Attention- deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder (Loe & Feldman, 2007). Children or adolescents with the disorder perform poorly in school and they have low reading abilities. Children with the disorder usually get involved in behavioral misconduct which cause their detention and sometimes expulsions from school (Brown, Reichel & Quinlan, 2011). These children hardly finish their primary or secondary education. One of the key symptoms of the condition is a persistent failure in tests and exams. Management of the condition involves behavioral management and use of pharmacological drugs but with very little assurance for improvement in child academic status (Loe & Feldman, 2007). In the discussion, we shall look at the causes of the condition, symptoms and the various treatments that are available for the condition. Also, we shall look at what groups or population that is most affected and the social implications of the condition.
Etiology of Hyperactivity ADHD
A combination of different factors is believed to be responsible for the occurrence of the condition. These factors include;
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Genetics
The condition is believed to be genetically inheritable. For instance, if both the father and the mother had the condition, the likelihood of their son or daughter having the condition are high (Sharma, & Couture, 2014). Previous studies on the molecular genetic studies of ADHD with the aim to localize the genes which increase the risk of having the condition when present, have shown that there are candidate genes responsible for the condition. About 27 different genes have been identified and linked to the ADHD. These genes have a huge impact on neurotransmissions. The serotonin transporter gene and the D 5 receptor genes were positively identified to have a significant impact on the occurrence of the condition. However, a gene that increases the susceptibility as identified is the quantitative trait locus which mainly causes reading difficulties. The locus is found on chromosome 6. When these genes are passed from the parents to the children, the percentage of the child having the condition is 50% (Sharma, & Couture, 2014).
Pregnancy Problems
Children born with less weight or born prematurely are at a higher risk of developing the condition. Pregnant women who take alcohol or smoke increase the risk of their babies having the condition. Usually babies born prematurely have an undeveloped brain, and usually unless put under good care they develop the condition. Additionally, those women who during pregnancy expose themselves to regions with high concentrations of lead or pesticides may be endangering their children’s lives as they may develop the condition, especially due to continuous exposure to these toxins (Sharma, & Couture, 2014).
Undeveloped Brain
Studies have shown that those children with the condition have underdeveloped brain parts (Visser et al, 2015). For instance, one part of the brain may be bigger than the other. With the poor functionality of neurotransmitters, the process of learning is very difficult. For example, if the child has an underdeveloped hippocampus, it means they won’t have the opportunity to properly process the memories of what they learn in class. With poor working memory, these children cannot read well as both the working memory and processing speed determine the reading capabilities.
Injury to the Brain
Brain injuries can be as a result of accidents, diseases, trauma, brain tumors or stroke. These injuries may result in poor motor coordination and therefore poor signaling. That may cause ADHD (Sharma, & Couture, 2014).
Food Additives
Some food additive has been linked to increasing cases of ADHD in the European countries. Processed food with artificial colors may pose a huge threat to the child as the colors in that food may result in mutations of important genes for neurotransmissions. Mutations of those genes may lower the rate of neurotransmission which may result in cases of ADHD. For instances, genes responsible for glutamine receptor formation, if mutated may cause poor reception of glutamine which is responsible for good learning (Sharma, & Couture, 2014).
Prevalence Cases
Symptoms of the condition are usually reported in children with ages 3-6 years old. These children can’t read when performing basic literacy skills. The American Psychiatric Association in their report indicated that, 5% of examined children have tested positive for the condition. Reports from the survey conducted in the year 2011 indicated that (6.4 million) 11% of children aged 4-17 years were diagnosed with the disease. The rate of diagnosis as per 2011 was on the rise given that in 2003 it was 7.8%, 2007 it was 9.5% and in 2011 it was 11%. Male children were the most affected with 13.2% against 5.6% of girls (Visser et al, 2015). The prevalence of diagnosis of the condition varied from state to state, for instance, Nevada had low cases of 5.6% as compared to Kentucky which had 18.7%. A Survey on medication treatments in the year 2011 indicated that 82.6% of parents, who reported the case of ADHD in their children, only 74.0% put those children under medication. The number of boys who had taken medication was higher than the number of girls. The survey also indicated that most of the parents used medication as the best option for treatment of ADHD, with CNSSs drug having a high usage. Only a third of the population used the both medication treatment and behavioral therapy (Brown, Reichel & Quinlan, 2011).
