==== ====
American Top Best Selling Perfect Publishing System !
http://bit.ly/wJ8LbI
==== ====
Attention Deficit Hyper Activity Disorder according to Singh (2002) is a developmental disorder
that is brain based and most often affects children. This developmental disorder can be
characterized as a disorder in which affects ones self control; primary aspects include difficulty
with attention, impulse control, and activity levels usually diagnosed prior to the age of 7yrs. of age
(Willoughby, 2003).
There are primarily three sub-types of ADHD. Inattentive sub-type 1 is ADHD which those who
manifest inattention without the presence of hyperactivity and impulsivity (Barkley, 2005). There is
also ADHD sub-type 2 with symptomolgy related to hyperactivity and impulsivity (Barkley, 2005).
Finally there is ADHD combined sub-type (Visser & Lesesne, 2005). For the purpose of my
paper, I will utilize information that represents all subtypes in various degrees and the affects of
these difficulties upon the individual, educational, family, and social development as well as issues
of social justice and cultural issues for those children who suffer from this disorder.
Historically the modern symptoms of ADHD were first identified (Barkley 1996, Rafalovich 2001,
& Stubbe 2001), by English physician George Still in 1902 (Neufeld & Foy, 2006).
Rafalovich (2001), explains that in a series of historical events from 1917-1918 in North America
that led to an encephalitis outbreak there was a dramatic increase in research of characteristics
that are similar to modern day ADHD symptomology. Through out the early years of research
there was even research and investigations into medical conditions which promoted swelling in
certain aspects of the brain, which many believe led to impulsivity and hyperactivity (Stubbe,
2000). As research evolved so did the diagnostic criteria for the disorder; shaping identifiable
factors believed to contribute to the causation of ADHD (Barkley, 2005). Physiologically, there
seems to be less dopamine and nor-epinephrine within the brains of those with ADHD and four
genes that regulate dopamine have been identified as ADHD causal agents; however a definite
causal agent has not been confirmed (Barkley, 2005). Brain activity is considerably lower in the
pre-frontal lobe regions in those with ADHD and there is also decrease in blood flow (Hans,
Henricksen & Bruhn, 1984), (Barkley, 2005). According to Barkley (2005), psychological
characteristics of ADHD are that it is about the "behavioral inhibition." These children do not
benefit from what may happen later based upon what they do now; which can be compared to a
"time near sightedness", (Barkley, 2005). They have difficulty identifying their past, preparing for
the future, organizing, scheduling, and working independently, with social and occupational issues
(Barkley, 2005). It is these difficulties when intermingled with the development of the individual that
could clearly cause great difficulties especially when enrolled in formalized schooling and onward
into the demands of school and adulthood.
The prevalence rates regarding the diagnosis of ADHD has been from ranges of 4 % to 18 %
depending upon the community, types of populations, and areas of analysis (Visser &
Lesesne, 2005). ADHD is one of the most common childhood disorders with 2.5 million children
with this disorder (Barkley, 2005). Estimates show (Biederman, 1996), that nearly 6 % of boys and
1.5 % of girls have ADHD (Singh, 2002). It cost nearly 3.3 billion dollars to medically treat ADHD
every year in the United States (Visser & Lesesne, 2005). Currently causation factors under
consistent follow up according to Barkley (2005) include;
1.Genetics
2.Premature Birth
3.Traumatic Brain Injury
4.Spine and Brain Infections
5.Early exposure to substances during pregnancy
6.Early exposure to lead
7. Less blood flow and lower brain activity
Because ADHD is a representation of physical imperfections within the brain and actually
manifests a decrease of activity in the pre-frontal lobe regions; certain treatment options with
amphetamines, stimulants and non-amphetamines have been utilized to increase brain activity
(Barkley, 2005). The size and anomalies within the brain have been verified and examined through
many technological processes such as Positron Emission Tomography and MRI scanning (Vance
& Luk, 2000). Other physical abnormalities of development according to Barkley (2005),
include appearances of slight deformities including; longer than average index finger, third toe that
is longer than second toe, ears that are slightly lower upon the head, no earlobes or a furrowed
tongue. Up to 80% of children suffering with ADHD will continue to struggle with this disorder into
adolescents and as many as 50 to 60 percent will continue to struggle into adulthood (Barkley,
2005). With the affects upon a child's school, family, and social environments a large emotional toll
can be identified. Emotionally, children can feel isolated, angry, guilty, frustrated and many other
emotions due to the disruption of relationships, opportunities and lack of clear decision making
skills (Barkley, 2005). Many of these children can become depressed and exhibit anxiety (Barkley,
2005). Many affective behaviors include stubbornness, defiance and at times can be verbally or
physically violent to others (Barkley, 2005).
