Understanding Attention Deficit/Hyperactivity Disorder (ADHD) - Research Paper Example

?Understanding ADHD For such a long time, children who cannot sit still in will not stop talking and are often disruptive in have been labelled as ADD, short for Attention Deficit Disorder. Over time, the word “hyperactivity” was inserted in the term, making it Attention Deficit/Hyperactivity Disorder due to the over-activity manifested by several of these children. In order to treat this disorder, much discussion on whether these children should be treated with stimulant medication, which ironically, has the opposite effect of calming down overactive bodies and brains, should be administered to them. However, recent studies have yielded findings on how medication treatment actually works in the brain along with some other interventions in managing this disorder. This paper gives an overview of ADHD from its definition to some interventions used to help children manage this disorder so that they will function well in society. It is important to understand the underlying causes of this disorder so that children who have it will not be misjudged as “bad” or “misbehaved”, but instead, overcome by a disorder that they may not have control. Attention Deficit/Hyperactivity Disorder (ADHD) is a behavioral disorder characterized by inattention, impulsivity, and hyperactivity (American Psychological Association, 2000). It is complex syndrome of impairments related to the development of brain cognitive management systems or executive functions. It affects a person’s organization skills, concentration, focus and prolonged attention on a task, processing speed, short-term working memory and access recall, sustained motivation to work and the appropriate management of emotions. Brown (2007, p. 24) has enumerated the executive functions of the brain that work together in various combinations as thus: Activation – the process of organizing, prioritizing and activating for work Focus – focusing, sustaining and shifting attention to tasks Effort – regulating alertness and sustaining effort and processing speed Emotion – managing frustration and modulating emotions Memory – using working memory and accessing recall Action – monitoring and self-regulating action Typically, ADHD symptoms manifest in early childhood before age seven. The prevalence of ADHD is about 4% to 8% of the population in school age children (Erik and David, 2008). Most symptoms are observed in the school setting. Due to the fact that the behaviors that define inattention are related to academic activities, classrooms require children to focus their attention and demonstrate self-application and self discipline (Jensen, et al, 1999; Hawkins, Martin, Blanchard & Brady, 1991). However, AD/HD may or may not be accompanied by hyperactivity or other readily observable symptoms. Some students may appear to be paying attention to the discussion in class but they are actually drifting off and thinking of unrelated things. Others may be diligent in reading assignments but shortly after, will be unable to recall what had just been read. Brown (2007) has identified three specific groups of students with ADD that tend to be overlooked namely the bright students, female students and students under stress. Bright students who underachieve are merely thought of as lazy, as it seems inconsistent to think that one is bright and at the same time have significant ADD impairments. ADD is indeed possible to affect all IQ levels. Female students with ADD may be harder to spot because young girls do not generally call attention to themselves with dramatic misdemeanours. Students under stress like those affected by social stressors such as divorce, unemployment, poverty and multiple relocations, are believed to perform poorly due to such stressors. Recent research on AD/HD gives evidence that it is not a problem of will power but a chronic impairment in the chemistry of the management system of the brain. Brown (2007) reports that there is much evidence to show that ADD is a heritable disorder with impairments in the release and reloading of two crucial neurotransmitter chemicals made in the brain: dopamine and norepinephrine. These chemicals play a significant role in facilitating communication within neural networks that facilitate cognition (Brown, 2007). Certain medications have been manufactured to compensate for the inefficient release and reloading of essential neurotransmitters at countless synaptic connections in the brain. Individuals with the ADHD disorder have experienced remarkable improvement in their functioning when they are treated with appropriate doses of such medications. These medications alleviate symptoms only for the time when the medication is active in the brain, thus helping the individual in most self-management tasks. For children, management of ADHD should not be limited to medication and should be given a combination of interventions. Harlacher, Roberts & Merrell (2006) identify some Behavioral and interventions for managing ADHD as follows: Contingency Management; Therapy Balls; Self-Monitoring; Peer Monitoring and Instructional Choice. Academic Interventions include: Classwide Peer Tutoring; Instructional Modification and Computer-Assisted Instruction. Contigency Management is the application of consequences that are contingent on identified behaviors. To increase the frequency of appropriate behaviors, positive reinforcement is given every time they manifest it. For example, students earn tokens or chips for certain behaviors exchangeable for greater reinforcers, praising when they are attentive as well as removal of such reinforcers on inappropriate behaviors (Harlacher, Roberts & Merrell, 2006). Another effective intervention is the use of Therapy balls as the child’s seat, as they need to concentrate and sit still in order to balance themselves on such balls. Self-monitoring involves agreed upon behaviors that the student will monitor himself (ex. Completion of task, attentiveness, talking out) and self-evaluate to indicate how well he has performed. If the student matches his rates with the teacher’s evaluation, he is rewarded. This happens until the teacher fades out her own evaluation and the student relies on his own realistic evaluation of his behaviors. Peer Monitoring involves students monitoring each other and reinforcing positive behaviors. Instructional Choice is the provision of choices to the student as to which activity he prefers to do, or the schedule of what comes first or last in his task list. Being given choices makes the child feel powerful over some things, as he needs to commit to his own choice. In terms of gaining academic skills, one intervention is class-wide peer tutoring. Students are paired, provided the curriculum materials and take turns tutoring each other. To further reinforce the effectiveness of peer tutoring, points may be earned for correct answers, successful error correction and correct procedures (Harlacher, Roberts & Merrell, 2006). Another strategy is instructional modification wherein the student’s tasks are modified into shorter ones so he can easily complete them because they are more manageable and not overwhelming for his challenged attention span. Finally, computer-assisted instruction (CAI), a popular intervention among students today, makes use of computer-based software programs designed to supplement the teacher’s instruction while providing additional academic material. All these interventions have been found to decrease inattentiveness of students with ADHD as well as help them complete their tasks with more accuracy. It has also been found to decrease hyperactivity, disruptive behavior and increase their compliance to directions (Harlacher, Roberts & Merrell,2006) . It just goes to show that having ADHD is not a hopeless condition if there is enough support and patience for the diagnosed child. He can still function well in a mainstreamed environment. References American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev,). Washington, DC: Author. Brown, T.E. (2007) New approach to attention deficit disorder, Educational Leadership Feb. 2007 Erik & David, 2008 Harlacher, J.E., Roberts, N.E., Merrell, K.W. (2006) Classwide interventions for students with ADHD. Teaching Exceptional Children. Nov/Dec 2006 Council for Exceptional Children Hawkins, J., Martin, S., Blanchard, K. M., & Brady, M. P. (1991).Teacher perceptions, beliefs, and interventions regarding children with attention deficit disorders, Action in Teacher Education,13, 52–59. Jensen, P. S., Mrazek, D., Knapp, P. K., Steinberg, L., Pfeffer, C., Schowalter, J., et al. (1999). Cultural issues in diagnosis and treatment of ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1591–1597. Read More