Posted on 10/14/2007 9:48:10 AM PDT by crazyshrink
Attention-deficit/hyperactivity disorder (ADHD), a state of serious impairments in both learning ability and social functioning, is one of many labels for one of the most prevalent conditions in child psychiatry, and, undoubtedly, the most controversial, which partly persists into adulthood. ADHD is conservatively estimated to occur in 3,0–7,5% of school-age children (Goldman et al., 1998), but more permissive criteria yield estimates of up to 17% (Barbaresi et al., 2002). Up to 20% of boys in some school systems receive psychostimulants for the treatment of ADHD (LeFever et al., 1999). Partly in response to legitimate concern about an apparent rapid increase in its prevalence in the 1990s, investigators have unsuccessfully attempted to formulate a single theory of ADHD, that would facilitate the development of an objective diagnosis test.
Aetiological factors of ADHD include not only genetic variations or mutations, but also environmental factors (brain injury and stroke, severe early deprivation, family psychosocial adversity and maternal smoking during pregnancy) and, most importantly and most difficult to identify, interactions between genes, and between genes and the environment. These factors are the initial causes of the multiple conditions that manifest symptomatically as ADHD, and their eventual identification should be accorded high priority.
(Excerpt) Read more at eurekalert.org ...
I agree. Why did you excerpt it?
Attention-deficit/hyperactivity disorder (ADHD), a state of serious impairments in both learning ability and social functioning, is one of many labels for one of the most prevalent conditions in child psychiatry, and, undoubtedly, the most controversial, which partly persists into adulthood. ADHD is conservatively estimated to occur in 3,0–7,5% of school-age children (Goldman et al., 1998), but more permissive criteria yield estimates of up to 17% (Barbaresi et al., 2002). Up to 20% of boys in some school systems receive psychostimulants for the treatment of ADHD (LeFever et al., 1999). Partly in response to legitimate concern about an apparent rapid increase in its prevalence in the 1990s, investigators have unsuccessfully attempted to formulate a single theory of ADHD, that would facilitate the development of an objective diagnosis test.
Aetiological factors of ADHD include not only genetic variations or mutations, but also environmental factors (brain injury and stroke, severe early deprivation, family psychosocial adversity and maternal smoking during pregnancy) and, most importantly and most difficult to identify, interactions between genes, and between genes and the environment. These factors are the initial causes of the multiple conditions that manifest symptomatically as ADHD, and their eventual identification should be accorded high priority.
The current criteria for the diagnosis of ADHD, published by the American Psychiatric Association in the 1994 Diagnostic and Statistical Manual of Mental Disorders (fourth edition; DSM-IV), are the most widely used and form our starting point. Other proposed criteria include those for the International Statistical Classification of Diseases and Related Health Problems (tenth revision; ICD-10) diagnosis of hyperkinetic disorder, which represents a more severe and ‘refined’ subset of DSM-IV ADHD, but which does not recognize the DSM-IV predominantly inattentive subtype (Castellanos & Tannock, 2002).
Terms applied to ADHD include:
ADHD & Working Memory
Research on ADHD has, mostly, been descriptive and atheoretical. The imperative to discover the genetic and environmental risk factors for ADHD is motivating the search for quantifiable intermediate constructs, termed endophenotypes. It could be concluded that such endophenotypes should be solidly grounded in the neurosciences.
Three such endophenotypes a specific abnormality in reward-related circuitry; deficits in temporal processing that result in high intrasubject intertrial variability; and deficits in working memory Are most amenable to integrative collaborative approaches that aim to uncover the causes of ADHD.
Working memory (WM) capacity is the ability to retain and manipulate information during a short period of time. This ability underlies complex reasoning and has generally been regarded as a fixed trait of the individual. Children with attention deficit hyperactivity disorder (ADHD) represent one group of subjects with a WM deficit, attributed to an impairment of the frontal lobe.
A previous preliminary study indicated that training of WM tasks can enhance executive functioning including working memory, response inhibition, and reasoning in children with ADHD (Klingberg et al., 2002b).
A randomized, controlled, double-blind trial to investigate the effect of improving working memory by computerized, systematic practice of WM tasks including 53 children with ADHD revealed a significant treatment effect both at intervention and follow-up (Klingberg et al., 2005).
The method evaluated in this study differs from that of previous ones in that it focuses entirely on training WM tasks. Moreover, the training is computerized, which makes it possible to automatically and continuously adapt the difficulty level to the performance of the child to optimize the training effect. Executive functions were measured and ADHD symptoms were rated before, immediately after, and 3 months after intervention.
