Attention-Deficit/Hyperactivity Disorder, commonly referred to as ADHD, is a common brain disorder that tends to affect concentration, self-management and other skills considered significant in day to day life (Adler, Spencer & Wilens, 2015). Generally, inattention and impulsivity or hyperactivity is the main behaviors associated with ADHD. There are some individuals who only exhibit issues with one of the behaviors, while others may possess both issues.
In this paper, we will take a closer look at effective strategies that are used for children with ADHD. It will also discuss the effectiveness of play therapy and how stricter punishments for ADHD children do not really help, but rather worsen things. The paper will discuss how medication assists but only to a certain extent because while school may manage to improve on medication, home life sometimes does not. A conclusion will then be provided at the end.
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Introduction
The number of children estimated to have ADHD has transformed with time and its measurement tends to vary. According to the American Psychiatric Association (APA), an estimated 5% of children suffer from this particular disorder (El-Nagger, Abo-Emagd & Ahmed, 2016). In 2016, 9.4% of children aged between two years and seven years were diagnosed with ADHD, the number having increased by more than 50% from 2008 (Low, 2018). Overall, the number of children diagnosed with ADHD has reached 10%, something which is considered a significant increase in the course of two decades, according to research (Bell, Shader & Beauchaine, 2017). The increased has been observed mostly in minority groups, suggesting that better access to psychological health treatment and health insurance may have contributed to such increase (Floet, Scheiner & Grossman, 2010). America, in particular, has more recorded instances of ADHD compared to other developed nations, which researchers believe has resulted in some people believing that Americans are over-diagnosing their children.
It has been suggested that fewer stigmas regarding psychological health care in minority groups may lead to more individuals receiving an ADHD diagnosis. By the late ‘90s, 7.2% of non-Hispanic white children, 3.6% of Hispanic children, and 4.7% of non-Hispanic black children were diagnosed with ADHD (Adler, Spencer & Wilens, 2015). Additionally, rates of this particular disorder amongst girls increased from 3% to above 6% over the years. In the past, ADHD pertained to children who appeared to be hyperactive (Floet, Scheiner & Grossman, 2010). However, recently, the APA incorporated to its guide of psychological health conditions that diagnosis should also incorporate children who are inattentive (El-Nagger, Abo-Emagd & Ahmed, 2016). This, in turn, raised the number of girls because it appeared they are more likely to be in the second subtype.
When individuals think of ADHD, they usually have an image of an out-of-control child in constant movement, bouncing off the walls, and disturbing everyone around them. However, this is not the only possible image. A few children suffering from this disorder are quite hyperactive, while others are silent, with their focus miles away (Low, 2018). There are those who put too much concentration on a particular task and may have a problem moving it to something else. Others, on the other hand, may only be mildly inattentive, but overly impulsive (Bell, Shader & Beauchaine, 2017). Just because a kid is showing symptoms of impulsivity, hyperactivity, or inattention does not necessarily mean that they have ADHD. A few medical conditions, stressful life occurrences, and mental disorders can actually cause symptoms similar to ADHD (Low, 2018). That is why prior to making an accurate diagnosis of the disorder, one should see a psychological health expert to discover and rule out possibilities such as traumatic experiences, behavioral disorders, psychological conditions, and learning disabilities.
Given that there is presently no cure for Attention-Deficit/Hyperactivity Disorder, the only available treatments can assist in reducing symptoms and improving functioning. Some of the treatments include education or training, psychotherapy, medication, or a mixture of treatments (Adler, Spencer & Wilens, 2015). For children above 6 years, it is recommended that both medication and behavior therapy be used in the course of treatment. For those under the age of six years, behavior therapy is recommended as the initial line of treatment, prior to medication being given (El-Nagger, Abo-Emagd & Ahmed, 2016). It should be noted that ADHD happens to be more common in males and boys, than females and girls. Females are more likely to have issues mainly with inattention. Generally, risk factors such as low birth weight, genes, exposure to environmental pollutants in the course of pregnancy, and cigarette smoking, drug use, or alcohol use in the course of pregnancy, can contribute to ADHD.
Discussion
Medication may work, but only to a certain extent
From what has been observed, ADHD can take quite a toll on both children or teens and adults having the disorder. It is even harder for the individual who is forced to cope with day to day stresses. It is rough on family members whose lives are constantly interrupted by the outbursts, temper tantrums, disorganization, or other misbehaviors of the adolescent or child (Bell, Shader & Beauchaine, 2017). It is also normal for parents or guardians to feel confused and helpless about the most appropriate ways of handling their child in such situations (Floet, Scheiner & Grossman, 2010). Luckily, there are a few treatment alternatives that can assist ease the symptoms of ADHD and equip families with the necessary instruments needed to better address the problem behaviors when they emerge.
