention- Deficit/ Hyperactivity Disorder (ADHD). Swiss Journal of Psychology, 69(1), 7-14.

West, J., Douglas, G., Houghton, S., Lawrence, V., Whiting, K.,&Glasgow, K. (2000).

Time perception in boys with attention-deficit/hyperactivity disorder according to time duration, distraction, and mode of presentation. Child Neuropsychology, 6, 241–250.

Willcutt, E.G., Doyle, A.E., Nigg, J.T., Faraone, S.V., & Pennington, B.F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 1336–1346.

Zakay, D. (2005). Attention et jugement temporel. [Attention and duration judgment.] Psychologie Française, 50, 65–79.

Abstract

Attention deficit hyperactivity disorder abbreviated as ADHD is a behavioral disorder prevalent among children and often persists into adulthood if untreated. Controversies surround this ailment includes causes and appropriate treatment program available. Since the beginning of1970, treatment and diagnosis of ADHD has remained a debatable issue among teachers, clinicians, policymakers, and the media.

It is difficult to ascertain actuality of ADHD, causes, and effectiveness of stimulant medications prescribed by medics. In America, it is universally accepted by medical practitioners that ADHD is a medical disorder affecting behavioral patterns. In 1998, the American Medical Association concluded that ADHD diagnosis is carried out on the facets of external observable research, which when critically monitored, may lead to a reliable result.

Thus, this research essay attempts to confirm that Attention Deficit Hyperactivity Disorder is a medical condition affecting childhood behavior.

Attention Deficit Hyperactivity Disorder

ADHD is a behavioral conditional disorder affecting an estimated eight to ten percent of school going children. Generally, this condition is three times likely to affect boys than girls. However, research done so far is unclear on the reasons surrounding the variance of gender in prevalence rate.

Reflectively, children suffering from ADHD are prone to acting with improper coordination between action and consequence (Andrew, 2006). Besides, they are hyperactive and not keen to focus on interactive discussion. Though they understand expectations from parents, peers, and teachers, there is serious trouble in interpreting and following the expected due to restlessness.

Thus, the victim cannot sit still, attends to fine details, or pay attention (Andrew, 2006). As a matter of fact, children of younger age exhibit these behavior characteristics as described when happy, exited, or anxious. It is a common scenario to monitor behavior of younger children when with peers or in the house.

However, for ADHD condition, these characteristics are prolonged and occur intently. ADHD ailment impairs the ability of a child to function academically, socially, and at home. From the findings of advanced scientific research, this condition is treatable. The treatment schedule influences ability to learn practical ways of comfortably managing and living with these symptoms (Bee &Boyd, 2011).

Attention deficit hyperactivity disorder, abbreviated as ADHD or ADD is a disorder of development and growth among children. The onset of ADHD symptoms is at the age before seven years. Globally, infection rate stands at 3% to 5% among children. Besides, diagnosis rate in school going children is at 2% to 16%.

Being a chronic condition, 30% to 50% of the infected children may exhibit persistent symptoms late into adulthood (Bee &Boyd, 2011). Notably, adults and adolescents with this condition adopt coping mechanisms as a means of making up for their shortcomings. At present, the statistical estimate of America adults suffering from this ailment is at 4.7 percent (Bee &Boyd, 2011). To carry out a standardized and non-biased screening, world bodies such as W.H.O have confirmed this as the official rate of infection.

Specific medical conditions associated with ADHD ailment are unknown. However, twin studies reveal that this condition is hereditary with genetic factors accompanying 75% of all infections. In the findings of this research, gene combination affects dopamine transporters associate with behavior determinant code.

For instance, LPHN3 gene is believed to influence occurrence of 9% of infections. Besides, environmental factors may contribute to dominance of ADHD in children. Reflectively, tobacco and alcohol exposure at pregnancy may lead to the infant being infected. Nicotine from tobacco depletes oxygen rich blood from reaching the fetus staving it of oxygen (Andrew, 2006).

As a result, hypoxia is likely to trigger premature delivery and damage to the baby’s head. Victims of ADHD have prevalent rates of injuries on the head than others. Moreover, infections occurring at delivery and early infantry are also contributory factors. Viruses such as varicella, rubella, measles, and entrerovirus 71 alongside streptococcal infections are secondary agents of ADHD disease (Bee &Boyd, 2011).

In the findings of the American Medical Association research, carried out in 2007 and 2010, it revealed that insecticides of organophosphate chlorpyrifos form used in treatment of vegetables, affects infant physical and behavioral coordination.

Done on a sample of one thousand and one hundred children of age eight to fifteen, urine samples revealed that those with higher concentration of organic dialkyl, a breakdown product of phosphoric pesticides, were more likely to be infected with ADHD.

Also, in a study carried out in 2007 by Southempton linked hyperactivity to sodium benzoate used in America as a food color preservative. Children who consume large quantities of artificial food are at risk of infection. This is because artificial food is often preserved with large quantities of harmful benzoate preservatives.

Notwithstanding, the W.H.O has indicated that this ailment is as a result of family dysfunction and inconsistencies in system of education. For instance, complex post Traumatic stress disorder and sensory integration dysfunction may trigger individual psychopathology climaxing with an onset of ADHD infection (Andrew, 2006). Neglecting or abusing children for a longer period of time may trigger frustrations and overwhelming behavior inconsistency.

Patho-physiology reveals that ADHD is associated with the brain malfunctioning. Therefore, impulsivity, hyperactivity, and inattention are symptoms of brain disorder especially in the dorsal anterior cortex. Victims of this ailment exhibits predominant delay in brain response to stimuli causing them to mature at a rate higher than that of normal children (Bee &Boyd, 2011).

Consistent diagnosis of ADHD infection is inclusive of psychiatric, physical, laboratory, and radiological imaging examinations. For instance, the American Psychiatric Association has classified diagnosis on three facets. These facets explore the symptom characteristics displayed by the victims who are children, teenagers and adults. Irrespective of the age bracket, this ailment displays more or less the same symptoms depending on maturity and environmental influences.

Classification of ADHD ailment relies on the nature of persistence of symptoms associated with it. For instance, irresponsiveness to impulse control may signify a developmental or growth lag. By use of Magnetic Resonance Imaging, scientists and psychologists have discovered an acceptable prefrontal cortex estimating the onset of this ailment between three and five years of age. However, this condition is behavior controlled and not neurological.

Psychologists describes ADHD as a disruptive behavioral disorder (Bee &Boyd, 2011) consisting of conduct, antisocial, and oppositional defiant disorder (Bee & Boyd, 2011). The three subtypes of ADHD include the impulsive, inattentive, and impulsive-inattentive order. Patients who suffer from hyperactive impulsive ADHD are predominantly normal and only display partial symptoms in lifetime.

However, those in inattentive class, especially children, experience challenges when interacting with peers and are prone to retreat into their own world quietly without realizing it. Due to this, this victim may not receive attention from parents, teachers and peers. A combination of impulsive and inattentive types is referred to as a full blown ADHD condition (Andrew, 2006).

In childhood, victims of this condition are easily distracted, forgetful, cannot maintain focus in a single task, easily bored, and seem to be distance when being spoken to. Besides, the victim becomes restless and destructive in the house and at school. Often, parents with children suffering from this ailment do complain of them being over-destructive, inattentive, and struggle to follow simple instructions. When seated, these children squirm a lot and talk nonstop.

Within a short time, they dash out and touch everything in sight. In addition, the impaired is prone to restlessness during dinner and story time. Moreover, given the slightest opportunity, the child is likely to remain in motion constantly. Also, when in companion of peers, the impaired is unable to exercise patient in game turns and make inappropriate hurting comments on friends (Bee &Boyd, 2011).

At teenager, ADHD patient is prone to making careless mistakes in academic work, peer interaction, and decisions. The first symptom is predominant failure to complete homework, exams, and co-curriculum activities. In addition, careless in organizing work of scheme creeps in and forgetful dominate (Andrew, 2006).

Moreover, when not in classroom, the impaired is prone to excessive talking accompanied by rebellion when faced by a disagreeing opinion. Generally, there is a feeling of restlessness and an urge to interrupt or intrude a conversation.

Regardless of treatment, adolescent victims of full blown ADHD are prone to academic failure. In America alone, 37% of ADHD victims fail to secure high school diploma even when learning in special education programs with only 5% acquiring college degree. Besides, they are at higher risk of injury, auto crashes, earlier conjugal activities, teen pregnancy, and higher expenses on medical treatment (Andrew, 2006).

In adults, ADHD infection is characterized by persistent lack of self-motivation and control. As a matter of fact, such an adult is impulsive, inattentive, and hyperactive when interacting with peers.

Full blown infection symptoms in adult includes occupational inconsistency, education failure, sexual malfunctioning, poor social relationships, failed marriage, inconsistent dating tendencies, irresponsible parenting, psychological morbidity, frequent drugs and internalized crime activities, and poor financial management skills (Bee &Boyd, 2011).

Treatment of ADHD consists of psychosocial behavior counseling and therapies such as cognitive, interpersonal, family support, training on social skills, and interventions in school. Besides, short term stimulant medication is by choice. Atomoxetine stimulants are recommended by medics for preschool victims.