A significant effect was shown for the span-board task, a visuospatial working memory task, that was not part of the training program, as well as for tasks measuring verbal WM, response inhibition, and complex reasoning. Moreover, parent ratings demonstrated significant reduction in symptoms of inattention and hyperactivity/impulsivity.
Working memory can be improved by training in children with ADHD and could be of clinical use for ameliorating the symptoms in ADHD. Altogether, the effect sizes for reduction of inattention are clinically strong.
Clinical implications
References
Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 1998;279(14):1100-7
LeFever GB, Dawson KV, Morrow AL. The extent of drug therapy for attention deficit-hyperactivity disorder among children in public schools. Am J Public Health 1999;89(9):1359-64
Barbaresi WJ, Katusic SK, Colligan RC, et al. How common is attention-deficit/hyperactivity disorder" Incidence in a population-based birth cohort in Rochester, Minn. Arch Pediatr Adolesc Med 2002;156(3):217-24
Castellanos FX, Tannock R. Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes. Nat Rev Neurosci 2002;3(8):617-28
Klingberg T, Fernell E, Olesen PJ, et al. Computerized training of working memory in children with ADHD--a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 2005;44(2):177-86
Klingberg T, Forssberg H, Westerberg H. Training of working memory in children with ADHD. J Clin Exp Neuropsychol 2002;24(6):781-91
Interesting. Thanks for posting.
These are the 6-week-old babies left at the babysitters for 10-hours every day who get no human contact. Their synapses don't develop.
Solution: Women raise they own children.
My dad had his own solution to my ADHD, back in the 60’s and 70’s.
He took me to the farm nearby, and I got a job working with the farmer, mucking out stallls and tending the farmers chickens.
I learned to work long and hard, and I have been ever grateful for that lesson.
I wasn’t back then, though! ;^)
stallls = stalls
Why did you excerpt it?
***********
I was under the impression we were allowed to post only 300 words. Am I mistaken?
So how does one train the Working Memory? Any resource recommendations?
How is this 'most importantly' except for being the latest research funding center and the most expensive because the 'most difficult.'
You are chemicals and Big Pharma has just what you need.
I have been using the “training method” for several years with my cliewnts with ADHD behaviors.
One resource is :
“The AD/HD Strategy Manual for Professionals” by Susan Pye Brokaw, Copyright 2000
Check used books on B & N, Amazon, etc.
or
Distributed by ADSS, 14525 Hwy 7, Ste. 145D, Minnetonka, MN 55345, 952-933-9926
(Sue was my prof at grad school.)
Practice remembering stuff. Rule: memory is never lost but sometimes becomes inaccessable through injury or disuse of the circuitry.
It would be interesting to know when this “condition” first started appearing, and possibly helpful in finding a “cure”. I went to elementary school in the 50’s. It did not exist then. By the way, that’s when we got TV.......
IMHO, meds only mask the symptoms. The medical model focises on “fixing symptoms” when it cannot “fix the underlying problem”.
ADHD is a genetic (physical) problem in which sufferers often “self medicate”.
How many people in prisons have ADHD? A beautiful topic for a Doctoral thesis!!
see also: theories of Alfred Adler (no/few meds in psych)
http://ourworld.compuserve.com/homepages/HStein/
Looks like your fingers are still hyperactivity.
Looks like your fingers are still hyperactivity.
ADHD has been around forever. Albert Einstein had this behavior. It is now being recognized and various forms of Tx are being devised.
LOL! As are yours, judging by the double post! ;^)
But, a large component, maybe most of it, of the crisis is political. This is where Hillary!08 gets her power.
Attention deficit hyperactivity disorder was first described by Dr. Heinrich Hoffman in 1845.
In 1902, Sir George Frederic Still published a series of lectuers to the Royal College of Physicians in England. The lectures described a group of twenty children who were defiant, overly emotional, passionate, lawless, spiteful, and displayed little inhibitions.
The troubling behaviors of these children were displayed before the ages of eight.
Sir George theorized that there was a biological basis to this proneness toward moral deviation. His theory was strengthened with the discovery that some members of these children’s families had psychiatric problems like depression, alcoholism, and conduct problems.
Prior to Sir George’s work, this uncontrollable behavior in kids was viewed as a moral failing by either the parents/children/both. Physical punishment was the only “treatment.”
