ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

A Research Paper presented to the faculty of English Department of Xavier University High School. Ateneo de Cagayan

In partial fulfilment of requirement of English IV

Fay Isabel A. Ranido IV- St. Juan del Castillo

February 8, 2011

Table of Contents

I. II.

Introduction Background of the Study A. Statement of the Problem B. Significance of the Study of ADHD C. Scope and Limitations of the Study D. Definition Of Terms

3 4 4 4 5 5 6 6 7

III. IV. V.

What is Attention-Deficit/Hyperactivity Disorder? Diagnosis of Attention-Deficit/Hyperactivity Disorder Different Types of ADHD A. Predominantly Inattentive Type B. Predominantly Hyperactive-Impulsive Type C. Combined Type

VI.

Symptoms of Children with ADHD A. Behaviour of Predominantly Inattentive Type B. Behaviour of Predominantly Hyperactive-Impulsive Type C. Behaviour of Combined Type

VII.

Factors that causes ADHD A. Mothers Pregnancy Period B. Genes C. Others

9 10 11 12 12 13 14 15 16 17

VIII. IX. X. XI. XII. XIII.

What do not cause ADHD Advantage of an ADHD Child Disadvantage of an ADHD Child Treatments and Medications for Children with ADHD Conclusion Bibliographies

I.

Introduction Attention-Deficit Hyperactivity Disorder is a condition that involves behavioural

problems which normally occur on children. ADHD Society of the Philippines stated that children these days are very hyperactive. Some cant wait for their turns, others make nonstop noises, and most or rather all of them are always running around like as if they do not have any other time to run and play with their friends and siblings. But not all children with these behaviour are normal, some children with these kind of behaviours are special. And these children are the ones we call children with Attention deficit /hyperactivity disorder. They have behavioural problems that interfere and affect their normal lives. Furthermore, these problems make it difficult for them to adjust, which means the people around them are the ones who must adjust to be able to fit them into our society. I have been living with my cousin with ADHD for almost 4 years and before he was diagnosed with ADHD we were so dumb-confused on the kind of behaviour he was showing to us. We did not know how to treat him because he sometimes has erratic mood with restlessness and short attention span. He throws tantrums if he could not get his wants and frequently encounters fights with his peers. He also like to make-up stories that deceived other people and make up excuses to escape an action. He has poor academic performance in school and he tends to forget the important things he needs to do like brushing his teeth and cleaning his nails. After these observations, his parents finally decided to consult a psychologist. And according to the pediatrician, my cousin is an Attention Deficit/Hyperactivity Disorder Combined Type with Mild Learning Disability. He can read but there are certain words that he cannot pronounce, he cannot stay focus if he is unsupervised. He can only sustain 10-15 minutes after which he is already squirmy and fidgety. The doctor said, If the disorder is left untreated a severe form of ADHD will lead him in his misery. His parents were advised to find an activity that would make him busy and make him stay out of trouble. Now my cousin is into Kumon study, which aims to teach children how to do independent learning and this is one of the ways why he is
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having a better life right now but there are times were he still throw tantrums and lie to us. But what must be done in order to fully understand children with Attention Deficit Hyperactivity Disorder? A lot of parents and families are having a hard time to treat their children or siblings. This study aims to find answers to the concerned people around children with ADHD and possible treatments and medications. II. Background of the Study

A. Statement of the Problem The purpose of the study is to find better treatment and medications to guide parents and people understand children with ADHD. Specifically, this study aims to answer these questions: a.) How do we know that a child has Attention Deficit Hyperactivity Disorder? b.) What are the different types of children with ADHD? c.) What are the factors that could cause ADHD? d.) What are the possible treatments and medications for children with ADHD?

