ADHD, Research Paper Example

What Is ADHD?

George’s son had always been a bit hyper. He was frantically playing with his toys, breaking them and nothing could hold his attention for a while. He was also unaware of the dangers around him…like just throwing himself in the middle of a crowded road. It was exhausting for the parents, and they shunned of the activities of their boy thinking that it was natural for the boys to have this nature. However when he grew inattentive and disruptive even at the school, the teacher suggested an evaluation of Attention Deficit Hyperactivity Disorder (ADHD).

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (4th edition, 1994), defines ADHD “as the ‘core’ signs of inattention, hyperactivity and impulsiveness,” while International Classification of Diseases describes it as ‘hyperkinetic disorder’ in the 10th revision of the (WHO, Geneva, 1992).

The Background on the Disability ADHD

For decades, the symptoms of inconsistent behavior, chronic restlessness and impulsive actions were characterized by childhood behavioral patterns of ADHD. There was little research on ADHD and how it was different from hyper active yet normal behavior of children. There was no clear definition or demarcation between the thin lines of “hyperactive” or “abnormal” behavior. Thus the disease went undiagnosed. Gradually the disease gained momentum and received different connotations.

In 1902, the first case relating to the disorder was documented which related to impulsive behavior. Dr. Still diagnosed this behavior in Britain and named it “Defect of Moral Control” and considered that the patient had a peculiar disorder beyond medical control. The next evidence of such symptoms were attributed the name “Post-Encephalitic Behavior Disorder.” The next case was registered in 1937, under the supervision of Dr. Charles Bradley. He introduced the use of stimulants to treat hyperactive children, and in 1956 Ritalin was formulated as the medicine to treat hyperactivity.  Thus the major symptom which detected abnormal behavior was hyperactivity. However, at the end of the decade, the disorder got the name of “Hyperkinetic Disorder of Childhood.” In 1970, the number of cases grew and the doctors recognized that there were certain other symptoms like ‘paying attention or listening to teachers’. Thus the focus changed from exclusive hyperactivity to inattentive behavior, restlessness and impulsive activity and gave a major change in the paradigm of the disease and its diagnoses.

Thus now after the symptoms of inattentive nature, impulsiveness were added in the list of characteristic symptoms of ADHD, and in 1980 the disease got its current name Attention Deficit Disorder and the American Psychiatric Association (APA) documented ADD and ADHD as two different diagnoses. In 1987, ADD transformed into ADHD and was noted as a medical diagnosis rather than a psychological disorder by the APA. New research further highlights ADHD symptoms which neuropsychologists term as impairment of executive functions. These are essentially ‘brain’s cognitive management functions’, the parts or the circuits which control and prioritize, mitigate and synchronize other cognizant functions.

Methods of Diagnosis

ADHD has been divided in three subgroups:

1. The combined Type: The patients are inattentive, hyperactive and impulsive
2. The Inattentive Type: The patients are basically inattentive but does not show signs of hyperactivity or impulsiveness
3. The Hyperactive/Impulsive Type: The patients suffer from hyperactivity/ impulsivity rather than being inattentive.

There are no diagnostic laboratory tests for the disease. It is based fully on evaluation of symptoms. Medical tests are needed to be done to know whether the disease actually persists and also to identify the category of the disease for treatment. The most prevalent diagnostic tool is Clinical interview. ADHD affects all age groups but is diagnosed in childhood. The symptoms are studied and diagnosed in the Clinical interview and includes: family history, academic and family environment, emotional and social influences and level of development. Various psychological tests are also performed like: For Children – The Conner’s’ Parent and Teacher Rating Scale; for teenagers – The Brown Attention Deficit Disorder Scale (BADDS).

Symptoms: In children at the age of 5 years the soft signs of ADHD appear like: difficulty in coordination, the involuntary movement of the eyes (nystagmus), and impaired visual –motor problems (also known as hand-eye coordination).

Possible treatments: Since the disease was based on evaluation, doctors differed in their treatment approaches until Dr. Gephart in a joint initiative by National Initiative for Children’s Healthcare Quality and the Robert Wood Johnson Foundation made a set of formulations and guidelines for the pediatrics to diagnose and treat ADHD. It is mostly treated in a combination therapy of medication as well as behavioral changes. The parent works in tandem with the advice of the doctor to help the child control his own behavior. The medications used are mostly Stimulants, Non Stimulants and Antidepressants. While in Behavior therapy, attempts are made to change and stabilize the behavioral patterns of the child by adjusting the environment of his school, home and his social circle.

Classroom Teaching of ADHD Learning

A quote from Henry Adams, “A teacher affects eternity; he can never tell where his influence stops.” Teachers play one of the major roles in the life of an ADHD child. In one of the Bollywood films, which even competed for the Oscar nominations, “Tare Zameen Par”, there is a great revelation of the teacher student relationship. It characterizes the teacher as a guiding force in the life of the child and how his fun teachings strategies and easy interpretations made the child win over the disease. With my personal experience, I feel it is difficult at the foremost to manage a ADHD child but is lot easier with time and developed relationship.

Yes, once you meet the child who answers you while looking at the ceiling, and replies to your question: what is the color of your hair? Huh, this is my pencil. So do not be perturbed by their activity. The criteria required for studying in the class like: attention, concentration and following instructions are difficult for the ADHD children to adapt, not because they do not want to do so but are their brains would not let them do so.

What are the classroom challenges faced by the teachers?

