ADHD or attention deficit-hyperactivity disorder is defined as a psychiatric neurobehavioral disorder. It is characterized by the person’s inability to focus and pay attention. At the same time, there is hyperactivity and impulsiveness or sometimes both of these. A person who has ADHD has trouble keeping on with any task. They might start out normally but then in the process they will get the feeling that they are unable to continue with the activity and become extremely bothersome. It is sometimes referred to as ADD, attention deficit disorder but it has been outdated for some time. The individual experiences intense restlessness, act impulsively, without any good reason or explanation. The mind is unable to stay on one task for longer periods, which impacts learning, as it requires the focus of attention. ADHD greatly affects the retention and storage of information in the brain and thus it becomes extremely difficult to use any knowledge that was partly learned. The person cannot control the feelings of emotional distress and inability to concentrate. Very often it leads to further frustration and prevents any participation in the activity.
ADHD affects all people but mostly it is children who are suspected of the negative influences of the condition. It is considered to be one of the most common conditions in childhood. The statistics show that about 5% of school-aged children are affected by the disorder. It mostly affects children at the young age. When children get older they find and learn ways to cope with the symptoms partially or completely. There are two types of behaviors that can be seen with ADHD. One is the inattentive type. It usually sets out in children who are older, primary or high school. Boys and girls are affected approximately equally. It greatly affects academic performance. The person with this disorder is usually thought of as a “quiet underachiever or dreamy.” The other type is hyperactive-impulsive. This one is characterized by an early onset, in the nursery or in children in primary school. Here boys outnumber girls. It mostly affects behavior and physical actions. It is sometimes said that a person acts without thinking or is too energetic and cannot sit still.
As mentioned above some signs and symptoms include extremely active behavior patterns or the opposite, quiet behavior with inability to focus. Sometimes children with such conditions will show signs of fearlessness and engage in dangerous activities. The child always asks questions, changes activities without engaging in a certain one for a long period of time. Children always feel the need to explore and often leave their parent’s side. It is thought that busy environments often make the symptoms worse and so parents are advised to avoid such places. In reality it is very hard to define specific signs of ADHD because it seems very relative where to draw the line in the type of behavior. The symptoms must be observed in two different settings over a period of six months. Also the obvious difference from other children must be clearly noticeable. When such signs become obvious, the person is diagnosed with the disorder. Also children at the low activity side will often show no interest in the activity that is presented. The organizational skills greatly suffer and the frustration becomes very evident. All these symptoms are experienced by people without the disorder but the difference is seen in the degree and intensity of the emotional outburst or lack thereof. As the cognitive mechanism of the brain is malfunctioning, children will have trouble focusing on the tedious task. In their school work they show a significant decline in attention to the details and so make many careless errors. The activities in school are very hard to focus on and so children with ADHD should have private sessions in a one-to-one situation. One of the interesting facts is that children will have a better ability to focus on visual stimuli when compared to things they have to listen to. A more interactive activity will be more effective and video games are considered to be one of these activities. Very often children will begin to work very effectively and might display great amount of knowledge and understanding but the ending will be much different from the beginning. Children with ADHD are forgetful and often parents have to supervise them throughout an activity. It is extremely hard for a child to follow any sort of sequence or structure and so they wander off. ADHD is divided into categories that relate to the child’s response to the supervision and requests. One is oppositional behavior, which is categorized by active defiance, argumentativeness and temper outbursts, projection of blame, resentfulness and swearing. And there is the conduct disorder, which entails lack of responsiveness, over-talkativeness, difficulties reading facial expression, aggressive tendencies and poor behavior-modification strategies.
At the present time the etymology and the source of ADHD are not completely understood. There is evidence that there is a genetic predisposition to the disorder. One hypothesis supposes that due to the mixture of dominant and recessive major genes, which are responsible for the transmission patterns, a genetic abnormality occurs and causes the disorder. There have been studies that observed differences in the dimensions of the frontal lobes of the brain. There has also been a notice of the problems with the executive function and motivation. Particularly, there is a sensitivity to delay the reinforcement. The neurotransmitters are responsible for the transfer of dopamine and the actions on the cellular level influence the work of the brain’s systems. There is definitely a genetic predisposition that shows a change in the neurotransmitters responsible for the transfer of dopamine and norepinephrine, which affect the nerves connected to the frontal lobes. Some neuroimaging studies have shown a reduced amount of white matter volume and cortical thickness in ADHD patients. The most common view is that there are both genetic and environmental factors that affect the brain and cause the disorder.