According to Barkley (2005) nearly 57% of preschool children are likely to be rated as inattentive
and over-reactive by their parents up to the age of four. As many as 40% according to Barkley
(2005), may have these problems for up to three to six months, concerning parents and teachers.
According to Lavigne, Gibbons, Christoffel, Rosenbaum and Binns (1996), however, it is estimated
that 2% of preschool children truly meet the criteria for ADHD, and (Biederman, 1996), clarified
that possibly 10 % of all children meet diagnostic criteria for ADHD (Singh, 2002). Barkley clearly
indicates that the earlier the symptoms of ADHD appear and the length of time they last in
childhood will determine the severity of its course and prognosis (Barkley, 2005). Individually there
are many distressing problems for children suffering from this disorder. Some features that Barkley
(2005) indicate are important to recognize as the individual child develops into school age include;
1.An emergence of high demanding ness of preschool age
2.Critical directive behavior by parents to control circumstances
3.Problems reported by preschool / formal school staff regarding child's behavior
4.Problems with learning and reading
5.Decisions to withhold a child an educational grade
6.Excessive temper tantrums / difficulty in getting child to do chores
7.Social exclusion from activities
According to Spira & Fischel (2005), within the pre-school environment at the age of 3 yrs.
old, children's attention controls, and self control mechanisms begin developing. Increased self
control and speech development continues from age 3yrs. old (Spira & Fischel, 2005). Self
control processes continue to well develop through the age of 4yrs. old (Spira & Fischel,
2005). These processes work together allowing the child to maintain self-control and through 4
yrs. of age the child develops the ability to direct attention to relavent environmental stimuli (Spira
& Fischel, 2005). Together, the maintaining of attention and control over responses emerges
and of course is very important in identifying task's and working functionally within the educational
environment, however; these processes indicated do not emerge for those with ADHD due to the
manifestation of hyper-activity and impulsivity around the age of 3 to 4 yrs. of age, and inattention
manifesting near 5 to 6 yrs. of age (Spira & Fischel, 2005). As children develop into school
age and adolescents, Barkley (2005) indicated that 30 to 50 percent of children will be retained
one grade during their school years. According to Vance & Luk (2000), 20 to 30 percent of
children with ADHD will manifest comorbidity with learning disorders; reading, arithmetic, writing or
spelling. If a child is diagnosed with ADHD and Conduct Disorder the percentages increase for a
co morbid learning disorder (Vance & Luk, 2000). One theoretical position (Velting &
Whitehurst, 1997), is that according to Spira and Fischel, (2005) those children with ADHD do not
acquire the literacy skills necessary for early reading and learning. Furthermore, it is hypothesized
that the frustration due to lack of ability perpetuates acting out behaviors consistently witnessed by
school staff of children with ADHD (Spira & Fischel, 2005).
As children move through adolescents it is abundantly clear that with vast developmental changes;
finding ones role identity as clarified by Eric Erickson (Berger, 2006), relational dating, peer
pressure, and other demands of adolescents become extraordinarily difficult with individual
difficulties of impulsiveness, hyperactivity and inattentiveness (D. Moilanen CMSW, Personal
Communication, January 25, 2007). According to Gordon (2006), adolescents continue to have
many difficulties especially;
1.Disorganization
2.Planning long term assignments
3.Completing homework
4.Complying with parental rules.
5.Sustaining attention and focus
Because adolescents are seeking to find a competent and healthy identity, conflicts with parental
and academic systems can leave an adolescent to feel diminished, angry and frustrated before the
entry into adulthood (D. Moilanen CMSW, Personal Communication, January 25, 2007).
Adulthood brings new challenges and according to Jaffe, Benedictis, Segal & Segal, (2006),
the following are just a few of the challenges for adults living with ADHD;
1.Managing money
2."Zoning out in conversations"
3.Speaking without thinking
4.Procrastination
5.Becoming easily frustrated
Eric Erickson in Berger (2006) clarifies his theory of Psycho-Social Development and indicates
that as early adults we want to find intimacy or we will face isolation. It seems clear that these
adults due to their disability will continue to confront difficulties with their families, social
relationships, and negative individual perceptions onward into adulthood. These difficulties could
place them at risk to become isolated.