Health experts are well aware of the fact that ADHD is an unending condition lasting for many years and sometimes for a lifetime. Notably, the advantages and risks of medications can transform with time, so usually the treating doctor and family need to constantly reassess medication utilization. ADHD medications are aimed at being used for longer periods of time, unlike short courses of antibiotics (Adler, Spencer & Wilens, 2015). That is why parents or guardians should expect that, if a child begins taking medication at the start of the learning year, then they are going to be committed to collaborating with that medication for the rest of the school year (El-Nagger, Abo-Emagd & Ahmed, 2016). A child’s circumstance may actually improve to where other accommodations and interventions come in and the child is able to operate quite well without the medication.
Given that children transform as they develop, and their settings and demands they experience evolve as well, it is important for parents and the treating doctors to uphold an open channel of communication. Issues may come up when families discontinue medication without discussing their concerns with the physician first (Low, 2018). Similarly, adults suffering from ADHD also react well to the same interventions, including refreshment medications. When making treatment options, practitioners should keep in mind a person’s lifestyle (Floet, Scheiner & Grossman, 2010). While these medicines can be advantageous, side effects can be seen and should, therefore, be observed. There are a number of therapies that are yet to be scientifically proven to be helpful in treating ADHD, for instance, megavitamins, allergy treatments, supplements, yeast infection treatments, medications for inner ear issues, pet therapy, colored glasses, and eye training (Bell, Shader & Beauchaine, 2017). It is best to avoid them.
The effectiveness of Play Therapy in treating ADHD in children
Play therapy refers to an interpersonal process whereby a psychotherapist or an experienced pediatric and school nurse steadily applies the curative authorities of play, such as role playing, communication, mastery, attachment formation, and relationship enhancement (Floet, Scheiner & Grossman, 2010). It is a method during which a child is given a chance to experience development under ideal circumstances. Playing is considered an inherent way for a child to express himself or herself, and provides them with the most developmentally suitable ways for development and communication (Adler, Spencer & Wilens, 2015). It also provides a chance to steadily release suppressed stresses and emotions, feelings of insecurity, fear of confusion, aggression, and disappointments (El-Nagger, Abo-Emagd & Ahmed, 2016). Play therapy is commonly applied to the treatment of ADHD in an effort to link, provide reassurance, enhance self esteem, learn, and calm anxiety in children.
This form of therapy is helpful in assisting children to solve their own issues. Play consequently explains the realities that play, for children, whether sane or insane, is something intrinsic. According to the famous psychologist, Jean Piaget, play therapy and children’s play have a significant role in the cognitive development of children (Low, 2018). His theory helps to strengthen play therapy since it recognizes that play will assist a child to develop intellectual abilities and construct knowledge (Bell, Shader & Beauchaine, 2017). Piaget also suggests that linguistic, interpersonal, and social factors tend to play a key role in the psychological development of children (Floet, Scheiner & Grossman, 2010). This means that social associations in the course of play are vital to the development of intellectual learning. They are also important in developing the kid’s attention, focus, perception, recollection, and agility.
Play therapy is to a child what psychotherapy is to an adult. It is a designed, theoretically based approach to therapy that establishes the normal learning and communication processes of children (Adler, Spencer & Wilens, 2015). School nurses, psychologists, pediatricians, and play therapists work with children of all ages in a secure and trusting setting to help move points of views of difficult experiences and encourage self esteem and confidence. The main purpose of a play therapist is to assist a kid with better coping system and adaptive behaviors for daily life, developing a more constructive perspective of their place in this world (El-Nagger, Abo-Emagd & Ahmed, 2016). Notably, primary nurses and care clinicians cannot work alone in treating school-aged and preschool kids with ADHD.
Constant communication with teachers, parents, and other school based experts is needed to keep an eye on the progress and effectiveness of play therapy and other specific interventions (Low, 2018). Moving past a traumatic experience can be done through play therapy methods that are used, allowing children and their parents to reconnect with a secure and protective attachment (Bell, Shader & Beauchaine, 2017). That is why participation of parents or guardians is important for making constructive transformation, and they are able to utilize play therapy methods with the child at home, constantly establishing a linked association with their child.
Harsher punishments for children with ADHD do not help, but make things worse
Oppositional actions from a child can be quite frustrating and repeated defiance over a long period of time can be infuriating to a parent. A majority of parents will automatically react to oppositional behavior through the use of punishment to halt it, but this is not always the most effective technique, particularly for children with combined ADHD (Floet, Scheiner & Grossman, 2010). It is time for parents or guardians to realize that harsh punishment alone never educates a new behavior. It only educates on what not to do, but not what to do (Adler, Spencer & Wilens, 2015). From recent observations, there are 6 main methods that parents or guardians tend to utilize as harsh punishment in the household, and these are discussion or lecturing, using time-outs, using reaction costs such as taking things away, using corporal punishment such as spanking, yelling or verbally reprimanding, and overcorrecting through giving additional work or chores.
