Attention Deficit Hyper Activity Disorder according to Singh (2002) is a developmental disorder that is brain based and most often affects children. This developmental disorder can be characterized as a disorder in which affects ones self control; primary aspects include difficulty with attention, impulse control, and activity levels usually diagnosed prior to the age of 7yrs. of age (Willoughby, 2003).
There are primarily three sub-types of ADHD. Inattentive sub-type 1 is ADHD which those who manifest inattention without the presence of hyperactivity and impulsivity (Barkley, 2005). There is also ADHD sub-type 2 with symptomolgy related to hyperactivity and impulsivity (Barkley, 2005). Finally there is ADHD combined sub-type (Visser & Lesesne, 2005). For the purpose of my paper, I will utilize information that represents all subtypes in various degrees and the affects of these difficulties upon the individual, educational, family, and social development as well as issues of social justice and cultural issues for those children who suffer from this disorder.
Historically the modern symptoms of ADHD were first identified (Barkley 1996, Rafalovich 2001, & Stubbe 2001), by English physician George Still in 1902 (Neufeld & Foy, 2006). Rafalovich (2001), explains that in a series of historical events from 1917-1918 in North America that led to an encephalitis outbreak there was a dramatic increase in research of characteristics that are similar to modern day ADHD symptomology. Through out the early years of research there was even research and investigations into medical conditions which promoted swelling in certain aspects of the brain, which many believe led to impulsivity and hyperactivity (Stubbe, 2000). As research evolved so did the diagnostic criteria for the disorder; shaping identifiable factors believed to contribute to the causation of ADHD (Barkley, 2005). Physiologically, there seems to be less dopamine and nor-epinephrine within the brains of those with ADHD and four genes that regulate dopamine have been identified as ADHD causal agents; however a definite causal agent has not been confirmed (Barkley, 2005). Brain activity is considerably lower in the pre-frontal lobe regions in those with ADHD and there is also decrease in blood flow (Hans, Henricksen & Bruhn, 1984), (Barkley, 2005). According to Barkley (2005), psychological characteristics of ADHD are that it is about the “behavioral inhibition.” These children do not benefit from what may happen later based upon what they do now; which can be compared to a “time near sightedness”, (Barkley, 2005). They have difficulty identifying their past, preparing for the future, organizing, scheduling, and working independently, with social and occupational issues (Barkley, 2005). It is these difficulties when intermingled with the development of the individual that could clearly cause great difficulties especially when enrolled in formalized schooling and onward into the demands of school and adulthood.
The prevalence rates regarding the diagnosis of adhd has been from ranges of 4 % to 18 % depending upon the community, types of populations, and areas of analysis (Visser & Lesesne, 2005). ADHD is one of the most common childhood disorders with 2.5 million children with this disorder (Barkley, 2005). Estimates show (Biederman, 1996), that nearly 6 % of boys and 1.5 % of girls have ADHD (Singh, 2002). It cost nearly 3.3 billion dollars to medically treat ADHD every year in the United States (Visser & Lesesne, 2005). Currently causation factors under consistent follow up according to Barkley (2005) include;
2. Premature Birth
3. Traumatic Brain Injury
4. Spine and Brain Infections
5. Early exposure to substances during pregnancy
6. Early exposure to lead
7. Less blood flow and lower brain activity
Because ADHD is a representation of physical imperfections within the brain and actually manifests a decrease of activity in the pre-frontal lobe regions; certain treatment options with amphetamines, stimulants and non-amphetamines have been utilized to increase brain activity (Barkley, 2005). The size and anomalies within the brain have been verified and examined through many technological processes such as Positron Emission Tomography and MRI scanning (Vance & Luk, 2000). Other physical abnormalities of development according to Barkley (2005), include appearances of slight deformities including; longer than average index finger, third toe that is longer than second toe, ears that are slightly lower upon the head, no earlobes or a furrowed tongue. Up to 80% of children suffering with ADHD will continue to struggle with this disorder into adolescents and as many as 50 to 60 percent will continue to struggle into adulthood (Barkley, 2005). With the affects upon a child’s school, family, and social environments a large emotional toll can be identified. Emotionally, children can feel isolated, angry, guilty, frustrated and many other emotions due to the disruption of relationships, opportunities and lack of clear decision making skills (Barkley, 2005). Many of these children can become depressed and exhibit anxiety (Barkley, 2005). Many affective behaviors include stubbornness, defiance and at times can be verbally or physically violent to others (Barkley, 2005).
According to Barkley (2005) nearly 57% of preschool children are likely to be rated as inattentive and over-reactive by their parents up to the age of four. As many as 40% according to Barkley (2005), may have these problems for up to three to six months, concerning parents and teachers. According to Lavigne, Gibbons, Christoffel, Rosenbaum and Binns (1996), however, it is estimated that 2% of preschool children truly meet the criteria for ADHD, and (Biederman, 1996), clarified that possibly 10 % of all children meet diagnostic criteria for ADHD (Singh, 2002). Barkley clearly indicates that the earlier the symptoms of ADHD appear and the length of time they last in childhood will determine the severity of its course and prognosis (Barkley, 2005). Individually there are many distressing problems for children suffering from this disorder. Some features that Barkley (2005) indicate are important to recognize as the individual child develops into school age include;