Chris Brown
English 102: section 6
May 3, 1996
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, following 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
brain, 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
glucose, 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 and 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 of 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 with 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 parents 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, impulsive 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, the 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 way 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.
....................................................................................................
.
Chris Brown
English 102: section 6
May 3, 1996
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, following 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
brain, 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
glucose, 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 and 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 of 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 with 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 pa
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