Ecological Factors and Social Justice Implications
Children with the condition may have poor receptions in the society. Most normal children may avoid associating with them creating a discriminatory gap. With poor reading, calculation and writing disability, the children diagnosed with the ADHD, may fail to express themselves. For instances, good communication and etiquette skills that are taught in schools, may not be understood by these kids gave their inability to read. That may make it hard for them to adequately communicate with other people. They, therefore, have poor interpersonal interactions and relationships. Sibling conflicts may arise as the children will not be able to understand each other. They may also face discrimination due to the inability to maintain and manage their behaviors. A child with this condition may face difficulties in managing their personal behaviors and therefore most of the time they end up misbehaving. That may force some parents to inhibit their normal children from having a relationship with these children as they fear that they may be influenced negatively. Also parents of these children may undergo an emotional stress which may result into depressions (Loe & Feldman, 2007).
Adults with such conditions have difficulties in their work as they cannot deliver quality work in good time in such cases they end up having bad reputations. They may probably lose their jobs which may be a result of financial difficulties. For instance, a survey conducted in the United States indicated that many adults with the condition did not have a permanent job as compared to healthy individuals.
With poor memory and inability to control their emotions these children sometimes may be involved in offensive activities which may hurt others and such cases may result in poor relationship developments (Loe & Feldman, 2007). Involvement in criminal a activities may result to juvenile detentions, and that may be hurting to the parents.
The government spends a lot of money in setting up special schools and hospitals for these kids. As the cases of this condition increases, the more the country will be worried as those children will have no impact in contributing to the development of the economy. Increased cases of criminal activities are another challenge for the government. An increase in the number of persons with ADHD in a society may result in the increase of criminal cases majorly due to unemployment and poor judgment and behaviors that accompany those with the condition (Brown, Reichel & Quinlan, 2011).
Interventions
The condition is mainly managed by pediatricians. Treatments are categorized based on their abilities to improve body functions, enhance participation or execute functions.
Medical Treatments
Use of psychopharmacological treatments, the use of stimulant medications (methylphenidate and amphetamine) help in lowering the symptoms of ADHD. The use of these medications also helps the children with the condition to perform general tasks and follow instructions. For example, when a child with the ADHD uses stimulant medications he or she is able to score some questions when asked, he or she is able to complete the assignments or homework, and they are able to write notes. Stimulant medication has limitations like not affecting or improving the reading abilities, and the medication can only be used for 2- 3 years. The use of nonstimulants medications like Atomoxetine, a norepinephrine uptake inhibitor, is a potential drug that helps in improving intentions and hyperactivity. The drug can also improve and regulate mood.
Change of Diet
Development of a good diet plan for those persons with ADHD may be beneficial. Avoidance or reduction in eating foods with a lot of sugar may help in lowering the symptoms of ADHD (Visser et al., 2015). Parents of children with that condition, therefore, should visit a dietary specialist to seek more advice on matters nutrition.
Behavior Management
This includes parent training and classroom interventions to help lower the symptoms of the condition. Parent takes the first steps in guiding the child upon the discovery that he or she has the condition (Sharma, & Couture, 2014). The process may be useful in producing short-term effects of good manners, but the process will have little or no impact in academic or educational studies. This makes the treatment less effective as compared to the use of psychopharmacological stimulants.
Combined Management of ADHD
The application of multiple treatments to fight off the condition may be important. For instance, the use of both behavioral and stimulant medications may improve up to 2% the ability to read. However, the use may have no impact on the academic or educations status of the child with ADHD (Visser, Bitsko, Danielson, Ghandour, Blumberg, Schieve & Cuffe, 2015).
Educational Interventions and Services
Teachers have an understanding of the need to offer their help to kids with ADHD. Every public school is required by law to have a special academic program for kids with ADH, and their needs must be met at all cost. Students who have the conditions and have displayed an inability to learn are taken to special schools where they are able to receive special educational programs.