Adults with ADHD have a better chance of controlling the symptoms and often find a way to accomplish such tasks. But there are those who do not receive any treatment and the problem worsens. Adults might lead a chaotic lifestyle, be much disorganized in their daily activities. In many cases adults resort to non-prescribed drugs or alcohol. There are many instances when untreated ADHD causes other problems. These may include severe depression, anxiety disorder, substance abuse and learning disability. The memory is also greatly affected and it causes an ineffective approach to everyday tasks, leading to persistent impairment in other areas of life. The fact that they become alienated and secluded from the society worsens the condition. Adults often feel ashamed of their disorder. They are unable to create any structure in life and so are forced to deal with the problem constantly and without major changes in the condition. There is also the problem of diagnosis, as clinicians do not deal with adult cases very often, they specialize more in children. Sometimes an adult can cover the signs and symptoms of ADHD by showing significant intellect and coping abilities (Selikowitz, 2009).
As with many other psychological disorders, the treatment includes some form of medication, together with behavioral modification, counseling and changes to the lifestyle. Usually the medication is resorted to when everything else fails. As children are unable to use their brains fully, it is hard for them to be treated by a counselor or any other “talk therapy.” They do not yet have the brain capabilities that an adult might have. But there is strong evidence that behavioral treatment plays an important role in the bettering of the symptoms. Sometimes there are interchangeable cycles of psychiatric treatment then there is an administration of the prescribed medicine and then the return to the psychiatry. Therapy is the preferred treatment for those with mild symptoms, as the person is more able to control their behavior and attitude. An important aspect of treating the disorder is the support of family and friends. The person must feel the love and presence of people who care. Sometimes children are alienated and it makes the symptoms worse. There have been numerous examples when parents provided a structure to the daily activities and found techniques that interested the child. There are cases when children showed great talents and so parents were able to focus the child on what was interesting to them, keeping them busy and at the same time providing the much-needed support. Sometimes parents would change schools in order to differentiate the setting. Other times they would teach the child skills in how to find friends or even request another child to play with theirs. When considering the medication, it is usually a stimulant in its nature. There is some medication that is non-stimulant, such as atomoxetine and it is used as an alternative or in milder conditions. Unfortunately, there is a lack of studies aimed at the long-term effects of medication. Short-term use of medication has shown to be of little effect; whereas prolonged usage has little evidence about the academic performance and social behaviors. The fact that medication is not recommended for preschool children makes the treatment of ADHD problematic. In the worst cases there are side effects, which include psychosis, mania and later substance abuse. But there is also the possibility that an individual will develop a dependence on the medication and will start to abuse it. There is a difference between the prescription techniques among several countries. UK’s clinicians recommend the use of medication in most severe cases, whereas United States recommends the use of medication in the majority of cases. Some studies have shown that children with ADHD have a deficiency in zinc and so supplementation can be beneficial for such instances (Chandler, 2011).
As previously discussed family plays an important role in the treatment and control of ADHD. When considering the United Arab Emirates, it is possible to see that family plays an important role in the society. There were several studies, which revealed that parental neglect made the children more vulnerable and the identification of the disorder became a problem. The prevalence of behavior disorders in children in the UAE was 13.5%, with males being affected in more instances than females. The emotional disorders reached 4.8% and conduct-related cases showed 6.9%. The females displayed a very good scholastic performance in grades 3 to 6 and so the behavior problems were much lower. But behavior disorders in three-year-old children in UAE were estimated to be 10.5%. These results are very similar to those in the Western world. The prevalence of ADHD in primary school children was shown to be 9.4%. Girls had a much lower count of 4.4% when compared to boys and 14.1%. Even though the family ties are generally beneficial, a random sample of children of 12 to 17 year-olds showed that they had excessive fearfulness. The fear was related to all kinds of aspects of life, including family problems, personal views and general fear towards the world. The sad fact is that the Arab world is experiencing many pressures. There is cultural change, political conflicts, and increased mobility. As the children are very dependent on the family for survival, they become particularly vulnerable to mistreatment and misdiagnosis (Nasir, 2008).
ADHD is an area of study that requires much research. As it affects children who are unable to effectively deal with the problem, everything possible must be done in treating and studying the problem.
Chandler, C. (2011). The science of ADHD: A Guide for parents and professionals. West Sussex, United Kingdom: John Wiley & Sons.
Nasir, L. (2008). Caring for Arab patients: A biopsychosocial approach. Oxon, United Kingdom: Radcliffe Publishing.
Selikowitz, M. (2009). ADHD. New York, United States: Oxford University Press.