To manage this condition, an array of medical, behavioral, counseling, and lifestyle modification is the best combination. The hurdles towards ADHD sustainability lies on difficulty to separate its symptoms from other ailments and inefficient training for medical staffs on the best practices of treatment and assessment in patients of adult age (Bee &Boyd, 2011).

Research indicates that 60% of childhood ADHD infections go into adulthood. However, many of these adults remain untreated. Due to un-treatment, the symptoms develop into disorganization, alcoholism, drug abuse, and chaotic lifestyle.

Besides, the victim is at risk of developing anxiety disorder, depression, learning disabilities, and substance abuse. Proper diagnosis may be a solution towards individual insightfulness on behavior and awareness of treatment and coping strategies. However, controversy surrounds the belief that this ailment persist into old age.

Among other obstacles to proper diagnosis includes inappropriate diagnosis criteria, comorbidities, and possibility of a link to situational and intelligence levels. Successful treatment in children is a cordial partnership between a doctor, child, and the parents. Stimulant medications are available to calm down the impaired (Bee &Boyd, 2011). ADHD affects children and adults. In fact, impact on adults is often devastating on the ability to maintain relationships, work, and family demands.

References

Andrew, G. (2006). Taking Sides: Clashing Views in Lifespan Development, 2nd Ed. Hightstown: McGraw Hill Contemporary Learning Series.

Bee, H & Boyd, D. (2011). Lifespan Development, 5^th Ed. New York: Pearson Education.

Attention deficit hyperactivity disorder (ADHD) refers to a condition that occurs in children that involves deficiencies in motivating and regulating oneself (Ashley, 2005, p.24). These deficiencies result in extensive and involuntary distractions, problems with organization, procrastination and poor prioritization.

ADHD is a recurrent and long-lasting condition that begins in the early years of childhood and persists throughout life into adulthood (Ashley, 2005, p.28). When this ADHD persists into adulthood, it is referred to as adult attention deficit disorder (Adult ADD).research has shown that 60% of children with ADHD show signs of the condition in their adulthood.

It is so prevalent that 15% of the world’s population has ADHD (Ashley, 2005, p.33). With time, ADHD develops into adult ADD.ADHD is treatable with a combination of skills training, behavior and cognitive therapy and medication. Adults who exhibit the adult ADD have the same mental potential as adults who do not have the condition.

The development of ADHD into adult ADD involves the change of symptoms as the child grows into maturity (Anne, 2000, p.54). The symptoms of the condition are different in both stages of life. In childhood, symptoms include forgetfulness, frequent distractions, making of careless mistakes that result from lack of paying attention, easy distractions and carelessness.

These symptoms develop and change to procrastination, poor time management, impatience, boredom in most tasks and high activity (Anne, 2000, p.55). The change in the symptoms make them difficult to identify in contrast to childhood when they are easy to identify .Adults with this condition are less likely to show hyper active behaviors. However, they experience more accidents and low employment opportunities than adults who do not have the condition.

Research conducted on the development of ADHD to adult ADD has revealed ADHD affects three main aspects of physical development in children. These aspects include the use of the five senses to process information and sensations, proprioception and development of dominance (Anne, 2000, p.47).

Children who have poorly developed touch abilities, may exhibit more activity in an effort to develop sensation. Children with poor visual and auditory processing abilities may experience short-term memory, experience difficulties in trying to follow instructions, get easily distracted and frequent shift of attention from matters at hand (Anne, 2000, p.50).

Poorly developed proprioception leads to poor coordination and frequent careless accidents. In addition, the child may get involved in dangerous activities (Anne, 2000, p.53). The development of dominance is vital in processing sensations and information, storage and the subsequent use of the information. If dominance is poorly developed, then there is limited use of the brain in processing external stimuli.

Extensive research that has been conducted shows how the different stages of development and the gender of the child correspond to development of ADD. In young children, there is a higher rate of occurrence of hyperactivity-impulsivity type of ADHD that may be caused by late diagnosis.

In terms of gender, males are more predisposed to ADHD than females (Anne, 2000, p.67). Children have trouble in trying to calm and control themselves because of their high sensitivity to the environment and overflow of information. As such, they are unable to organize and make sense of stimuli and as such, react adversely to them.

This is sometimes regarded as a sensory disorder by therapists. As the child approaches school age, the child deals with the task of developing individualism and self-awareness.at this stage most develop fear, confusion, and avoidance due to the feedback they receive regarding their chaotic and unappealing behavior. This problem is aggravated by the fact that it is beyond their control. These problems later develop into anxiety disorders.

As they enter elementary school, children with HDD show signs of social limitations (Barkley et al, 2010, p.61). They react aggressively to reactions from other children and criticisms received from teachers and friends. This makes them develop a negative self-image, low esteem and confidence and feelings of depression and inward anger.

Successful social interaction is an important aspect in child development. Children with ADHD lack these skills and are often involved in misdemeanors. As they become teenagers, there is a change in the symptoms of ADHD. Levels of inattentiveness and distraction increase and cause the development of aggression and anti-social behaviors (Barkley et al, 2010, p.69).

These result in frustration and great feelings of inadequacy as they compare themselves to other children. At this stage, a child heavily feels social non-acceptance and limitations in abilities. Research shows that delays and uneven maturation of the cortex are responsible for ADHD (Anne, 2000, p.130).

As the teenagers enter adulthood, the symptoms further change, owing to more and better development of the three aspects of physical development discussed above. As adults, information processing and response to stimuli is well developed and as such, the symptoms are less severe. However, they exhibit destructiveness, difficulty in concentrating and reduced attention span. This continues in old age and needs management for proper functioning.

ADHD is a condition that if diagnosed early can be treated by a specialist using therapy and proper medication. Scientists have attributed it to the uneven and late development of the cortex (Anne, 2000, p.130). The brains of children with ADHD develop in the same way as that of normal children but it is slower. However, due to late discovery, ADHD develops throughout the life of the child into adulthood. However, the symptoms in adulthood are different from those in childhood because they are less severe.

References

Anne, T. (2000). Interventions for ADHD: Treatment in developmental context. New York: Guilford Press

Ashley, S. (2005).The ADD and ADHD Answer Book. Oxford: Sourcebooks Inc.

Barkley, A., Murphy, K., and Fischer, M. (2010). ADHD in Adults: What the Science Says. New York: Guilford Press.

Defining the phenomena that are related to human psychology is not an easy task; even though there are certain ways to define the existing psychological disorders, with most of their symptoms, as well as their consequences, some of the aspects of the disorder will still be left out.

As Gregg and Deshler explain, “A major problem […] involves the eligibility criteria used to operationalize disability definitions” (Gregg & Deshler, 2011, 39). The above-mentioned is especially characteristic of such a phenomenon as ADHD, or attention-deficit hyperactivity disorder. Robin and Barkley were two of the psychologists who managed to pinpoint the specifics of the ADHD:

“Attention-deficit hyperactivity disorder is a heterogeneous disorder of unknown etiology.” This is the opening line of a major review of the literature medication for treating ADHD by one of the leading child psychiatry research teams in the country […].To this line, we could easily add the phrase “and of highly changeable definition.” (Robin & Barkley, 1998, 13)

Therefore, to properly represent the specifics of the ADHD disorder and to define the phenomenon, one will have to incorporate several definitions. Once the disorder is described from several viewpoints, it will be represented in a more adequate way. To put it the way Gregg and Deshler did, “professional institutions should provide the specific definitions used to construct their documentation guidelines and eligibility criteria” (Gregg & Deshler, 2011, 39).

Therefore, as the authors claim, “no definitions […] are included in the regulations for these statuses, unlike the definition of ‘specific learning disabilities’” (Gregg & Deshler, 2011, 39). However, it would be a far stretch to claim that ADHD cannot be defined – the phenomenon still has a lot of characteristic symptoms. Moreover, it is also worth mentioning that not only children, but adults as well can have ADHD.

In the case with adults, however, the definition of the disorder will be quite different from the one which is provided for a child ADHD. Speaking of a more or less traditional definition of ADHD, the one offered by Echeverri can be considered rather precise: “Attention-deficit hyperactivity disorder is a neurobiological condition involving behavior dysfunctions and cognitive distortions” (Echeverri, 2008).

When it comes to defining neurological diseases, psychological disorders, or other health issues which influence the work of a human brain rather than any other part of body, finding the appropriate definition for the phenomenon in question is rather hard. Likewise, attention deficit-hyperactivity disorder is quite hard to define.

Since its symptoms have not been studied well enough yet and the factors of its development have not been fully discovered, it is not simple to define the disorder. One of the key problems, thus, is that the people who research the issue in question are not quite sure what they are exploring. Moreover, some of the researchers argue that ADHD, in fact, does not exist. With that in mind, one can see why ADHD does not have a full-fledged definition yet.

ADHD is mostly known for affecting children; however, adults can also display the symptoms of ADHD, according to the existing evidence concerning the issue. Since the issue of child ADHD and the instances of ADHD symptoms among students have been strongly emphasized in the media quite recently, one might have thought that there is a relation between the age of a person and his/her age.

