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Attention deficit hyperactivity disorder is a persistent condition, the most commonly diagnosed behavioral disorder among adolescents and children.

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Children and adolescents with this disorder normally have difficulty controlling their behavior both while at school and also in social settings. Like the home. Although some of them may not perform well in, most of them have an intelligence that is normal or above-normal.

             Attention deficit hyperactivity disorder is found in three main types, each of which has different signs and symptoms. These types include inattentive, hyperactive-impulsive, and also combined attention deficit hyperactivity.

Adolescents who suffer from the inattentive type usually have short attention spans, do not pay much attention and are easily distracted. Those who have the hyperactive-impulsive type usually become restless, talk more than they should and also interrupt other people.

            In the fight against the disorder and its consequent behavior, stimulants could be used, which help increase activity in the brain. Better still, the technique of behavior therapy could be very effective and should be followed to mould and shape the minds of the affected adolescents in order to help them manage in the future and also avoid indulgence in behaviors that could risk their health.

Attention Deficit Hyperactivity Disorder in Adolescence

Introduction

According to the U.S Department of Health and Human Services, Attention Deficit Hyperactivity Disorder is a persistent behavioral disorder that affects adolescents hence making them have a problem in controlling their behavior.

It is an array of emotional, behavioral, and mental disorders which bring about depression, attention deficiency, hyperactivity, anxiety and conduct disorders. In other cases, it turns out to be a serious emotional disturbance for adolescents and disrupts daily functioning at home, at school and in the community. (DHHS, US, 1999:05)

It is very important to address the disorder because if care is not taken, the affected adolescents are at risk of contacting other mental disorders like oppositional or conduct disorder, anxiety disorder, depression or learning disabilities.

This paper looks into the causes of the disorder identifying its signs and symptoms and goes ahead to give several preventive measures and treatment of the disorder. We also look at how the concerned parties like parents can help the affected adolescents to recover and manage their behavior.

Demographics

Attention deficit hyperactivity disorder is a common childhood and adolescent disorder. According to E Wilens, it is roughly estimated to affect 3 to 7 percent of the children in the United States of America, which represents about two million children.

This fraction may possibly be even higher, with about 15 percent of boys in grade one to five being mostly afflicted. On average, one child in every public as well as private classroom in the United States suffers from the attention deficit hyperactive disorder.

 In other countries like Canada, New Zealand, and Germany, the occurrence rates are predictable to be 5 to 10percent of the total population. (E Wilens, 2008:43)

The traditional view of attentive deficit hyperactivity disorder is that boys are more likely to be affected than girls. Community based models have found an occurrence rate in boys that is double the one for girls. In deed, statistics which have been gathered from patient populations have pointed out male to female ratios which go up to 4:1.

Despite this, as the understanding of the disorder has been growing since the early 1990s and as the signs and symptoms have been recognized in a better way, the actual number of affected females is likely to be more similar to the one of the males than it has previously been thought.

Causes

The cause of attention deficit hyperactivity disorder is not actually known. However, there is consistent evidence that gives out biological causes rather than environmental ones.

This suggests that most adolescents get the disorder from the life they get at home. However, it is not all children who come from dysfunctional homes or families who get to be affected by the disorder.

For a long time, it was thought that the attentive deficit hyperactivity disorder developed due to a physical blow made to the head, or perhaps from an early infection gotten in childhood that led to a sort of brain damage and brain dysfunction.

However, all of these definitions could only apply to just but a very small number of adolescents diagnosed with attention deficit hyperactivity disorder, and are hence not the major causes of the disorder.

Another theory that was once commonly believed was that of eating refined sugar or taking chemical additives in one’s food, which was said to produced hyperactivity and inattention. Although sugar can produce some changes in behavior, there is evidence that does not support this association proposed

R Cox suggests that attention deficit hyperactivity disorder is caused by different factors in different people. It could be caused by viruses or even by harmful environmental chemicals in the surroundings.