In the 1940’s, ADHD like behavior was defined as “minimal brain damage.”
A disorder resembling ADHD appeared in the DSM II in 1968. It was called “hyperkinetic reaction of childhood” and was a type of hyperactivity.
Symptoms of this disorder were a short attention span, hyperactivity, and restlessness.
Previously ADHD was defined as just attention deficit disorder, with or without hyperactivity. This term was defined in the DSM-IIIR. It is now defined in the DSM-IV-TR as attention-deficit/hyperactivity disorder.
http://sitemaker.umich.edu/356.gamache/brief_history_of_adhd
“investigators have unsuccessfully attempted to formulate a single theory of ADHD”
This should concern any parent. I’ve seen unruly children but the whole list of behavioral “symptoms” of ADHD are very general and contain what are entirely normal personality variations. Also the studies I have seen do not show any long term benefit from Ritalin use. The best indicator I have to suggest that ADHD is a largely a “made up” disability is that before the medication became available so few children were diagnosed as hyperactive and it can be argued that whole generations survived and matured just fine without such medication. Children received greater doses of discipline and boys were not expected to behave like little girls. Also we have a society fed on hyper stimulation and entertainment through endless media so is it as surprise that the brains of young children would reflect this? The brain is a highly adaptable organ that changes structurally based on stimuli.
Some things that should concern everyone:
1. Rates of diagnosis of ADHD are twice as high in Caucasian children as in Latinos and African Americans.
2. Boys are three times as likely as girls to have a diagnosis of ADHD alone, and twice as likely to have ADHD with a learning disability. (I will expect we will eventually see the rates of young girls being diagnosed increased as they scrutinize them more for latent ADHD)
3. ADHD appears to be uncommon among the Amish. Researchers have reported that among 200 Amish children followed prospectively and compared with the non-Amish population, symptoms of ADHD were unusual.
4. Poor children are twice as likely to be diagnosed with a learning disability while children from families with health insurance were more likely to have a diagnosis of ADHD without a learning disability.
I believe there is great confusion being sown by “Mental Health Care Professionals”. It reminds of global warming. They make statements about genetics, brain development, and social development that are not only false but seem specifically tailored to mislead parents into thinking their children have a disability when in many cases the primary disability is the parents themselves. Now of course adults are being diagnosed with ADHD so even they can feel happy and totally disengaged for being a screw up. I ask any reasonable person to look at this laundry list of behavioral markers and tell me it isn’t crap?
1. A sense of underachievement, of not meeting one’s goals (regardless of how much one has accomplished)
2. Difficulty getting organized
3. Chronic procrastination or trouble getting started
4. Many projects going simultaneously; trouble with follow-through
5. Tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark
6. An ongoing search for high stimulation
7. A tendency to be easily bored
8. Easy distractibility, trouble focusing attention, tendency to tune out or drift away in the middle of a page or a conversation, often coupled with an ability to focus at times
9. Often creative, intuitive, highly intelligent
10. Trouble going through established channels, following proper procedure
11. Impatient; low tolerance for frustration
12. Impulsive, either verbally or in action, as in impulsive spending, changing plans, enacting new schemes or career plans
13. Tendency to worry needlessly, endlessly; tendency to scan the horizon looking for something to worry about alternating with inattention to or disregard for actual dangers
14. Sense of impending doom, insecurity, alternating with high risk-taking
15. Depression, especially when disengaged from a project
16. Restlessness
17. Tendency toward active behavior
18. Chronic problems with self-esteem
19. Inaccurate self-observation
20. Family history of manic-depressive illness, depression, substance abuse or other disorders of impulse control or mood
The Mental Health Care profession when united with the government bureaucracy is a horror in waiting because when one has a science which is so broadly ill-defined that anyone can be found to have a disorder when showing normal behaviors during the conflict resolution process and interaction otherwise known as living and we have government that enforces medication for the “good of the patient” for such general disorders it becomes quickly impossible by any any empirical means to prove one’s health without submission to the will of the government and the Mental Health Care profession.
I am well read on the inquisition and the smoke and mirrors way by which sanity and disorder is loosely defined today should bring pause to us all before we find ourselves tied firmly to a proverbial stake strapped down in a bed as the mind numbing chemicals find their way through our veins to wipe our individuality and passion away along with our depression, our guilt, and our anxieties.
Here is link to the original source:
http://www.family.org/parenting/A000001135.cfm
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