According to the data provided by Buitelaar, Kan and Anderson, with a person getting older, the risks of his/her developing an ADHD syndrome decrease. As Buitelaar, Kan and Anderson explain, the peak of an ADHD threat in women appears at the age of 6; the same goes for men, while at the age of 18-20 for men and 16-18 for women, the threat of developing ADHD shrinks rapidly. Nevertheless, it is necessary to mention that adults can also develop ADHD, though not as rapidly as children do.

Another essential detail about ADHD which is worth bringing up is the statistics on the ADHD records and the patients’ gender. In the given case, it is not as easy to figure out the relations between the two issues as in the previous one. As Buitelaar, Kan and Anderson explain,

Although there is a general agreement that gender-related differences exist in comorbid conditions, these differences have been described in clusters: boys have been found to have more “externalizing” disorders, and girls have been described as tending to have more “internalizing” disorders such as anxiety and depression. (Buitelaar, Kan & Anderson, 2011, 18)

Therefore, judging by the existing evidence, there is little to no correlation between the gender and the possibility of developing ADHD among adults. However, when considering the instances of children developing an ADHD syndrome, one will discover a completely different picture. As the research says, boys are subjected to the risks of developing an ADHD syndrome to a much higher degree than girls. Mostly explained by the specifics of boys’ psychological development, this is an inevitable scientific fact:

In childhood, boys are three times as likely as girls to have A.D.H.D. Boys with the disorder tend to be more hyperactive and impulsive and are more likely to develop oppositional behavior, conduct problems and later delinquency than girls, though girls, too, can develop these problems. (Barkley, 2011)

According to the authors, the fact that boys are more subject to the ADHD syndrome can be explained by the specifics of upbringing and the emotional development, namely, the fact that boys are not encouraged to express their feelings in the open and, hence, are under much more strain than girls are.

Therefore, when boys set their emotions loose, the consequences are much bigger and the boys’ hyperactivity level is much higher than the one of the girls. “With ADHD represent a more significant proportion of adults with ADHD than has been previously recognized. (Buitelaar, Kan & Anderson, 2011, 18).Therefore, it can be considered that the chances of men developing ADHD are only slightly higher than the ones of women.

As it has been stated above, the symptoms of ADHD have not been fully explored or described yet; there are only vague assumptions as for what a person with ADHD might behave like and in what way his/her behavior might differ from the rest of people.

However, one can hardly demand more in the case when even doctors are not quite sure whether ADHD exists or it is another excuse for the lack of willingness to concentrate. Nevertheless, some of the specifics of behavioral problems which people with ADHD display have been described in a rather exhaustive manner, which gives another reason to reconsider these symptoms.

However, in the given case, it is necessary to keep in mind that there is a child ADHD syndrome and an adult one. Since the two groups are on different levels of psychological development and have different emotional specifics, the symptoms of the ADHD development in each group are going to vary. To start with, as the research results say, the key symptoms of ADHD in adults are:

• Problems with becoming organized.
• Inability to concentrate.
• Family issues.
• Problems with relaxation.
• Inability to find a way to start working on something.
• Constantly being late on something.
• Outbursts of rage.
• Troubles with priorities (Tuckman, 2007).

As for children, ADHD symptoms are quite similar. According to Everett and Everett, there are two key signs that a child is developing an ADHD syndrome:

• The child is hyperactive and cannot focus;
• The child is dreamy and cannot focus (Everett & Everett, 2001).

As it can be easily spotted, the two symptoms are quite opposite to each other; the child can be either too active or, on the contrary, lack activeness. However, in both cases, the inability to focus is represented. Therefore, the key symptom of ADHD is the inability to concentrate.

However, when diving deeper into the specifics of ADHD development in children, one will see that there is more than just the inability to pay attention that children with ADHD suffer. As Everett & Everett explain, the problem is even more complicated – children with ADHD often fail to understand, start and/or complete the task which they are offered, disregarding the task complexity.

Therefore, it can be assumed that the problem goes beyond lacking focus; ADHD obviously decreases the students’ motivation, leaving them lacking any interest in the activities which they used to enjoy (Everett & Everett, 2001). Therein lies the difficulty of the problem – incorporating the biological and the psychological issues, it needs a complex solution that will help defeat the disorder not solely on the neurological level, but also on the physiological one.

Like any other disorder, ADHD can be explained from a biological point of view. Since there are several perspectives from which the given phenomenon can be explained, it is most reasonable to consider each. To start with, there is a neurological theory concerning where the ADHD syndrome comes from and what factors it is induced by.

As Weiss, Trokenberg-Hentchmann and Weiss explain, “Neurological dysfunction or damage has always been considered an important determinant of ADHD” (Weiss, Trokenberg-Hentchmann & Weiss, 2010, 28). Indeed, there are sufficient reasons to consider ADHD primarily a brain dysfunction, since people with ADHD display obvious differences from the rest of the people in their behavior and process of thinking.

As it has been stated before, the key symptoms of an ADHD syndrome are memory malfunction and the inability to concentrate, which serve as strong indicators of something going wrong on a neurological level. However, calling ADHD a “minimal brain damage” (Weiss, Trokenberg-Hentchmann & Weiss, 2010, 28) would also mean defining it from a strictly neurological point of view, since it is not only the brain, but also the nervous system that suffers.

Therefore, apart from a neurological one, there must be another explanation of the ADHD phenomenon. Despite the fact that the phenomenon of ADHD is rather well-known and often researched, its true origins are still a mystery. As Weiss, Trokenberg-Hentchmann and Weiss claim, there is a reason why the neurological theory of ADHD is so popular among most doctors:

Many of these theories are used to support treatments that are profitable to providers, but costly to patients in terms of both delaying effective treatment and of unnecessary dollars spent. More recently, researchers have tended to put more of their effort into investigating causes of ADHD that are supported by empirical data. (Weiss, Trokenberg-Hentchmann & Weiss, 2010, 29)

Therefore, there are reasons to search for some explanations of ADHD other than the neurological one. As Weiss, Trokenberg-Hentchmann and Weiss assert, the factors which enhance development of ADHD are much more diverse than most researchers used to think and involve not only neurological, but also social aspects and the aspects of genetics: “Our knowledge of ADHD has increased through study of genetics, neuroanatomy, neurochemistry, risk factors associated with pregnancy, and other environmental influences” (Weiss, Trokenberg-Hentchmann & Weiss, 2010, 29).Hence, it can be considered that the factors inducing the development of ADHD are not only neurological, but also environmental.

As it has been mentioned previously, not only children suffer from ADHD – adults are also disposed to developing the given psychological disorder. However, it is worth mentioning that, in case of an adult developing the symptoms of ADHD, the treatment methods are going to be considerably different from the ones which are usually offered for curing ADHD in children.

As a rule, adults are usually prescribed with specific medicine, such as stimulants. If considering some of the most advanced strategies of curing ADHD, one will find out that MAO inhibitors are the most popular medicine for adults. Buitelaar, Kan and Anderson claim that there are several ways of pharmacological treatment acceptable for adults.

One of the most common methods is prescribing the monoamine oxidase (MAO) inhibitors. However, when it is necessary to cause an agonist effect in the patient, norepinephrine and dopamine reuptake inhibitors, such as Buropropin, can be chosen for an efficient treatment (Buitelaar, Kan & Anderson, 2011). In certain cases, however, combined therapy is used. Still, medicine alone will not help – it is only with efficient therapy that one will be able to return to one’s normal state.

Speaking of the medicine which is typically prescribed for the children who were diagnosed with an ADHD disorder, one has to mention a comparatively recent scandal concerning Ritalin, its use and its actual effect on children. There are serious concerns that Ritalin is overprescribed and that, when overused, Ritalin can cause even more problems than ADHD disorder, making children more passive.

The medicine could actually seem rather innocent and efficient – as a matter of fact, it does have a positive effect on the patients; however, it is still necessary to check whether the game is worth the candles and whether the positive effects of Ritalin are more numerous than the negative ones.

If considering the properties of Ritalin as they are listed in the instruction for the medicine, one will not find anything suspicious about Ritalin at all. To paraphrase Palank, Ritalin, the medicine is best known for its ability to make the patients focus (Palank, 2000, 60). Enhancing people’s ability to pay attention and making their memory work in a proper way, Ritalin can be considered a rather decent medicine for curing ADHD.

As Palank explains, there has been a record of positive effects of Ritalin: “The medication Ritalin is known to enhance a person’s ability to focus” (Palank, 2000, 60). As Palank explains, Ritalin “is helpful for many people with this disorder” (Palank, 2000, 60). It seems that Ritalin has stood the test of time, which means that doctors have the right to make Ritalin a number one medicine for ADHD.

However, what seemed to be an obvious solution might actually turn out another misconception. As Palank confesses, “There is no evidence that this medication will enhance concentration or focus in individuals without ADD who have normal chemistries” (Palank, 2000, 60). Hence, the question concerning how exactly Ritalin makes the children with ADHD return back to their normal state remains open.

Geographically, one can hardly draw any pattern of ADHD development – it seems that the disease cannot be referred to specific regions and affects children and adults disregarding their nationality. It is rather the environment that matters for developing ADHD symptoms.

