ADHD Case Study

ADHD, a disorder beginning in childhood, characterized by a persistent inability to sit still, focus attention on specific tasks, and control impulses, contributed by Michael Woods to Microsoft Encarta Encyclopedia. Attention Deficit Hyperactivity Disorder is one of the most common mental disorders of childhood. Many children grow out of ADHD by adolescent or adult years, but many do not. Studies show ADHD in adulthood is more severe and may cause long term effects. Diagnosing ADHD is very difficult, because most children are inattentive, hyperactive, and impulsive at least some of the time. When diagnosing there is no blood test, or written test to determine if ADHD is present. All there is are guidelines and an educated guess. The guidelines include, A disturbance of at least six months during which at least eight of the following are present:

1. often fidgets with hands or feet or squirms in seat 2. has difficulty remaining seated when required to do so 3. is easily distracted by extraneous stimuli 4. has difficulty awaiting turn in games or group situations 5. often blurts out answers to questions before they have been completed 6. has difficulty following through on instructions from others 7. has difficulty sustaining attention in tasks or play activities 8. often shifts from one uncompleted activity to another 9. has difficulty playing quietly 10. often talks excessively 11. often does not seem to listen to what is being said to him or her 13. often loses things necessary for tasks or activities at school or at home ( e.g.. pencils ) 14. often engages in physically dangerous activities without considering possible consequences ( not for thrill seeking purposes ) e.g.. runs into the street without looking

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The above items are listed in descending order of discriminating power based on data from national field trial of the DSM-III-R criteria for Disruptive Behavior Disorders, contributed Sam & Michael Goldstein to Managing Attention Disorders in Children page11. In order to diagnose ADHD, these symptoms must occur more frequent than children of the same age and must occur in more than one sitting. 90% of ADHD patients take Ritalin, a mild central nervous system stimulant believed to calm hyperactivity by helping the brain disregard distracting stimuli, ADHD has been estimated to affect 3% to 5% of school-age children nation wide, with less than 3% actually receiving medication, said Gretchen LeFever, a pediatric psychologist, on an Internet column. Gretchen LeFevers research found that 8% to 10% of children in second through fifth grades routinely took ADHD medication in school during 1995-1996 school year. LeFever also conducted another study which she examined records of student enrolled in the second through fifth grade once again, but she chose two specific cities this time, Portsmouth and Virginia Beach.

She chose these two cities, because they are the most diverse cities in Virginia, Portsmouth is a small, urban, poor, mostly black district, while Virginia Beach, Virginia is a larger, more wealthy, and mostly white district. LeFever and her researchers found that ADHD medication was used three times as many boys as with girls and twice as many whites as blacks. The researchers also found that the use of medication increased as the children aged. By fifth grade, 19% to 20% of white boys received ADHD medication. Scientists do not know what causes ADHD, however, they have discredited many theories that ADHD was a result from minor head injuries or undetectable brain damage due to infections or complications during birth. Another theory blamed the consumption of refined sugar and food additives, a study was done and it showed that very few ADHD children benefited from a special diet.

Another theory junked was the theory of bad parenting or a dysfunctional home life. Controversy exists over the diagnosis of ADHD. Physicians in the United States diagnose the disorder more often than doctors elsewhere in the world, contributed Michael Woods to Microsoft Encarta Encyclopedia. Researchers examined about 30,000 grade-school children in two districts in southeastern Virginia and found that pupils took drugs for ADHD in school at two to three times the expected rate, according to the study in the American Journal of Public Health. Its hard to believe this many children have the specific brain-related problem called ADHD, said Dr. Louis H. McCormick, a faculty member in the family medicine department at Louisiana State University medical school.

He said that his study confirmed that his suspicion that kids are being overdiagnosed. Although there is no cure for ADHD, a variety of treatments may help children with this disorder. These include medication, counseling, social skills training, and other methods. Drugs are the most common treatment for ADHD and can help reduce symptoms of the disorder. Physicians usually prescribe one of three drugs: methylphenidate (Ritalin), dextroamphetamine (Dexedrine or DextroStat), and pemoline (Cylert). These drugs are normally stimulants, yet they ease hyperactivity and other symptoms in 90% of children with ADHD. The drugs work by altering levels of neurotransmitters, brain chemicals that transmit nerve signals. A newer stimulant used to treat ADHD, Aderall, combines dextroamphetamine and amphetamine.

