The Attention Deficit Disorder Controversy

Attention Deficit Disorders have become a very highly controversial topic during the last decade. Attention Deficit Disorder, also known as ADD, is a broad, almost generic term for the different types of Attention Deficit Hyperactivity Disorders. The Diagnostic and Statistical manual of the American Psychiatric Association offers us this definition: "ADHD is a disorder that can include a list of nine specific symptoms of inattention and nine symptoms of hyperactivity/impulsivity. " In addition, the Concise Columbia

Electronic Encyclopedia provides this interpretation: " (a) chronic, neurologically based syndrome, characterized by any or all of three types of behavior: hyperactivity, distractibility, and impulsivity. Unlike similar behaviors caused by emotional problems or anxiety, ADHD does not fluctuate with emotional states. " About 1-3% of the school aged population has the full ADHD syndrome, without symptoms of other disorders. Another 5-10% have partial ADHD syndrome with one or more other problems, such as anxiety or depression.

CHADD) Gender and age affect the way the patients display their symptoms. Boys are more likely to have the disorder than girls. The symptoms of ADHD usually decrease with age, but those symptoms related with other similar disorders are said to increase with age. 30-50% of children with ADHD may display symptoms, although often times less ADHD may be observed in children before the age of four, but it"s signs are often missed until the child begins school. ADHD is often accompanied by learning difficulties, excessive physical activity, impulsive actions, nattention and social inappropriateness.

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Many of the children affected by ADHD exhibit a low threshold for frustration, which predisposes them to uncontrollable tantrums, and inability to concentrate in a controlled setting, such as a classroom. The behavioral symptoms associated with ADHD must last more than six months to be diagnosed as an attention disorder, although, it is not uncommon for medical doctors promote the idea of office diagnosis. Diagnosis of ADHD syndrome in a doctor"s office however, presents an evaluation in a controlled environment, which are subject to rror.

Office diagnosis entails a child being put in a observation room, usually alone, which enable the doctor to observe their behavior. This observation does not produce accurate results due to the fact that the environment is not one of which the child frequently has problems in. Frequently the behaviors of children affected by ADHD will parallel those of a normal child, other times, the child can be uncontrollable. Most children with ADHD have problems with interacting with other children or when asked to omplete a task, especially if additional distractions are present.

More frequently, children suspected of having ADHD are evaluated by their intellectual, academic, social and emotional functioning. The evaluation often includes input from the child"s teacher(s), parent(s), and others adults that frequently interact with the child. There are questionnaires that will rate the child behavior that are often used by the parents and teacher of the child. (See Addendum 1) Being that the behavior must last for at least six months, a log of behavior is also encouraged to be kept.

ADHD -- Combined type is defined by an individual meeting both sets of attention and hyperactive/impulsive criteria. ADHD -- Not otherwise specified is defined by an individual who demonstrates some characteristics but an insufficient number of symptoms to reach a full diagnosis. These symptoms, however, disrupt Although we mostly hear of children having the disorder, many adults are also affected by ADHD.

Adults often try and shape their lifestyles to compensate their abilities by seeking jobs in fields that: do not require long periods of focused attention, allow them the freedom to move about, do not equire close attention to detail, etc. (Wender, 15) In adults, their are greater problems with stress, which lead to greater expressed emotions. Other psychiatric disorders, known as comorbidity, are also found in ADHD patients. Oppositional Defiant Disorder , Conduct Disorder, and Learning Disorders can confuse the diagnosis and treatment of ADHD.

These disorders display similar characteristics and can be negatively influenced if the patient is treated for disorders they do not have. Treatment of ADHD is often done through behavior management, parent training, psychiatric treatment, educational intervention and psychostimulant medications. The combination of medication and psychosocial intervention is called multimodality treatment. 70-80% of children treated with ADHD respond positively to psychostimulants.

Medications primarily used in treatment include Ritalin (methylphenidate), which is the most commonly prescribed, Dexedrine (dextroamphetamine), and Cylert (pemoline). (CHADD) The most common side effects of these are loss of appetite, loss of weight, and problems with falling asleep. The loss of appetite typically lasts while the drug is working, and after it has worn off, the patients hunger returns, often stronger. Weight loss occurs rarely, and fter research, growth is not revealed to be affected. Insomnia and sleeping problems are mainly credited to doses taken too late in the day.

It is common practice to give the last dose no later than 4:00 p. m. (Diller, 263) Ritalin, which is a stimulant, confuses many people on why it is used to treat ADHD patients. The reasoning is that ADHD patients have a chemical imbalance within their brains, which causes Amphetamines, such as Ritalin, to have a reverse, typically calming affect. These effects allow the patient to concentrate more and interact better with others. Schools are developing better programs to aid children with attention eficit disorders.

IDEA (Individuals with Disabilities Act) and ADA (Americans with Disabilities Act) ensure that students with all types of disabilities, including ADHD, receive a free and appropriate education. ADHD students have an IEP (Individualized Educational Program) which can result in placement in resource or SDC (Special Day) classes. IEP"s involve the child"s parent(s), teacher(s), school psychologist, and even a school administrator. The IEP"s provide the student"s current level of performance, a plan of educational goals, both long and short term, and how these goals

The prognosis with children affected by ADHD is encouraging, especially for those whose symptoms are identified early and treated accordingly. Many children can cope with their disorder and become productive members of society. Untreated cases of ADHD can lead to failure in school and emotional and social difficulties, which puts them at a disadvantage compared to their peers. Numerous studies are underway and will hopefully produce more answers and a better understanding of the American Psychiatric Association. The Diagnostic and Statistical manual of Psychiatric Diagnoses.

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