Therefore, UAE should not have any outstanding records on the number of ADHD instances in the state. However, checking on the statistics of the ADHD instances will help understand the way the UAE handle the problem of ADHD among children and adults. According to the results of the 2011 research conducted by Khamis,

Results indicated that 12.5 % of the children had ADHD symptomatology, and that the prevalence ratio varied across the three ADHD subtypes, with the following rates; 1.5 % for the combined type, 7.5 % for the inattentive type, and 3.5 % for the hyperactive-impulsive type. (Khamis, 2011, 28)

Judging by the statistical data offered above, the rates of ADHD among the UAE children are quite high. Therefore, it can be considered that the given type of disorder is rather common in the United Arab Emirates.

Determining the key causes of ADHD among the UAE children, Khamis suggested that the family background must be the key factor: “Research in the Arab world […] has recently indicated that family environment and parental style of influence may be a key cause of ADHD” (Khamis, 2011, 29). Therefore, it can be considered that for UAE, ADHD is quite a topical issue.

Reference List

Barkley, Dr. (2011). Men, women and ADHD. The New York Times. Web.

Buitelaar, J. K., Kan, C. C., & Anderson, P. (2011). ADHD in adults: characterization, diagnosis, and treatment. Cambridge, UK: Cambridge University Press.

Echeverri, L. E. V. (2008). Attention-deficit hyperactivity disorder (ADHD). Web.

Everett, C. A., & Everett, S. V. (2001). Family therapy for ADHD: Treating children, adolescents and adults. New York, NY: The Guilford Press.

Gregg, N. & Deshler, D. D. (2011). Adolescents and adults with learning disabilities and ADHD: Assessment and accommodation. New York, NY: Guilford Press.

Khamis, V. (2011). Attention-deficit and hyperactivity among school-age United Arab Emirates children. International Journal of Special Education, 26(3), 28-35.

Palank, E. (2000). The god doc: Health, humor and insight to improve your game. Toronto, CA: Jones & Bartlett Learning.

Robin, A. L. & Barkley, R. A. (1998). ADHD in adolescents: Diagnosis and treatment. New York, NY: Guilford Press.

Tuckman, A. (2007). Integrative treatment for adult ADHD: A practical, easy-to-use guide for clinicians. Oakland, CA: New Harbinger Publications.

Weiss, M., Trokenberg-Hentchmann, L., & Weiss, G. (2010). ADHD in adulthood: A guide to current theory, diagnosis, and treatment. Baltimore, MD: JHU Press.

As it would be observed, human development is a term with a lot of meanings in life. However, no matter the perspective used to define it at any given point, it simply involves aspects related to human development, just as the name suggests. Human development is a significant process whose main focus is to enlarge human opportunities and / or freedom.

In other sense, the concept of human development would revolve around the freedom that ordinary human beings possess to be able to make crucial decisions about their lives, thus ending up realizing the true purpose of life. Generally, the concept of human development would tend to feature biological, cognitive, social, and emotional factors that are likely to play a crucial role in shaping behavioral development in humans.

In that regard, the department of human development has over the years established a platform which offers great potential for study aimed at enhancing and promoting human development and wellbeing from birth through later developmental stages of life in numerous social contexts.

It is obviously clear that, no matter the effort we apply to improve our lives, the full expectations of human development are rarely met in life, owing to a number of unavoidable issues which tend to arise in our lives such as diseases and deformities. For the purpose of this particular subject, this paper examines Attention-Deficit Hyperactivity Disorder or ADHD as one of the major issues affecting human development today.

ADHD is a psychiatric health condition which is characterized by a number of significant complications of either impulsiveness and hyperactivity or inattention. In some cases, the disease could be a combination of the above two conditions. According to Campbell (2000) ADHD is characterized by a number of behavioral symptoms which include, but are not limited to, hyperactivity, inattentiveness, a short attention span, restlessness, easy distractions, and impulsiveness.

Other additional difficulties that are likely to occur as symptoms in people suffering from ADHD are learning and understanding complications and sleep disorders, among other serious complications. It has been observed that, ADHD victims will tend present serious problems in controlling impulsive behaviors and in paying attention. In this case, people having this disorder may tend to act without stopping to think about the possible outcomes of their deeds or reactions.

As a matter of fact, most of these behavioral symptoms could be too distractive to the victims, thus contributing to impairment of school performance in children attending school. Moreover, children with this disorder will also find it hard to complete tasks at home or getting along with their friends and classmates.

Children who have been diagnosed with attention-Deficit Hyperactivity Disorder usually undergo a number of severe and traumatizing inattention behaviors. For instance, the children are likely to be easily distracted, and this makes them miss important details taking place around their world.

The children also find it difficulty to focus and concentrate on one thing, and would therefore frequently switch from one event to another. The children are also likely to become bored with something they are doing after only a short while, unless the thing proves to be of great meaning to them.

ADHD children are also associated with the habit of forgetting and losing things easily. Moreover, unlike their peers at school, children with this type of psychiatric disorder would also tend to have complications processing information in a fast and accurate manner. As Biederman and others (1993) observe, these are just some of the many symptoms of inattentions associated with children suffering from Attention-Deficit Hyperactivity Disorder.

As it would be observed, some of the symptoms associated with the disorder for children would differ from those of adults suffering from the same condition in a number of ways. For instance, whereas a child with the disorder may run about excessively, an adult with the same disease may found it difficulty to relax, thus talking excessively in social grounds. Gambling and substance abuse are also very common in adult individuals with the disorder, among other addictive behaviors.

ADHD is arguably the most commonly researched and diagnosed disease of the human brain in young children and adolescents. The disorder is said to affect about 7 percent of young people and can be diagnosed in up to 16 percent of school-going children. However, even though most cases of this disease are diagnosed in childhood, the victims will continue to show symptoms even into their teenage and adulthood stages.

Easy diagnosis of ADHD is usually done between three and seven years of age, and the reason for this is simply that children are easier to diagnose compared to adults, owing to the presence of definitive set of symptoms which are appropriate to age. In some cases, however, this may not happen until at some later stages of development.

As it would be observed, it is not always easy to differentiate ADHD symptoms from those of other diseases, and in that case, it would be easy to miss the diagnosis, especially in the adults (Gillberg, Gillberg & Rasmussen, 2004).

However, in order to be able to address this challenge successfully, health care professionals have been equipped with formal skills and knowledge on how to assess and treat ADHD in all stages of human development. More importantly, effective diagnosis tools and equipment which include standardized rating scales have also been introduced to enhance screening of the disorder and assessment of the severity of its vast symptoms.

ADHD is said to be the most common behavioral disorder in most parts of the world, where it is estimated that about 2 to 5 percent of young people in the world are affected by the disorder. However, even though many children having the disorder are likely to show symptoms in both teenage and adult stages, it has not yet been proven whether the disorder can present in adulthood without first having occurred at childhood.

Despite the many studies that have been carried out over the years on ADHD, little is known about the causes of the disorder. However, the constant work of scientists on the matter has pointed out to some factors which may tend to play a big role in the occurrence of the disorder in humans. As it would be observed, this combination of factors include things such as genetics factors, environmental factors, diet and nutrition, the social environment, and physical harm to the brain, among other factors.

In regard with the genetic factors, the genes that we inherit from our parents would often tend to determine who we are, and in that regard, studies in issues of human development from numerous studies have confirmed the possibility of ADHD running in families. However, researchers have not yet identified the specific genes which may make people more vulnerable to the disorder, which could have been a milestone achievement towards the prevention of the disorder.

Getting to know the genes involved in making people vulnerable to the disorder could enable the researchers to take full control of the disorder before the symptoms develop to extreme levels (Lahey, Applegate, McBurnett & Biederman, 1994). More importantly, this could have opened up doors leading to better and improved treatments of the disorder. As it would be observed from various studies based on ADHD, children having a particular gene version would tend to have defects in some crucial parts of their brains.

A good example here is whereby the arteries in those parts of the brain are unusually narrower. Based on the results of these studies, it has been shown that this difference is just temporary, and as the people with this particular version of gene enter various developmental stages, their brain tissues are likely to develop to normal thickness. This way, their ADHD symptoms are also improved.

Previous studies on the matter have also confirmed a significant link the psychiatric disorder and a number of environmental factors. For example, it has been observed that there is a close link between alcohol drinking and smoking of cigarette and Attention-Deficit Hyperactivity Disorder in unborn children. The consumption of alcohol by a pregnant woman can result to the fetal developing a type of disorder whose symptoms are identical to those of ADHD.

Excessive exposure to tobacco, on the other hand, in the course of pregnancy is much likely to affect the normal development of the unborn child (Mayes, Bagwell & Erkulwater, 2008). In extreme cases this could result to the occurrence of ADHD. There are claims that children who are highly exposed to concentrated levels of lead, as it can be found in a variety of building materials are also at a greater risk of developing this disorder.

Brain injuries, especially ones that are experienced at a very tender age, are thought to trigger behavioral symptoms that are similar to those of Attention-Deficit Hyperactivity Disorder as the child grows. This claim, however, has been refuted by a number of studies that have been conducted with the aim of proving whether there is any significant connection between previous brain injuries and ADHD.