Clinical Behavior Therapy
Training for teachers, parents and other palliative caregiver effects implementations and applications of contingency management programs for kids with ADHD (Loe & Feldman, 2007). The use of report cards to monitor the behavior of the children and reward those who behave well at the end of the day motivates and makes the kids try to behave well. That may be useful in dealing with kids with ADHD.
Some interventions have been proposed that if well applied may be beneficial for those students with ADHD. These include;
Small Class Size
Children with special needs perform better when they are engaged in one on one instructions. With a small class number of about 8-15 pupils, a teacher may be able to constantly monitor the academic progression of the pupil and issue their assistance when need arises (Loe & Feldman, 2007). In such a way children with ADHD may not be left out as in the cases when the pupils are many in a class of like 30-40. This approach therefore may enable teachers to apply innovative teaching and educational approaches which may benefit all the pupils in class including those with and without the condition (Visser et al, 2015)
Increased Physical Activity
Increased use of recess and general physical activities may be useful in reducing the over activity. Having quality exercise each and every day may be very useful in promoting good health and in behavior regulations for both children with ADHD and those who don’t suffer from the condition. Exercise keeps the body in an active form, and therefore active participation makes the children more active than they were (Loe & Feldman, 2007).
Reduced Distractions
This method of intervention may be helpful as children with that condition will have improvements in their symptoms. Usually, a noisy class may cause children to fail in their exams. That mainly happens to children since the ability to listen well in a noisy environment is not fully developed. If children with ADHD are taught in a silent environment with little or no distractions where they are likely to perform better than when in noisy environments (Brown, Reichel & Quinlan, 2011).
Alternative Methods of Discipline
Usually, when students fail to work or deliver their work in time, they are suspended. That may act as a positive motivator to those who actually don’t like working hard; sending them home therefore will make them even lazier. Children when express bad behaviors as such of not wanting to work they should be taken through training programs to make them understand the importance of good behavior and working hard. That may positively contribute to the general improvements in their performance (Loe & Feldman, 2007).
Conclusion
ADHD as discussed above is a condition that poses a threat to the children’s academic endeavors. Parents therefore should take precautions especially pregnant women to watch what they eat and avoid smoking and drinking of alcohol. This is a factor that contributes to the occurrence of the disease. The government on the other hand must ensure that women who are pregnant are advised or receive training on the disadvantages of smoking and drinking as some women may drink and smoke without knowledge that they are affecting their unborn babies. Also, parents have a responsibility of ensuring that when their children are diagnosed with the condition they are supposed to offer them special behavioral therapy as the first treatment. Through that the symptoms of the condition may lower and be manageable. The state and the healthcare providers also have a major responsibility of promoting the health care services. A palliative healthcare provider will not only be helpful to the patient but also to the family members. He or she offers advices on how the parents or the guardians should take care of these kids and encourage them to be strong given that they undergo very difficult emotional and financial stress. The state through implementing and changing laws or policies in favor of those with condition may help in lowering cases of ADHD. Also of importance is the intervention of the teacher, teachers may help children with ADHD improve their academic performance and social skills. This therefore mean that a combine effort of the parents, teachers , healthcare providers and the government may help in managing and reducing cases of ADHD in the country if they agree to work together.
References
Brown, T. E., Reichel, P. C., & Quinlan, D. M. (2011). Extended time improves reading comprehension test scores for adolescents with ADHD. Open Journal of Psychiatry , 1 (03), 79.
Brown, T. E., Reichel, P. C., & Quinlan, D. M. (2011). Executive function impairments in high IQ children and adolescents with ADHD. Open Journal of Psychiatry , 1 (02), 56.
Loe, I. M., & Feldman, H. M. (2007). Academic and educational outcomes of children with ADHD. Journal of pediatric psychology , 32 (6), 643-654.
Sharma, A., & Couture, J. (2014). A review of the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Annals of Pharmacotherapy , 48 (2), 209-225.
Visser, S. N., Bitsko, R. H., Danielson, M. L., Ghandour, R. M., Blumberg, S. J., Schieve, L. A., ... & Cuffe, S. P. (2015). Treatment of attention deficit/hyperactivity disorder among children with special health care needs. The Journal of pediatrics , 166 (6), 1423-1430.
