Attention Defecit Disorder By Jim Jacob Discovery BBS 818-353-0770 In 1902 a doctor named

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Attention Defecit Disorder By Jim Jacob Discovery BBS 818-353-0770 In 1902 a doctor named Still describe children who had behavioral problem which he termed "defects in moral control" and he recoginzed that the condition occurred more commonly in boys. He described the childern as having conduct disorders and poor attention. The discovery of the "paradxivcal quietening effect" and marked behavioral and school improvement of hyperactive childern treated with Benzedrine in 1937. This find may have influenced the selection of the term of "Minimal Brain Dysfunction." In 1959 Knobloch and Pasamanick, who compared birth history of 500 childern referred for behavior problem with a matched control groups of 350 children from the same socioeconomic group and found that the behavoir disordered children had significantly more complications of pregnancy and that most common behavioral syndrone was hyperactivity. Below is a brief historical highlights: 1. The discription of the syndrome is not new in the medical literature and appeared as early as 1902. 2. The interaction between organic factors and the environment in the perpetuation of the behavioral syndrome was recognized in the 1930's. 3. The terminology of the syndrome has changed over time from MBD to Attention Deficit Disorder. (Hyperactive Childern Grown Up, Grabrille Weiss and Lily Trokenberg Hechtman). Within the past 20 years the condtion has become the most- researched and best known of the childhood behavior disorders. It is the most common single condition referred to child psychiatry clinics. The condition is severe enough to be very distressing to teachers and parents. In 1960's the use of stimulants drugs began to help behavior. In 1970's discovery that hyperactive child syndrome was not limited to childhood, and that children do not necessarily outgrow this condition. The fact of psychiatric and social impairment and continuing into adolescence and adulthood was established. Finally, attention deficit disorder (ADD), has become the established, current name. It can take a long time to diagnose attention-deficit hyperactivity disorder. It effects one in five school age childern. In the past it was assumed that after puberty it would disappear, which in today's research is not necessarily true. Three things are giving hope to adults with attention-deficit hyperactivity disorder: 1. Early intervention 2. More of the population becoming aware 3. Researchers are beginning to focus on the underlying causes of this disorder. Identifying the child with attention-deficit hyperactivity disorder has become easier. These are inability to sustain attention, impatient, impulsive, and nonreflective. There often is a lack of social skills. Other disabilities may be present, including conduct disorder. The American Psychiatric Association states the essential features of ADD as: ADD With Hyperactivity Inattention Does not finish tasks Does not seem to listen Is distractible Has diffculty concentrating on tasks Has difficulty sticking to play Impulsivity Acts before thinking Shifts from one activity to another Has difficulty organizing work Needs much supervision Often calls out in class Has difficulty awaiting turn Is restless during sleep Is always "On the go" Onset: Before 7 years of age (Usually by 3 years) ADD Without Hyperactivity As above, except for the absence of hyperactivity. There are many approaches to therapy with a child showing ADD. It is geared to a a child's particular needs. Almost always, the child with ADD is treated through educational management. The more individualized education and positve approach is best for the child. Having least amount of distraction in class by sitting near the teacher can be of great help. Short sessions of work with regular breaks seems to work well for the child. Medical management is often a essential part of ADD treatment. It should not be the only treatment. Treatment with drungs such as dextroamphitamine, methylphenidate, or pemoline depends on the degree of ADD in academic and social activities. The drugs should be given only after extensive discussion with the child's parents and school. Medical history, findings on examination, or the results of laboratory testing will not show the child's reaction to medication. An appoved questionaire for parents and teachers should be used to determine a child's behavior. This can assist the health care professional in determining whether to treat a patient with medication. Follow-up reports are important to keep track of the child's progress. Beacause some ADD childern have poor motor control, they can be helped through physical education. If a child is gifted in sports, running most common, it should be encouraged by professionals. This is a socially accepted form of self-expression with no limits and builds good self-esteem. Psychotherapy is widely used with medical treatment in children with ADD. The child should be shown that medical treatment cannot correct all problems but to increase personal control of behavior help along with medication. In this situation parents need to have counseling as well. There is a strong genetic infulence in attention-deficit hyperactivity disorder. In recent years several studies have been done with family and twins to suggest this disorder is hereditary. One of the studies was done by David Comings, M.D., director of the Department of Medical Genetics at the City of Hope Medical Center. New research attached to genetics include theories about children with attention-deficit hyperactivity disorder will have more genetic problems. Research also shows systems play a central role in ADD. This research was done by Bennett and Sally Shaywita. Reports of reduced concentrations of homovanillic acid (HVA) in the cerebrospinal fluid of children with ADD suggest adnormalities in central dopaminergic system. This new research seems to not support the other theory call lag theory. This theory states children with attention-deficit hyperactivity disorder (ADD) are behind their peer but not different in any important ways. Whatever the causes, today about at 3% worldwide if the average amount of children with the desease. In the past 15 years more and more interest in ADD has taken place. Whatever the location, it is likely this interest will continue, so research can go forward to find the best ways to treat this common problem.


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