The individual within their family is greatly impacted by this developmental disorder. According to
Barkley (2005) ADHD is 25 to 30% acquired by heredity, and if a parent has ADHD the child is 8 to
10 times more likely at acquiring the disorder. Barkley (2005) also indicated that parents at the
beginning of preschool attend and manage their child fairly well, however; parents tend to lose
what they feel as control over their child the further the child develops through school. Parents can
feel drained, overwhelmed and exhausted; even feeling depressed, and begin blaming themselves
for their child's behavior (Barkley, 2005). Over time these difficulties can lead to perceptions by
parents that may be less than positive (Maniadaki, Sonuga, Kakouros, & Karaba, 2006).
Research shows that parental perceptions within the family can clearly have implications regarding
how a child is treated and the negative affects and perceptions that affect the child's
developmental stages (Maniadaki et al., 2006). According to Maniadaki et al., (2006), parental
perceptions do have significant impact upon children suffering from ADHD due to the likelihood of
the parents not obtaining mental health services for their children; the difficulty parents had
identifying the impact the child's behavior would have on the child's development; and the parents
inability to identify the severity of the child's symptoms, all have dramatic affects on the child's
developmental processes. Siblings can also have negative perceptions of the child's behavior,
affecting the degree of support siblings bring to each other within a family. According to Gordon
(2006), siblings can feel sorry for their sibling with ADHD or they can get angry and resentful.
These reactions create dynamic challenges for any family and or individual dealing with ADHD.
Other possible hindering perceptions by parents within the family system can be identified by
comparing Erickson's, Psycho Social Developmental Perspectives (Berger, 2000). According to
Erickson, children from the age of 3 yrs. old to 6 yrs. of age will develop through a series of
challenges to parents, taking the "initiative" or "failing," bringing feelings of "guilt" (Berger, 2000).
When the child's challenging behavior takes place however, as Camparo, Christensen,
Buhrmester & Hinshaw, (1994) states, that parents may not allow these children to have the
benefit of the doubt, due to past excessive behavior under normal circumstances, and the parents
may see their child as an "easy target." According to the evidence, miscalculating the child's
natural challenging behavior could take place and disallow the child to develop in a healthy, "guilt
free" way, having significant affects on their psycho-social development. Excessive amounts of
guilt can produce significant amounts of anxiety and depression (Burns, 1990). These negative
processes in variable degrees can clearly lead to negative affects on social and emotional
processes (Burns, 1990).
Other family processes affecting ADHD and development according to Peris & Hinshaw
(2003), is that core symptoms of impulse control and inattention are primarily heritable, and
parental practices do not warrant significant (Barkley, 1998; Hinshaw 1994; Johnston &
Mash, 2001), causation for ADHD. However, the family interaction patterns and external
influences may have a significant impact on severity and the developmental course of ADHD
(Peris & Hinshaw, 2003). Furthermore, evidence suggests (Barkley, 1985; Battle &
Lacey, 1972; Buhrmester, Camparo, Christensen, Gonsalez, & Hinshaw, 1992; Campbell,
1973; Cunningham & Barkley, 1979; MacDonald, 1988; Mash & Johnston, 1982;
Tallmadge & Barkley, 1983) that mothers of ADHD children are less affectionate. Other
disturbing findings indicate that parents can be more critically demanding and parents
independently report a greater tendency to blame their ADHD child for problems they actually had
with their spouses; thus proving further that family systemic patterns can play a major role in the
perpetuation and affects of ADHD upon child development (Camparo et al., 1994). Of course
these processes clearly affect a school-age child within their families and external systems in ways
which reduce a child's self worth, confidence, and abilities to properly interact and function within
their environment; proving this, Dumas & Pelletier (1999) indicated that pre-adolescents
were found to have lower levels of self esteem in areas of scholastic competence, behavioral
conduct, and social acceptance.