Research has shown that, only a small portion of children having the disorder have experienced a traumatic brain injury at some point of their life. As a matter of fact, about only 30 percent of children who may happen to suffer brain injury are likely to develop the psychiatric disorder.

In regard with diet and nutrition, some people have always associated food additives and colorings with ADHD, where it is believed that some certain food spices in form of color and additives would tend to trigger ADHD in children (Schatz & Rostain, 2006).

However, previous and current studies on this particular matter have refuted this claim, concluding that there is no any significant connection between food additives or colorings and the disorder, even though the evidence is said to be inconclusive. The most acceptable claim as far as food spices and their association with ADHD are concerned is that, a number of children having the disorder may be more sensitive to food-stuff additives and colorings.

Still on diet, there have been claims that refined sugar increases chances of one developing ADHD. However, a higher percentage of studies conducted with the focus of testing these claims have discounted the theory. This observation was confirmed through a study that was carried out on two groups of children selected from the same neighborhood.

One group was fed with foods containing sugar substitutes on daily basis, while the other group was given foods containing higher than average levels of sugar. However, based on the study outcomes, there were no differences in behavior that were made from the observational studies carried out on the two groups. In this regard, there is no significant connection between sugar or sugar substitutes and Attention-Deficit Hyperactivity Disorder.

There have been mixed reactions from various researchers about whether or not our social environments could contribute to development of Attention-Deficit Hyperactivity Disorder.

While some people have seen no connection at all between social environments and ADHD, other researchers have observed that relations and interactions with nannies and caregivers could have a big impact on attentional abilities, among other behavioral aspects. A research that was conducted on foster children would indicate that a high percentage of them presented symptoms similar to those of Attention-Deficit Hyperactivity Disorder.

As Khan and Faraone (2006) observe, attention-Deficit Hyperactivity Disorder (ADHD) has for long time being part of the human condition. However, since 1970s, when the first realistic concerns towards the disorder were observed in the world, there have been a lot of controversies about the disorder and its diagnosis and its treatment.

As it would be observed, disagreements were not only observed in the possible causes of this serious psychiatric disorder as highlighted in the above paragraphs, but also in the various ways or approaches that can be used to diagnose and treat the disorder.

According to the U.S. Health Department, there is no known cure for Attention-Deficit Hyperactivity Disorder, but the disease can easily be managed through one’s stages of development using a number of appropriate interventions. More importantly, some symptoms aligned to the disorder may also get to improve as a child grows.

Currently, researchers have developed a wide range of effective protection and treatment interventions that can be used to address this disorder in the world. The available treatments of the disorder in the contemporary world can only be useful at improving functioning and reducing the symptoms. Some of the common forms of treatment here would include the use of medicines, application of various types of psychotherapy, appropriate training, and parental support and advice.

The medication of this psychiatric condition entails the use of stimulant and non-stimulant medications. Whereas stimulants medications would include medicines such as amphetamines and methylphenidates, non-stimulant medications would include guanfacine, atomoxetine, and clonidine.

As Barkley and Murphy (1998) observe, the main reason why stimulants are used to treat the disorder is because they are effective in activating the parts of the human brain that supports focused behavior and attention. Apart from improving the ability to focus and be able to pay attention, these medications are also known to play a significant role in improving the physical coordination of the victims.

Despite the many benefits associated with stimulant ADHD medication, there is also a number of associated side effects, and these would include headaches, sleep disorders, irritability, mild stomachaches, lowered appetite, and anxiety. However, these side effects can be addressed using appropriate interventions. For example, healthy meals can be introduced where decreased appetite has been observed, while a consistent sleep routine that comprises of a soothing environment could be of great help here.

Apart from the stimulant and non-stimulant medications discussed above in the above sentences, different forms of psychotherapy intervention are also applied to treat Attention-Deficit Hyperactivity Disorder. The main aim of these behavioral therapies is to help the victims change their behavior.

This intervention usually entails conducting practice assistance on victims, such as engaging them in emotionally challenging tasks or activities. A good example here is helping them organize their tasks and complete school assignments in time. Another important benefit of behavioral therapy is that it plays a crucial role in helping ADHD children monitor their behavior.

In this regard, therapists commit themselves to teaching children all manners of social skills, such as how to engage others in peaceful play, ask for assistance, and report a situation to their teachers or any other person who plays a role in their lives. According to Davidson (2008) therapy is also a stress-management technique which can be applied parents and guardians to diversify their own capabilities of dealing with frustrations, thus enabling them to deal with their children’s behavior in a calm way.

Therapy may also be extended to the entire family members to help them understand better and effective ways of handling disruptive behaviors as they are portrayed by their children who have been diagnosed with ADHD disorders. Even though these interventions may never completely eliminate behavioral symptoms from the affected children and adults, they do play a significant role in helping the victims learn new strategies of realizing their real purpose in life, thus living a successful life.

As it is observed from this paper, Attention-Deficit Hyperactivity Disorder or ADHD presents significant challenges to human development. As we all know, human development in almost all aspects of life is determined by a sound mind and in that case, a well-functioning human brain would be essential for a smooth human development.

As Rader, McCauley and Callen (2009) observe, given the nature of its implications on the human brain, Attention-Deficit Hyperactivity Disorder (ADHD) could be a serious problem of human development today, if it were not for the numerous interventions that have been made over the years.

As a matter of fact, most countries in the world have accepted Attention-Deficit Hyperactivity Disorder as a genuine psychiatric disorder, thus engaging in activities and initiatives aimed at ensuring that there is a successful management of the disorder in almost every part of the world.

Unlike in the past, where Attention-Deficit Hyperactivity Disorder was viewed as a behavioral problem resulting from environmental factors, modern studies have offered much sense about the development, diagnosis, and the treatment of the disorder using medications and psychotherapy, among other key interventions.

Improved knowledge on ADHD gained over the years, coupled with the use of valid and reliable diagnosis equipment and treatment approaches used to address the disorder has enhanced life in a great way, thus helping to solve key problems about human development.

This topic is important because it shades light on the many controversies surrounding HDAD as one of the major issues affecting human development today. Moreover, it clearly indicates the need for more studies on the matter, with a focus on introducing better ways of diagnosing and treating Attention-Deficit Hyperactivity Disorder in both children and adults.

References

Barkley, R. & Murphy, K. (1998). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment [and] A Clinical Workbook. New York: ERIC.

Biederman, J., Faraone, S., Spencer, T., and Wilens, T. (1993). Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. The American journal of psychiatry, 17(6), 48-52.

Campbell, S. (2000). Attention-deficit/hyperactivity disorder: Handbook of developmental psychopathology. Oklahoma: Springer Publishers.

Davidson, M. (2008). Literature Review: ADHD in Adults A Review of the Literature. Journal of Attention Disorders, 11(6), 628-641.

Gillberg, C., Gillberg, I., and Rasmussen, P. (2004). Co–existing disorders in ADHD — implications for diagnosis and intervention. European Child & Adolescent Psychiatry, 13(1), 80-92.

Khan, S., & Faraone, S. (2006). The genetics of ADHD: a literature review of 2005. Current Psychiatry Reports, 8(5), 393.

Lahey, B., Applegate, B., McBurnett, K., & Biederman, J. (1994). DMS-IV field trials for attention deficit hyperactivity disorder in children and adolescents. The American Journal of Psychiatry, 12(15), 46-50.

Mayes R, Bagwell C, Erkulwater J (2008). ADHD and the rise in stimulant use among children. Harv Rev Psychiatry 16(3), 151-66.

Rader R, McCauley L, & Callen, E. (2009). Current strategies in the diagnosis and treatment of childhood attention-deficit/hyperactivity disorder. Am Fam Physician 79 (8), 657–65.

Schatz, D., & Rostain, A. (2006). ADHD With Comorbid Anxiety A Review of the Current Literature. Journal of Attention Disorders, 10(2), 141-149.

Abstract

Impaired working memory is one of the factors associated with symptoms of ADHD. Recent studies have aimed at testing whether repeated training of the working memory (WM) and its improvement can ameliorate the symptoms of ADHD.

Whereas many studies have indicated the possibility of the beneficial effects of WM training on people with ADHD, critics have dismissed them on the basis of flawed research design and interpretation. Given the lack of consensus on this issue, cognitive approaches such as WM training are unlikely to replace traditional interventions for ADHD such as medical stimulants any time soon.

Working Memory in Attention Deficit and Hyperactivity Disorder (ADHD)

ADHD is common in school-age children and has been associated with negative development in social, emotional, academics as well as anti-social behaviors in adult life (Johnstone, Roodenrys, Phillips, Watt, & Mantz, 2010). Recent data indicate that ADHD prevalence rate has increased from the long held figure of 3 to 5% of school-age children but remains at 4 to 5% in adults (Antshel, Hargrave, Simonescu, Kaul, Hendricks, & Faraone, 2011).

Three subtypes of ADHD are recognized namely: hyperactive/impulsive subtype, inattentive subtype and the combined subtype (Toplak, Connors, Shuster, Knezevic, & Parks, 2008). Risk factors associated with variations in prevalence include age, male gender, chronic health problems , low socio-economic status as well as urban living (Antshel et al., 2011). This paper is an attempt to examine new congnitve approaches relating to working memory that empirical studies have proposed as potential intervention strategy for ADHD.

