Attention Deficient Hyperactivity Disorder (ADHD)

Attention Deficient Hyperactivity Disorder (ADHD)Group 5: Artee Sharma, Alejandra Alanis, Gianna Tajadillo-Strong, & Nazia Nazir

Middle Childhoodages 6-11Middle-aged children tend to face many developmental changesDuring this developmental period, many children begin to take initiative when it comes to learningChildren acquire fundamental skillsi.e. reading, writing, arithmetic, and self-awarenessChildren begin to realize that studying and practicing help improve performance in schoolMost importantly, during this developmental stage children begin to seek information, analyze information that is given to them, and apply that information to solve problems or cope with new situationsIndustry vs. InferiorityThe stage in development where children learn to be competent or productive or feel inferior and unable to do anything wellIf not given the opportunity to be productive in their learning, children can develop a sense of inferiority which can suppress the healthy development of the child in social, emotional, and intellectual aspects of life

What is ADHDAccording to theNational Institute of Mental Health:Attention Deficit Hyperactivity Disorder is a common childhood brain disorder that can continue onto adolescence and adulthood (Attention Deficit Hyperactivity Disorder, 2012).

Three Types of ADHDPredominantly Inattentive TypePredominantly Hyperactive - Impulsive TypeA Combination Type

The symptoms a person experiences inform them of the type of ADHD (Roth, 2013)

SymptomsInattentiveEasily bored, confused, and/or distractedDifficulty completing a task or starting something new unless it is enjoyableDifficulty following instructionsOften misplaces items

HyperactiveFidgety/trouble staying still they must constantly be in motionDifficulty staying quiet

ImpulsiveImpatientInterruptive

(Attention Deficit Hyperactivity Disorder, 2012)6CausesExact cause is not knowStudies show that genes play a large roleADHD most likely results from a combination of factorsGeneticsEnvironmental Brain InjuriesNutritionSocial Environment

(Attention Deficit Hyperactivity Disorder, 2012)

Risk FactorsGeneticsGenes are the blueprints of lifeTwin studies show that ADHD runs in familiesResearchers look at several specific genes that increase risk of developing the disorderEnvironmental Link between cigarette smoking and alcohol use during pregnancy and ADHD in childrenExposure to high levels of lead in preschoolersBrain InjuriesChildren who suffered a brain injury display behaviors similar to those of ADHD children (Attention Deficit Hyperactivity Disorder, 2012)

Too Much Sugar?Common theory that refined sugar leads to ADHD or makes the symptoms worseResearch discounts this theory in several studiesExample: Researchers gave children foods containing either sugar or a sugar substitute every other day. The children who received sugar showed no different behavior or learning capabilities than those who received the sugar substitute ("Attention Deficit Hyperactivity Disorder, 2012).

9DiagnosisSymptoms usually appear early in life between the ages of 3-6Diagnosis is hard since the symptoms vary amongst childrenParents first notice that their child loses interest in things quicker than other childrenTeachers first notice that children have trouble following directions and/or frequently spaces outThere is not a test to diagnosis ADHDHealth professionals gather information about the childs behaviors, environments, first meetingsPediatricians usually refer the family to a mental health specialist (Attention Deficit Hyperactivity Disorder, 2012)DiagnosisChildren get distracted, act impulsively, and struggle to concentrate at one time or another are normal factors that are mistaken for ADHD symptomsMental health specialists try to rule out other issuesLook to see if the child has any previous/current medical problemsCheck school medical records to determine the stress level at school and homePay close attention to a childs behavior in different situationsDiagnosed based on the DSM-VChildren must have at least 6 symptoms from either criteria (inattention, hyperactivity, & impulsivity)Older Adolescents must have at least fiveFor DSM-V several of the symptoms must be present before the age of 12 (Attention Deficit/ Hyperactivity Disorder, 2013)

Treatment - Psychotherapy Can be used as a sole treatment or with medicationsResearch has proven psychotherapys effectivenessPsychotherapy: The child is provided with coping mechanismhelped by talking about upsetting thoughts/feelings, exploring self-defeating patterns of behavior, learn alternative methods to handle emotions, etc.Can help families to better handle disruptive behaviors, promote change, & improving their childs behaviorBoost childs esteem through improved self awareness & compassion

Behavioral Therapy (type of psychotherapy)Focuses on ways to deal with immediate issuesTackles thinking & coping patterns without trying to understand its originsAim = Behavioral ChangeThe child may be asked to monitor their actions and reward themselves for positive behaviors.(Martin, 2013)

Treatment - MedicationsA medication that works for one child may not work for another childStimulant medications are commonly prescribedShort and long actingBeneficial in curbing hyperactivity and impulsivityHelp the person to focus, work, and learnHelps with coordination problems Side-Effects are usually minorDecreased appetiteInsomniaIncreased anxiety/irritabilityMild stomach aches or headachesTics (rare) sudden repetitive movements/sounds(Attention Deficit Hyperactivity Disorder, 2012)

