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Attention Deficit Disorder

Attention Deficit Disorder, widely known as ADD, is a brain disorder which many people suffer from daily. The symptoms described by three authors all go hand in hand, but ADD varies greatly from person to person and some may have completely different symptoms than others. The diagnosis of ADD varies in each author with their own technique. ADD treatment is a long debated and very rough subject, as the authors have different views. The authors express their outlook on the symptoms, diagnosis, and treatment. There are eight common symptoms of ADD.

The carriers of ADD mostly have varying symptoms thus causing need for a different diagnosis and treatments. The best known symptom of ADD is inattention or distractibility. This symptom results in the sufferer being unable to sustain attention on a task or activity. This can greatly affect a childs education while in class and trying to pay attention to a boring teacher. The second symptom is impulsivity, meaning acting out before thinking. An example of an impulsive ADD action is a child jumping in a swimming pool forgetting that he did not know how to swim.

The third symptom is impatience. The word speaks for its self; the patient will desire something and strive to get it no matter what. The fourth symptom is hyperactivity. This is more prominent in males and causes kids to go off the walls. The next symptom is emotional over arousal. The result of this symptom is extreme happiness on the positive side, and extreme anger on the negative side. The sixth symptom is noncompliance. This is one of the worst symptoms because it can cause a sufferer to not follow rules, and lead to aggressive behavior including arguing and yelling.

The seventh symptom is social problems. The patient may have a difficult time getting along with others possibly because of being too intense, bossy, aggressive, and competitive. The final symptom of ADD is disorganization. Disorganization causes one to be forgetful, lose track of time, and lose things. These symptoms can all be caused by ADD but do not all have to be present in order to have ADD. The diagnosis of ADD is done differently from doctor to doctor. Thomas A. Phlenan, Ph. D, diagnoses ADD in an 8 step program.

The first step is a parent interview used to discover present problems, developmental history, and family history. The next step is the child interview. Third, behavior rating scales are done describing home and school functioning. Fourth, data from school, such as grades, achievement test scores, and current placement are all noted. Fifth, psychological testing for IQ and learning disabilities are sometimes done. Finally, a recent physical exam is used. (Phelan, 1993, p63)

Daniel G. Amen, M. D. s a different approach at diagnosing ADD. Amen uses an imaging technique called SPECT to measure brain blood-flow and activity patterns in the brain. He has found that the ADD brain is different, and depending on his findings, he can give appropriate treatments for ADD patients that were not helped by former treatments. (Amen, 2001, p72) Dale R. Jordan, author of Attention Deficit Syndrome, diagnoses simply by the symptoms after close evaluation of the patient in and out of the office (Jordan, 1988).

The three doctors all vary slightly in their diagnosing of ADD. Like diagnoses, treatment for ADD varies from author to author as well. Phelan believes unless there are contraindications for using stimulants, they should be tried for all ADD patients. The medication he has used is Ritalin, Dexedrine, Cylert, Tofranil, Norpramin, Clonidine, Tegretol, Lithium, and Mellaril. Ritalin, Dexedrine, and Cylert are all stimulants used to calm down patients in hopes to be more focused and more organized.

Tofranil and Norpramin are antidepressants Phelan uses in most cases where stimulants are not successful, when the parent does not want to use stimulants, or when stimulants benefits do not last long and need to be prolonged with additional medication. Clonidine is actually a high blood pressure medicine that has similar effects of Ritalin but takes a lot long to kick in. Tegrtol and Lithium are sometimes used in cases of extreme behavioral problems. Mellaril is sometimes used by Phelan where a child shows symptoms of ADD but may also be extremely aggressive.

Phelan, 1993, p112-3) Amen classifies six different types of ADD, each with a specific treatment. Type one is what he calls Classic ADD, it consists of the primary symptoms and is best treated by stimulant medication such as Adderall or Ritalin. He also found that these patients benefited from higher protein diets. Type two he calls Inattentive ADD, which consists of the primary ADD symptoms with low energy and motivation and is diagnosed later in life, if at all. The treatment is the same for Type one and two.

Type three he calls Over focused ADD which consists of primary ADD symptoms with cognitive inflexibility and difficulty with shifting attention. They worry, bear grudges and are argumentative. He prescribes an antidepressant, combined with a stimulant and a high-carbohydrate diet. Type four he calls Temporal-lobe ADD, marked by primary ADD symptoms with a short fuse, periods of anxiety, memory problems and difficulty reading. For this type he prescribes a combination of an anti-seizure drug like Neurontin, a stimulant, and a high protein diet.

The last type he nick-named the ring of fire. It features primary ADD symptoms with extreme moodiness, anger outburst, inflexibility, fast thoughts, and excessive talking. He gives these patients Neurontin, combined with antipsychotic medication such as Risperdal or Zyprexa. Amen quotes ADD is a multifaceted illness that usually responds to well-targeted treatment. (Amen, 2001, p72-3) Jordan differs from both of the previous doctors in the belief that medication and diet control need only be used in the more severe ADD cases.

