Attention Deficit Disorder

Without Hyperactivity

Introduction

Most writing about attention
deficit disorder (A.D.D.) stress on negative symptoms and frustrations. There are many
positive aspect of this entity. The world would have been poor without the contributions
from individuals with A.D.D. Big names like Winston Churchill and Amadeez Mozart were
labeled A.D.D. They learned how to use A.D.D. to their advantages.What is
A.D.D.
This is a collection of traits that
reflects the childs inborn, neurological based temperament. These children are difficult
to raise due to the particular duster of temperament traits that characterizes
them. Among the traits there are positive tracts and negative ones.

Positive traits:

  • Spontaneity.
  • Non-activity.
  • The ability to lock on to and hyper focus on the looks of the child own choosing.

Negative tracts: ·

  • Selective Attention.
  • Distractibility.
  • Impulusity.

Depending on how they are perceived and shaped the traits can work to the child’s advantages and disadvantages.

In order to label the child on having A.D.D the child must exhibit behavior that is out of line with the children of the some age, these behavior must be caring empowerment of suctioning at home or school.

The term A.D.D is not a judgement on whether the child is good or bad. It is just a term desenbring how the child acts or thinks. That I why is in important to focus on both negative and positive tracts of the child. The parents and teacher should learn to focus on both negative and positive aspects of the disorder.

Attention defect disorder without hyperactivity is a distect syndrome from a common A.D.D with hyperactivity. These
children are lethargic and seem to spend much of their time in their own world. They are often faulty, labeled lazy.  Teacher’s think they don’t care.

These children’s A.D.D tracts are often missed because they are not disruptive, annoying or inconvenience to the family and school. A.D.D without hyperactivity is recognized at a later age A.D.D (with hyperactivity) when there are obvious with underachievement in school.

The diagnosis is common in boys than girls, because girls are generally calm, more eager to please and less disruptive than boys.

Some children with A.D.D without hyperactivity may be described as lazy. They have invisible disabilities unlike children with hyperactivity; they are often sensitive, rather anxious individuals who exhibit low self-esteem. Their children are rarely identified as having A.D.D until they are about thirteen years old. Few of the children does confess and confide their frustrations that other children seem no brighter have easier since learning things and organizing
time. These teenage are extraordinary frustrating to their parents who want to light the five under them. They don’t complete assignments and don’t seem to care about consequences. Parents often lament, “If only she could show some dive.”

Some students with A.D.D without hyperactivity may show some achievement in some areas as music dance,
art, sport etc.

They work hard in the activities they liked most and have used their abilities  to excel, but with regards to their school performance they might still look unmotivated and lazy.

Some of the A.D.D without hyperactivity are late conclusion of A.D.D with hyperactivity. These groups usually start showing no signs of hyperactivity often puberty; they are usually excellent daydreamers, aware of their shortcomings and as an involuntary comperatory mechanism, excel in activities that requires manual manipulation.

The Quality of A.D.D without Hyperactivity.

The three main qualities of A.D.D. without hyperactivity are: ·

SELECTIVITY

Children with A.D.D. pay attention selectively. They don’t have attention defeat as much as they have selected attention.  Depending on the selectation they operate from one extreme to another, exhibiting either brief attention to intense concentration. The child cannot stick to assigned tasks, his concentration is fine when doing his own-things like watching TV or playing video games. These children need thing in a stimulating way to combat boredom. That is why are better at hands –on learning that involves building models or playacting than they are at sitting and listening or reading a text book.

Children with selective attention select out what is important to them in that moment. Once they are distracted and off task, these children have more difficulty tuning back in to the task at hand.

The selective attention can work to a child’s advantage of disadvantage. This allows a child to get into things in a deeper and more creative way, provided he is interested.

The major disadvantage in this child is that, while we all have difficulty in focusing to boring thoughts, to them it is impossible. They can’t just make themselves do things that are not of their personal interest e.g. homework. In some older children, deadline finally gets them to settle down and do some work.

Educators and psychologist tend to focus on the child’s attention defeat than the child’s strength. It is not that these children cannot focus, they focus inappropriately. One should look at he child’s strong points, channel them so that they work for them as an adult.

ATTENTION DEFICIT AND AGE

Attention span is age related. A child of two years with a short attention span is not considered to be outside normal range by parents and kindergarten tutors. The same attention span at four years might be considered a problem. Attention difference is usually spotted when the child enters grade school.

Their memory is selective too.

They differ from other peers in that they only remember and recall from reading only than facts that interested them. When given a passage to read, they only read just to get it done, not to process the information. This difference in recall from children with A.D.D. is not a matter of a will, but it is unborn thing. They cannot force themselves to pay attention even if they wanted to.

One will notice that most children have, relatively short attention span, selective listening, daydreaming when they are subjected to boredom but those with A.D.D. do have them to extreme degree.

The children with A.D.D. differs from their peers in that, they can’t play with their peers. They often do well with younger children. Parents often label them as immature.

DISTRACTIBILITY

The children with A.D.D. without hyperactively are easily distracted but less to them those with hyperactivity component.  They have inability to set priorities e.g. He may concentrate on watching insects while the schoolbus is coming in a minute.  These are various stimuli that may distract them. Others are auditory while most are visual.

Dr. Linda, a child psychologist referred to this children as a hunter’s mind. The mind is said to be in a scanning model. ”Their minds are like idea salad” with all thoughts in shredded bits tossed randomly.