In other cases, it is caused by heredity factors whereby adolescents inherit it directly from their parents or immediate ancestors like grand parents. In other adolescents, it is contacted during pregnancy, for example if the expectant mother has severe sexually transmitted infections or other types of infections, or health risking habits.

During delivery, problems may arise that could cause mental damage to the baby hence developing the disorder from birth. In general, anything that impairs the development of the brain is most likely to cause attention deficit hyperactivity disorder in children hence in adolescents. (E. R. Cox 2008: 14)

Signs and Symptoms

Attention Deficit Hyperactivity Disorder in Adolescence occurs in three different types, each of which has different symptoms. In the inattentive type, adolescents have very short attention spans and forget very easily.

They are easily abstracted hence making a lot of mistakes in a given task. They do not easily pay attention to any details that they are given and do not seem to listen to instructions. In return, they always fail to finish any given assignment and are found to be generally disorganized. (Barkley, R. A. 2003:37)

With the hyperactive impulsive type, adolescents are generally restless and move about without a purpose. They find it hard to stay seated or play even quietly and tend to run too much and climb when they should not.

They also talk excessively and unnecessarily, giving out answers even before questions are completely asked. Due to hyperactivity, they have a lot of trouble in taking turns and interrupt other people when talking or doing other activities.

The combined attention deficit hyperactivity disorder is the most common of the three types. It is a mixture of the inattentive type and the hyperactive impulsive type. This indicates that the combined type of disorder have a combination of the two sets of signs and symptoms, where the affected adolescent shows signs of both inattentiveness and hyperactivity. (Barkley, R. A. 2003:37)

If an adolescent shows several of these symptoms, he is diagnosed of the attention deficit hyperactivity disorders. However, these symptoms have to be noted in two or more different settings which include at home, at school or at social gatherings before a diagnosis is finally made.

This helps to avoid incorrect diagnosis due to change of the adolescents’ behavior which could be caused by other factors like stress and uncondusive environment or even developmental changes.

Treatment

There have been many treatments which have been recommended for adolescents with attention deficit hyperactivity disorder, most of which have good scientific basis. The best treatments that have been proven are however medication and behavior treatments.

1.) Medication

According to the U.S Department of Health and Human Services, as far as medication is concerned, the most common drugs that are used to treat attention deficit hyperactivity disorder are stimulants. These include amphetamine (Dexedrine, Dextrostat, and Desoxyn), methylphenidate (Ritalin), and pemoline (Cylert).

Stimulants help to increase activity in the under active parts of the brain of adolescents with attention deficit hyperactivity disorder. It is believed that this is the reason why the stimulants improve attention while at the same time reduces impulsive, aggressive or hyperactive behavior.

However, individual adolescents may act better in response to one prescription than to another. Taking the example of clonidine (Catapres), which is often used, even though its efficiency has not yet been clearly shown, may be useful to some affected adolescents. Several antidepressants may also work for some people.

Tranquilizers such as thioridazine (Mellaril) have been proved to be effective for some adolescents. Care must however be taken in prescribing as well as monitoring all medication. (DHHS, US, 1999:13)

On the other hand, just like most medications, the medications used for treating attention deficit hyperactivity disorder have their own side effects. When being treated with these medications, some adolescents usually lose some weight, have a lower appetite, and momentarily grow more slowly.

Other adolescents normally have trouble getting to sleep. However, according to many doctors, the benefits gained from these medications are more important than the side effects that may later occur. The side effects which occur can most likely be handled by reducing the amount of the dosage. (B.S.G Molina, 2008:19)

2.) Behavior Treatment

Behavior treatment is another way of treating attention deficit hyperactivity disorder. Parents and teachers are taught how to handle and amend the adolescent’s behavior. They may, for example reward good behavior in the affected adolescents in order to encourage the behavior.

Both teachers and parents should work together in this, for instance keep a daily report card which should link the home with the activities of the school and show the parents the efforts that the adolescent has been putting in the course of the day.

The parent should reward the adolescent for any indicated good school performance and outstanding behavior. Saturday and summer programs are very beneficial for adolescent behavior change. In addition, special classrooms that use exclusive behavior modification could also be used.

