Supporting Parenting: A Public Health Approach - Case Study Example

Critical evaluation of evidence-base for initiative (ADHD) and its impact on individual and community – Part B Attention deficit hyperactivity disorder (ADHD) is a severe psychiatric disorder quite common in childhood (Dean, 2005); in fact, in a report published by the Office of National Statistics (UK, 2004) it is noted that the percentage of school-aged children that have been diagnosed with ADHD has been estimated to 3-9% (Office for National Statistics, 2004); the specific disorder is usually related with the following problems: ‘hyperactivity, inattention and impulsivity’ (Shah, Cork & Chowdhury, 2005). Current paper aims to provide a critical evaluation of evidence-base for initiative (ADHD); at the next level, the impact on individual and community health will be critically evaluated – taking into consideration the existing evidence but also the needs of the individual and the community – as identified through the relevant research. As noted above, ADHD affects a significant percentage of children; the need for developing appropriate programs for controlling this disorder is emergent, as proved also from the existed evidence; more specifically, if not appropriately treated in its early phases, the above disorder can be further developed during the adolescence but also the adulthood (National Health Service, 2008); in fact, it has been estimated that 132,000 young people already suffer from severe ADHD (Office for National Statistics, 2004). Despite the fact that the delays in treating the above disorder can have severe consequences for the health of children suffering from ADHD, the parents of these children are likely to avoid reporting the problem – at least during its initial phase – worrying that they will be blamed for the appearance and the development of the disorder (Dennis, Davis, Johnson, Brooks & Humbi, 2008). In accordance with the existed evidence, the appearance and the development of ADHD are closely related with the child’s environment; the above finding is based on the fact that ADHD is depended on the response of brain – as influenced by the events and the conditions in the child’s environment. The interaction with parents also plays a key role in the development of the above disorder; moreover, parents have the responsibility for the development of ADHD by supporting the stress and the disruption in the family; in this context, parents often realize the need of a professional that can offer necessary advice on the limitation of the problem; when ADHD is already well developed then a need for intensive support emerges (Dennis, Davis, Johnson, Brooks & Humbi, 2008). From a similar point of view, it has been proved that ADHD negatively affects the family environment – problems like parental alcohol use and social isolation have been identified in families with children that suffer from ADHD; parents should realize that the problem would require their active involvement in its resolution (Dean, 2005); In accordance with the above, parents have an important role in the effective control of ADHD; for this reason, their participation in the relevant programs developed by governmental and non-governmental organizations is quite important. The government has developed a series of programs and initiatives in regard to the confrontation of ADHD in its various phases; in accordance with the NICE Guidelines (2008) the treatment of ADHD needs to be based on appropriately customized parenting programs which would be supervised by medical specialists and carers – the access of the children to these programs is not depended on specific criteria – referring especially to the children’s age (NSF, 2004, NICE Guidelines, 2008). On the other hand, it is suggested that the parenting programs for the treatment of ADHD should focus – indicatively - on the following issues: a) the development of an b) the cooperation in the development of the program – cooperation among parents, children and specialists, c) the improvement of conditions in the family environment – difficulties in communication between parents and children need to be eliminated and d) the provision of continuous and necessary medical and care support (UK, DH, 2007, UK, DH, 2005). The coordination between parents and carers has been proved to be quite important for the success of the above programs (National Institute for Clinical Excellence, 2008). Moreover, in order for the above initiatives to be successful they should be appropriately supported – it is implied that practitioners participated in the above programs need to be appropriately skilled (Shah, Cork and Choudhury, 2005). The support of the state to the families with children that suffer from ADHD is developed in accordance with the UK National Service Framework (2004); in accordance with the above framework, the participation of the parents in the effective treatment – as possible – of the above disorder is quite necessary (Brimble, 2009); The most know initiative – program - of this type is the Children’s Plan: Building Brighter Futures (UK.DCSF, 2007); the above program outlines the methods that should be used for the control of ADHD – relevant guidelines are provided to the parents participating in the specific program; however, it would be required that the above plan would become more flexible in order to meet the needs of families that face the specific problem. In the context of national support, the ADHD Information Services (ADDISS) is an organization operating nationwide aiming to ensure the quality and the adequacy of support provided to families with children who suffer from ADHD. The role of the above organization is quite important to the limitation of the effects of ADHD – the treatment of the disorder is also possible especially if the disorder is addressed in its early phases; the number of parents participated in the group programs organized and arranged by ADDISS is estimated to 6,000. Group programs for the support of families that face this problem are arranged across the country – this means that these programs are available at a local level/ community level in order to minimize the cost for parents. Practitioners in the specific field have emphasized on the importance of professional support and coordination in the management of ADHD – referring mainly to health visitors and school nurses (Dennis, 2008). The need for effective support of children suffering from ADHD and other similar disorders causing behavioural problems is also emphasized by Every Child Matters (2004). Because of the problems related with ADHD it is noted that