What most parents do not realize is that punishment may actually lead to counter aggression and avoidance. Although punishment techniques used may seem to work in the short run, they do not necessarily prevent oppositional behavior in children with ADHD, eventually leading to increased issues (El-Nagger, Abo-Emagd & Ahmed, 2016). Excessive use of punishment can train aggressive and oppositional behavior, teaching a child how to punish back (Low, 2018). A child may also start participating in avoidance or escape behavior in an effort to avoid confrontation with the parent or guardian. An additional side effect of using harsh punishment on children with ADHD is emotional dysregulation, which results in both parties being unhappy, emotionally alienated, angry, or upset with each other (Bell, Shader & Beauchaine, 2017). Punishing a child with ADHD may result in self doubt. This means that a child’s ability to continue to behave effectively is reduced. Chronic utilization of punishment also makes the kid doubt their own ability to be better in future.
Effective strategies other than corporal punishment to manage children with ADHD
Considering the fact that harsh punishment does not and will never teach new behavior in a child with ADHD, one of the most obvious strategies for parents or guardians to utilize is teaching the child what to do (Floet, Scheiner & Grossman, 2010). Emotional hypersensitivity is among the main ADHD characteristics, so the physical act of punishment can result in emotional hurt. Therefore, taking a constructive approach is more effective in teaching a kid to act their best. As a strategy, parents or guardians should plan ahead for possible meltdowns. They should pick a time when both of them are calm, and plan an escape path if things go wrong unexpectedly (Adler, Spencer & Wilens, 2015). Parents should keep calm because if they get angry in the course of talking with their ADHD kids, they lower the opportunity for the kid to learn from the discipline moment.
If behavioral adjustment is necessary, a key strategy would be to have the kid stare at a blank wall, with nothing to entertain them. As soon as the child is calm, the parent should explore the situation with the kid and plan together, coming up with better options for the future (El-Nagger, Abo-Emagd & Ahmed, 2016). All kids actually find it easier to behave appropriately if they are not tired. Therefore, to stop children from getting too tired, parents should get the kid into good sleep habits, establish rest breaks into activities, and provide healthy food choices for long term concentration and energy (Low, 2018). Parents should also learn how their kid is hardwired, adjusting their discipline strategies in the process (Bell, Shader & Beauchaine, 2017). Acknowledging and respecting a child’s hypersensitivity as part of the child’s ADHD nervous system is important. This will assist in differentiating between deliberate noncompliance and real discomfort or misunderstanding on the kid’s part.
Conclusion
Being a common brain disorder, Attention-Deficit/Hyperactivity Disorder is manageable. Health experts can provide advice on how best to utilize medication, behavior strategies, or a mixture of both. Parents of ADHD children tend to express frustrations over getting their kid to slow down, follow guidelines, and pay attention. Moreover, most parents or guardians are unsure of how to handle temper tantrums that can take place when a kid becomes extremely frustrated. The most effective approach to calming an emotional kid is for parents to also remain calm. Regardless of how much the child’s world may be spinning out of management, a parent or guardian needs to show them that they, as the adult in their lives, are managing and that everything is okay. Use of harsh punishment is not the solution to controlling an ADHD child. Instead, taking a constructive approach is more effective in teaching the child to be in their best behavior. Using a constructive approach means that during discipline time, the child will be more receptive to the parent’s authority, and not be afraid of them.
References
Adler, A., Spencer, J., & Wilens, E. (2015). Attention deficit hyperactivity disorder in adults and children . England: Cambridge University Press.
Bell, Z., Shader, T., & Beauchaine, T.P. (2017). ‘Improvements in negative parenting mediate changes in children’s automatic responding following a preschool intervention for ADHD.’ Clinical Psychological Science .
El-Nagger, N.S., Abo-Emagd, M.H., & Ahmed, H.I. (2016). ‘Effect of applying play therapy on children with attention deficit hyperactivity disorder.’ Journal of Nursing Education and Practice , Vol. 7, No. 5. Pp. 104 – 117.
Floet, A., Scheiner, C., & Grossman, L. (2010). ‘Attention-deficit/hyperactivity disorder.’ Pediatrics in Review , 31(2). Pp. 56 – 69.
Low, K. (2018). ‘ Tips for improving communication with your ADHD child .’ Retrieved on 27 February 2019, from https://www.verywellmind.com/parenting-adhd-children-parenting-strategies-20543