Together with this, there are usually specially trained classroom aides to assist the affected adolescents with behavior change. Apparently, both the stimulants and the behavior treatment methods can be helpful for a given duration of time. Nevertheless, it is not very clear for how long the benefit may last. (Hinshaw, S. P, (2002:20)

An adolescent who is in need of treatment or medical services and the immediate family members may need to make a care based plan on the sternness and the duration of the symptoms. The plan is most favorably developed with the immediate family members, treatment service provider as well as a general service coordinator, who is commonly referred to as a case manager.

 Whenever possible, the adolescent should be involved in making decisions. Bringing together all the different services and supports in a plan of care for a given adolescent and the related family is mainly known as a system of care.

A system of care is normally intended for improving the adolescent’s ability to function in every area of life, both at home, in the school, and in the general community. (Hinshaw, S. P, (2002:20)

Prevention

Due to the big number of suspected causes of the attention deficit hyperactivity disorder, prevention proves to be difficult. However, it is always wise for an expectant mother to have proper prenatal care as well as to stay away from alcohol, tobacco, and every other chemical that could harm the unborn baby during pregnancy.

One should also ensure good general and protective health care for the unborn child. These suggestions are especially of great importance if attention deficit hyperactivity disorder is also suspected in any other member of the family.

This knowledge that attention deficit hyperactivity disorder has attacked the family can prepare parents to take an action early enough to prevent greater problems in future.

Conclusion

            In conclusion, when it comes to dealing with attention deficit hyperactivity disorder, parents and caretakers should be very careful not to jump into a conclusion. Instead they should continually observe the children and adolescents under their care.

A high level of energy alone in an adolescent does not mean he has the disorder. The judgment depends on whether the adolescent is able to focus well enough in order to complete the tasks that suit their intelligence and age.

If the adolescent is diagnosed, the parent and teachers should ensure total moral support and encouragement to facilitate easy management of behavior as well as behavior change.  This capability is most likely to be noticed by a teacher. Input from teachers should therefore be taken seriously. Teachers and parents should work together for good results.

Bibliography

U.S. Department of health and human services. (1999).Mental health: A Report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services.
B.S.G Molina et al. (2008). Feasibility and preliminary efficacy of an after-school program for middle scholars with ADHD: A Randomized Trial in a Large Public Middle School. J Atten Disord, November 1, 2008; 12(3): 207 – 217.

E. R. Cox et al. (2008) Trends in the Prevalence of Chronic Medication Use in Children: 2002-2005 Pediatrics, November 1, 2008; 122(5): e1053 – e1061.

T. E. Wilens, et al. (2008) Effect of Prior Stimulant Treatment for Attention-Deficit/Hyperactivity Disorder on Subsequent Risk for Cigarette Smoking and Alcohol and Drug Use Disorders in Adolescents. Arch Pediatr Adolesc Med, October 1, 2008; 162(10): 916 – 921.

L. Zylowska, et al. (2008) Mindfulness Meditation Training in Adults and Adolescents with ADHD: A Feasibility Study. J Atten Disord, May 1, 2008; 11(6): 737 – 746.

Erk, R. R. (2002). Five frameworks for increasing understanding and effective treatment of attention-deficit/hyperactivity disorder: Predominantly inattentive type. Journal of Counseling and Development, 78, 389-399.

Erk, R. R. (2004). Counseling treatment for children and adolescents with DSM-IV-TR disorders. Upper Saddle River, NJ: Merrill Prentice Hall.

Hinshaw, S. P. et al., (2002). Family processes and treatment outcome in the MTA:

Negative/ineffective parenting practices in relation to multimodal treatment. Journal of Abnormal Child Psychology, 28, 555-564

Barkley, R. A. (2003). Commentary on the multimodal treatment study of children with AD/HD. Journal of Abnormal Child Psychology, 28, 595-598.

Learner, J. W., Lowenthal, B. ; Learner, S. R. (2004). Attention Deficit Disorders: Assessment and Teaching. Pacific Grove, CA: Brooks/Cole.

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