His standpoint is to work with the patients who experience mild ADD instead of giving them medication. (Jordan, 1988) The biggest controversy over ADD is and always will be in the treatment of the disorder. People question the moral use of stimulants, anti-depressants, and high blood pressure medication to treat ADD. They worry about the side effects, allergic reactions, or just the idea of something unnatural in their body. The symptoms and questionable diagnosis and treatments of ADD are compared by Dale Jordan, Thomas Phelan, and Daniel Amen.

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Home » Disorder » Attention Deficit Disorder

Attention Deficit Disorder

Approximately 3-5% of all American children have an Attention Deficit Disorder (ADD). ADD is a leading cause of school failure and under-achievement. ADD characteristics often arise in early childhood. As many as 50% of children with ADD are never diagnosed. Boys significantly outnumber girls, though girls are more likely to be undiagnosed with ADD. “ADD is not an attention disorder, but a disorder of impulse control ( Seminar notes Barkeley).

Characteristics of Attention Deficit Disorder can include : Fidgeting with hands or feet , difficulty remaining seated, awaiting turns in games, ollowing through on instructions , shifting from one uncompleted task to another, difficulty playing quietly, interrupting conversations and intruding into other children’s games, appearing to be not listening to what is being said, doing things that are dangerous without thinking about the consequences. Most scientist now believe that a brain dysfunction or abnormality in brain chemistry could be to blame for the symptoms of Attention Deficit Disorder.

The frontal lobes of the brain are thought to be most responsible for the regulation of behavior and attention. They receive information from the lower rain, which regulated arousal and screens incoming messages from within and outside of the body. The limbic system , a group of related nervous system structures located in the midbrain and linked to emotions and feelings, also sends messages to the frontal lobes. Finally, the frontal lobes are suspected to be the site of working memory, the place where information about the immediate environment is considered for memory storage, planning, and future-directed behavior.

Scientist believe the activity in the frontal lobes is depressed in people with ADD. Studies show a decrease in the ability of the ADD brain to use lucose, the body’s main source of energy, leading to slower and less efficient activity. Neurotransmitters provide the connection between one nerve cell and another. In essence, neurotransmitters allow electrical impulses to pass across synapses from one neuron to another. It is now suspected that people with Attention Deficit Disorder have a chemical imbalance of a class of neurotransmitters called catecholamines.

Dopamine, helps to form a pathway between the motor center of the midbrain and the frontal lobes, as well as a pathway between the limbic system and the frontal lobes. Without enough dopamine nd related catecholamines, such as serotonin and norepinephrine, the frontal lobes are under stimulated and thus unable to perform their complex functions efficiently. Attention Deficit Disorder is strongly considered genetically inherited, however, not all cases of ADD may be genetically linked. . Studies have shown that 20-30% of all hyperactive children have a least one parent with ADD.

The environment is a big influence on a child during pregnancy and after. Some studies show that a small percentage of ADD cases were influenced by smoking, drinking alcohol, and using drugs during pregnancy. Exposure to toxins, such as lead, may also alter the brain chemistry and function. If you suspect that you are suffering from Attention Deficit Disorder you will need to discuss it with your medical doctor. In most cases the doctor will recommend that you visit a psychologist for an evaluation.

The psychologist is professionally trained in human behavior and will be able to provide counseling and testing in areas related to mental health. The psychologist is not able to prescribe medication to help you, but may send you to a psychiatrist to prescribe and monitor medication. A neurologist may be consulted in order to rule out neurological conditions causing your symptoms. Your doctor will gather information about your past and present difficulties, medical history , current psychological makeup, educational and behavioral functioning.

Depending on your symptoms, your diagnosis may be categorized as ADD, inattentive type ADD, or hyperactive/impulsive type ADD. After your diagnosis you may learn that you are also suffering from a learning disability, depression, or substance abuse, which is often associated with ADD. There is no cure for Attention Deficit Disorder. Along with increasing awareness of the problem, a better understanding of its causes and treatment has developed (3 Wender)”. There is medication for ADD which will only alleviate the symptoms.

The medication will not permanently restore the chemical balance. Approximately 70% of adults with ADD find that their symptoms significantly improve after they take medication prescribed by their doctors. The patient is able to concentrate on difficult and time-consuming tasks, stop impulsive behavior , and tame the restless twitches that have been experienced in the past. Some ADD patient’s psychological and behavioral problems are not solved by medication alone, and are required more therapy or training .

There are two types of drugs that work to balance the neurotransmitters and have been found to be most effective in treating ADD. Stimulants are drugs that stimulate or activate brain activity. Stimulants work by increasing the amount of dopamine either produced in the brain or used by the frontal lobes of the brain. There are several different stimulants that may work to alleviate the symptoms of ADD, including methylphenidate (Ritalin), dextroamphetamine Dexedrine), and pemoline (Cylert). Stimulants are by far the most effective medications in the treatment of ADD.

