Attention-deficit/hyperactivity disorder commonly denoted as AD/HD refers to a medical diagnosis of a behavioural condition that encompasses a diverse group of disruptive behaviours. This assortment of behaviours can have numerous effects and causes and their features merge with the normal behaviours. Attention-deficit/ hyperactivity are a clinical diagnostic label assigned when these behaviours result in difficulties in the child’s family relationships, development, social interaction and performance and behaviour. According to the centre for disease control, AD/HD is part of the common childhood neurobehavioral disorder. The three primary hallmarks for AD/HD include almost reckless impulsiveness, inattention and in some but not all cases, toe-tapping and knee-jiggling hyperactivity. These three hallmarks form the basis for categorizing AD/HD into three types including predominantly hyperactive, predominantly inattentive and combined type (Solanto, 2004).
For mostly hyperactive frequently referred to as impulsive type, the major characteristics of individuals are continuous talk in addition to a lot of fidgets. Individuals in this category find it difficult to concentrate on a given task for a long time e.g. taking meals or working on assignments. It is difficult for such children to pay attention, control their emotions, sit still or think about their next course of action before their action. Most of them are fearless and hence prone to accidents, blurt answers in class, often fail to adhere to rules, have difficulty in waiting for their turn and have difficulties in staying on their task. They are restless and have difficulties with impulsivity, hence are characterised by frequent interruption of others, talking at the wrong time as well as grabbing items from others. Due to their frequent inattentive and impulsive behaviour, these children or individuals are at an increased risk socially and find it difficult to form relationships.
Individuals categorized under the predominantly inattentive type have difficulties in both finishing and organizing a given task. They also do not pay much attention to following directions, details or even conversations. They are readily distracted and frequently forget daily basic routine details. Most children in this category are often unable to get along with children of the same age and to act out. They barely pay attention to their activity. Others may just sit doing nothing at all. This makes it difficult for either parents or teachers to notice. For instance, my 8-year-old daughter Ashia who is suffering from AD/HD has exhibited most of the above symptoms. For the combined type symptoms for both predominantly inattentive and predominantly hyperactive types are present in equal magnitudes.
Developmental swings in AD/HD symptoms
Infancy: AD/HD children may possess a history of perinatal and prenatal difficulties. One of the most common symptoms is the sleeping disorder, which can be evident even during the earlier months of the child’s life. A large portion of the child’s earlier history often points to a restless, crying, irritable baby who is difficult to feed and settle.
Preschool period
Most scholars agree that diagnosis at this stage is complicated by the manifestation of a broad range of normal behaviours. As preschoolers and toddlers, however, these individuals are more exploratory and active than it is characteristic for this stage of development. Due to their impulsivity, they may engage in difficult behaviours and become difficult to regulate.
Early schooling period
When these children join school they get it difficult to concentrate or pay attention. They are characterised by the inability to modulate both their attention and level of activity to match with the environmental demands. Given learning difficulties may become apparent in addition to peer difficulties which contribute significantly to low self-esteem.
Adolescence
This period is characterized by reduced hyperactivity through difficulties with impulsivity, attention among others may persist.
Comorbidities and related problems
Once an individual has been diagnosed with AD/HD, the possibility of such an individual possessing other numerous complications is very high- a phenomenon referred to as comorbidity. Specifically, children suffering from AD/HD may be at an increased risk of having additional developmental, medical, emotional, social, behavioural and academic difficulties.
Children with AD/HD are more likely relative to others to have a given learning complication, to experience language and speech difficulties and to be clumsy. Vinson (1994), states that approximately twenty to forty per cent of children with AD/HD have been shown to at least posse one form of learning difficulties in spelling, reading or mathematics. He further points out that about 33 per cent of American children suffering from AD/HD are categorised as having reading difficulties.
Other studies have shown that AD/HD children are likely to lag behind the general intellectual or mental development of normal children to some significant degree. But the observed disparities may be a reflection more of the troubles Attention-deficit /hyperactive disorder imposes on the children’s ability to undertake tasks than inherent intelligence.
AD/HD children are often regarded as incompetent and immature socially. They have difficulties in joining ongoing conversations or activities. They lack knowledge on how to take turns. The low self-esteem among these children has been linked to this. These children have also been shown to experience enuresis, have difficulties with their general health and have poor sleeping patterns. These children have also been shown to be highly prone to risk.
Attention-deficit/ hyperactivity disorder is commonly correlated with other behavioural and emotional disorders. According to Moser and Kallail (1995), more than forty-five per cent of children suffering from AD/HD have been diagnosed with at least one other psychiatric disorder apart from AD/HD. These children are also at an increased risk of developing conduct and opposition Defiant Disorders, hence complicating the possibility of meeting their needs through mainstream education. Instructors need to understand that this course of events can be avoided through the treatment of AD/HD before the child develops serious behavioural, emotional, academic and social problems.
