Attention-deficit Hyperactivity Disorder and Behavioral Management

In almost every classroom, there will be a child that will bring the most attention of the teacher to him/her. Immediately, one might believe that this child has ADD as it’s most commonly related to a hyperactive child. However, ADD is not the correct term to describe this child, and furthermore, this child might not have ADD, but just a simple case of hyperactivity. First of all, ADD is not the correct name for this disorder. ADD is attention deficit disorder, however the correct name for this type of disorder is ADHD, which means attention deficit hyperactivity disorder. It was renamed ADHD in 1994 by the American Psychiatric Association and includes three subtypes: inattentive, hyperactive, and combination of these two (Tylan) Secondly, not every child that is hyperactive has ADHD. All children have difficulty paying attention, following directions, or being quiet from time to time, but for children with ADHD, these behaviors occur more frequently and are more disturbing to the children and those around them. The most conservative estimates suggest that about 3 to 5 percent of children under the age of 18 have Attention Deficit Hyperactivity Disorder (Ingersoll 1). The core problems of ADHD are attention problems, difficulty controlling impulsive responding, and excessive motor activity (Ingersoll15). Each of these problems can multiply into many different sub-categories. Attention problems included inability to pay attention to details or a tendency to make careless errors in schoolwork or other activities, difficulty with sustained attention in tasks or play activities, apparent listening problems, difficulty following instructions, problems organizing tasks and activities, avoidance or dislike of tasks that require mental effort, tendency to lose things like toys, notebooks, or homework, distractibility, and forgetfulness in daily activities. Impulsive respond and excessive motor activity included fidgeting or squirming, difficulty remaining seated, excessive running or climbing, difficulty playing quietly, always seeming to be "on the go, excessive talking, blurting out answers before hearing the full question, difficulty waiting for a turn or in line, and problems with interrupting or intruding. The disorder known as ADHD has been called by many names over the years, including minimal brain damage, minimal cerebral dysfunction, hyperactive child syndrome, and attention deficit disorder with or without hyperactivity (Batshaw 449). There are no symptoms for ADHD. There are no specific physical examination findings or blood, urine, brain imaging, brain wave, or other neurological findings that establish the diagnosis for ADHD (Silver 207). The disorder is only diagnosed by observing behaviors through situations. Scientists have not yet identified a single cause behind all the different patterns of behavior--and they may never find just one. Rather, someday scientists may find that ADHD is actually an umbrella term for several slightly different disorders (Neuwirth). ADHD can be difficult to diagnose, especially when co-existing disorders are present. Additionally, there are medical conditions with symptoms that can mimic some of the symptoms of ADHD. Some of these conditions included autism, lead toxicity, sensory disorder, and Hypothyroidism (Bailey). There are methods to treating Attention Deficit Hyperactive Disorder, however there are too many uncertainties for a single method to work effectively. The comprehensive treatment of attention deficit hyperactivity disorder initially involved several models of help, including individual and family education, appropriate school programs, and specific medications (Silver 249). Each of these methods can target each sub-type of the disorder, but not one type of treatment is capable of curing the disorder completely. Attention deficit hyperactive disorder has no real treatment, but it has a series of steps that can be taken in order to control the problem. Diagnosing the disorder is considered to be the hardest step in finding a suitable treatment. There is no one test, which can determine the presence or absence of ADHD (Ingersoll 33). Furthermore, there is no single cause of ADHD that can be identified, but researchers have been looking at a number of possible genetic and environmental links. Research shows that some children may have a genetic predisposition toward ADHD; it is most common in children who have close relatives with the disorder. Although scientists are not sure whether this is a cause of the disorder, they have also found that certain areas of the brain (in the frontal lobes and basal ganglia) are about 5% to 10% smaller in size and activity in children with ADHD (Tylan). Since this is a behavioral disorder, it can only be determined based upon tests, and behaviors, and common everyday activities. In some cases, the child may be checked for social adjustment and mental health. Tests of intelligence and learning achievement may be given to see if the child has a learning disability and whether the disabilities are in all or only certain parts of the school curriculum (Neuwirth). The most likely situation that ADHD can be diagnosed is when a teacher reports the