Learning Disorder: Attention-Deficit Hyperactivity Disorder - Research Paper Example

Learning Disorder: Attention-Deficit Hyperactivity Disorder Liberty Learning Disorder: Attention-Deficit/Hyperactivity Disorder At some point in life, nearly everyone encounters inattention periods; learners may lack concentration in their studies and adults may find it difficult to pay attention to projects at work or home. Similarly, it is not abnormal for healthy individuals to sometimes act hyperactively or impulsively; however, for an incredible number of individuals these signs of impulsivity, hyperactivity and poor attention happen frequently and with adequate intensity causing significant incapacity in performance at school, or any other lifestyle activity. Some of these individuals may, in fact, be suffering from ADHD (Attention-Deficit/hyperactivity Disorder) (Castellanos and Krain, 2006, p.433). Contemporary Definitions of ADHD Since the first definition of ADHD, differences over the explanation of the disorder have led to two faintly dissimilar diagnostic criteria. The DSM-IV criteria are often the diagnosis basis in North America, while the ICD-10 is used as the basis for diagnosis in European countries; however, issues within the DSM or ICD have been discovered to impact the diagnosis of ADHD in medical practice. Other aspects such as a child’s school and social environment, as well as, educational demands at school are likely to influence the diagnosis of ADHD (Altaf, Fathina and Rasheed, 2013, p.1677). These conceptual inconsistencies are mostly responsible for variations in ADHD occurrence evaluation between the Europe and U.S., as well as, the difference between the two main analytic diagnostic criteria. The first, DSM-IV-TR is from the 4th edition of American Psychological Association’s Diagnostic and Statistical Manual Text Revision. DSM-IV-TR currently identifies three kinds of ADHD: ADHD Predominantly Inattention, characterized by difficulty in arousal and attention; ADHD Predominantly Hyperactive Impulsive, characterized by difficulty in impulse and motor control and ADHD Combined, characterized by difficulty in both areas of inattention and hyperactive impulse (Altaf, et al., 2013, p.1673). On the other hand, the predominant definition used in Europe, stems from the tenth 10th edition; ICD-10 (International Classification of Diseases) in the Diseases and Related Health Problems International Statistical Classification. In this case, the ADHD symptoms are given the term Hyperkinetic disorders. Given that a conduct disorder exists, the condition is referred to as Hyperkinetic conduct disorder. Otherwise, the ADHD disorder is categorized as Disturbance of Attention and Activity, Hyperkinetic Syndrome or Other Hyperkinetic Disorders (Altaf, et al., 2013, p.1679). This classification defines its ADHD complement, HKD (Hyperkinetic Disorder) more restrictively than that of DSM-IV. According to ICD-10, for a diagnosis of Hyperkinetic Disorder, the following ought to be present in more than one setting: at least six out of eight inattentive symptoms, at least three out of five hyperactive symptoms, and at least one out of four impulsive symptoms. As illustrated in the table below (from Castellanos, Kennedy, LaHoste, Murias and Swanson, 1998), there is substantial overlap in the required symptoms to meet the ICD-10 and DSM-IV criteria for HKD and ADHD, respectively. Source: Castellanos, et al., 1998 ADHD in Adults Until recently, ADHD had been primarily considered a childhood disorder; however, ADHD has been formally recognized to persist into adulthood. Experts have in the past believed that ADHD symptoms tend to decline with age; however, studies show that 60% of children diagnosed with ADHD, persist in having ADHD symptoms in adulthood. Nevertheless, countless adults remain untreated. Adults with ADHD that are untreated often have disordered lifestyles and appear confused; moreover, they rely on alcohol and non-prescribed drugs to overcome ADHD. They regularly have linked psychiatric co-morbidities such as learning disabilities, depression, substance abuse and anxiety disorders (Altaf, et al., 2013, p.1673). Impact of ADHD to the functioning of a person ADHD is a form of learning disorder that is typical in children and may be characterized by poor attention, low tolerance for disappointment, impulsiveness, and hyperactivity. It can be a distinctive developing condition with possible serious effects for those who experience it, as well as, their family and friends. Research shows that children with ADHD have executive function deficits, predominantly in response inhibition (Castellanos and Krain, 2006, p.433). Learning disability due to ADHD explains the difficulty in learning or mastering concepts; this includes knowing or using written or verbal language. This difficulty occurs in thinking, listening, studying, spelling and writing. To be categorized as a learning disability, the problem is not mainly the result of hearing, motor or visual disabilities; psychological retardation; psychological disorders; or due to ecological, social, or economic drawback (Growth Development or Life Span). ADHD can be termed as a serious problem with 30% to 50% of individuals clinically diagnosed in childhood having symptoms into maturity. Children and adults with ADHD usually develop mechanisms to deal with all or some of their problems. Epidemiological estimates of ADHD prevalence among adults in America can be estimated to be 4.7%. In addition, the global prevalence among children is approximately between 3% and 5%. School-aged children diagnosed with ADHD can be estimated to be about 2% to 16% (Altaf, et al., 2013, p.1669). Consequently, ADHD has been at the center of research over the past years. Researchers have made an effort to establish the causes of the problem, as well as, enhance its treatment methods. Despite the large amount of information obtained on ADHD, its actual