Group Essay: ADHD

It is becoming more common to see children diagnosed with ADD/ADHD. These disorders have been used to explain why kids are increasingly hyperactive and inattentive. Children are then prescribed medication; the most common used medications are Ritalin and Adderall. But, because there is no actual test for ADD/ADHD, doctors are forced to guess based on an overall evaluation. With new medical advances and more and more medication to treat this “defect,” more children are being diagnosed and prescribed medication. Medication, though helpful, is not the only way a child can be treated for ADD/ADHD; therefore doctors should not just rely on medication to treat ADD/ADHD in children.
scientists started believing that ADD was largely genetic. ADD researchers assumed that our population was going through large scale genetic mutations. By 1990 experts on Attention Deficit Disorder began to see ADD not as a disorder, but as a natural condition. They believe that it left ADD people with disadvantages in certain modern settings, but advantages when it came to things like creativity. Today the diagnosis is so broad that millions of children are getting labeled as being ADD. (Gallagher, 1999) Now is that good or bad?
Attention Deficit Hyperactivity Disorder, or ADHD, is a common condition that is affecting close to 7 percent of children in grade school age. ADHD is more common for boys, but in girls it may be under diagnosed. There are three different types of ADHD disorders. The first is ADHD mainly inattentive, this is commonly known as ADD. The second is ADHD mainly hyperactive-impulsive. And the third is ADHD which is the first two combined, which is considered to be the worst state of ADHD to have. The basic definition of Attention Deficit Hyperactivity Disorder is an impairment of either activity or attention control or it could be both. There are many symptoms specialist use to diagnose ADHD, which include a child always on the go, does not settle to anything, has poor concentration, poor ability to organize activities, unable to engage in tedious activities or tasks requiring sustained mental effort, and a child who cannot stay still or wait for others. Both ADD and ADHD are very similar in certain ways such as children being unable to focus, sit for long periods of time, and have poor abilities when it comes to organization. But the difference is that ADHD is an advanced form of ADD (Gillberg, 2003).
The exact cause of ADD/ADHD has not been determined (Low, 2009). However, parents are thought to be potential predictors of ADHD in children since behaviors seem to run in families. Some of the symptoms can be linked to smoking, alcohol consumption and or the poor health of the mother during pregnancy plus poor infant health, and delayed motor and language development (Stein, 1999). In a study at McGill University, researchers separated newborn rats from their mothers for either 15 minutes or six hours a day. One of the researchers, biologist Michael Meaney, reported that he had found receptors for certain brain chemicals and the gene for the receptors are both altered as a result of stress of separation in the six-hour group (Begley, 1996). Therefore one could say that the stress of both mom and dad working produces ADHD like symptoms in children raised in a modern household so it does not necessarily have a genetic link at all.
When it comes to diagnosing these particular disorders it becomes very complicated. The reason it becomes difficult is because every doctor and specialist in the field of ADD/ADHD has different opinions and different ways of going about diagnosing their patients. Ideally a doctor when diagnosing a child would go through every aspect and angle possible before assuming that the child has ADD or ADHD, but that does not always happen. Some doctors recommend a large battery of test that often cause thousands of dollars worth of bills towards the family. While others are considered to be hurried physicians which only give a brief rating and then diagnose and prescribe treatments. And with these two extremes neither of these are for the best interests of the patients (BMJ, 2008 & Gallagher, 1999).
When children are diagnosed with ADD/ADHD, they are given a variety of pills in order to “help” them focus better. But do these drugs actually do what they are supposed to? Ritalin and Adderall are the most commonly used psycho-stimulants to treat ADD/ADHD, but Concerta, Metadate, Dexodrine, Dextrostrat, Desoxyn, Gradumet, and Cylert are also used. Ritalin contains a major “WARNING” section on the label. The first two warnings are of extreme importance and should be shown full attention by anyone who is possibly going to take this drug. The warnings are as followed:
• “Ritalin should not be used in children under six years of age, since safety and efficacy for this age group have not been established.” (even though there are many cases where children under this age are taking Ritalin because they have been diagnosed with ADD/ADHD).
