Another name of hope !


General Introduction


          From the past five years the Prevalence of ADHD features in childhood is higher than before. Identification of the ADHD child among from the special children (Autism, MR (Moderate � Severe), ADHD and Multi Disabled) is more difficult due to the similarity of signs and symptoms.� If ADHD is identified with its category followed with early proper therapy and treatment, the signs and symptoms of ADHD will be reduced and should be promoted as near normal.� Treatment and special training are varied for every individual but no one concern the importance for this individual care. Many specialists have taken efforts to control the signs and symptoms of ADHD, but they could achieve only about 30 to 60 per cent. �Improvement is delayed and not achieved their goals due to misinterpretation of the signs and symptoms and improper therapy for ADHD children.

          In our organization, professionals who share and spend more time with child and the trainers who follow the instructions of chief practitioner and the parents also following the instructions for the improvement of their children.� Here we work with team spirit and we could achieve the improvement level even up to 99%.� Our vidial group mainly focuses one to one teaching for every individual to promote independent life.


Introduction

Introduction:


          ADHD is Attention Deficit and Hyperactive Disorder. With the early identification of ADHD and the proper treatment, support, and education, the child can overcome many of the difficulties and achieve success. �Most children with ADHD should be taught in a special education with one to one teaching and then promoted to regular education classroom with modifications made to the classroom setting and regular monitoring. However, due to their inability to concentrate, their true potential is often times never reached and they may wind up becoming underachievers. Unfortunately, children with ADHD are at risk for school failure, emotional difficulties, and significant negative adult outcomes in comparison to their peers. Hyperactivity is often improved at puberty and there may be a reduction in symptoms of ADHD when the individual reaches adulthood through with proper guidelines. In addition, with the appropriate help, they can learn to suppress and channel their hyperactivity into more acceptable behaviors such as exercise.


Causes

ADHD


          Children with Attention Deficit Hyperactivity Disorder (ADHD) have problems with attention, controlling their impulses, trouble completing tasks and may be hyperactive. Boys are three times more likely than girls to be affected by the disorder.

Causes

  • Unknown etiology
  • Chemical imbalance in the brain with a strong genetic basis.�
  • Environmental factors - Alcohol and tobacco smoke exposure during pregnancy

  • Premature birth
  • Artificial food coloring and preservatives in foods
  • Complex post traumatic stress disorder

Classifications

Classifications of ADHD:


  • Inattentive�
  • Hyperactive/Impulsive,
  • Combined
  • Not Otherwise Specified

Features and Characteristics

Features and Characteristics


Those with Inattentive ADHD display at least six of the nine characteristics as follows:

  • Often does not give close attention to any activities (or) makes careless mistakes in schoolwork, work, or other activities.

  • Often has trouble keeping attention on tasks or play activities.
  • Often does not seem to listen when spoken to directly.
  • Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).


  • Often have trouble organizing activities.
  • Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).

  • Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).

  • Is often easily distracted.
  • Often forgetful in daily activities.


With Hyperactive/Impulsive ADHD display at least six of the nine characteristics as follows:


Hyperactivity:

  1. Often fidgets with hands or feet or squirms in seat.
  2. Often gets up from seat when remaining in seat is expected.
  3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
  4. Often has trouble playing or enjoying leisure activities quietly.
  5. Is often "on the go" or often acts as if "driven by a motor".
  6. Often talks excessively.

Impulsiveness:

  1. Often blurts out answers before questions have been finished.
  2. Often has trouble waiting one's turn.
  3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

          Those with Combined ADHD meet the criteria for both Inattentive and Hyperactive/Impulsive ADHD.

          Those with Not Otherwise Specified ADHDdisplay some of the characteristics seen in the other types, however, do not have enough of the symptoms to reach a full diagnosis. The symptoms they do have, however, disrupt everyday life.

ICD-10������

          In the tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) the symptoms of ADHD are given the name "Hyperkinetic disorders". When a conduct disorder (as defined by ICD-10) is present, the condition is referred to as "Hyperkinetic conduct disorder". Otherwise the disorder is classified as "Disturbance of Activity and Attention", "Other Hyperkinetic Disorders" or "Hyperkinetic Disorders, Unspecified". The latter is sometimes referred to as, "Hyperkinetic Syndrome".


Differential diagnose

Differential diagnoses


          To make the diagnosis of ADHD, a number of other possible medical and psychological conditions must be excluded.

Medical conditions

          Medical conditions that must be excluded include: hypothyroidism, anemia, lead poisoning, chronic illness, hearing or vision impairment, substance abuse, medication side effects, sleep impairment, and child abuse, among others.


Treatment

Treatment

          Medication is often used to treat ADHD. Usually, drug treatment is not enough. Often times, teacher and parent training as well as family or individual counseling may be necessary. Behavior therapy is also helpful to help modify inappropriate behaviors and to deal with the emotional effects seen in individuals with ADHD.

          In addition to medication and therapeutic measures, other important things can be done such as providing a supportive environment for the child, and teaching him or her organizational skills, study skills, memory skills, and time management skills. Medication will often be helpful if used when the child is trying to learn these skills in that it can decrease the impulsivity/hyperactivity, increase the child's attention, and reduce aggressive behaviors, allowing the child to better concentrate at the task at hand.