Causes of AD/HD
There is no known specific cause of Attention-deficit/ hyperactive disorder, though various experiments or studies have indicated the possibility of genes playing a central role. Like other types of diseases, this condition probably emanates from an amalgamation of factors. Apart from genetics, scientists are studying the potential environmental factors and they are currently evaluating the played by nutrition, brain injuries and the social in the development of AD/HD.
According to Sloan et al (1999), a study carried out by Russell Barkley, one of the renowned researchers in this field indicated that AD/HD is a result of developmental failure in a child’s brain circuitry that activates self-control and inhibition. These studies by Barkley indicated that sections of AD/HD children’s brains are smaller relative to those of normal children and correlated this to genetic factors. It is also worth noting that various research findings have shown that Attention deficit and hyperactive disorder tend to cluster around families. Although, numerous attention deficit and hyperactive family studies have been marked with methodological difficulties like partisans of both environmental and genetic positions and non-blinded diagnosis would be astonished if they fail to find a familial clustering of attention-deficient and hyperactive disorder. Despite the universal acceptance that family studies cannot be able to disentangle environmental and genetic influences, some scientists in this field have concluded otherwise. For instance, a 1995 study by Biederman and colleagues indicated that familial aggregation of this condition has a significant genetic component. According to Moser and Kallail (1995), twin studies by Barkley have offered the most conclusive evidence that genetics play a central role in the development of AD/HD. Other twin studies, most if not all, of which have employed the twin method have indicated consistently that identical twins are more concordant for attention-deficit/ hyperactive disorder, or correlate higher for attention-deficit/hyperactive disorder-related behaviour, as compared to fraternal twins (Solanto, 2004). However, the central concern is whether the greater behavioural resemblance observed between identical twins can be credited to their genetic resemblance, as proponents of twin methods maintain.
Another type of study employed to assess genetic influences on attention-deficit/hyperactive disorder is the study of individuals who have been adopted. Theoretically, an adoption study has the potential of disentangling possible environmental and genetic influences on psychiatric disorders since adoptees get their genes from one family, although are raised in the environment of another family (CDC, 2010).
Various research findings have shown that children or individuals with brain injuries often exhibit some characteristics analogous to those of attention-deficit/hyperactivity disorder. It is however important to note that only a very small population of children or individuals with this condition have suffered an upsetting brain injury.
Several study findings have indicated the potential correlation between this disorder and alcohol consumption and narcotic use during pregnant children. Other studies have shown that preschool children exposed to significant amounts of lead are at a high risk of developing this condition.
The theory that children taking in large amounts of sugars are more likely to develop AD/HD has been disqualified by various studies. Various studies are underway in Britain to ascertain claims that certain food additives for example some food preservatives and colours result in hyperactivity in children.
Diagnosis
Some steps have to be followed before clinicians decide whether a child is suffering from attention deficiency/hyperactive disorder. There is no specific test for the diagnosis of this condition, since other conditions like depression; certain forms of learning disabilities, anxiety have been shown to exhibit the same symptoms. Assessment for attention-deficit/hyperactive disorder needs the employment of numerous data collection methods across settings and informants. In specific, emphasis is put on getting reliable information about the behaviour of the child from teachers and parents in addition to first-hand observations. The primary components of assessment should incorporate psychological and school evaluation, interviews with parents and medical and clinical examination (Handler and DuPaul, 2005).
Treatment
Current treatments for this condition are aimed at minimizing its symptoms and enhancing functionality and they include training or education, chemotherapy, psychotherapy or a combination of both. The commonly used drugs (chemotherapy) are mostly stimulants that are meant to reduce impulsivity and hyperactivity, at the same time enhancing their capability to pay more attention to work and learning. Some of the drugs used include dextroamphetamine, methylphenidate etc.
Conclusion
Since AD/HD represents the comparative extremes of a normal dimension of a specific trait, care should be taken before labelling children as AD/HD. There is also a need for the collection of enough information from both parents and teachers to supplement other diagnostic methods during the assessment.
References
Centre for Disease Control and prevention. (2010). Attention-deficit/ hyperactivity disorder.
Handler and DuPaul (2005).Assessment of ADHD: Differences across Psychology Specialty Areas. Journal Attention Disorder, 9, 402-412.
Moser, S. E. And Kallail, K. J. (1995). Attention-deficit hyperactivity disorder. Archives Family Medicine, 4(3), 241-244
Sloan et al (1999). Assessing the service for children with ADHD: Gaps and opportunities. Journal Attention Disorders, 3, 13-29.
Solanto, M. V. (2004).Stimulant drugs and ADHD: basic and clinical neuroscience. Oxford: Oxford university press.
Vinson, D. C. (1994). Therapy for attention-deficit hyperactivity disorder. Archives Family Medicine, 3(5), 445-451.