B. Significance of the Study The study of Attention-deficit/hyperactivity disorder would be beneficial to a lot of people concerned about children with ADHD. Specifically to: Parents. This study aims to give free reference to parents who are concerned to children with ADHD. Practicality is indeed a concern to most people in the society today and people cannot afford to spend much on something. As such, this study will guide every parent on how to treat children with ADHD to be able to give them a good life. Teachers. To children, teachers are their second parents for school is their second home. The same with parents they must be able to know how to treat and

understand children with ADHD so that they will not feel that they are different from other children. Society. As people we must treat each other the right way. Making children feel that they are valuable to us is a good way to understand children with ADHD. This will provide basic information to people who do not have any knowledge about these special children. Future Researchers. This will provide massive information that will aid researchers in their relative studies. C. Scope and Limitations of the Study The study will only focus on the basic information that answers the questions and only children with ADHD. No fieldwork is done like surveying. Thus, additional information like ADHD as another cause of another disorder is not included for it could widen the information and would need a broader discussion which will result into a failure of focusing on the main topic. The study is also compose of limited information on the factors that causes of ADHD for there are only limited information used and lack of resources. D. Definition of Terms Most glossaries have the same definition and some do not have an exact definition which is why the terms are explain based on common use.

Neurotransmitters - powerful chemical messengers in the brain Cyanide a kind of chemical compound; cyanides are highly toxic; produced by certain bacteria, fungi, and algae and are found in a number of plants

Lead is a poisonous substance to animals. It damages the nervous system and causes brain disorders. Excessive lead also causes blood disorders in mammals

Nicotine a chemical substance wherein if it enters the body there is a possibility that it will affect a variety of neurotransmitters.
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Carbon Monoxide a colourless gas in the air; highly toxic and can damage the body if high amount of it is taken in. Toxic brew a production of toxic substance Bloodstream a part in the body were the blood passes. The Kinney Medical and Gynecological Questionnaire a

questionnaire used by doctors for pregnant mothers. Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association Guidelines used by the doctor to determine if a child has ADHD Stimulants drugs that are induce to give temporary improvements in both physical and mental problem.

III.

What is Attention-Deficit/Hyperactivity Disorder?

Attention-Deficit/Hyperactivity Disorder is a neurological disorder which affects school-aged children from 3 to 5 %. ADHD was called before as minimal brain damage as to the assumption that it is a mild brain damage. The symptoms normally start to occur before the age of 7 yet some of the children with ADHDs symptoms occur as they reach their teenage years. This disorder could reach into adulthood if not treated immediately. Boys are three times more likely affected with ADHD than girls. ADHD children are the ones who are very active than the normal children in school. In addition, ADHD is a condition wherein children find it difficult to stay still, control their behaviour and stay focus. It affects a person physically and emotionally.

IV.

Diagnosis of Attention-Deficit/Hyperactivity Disorder

It is not easy to

determine whether a

child has Attention-

Deficit/Hyperactivity Disorder or none. There are a lot of processes involved in diagnosing a child. And one of this is observing the childs behaviour. A physician cannot just conclude directly that the child has ADHD since there are a lot of
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things to consider before declaring that the child has ADHD. To be diagnosed with ADHD the child must have at least 6 symptoms of any type of ADHD. Moreover, Kneisl & Trigoboff, 2009 stated that, Attention-

Deficit/Hyperactivity Disorder is normally diagnosed in early school years, when the demand for sustained attention increases. In contrast, by late childhood and adolescence the symptoms become less apparent. According to the ADHD Society of the Philippines, to determine whether a child has ADHD the parent must consult a physician. Furthermore, the doctor will interview the parent of the child and ask how the child is doing. In addition, the doctor will observe and evaluate the childs behaviour and compare it to other childrens behaviour, and will refer to the ADHD standard guidelines, the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.

V.

Types of ADHD Attention-Deficit/Hyperactivity Disorder is classified in three different types such that there are different kinds of symptoms shown by each type. The three different types of ADHD are Predominantly Inattentive Type, Predominantly Hyperactive-Impulsive Type, and Combined Type. A. Predominantly Inattentive type These children are not very active. Nevertheless, they fail to give their full attention on an activity and they get easily distracted by the things around them. They make careless mistakes and forget the things they need to do. Furthermore, they hate tasks that require their full attention since they easily lose focus. Their symptoms may not be easily noticed. Inattentive type is most common on girls.