Some patients respond well to antidepressants. Antidepressants also stimulate brain activity in the frontal lobes, but they affect the production and use of other chemicals, usually norepinephrine and serotonin. The antidepressants considered most useful for ADD include imipramine (Tofranil), desipramine (Norpramin), bupropion ( Wellbutrin), and fluoxetine hydrochloride (Prozac). All stimulants have the same set of side effects. Some patients complain f feeling nauseous or headachy at the outset of treatment, but find that these side effects pass within a few days.

Others find that their appetites are suppressed and or that they have difficulty sleeping. If the stimulant dosage is too high the patient may experience feelings of nervousness, agitation, and anxiety, In rare cases, increased heart rate and high blood pressure can result with the use of stimulants, especially if the patient has an underlying predisposition toward hypertension. Ritalin is the most widely prescribed drug used to treat ADD in both children and adults. Ritalin appears to work by stimulating the production of the neurotransmitter dopamine.

The benefits of Ritalin include improved concentration and reduced distractibility and disorganization. Dextroamphetamine is another stimulant medication that appears to have a slightly different pharmacological action than Ritalin. Both work to boost the amount of available dopamine. Dextroamphetamine, however, blocks the reuptake of the neurotransmitter while Ritalin increases its production (334 Kelly, Ramundo, Press). All the drugs used to treat ADD have the same goal: to provide the brain ith the raw materials it needs to concentrate over a sustained period of time, control impulses, and regulate motor activity.

The drug or combination of drugs that work best for you depends on the individuals brain chemistry and constellation of symptoms. The process of finding the right drug can be tricky for each individual. The physicians are not able to accurately predict how any one individual will respond to various doses or types of Attention Deficit Disorder medication. Medication is rarely enough for the patient. Most Attention Deficit Disorder patients require therapy to give guidance . Adult patients have the burden of the past that often hinders their progress.

The patient then needs help with the relief of disappointment, frustration, and nagging sense of self- doubt that often weighs upon the ADD patient. Some ADD patients suffer from low- grade depression or anxiety, others with a dependence on alcohol or drugs, and most with low self-esteem and feelings of helplessness. Therapy also helps the ADD patient fully understand the disorder and how it controls the patients life. The knowledge of ADD will make the patient and arents more capable of changing the behaviors or circumstances disliked and enhancing strengths and assets.

A second and most crucial part of the education process involves informing those around you about the disorder and its effects. Family members, friends, employers, and colleagues have been playing roles in the drama called ADD without ever being aware of it. Explaining how the disorder may affect the relationships around the patient will help repair any past damage as well as pave the way to a stable future. Attention Deficit Disorder is difficult for any family. ADD challenges the relationships and the issues of daily family life.

Getting a family household to function smoothly is challenging for any family, with or without the presence of ADD. Adults and children suffering from Attention Deficit Disorder have trouble establishing and maintaining physical order, coordinating schedules and activities, and accepting and meeting responsibilities. Parents with children suffering with ADD have to learn how to deal with the obstacles that they will have while raising their child. Adults dealing with ADD often have chronic employment problems, mpulsive spending, and erratic bookkeeping and bill paying.

Raising healthy, well-adjusted children requires patience, sound judgment, good humor, and, discipline which is difficult for an ADD parent to do. The presence of ADD often hinders the development of intimate relationships for a variety of reasons. Although many adults with ADD enjoy successful, satisfying marriages, the disorder almost always adds a certain amount of extra tension and pressure to the union. The non-ADD spouse bears an additional burden of responsibility for keeping the household running smoothly and meeting the needs of the children, he spouse with ADD, and, if he or she has time, his or her own priorities.

Parenting a child who has ADD can be an exhausting and, at times, frustrating experience. Parents play a key role in managing the disability. They usually need specialized training in behavior management and benefit greatly from parent support groups. Parents often find that approaches to parenting that work well with children who do not have ADD, do not work as well with children who have ADD. Parents often feel helpless, frustrated and exhausted. Too often, family members become angry and withdraw from each other. If untreated, the situation only worsens.

Parent training can be one of the most important and effective interventions for a child with ADD. Effective training will teach parents how to apply strategies to manage their child’s behavior and improve their relationship with their child. Without consistent structure and clearly defined expectations and limits, children with ADD can become quite confused about the behaviors that are expected of them. Making and keeping friends is a difficult task for children with ADD. A variety of behavioral excesses and deficits common to these children get in the ay of friendships.

They may talk too much, dominate activities, intrude in others’ games, or quit a game before its done. They may be unable to pay attention to what another child is saying, not respond when someone else tries to initiate and activity, or exhibit inappropriate behavior. I decided to write my research paper on Attention Deficit Disorder because my four-year old step-brother has recently been diagnosed with the disorder. I hope that my relationship with my brother can become closer now that I have a better understanding of what he is suffering from.

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