According to Barkley (2005), those with ADHD, at times do not give themselves time to evaluate
their emotions objectively before a reaction, fail to separate their feelings from fact. Being able to
internalize our emotions, evaluate them, and analyze them before displaying them publicly assist
in self control and is difficult for those suffering from ADHD (Barkley, 2005). Those who suffer from
ADHD develop a pattern of social rejection due to inappropriate interactions beginning during
formalized schooling according to Barkley (2005). According to Nixon (2001), those children
suffering from ADHD lack significant social skills that affect the quality of their interactions, such
as; verbal & physical aggression, disruptive attempts to enter new groups, negative
classroom behaviors, being quick tempered and violating the rules. Nixon (2001) presents more
evidence that social cognition is clearly affected and children with ADHD can have great difficulty
in making clear interpretations of their environmental interactions with others. These variables
clearly lead to inhibited social contact, and a dysfunction in psycho-social development. According
to Eric Erickson in Berger (2000), he clearly indicates that formalized school age children from 7 to
11 years old need to develop confidence that allow them to feel as if they have mastered
"Industry" (Berger, 2000). If this stage is not mastered, they may feel inferior (Berger, 2000). How
can these children who are excluded due to their ADHD manifestations of behavior, be given the
chance to participate and prove themselves to resist negative aspects of "Inferiority?" As these
children develop into adolescents and adults, one can hypothesize when comparing ADHD
behavior and social reactions with the Erickson Psycho-Social Framework (Berger, 2000).
Erickson states that adolescents attempt to find their roles in the world and if they fail, role
confusion develops (Berger, 2000). Confusion for those suffering from ADHD would come easily
due to their exclusion from social groups and activities (Barkley, 2005). In order for adolescents to
find their role and their identity; they must interact with others and feel accepted in their
participation (Berger, 2000). Further into adulthood Erickson in Berger (2000), indicates that as
adult's, individuals will seek intimacy with others or become isolated. The factor of isolation relates
to the extent in which those developing fear rejection and disappointment (Berger, 2000).
Unfortunately, prior social experiences of those suffering from ADHD can be littered with social
rejection, feelings of disappointment and unacceptance due to impulsiveness and hyperactive
behaviors (Barkley, 2005). Furthermore, (Pope, Bierman, & Mumma, 1999), these authors
according to Nixon (2001), also claim that hyperactivity and the inattentive / immature nature of a
child's behavior with ADHD contributes greatly to interpersonal problems.
In regards to social justice and cultural issues; according to Bender (2006), African American
children may be under represented and under diagnosed in regards to ADHD. Experts such as
(Dr. Rahn Bailey, 2006) according to Bender (2006), claim that as science is pursuing new
technological processes to diagnose and treat ADHD, cultures like the African American
community are subjected to propaganda, suspicion due to past and current discrimination, and
negative stereotyping regarding mental illness; thus forming cultural decisions to avoid diagnosis
and treatment of ADHD. This cultural-lens, based upon discriminatory and fear based experiences
with the dominant culture dis-allows ethical decisions to help and assist African American children
(Bender, 2006). These decisions according to experts (Bailey, 2006), is contributing to high rates
of African American children disproportionately over represented in remedial programs and
disproportionate amounts of African American children over represented in the criminal justice
system (Bender, 2006). The issues of classism and impoverishment can also be a topic of concern
regarding those who suffer from ADHD. According to Visser & Lesesne, (2005), ADHD
diagnosis among males was reported significantly more often in families with incomes below the
poverty threshold than in families with incomes at or above the poverty threshold. Here again,
poverty makes a clear and consistent statement of risk for our developing children.
In conclusion, I believe that ADHD seems to be an elusive, devastating, developmental disorder.
This disorder for my self is so destructive because of its manifesting elements of hyperactivity,
impulsivity and inattentiveness. These variables are processes that if represented to certain
degrees are perfect for destroying social, educational, emotional and individual development
across the life span. Because our lives are so dependent upon not just our biological construction
but also our social and environmental interaction; this disorder can be serious and detrimentally
disruptive. I do however believe that new technologies are hopeful in understanding this disability
in greater measures. I also have gained ideas regarding the new information regarding neuro-
plastisity and the changing mind based upon therapeutic thought. I feel this may be a possible
frontier of research that should be a priority in better understanding how the brain can change
forms; especially the pre-frontal cortex regions.
L.J. Riley Jr. BSW, LLMSW
Reference
Barkley, R. A., (2005). Taking Charge of ADHD: The Complete Authoritative Guide for
Parents. New York: The Guilford Press.
Bender, E., (May 19, 2006). Scare tactics may deter blacks from ADHD help. Psychiatric News, 41
(10) 16. Retrieved January 20, 2007 from [http://pn.psychiatry]
online.org/cgi/content/full/41/10/16.
Berger, K. S., (2001). The Developing Person: Through the Life Span. New York:
Worth Publishing.
Burns, D. D., (1999). The Feeling Good Hand Book. New York: Plume Books.