B. Predominantly Hyperactive-Impulsive type This type of children is the opposite of the Inattentive type of ADHD children for they are very active and cannot stay in one place. Whenever
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there are activities, like in class, they cannot do something quietly and they talks excessively. They run, jump and climb around as if they do not have any other time to do it. Fidgets in hands or feet or squirms in chair. In addition, they cannot wait for their turns and interrupts others. In contrast, they can pay attention.

C. Combined Type These are children who have the symptoms of both Inattentive and Hyperactive-Impulsive types of children. They are often forgetful and hyperactive. They have a hard staying focus but there are also times that they pay attention.

VI.

Symptoms of children with ADHD

A person cannot easily predict or conclude that a child has ADHD even if the symptoms are present. Children these days are very active and playful and have short attention spans. Moreover, they do not stay in a certain task for too long and many children are not doing well in school. Based from an anonymous author from the internet site of Yahoo! Health, for a child to be diagnosed with ADHD the symptoms must be present for at least 6 months and observable in two or more places, like school or at home. In addition, the symptoms present must not be a cause by another problem and present before the age of 7. Proper evaluation and observation must be done before concluding. These are the symptoms of the different types of ADHD: A. Predominantly Inattentive type Has difficulty organizing tasks Does not seem to listen Often forgets the important things he/she needs to do Easily distracted Often loses focus
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Struggles to follow instructions

B. Predominantly Hyperactive-Impulsive type Fidgets with hands or feet or squirms in chair Excessive talking Runs or climb excessively Interrupts others Acts as if driven by a motor Very active and has difficulty remaining seated Cannot wait for his/her turn Blurts out answers before questions have been completed

C. Combined Type Have both the symptoms of both Inattentive and Hyperactive type.

VII.

Factors that cause ADHD.

There

are

many

factors

involved

that

caused

Attention-

Deficit/Hyperactivity Disorder. But no one really knows the true reason for the existence of this disorder. Based from Charles Harrison of adhd.org, medical and scientific community agreed that ADHD is biological in nature and many also believed that a chemical imbalance in the brain was the reason for the disorder. Several factors have been suspected as causes for Attention Deficit/Hyperactivity Disorder, and some of these are:

A. Communication of the brain between neurons. Charles Harrison of adhd.org stated that, Neurotransmitters are passed between neurons, and this is how neurons communicate with each other. And because of this, researchers suspected that a problem may have occurred in the brain that associated the passing between neurons in the brain that caused the disorder.
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B. Mothers Pregnancy Period Mothers should take care of themselves especially when they are in their pregnancy period because every action they do and every food they eat can affect the baby in their womb.

Cigarette Smoking Cigarette smoking during pregnancy is one of the causes of ADHD. According to Chris Woolston, 2009, a cigarette smoke contains more than 4, 000 chemicals, like cyanide, lead, nicotine, carbon monoxide, and many other harmful chemicals that are not good for the health of the baby and the mother. Smoking during pregnancy could make the toxic brew get into the bloodstream of the babys source of oxygen and nutrients and the red blood cells that carries oxygen starts to pick up the carbon monoxide and the narrow stream cannot hold as much oxygen as it does before. In addition, the shortage of oxygen can have a harmful effect in the baby, especially to the babys brain. As such, it could complicate the mothers pregnancy and would put the life of the infant in danger and the infant could possibly die.

Stress When we think of stress for us it is not a very big problem anymore. Our generation today is practically used to being stressed everyday for time flies so fast that everyone of us are busy of our schedules even pregnant women with their work. But this stress could cause a big damage to the infant in the mothers womb. A mother needs to rest for at least 8 10 hours each day so that the baby inside will be healthy when it comes out. McGill University researchers conducted a study using The Kinney Medical and Gynecological Questionnaire, whether there is a connection
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between the severity of maternal stress during pregnancy and their offspring. The results showed that 203 children from 6-12 years old of age were identified with ADHD due to maternal stress and this is an enough reason why maternal stress should be avoided during pregnancy period.