1. They are inattentive and absent minded. Many of them find the characters are flowing or running and they cannot categorize A-Z of the alphabetical order. So the alphabets A and E are almost same to them. Thus have tremendous learning difficulties and the teachers need to divert more attention to them.
2. They are negligent in writing down their homework, they are not able to take notes and since alphabets have no meaning to them, reading their work is a real problem.
3. They fail to comply with stand alone projects
4. Does not concentrate and may even jeopardize class activities

What makes the situation worse? When teachers are stressed to handle the activities of the extraneous child, they often opt for punishments and scolding, resulting in further aggravation of the problem. Thus “the primary purpose of a school is to guide the child’s discovery of herself and her world and to identify and mature the child’s talents. Just as each seed contains the future tree, each child is born with infinite potential.” The teachers should assume the role of gardeners instead of being potters in molding the future of these children.

The successful integration of the techniques of psychological teaching, accommodation, instructions and intervention help the ADHD children to learn better and develop the core method of controlling his emotional self.

• The Psychological Teaching Method

1. Focus on the strengths of the ADHD child
2. Boost his/her self confidence
3. Tame his hyperactive spirits
4. Discover the child’s hidden talents
5. Help the child to find his right vocation in the discourse:
6. Observe the tendencies of the child
7. Have fun while learning:
8. Teacher should be affectionate and patient:

• Accommodation

1. Seating: The ADHD students should be seated away from the windows and doors so that they are not distracted.

1. Always try to put the child close to your desk, in front of your desk so that you can observe closely his activities.
2. Seating should be row wise not in round tables so that there is a constant teacher student eye contact.

• Information Delivery

1. The instructions should be broken in parts and one at a time.
2. Work on difficult assignments in the morning
3. Diagrams, visual display, colors, music, pictures are the best tools for teaching.
4. Give them an outline of the home work so that they learn to organize and synchronize.
5. Create special worksheets for them with fewer items so that they don’t feel confused.
6. Give them occasional quiz, puzzles to solve
7. Reduce the number of time tests which creates pressure on their brains
8. Give the ADHD students more fill in the blanks
9. Help them track their work by using bookmark or pointers
10. Always give credit to their work

• Teaching Pattern

1. Use Short Segments: Break the lessons in parts and sub parts, this will help the student from being attentive and increase his concentration on the subject. Keep in consideration that the lessons should be allocated a few minutes, and make them more colourful with music, colour, rhythm and involving partial playing activities.
2. Give them short, easy and achievable goals: Give them homework or projects which are easy and short. This would give them the inertia to complete their work and once the work is achieved it would boost their self confidence.
3. Repetition: Repeat the sentences, words and assignment details. Help them absorb the content or the project in their minds and let four different students repeat it and then let the class talk about it in unison and then put it on board.
4. Make the learning a fun: Let the ADHD students enjoy as they learn. Don’t make the studies be a burden to them and help them learn the work in fun. This will greatly help them to cope with the excess stress of education. Divide the chapters in a game display board..like in Mathematics, draw the trains that is coming at different speeds and calculate their distance.
5. Signal the start of a lesson: Always start a lesson with a aural cue so that he becomes immediately attentive.
6. Set unobtrusive clues: The teacher should set up unobtrusive clues with the ADHD child, like a pat on the shoulder or placing a sticker on the table of the child to remind him of the assigned task.
7. Let the child play with a Koosh ball or some soft toys that will not make any noise in the class.
8. Let the student take multiple breaks.
9. Do not allocate difficult tasks to him
10. Do not embarrass him before the class or in public.
11. Teach them in the method of stories

Thomas Edison, Pablo Picasso, Albert Einstein and Winston Churchill all suffered from ADHD at some point of time in their lives. However, proper guidance, love and proper channelization of their talents made them what they are. Thus teachers are the building block in their traumatised lives and a bridge between the hypothetical and reality.

Reference

Martha Bridge Denckla,, InAttention Memory and Executive Function,

Thomas E. Brown, Attention Deficit Disorder: The Unfocused Mind in Children and Adults.

Londrie, Keith, (2006)”History of ADHD.” History of ADHD

Movie: Taare Zammen Par, (2007) last Retrieved On November 13, 2009 from http://wplay.wordpress.com/2007/12/28/aamir-khans-taare-zameen-par/

Biederman J (1998). “Attention-deficit/hyperactivity disorder: a life-span perspective”.The Journal of Clinical Psychiatry

Ramsay, J. Russell. (2007) Cognitive Behavioral Therapy for Adult ADHD.

Nair J, Ehimare U, Beitman BD, Nair SS, Lavin A (2006). “Clinical review: evidence-based diagnosis and treatment of ADHD in children”.

Van Cleave J, Leslie LK (August 2008). “Approaching ADHD as a chronic condition: implications for long-term adherence”. Journal of psychosocial nursing and mental health services.

National Association of School Psychologists (NASP) http://www.nasponline.org

American Academy of Pediatrics (AAP) http://www.aap.org

National Attention Deficit Disorder Association (ADDA) http://www.add.org

hildren and Adults With Attention Deficit / Hyperactivity Disorder (CHADD) http://www.chadd.org

Adult ADHD: Evaluation and Treatment in Family Medicine by HR Searight, Ph.D., JM Burke, Pharm.D. and F Rottnek, M.D. (American Family Physician November 1, 2000, http://www.aafp.org/afp/20001101/2077.html)