Psychological Disorder (ADHD) ADHD is a disorder that has been reported to affect up to 20% of school-age children. The disorder affects boys more frequently than girls at a rate of about 10 times higher incidence of ADD/ADHD diagnoses made for boys than for girls. The most commonly accepted medical treatment for this condition is the drug Ritalin. However,...
Psychological Disorder (ADHD) ADHD is a disorder that has been reported to affect up to 20% of school-age children. The disorder affects boys more frequently than girls at a rate of about 10 times higher incidence of ADD/ADHD diagnoses made for boys than for girls. The most commonly accepted medical treatment for this condition is the drug Ritalin. However, researchers and professionals have increasingly recognized that the dangers associated with drug treatment for children warrant at least an attempt to find alternative or combined treatments.
On the other hand, ADHD symptoms in children have responded best to drug therapies and combined drug and therapeutic interventions rather than to therapeutic interventions alone. The most important factor involved in the treatment of any mental disorder is, however, to recognize that each individual is different. This has been shown by empirical studies: individuals react differently to similar interventions.
Hence, when determining therapeutic interventions for the treatment of ADHD in children, the professional and family must recognize that a number of interventions will most likely have to be attempted before the optimal one is discovered. TREATMENT OPTIONS The most commonly accepted treatment for ADHD, especially in its more severe forms, is drug treatment. As mentioned, the most common drug prescribed for the disorder is Ritalin, especially in children older than 6 years.
There are, however, several other drugs that are also commonly prescribed, depending upon their efficacy for the individual concerned (Martin, 2011). Aderall, Aderall XR, Dexedrine and Dextrostat are medications that can be given to children as young as 3 years old. Most drugs are recognized for their efficacy and safety in children 6 years or older. Among these is Cylert, which has, however, been found to have potentially serious side-effects for the liver. For this reason, Martin (2011) recommends that it not be used as a first-line drug for the disorder in children.
The drug Tenex is recognized as safe for children over 12 years old. However, insufficient empirical studies have been conducted to gain FDA approval for this drug. Other drugs that are considered safe from 6 years of age include Concerta, Daytrana (administered by patch), Focalin, Metadate ER and CD, Ritalin, Ritalin SR and LA, Strattera, and Vyvanse. There are therefore a number of drug options for the treatment of the disorder. According to studies, most children participating in empirical studies have responded well to the drugs, with only minor side effects.
Martin (2011) cites a large-scale study examining medication treatment on children. The study was titled the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA). The study involved 579 elementary school boys and girls diagnosed with the disorder, subjected to four treatment programs for a period of 14 months: 1) medication management alone; 2) behavioral treatment alone; 3) a combination of behavioral and medication treatments; and 4) routine community care. Children on medication were seen once per month by the prescribing physician, while all children were regularly assessed for symptoms by specialists and teachers.
The findings indicated the best improvements experienced by the children receiving combined treatments and those receiving medications alone. By association, the best treatment option was therefore found to involve at least medication or at best medication combined with therapeutic treatments. Today, most therapists recognize that children with the disorder need to manage the condition not only by means of medication, but also by associated non-medical interventions such as psychotherapy and specific parenting interventions.
Medication can, at best, be expected to result in partial success when treating ADHD, since so many of its effects also concern the way in which these children interact with others, as well as the long-term issues associated with the disorder. When medications have proved successful in controlling the most severe symptoms associated with ADHD psychotherapy and parenting strategies can be used to help children understand how to handle the challenges associated with their condition.
The greatest concern with medication, especially for children with the disorder, is the potential side-effects, however minor these might be. In the MTA study, for example, about 30% of children in the drug treatment groups experienced side-effects such as loss of appetite and trouble sleeping (Martin, 2011). Many parents are also concerned about the dangers of medicating their children with the stimulants commonly used to treat the disorder. Indeed, common side-effects cited include decreased appetite, insomnia, anxiety, irritability, stomach or head aches, and tics.
Insomnia could be relieved by administering the drug earlier in the day or by adding an antidepressant in the more severe cases, while good nutrition is vital for the management of the disease. Another concern is the likelihood that children who are given ADHD medication at an early age may later become dependent upon illegal drugs and other substances. This has, however, not been empirically indicated. For these reasons, parents and an increasing number of professionals recommend that alternative therapies be attempted before resorting to drugs.
One common alternative is nutrition, as suggested by the ADHD Information Library (2008). This involves avoiding any toxic preservatives and sugars. Only natural foods are recommended for ADHD sufferers, and specifically those that stimulate brain activity. In addition, all processed foods are to be avoided, as these often contain harmful chemicals and preservatives. While very healthy, the main challenge in this strategy is the effort and money that parents will have to make to prepare non-preservative dishes for their ADHD suffering children.
However, from a physical health perspective, this is a very good strategy, even for the whole family. Another significant advantage is that there will be no physical side-effects like those that might be expected with the use of drugs. Another interesting and less common alternative is the use of EEG Biofeedback. This involves the use of computer technology to train the individual to recognize and respond to their own brainwaves in such a way that the disorder is brought under control.
This strategy is generally combined with extensive psychotherapy to help the individual recognize the specific patterns being identified. Although non-invasive and drug free, this strategy's main disadvantage is its cost. Therapy sessions can cost up to $120 per sessions, which many families will not be able to afford in addition to their other day-to-day costs. As mentioned above, psychotherapy combined with good parenting can be greatly beneficial for children suffering from ADHD. Second to medical interventions, this is the most commonly accepted treatment for the disorder.
The ADHD Library recommends that parents should carefully select their treatment options, as each child responds differently to various treatments. Parents should also make decisions based upon their own ability to invest time and money into providing management strategies for their ADHD suffering children. Even if a therapy like EEG Biofeedback is the best possible one for a specific child, parents who cannot afford the time or money to use it will have to seek secondary alternatives that could also be helpful to their children.
In this search, it is vital that the correct professionals be involved in the decision-making process (Personal Health Lifestyles, Inc., 2001). When faced with the disorder for the first time, some parents consult their family physicians as a first resort. These physicians are, however, not professionally trained in the intricacies of the disorder or its various treatment options. Parents are therefore warned against simply using drugs that a family physician prescribes without obtaining a secondary, professional opinion.
APPLICATION Adam is a 7-year-old boy whose parents brought him to me for an assessment of his condition and a discussion of treatment options. Adams' teachers complain that he seldom finishes his work in class and that he is often restless and disruptive. No amount of punishment or scolding has helped the situation. The teachers involved ultimately contacted Adam's parents and discussed the problem with them. This came as a shock, as Adam did not display similar problems at home, where he has one older sister.
I was recommended by a family friend to help the family determine what their next course of action should be. I discussed all the treatment options with the family, including diet, psychotherapy, EEG Biofeedback, as well as medical interventions. I explained both the advantages and disadvantages related to each course of action and asked the parents to carefully consider their options. I explained that, should they opt for medication as a first choice, we need to carefully monitor Adam for any side-effects.
Before leaving them to discuss their options, I also recommended that we might start with a non-medical strategy such as diet and psychotherapy first before using medication as a resort. Because they both have busy schedules and cannot always monitor what Adam eats, they asked me to prescribe a.
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