cause continues to be unidentified. According to the best current analysis results, it is probable that ADHD is caused by inherited factors such as genes, environmental, biological and physiological factors. Medicinal therapies have proved effective for many individuals with ADHD, however, the fact remains that ADHD’s medication therapies are not always effective to the understanding of its biological basis, as well as, the significance of its environmental element. Etiology of ADHD ADHD can be viewed as one or more incessant characteristics usually found throughout the general populace. It is a developmental disorder where traits such as impulse control, lag in growth. Using MRI (Magnetic Resonance Imaging) of the prefrontal cortex, this lag in development has been estimated to vary from three to five years. However, ADHD’s definition may be based on behavior and this may not imply a neurological ailment. ADHD can be classified as a disorder that disrupts behavior that can be accompanied with antisocial personality disorder, oppositional defiant disorder and conduct disorder (Altaf, et al., 2013, p.1673). Although environmental and psychosocial factors may habitually contribute to the expression and development of ADHD, there is evidence that this disorder has a biological basis. Currently, numerous researchers agree that ADHD signifies a genetic predisposition corresponding to certain environmental stimuli that evoke ADHD. Studies in the fields of brain anatomy, genetics and physiology are beginning to discover the causes of ADHD and are providing improved diagnostic and treatment techniques to clinicians. Genes Family studies suggest that ADHD like any other developmental and psychiatric disorders have a strong genetic component (Cooper, Eyre, Langley and Thapar, 2013, p.3). Twin studies in different countries have demonstrated high rates of ADHD heritability of approximately 71% to 90%. In addition, the estimates have remained constant over a long period despite the variable diagnostic criteria. Hereditary approximations not only include genetic factors, but also the effects of gene-environment interaction. Thus, elevated heritability estimates never rule-out the environmental risks contribution. The most vital environmental risk factors for ADHD and its resultant adverse consequences are prone to being affected by child and parental dispositions that are genetically influenced; for instance, peer-rejection and pre-natal exposure to cigarette smoking (correlation in gene-environment). Molecular and twin studies have tested an exploratory system for gene-environment correlation effects, in ADHD (Cooper, et al., 2013, p.11). Thus, relationships of ADHD with environmental risks might arise partly or completely through inherited confounds (Cooper, et al., 2013, p.4). Major advances have been made in understanding specific genes and their correlations with ADHD. A bulk of genes implicated in causing ADHD, encode elements of catecholamine systems of signaling. One of these genes is the DAT (Dopamine Transporter Gene). The neurotransmitter dopamine is central to reward, motor and motivational-related functions. The Dopamine Transporter Gene can be thought to limit the amount of time that dopamine stays in the synapse. Proof of the Dopamine Transporter Gene link to ADHD can be supported by the general belief that stimulant medications that are highly effective in ADHD treatment, block the Dopamine Transporter Gene; consequently, increasing extracellular dopamine levels. Researchers consider most of the ADHD cases occur from a mishmash of different genes, the majority of which affect dopamine transporters. Candidate genes include SLC6A4 (serotonin transporter promoter), dopamine receptors D2/D3, dopamine transporter, 5HT2A receptor, among other genes (Altaf, et al., 2013, pp.1673-1674). Physiological component: Brain Anatomy Findings in neurophysiology of ADHD suggest that, these actions result from core deficits in executive functioning, response inhibition and delay aversion which, in turn, may be presumed to be associated to dysfunction of frontal-striatal-cerebellar circuits. MRI (Magnetic Resonance Imaging) has been applied to study anatomic disparities in cerebellum, pre-frontal regions, the corpus callosum and basal ganglia. Moreover, MRI has also been used to study disparities between control in children and ADHD. These aspects inevitably provide and contribute to the physiological explanation for ADHD. Most researches of ADHD anatomy have revealed overall decreases in total brain volume. The brains of adolescents and children with ADHD are 3% to 4 % smaller than the brains of children and adolescents with healthy controls. The smaller the frontal lobes, cerebellum, temporal grey matter and caudate nucleus, the more the symptoms of ADHD are severe in a patient (Castellanos and Krain, 2006, p.437). Delayed development in particular brain structures, such as, the temporal lobe and frontal cortex are associated with the ability to focus, think and control. The motor cortex in ADHD patients mature quicker than normal; signifying that both advanced and slower development of control in behavior characterizes ADHD. Moreover, neurotransmissions from the pre-frontal cortex to other regions of the brain are enhanced through neurotransmissions by dopamine. Too little dopamine can cause ADHD while a large amount of dopamine can cause ADHD. Dopamine levels index is inversely related not only to ADHD symptoms in childhood but also to adult psychiatric patients. Besides, the disparities in specific areas of the frontal lobe may be statistically correlated with the severity of ADHD (Altaf, et al., 2013, pp.1676-1677). Treatment of ADHD: Medication The extensive treatment of attention deficit disorder (hyperactivity) begun in the 1930s, when physicians found that certain types of medication could successfully reduce both impulsivity and attention deficit disorder. Since that