child’s behaviors within the classroom to the parent. The parent can start by talking with the child 's pediatrician or their family doctor. Some pediatricians may do the assessment themselves, but more often they refer the family to an appropriate specialist they know and trust. During the period of time of observing, the specialists have to determine if the situation require additional attention and/or treatments. Based upon series of tests and/or behavioral observation, the specialist can then conclude if the child has ADHD or not. If the child has this disorder, than treatment can begin. The first type of treatment is counseling and management. It starts with the classroom. Beside the parent, teachers are the people who will spend the most time with the child. The teacher may need to use behavior management techniques to maintain the child’s attention on tasks and improve behavior, teach the child organizational skills, and modify class work or assignments to help manage the child’s co morbid learning disabilities (Batshaw 454). The classroom environment with the teacher ability will help the child to deal with the disorder. However, not every child will response positively. Some children will learn the cope with the new situation and able to control their actions. However, there will be a few children who are unresponsive. When children with ADHD are in need of more educational assistance than is typically provided in the general education classroom, they qualify for accommodations within their general classes or in other special education services under both the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act of 1973 (Batshaw 455). Children with ADHD often need some special accommodations to help them learn. For example, the teacher may seat the child in an area with few distractions, provide an area where the child can move around and release excess energy, or establish a clearly posted system of rules and reward appropriate behavior. This method of treatment can bring immediate success, however it is not a long-term solution. Some children may out-grow the behavior-reward system and can demand even more reward. In the end, the child will become more unwilling to follow rules and guidelines even if there is a reward for appropriate behavior. Beside the classroom, home is the environment that the child will spend most of his/her time. The child must understand that having this disorder does not mean that they are stupid, sick or alone. Family members need to provide support for the child. Specialists recommend parent education and support groups to help family members accept the diagnosis and to teach them how to help the child cope with frustrations, organize his environment, and develop problem-solving skills (Kids Health). Teaching a child to control his/her action is hard especially when the child is confused about where the actions are appropriate or not. Furthermore, the parent needs to have positive reinforcements if the child behaves appropriately. Studies suggest that children with ADHD will usually choose small, frequent reinforcements over larger, less frequent ones (Batshaw 456). Each time a child did something correctly, a small reinforcement will help the child learn that the behavior will bring a reward. However, too many reinforcements will cause a child to expect it every time. Linking classroom and home is an effective treatment. Since the child will spend almost all of his/her time in these two areas, it is very effective to provide proper management. One commonly used strategy is the daily school-home note. With this procedure, the child and parents receive daily feedback from the teacher on how the child did in selected areas of classroom functioning (Batshaw 456). By knowing if the child does well in certain areas in the classroom, the parent can reinforce other areas that the child does not do well in and vice versa. Treating ADHD with this method is very effective and does not cause any physical harm to the child. However, it is not possible to treat all of ADHD cases with this method. There is no evidence that suggest that proper behavioral management can help a child overcome ADHD, but in many cases, it does benefit the child. There are some cases that this type of treatment brings negative results. There is no single type of behavioral management that can eliminate ADHD. Each child requires a different type of management and no two children are alike. This makes behavioral management a difficult treatment to follow. There are too many different situations and events that can cause behavioral management to not work effectively. Beside management, counseling is also another type of treatment that can help a child deal with ADHD. However, counseling does not guarantee that a child will be able to overcome this disorder. Even worst, counseling can cause a child to believe that there is something wrong with him/her whether it is sickness or stupidity. A child does not response effectively as an adult when he/she is under counseling treatment. The second type of treatment is medical treatment. There are many different types of drug that can help a child control his/her activities and actions. These drugs are called psycho-stimulants. Psycho-stimulants, such as