Sunday, May 10, 2015

Attention Deficit or Hyperactivity Disorder

Attention Deficit or Hyperactivity Disorder

Roll: M120603014
Masters 1st year 1st semester
Educational & Developmental Psychology
Jagannath University
Attention, Deficit, or, Hyperactivity, Disorder, psychology, mental, amei, rifat, jnu, disorder,
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What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD is a brain condition that is often first identified in school-aged children when it causes disruption in the classroom or problems with schoolwork. ADHD can affect adults too. While some children seem to outgrow the disorder, or learn to compensate for the symptoms, others do not.

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žAttention-deficit/ hyperactivity disorder is a neurobehavioral disorder characterized by a combination of inattentiveness, distractibility, hyperactivity, and impulsivity.

žAD/HD appears early in life. It is estimated that 3 percent to 7 percent of school-age children are diagnosed with AD/HD; boys are diagnosed more often than girls. Untreated AD/HD has been shown to have long-term adverse affects on academic performance, vocational success, and social-emotional development. AD/HD children have difficulty sitting still and paying attention in class and do not do well at school, even when they have normal or above-normal intelligence. They engage in a broad array of disruptive behaviours and experience peer rejection.

žPerhaps as a result of their behavioral problems , hyperactive children are often lower in intelligence, usually about 7 to 15 IQ points below average.


Signs and symptoms

žInattention, hyperactivity (restlessness in adults), disruptive behaviour, and impulsivity are common in ADHD. Academic difficulties are frequent as are problems with relationships. The symptoms can be difficult to define as it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and significant levels requiring interventions begin.

žTo be diagnosed per DSM-5, symptoms must be observed in multiple settings for six months or more and to a degree that is much greater than others of the same age. They must also cause problems in the person's social, academic, or work life.

žBased on the presenting symptom ADHD can be divided into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined type.


An individual with inattention may have some or all of the following symptoms:

žBe easily distracted, miss details, forget things, and frequently switch from one activity to another

žHave difficulty maintaining focus on one task

žBecome bored with a task after only a few minutes, unless doing something enjoyable

žHave difficulty focusing attention on organizing and completing a task or learning something new

žHave trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities

žNot seem to listen when spoken to

žDaydream, become easily confused, and move slowly

žHave difficulty processing information as quickly and accurately as others

žStruggle to follow instructions
Causes
Genetically:

žHealth professionals are still unsure about what causes AD/HD. It may be a genetically determined disorder, as attention disorders often run in families. Studies indicate that 25 percent of close relatives in the families of AD/HD children also have AD/HD, whereas the rate is about 5 percent in the general population. Many studies of twins now show that a strong genetic influence exists in the disorder.


žRecent studies show that AD/HD is caused by neurobiological dysfunction. Scientists using neuroimaging and brain scanning tools for studying the brain have demonstrated a link between a person's ability to maintain attention and the level of activity in the brain. For example, scientists have found differences between the frontal lobes of individuals who have AD/HD and those who do not.

 
Environmental:


Environmental factors are believed to play a lesser role. Alcohol intake during pregnancy can cause fetal alcohol spectrum disorder which can include symptoms similar to ADHD. Exposure to tobacco smoke during pregnancy can cause problems with central nervous system development and can increase the risk of ADHD.

Very low birth weight, premature birth and early adversity also increase the risk as do infections during pregnancy, at birth, and in early childhood. These infections include, among others, various viruses (measles, varicella, rubella, enterovirus 71) and streptococcal bacterial infection. At least 30% of children with a traumatic brain injury later develop ADHD and about 5% of cases are due to brain damage.
 
Diagnosis
ADHD is diagnosed by an assessment of a person's childhood behavioural and mental development, including ruling out the effects of drugs, medications and other medical or psychiatric problems as explanations for the symptoms. It often takes into account feedback from parents and teachers with most diagnoses begun after a teacher raises concerns.


Behavioral therapies:

There is good evidence for the use of behavioural therapies in ADHD and they are the recommended first line treatment in those who have mild symptoms or are preschool-aged. Psychological therapies used include: psycho educational input, behaviour therapy, cognitive behavioural therapy (CBT), interpersonal psychotherapy, family therapy, school-based interventions, social skills training, parent management training, and neurofeedback.

žTraining in social skills, behavioral modification and medication may have some limited beneficial effects. The most important factor in reducing later psychological problems, such as major depression, criminality, school failure, and substance use disorders is formation of friendships with people who are not involved in delinquent activities.

žRegular physical exercise, particularly aerobic exercise, is an effective add on treatment for ADHD, although the best type and intensity is not currently known.
 

Medication:

  Stimulant medications are the pharmaceutical treatment of choice. They have at least some effect in the short term in about 80% of people. There are a number of non-stimulant medications, such as atomoxetine, bupropion, guanfacine, and clonidine that may be used as alternatives. There are no good studies comparing the various medications; however, they appear more or less equal with respect to side effects. Stimulants appear to improve academic performance while atomoxetine does not. There is little evidence on their effects on social behaviours. Medications are not recommended for preschool children, as the long-term effects in this age group are not known. The long-term effects of stimulants generally are unclear with one study finding benefit, another finding no benefit and a third finding evidence of harm.
 
Evaluation
žADHD is characterized by difficulties that interfere with effective task-oriented behaviour in children. The symptoms are relatively common among children seen at mental health facilities. The causes have been much debated but both environmental and biological factors are precursor of ADHD. For treatment, the use of behaviour therapy with medication in a total treatment program has reportedly shown good success.


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