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Holistic Approach to ATTENTION DEFICIT HYPERACTIVITY DISORDER.

Part 1


ATTENTION DEFICIT HYPERACTIVITY DISORDER is a neurobehavioral disorder that involves children and adolescents with complications lasting till adulthood. ADHD often co-occurs with some mental disorders. Symptoms and impairment review are the primary requirements for diagnosis. It requires Multimodal treatment.



What do you know about attention deficit hyperactivity disorder?

ADHD is a common chronic neurobehavioral disorder in children and adolescents. The clinical manifestation can last till adulthood and often coexists with psychiatric problems such as oppositional defiant disorder (ODD), conduct disturbance, mood and anxiety ailments, and cigarette and substance abuse. ADHD is a significant public health issue because it affects men and women.


Today, the most widespread childhood behavioral condition is ADHD, which affects 6.4 million children nationwide and 10% of American children aged 4 to 17. The variety of factors that can influence the adequate examination of children and adolescents may cause variation in the prevalence of ADHD internationally and within the US. These barriers to assessment contribute to the underdiagnosed, misdiagnosed, and inadequate treatment of ADHD. 


How Do You Recognize Attention Deficit Hyperactivity Disorder?

  1. One of A (inattentional) or B (hyperactivity-impulsivity):

1(A) at least six of the following inattentional symptoms, when present, have lasted for at least six months in a maladaptive way and are out of line with their developmental stage: Inattention: 

  • Frequently makes careless errors or pays no attention to details when performing tasks at work, school, or elsewhere. 

  • Frequently finds it challenging to focus on tasks or play activities. 

  • Frequently, when addressed directly does not listen.

  • Frequently disobeys orders and neglects to complete homework, housework, or work-related responsibilities (not due to oppositional behavior or failure to understand instructions). 

  • Often struggles with task and activity organization. 

  • Frequently avoids, hates, or shows reluctance to perform tasks requiring prolonged mental effort (such as school assignments or homework) 

  • Often misplaces items required for jobs and activities (e.g., toys, school assignments, pencils, textbooks, or devices)

  • Frequently quickly diverted by other stimuli.

  • Frequently forgets to do daily tasks.


1(B) six or more of the hyperactivity-impulsivity symptoms have lasted for at least six months in a maladaptive way and are out of line with their developmental stage. Hyperactivity: 

  • Often fidgets with their hands, feet, or seat. 

  • Frequently stand up from their seat in a lecture hall or other settings unexpectedly. 

  • Frequently moves around or climbs excessively in improper situations (in adolescents or adults, it may be limited to personal feelings of restlessness) 

  • Frequently finds it challenging to play quietly or partake in leisure activities.

  • Repeatedly "on the go" or behave as though they are "propelled by a motor." 

  • Speaks too much a lot of Impulsivity 

  • Frequently answers questions in a hurry. 

  • Often struggle to wait for their turn.

  • Frequently interrupts or interjects other people (e.g., butts into conversations or games).


2. Before age seven, certain hyperactive-impulsive or inattentive symptoms that led to impairment were apparent.


3. Some impairments are brought on by the symptoms in two or more contexts (e.g., at school, work, or home).


4. There must be believable proof of an impairment in social, scholarly, or occupational functioning that is clinically substantial.


5. Another mental illness cannot explain the symptoms and does not just manifest throughout the pervasive developmental condition, schizophrenia, or another psychotic illness (e.g., Mood disruption, Anxiety Disease, Dissociative Condition, or Personality Disorder).


These standards lead to the identification of three distinct subgroups of ADHD:

1. ADHD, Combined Type: if both 1A and 1B criteria have been satisfied over the previous six months.

2. ADHD, Predominantly Inattentive Type: If only criterion 1A is satisfied for the previous six months.

3. Predominantly Hyperactive-Impulsive ADHD: if Criteria 1B is satisfied but Criteria 1A has not been met for the previous six months.


WHAT ARE THE FACTORS THAT CAUSE OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)?

The causes of ADHD are numerous; 

  • Genetic, 

  • Perinatal, and 

  • Gestational factors.