the effective confrontation of the disorder can be achieved only with the appropriate cooperation – or else, the partnership working; in the context of group work on the confrontation of ADHD the following issues would be addressed: assessment of the problems caused by ADHD in the family environment, proposal of the changes required and monitoring of the progress achieved (ADD-vance, 2010); in any case, it would be required that the programs developed are flexible enough so that they can respond to the needs of all families of children that suffer from ADHD. The need for the development of effective programs for the confrontation of ADHD is emergent due to a series of subjective reasons: families with children that suffer from ADHD are more likely to develop problems like the alcohol use of parents, the increase of stress and anxiety and the appearance of financial problems – referring to the difficulty to afford the expenses of the required treatment or to respond to the financial needs of the family because of the hours required for participating in the relevant group programs; in other words, the parents of children suffering from ADHD have to face more challenges compared to those in families that do not face such a problem (Pouretemad, Khooshabi, Roshanbin & Jadidi, 2009). The financial and behavioural problems developed in families with children suffering from ADHD have been also emphasized in the study of Matza, Paramore & Prasad (2005). Another important problem for these families is the fact that children with ADHD cannot perform appropriately at school; in this way, those children are not likely to be accepted by all educational institutes or they can be even rejected as of the provision of certain healthcare services (Matza et al, 2005); the problem is made clear in the study of Dean (2005) where it is noted that in families with children suffering from ADHD the program of daily life is similar to that of the army – it does not have similarities with the style of life in families that do not face such problem. Moreover, it is noted that parents may face difficulties in facing the behavioural disorders caused because of ADHD within the family; the intensive care support from professionals is may required in order for the parents to be able to face the above challenge (Dean, 2005). The parenting programs available to parents of children with ADHD – referring especially to the group programs developed by ADDISS – can be characterized as quite effective; parents are given important guidelines on the methods they could employ in order to improve their relationship with their child; they are also being informed on the methods available for the effective handling of their children’s behavioural problems and for the decrease of their social isolation – a result of the ADHD. At the next level, it should be noted that the evaluation of the program is part of the program; in this way, the potential weaknesses of the program can be identified and appropriate solutions can be suggested; in this context, the discussion with parents after each session has been proved to be particularly helpful – to be informed on their view in regard to the specific program and their suggestions in regard to the alterations that would be possibly made on the program in order to become more effective; the participation of the parents in the formulation of the program has been emphasized by Grimshaw & Mcguire(1998). Through the program used for the confrontation of ADHD a series of benefits can be identified, both for the individual and the community; at the level of the family, the above program is expected to have the following benefits: a) improvement of the relationship between parents and their children suffering from ADHD, b) development of communication among the members of the families that face the specific problem, c) better understanding of the needs of children with ADHD, d) improvement of the family environment – in terms of limitation of stress caused because of the above disorder; this improvement could directly benefit the children with ADHD as their brain would have to face less turbulences in the context of the family, e) improvement of the communication between those families and their environment – referring to the limitation of the social isolation caused because of the ADHD. For the community, this program would lead to the increase of co-ordination and cooperation among families facing this problem; this fact could lead to the increase of the effectiveness of the program and the increase of socialization in the context of the community. The overall performance of the specific group programs has been found to be important even when initially there is no willingness of the parents to take part to the specific program (UK DCSF, 2008); therefore, the development of the above program would be further supported at the level both of individual and of the community. (1817 words) References ADHD Information Services (2003) Parents Provision and Policy: A Consultation with Parents. London: ADDISS. Brimble, M. (2009). Diagnosis and management of ADHD: a new way forward? Community Practitioner, 82(10), 34-37 Dean, D. (2005). ADHD and its impact on family life. Mental Health Practice, 8(9), 20-23 Dennis, T., Davies, M., Johnson, U., Brooks, H., Humbi, A. (2008). Attention deficit hyperactivity disorder: parents’ and professionals’ perceptions. Community Practitioner, 81(3), 24-28•Grimshaw, R. & Mcguire, C. (1998). Evaluating parenting programmes. York: Joseph Rowntree Foundation •HM Government. (2004). Every child matters: change for children. Nottingham: Department for Education and Skills. Matza, L., Paramore, C., Prasad, M. (2005). A review of the economic burden of ADHD. Cost Effectiveness and Resource Allocation, 3(5) Moran, P., Ghate, D., Van De Merwe, A. (2004). What works in parenting support? A review of the international evidence. London: Department for Education and Skills. Office for National Statistics (2004) Census 2001:National report for England and Wales. London: Office for national Statistics. Pouretemad, H., Khooshabi, K., Roshanbin, M., Jadidi, M. (2009). The effectiveness of group positive parenting programme on parental stress of mothers of children with Attention Deficit Hyperactivity Disorder. 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Choosing health: making healthy choices easier. London: Department of Health. United Kingdom. National Health Service. (2008). Attention deficit hyperactivity disorder. Retrieved March, 27, from http://www.nhs.uk/condition/attention-deficit-hyperactivity-disorder/pages/introduction.aspx Read More