A critical review of the case
Attention deficit hyperactivity disorder is a childhood disorder that thrives from adolescence to adulthood. It is characterized by difficulties in staying focused and paying attention among children, problems in behavior control, and more prominently, hyperactivity. The symptoms may entail distractions, difficulty in comprehending and processing information, fidgeting, inability to act quietly, and impatience.
Various studies have shown how biological and psychological factors are often intertwined with cultural factors in the development of the disorder. Culture is blamed for neurological differences such as the one caused by the eye. Studies have shown that the disorder is heritable and is mainly passed down the family lineage. An increasing number of cases have been noted in single families and in working parents who have little time to spend together with their children. The medications administered do not offer a cure but act to minimize and lower the symptoms thus helping the children participate normally in daily chores. Administration of stimulant drugs has been the popular mode of treatment in the United States. Ritalin is known to improve the attention capacity in the child. Scientists argue that integration of the medications with behavioral therapy is imperative in overcoming the challenges that the child may be facing.
The fact that ADHD symptoms are observed in many diseases and conditions makes the clinical description prone to ambiguity leading to unreliable results during diagnosis. There is a high chance of misdiagnosis owing to a lack of clear diagnosis of causative agents and factors, diagnosis, and treatment procedures for ADHD. The presentation of the boy seems to be in tandem with the symptoms provided by the DSM-IV (DSM-IV-TR workgroup 8).
According to the National Institute of Mental Health, the behaviour evident in the boy is abnormal and is characteristic of mental disorders. Hyperactivity is an abnormality that affects the overall life of the child since they tend to jump into making decisions, conclusions and into other people’s affairs without themselves knowing. Inattention and poor judgment are also some of the symptoms present in many disorders. The boy is aware of this condition and acknowledges the existence of a difference between himself and his peers. The feeling may lead to his withdrawal from other peers or the development of anxiety that can result in depression. His behaviour is characterised by hyperactivity and impulsivity as witnessed in all cases of ADHD. Medications provided David with relief since he was able to conduct some chores and classwork without getting distracted. The cameramen were nervous while interacting with David due to his impulsive behaviour and hyperactivity. This was mainly driven by the fear that David could act in a weird way leading to the cameramen being harmed or their equipment being damaged.
The diagnosis is in tandem with the national guidelines on mental health. The three major symptoms are utilised in the diagnosis. However, the symptoms are also evident in anxiety and bipolar disorders. These disorders lead to mood swings that may be confused with the side effects of the medications given to treat ADHD.
The causation of ADHD is mainly explained through biological factors. Studies have shown that genetic material responsible for causing ADHD is passed down the generations. It has been noted that children suffering from ADHD have relatively smaller brain tissue particularly in the area responsible for attention. This is mainly due to the presence of a particular gene (Khan and Faraone 395).
According to the National Institute of Mental Health, environmental factors such as cigarette smoking and to a larger extent alcohol use by pregnant mothers predispose the unborn child to ADHD. Brain injuries and food addicts have also been found to result in increased activity, particularly in children.
Several influences towards the development of ADHD exist in the social environment. The ostracization by the peers is a negative influence on the control of the disorder. Lack of emotional support from peers is one of the major inhibitors in the effective management of the disorder. David has a negative attitude toward the medications despite the knowledge that they are beneficial to him. The reliance on medications that offer short-term solutions only helps in postponing the adequate treatment of David.
Segregation and stigma of sick individuals by members of the society make them feel dejected thereby resulting in the eventual development of depression. Love extended by the family members is imperative in helping the individual to accept the needed change. However, failure by the mother to offer guidance made the boy maintain the unfocussed behaviours. Mental health professionals usually generalise the cases thereby failing to offer the necessary guidance and treatment.
Wellbutrin and Ritalin were the combinations of drugs used in the treatment. The medications improved concentration thereby helping David accomplish assigned tasks and chores. Their effectiveness is however curtailed by the tendency to make him antisocial and hazy. Alternative treatment should include behavioural therapy coupled with some medications (ADHD in children). Social skills training is important in the acquisition of appropriate behaviours. Talk therapy is useful in addressing issues that are emotive and day-to-day issues (ADHD in children). Psychotherapy is also applied in some patients. Self-help is also employed together with self-healing.
David is best suited to receive treatment from a psychologist since his condition requires encouragement to adopt certain behaviours vital in helping him overcome the disorder. A psychoanalytic form of treatment that entails behaviour change combined with medications would be preferred. This is due to the ineffectiveness of medications in achieving long-term solutions. Outpatient treatment would be recommended because the combination of associative learning reinforced with medications would require closer interaction with influences in the social environment. However, closer monitoring by the psychologist will occur regularly to ascertain the functioning of the therapy (ADHD Treatments).
Almost all the states in the United States have treatment facilities for ADHD. Hallowell-West Medical Center is found in California and cares for a patient residing around Los Angeles. The medical charges are covered by the health insurance offered by the employer. Patients who lack medical cover are required to cater for payments incurred after receiving the services. In the latter case, treatment is mainly terminated halfway due to inadequate funds thereby leading to ineffective treatment. Local self-help groups help in the initiation and maintenance of healthy lifestyles and habits that ensure that the individual takes control of impulsivity and hyperactivity (helpguide.org). There are several local self-help groups in all residential areas which are under the control of the parent organisation, CHADD. Meetings are conducted in members’ homes or open parks once per month but members have the right to dictate the number of meetings to be held (ADHD in children).
Medications are aimed at improving concentration and attention in the patient. Stimulants are the commonly applied medication to induce calming effects in the patients. Ritalin is known to improve the attention capacity in the child. However, the drugs do not offer long-term solutions to the disorder. Scientists argue that integration of the medications with behavioral therapy is imperative in overcoming challenges that may be facing the child.
ADHD in Children. Help guide. WISE & Healthy Aging. Web.
ADHD Treatments. AdhdNews. Web.
DSM-IV-TR workgroup. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association. Print.
Khan, Sajjad & Faraone, Stephen. ‘’The genetics of attention-deficit/hyperactivity disorder: A literature review of 2005’’. Current Psychiatry Reports. 8 (2006): 393- 397.
National Institute of Mental Health. ‘’ Attention Deficit Hyperactivity Disorder (ADHD)’’. 2009. Web.