Birth complications Dr. Yannick Pauli, 2010, stated that the best way to give birth is when the baby passes through the vagina for the pushing motion activates the primitive neurological reflexes that are needed for the proper neurological development of a child. But, this does not mean that the child will be safe from any developmental problems. Stressful birth, like a lot of pulling and twisting are done it can damage the tissues in the delicate part of the neck and affect the spines ability to send messages to the brain. This is why a healthy pregnancy is advised by the doctor to avoid complications.

C. Genes Genetic plays an important role in our lives. It can have an advantage but it also has a disadvantage. A disadvantage because a family trait or disease can possibly be inherited from a family member of yours and it can never be avoided. Researchers before thought that ADHD could be the result of poor parenting skills and deprivation of social privileges but they stand corrected. A clinical study proved that ADHD can be inherited, as the parent of the child with ADHD was interviewed and found out that they also had the symptoms of ADHD when they were young. According to an anonymous author in the internet site addandadhd.co.uk, the strongest evidence for a genetic link to ADHD comes from a careful study of twins, 72 to 83 per cent probability that the other twins would also have ADHD signs. In contrast, the findings in nonidentical twins of the same sex lowered down to 21 to 45 per cent. The disorder can skip generation and the effects can be mild in some people.
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Nevertheless, poor parenting skills are very unlikely the cause but it can help in exacerbating the problems.

D. Other Causes A sudden life change Divorce of parents, death of an important person, disrupted families and change in residence can cause a traumatic event in a childs life. It can have a big impact to them and it can cause depression and anxiety, which is also another cause of ADHD. In addition, children cannot easily understand what is happening, they needed to be guided and explained so that they can slowly accept the unfortunate event that happened to them. Brain injuries Brain damage can cause a big problem to the child as a whole. There is a part of the brain that is responsible for organizing thought and if this part is affected by the injury it can affect the thinking ability of the child.

VIII.

Factors that do not Cause ADHD Bad Parenting Skills Researchers before concluded that bad parenting skills is one the reason why a child has ADHD but as time goes by and as researchers continued on researching, slowly they uncovered the truth that it is not one of the reasons that contribute to the existence of ADHD. In contrast, it can help in making the situation worst. Sweets Just like bad parenting skills, sweets are also mistaken as the reason of ADHD. Researchers thought this can make the matter worst since it can cause hyperactivity, true, but it can never be the reason. Chocolates
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have a component called Theobromine that causes a child to be very active. Theobromine is found on cocoa and any product that has an ingredient of cocoa can affect the childs behaviour.

IX.

Advantage of being an ADHD Child Keep in mind that a child with Attention-Deficit Hyperactivity Disorder does not only have disadvantage but also an advantage. Most children with ADHD are intellectually or artistically gifted. Furthermore, parents may not notice that their child has ADHD because of their intellectually-gifted abilities. Creative. ADHD children, especially Inattentive type are fond of daydreaming and because of this they can think of 10 different thoughts at once and can fountain a lot of ideas. Not all children are able to do this kind of activity only gifted ones. Enthusiastic and Spontaneous. ADHD children, as a matter of fact are fun to be with. They are very lively and interesting in different ways. Energetic. They are difficult to distract whenever they are doing something that interest them. They play and work very hard.

X.

Disadvantage of being an ADHD Child

It is sad to note that children with ADHD are sometimes discriminated. Because of their special ability many children do not like how the way they act and treat people. Based from Susan-Nolen Hoeksema, 2004, children with ADHD have extremely poor relationships with other children. They are often rejected by other children because of their attitude. Furthermore, children with ADHD, if not treated, can lead to serious cases like having criminal behaviour, drug addiction and emotional problems. In addition, children with ADHD are irritable, demanding and have problems interacting with their peers because they are disorganized and never

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finish anything. They want to play with their own rules and if things do not go their way they throw tantrums and this eventually leads to physical violent.

