How a Child Lives with Attention Deficit Hyperactivity Disorder - Research Paper Example

ADHD At the time our son, 7-year-old Johnny, was diagnosed with ADHD, we were both happy to finally have something to blame for his behavior and fearful of what that meant for our son’s future. We knew from general discussions on the news and elsewhere that ADHD is an acronym that stands for Attention Deficit Hyperactivity Disorder. We knew from our son’s behavior that people who have this condition have a difficult time remaining focused on things, have a hard time remembering things and are bored easily. It was soon clear that we had a great deal to learn about our son’s condition and what would best help him overcome the issues this condition will generate so we used the internet to find more information as well as to locate nearby groups that might provide more direct help and support. According to the DSM-IV, there are actually three different kinds of ADHD. These include predominantly hyperactive-impulsive ADHD, predominantly inattentive ADHD and combined hyperactive-impulsive and inattentive ADHD. Our son falls under the first of these categories – predominantly hyperactive-impulsive. This type of ADHD is diagnosed when most of the child’s symptoms (six or more) fall under the heading of hyperactivity-impulsivity behaviors and less than six symptoms of inattention are found. Although no one knows what actually causes ADHD, scientists believe it may be related to genes, environmental factors such as smoking while pregnant, brain injuries or food additives. There is nothing we can do to alter our son’s genetics and we are aware that the environmental factors listed, cigarette smoking or lead pipes, were not present during our son’s prenatal through preschool development. Johnny has also never suffered from a significant brain injury. However, we have not paid a great deal of attention to the food additives included in Johnny’s food. According to McCann et al (2007), additives such as certain food dyes and preservatives may cause increased hyperactivity in children, so we will be paying closer attention to the ingredients we put in the grocery cart from now on. ADHD is commonly treated with a variety of medications that are typically classified as stimulants but each one has its own unique ways of working. However, discovering the correct medication that will work for Johnny will be an experiment as we try first one medication and wait to see the effects before trying another. There are several side effects that can accompany these medications and there are several other associated negative elements to consider when using these medications (MTA Cooperative Group, 1999), making us nervous about using this approach. From our research on the internet and discussions with our doctor, we have decided to try another recommended approach, that of behavior therapy. Behavior modification can be loosely defined as a means of targeting specific, observable behaviors and employing deliberate means to effect change. According to Mather and Goldstein (2001), this method is largely based upon the idea that consistent rules are typically applied to individuals’ behavior patterns. In this process, reinforcement techniques are used as a means of encouraging and strengthening desired behaviors, sometimes as indirect counters to poor behaviors, while punishment can be used to weaken undesirable behaviors. Behavior modification therapy is based largely upon the concepts of social learning theory brought forward by Alfred Bandura (1963) which emphasizes the importance of observing the behaviors and emotional reactions of others. “Learning would be exceedingly laborious, not to mention hazardous, if people had to rely solely on the effects of their own actions to inform them what to do. Fortunately, most human behavior is learned observationally through modeling: from observing others one forms an idea of how new behaviors are performed, and on later occasions, this coded information serves as a guide for action” (Bandura, 1977: 22). According to Bandura’s theory, observational learning is the result of continuous reciprocal interactions between cognitive, behavioral and environmental influences primarily occurring through attention and the observer’s particular abilities to synthesize what has been observed, retention of the knowledge thus gained, motor reproduction in terms of a physical action or deliberate attempt to duplicate what has been learned and motivation to continue this behavior. This concept is echoed in the work of Payne (2005) who indicates a great deal of interrelationship between the various models. Behavior modification therapy has been shown to work quickly, produce long-term desired results and to benefit the individual overall. It is a less invasive therapy in that it doesn’t necessarily require drugs to be effective and, when drugs are required, studies conducted on ADHD diagnosed patients indicated that much lower doses were necessary (Pelham cited in Contrada, 2004). This is seen as a tremendous improvement especially when compared to older techniques. “[Behavior modification] does not ordinarily short-circuit whatever capacities for awareness and reflection, for approving or disapproving motivation, for identifying with or resisting one’s own behavior, which the subject possesses, at least it does not short-circuit them in the ways that psychosurgery, psychotropic drugs and electronic stimulation of the brain do” (Steinfels cited in McCrea, 1975). In addition to these benefits, the principles of behavioral therapy are relatively simple to understand, even to the extent that we can apply it in the home. Finally, this form of therapy has been found to “restore aspects of human functioning which are undeniable conditions of any sort of autonomy. It can overcome massive obstacles to autonomy” (Steinfels cited in McCrea, 1975). One of the major concerns regarding behavior modification therapy is its ability to remove the concept of free will. “How does one who has as his (her) goal the development of children into bright, creative, free, and open individuals reconcile this goal with a program that controls and manipulates behavior? Behavior modification can indeed control behavior to such a degree that we can create, maintain and eliminate almost any behavior that we can define and measure. Behavior modification can take freedom of response from the child and place it into the hands of the controlling teacher” (Cote, 1973: 45). In addition, there has been conflicting evidence regarding whether this technique can be quickly implemented and maintain long-lasting effects. In a study conducted by Macdonald and Turner (2005), children who were looked after in social care showed little effect in psychological functioning, the extent of their behavioral problems or their interpersonal functioning after training interventions had been implemented. “Results relating to foster carer(s) outcomes indicate some improvements in measures of behavioral management skills, attitudes and psychological functioning. Analysis pertaining to fostering agency outcomes did not show any significant results” (Macdonald & Turner, 2005: 1265). As a result of their study, as well as their investigation into the relevant literature as an element of the study, the authors concluded that there is not enough evidence available indicating a definite positive outcome of CBT-based training interventions given to foster care givers. Clearly, we may still need to turn to drug therapy to help our child and would benefit from more localized and personal support as we engage in this process. Following is a list of nearby organizations that may prove helpful: Works Cited Bandura, A. & Walters, R. Social Learning and Personality Development. New York: Holt, Rinehart & Winston, 1963. Bandura, A. Social Learning Theory. New York: General Learning Press, 1977. Contrada, J.D. “Consider behavioral therapy before medication for AD/HD kids, UB psychologist says.” UB Reporter. University at Buffalo: Vol. 36, N. 2, (September 9, 2004). May 10, 2010 Cote, R.W. “Behavior Modification: Some Questions.” The Elementary School Journal. Vol. 74, N. 1, (1973): 44-47. DSM-IV-TR workgroup. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association. Macdonald, G. & Turner, W. “An Experiment in Helping Foster-Carers Manage Challenging Behaviour.” British Journal of Social Work. Vol. 35, (2005): 1265-1282. Mather, N. & Goldstein, S. “Behavior modification in the classroom.” Learning Disabilities and Challenging Behaviors: A Guide to Intervention and Classroom Management. (2001): 96-117. McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, Kitchin E, Lok E, Porteous L, Prince E, Sonuga-Barke E, Warner JO. Stevenson J. “Food additives and hyperactive behavior in 3-year-old and 8/9-year-old children in the community: A randomized, double-blinded, placebo-controlled trial.” Lancet. Vol. 370, N. 9598, (November 3, 2007): 1560-1567. McCrea, Ron. “Thinking About Behaviour Mod: A Road Map Through Never-Never Land.” The Capital Times. Alice Patterson Foundation, 1975. May 10, 2010 The MTA Cooperative Group. “A 14-month randomized clinical trial of treatment strategies for attention-deficit hyperactivity disorder.” Archives of General Psychiatry. Vol. 56, (1999): 1073-1086. Payne, M. Modern Social Work Theory. Basingstoke: Palgrave, 2005. Read More