Definition of Attention Deficit Hyperactivity Disorder

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    ATTENTION DEFICIT HYPERACTIVITY DISORDER

    Attention Deficit Hyperactivity Disorder

    Erika B. Herrera

    Westwood College

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    Abstract

    One of the most challenging disorders of todays era is Attention Deficit Disorder Hyperactive

    (AD/HD), causing childrens to have difficulty controlling and balancing their social setting and

    school behavioral; What exactly is AD/HD? What are the reasons that cause children to develop

    these disabilities; what is the best treatment for children diagnosed with AD/HD? These are some

    important generalities that need to be discussed in order to better understand Attention Deficit

    Disorder as a childhood disorder.

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    One of the most challenging disorders of todays era is Attention Deficit Disorder

    Hyperactive (AD/HD), causing childrens to have difficulty controlling and balancing their

    social setting and school behavioral; What exactly is AD/HD? What are the reasons that cause

    children to develop these disabilities; what is the best treatment for children diagnosed with

    AD/HD? These are some important generalities that need to be discussed in order to better

    understand Attention Deficit Disorder as a childhood disorder. Children that are diagnosed with

    this disorder have to follow a pattern of symptoms that will determine if they are affected by

    these circumstances. Some of the childrens because of the type of AD/HD may present learning

    disabilities and some other may present a picture of being very smart but extremely hyperactive.

    Creating totally different scenarios but at end possessing both the same type of disability.

    Attention Deficit Hyperactivity Disorder

    Definition of Attention Deficit Hyperactivity Disorder.

    What is Attention Deficit Hyperactivity Disorder? Dr. Jaska (1996), defines it as a

    diagnosable, treatable, biological disorder which we understand now much better than we did

    even 15 years ago. The primary symptoms include some combination of inactiveness or

    distractibility, impulsivity, and some people physical restlessness or hyperactive behavior. The

    Attention Deficit Disorder Association (1998), stated that the mayor difference that exists

    between Attention Deficit Disorder and Attention Deficit Hyperactivity disorder is mainly the

    terminology that can mainly that can be confusing at times. AD/HD are related disorders, but

    they are not the same disorder, because a learning disability is the one the impacts on the basic

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    psychological process needed to learn; this results in behaviors that can make the individual

    engaged for the learning experiences.

    Types

    The official clinical diagnosis is Attention Deficit Hyperactivity Disorder (AD/HD);

    which is broken down into three different subtypes:

    a. AD/HD Combined Type: this subtype is used when six or more symptoms of

    hyperactivity-impulsivity have persisted at least for six months. It is a fact that mostchildren and adolescents have this type of disorder.

    b. AD/HD Predominantly Inattentive: this subtype should be used in six or moresymptoms of inattention but with fewer or less than six symptoms of hyperactivity-impulsivity.

    c. AD/HD Predominantly Hyperactive-Impulsive Type: this subtype should be used for

    six or more symptoms of hyperactivity-impulsivity but fewer or less than six

    symptoms of inattention.

    Diagnosis of AD/HD

    The best technique is clinical history of the child; this technique must include

    observational data from school and family. Currently there are no formal tests to predict a

    diagnosis for a patient, there are some behavioral tests that are able to identify and rate scales of

    hyperactivity, distractibility and impulsivity.

    The official diagnose manual is DSM-III-R this manual states that in early childhood, it may be

    difficult to distinguish symptoms of AD/HD from age appropriate behaviors in active children.

    Most of the symptoms are common within children; however there behaviors must be

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    distinguished with similar signs in children with AD/HD. Some of the examples of behaviors

    that must be charted in order to make the proper diagnose are children presenting scenarios of

    excessive hyperactivity, symptoms of inattention in class, resistant to work inactivates that have

    to be done individually. The DSM-IV-TR states that the following criteria needs to be followed

    in order to effectively diagnose a patient:DSM-IV Criteria for ADHD

    I. Either A or B:

    A. Six or more of the following symptoms of inattention have been present for at least 6

    months to a point that is disruptive and inappropriate for developmental level:

    Inattention

    1. Often does not give close attention to details or makes careless mistakes in

    schoolwork, work, or other activities.