XI.

Treatments and Medication with Children

There are a lot of medications and treatments to maintain to help children with ADHD. There is no cure to ADHD but with good parenting skills and maintaining of medication, it can lessen the hyperactiveness of an ADHD child. With medications it is easier to control the impulses of a child but there are no long-term effects on stimulants and researchers are still looking and researching for a very effective medicine. Medical Treatments According to Kneisl, 2009, it is very important to monitor the childs vital signs as each dose wears off ever 3-5 hours so a schedule is important for the childs parents who manage the medication. Stimulants, like Ritalin, the number one stimulant that is advised by most doctors to be used by children with ADHD can result in fast but temporary in both performance and social interaction. It can make them control their behaviour and pay attention. Many parents are having second thoughts in using stimulants for it might not be effective and very expensive but doctor have proved that for more than 50 years of treating stimulants are the number one safe and successful medication used. But there is no proof that these stimulants could have long term effects for long term studies have not been done. Emotional and Physical Treatment The best way to medicate a child with ADHD is through a love from a parent. ADHD is hard to treat for it needs a lot of patience and

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understanding from a parent. But if it means giving the child a better future then it will be a fruitful sacrifice. According to an anonymous author of the internet site familydoctor.org, a team effort of teachers, parents and doctors is the best way to help a child with ADHD. Handling a child with ADHD is a very difficult task. One of the things that can help the lives of children with ADHD a light one is by making a daily schedule for them, a constant schedule that they will follow. It will also help them stay out of trouble if you will give them simple house rules that are very easy to follow. In school, teachers can help them by giving them tasks that they can work on and make theirselves busy. Giving them simple reward as a token for a good deed is also another way that could make them feel appreciated. Understanding them is the best solution but considering the bad deed they have done is another story. They must also be taught of the things they must not do.

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XII.

Conclusion

Attention Deficit Hyperactivity Disorder could not be avoided if genes are being talked about but it can be avoided by a mother during her pregnancy period by being careful. Since the mothers activity can affect the baby inside. There is no cure for Attention-Deficit/Hyperactivity Disorder. Researchers are still looking for a cure for this disease but medical assistance and parental guidance proved to be a good help to children with ADHD. Treating them like normal children would make them feel that they are not different from other children. Discriminating ADHD children should be avoided for it could have a big impact on them. Nevertheless, considering something that they have done wrong should not be allowed for they might think that it is good to do something not right. In addition, they should also be given rules to follow so that they would not take advantage and use the reason that they are special. Parental guidance is indeed a must to children with ADHD. Parents are the only ones who can understand their children better and make them feel loved. Medical treatments can help lessen the attention disorder yet it can only have temporary effects to children for there is still no long term medicine discovered that could be used for a lifetime. A team effort is expected from teachers, parents, and doctors because it is the best way to help the child face every challenge he/she will face. As stated by an unknown author in an internet site on chadd.org, Effective treatment of ADHD in children requires comprehensive approach that professionals call multimodal. It means that the best outcomes are attained when multiple interventions work together as a part of a comprehensive treatment plan.

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XIII.