Camparo, L., Christensen, A., Buhrmester, D., & Hinshaw, S., (1994). System functioning in
families with ADHD and non-ADHD sons. Personal Relationships, 1, 301-308.
Dumas, D., & Pelletier, L. (1999). Perception in hyperactive children. Maternal Child
Nursing, 24, 12-19.
Gordon, J., (2006) Ohio facts sheet; adolescents with ADHD. Retrieved January 20, 2007 from
[http://ohioline.osu.edu/hyg-fact/5000/5270.html].
Jaelline J., Benedictis, T., Segal, R., & Segal, J., (March 7, 2006). Adult ADD & ADHD:
recognizing the symptoms and managing the effects. Retrieved on January 20, 2007 from
http://www.helpguide.org/mental/adhd_add_adult_symptoms.htm.
Laigne, J.V., Gibbons, R.D., Christoffel, K.K., Arend, R., Rosenbaum, D., Binns, H., et al. (1996).
Prevalence rates and correlates of psychiatric disorders among preschool children. Journal of the
American Academy of Child and Adolescent Psychiatry, 35, 204-214.
Maniadaki, K., Sonuga-Barke, E., Kakouros, E., & Karaba, R., (February, 21, 2006). Parental
beliefs about the nature of ADHD behaviors and their relationship to referral intentions in
preschool children. Journal Compilation of Blackwell Publishing. Retrieved on January 20, 2007
from http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2214.2005.00512.x.
Neufeld, P., & Foy, M., (2006). Historical reflections on the ascendancy of ADHD
in North America. British Journal of Education Studies, 54, (4), 449-470.
Nixon, E., (2001). The social competence of children with Attention Deficit Hyper-
activity Disorder: a review of the literature. Child Psychology & Review of the
Literature, 6, (4), 172-177.
Peris, T. S., Hinshaw, S. P., (2003). Family dynamics and preadolescent girls with ADHD: the
relationship between expressed emotion, ADHD symptomatology, and comorbid disruptive
behavior. Journal of Child Psychology and Psychiatry, 44 (8) 1177 - 1190.
Rafalovich, A. (2001). The conceptual history of Attention Deficit Hyperactivity
Disorder: idiocy, imbecility, encephalitis and the child deviant, 1877-1929.
Deviant Behavior: an Interdisciplinary Journal, 22, 93-115.
Singh, I., (2002). Children and society. Center for Family Research University
of Cambridge, 16, 360-367.
Spira, E. G., Fischel, J. E., (2005). The impact of preschool inattention, hyperactivity, and
impulsivity on social and academic development: a review. Journal of Child Psychology and
Psychiatry, 46 (7), 755-773.
Stubbe, D. E. (2000). Attention-deficit/hyperactivity disorder overview: historical
perspectives, current controversies, and future directions. Child and Psychiatric
Clinics of North America, 9 (3), 469-479.
Vance, A. L. A., Luk, E. S. L., (2000). Attention deficit hyperactivity disorder: current
progress and controversies. Australian and New Zealand Journal of Psychiatry, 34,
719-730.
Visser, S. N., Lesesne, C. A., (August 31, 2005). Mental health in the United States: prevalence of
diagnosis and medication treatment for attention-deficit/hyperactivity disorder --- United States,
2003. Retrieved January 20, 2007 from
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a2.htm
Willoughby, M. T., (2003). Developmental course of ADHD symptomatology during
During the transition from childhood to adolescence: a review with recommendations.
Journal of Child Psychology and Psychiatry, 44 (1), 88-106.
L.J. Riley Jr. is a writer of metaphorical and childrens literature, motivational poetry and an
advocate for those in need. L.J. graduated from Davison, Michigan in 1988 and joined the U.S.
Army where he served as a combat veteran. College career includes; a Phi Theta Kappa graduate
from Mott Community College, a Maize and Blue Scholar Award Winner from the University of
Michigan Flint, a National Scholarette Nominee, a published recipient in the National Deans List, a
Golden Key Honors Graduate, and a recipient of the Howard and Judy Simms Fellowship at the
University of Michigan School of Social Work in Ann Arbor, Michigan. He resides in Burton,
Michigan and can be contacted at Compassionpwr@juno.com
Article Source:
http://EzineArticles.com/?expert=Laverne_John_Riley_Jr.
==== ====
American Top Best Selling Perfect Publishing System !
http://bit.ly/wJ8LbI
==== ====