The word’s mind came form a hunter who is constantly scanning the territory for a prey. He locks and goes into hyper focus the moment he finds something worth pursuing, like an animal to kill.

IMPULSIVITY

The other quality of their children is impulsivity. These children usually act before they think. The quality is called spontanecty when the results is positive and impulsivity when the child gets into trouble.

The impulsive behavior is not always like a knee jerks reaction to a stimulus. These problem is failing to think the consequences before acting. Sometimes without any attention towards the end results, there is a great planning. Acting before thinking is nature of the consequences is one that get the children into dangerous situations. They have to be taught to think first. A classic worry to mothers is that the child may run out into the street after a ball and be hit by a car. Though some children do grow up without injuries, but their near missed and concentration cost their parent a lot of grey hair.

AETIOLOGY

The etiology
cannot be certainly defluid. Some neurologist believe it as a problem of imbalance in
the neurotransmitters in the brain. Some believe it is a myelination disorder while others
believe it is a combatation of events, but lay parents and teachers just dismisses it
as undisciplined.

Despite all that
the management does not depend on the particular actiological belief but on how you
approach the child and develop a management plan that will work for the child’s
advantage.

MANAGEMENT

The management
of this condition is multifaceted. One approach that interest the most is the intrauterine
management.  This management will start with prevention.

The pregnant
mother should refrain from indulging in behaviors that are likely to harm the babies
neuronal development, more especially the developing brain. Cigarettes, drugs and alcohol
have been shown to affect brain development and increases the risk of a child having
leaning and behavioral problem.

A healthy
lifestyle and died is all that measure the child ‘s potential. There are lot of
unsubstantiated theories on fetal psychology that has to do with improvement of
A.D.D.

The other more
important contributing factor is the first impression that the parent gives to the child
soon after birth, the baby should know where it belong. She should receive the message
that she/he is welcome in a warm hands. That is why it is important for all maternity
units to practice rooming in for  proper bonding.

The next message
the babies must receive is that their cries will receive response and their needs will be
met. Parents should respond intuitively to a babies cry. When a parent respond
positively to a babies cry, a baby develops a positive attitude of who  he is. A
babies cry is a signal, a language to be listened and responded to rather than a problem
to be fixed or a habit to be broken.

Does
breastfeeding have any role to may in the actiology of A.D.D. Ear allergies, ear
infections etc are then predisposing factors for A.D.D, and breastfeeding is known to
reduce the frequency of such illnesses . Breastfeeding will no in itself prevent the
development of A.D.D. but may diminish the severity and makes the child easier to manage.

Babies who are
carried close to their mother’s babies or arms tend to develop a feeling of security
and develop better with little chance of A.D.D. It means that the traditional African
methods of caring the babies on the back when the baby is always in a direct contract with
the mother is the best method in contrast with the contemporary prems and baby carriers.
Attachment parenting helps the parent to know their children better and help on managing
them properly. This form of attachment usually involves from pregnancy, through
infancy to adulthood. In the management assesmentrovetry for these children we have
several strategies for modifying their behavior, few of them will be shortly measured.

Identification
of the child’s problem by both parent, teachers and health personnel. The
problems should be identified and modified and teamwork between, parent, teacher should be
built. Look at the child environment, family interaction, and problems on marriage, recent
death in the family, change in school. Although no child develops in a problem free
family, parents should realize that these environmental factors that may optimize the
child’s potential are the  things that can make the child get
worse. Parents should act as models and pass mostly good messages to
their children. Children unlike animals should not be left to develop by the law
of the jungle.(The survival of the fittest)

The child’s environment, should be structured in such a way that it has limits that are easier to follow. It should not be “mitary or rigid.” The environment should be structured to fit the child and the child to fit the environment both at home and at school e.g. In the classroom the child should sit in a less distracting place.

If the child is
caught in the act of been good, a reward may be a positive reinforcement.

As the cardinal
features of the disorder is learning difficulty and the school may usually be the first
institution to refuse this child for evaluation. There are several approaches to the
management. The two main kind of assessment are:

  1. Those procedure that applies only to laboratory setting or practical only in the case of clinical investigation.
  2. Those procedures that may be utilized not only in research methodology but are applicable as well in the usual clinical setting.

Examples of procedures limited to laboratory are: Heart rate changes, events relating to brain action potential, and behavioral assessment of classrooms performance using trained observer who scores the target children as well as controls for specified period during school days. Clearly most of these procedures will be difficult to implement in the usual therapeutic setting.

The most practical management is frequent assessment of the child act regular intervals both at home and at school.  Parents and teachers scale (CAPTS) Yale teacher’s behavioral seal. This scale may be used to assess the child prior to treatment, during the treatment and in post treatment period.

Usually parents and teaches are very co-ordinate is filling these form. There should not be bias in filling the forms as both parent and teachers observations are very important in the management plan for the child.

In conclusion there are same a to lot of batteries of non standardized treatment modalities for A.D.D that has dubious utility and not supportive by clinical investigation like dietary management and continuos suppression of CNS with stimulants.

References:
1.) The Paediatric Clinic of North America.  Volume 31, No: April 1984 Symposium on Learning Disorder.
2.) The A.D.D book. William Seas and Lynda Thempson et al 1998.