    2. Often has trouble keeping attention on tasks or play activities.

    3. Often does not seem to listen when spoken to directly.

    4. Often does not follow instructions and fails to finish schoolwork, chores, or duties

    in the workplace (not due to oppositional behavior or failure to understand instructions).

    5. Often has trouble organizing activities.

    6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort

    for a long period of time (such as schoolwork or homework).

    7. Often loses things needed for tasks and activities (e.g. toys, school assignments,

    pencils, books, or tools).

    8. Is often easily distracted.

    9. Is often forgetful in daily activities.

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    B. Six or more of the following symptoms of hyperactivity-impulsivity have been present

    for at least 6 months to an extent that is disruptive and inappropriate for developmental

    level:

    Hyperactivity

    1. Often fidgets with hands or feet or squirms in seat.

    2. Often gets up from seat when remaining in seat is expected.

    3. Often runs about or climbs when and where it is not appropriate (adolescents or adults

    may feel very restless).

    4. Often has trouble playing or enjoying leisure activities quietly.

    5. Is often "on the go" or often acts as if "driven by a motor".

    6. Often talks excessively.

    Impulsivity

    1. Often blurts out answers before questions have been finished.

    2. Often has trouble waiting one's turn.

    3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

    II. Some symptoms that cause impairment were present before age 7 years.

    III. Some impairment from the symptoms is present in two or more settings (e.g. at

    school/work and at home).

    IV. There must be clear evidence of significant impairment in social, school, or work

    functioning.

    V. The symptoms do not happen only during the course of a Pervasive Developmental

    Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better

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    accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder,

    Dissociative Disorder, or a Personality Disorder).

    Bottom line is that if a child presents one or more of the above mentioned conditioned they

    are most likely to be diagnosed with AD/HD.

    Causes of AD/HD

    There have been several researches that have studied some causes of this behavior

    disorder. The current view supports that there is a biological-neurological etiology for AD/HD

    and that how it is manifested is influenced by physiological and some social factors (Silver,

    Larry B, 2005). Silver also stated that there is evidence of a genetic factor, some studies suggest

    that 30 to 40 % childrens with AD/HD have inherited a familial pattern, this supports the

    theories of neurochemical. Some other studies focused on different factors that might influence

    fetal development.

    Silver, (2005) defined the different factors that affect children with AD/HD as the

    following:

    -Genetic Factors. Factors in the genes that affect children to test positive with AD/HD

    -Neurochemical Factors. The compound that has received the most attention as the possible

    cause of Ad/HD are the monoamines comprising the catecholamine (dopamine and nor

    epinephrine) and the indoleamine, serotonin. The theories relate to the factors in the development

    of these monoamines or in the breakdown process. This whole process is the one that acts and

    originates from the brain until it produces a metabolic effect and sends stimulations to the body.

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    -Fetal Development. Prenatal, natal, perinatal and socio environmental factors may impact on the

    development of a fetus. Some examples of behaviors such as stress, toxic factors, and poor

    nutrition have result in high number of children being diagnosed with AD/HD. It is vital that

    parents adapt an appropriate environment and nutrition for their childrens.

    Treatment

    The treatment for AD/HD must be a combination of family education, sessions of family

    and individual counseling and the use of behavior modification with the proper use of

    medication. There have been several medications to treat a child with the symptoms of AD/HD

    some recommend their use, other recommend behavioral change and changes in the diet and

    activities that a child is exposed to and applying a natural treatment as an alternative.

    Hopkins(2005), in the Journal of Neuropsychiatry defined that there are two groups of drugs

    prescribed by doctors.