Bibliographies Books Hoeksema, Susan-Nolen. Attention Deficit Hyperactivity Disorder. Abnormal Psychology 3rd Edition. USA: McGrawHills, Inc., 2004. (2004): p. 439 440, 471. Kneisl, Carol and Trigoboff, Eileen. Attention Deficit Hyperactivity Disorder. Contemporary Psychiatric-Mental Health Nursing 2nd Edition. New Jersey, USA: Pearson Education Inc. (2009): p. 695-696, 717. Periodicals Agcaoili-Manaligod, Ma. Paz. Coping with Children with ADHD. Philippine Panorama. Volume 37 No. 41. (October 12,2008): p. 16-17. Boswell, Delphine. Turn Deficits into Dividends. Religion Teachers Journal. Volume 34 No. 1. (February 2008): p. 12-13 Web Pages Attention Deficit/Hyperactivity Disorder: Causes of ADHD. Cleveland Clinic. The Cleveland Clinic 1995-2011. 2010. <http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/ hic_Attention_Deficit_Hypeactivity_Disorder_Causes_of_ADHD.aspx> Attention Deficit/Hyperactivity Disorder: Nonstimulant Therapy(Strattera)and other ADHD drugs. Cleveland Clinic. The Cleveland Clinic 1995-2011. 2010. <http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/ hic_Attention_Deficit_Hypeactivity_Disorder_ Nonstimulant _ Therapy _ Strattera_and_Other_ADHD_Drugs.aspx> Attention Deficit/Hyperactivity Disorder (ADHD) and Medications. Cleveland Clinic. The Cleveland Clinic 1995-2011. 2010. <http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/ hic_Attention_Deficit_Hypeactivity_Disorder_ ADHD _and_Medications.aspx> Attention Deficit/Hyperactivity Disorder: Stimulant Therapy. Cleveland Clinic. The Cleveland Clinic 1995-2011. 2010. <http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/ hic_Attention_Deficit_Hypeactivity_Disorder_ Stimulant _Therapy.aspx> Attention Deficit/Hyperactivity Disorder: ADHD Basics. Cleveland Clinic. The Cleveland Clinic 1995-2011. 2010. <http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/ hic_Attention_Deficit_Hypeactivity_Disorder_ ADHD _Basics.aspx>

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ADHD in Children. Cleveland Clinic. The Cleveland Clinic 1995-2011. 2010. <http://my.clevelandclinic.org/disorders/Attention_Deficit_Hyperactivity_Disorder/ hic_ADHD_in_Children.aspx> Attention Deficit Hyperactivity Disorder. Kennedy Krieger Institute. 2005 Kennedy Krieger 707 North Broadway, Baltimore. 2005. <http://www.kennedykrieger/org/kki_diag.jsp?pid=1071>. Attention-deficit/hyperactivity disorder (ADHD) in children:Cause. MAYO CLINIC. 1998-2011 Mayo Foundation for Medical Education and Research. 2011. <http://www.mayoclinic.com/health/adhd/DS00275/DSECTION=causes>. ADHD: Historical Development of ADHD. Mentalhelp.net. Copyright Centersite, LLC, 1995-2010. 05.November.2007. <http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=13848&cn=3>. ADHD. American Psychological Association. 2011 American Psychological Association.2010. <http://www.apa.org/topics/adhd/index.aspx>. Attention Deficit/Hyperactivity Disorder (ADHD). Centers for Disease Control Prevention. CDCD 1600 Clifton Rd. Atlanta, GA 30333,USA. 25. May. 2010 <http://www.cdc.gov/ncbddd/adhd/facts.html>. ADD/ADHD in Children: Signs and Symptoms Of Attention Deficit Disorder. Helpguide.org. 2001-2010. 2010. <http://helpguide.org/mental/adhd_add_signs_symptoms.htm>. Attention Deficit Hyperactivity Disorder (ADHD). National Institute of Mental Health. National Institute of Mental Health: NIH Publication No. 08-3572. 27. September. 2010 <http://www.nimh.nih.gov/health/publications/attention_deficit_hyperactivity_disor der/complete_index.shtml>. Attention Deficit Hyperactivity Disorder (ADHD): treatments. Yahoo! Health. Copyright 2010 Yahoo! Inc. 2005. <http://health.yahoo.net/channel/add_adhd_treatments>. ADHD: What Parents Should Know. FamilyDoctor.org. Copyright 1999-2010 American Academy of Family Physicians. September. 2010. <http://familydoctor.org/online/famdocen/home/children/parents/behavior/118.htm l>. Stress During Pregnancy Increases ADHD Risk. Massachusetts General Hospital. Harvard Medical Center. Copyright 2011.2008. May. 10: <http://womensmentalhealth.org/posts/stress_during_pregnancy_increases_adh d_risk/>.
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