("How to manage medication for children with ADHD, 2014)14Coexisting Conditions with ADHDA Learning DisabilityOppositional Defiant Disorder Child is overly stubborn, rebellious, often argues with adults, & refuses to obey rulesConduct DisorderChildren at risk of getting into trouble at school or with the policeAnxiety and depressionBipolar disorderExtreme mood swings go from mania to depression in short periods of timeTourette syndromeBrain disorderNervous ticsCan be controlled by medication, behavioral interventions, or both (Attention Deficit Hyperactivity Disorder, 2012)

(Data & Statistics, 2014)State-based Prevalence Data of Parent Reported ADHD Diagnosis by a Health Care Provider (2011-2012)

(Data & Statistics, 2014)The far-reaching effects of ADHDADHD may not only negatively affect the diagnosed person, but the disorder may also affect the immediate-familyADHD can cause anger, frustration, and blame to accumulate within a family before a child is diagnosedParents and children may need to get counseling to assuage negative feelings in the householdEducative programs can help the family develop new attitudes and communication mechanisms to help combat the negative effects of the disorderNature At SchoolPoor school performance & underachievementChildren with hyperactive and/or impulsive behaviors are viewed as having discipline or environmental problemsChildren with inattentive behavior (daydreaming) are often overlooked or viewed as lazy or unmotivatedADHD is first identified in a school setting since teachers interact with students on a daily basisTend to have below average IQ scores and standardized test scoresDue to the concentration that the exams requireLearning Tasks that do not require concentration, disciplined effort are not greatly affectedComprehension, Vocabulary, etc.(Austin, Burgdorf, Reiss, 2007)

Nature At HomeChildren with ADHD have a significant effect on the entire familyFrequent family conflicts due to the childs behaviorsStressors: High activity level, moodiness, constant difficulties, problems at school, tension & anxiety for parents and siblingsTypical Response: occurs once the behavior has occurred and is reactionary, not preventative or corrective(Austin, Burgdorf, Reiss, 2007)

Nature With PeersADHD makes it difficult to make and keep friends Critical issue because a childs happiness is linked with their relationship to other childrenTend to be loners, rejected by peers, and taken advantage of.At a higher risk for developing anxiety, mood disorders, substance abuse, and delinquencyHyperactive Type: Problems begin in preschool due to the childs bossiness, aggressive behavior, trouble taking turns, etc.Hyperactive/Impulsive Type: Less involved in school activitiesInattentive Type: perceived as shy, withdrawn, a target for bulliesResearch shows that ADHD children may be punished more often at home than at school(Austin, Burgdorf, Reiss, 2007)

Major Theorist: Dr. Russell BarkleyClinical professor of psychiatry at the Medical University of South Carolina.Leading expert on ADHD and the editor of the bimonthly ADHD Report.Believes ADHD is related to executive functioning.Theory includes five cognitive abilities impaired in ADHD.

Executive FunctioningBarkley believes that executive functioning are those capacities for self-control that allow us to sustain action in problem-solving toward a goal.There are five cognitive abilities related to executive functioning that Barkley believes is impaired in children with ADHD.Ability to inhibit behaviorAbility to use visual imagery for long-term goalsAbility to talk to oneself Ability to control emotionsAbility to plan and solve problems

Inhibit BehaviorADHD comprises a deficit in behavioral inhibition.There is difficulty in self-control, and children with this disorder act on impulse more than usual.Children with ADHD may not lack skills to be successful, but problems with self-control lead to the inability to inhibit behavior.The children are not able to apply their knowledge and skills at the necessary times due to their problems with self-regulation.For instance, a child with ADHD might not want to share a toy with a classmate because they are more interested in the immediate reward (the toy), rather than creating a friendship (long-term goal), even if they understand sharing is a good skill to have (Barkley).

Visual Imagery for Long-term GoalsVisual imagery is a form of non-verbal working memory.The ability to form images in ones mind allows them to use imagery to create mental maps in order to guide behavior. ADHD inhibits the ability to form visual images and create long-term goals.This is due to the childs inability to focus their mind, and instead the child turns their attention to the more immediate context (Rabiner, 2008). Barkley suggests that in order to fix this issue, parents and their children with ADHD should create several short-term goals, each with its own associated reward, and gradually work towards creating long-term goals.

Talk to OneselfTalking to oneself is a form of verbal working memory.It is also a form of self-guidance that allows to question oneself and aids in novel situations or problems.This is a cognitive ability that is impaired in ADHD, and can make self-regulation difficult.The executive action of internalized speech is absent and a child may act more on impulse before thinking.This may lead to an inappropriate action, which is heightened by the childs inability to inhibit behavior (Barkley).

Control EmotionsChildren with ADHD are not able to obtain emotional self-control and often lack motivation. This often results in the inability to inhibit strong emotions that are elicited by the childs surroundings.It interferes with the childs ability to moderate emotions and keep up with long-term welfare.Often in children with ADHD, emotions are intensified, for instance, if a child receives a bad grade on a test, they may feel overly upset and disappointed, often losing motivation (Rabiner, 2008). To help a child in this situation, Barkley suggests providing a child with coping strategies, encouraging them to forgive themselves for their mistakes, and help the child plan for problem situations.