    -The amphetamine, which have multiple chemical properties, they are reuptake inhibitors and

    they are neurotoxins and have tremendous side effects in the children.

    -Reuptake Inhibitors , which is the second group have the same type of side effects.

    In general, side effects of stimulants can include a decreased appetite, headaches, stomachaches,

    trouble getting to sleep, jitteriness, and social withdrawal, and can usually be managed by

    adjusting the dosage or when the medication is given. Other side effects may occur in children

    on too high a dosage or those that are overly sensitive to stimulants and might cause them to be

    'over focused on the medication or appear dull or overly restricted.' Some parents are resistant to

    using a stimulant because they don't want their child to be a 'zombie,' but it is important to

    remember that these are unwanted side effects and can usually be treated by lowering the dosage

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    of medication or changing to a different medication. Examples of medications that are currently

    out in the market are: Dexedrine (Dextroamphetamine sulfate) ;Dextrostat ;Adderall ;Adderall

    (generic) ;Dexedrine spansules; Focalin.

    Parent and Doctors are recommending more natural treatments instead of drug

    treatments. There have been several natural treatments that have demonstrated improvement in

    behavior of children without having secondary effects in their health. These natural treatments

    focus more in the diet that a child has and by changing some food ingredients that stimulate the

    serotonin and metabolism, they can adjust the behavior and reactions of childrens. Some

    examples of food that need to be lowered or if possible taken out completely from a childs diet

    are: sugars, chocolates, junk food, food colorings. The recommendation is to feed natural foods

    only, like vegetable fruits and avoid processed foods.

    Testimony

    Sandy Henry was a mother of a child that had been diagnosed with AD/HD, this is her

    testimonial on her child victory at school: I just thought I would share my sons victory against

    the school district. After struggling for the past three years with behavior issues due to an

    acquired brain injury and ADHD, the district started putting my son in an isolation room starting

    in December 1996. After sitting in there for more than two months my son finally had had

    enough and refused to go there. On March 27th, 1997 I pulled my son out of our district after

    being told by the Vice Principal (he also held the title of Special Education Director for our

    District) that he would be physically restrained if he left his chair.

    In April, 1997, the district started homebound tutoring to go through the summer in order that he

    could complete the 7th grade curriculum which he was severely behind on.

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    At the beginning of the current school year we went to mediation to try to get the school to agree

    to an out-of-district placement. Mediation was exhausting - and all that was accomplished was

    that I missed a days work because after reaching a tentative agreement, the district backed out

    and mediation isn't binding so that was that. My son continued with tutoring for the current

    school year.

    I filed a complaint with the State Department of Children Families and Learning in December,

    1997 on two issues: 1) the district failed to develop an educational program based on the students

    needs and 2) the district failed to provide special education services since March 1997.

    We won on both issues and here are the decisions:

    1) The district must immediately contact a specialist in the area of traumatic brain injury and

    behavior management for consultative purposes.

    2) The district must immediately conduct an assessment of the student's educational and

    behavioral needs to determine the extent of harm caused by a prolonged and egregious failure to

    provide special education services from April 1997 to the current date.

    3) The IEP (Individual Education Plan) team must reconvene and develop an interim IEP

    reflecting the needs of the student. The IEP team must consider the inclusion of this student into

    regular education classes with appropriate behavior support systems.

    4) To date, the student has been denied approximately 465 hours of special education services,

    the complaint investigator will determine the amount and extent of compensatory services for

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    this student. The decision regarding the award of compensatory services will be made by May

    15, 1998.

    The most important point of winning is that it gave me the sense that my instincts were right in

    believing that how they were treating my son was not okay. I finally feel that what I did was the

    right thing. Most people told me that I was strong and doing the right thing, but in the meantime,

    my son was still not in school and I was still questioning my decision to remove him. Winning

    this has made me finally understand that I was right, I was not being an overprotective mom, and

    that he did not deserve what they were doing to him.

    As described by...

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