• “Sufficient data on safety and efficacy of long-term use of Ritalin in children are not yet available.” Considering what this drug can do to an adolescent brain and body within a reasonably short period of time, why would a parent have their child to be in a study using these kinds of stimulants? (Breggin)
The drugs doctors are prescribing to our kids are quite similar to the drugs we are trying to rid from our society, such as speed. These drugs are more readily given out to children because it is easier instead of trying to meet that child’s genuine needs. These drugs can cause addiction and dependency problems and a range of stimulant-abuse problems. For example, a child can become a lifelong dependent of drugs and tobacco if over-prescribed. When a habit develops early on, there is a greater tendency for it to become a lifelong pattern. Children who smoke tobacco or who are given stimulants, such as Ritalin, develop the habit of using these things as a crutch to deal with emotions or outrageous behavior. Nicotine and stimulants can change the child’s development of the brain, which can make it dependent on these substances. This can induce further use later on in life. (Breggin, 2001)
Younger children and adolescents taking these drugs can experience severe side effects. These medications can cause shrinking in the brain, decreased appetite which can lead to anorexia, and an increase in insomnia. These are just a select few of the more known side effects that can occur within 20 days of taking these drugs. The symptoms do not include what happens to the child in a long period of time because there is not enough research done in those areas for ADD/ADHD stimulants. Even more harmful side effects have been known to occur in the following stimulants; Ritalin, Dexedrine, Adderall, Concerta, and Metadate. The side effects can include depression, aggression, obsessive-compulsive disorders, convulsions, headaches, abnormal heart beats, cardiac arrest, and also heart disease (Breggin, 2001& US, 2002).
Since stimulants can be harmful to young children and young adults there are many alternatives that also help with the needs of a supposed ADD/ADHD child. Those alternatives include the most common ATTEND and Strattera. ATTEND is a natural based drug that is used to treat symptoms of ADD/ADHD. Even though it is made up of natural ingredients it still shows 70% improvement for a child in areas of focusing on certain tasks, self control, response time, and consistency. ATTEND is a good alternative because Ritalin and Adderall only show up to 10% more improvement over ATTEND in these areas. On the other hand Strattera only shows about 60% of improvement in these areas, but since it is not a stimulant it is still a better choice when comparing to actual stimulants used for ADD/ADHD. This is because Strattera does not cause as severe medical conditions as the stimulants do (Gillberg, 2003).
Educators do not consider Ritalin as the first treatment for children diagnosed with ADHD. Therefore, teachers in the classroom have gone to great strides to help these kids get through the day. These methods could be put in place of medication to help the child cope with ADHD and still maintain a healthy lifestyle. Teachers have found that by putting a sort of points system into the classroom, it can motivate these children to want to do things like homework and classroom chores, making it fun rather than time consuming. This type of “medication” is also known as Behavioral Therapy (Peter, 2001). Early elementary students have a much harder time concentrating, so aides or even the counselors may come into the classroom to sit with that child. Giving these kids as much one on one attention as possible helps them to better understand the lesson. (Everett, 1999)
Other methods include Psychotherapy, and Parent Skills Training. Psychotherapy consists of a series of visits to a trained counselor so the child may be able to talk out their issue and deal with them in a healthy manner. Parent Skills Training is where the parents go through workshops to learn how to deal with and help an ADHD child. These parents learn about how to make chores fun and how to use a point system in the house to give the child something to look forward to. This instills a sense of pride into a child who may not be feeling very proud of themselves.
The parent of an ADHD child will find it more effective to give clear instructions, rearrange work so it’s more interesting and motivating, redirect the child’s behavior toward future goals verses immediate gratification, and provide immediate awards for a completed task or adherence to rules (Barkely, 1995).
There are several general principles that might help a parent with an ADHD child. When children are finding their activity boring or unrewarding a parent can arrange for positive, frequent feedback and consequences to help keep them on task. Positive feedback can be putting what the child had done in a positive light. Using physical affection extra privileges or rewards. Consequences should encourage parents to use incentives before punishment when an ADHD child misbehaves. A simple rule is positives before negatives because ADHD children receive enough reprimands and everyone responds well to praise (Barkely, 1995).
Difficult-to-manage children may cause parents to become angered, embarrassed, or frustrated. Parents should always remember they are the adult, and should behave reasonably, fairly and rationally. Don’t let behavior problems become a contest, stay calm, and maintain a sense of humor. And know you’re not a bad parent when things don’t go exactly as you planned.
In summary, it has been concluded that in most cases children are being over diagnosed and medicated. We believe is that Physicians, Teachers, and Psychiatrists need to be more careful when dealing with these two disorders. They need to not assume that just because a child is showing certain behaviors or distinct differences that it should automatically be concluded as ADD/ADHD. They need to not make excuses for children that are simply just not interested in certain topics, they need to be 100% sure that a child has Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder. These disorders are serious conditions when accurately diagnosed to a child, so until there is an accurate test for ADD/ADHD then it should not be taken lightly.