The view supported here is that even with improved working memory deficit ,cognitive approaches that result in such improvement are unlikely become stand-alone interventions but may serve to supplement traditional measures such as pharmacological interventions.

Working Memory in ADHD

The most widely accepted models explaining the cause of ADHD are those that attribute it to deficits in overall executive functions or various aspects related to these functions such as impaired working memory (Bidwell, McClernon, & Kollins, 2011).

This view is supported by high number of studies over the last two decades that have emphasised on impairement of executive functions such as inhibitory control and working memory (Toplak et al., 2008). By definition, working memory is the short-lived ability of the brain to retain information necessary to guide present and future behaviors (Mezzacappa & Bukner, 2010).

It is believed to be made up of three components : a visuo-spatial part for storing visual information, a speech component that handles verbal content and an executive section that directs attention and control of processes (Klingberg, 2007). Later, an additional component, an episodic zone was included. This new inclusion is thought to be a complex system that records serialized contents from visual , spatial and verbal domains of the greater working memory (Rasmussen, Treit & Pei 2012).

MRI investigations have revealed that persons with ADHD have atypical development in the brain’s prefrontal cortex, a region believed to be the nerve centre of executive functions considered critical in developing problems solving skills necesssary for attainment of future personal goals (Bidwell et al., 2011).

Working memory training and ADHD

The primary intervention measure for ADHD has been administration of medical stimulants such as methylphenidate and amphetamine. These have proved effective in arresting inattention, hyperactivity and impulsive behaviours, the major manifestations of ADHD.

However, due to unwanted side effects of these medications such as growth impairment, heart arythmia,and insomnia alternative treatments became desirable for parents and medical caregivers (Johnstone et al., 2010). Behaviour modification, operant conditioning and increasingly computer-based working memory training have emerged as possible alternatives to traditional drug-based interventions (Johnstone et al., 2010).

Working memory training is normally conducted by administration of working memory tasks involving verbal and non-verbal materials (Melby-Lervag & Hulme, 2012). These tasks are designed to evaluate how an individual retains information in active memory while distracted by external happenings in the surroundings (Melby-Lervag & Hulme, 2012).Verbal working memory task may involve requiring individuals to repeatedly process, retain and reproduce a much information as possible until a recall mistake is made.

In contrast, visual spatial working memory tasks may be simple in the sense of rotating pictures and the recalling of their positions. In my own perspective, am persuaded working memory training could emerge as a viable treatment option for developmental disorders. I find it a cheap and potentially side-effect free alternative that may gain widespread acceptance if its efficacy is established.

Empirical evidence for working memory training

Attention towards working memory grew out of the substantial empirical evidence showing that individuals with ADHD have marked impairment in working memory. It is imagined that getting to improve this memory might produce concomitant cognitive improvement in ADHD-related impairments (Melby-Lervag & Hulme, 2012).

Thus it was hypothesized that improved working memory would lead to beneficial effects in affected subjects that should be evident in terms of better language processing, faster speech co-ordination, reduced inattention, better long term memory and possibly improved academic performance.

These ideas are supported by various investigations showing that training the working memory can lead to enhanced cognitive deficits accompanied by a reduction in the primary symptoms of ADHD (Bidwel et al., 2011;Holmes et al., 2010; Mezzacappa & Bukner, 2010; Klingberg, 2007).

In a school based pilot study, Mezzacappa and Bukner (2010) employed a computer program to train the working memory of children with attention or hypersensitivity problems from economically challenged backgrounds. They were particularly concerned with teacher’s ratings of total ADHD symptoms during the study period.

Overall, there was improved teachers’ rating of total ADHD symptoms in participants taking the program compared to the control group and baseline values. The findings of this study are consistent with effects of cognitive training on working memory reported by other investigators.

Green and fellow researchers (2012) studied the extent to which WM training in ADHD would ameliorate a core dyfunctional behaviour associated with the disorder. In a randomized ,double blind ,placebo-controlled study, the effect of WM training using CogMed training program was compared to healthy control subjects in 26 children(aged 7 to 14 years old) diagnosed with ADHD (Green, et al., 2012). The active training group had 12 children while the placebo had 14.

The study involved intensive 25 sessions and Restricted Academic Situation Task (RAST) observation system was used to assess responses of participants upon completion completion of daily tasks (Green et al., 2012) . Alongside RAST, Conners Parent Rating Scale and standardized WM tests were used to measure improvement in the active training group (Green, et al., 2012).

Result showed significant differences between the placebo and the active participating group. There was also significant improment in WISC-IV WMI, a widely used WM measure in the active group than in the placebo. They concluded that WM training could be generalized to improve non-trained related impairment but called for specific trainings designed for additional impairements in larger samples in future (Green et al., 2012).

In similar vein, a combination of WM training and stimulant medication has been found to produce differential enhancement on WM impairments in children with ADHD (Holmes et al., 2010). Holmes et al.(2010) investigated the changes in WM of children with ADHD as a result of pharmacological intervention and WM training.

The study participants totalled 25 aged between 8 and 11 years old. Assessment was done in four phases within selected weeks for WM training using Cogmed Working Memory Training Program while medication was maintained throughout the study period (Holmes et al., 2010). Each child completed an average of 22 training sessions. Post study assessment was done 6 months after training. Consistent with previous investigations stimulant medications only significantly enhanced visuo-spatial WM performance.

On the other hand, training produced greater improvement in visuo-spatial and verbal components of WM as evident in reduced inattention and behavioural control (Holmes et al., 2010). Notably, from the follow up analysis, the training gains(visual spatial short –term memory, verbal WM and visuo-spatial WM) persisted over a 6-month period but their was no improvement in IQ score during and after the study period (Holmes et al., 2010).

Johnstone and fellow researchers (2010) examined the behavioural and psychological effects of concurrent computer-based WM and inhibition training for children with ADHD. In a pilot double-blind active-control design, 29 ADHD diagnosed children completed a 5-week home training program and a post-study session that involved assessment of overt behaviour, resting EEG, task performances, skin-tests and event related potentials during a go/no-go task.

Final results indicated improved attention and reduced hyperactivity in the active group (Johnstone et al., 2010). In conclusion, the researchers acknowledged the nascent nature of such outcomes and pointed out that although cognitive training indicated potential in treatment of WM impairment for ADHD, further research focussing on extensive training and response inhibition function are needed in the quest for affirming WR training as a viable treatment option for ADHD (Johnstone et al., 2010).

Klingberg and team (2002) used a double blind, placebo controlled design in evaluating the effect of intensive and adaptive training of working memory tasks on children with ADHD. The training lasted 24 days and each day the active group performed 25 minutes of training that involved visuo-spatial, backward digit span, letter span and go/no-go reaction tasks (Klingberg, Forssberg, & Westerberg, 2002).

They found that the training produced marked improvement in trained WM task and interestingly, non-trained visuo-spatial WM tasks (Klingberg et al., 2002). The study also atttributed a reduced motor activity realized in participants to the trainings.

These studies and numerous others indicate the great interest cognitive training in ADHD has generated. Even though not conclusive, I find them useful in providing explanatory knowledge about the diseases. They indicate the possibility that the workng memory can be manipulated.

Pharmacological intervention and cognitive training

There is also evidence indicating that the combination of medical stimulants and cognitive training produces more pronounced desirable cognitive outcomes in ADHD than either stimulant or cognitive training alone. This can inspire the imagination that future therapies against ADHD and related disorders could be made up of the two.

However, questions abound as to the change in medical stimulant to be implemented at such a time in relation to the present given that cognitive training do not form part of current treatments. Despite this uncertainty, it can be suggested that future better cognitive trainings on ADHD and related disorders producing far greater improvement in working memory could have far reaching implications on the kind of medical stimulant therapy that will be administered.

From the mid 20^th century, two stimulant formulations; amphetamine and methylphenidate have been associated with reduction in core symptoms of ADHD in majority of children making them the primary intervention approach (Bidwell et al., 2011; Johnstone et al., 2010). However, their efficacy has not been consistent in adults with ADHD although they still form an important part of therapeutic prescriptions for this group (Bidwell et al., 2011).

Despite mixed consensus, bias towards stimulant management of ADHD exits. This is attributed to the findings of the 1999 “Multimodal Treatment Study” of children with ADHD , considered by many to the most influential ADHD treatment study to date (Toplak et al., 2008, p. 803).

The study, which involved 579 children aged 7 to 10 years diagnosed with combined subtype ADHD and a follow up period of 14months found that medication management alone was significantly better than behavioural strategies or the combination of the two (Toplak et al., 2008). Although there was no consensus in the interpretation of the study’s data, it led many to favour stimulant medication intervention (Toplak et al., 2008)

Specifically some studies have also found that stimulants are more effective on non-executive functions tasks such as sustained attention than on tasks related to executive function such as inhibition, working memory and planning (Bidwell et al., 2011; Toplak et al., 2008 ;Klingberg et al., 2002 ).

Additionally, dose-response studies have shown that high doses of stimulants are needed to produce appreciable enhancements in domains such as attention, vigilance and working memory but the same is not the case in areas such as planning, cognitive flexibility, inhibitory control and motor speed (Bidwell et al., 2011).

