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Attention Deficit Hyperactive Disorder in Children (adhd)

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October 19, 2004

Attention Deficit/Hyperactive Disorder in children

Sam was your average 4-year-old boy. He had many friends and was well liked by everyone. All in all he seemed be well adjusted. However, when he started kindergarten, his teacher started sending notes home to his mother telling her that Sam was causing trouble and not following the rules. His mother was concerned, and would constantly try to get him to behave. But no matter how much he tried, Sam just kept on getting into trouble. Finally his mom took him to see a psychologist - maybe he would be able to tell her why Sam was always running around when he was supposed to be sitting, or why he was always fidgeting and not paying attention in class. After the conversation between the psychologist and Sam, which included Sam running around the room three times, knocking over a pile of papers, and a bit of conversing, the psychologist diagnosed Sam with ADHD. Sam's Mom was relieved to hear that there was a reason for his mischievous behavior, but was anxious to learn more about it. This is what she found out:

Attention Deficit Disorder, or ADD, as it is better known, is an inability to use skills of attention effectively. This results in children who are restless and easily distracted. The situation can be further exacerbated if a child also shows signs of hyperactivity, or an abnormal need for activity. In this case, the disorder is referred to as ADHD.

There are many more symptoms or signs that a child has ADD. For example, if a child, fails to pay close attention and constantly makes careless mistakes, gets easily distracted, talks excessively, is really impatient and relentlessly interrupts others, he most probably has ADHD. However, normal children also tend to have these tendencies, so how can one tell the difference between a normal child and one with this disorder? The National Institute on Mental Health addresses this question.

"Behaviors can be judged as normal, or "problem" ADD by evaluating them in relation to the person's age and developmental maturity. For example, the same behaviors that are acceptable in a 5-year old may be problematic for a 10-year old.

Problem behaviors are also long lasting, tend to occur more often and create more problems as time goes on. Children with ADD/ADHD will have more problems than other children their age experience in the same settings."1

Note: Since all children, at times, behave in these ways, only a professional can diagnose a child with ADHD.

ADD has a very interesting history. In 1902 the first clinical description of ADHD emerged, and was called "Morbid Defect of Moral Control." Time progressed and by the 1920's, ADHD encountered yet another name change. This time it was to be called, "Post-encephalitic Behavior Disorders." The mid 1960's were the years in which physicians first took into account that hyperactivity among children might be attributed to the structure of the brain, consequently the name was changed once again, this time to, "Minimal Brain Dysfunction". In 1980 the National Institute of Mental Health labeled this syndrome as Attention Deficit Disorder. One can have this disorder with or without hyperactivity; the former is called Attention Deficit Hyperactivity Disorder or ADHD. Amphetamines, a medication that was used to treat behavioral disturbances in children made its debut in 1937. In 1956, Methylphenidate, or better known as Ritalin was introduced as a treatment for hyperactivity. In the past decade prescriptions for stimulant medications to treat ADHD and Attention Deficit Disorder skyrocketed. The FDA approved 4 major treatments for ADD and ADHD. These treatments are: Concerta, Metadate, Focalin, and Strattera. Yet despite the long history of ADHD and millions of children currently taking ADHD medications, there is still a lack of adequate data on the long-term effects that ADHD treatments have on children.

Although these medications may calm the child down, there are those who feel strongly against using them. I have had such an experience when dealing with an ADD child who was under my supervision during camp. My co-counselor refused to give this child his Ritalin, because he felt that medication prevented the camper from being himself. I, on the other, felt that the camper needed his medication so as not cause harm to himself or others around him by acting up. This is one of the many moral issues that come up when discussing ADD.

Many children with ADHD have additional conditions that can complicate the diagnosis and treatment. Learning disabilities are the most frequent of these conditions. They include difficulty with reading, mathematics and written expression. These disabilities can cause the children to have a low self-esteem and poor social skills.

Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are also commonly found in children with ADHD, especially in boys. ODD is the defiant, negative and hostile behavior toward authoritative figures. CD is a disorder that includes aggression toward people and animals, destruction of property, deceitfulness, lying, or stealing, and serious violation of rules. The American Academy of Child and Adolescent Psychiatry states, "research shows that youngsters with conduct disorder are likely to have ongoing problems if they and their families do not receive early and comprehensive treatment. Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job." 2

Another set of symptoms that is commonly found amongst those who suffer from ADHD are mood and anxiety disorders. These mood disorders can go unnoticed until the child reaches adolescence or adulthood. Many experts believe that the effects of ADHD themselves may cause this anxiety or depression and lower self-esteem. When present, a mood or anxiety disorder can be treated in addition to the ADHD.

Due to the uncertainty of its origin many psychologists have theorized what the cause of ADHD may be. The most popular of these misconceptions were those blaming food, excessive television watching, or parents for their child's uncontrolled behavior. These factors were initially believed to be causes of ADHD because they appear to be connected. Parents claimed that when they fed their children sugar or various other foods, they became more hyperactive, while other diets claimed to eliminate hyperactivity. These and other mistaken beliefs were studied more in depth, and determined to be unfounded. For example, according to Robert D. Hunt, "contrary to parental beliefs, sugar did not make children significantly



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