           Since the behaviors associated with ADHD can have a substantial impact on the child's education, experts have identified the following classroom characteristics which best promote educational success for many children with ADHD: predictability, structure, shorter work periods, small teacher to pupil ratio, more individualized instruction, interesting curriculum, and the use of positive reinforcers. They also identified a number of things the teacher can do when working with a child who has ADHD: have positive academic expectations, frequently monitor and check the child's work, give directions with clarity, have warmth, patience and a sense of humor, be consistent and firm, have knowledge of different behavioral interventions, and have a willingness to work with a special education teacher.


Occupational Therapists

          Occupational therapy for children with ADHD enhances their ability to process lower level senses related to alertness, body movement and position, and touch. This allows them to pay more attention to the higher level senses of hearing and vision. For example, skills related to vision include visual tracking, fixation, focus change, binocular fusion and visualization. When all of these are well developed, children can sustain attention, make less errors while reading/writing, give meaning to what they hear and see, and rely less on movement to stay alert.

          The therapy focuses mainly on reducing hyperactivity, impulsivity, maladaptive behaviors and enhances attention and concentration to improve social skills like, co-operative play, sharing skills, develop self-concept / self-esteem, attention, listening skills, taking turn, following directions, cognitive perceptual skills, and produce expected adaptive behavior

          The other main areas that are targeted include self-care and school performance. In self care the occupational therapist provide orientation to the child about the dress materials, eating, bathing and grooming equipments and provide simulation activities that improves the independent performance of the child in various contexts.

           Therapists focus on developing pre-handwriting skills, writing, coloring, alphabet and numeral learning and recognition, which helps improve the school performance of the child.

           Occupational therapists evaluate the Cognitive and other functional skills of the child which can provide information on the developmental age of a child and may or may not concur with the psychological results. Profiling the child's sensory history can also provide crucial evidence in the determination of ADHD. It is often difficult to distinguish behaviors that are consistent with sensory integrative dysfunction from the ones consistent with ADHD. However there are some broad patterns that could be helpful. It is important to remember that not all children with ADHD have sensory processing issues but most children with sensory integrative problems may present with symptoms of ADHD.

          Speech Communication Method (Speech-Language Therapy): Children with ADHD need to learn not so much how to speak as how to use language socially to communicate. That includes knowing how to hold a conversation, thinking about what the other person in a conversation understands and believes, and tuning in to the meta-linguistic signals of the other person, such as facial expression, tone of voice and body language. It is important to remember that communication is as much nonverbal as it is verbal, and people with autism have great difficulty understanding nonverbal language.


Management

Management

Professionals involved:

          A good management program should involve the following consultants (along with medical practitioners) who will work as a team to enhance overall development and facilitate independence in the mainstream society. Parents play an integral role and hence should be actively involved in the whole process.

  • Psychiatrists & Psychologists
  • Occupational Therapists
  • Special Trainers or Special Educators

Psychiatrists & Psychologists:

          Occupational Therapist and psychologist are observing and evaluating children to take the assessment, on the basis of that Psychiatrists are confirmed their diagnosis if needed they prescribe medicines for severe cases.

Occupational Therapists:

          Occupational therapy for children with ADHD enhances their ability to process lower level senses related to alertness, body movement and position, and touch. This allows them to pay more attention to the higher level senses of hearing and vision. For example, skills related to vision include visual tracking, fixation, focus change, binocular fusion and visualization. When all of these are well developed, children can sustain attention, make less errors while reading/writing, give meaning to what they hear and see, and rely less on movement to stay alert.

          The therapy focuses mainly on reducing hyperactivity, impulsivity, maladaptive behaviors and enhances attention and concentration to improve social skills like, co-operative play, sharing skills, develop self-concept / self-esteem, attention, listening skills, taking turn, following directions, cognitive perceptual skills, and produce expected adaptive behavior

           Therapists focus on developing pre-handwriting skills, writing, coloring, alphabet and numeral learning and recognition, which helps improve the school performance of the child.

           Occupational therapists evaluate the Cognitive and other functional skills of the child which can provide information on the developmental age of a child and may or may not concur with the psychological results. Profiling the child's sensory history can also provide crucial evidence in the determination of ADHD. It is often difficult to distinguish behaviors that are consistent with sensory integrative dysfunction from the ones consistent with ADHD. However there are some broad patterns that could be helpful. It is important to remember that not all children with ADHD have sensory processing issues but most children with sensory integrative problems may present with symptoms of ADHD.

           Speech Communication Method (Speech-Language Therapy): Children with ADHD need to learn not so much how to speak as how to use language socially to communicate. That includes knowing how to hold a conversation, thinking about what the other person in a conversation understands and believes, and tuning in to the meta-linguistic signals of the other person, such as facial expression, tone of voice and body language. It is important to remember that communication is as much nonverbal as it is verbal, and people with autism have great difficulty understanding nonverbal language.

Special Education:

          They might need special inputs to perceive and comprehend the vast information presented to them using special instructional methodology and instructional material, learning aids and equipment specific to each individual's learning needs.


Prognosis

Prognosis


          ADHD diagnosed in childhood is estimated to resolve in 15-50% of individuals by the time they reach adulthood. Those affected are likely to develop coping mechanisms as they mature thus compensating for their previous ADHD.

           People with ADHD tend to work better in less structured environments with fewer rules. Self-employment or jobs with greater autonomy are generally well suited for them. Hyperactive types are likely to change jobs often due to their constant need for new interests and stimulations to keep motivated. Recent studies suggest that many expatriates.