methylphenidate, dextroaphetamine with amphetamine, and dextroamphetamine are the best-known treatments (Kids Health). These drugs provide immediate positive effects. The child will be able to control his/her behaviors. However the use of drugs is a very dangerous risk. Drugs provide immediate improvement, but there is a need to take these drugs regularly. Furthermore, these drugs do not cure ADHD, but rather is a temporary control substance. Unfortunately, when people see such immediate improvement, they often think medication is all that 's needed. Although the drugs help people pay better attention and complete their work, they can 't increase knowledge or improve academic skills. The drugs alone can 't help people feel better about themselves or cope with problems. These require other kinds of treatment and support. The use of medication to treat ADHD was first described in 1937. A pediatrician, Dr. Charles Bradley, tried a stimulant medication (Benzedrine) and found that the children became less active and less distractible (Silver 259). Stimulants have been put to use ever since then and in many cases provide improvements. However, stimulants have many negative effects as well. One of the disadvantages of these medicines is that they require several doses per day (each dose lasts approximately 4 hours). A number of longer-acting preparations of methylphenidate and dextroamphetamine with amphetamine, which last up to 12 hours, are now available (Kids Health). However, continuation of these stimulants can cause a dependency upon them. As useful as these drugs are, they have sparked a great deal of controversy. Most doctors feel the potential side effects should be carefully weighed against the benefits before prescribing the drugs. While on these medications, some children may lose weight, have less appetite, and temporarily grow more slowly. Others may have problems falling asleep (Neuwirth). Medications do not cure ADHD. They only control behaviors caused by ADHD. This is why usage of medications is not an effective treatment for ADHD. There are a few types of treatment that have not been scientifically shown to be effective in treating the majority of children or adults with ADHD. These treatments included: biofeedback, restricted diets, allergy treatments, medicines to correct problems in the inner ear, megavitamins, chiropractic adjustment and bone re-alignment, treatment for yeast infection, eye training, and special colored glasses (Neuwirth). These methods work in very few cases and have not have been scientific proven. Although behavioral management and medical treatments are not the cures for ADHD, they have been proven to work in many cases. However, the types of treatments that were just mentioned have no scientific evidence to be effective, but rather work with some cases so they are suggested treatments only.
ADHD has no cure. This is the most important concept. However, there are treatments available. These treatments are very effective, but are not guarantee for all cases of ADHD. Each case of ADHD required a different type of treatment or a combination of many. However, there will be cases that not any type of treatment will help. Behavioral management and counseling is the safest method in controlling ADHD. However, it is more depended upon the child in order for this method to work. If a child is willing to be under behavioral management and counseling, then this method is very effective. But not every child will be willing. Medical treatment is unsafe in many situations, but it is very effective. If the parents are willing to take risks to put their child under medical treatment, than it can work. Medical treatment can cause many side effect and dependency. This is why there are many courses of action that needed to be taken before stimulants can be use. Furthermore, stimulants do not provide a complete cure of ADHD. Other methods are still not scientific proven, thus are not suitable to be used. Because there are too many uncertainties in the methods treating ADHD, one must take careful consideration before using these methods. There is a high probability that the treatment methods will help the child, but there are those few cases where it will only bring negative effects.

Works Cited

Bailey, Eileen. Is It Really ADD/ADHD?. 2003. 8 November 2003.

Batshaw, Mark L. Children with Disabilities. Baltimore, Maryland: Paul H. Brookes Publishing Co., 1997.

Ingersoll, Barbara D. Attention Deficit Disorder and Learning Disabilities. New York: Doubleday, 1993.

Neuwirth, Sharyn. Attention Deficit Hyperactive Disorder. July 01, 1999. 8 November 2003.

Silver, Larry B. Misunderstood Child. New York: Random House Inc., 1998.

Tylan, Douglas W. What is ADHD? October 2001. 8 November 2003.

Cited: Bailey, Eileen. Is It Really ADD/ADHD?. 2003. 8 November 2003. Batshaw, Mark L. Children with Disabilities. Baltimore, Maryland: Paul H. Brookes Publishing Co., 1997. Ingersoll, Barbara D. Attention Deficit Disorder and Learning Disabilities. New York: Doubleday, 1993. Neuwirth, Sharyn. Attention Deficit Hyperactive Disorder. July 01, 1999. 8 November 2003. Silver, Larry B. Misunderstood Child. New York: Random House Inc., 1998. Tylan, Douglas W. What is ADHD? October 2001. 8 November 2003.