Environmental Factors linked to ADHD in the prenatal and perinatal periods and other stages of the central nervous system's (CNS) development could increase the incidence of ADHD.  

The environmental elements are: Perinatal hypoxia, toxins (Organophosphate pesticides).





WHAT ARE THE TREATMENT OPTIONS FOR ADHD?

Treatment for attention deficit hyperactivity disorder (ADHD) can aid with symptom relief and reduce the severity of the condition's impact on daily living.

A combination of therapy and medicine is often the most effective treatment for ADHD.


MEDICATION

Most commonly, medications are used to manage the symptoms of ADHD. Medication helps to manage through daily lives and regulate the behaviors that cause problems with their peers, family, and teachers.

The most widespread and renowned ADHD treatments are stimulants. When taking these quick-acting drugs, between 70 and 80 percent of youngsters with ADHD experience a reduction in their ADHD symptoms.

Non-stimulants can treat ADHD. Although they don't operate as quickly as stimulants, they might still have an impact for up to 24 hours.

For the treatment of ADHD, there are five different categories of approved medications:

  • methylphenidate 

  • lisdexamfetamine

  • dexamfetamine 

  • atomoxetine 

  • guanfacine

These medications do not cure ADHD but may improve concentration, decrease impulse, promote calmness, and aid new skill development.

Regular pauses from the regimen are necessary to decide whether the medication is still needed. 

Children might respond differently to medications. The medicines can have adverse effects such as decreased appetite or trouble sleeping. One drug may work well on one youngster but not another.


Therapy

Different methods can help treat ADHD in children, teens, and adults in addition to taking medication. Additional issues that may accompany ADHD, such as conduct or anxiety disorders, can be effectively treated with therapy.

A few of the potential treatments are.

  • Psychoeducation: talking with your child about ADHD and the implications. It can help you cope and live with the disease and can aid children, teenagers, and adults in making sense of the diagnosis of ADHD.

  • Behavior therapy: involves providing help to carers of kids with ADHD, teachers, and parents. Behavior therapy always applies behavior control, which uses a method of tips or bonuses to motivate your kid to try to handle their ADHD. If your child has ADHD, you can choose to foster a behavior such as sitting at the table to eat. You can then give your child some small rewards for good behavior. For teachers, behavior management entails understanding how to structure and schedule activities and recognize and reward students for even the slightest achievements.

  • Programs for parent education and training: If your kid has ADHD, carefully designed parent education and training programs can assist you in learning particular methods to speak to, play with, and interact with your child to enhance their attention and behavior. 

  • Social-skills instruction: Aiming to teach your child how to act in social circumstances by understanding how their behavior impacts others, social skills training entails your child participating in role-play scenarios.

  • Behavioral and cognitive therapy (CBT): talking treatment that might assist you in managing your issues by altering your attitudes and behaviors. A therapist would try changing how you or your child senses a circumstance, which could result in behavioral changes. CBT can be used with a therapist either one-on-one or in a group.


ADHD is a common chronic neurobehavioral disorder that affects children and adolescents with complications lasting till adulthood. Though medications can not cure ADHD, together with therapy, the symptoms are relieved, and the quality of life is improved.














Reference

Harpin, V. A. (2005). The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Archives of disease in childhood, 90(suppl 1), i2-i7.

Núñez-Jaramillo, L., Herrera-Solís, A., & Herrera-Morales, W. V. (2021). ADHD: reviewing the causes and evaluating solutions. Journal of personalized medicine, 11(3), 166.

Weiss, M. D., & Weiss, J. R. (2004). A guide to the treatment of adults with ADHD. Journal of Clinical Psychiatry, 65, 27-37.

Wilens, T. E., & Spencer, T. J. (2010). Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgraduate medicine, 122(5), 97–109. https://doi.org/10.3810/pgm.2010.09.2206

Te Meerman, S., Batstra, L., Grietens, H., & Frances, A. (2017). ADHD: a critical update for educational professionals. International Journal of Qualitative Studies on Health and Well-Being, 12(sup1), 1298267.








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