time, the medicinal treatment of ADHD has been thoroughly investigated and has been one of the most questionable aspects of the problem. Although alternative healthcare options have proven to be efficient in many experiments, drug treatments remain the most commonly recommended and prescribed tools for symptom management. Nevertheless, it may be overlooked, that medications are little more than tools of controlling the ADHD symptoms. Drugs cannot cure ADHD and are most efficient when coalesced with additional behavior therapies and/or social treatments. Besides, although the prescriptions given for ADHD are effective and safe for people with the problem, the treatment of little children with powerful medications continues to be a fiercely contested subject. Although the utilization of prescribed medications is by far the most popular alternative for ADHD treatment, non-pharmacological treatments have also exhibited effectiveness. Most scientists and physicians believe that medications alone do not and cannot treat ADHD; they can only manage its symptoms. Studies suggest that the most effectual treatment procedure for ADHD entail a mixture of drugs and cognitive-based or psychosocial therapy such as group therapy (Altaf, et al., 2013, p.1680). These behavioral and cognitive therapies are typically targeted at dealing with the cognitive processes and maladaptive behavior patterns linked to ADHD. Moreover, most of these therapies include teaching the patient about the ADHD itself, as well as, offering customized coping techniques. Alternative Treatment of ADHD: Group Therapy Several signs of psychosocial adversity; for instance, low income and family hardship, have been linked to children mental health issues, such as ADHD (Cooper, et al., 2013, p.10). Scientists believe the fact that group therapy can be valuable for teens, especially those with low self-esteem and social abilities failure, and can be even more successful than individual medication. These are common issues experienced by children who have been brought up in foster care or who have been adopted. Other writers have cited various grounds for group therapy as the best form of treatment for teens suffering from ADHD. Firstly, teens will more easily agree to feedback from their colleagues than from grown-ups. Secondly, categories of people from other backgrounds allow people to pay attention without challenging immediate effective contribution. Finally, professional bonds are important for teenage growth and the process of separation-individuation. Group therapy assists teens because it provides them with colleagues through whom they can assess thoughts regarding themselves, possibilities to help one another, and social relationships to back up their self confidence and decrease the sense of being alone. Cantor mentions that the significance of mental experience in group therapy is noteworthy and considers group therapy to be more highly effective if the teens continually learn how to with certain circumstances (Cantor, 2000). Conclusion This paper has looked at the biological basis and the physiological part of ADHD and how it impacts the functioning of a person. There are different types of ADHD that can happen to a person; nonetheless, this disorder is treatable. ADHD is not unique among mental; nevertheless, studies in ADHD have yielded incredible advances in research strategies and, as a result, improved diagnostic and treatment procedures have been established. A good comprehension on the etiology of ADHD such as its social, cultural, and/or environmental basis will lead to further advances in diagnosis and treatment of ADHD. Future genetic studies will ultimately allow doctors and clinicians to determine a patient’s optimal medication and dose, through genetic analysis. Furthermore, many children have improved and conquered ADHD as they grow into adulthood through non-pharmacological treatments such as group therapy. ADHD is not unique among emotional problems and disorders, in that there is much more to be researched regarding ADHD. Although, research in the past has produced amazing developments in research techniques and, as a result, better analytic and treatment techniques, the awareness of ADHD may still be far from complete. A better understanding of environmental, biological, cultural and social basis will lead to further developments in research and treatment of ADHD. Enhanced genetic research can eventually allow clinicians and physicians to figure out an individuals optimal medication through genetic analysis. Furthermore, scores of children have overcome ADHD and grown to adulthood through optimal treatments of ADHD (Cantor, 2000). Enhanced knowledge of ADHD’s biological and physiological basis and the causing factors will certainly benefit ADHD victims; however, it may be vital to have a wider range for the diagnosis of ADHD. Although people with ADHD often display actions such as being disruptive, every case is different from the other; thus, every person is capable of achieving similar levels of achievements as anyone else. References Altaf, M, Fathina,I., Rasheed, A. (2013). Attention Deficit Hyper Activity Disorder (ADHD): An Overview. International Journal of Pharmaceutical Sciences and Research, 4(5), 1669-1683. Cantor, D. (2000). The Role of Group Therapy in Promoting Identity Development in ADHD Adolescents. Journal of Psychotherapy in Independent Practice,1(2), 53. Castellanos, F. X. ,Krain, A.L., (2006). Brain development and ADHD. Clinical Psychology Review,26 (4), 433-444. Castellanos, F.X., Kennedy, J., LaHoste, G., Murias, M., Swanson, J (1998). Cognitive neuroscience of attention deficit hyperactivity disorder and hyperkinetic disorder. Current Opinion in Neurobiology,8(2), 263-271. Cooper, M., Eyre, O., Langley, K., & Thapar, A. (2013). Practitioner Review: What have we learnt about the causes of ADHD?. Journal of Child Psychology and Psychiatry, 54 (1), 3-16. Read More