Although there is no general consensus ,stimulants just like cognitive improvement therapies such as working memory training, have also been found to produce only short-term benefits in academic peformance. This calls for more research in this areas as academic performance is a serious challenge in majority of ADHD individuals.

In summary the above findings suggest that stimulants alone are not completely efficacious in ameliorating ADHD deficits. Given the beneficial effects (albeit preliminary) of WM training on cognitive development ,a combination of medical stimulants and cognitive trainings such as WM training perhaps represents a better treatment approach for ADHD. A possible predilection factor for cognitive trainings such as those targeting working memory is the high dose required for medical stimulants.

Given that such doses are likely to lead to new or much pronounced side effects in users, alternative treatments such as cognitive training could become more attractive. Furthermore, other pharmacological intervention drugs such as Atomoxetine and α 2 agonists have not yet yielded consistent cognitve improvement results in human population although they have already been approved by the FDA (Bidwell et al., 2011; Mezzacappa & Bukner, 2010; Klingberg et al., 2002).

Evidence against working memory training

The plethora of study evidence purporting the ameliorating effects of working memory training on ADHD has led to greater scrutiny of the design and findings of these studies. One such scrutiny published in the American Physiological Association website mid this year involved a meta-analysis of 23 peer reviewed studies that sought to evaluate the effects of memory training programs on general cognitive performance.

The researchers studied among other aspects, the study design ,measures and participants who ranged from healthy children, adults and ADHD children in the studies most of which were published within the last 10 years. In refuting the claims of these studies they cited small sample size, lack of control in some studies and limited generality of the benefits reported.

They concluded that the effects of memory training on cognitive development were only effective on tasks conducted during the training but did not produce any appreciable long term effect on general cognitive performance such as verbal, attention and scholastic improvement (American Physocological Association, 2012).

The above findings are also consistent with those of Shipstead and fellow authors (2012) who in a similar analysis found little evidence from similar studies for the association of WM training with better attention control, reduction in symptoms of ADHD and general fluid intelligence (Shipstead, Redick, & Engle, 2012). The authors offered that, for credibility, future related studies need to demonstrate that WM training and improvement transfer increases WM capacity.

A further related finding is from the analysis of 26 studies (6 cognitive-behavioral, 6 cognitive and 14 neural-based) that found the evidence of these approaches in ameliorating symptoms in ADHD insufficient (Toplak et al. 2008). The authors concluded that further investigations are necessary to determine the efficacy of these approaches on both cognitive and behavioural outcome measures (Toplak et al. 2008).

In my view, I find the analyses in the preceding paragraph uninformative as even authors of the studies analysed have themselves highlighted the inconclusive nature of their findings. However, these developments serve to cast doubts on the supposed benefits of WM training on cognitive development and by extension their theoretical and practical importance.

It also reveals that there is no general consensus among scientist on the effects of memory training on cognitive development in persons with attention disorders such as ADHD. Another challenge for ADHD remediation arises from the fact that ADHD has large comorbidity with other disorders.

This means that intervention strategies need to differentiate the underlying conditions and their related features. However, current literatures is lacking in explaining how different comorbidities influence traditional interventions or those with promising results but still under research. As researchers in this field have suggested, more rigorous study are needed before working memory training is considered a viable treatment alternative for ADHD.

Conclusion

Many studies have focused on working memory because it one of the central executive functions impaired in many developmental disorders such as ADHD. This approach is based on the idea that enhanced knowledge on the aspects of working memory in people with ADHD could be beneficial in the development of better intervention measures.

Similarly, many investigations have shown that working memory training can lead to short-lasting and durable reduction in symptoms of ADHD. On the other hand, scrutiny of these studies has led to their dismissal as inadequate and inexact.

The analysts contend these investigations are lacking in various critical aspects such as methodological design, sample size, and interpretation of data to mention just a few. Taken together, this mixed consensus can mean two things. One is that at least some form of artificial WM improvement is possible. The other is that more research is still needed to determine the efficacy of WM training and other cognitive strategies.

Although working memory impairment is a distinguishing feature in developmental disorders and conditions, the exact profile of the deficit in different affected individuals is still unclear. Available literature shows that this is one area many studies have failed to address. If the nature of the impairment is clearly understood, better interventions could be developed.

Lastly, due to the changing etiology and large comorbidity of ADHD with other disorders, its management is likely to remain as complex as it is today. Even with better correction of working memory deficit, stimulant medication and other interventions will likely still form part of treatment for the disorder.

References

American Physocological Association. (2012). Memory training unlikely to help in treating ADHD, boosting IQ. Web.

Antshel, K. M., Hargrave, T. M., Simonescu, M., Kaul, P., Hendricks, K., & Faraone, S. V. (2011). Advances in understanding and treating ADHD. BMC Medicine, 9, 72.

Bidwell, L. C., McClernon, F. J., & Kollins, S. H. (2011). Cognitive enhancers for the treatment of ADHD. Pharmacology, Biochemistry & Behaviour, 99, 262-274.

Green, C. T., Long, D. L., Green, D., Losif, A.-M., Dixon, F. J., Miller, M. R., et al. (2012). Will working memory training generalize to improve off-task behaviour in children with attention-deficit/hyperactivity disorder? Neurotherapeutics, 12(4), 120-124. Web.

Holmes, J., Gathercole, S. E., Place, M., Dunning, D. L., Hilton, K. A., & Elliot, J. G. (2010). Working memory deficit can be overcome: Impacts of training and medication on working memory in children with ADHD. Applied cognitive psychology, 24, 827-836. Web.

Johnstone, S. J., Roodenrys, S., Phillips, E., Watt, A. J., & Mantz, S. (2010). Pilot study of combined working memory and inhibition training for children with AD/HD. Atten Def Hyp Disord, 2, 31- 42. Web.

Klingberg, T. (2007). The concept of working memory. Web.

Klingberg, T., Forssberg, H., & Westerberg, H. (2002). Training of working memory in children with ADHD. J of Clinical and Exp Neuropsychology, 24(6), 781-791.

Melby-Lervag, M., & Hulme, C. (2012, May 21). Is working memory training effective? A meta-analytic review. Development Psychology, 28(2), 282-299. Web.

Mezzacappa, E., & Bukner, J. C. (2010). Working memory training for children with attention problems or hyperactivity: A school-based pilot study. School Mental Health, 12(3), 109- 127. Web.

Rasmussen C, Treit S, Pei J. (2012). Memory interventions for children with memory deficits. In J. Stone & M. Blouin (Eds.), International Encyclopedia of Rehabilitation (pp. 34-36). New York, US: CIRRIE. Web.

Shipstead, Z., Redick, T. S., & Engle, R. W. (2012). Is working memory training effective. Psychological Bulletin, 26(2), 122-133. Web.

Toplak, M. E., Connors, L., Shuster, J., Knezevic, B., & Parks, S. (2008). Review of cognitive , cognitive-behavioural, and neural-based interventions for ADHD. Clinical Psychology Review, 28, 801-823.

Introduction

The diagnosis of Attention Deficit Hyperactivity Disorder has increased over the recent years. It is one of the most common diseases in children and young adults.

The diagnosis of ADHD has drawn a lot of attention from scientific and academic circles as some scholars argue that there are high levels of over diagnosis of the disorder. Gifted children and ADHD children display similar characteristics. It is also quite difficult to diagnose the disorder in adults. The difficulty in diagnosis is also compounded by the fact that some children have ADHD with other disorders.

There are also concerns on the high prescription of stimulant drugs given to children who are very young. This is an area where a lot of research has been conducted to find out the causes, prevalence and effective treatment methods. There is however need for further research to address the controversies in the diagnosis and treatment of ADHD since it affects children. The long term effects of stimulant medication could have serious repercussions in adult life.

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder is a condition that is common in children and young adults. The symptoms of ADHD include patterns of inattention, impulsiveness and hyperactivity. The ADHD prevalence is high between 5 and 15% in children who go to school. The DSM-IV diagnostic tool is used to evaluate whether an individual has ADHD.

A person must display at least six of the nine inattentive and hyperactivity behaviours for a period of more than six months. The behaviour must be more severe or common comparable to people of the same stage in development. Behaviours that display inattention include difficulty in organizing tasks, forgetfulness, losing school items, failing to finish given tasks and avoiding mental tasks.

The individual may also be easily distracted or has difficulty in sustaining attention. The behaviours that display impulsiveness and hyperactivity include restlessness, impatience in waiting for their turn to speak and fidgeting. The behaviours should be noticed in the child before he is seven years old. It should also be demonstrated that the behaviours are interfering with the social, occupational and academic functioning of the child.

It is important that the disorder be diagnosed correctly. Lack of diagnosis presents various problems to the child. In adult life the individual will also have challenges. In academics, the child experiences learning disabilities in reading, spelling and performing math calculations.

It has been noted that children with ADHD are more likely to repeat a class, drop out or be suspended or expelled in school. Research studies have also indicated that these children have a high likelihood of being in automobile accidents or getting hurt physically while playing.