Medical experts regard stimulants as safe. The most common side effects include stomachaches, loss of appetite, nervousness, and insomnia. Drug therapy may slow a childs rate of growth temporarily, but growth usually returns to normal during adolescence. Low doses of stimulants do not cause a high sensation, sedate the child, or cause addiction. Experts often recommend that children take medication only during school, with medication breaks on weekends and holidays to reduce unwanted side effects, contributed by Michael Woods, to Microsoft Encarta Encyclopedia. Most children with ADHD need more than medication. Drugs only relieve symptoms of ADHD, which usually return when medication is discontinued. Although drugs help a child to concentrate and complete schoolwork, they cannot increase a childs knowledge, teach academic skills, or directly alter underlying learning disorders or other problems, contributed Michael Woods to Microsoft Encarta Encyclopedia.

There are many ways to treat ADHD without medication, there are several kinds of therapy, to help not only the patient, but the family too. Therapy helps the patient deal with the negative feelings that result form their symptoms. Social skills training can help them recognize how their behavior affects other people and help them develop more appropriate behavior. Because children with ADHD often cause family turmoil, parents and other family members may benefit from therapy or support groups in which other parents share their experiences. Parental skills training can teach parents to mange a childs behavior with praise and other rewards, and with penalties such as time-outs in which a child must sit alone to calm down. Most scientists think of ADHD as a biological disorder caused by abnormalities in the brain that control attention span and limit impulsive behavior are less active.

Brain structures are affected in ADHD use dopamine to communicate with one another. Genetic studies suggest that people with ADHD might have alterations in genes encoding either thD4 dopamine receptor, which receives incoming signals, or the dopamine transportor, which scavenges release dopamine for reuse, from Genes to Behavior ADHD. Also ADHD seems to run in the families, one third of fathers who had ADHD in childhood, have children with ADHD. Studies also show that a mother who smokes while pregnant, has a child who has ADHD, and that most children with ADHD are left handed, and are highly intelligent. A woman that was interviewed in a 1999 research study said that a child with ADHD is like a devil child. Gwendolyn Corley, a mother of four who has a son with ADHD said that her son is like four children in one. Gwens son, Matthew has many problems, he is dyslexic, and has a major attitude.

He also has no patients at all, so Gwen says. She said her son can never sit still, his hands must also always be moving, and everything is done in a rush. Gwen told the reporter of an incident in the summer, her son took apart the lawnmower, because he was bored, and put it back together, with parts to spare, and the mower still ran. She also stated that he was cleaning out his fish tank, and ended up dropping it on his leg, he had to be rushed to the hospital for stitches, because he was in a rush and didnt pay attention to what he was doing and was very negligent. Gwen told us that her son has just recently finished probation for an incident she rather not talk about and that he is no longer allowed to attend public school, he goes to an alternative school and is currently on Ritalin to try to help his behavior.

Gwen said that she believes there is no hope for her son. ADHD, a disorder beginning in childhood characterized by a persistent inability to sit still, focus attention on specific tasks, and control impulses, contributed by Michael Woods, to Microsoft Encarta Encyclopedia. ADHD is one of the most common childhood mental illness, it is very hard to diagnose and is very frustrating for an ADHD parent. ADHD is usually controlled by Ritalin, a mild nervous system stimulant. Due to the fact that there is no true way to determine ADHD, it is often a misdiagnosis of a child acting like a child.

Works Cited

ADD, What causes ADD?, 1997, Netscape Navigator 22 November <http://go.drkoop.com/wellness/mental_health/attention_deficit_disorder /page_341_826.asp>. ADD/ADHD, Diagnosing ADHD/ADD in Children 1999, Netscape Nvigator 22 November 1999. <http://go.drkoop.com/wellness/mental_health/attention_deficit_disorde r/page_341_822.asp>. ADHD Medications, Are Medicines OK for My Child? 1998, Netscape Navigator 22 November 1999, <http://home.healthcenter.com/english/brain/adhd/medicate.htm>. Corley, Gwendolyn, interview, December 9,1999 Flick, Grad L. Ph.D ADD/ADHD Behavior-Change Resource Kit West Nyack, New York: 1998 Glodstein, Sam and Michael, Managing Attention Disorders in Children. Canada: 1990 John Wiley and Sons Inc. Miscellaneous

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