Plan and Solve ProblemsPlanning and solving problems involves the ability to manipulate information in the mind to discover novel combinations that can help accomplish specific goals.Planning and problem solving requires a great deal of focus, and often involves working towards a goal (Barkley).Children with ADHD may find this difficult because their cognitive abilities of using visual imagery and internalized speech are impaired. This may cause a great deal of frustration, which heightens the childs inability to control their emotions (Rabiner, 2008).Barkleys suggestions for creating short-term goals for problem solving and coping with intensified emotions may help the child learn to better solve future problems.

Parenting Tips: Provided by: Margarita Tartakovsky 1. Stay calm.2. Set limits on your own behavior.3. Set structurebut make it pressure-free.4. Give your kids the chance to make wise choices.5. Use reasonable consequences for rule-breaking.6. Expect rule-breaking, and dont take it personally.7. Advocate for your child when appropriate.8. Avoid muting a headstrong child. 9. Realize that your child isnt misbehaving on purpose.10. Be persistent.11. Tackle one issue at a time.12. Educate yourself about ADHD and attention.13. Help your child adjust to change.14. Focus on your childs strengths.15. Cut yourself some slack.16. Celebrate being a parent and being with your child.(Tartakovsky, 2011)

How to create a strong relationship with your child:When speaking to your child, use as few words as possible, ADHD kids have short attention spans and struggle to pay attention2. Participate in interactive activities with them.3. Read to your child and help them with their homework. This way, they understand that their education is important to you.4. Allow them to feel comfortable and loved around you. You are their safety zone.

ACCEPT IT: No child is perfect!

caregiverkerivr/nounNORTH AMERICANa family member or paid helper who regularly looks after a child or a sick, elderly, or disabled person

As a parent, the proper emotional, physical, physiological and mental care of your child will always be a priority. POP QUIZThis is a short true or false quiz. The following questions are related to how you should react and interact with your child that has ADHD:(An 80% or better is a passing score.)If your child misbehaves in school, you should immediately yell and discipline them.Your child should spend most of his or her day watching television.Your child should feel comfortable with telling you or your spouse anything.Children with ADHD do not need more attention that children without ADHD.Your childs self confidence directly reflects how he or she deals with ADHD.33Answer KeyFalseFalseTrueFalseTrue

If you received a grade of 80% or higher, congratulations! You are in the right path to positively coping with your childs ADHD.ReferencesAttention Deficit Hyperactivity Disorder. (n.d.). Retrieved November 20, 2014, from http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml#pub3Attention Deficit/ Hyperactivity Disorder. (n.d.). Retrieved November 20, 2014, from http://www.dsm5.org/documents/adhd fact sheet.pdfAttention-Deficit/Hyperactivity Disorder: Prevalence, Etiology, and Persistence. (n.d.). Retrieved November 21, 2014, from http://www.medscape.org/viewarticle/547415_2Austin, M., Burgdorf, L., & Reiss, N. (2007, November 5). Mental Health, Depression, Anxiety, Wellness, Family & Relationship Issues, Sexual Disorders & ADHD Medications. Retrieved November 23, 2014, from http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=13856&cn=3Barkley, R. (n.d.). The 5 cognitive abilities that are impaired in ADHD.ADHD and Executive Function. Retrieved November 16, 2014, from http://www.childmind.org/en/posts/articles/2010-11-12-adhd-and-executive-functionData & Statistics. (2014, September 29). Retrieved November 21, 2014, from http://www.cdc.gov/ncbddd/adhd/data.htmlEccles, J. S. (1999). The development of children ages 6 to 14. The Future of Children, 9(2). 32-34. Retrieved October 11, 2014, from http://futureofchildren.org/futureofchildren/publications/docs/09_02_02.pdfHow to manage medication for children with ADHD. (2014, July 1). Retrieved November 23, 2014, from http://specialedpost.org/2014/07/01/how-to-manage-medication-for-children-with-adhd/Martin, B. (n.d.). Treatment for Attention Deficit Disorder (ADHD). Retrieved November 21, 2014, from http://psychcentral.com/lib/treatment-for-attention-deficit-disorder-adhdRabiner, D. (2008, February 23). Self-Regulation and Barkley's Theory of ADHD. SharpBrains. Retrieved November 16, 2014, from http://sharpbrains.com/blog/2008/02/23/self-regulation-and-barkleys-theory-of-adhd/Roth, E. (2013, June 9). What Are the Types of ADHD? Retrieved November 23, 2014, from http://www.healthline.com/health-slideshow/three-types-adhd#6Tartakovsky, M. (2011). Parenting Kids with ADHD: 16 Tips to Tackle Common Challenges. Psych Central. Retrieved on November 23, 2014, from http://psychcentral.com/lib/parenting-kids-with-adhd-16-tips-to-tackle-common-challenges/0006557