Analyses of diagnosis both in the USA and UK have shown that the disorder is more prevalent in boys than girls. Once the individual is an adult and the disease has not been treated, the person will have high levels of difficulty in employment, relationship challenges due to display of anti-social behaviour, driving offences and increased incidences of crime or substance abuse (Kuo and Faber, 1580). It is not a newly diagnosed disease as it has been treated for the last 100 years.

Under diagnosis of the disorder may be caused by various factors. There may be lack of awareness by the parents and teachers on what could possibly be the problem with the “difficult” child. There is also social stigma associated with mental conditions. The parent may fear taking the child for diagnosis as he does not want to be labelled “a bad parent.” Finally, the parent may not want to expose the child to consistent medication at such a young age.

Causes of ADHD

There are several factors linked to the development of ADHD in children. The main cause of the disease however is unknown. First of all, the disorder may be genetic. Research studies conducted on twins, families and adopted children have shown that the disorder is highly inheritable.

There are specific gene variants that have been identified that are involved in dopamine neurotransmission. There has also been evidence of brain dysfunction in individuals with ADHD. The researchers have used several cerebral imaging studies such as functional magnetic resonance imaging and single photon computed emission tomography. Many of the results have indicated that the prefrontal cortex and basal ganglia are affected (Kuo and Faber, 582).

Recent research studies have also indicated that children with ADHD have smaller cerebrum, grey and white matter volumes compared to non-ADHD children. The fact that pharmacological treatments especially stimulants have proved to be the most effective or superior treatments for ADHD also points to biological causes of ADHD. The stimulants increase the levels of extracellular dopamine.

ADHD may also be caused by neuropsychological functioning. Various studies have shown that children with ADHD have specific and global deficits in comparison with non-ADHD children.

There have been arguments that there may be psychosocial and environmental factors that increase the prevalence of the disorder. This is due to the fact that the condition has been identified more in the Western than non-Western countries. This has been contested by the fact that there is no evidence to suggest that the disease has become more prevalent. It is only that there have been higher cases of diagnosis and not prevalence.

Controversies in ADHD Diagnosis

The diagnosis of the disease is complicated by the presence of other co-morbid psychological disorders in addition to ADHD in an individual. These disorders have similar symptoms with ADHD such as social awkwardness, risk-taking characteristics and impulsive behaviours.

These disorders include diseases such as Conduct Disorder and Oppositional Defiant Disorder. There is also lack of formal diagnostic criteria for older children and adults. Diagnosis therefore presents a huge challenge to the primary care and family practice physicians (Kube, Petersen, and Palmer, 462).

There have also been concerns that there are high levels of over diagnosis of ADHD. There are several factors that could lead to over diagnosis of ADHD. First of all the physicians want to prevent the negative consequences associated with ADHD in the event of misdiagnosis.

The drugs for treating the disorder are also readily available in the market and thirdly there has been a lot of media coverage on ADHD and the pharmacotherapy treatment methods for the disorder. It has been argued that the stimulant drug companies have been using the teachers and physicians as their salespeople to aggressively sell the drug with their diagnosis.

The companies are interested in making a profit. It has been estimated that the money brought in by the sale of stimulants is $670 Million annually. The tactics used by the ADHD drug company are also very alluring. They love mentioning the fact that famous people such as Einstein, Picasso and Michelangelo also had the disorder so as not to alarm the parents.

There are also negligent parents who may not want to work hard and develop strategies to handle their children in these active ages. They want a way out even if it will involve the administration of drugs. These parents should be able to use alternative approaches to handle their children such as behavioural therapy approaches, counselling for the family and parental advice.

It has also been argued that the current educational system is facilitated by children sitting for long periods of time just listening to the teachers. The passivity and conformity levels expected of a child causes him to be restless and inattentive after some time. Interestingly some of the symptoms associated with ADHD are behaviours that are basically prevalent in children at a certain age. They are forgetful and fidget a lot.

Their attention spans are for a limited period of time. It is argued that a disease has been invented as an excuse for children failing to do their homework and chores at home. There could also be a challenge with the assessment procedures. When the physician is diagnosing a child, he is supposed to use multi-method approaches in order to ensure that the diagnosis is correct.

There should be interviews with the child, teacher and parent. There should also be a review of the child’s school records and physical observation of the child for a suitable period of time. Research studies have indicated that only 15% of the physicians use all the recommended approaches.

Many of them only rely on the clinical interviews while others do not use the standard instruments in assessment (Sciutto and Eisenberg, 108). There is therefore a danger in misdiagnosing a gifted child as one having ADHD. Gifted children have similar characteristics with ADHD symptoms.

They are usually intense when it comes to things such as relationships, sibling rivalry, responding to authority and mental tasks. They are also very hyper and restless. They tend to question the status quo a lot as they see numerous possibilities or alternatives. They are also very sensitive and easily moved to tears. It is a catastrophe when gifted and normal children are diagnosed with ADHD and put on medication.

The qualities of gifted children are appreciated in business settings especially on technical tasks. It is sad that when such qualities are displayed in children it becomes an issue that needs to be addressed. The gifted children could be restless as they wait for the other children to catch up. They should not be penalized.

Treatment of ADHD

The disorder is mostly treated by the administration of stimulants such as Ritalin (methylphenidate) in recommended doses. It addresses the condition by activating the central nervous system which includes the brain. It has been noted to reduce hyperactivity and impulsiveness. It also helps the children sustain attention in their school while being taught and doing their assignments. Due to the side effects associated with stimulants, researchers have advocated for other treatment methods that are natural in nature.

A research study was conducted on children with ADHD across different ages, gender and income groups. There were two treatment strategies. Some of the children were engaged in green outdoor activities while the others were subjected to indoor and built outdoor activities. The results indicated that the green outdoor settings for after-school and weekend activities reduced the ADHD symptoms after considerable time regardless of the age, gender and socio-economic class of the children (Kuo and Faber, 582).

The researchers argue that the symptoms of attention fatigue and ADHD are similar. Interestingly, ADHD is regarded as a disorder while attention fatigue is a temporary condition where once the person rests he will be fine. They therefore advocate for after-school and weekend activities in a naturalized settings where the children can get rejuvenated.

Controversies in treatment of ADHD

There have been controversies in the treatment of ADHD as several scholars are concerned with the high levels of stimulants being consumed by children. There is a perception that ADHD is being over diagnosed leading to high levels of stimulant consumption. Research conducted on Ritalin prescriptions in the 1990s showed that the prescriptions for the children aged between two and four years had tripled during this period (Zuvekas, Vitiello and Norquist, 580).

The use of the stimulant had increased by over 6% in America during the same period. It is an area of concern since 6% of the people diagnosed with ADHD are very young children. There have been arguments that the stimulants do not have significant side effects in the children which have been refuted.

There are research studies that have showed stimulants have side effects such as insomnia and anorexia. The stimulants are also being abused by teenagers. There are children and teenagers who are taking the drugs to enhance their cognitive performance yet they do not have ADHD (Mayes, Bagwell and Erkulwater, 155).

This is dangerous as the possible long term effects of the stimulant abuse have not been fully investigated. Researchers are concerned with long term side effects such as cardiovascular effects, reduced growth rates and carcinogenic effects. There have also been arguments against the effectiveness of the stimulant drugs in children by teachers.

There are teachers who feel that the drug makes the children have a zombie look in their eyes. It has also been noted that at times the drug causes the children to become withdrawn and isolated. They are over-interested in tasks that are boring and non-inspiring. It is argued that the drug suppresses the part of the child’s brain that assists with creativity, energy and freedom. Different scholars have suggested consideration of different treatment methods that do not require stimulants.

Conclusion

The discussion shows that ADHD is a serious condition that affects the academic and social development of a child if not treated. The symptoms will cause more problems to the individual even later in life. Physicians should adequately diagnose otherwise there will be over diagnosis.

Young children will be exposed to consistent doses of stimulants at a young age. There needs to be more research carried out on the use of adequate instruments in the diagnosis of ADHD. What mechanisms should be employed to ensure that the physicians carry out the assessments properly to prevent misdiagnosis and over diagnosis?

There needs to be further research on alternative treatments of ADHD. Currently, stimulants have been found to be the most effective. More research also needs to be carried out on the diagnosis of ADHD in adults in order to address adults with social and employment challenges.

Works Cited

Kube, David, Mario Peterson and Fredrick Palmer. “Attention deficit hyperactivity disorder: Comorbidity and medication use”. Clinical Paediatrics, 41(2002): 461-469. Print.

Kuo, Frances and Andrea Faber. “A Potential Natural Treatment for Attention-Deficit/Hyperactivity Disorder: Evidence from a National Study.” American Journal of Public Health, 94.9(2004): 1580-1586.

Mayes, Rick, Catherine Bagwell and Jennifer Erkulwater “ADHD and the Rise in Stimulant Use among Children”. Harvard Review of Psychiatry 16(2008):151–166. Print.

Sciutto, Mark and Michael Eisenberg. “Evaluating the evidence for and against the over diagnosis of ADHD”. Journal of Attention Disorders, 11(2007): 106-113.

Zuvekas, Samuel, Benedetto Vitiello and Grayson Norquist. “Recent trends in stimulant medication use among U.S. children”. American Journal of Psychiatry, 163(2006): 579-585. Print.