ADHD - Review of Literature - Effects on Development Within Family, Education, and Social Systems

Attention Deficit Hyper Activity Disorder according towith ADHD or they can get angry and resentful.
Singh (2002) is a developmental disorder that is brainThese reactions create dynamic challenges for any
based and most often affects children. Thisfamily and or individual dealing with ADHD. Other
developmental disorder can be characterized as apossible hindering perceptions by parents within the
disorder in which affects ones self control; primaryfamily system can be identified by comparing
aspects include difficulty with attention, impulse control,Erickson's, Psycho Social Developmental Perspectives
and activity levels usually diagnosed prior to the age of(Berger, 2000). According to Erickson, children from the
7yrs. of age (Willoughby, 2003).age of 3 yrs. old to 6 yrs. of age will develop through a
There are primarily three sub-types of ADHD.series of challenges to parents, taking the "initiative" or
Inattentive sub-type 1 is ADHD which those who"failing," bringing feelings of "guilt" (Berger, 2000). When
manifest inattention without the presence ofthe child's challenging behavior takes place however,
hyperactivity and impulsivity (Barkley, 2005). There isas Camparo, Christensen, Buhrmester & Hinshaw,
also ADHD sub-type 2 with symptomolgy related to(1994) states, that parents may not allow these
hyperactivity and impulsivity (Barkley, 2005). Finallychildren to have the benefit of the doubt, due to past
there is ADHD combined sub-type (Visser &excessive behavior under normal circumstances, and
Lesesne, 2005). For the purpose of my paper, I willthe parents may see their child as an "easy target."
utilize information that represents all subtypes in variousAccording to the evidence, miscalculating the child's
degrees and the affects of these difficulties upon thenatural challenging behavior could take place and
individual, educational, family, and social development asdisallow the child to develop in a healthy, "guilt free"
well as issues of social justice and cultural issues forway, having significant affects on their psycho-social
those children who suffer from this disorder.development. Excessive amounts of guilt can produce
Historically the modern symptoms of ADHD were firstsignificant amounts of anxiety and depression (Burns,
identified (Barkley 1996, Rafalovich 2001, & Stubbe1990). These negative processes in variable degrees
2001), by English physician George Still in 1902 (Neufeldcan clearly lead to negative affects on social and
& Foy, 2006). Rafalovich (2001), explains that in aemotional processes (Burns, 1990).
series of historical events from 1917-1918 in NorthOther family processes affecting ADHD and
America that led to an encephalitis outbreak there wasdevelopment according to Peris & Hinshaw
a dramatic increase in research of characteristics that(2003), is that core symptoms of impulse control and
are similar to modern day ADHD symptomology.inattention are primarily heritable, and parental practices
Through out the early years of research there wasdo not warrant significant (Barkley, 1998; Hinshaw 1994;
even research and investigations into medicalJohnston & Mash, 2001), causation for ADHD.
conditions which promoted swelling in certain aspectsHowever, the family interaction patterns and external
of the brain, which many believe led to impulsivity andinfluences may have a significant impact on severity
hyperactivity (Stubbe, 2000). As research evolved soand the developmental course of ADHD (Peris &
did the diagnostic criteria for the disorder; shapingHinshaw, 2003). Furthermore, evidence suggests
identifiable factors believed to contribute to the(Barkley, 1985; Battle & Lacey, 1972; Buhrmester,
causation of ADHD (Barkley, 2005). Physiologically,Camparo, Christensen, Gonsalez, & Hinshaw, 1992;
there seems to be less dopamine and nor-epinephrineCampbell, 1973; Cunningham & Barkley, 1979;
within the brains of those with ADHD and four genesMacDonald, 1988; Mash & Johnston, 1982;
that regulate dopamine have been identified as ADHDTallmadge & Barkley, 1983) that mothers of
causal agents; however a definite causal agent hasADHD children are less affectionate. Other disturbing
not been confirmed (Barkley, 2005). Brain activity isfindings indicate that parents can be more critically
considerably lower in the pre-frontal lobe regions indemanding and parents independently report a greater
those with ADHD and there is also decrease in bloodtendency to blame their ADHD child for problems they
flow (Hans, Henricksen & Bruhn, 1984), (Barkley,actually had with their spouses; thus proving further
2005). According to Barkley (2005), psychologicalthat family systemic patterns can play a major role in
characteristics of ADHD are that it is about thethe perpetuation and affects of ADHD upon child
"behavioral inhibition." These children do not benefitdevelopment (Camparo et al., 1994). Of course these
from what may happen later based upon what theyprocesses clearly affect a school-age child within their
do now; which can be compared to a "time nearfamilies and external systems in ways which reduce a
sightedness", (Barkley, 2005). They have difficultychild's self worth, confidence, and abilities to properly
identifying their past, preparing for the future, organizing,interact and function within their environment; proving
scheduling, and working independently, with social andthis, Dumas & Pelletier (1999) indicated that
occupational issues (Barkley, 2005). It is thesepre-adolescents were found to have lower levels of
difficulties when intermingled with the development ofself esteem in areas of scholastic competence,
the individual that could clearly cause great difficultiesbehavioral conduct, and social acceptance.
especially when enrolled in formalized schooling andAccording to Barkley (2005), those with ADHD, at
onward into the demands of school and adulthood.times do not give themselves time to evaluate their
The prevalence rates regarding the diagnosis ofemotions objectively before a reaction, fail to separate
ADHD has been from ranges of 4 % to 18 %their feelings from fact. Being able to internalize our
depending upon the community, types of populations,emotions, evaluate them, and analyze them before
and areas of analysis (Visser & Lesesne, 2005).displaying them publicly assist in self control and is
ADHD is one of the most common childhood disordersdifficult for those suffering from ADHD (Barkley, 2005).
with 2.5 million children with this disorder (Barkley, 2005).Those who suffer from ADHD develop a pattern of
Estimates show (Biederman, 1996), that nearly 6 % ofsocial rejection due to inappropriate interactions
boys and 1.5 % of girls have ADHD (Singh, 2002). Itbeginning during formalized schooling according to
cost nearly 3.3 billion dollars to medically treat ADHDBarkley (2005). According to Nixon (2001), those
every year in the United States (Visser &children suffering from ADHD lack significant social
Lesesne, 2005). Currently causation factors underskills that affect the quality of their interactions, such as;
consistent follow up according to Barkley (2005)verbal & physical aggression, disruptive attempts
include;to enter new groups, negative classroom behaviors,
1. Geneticsbeing quick tempered and violating the rules. Nixon
2. Premature Birth(2001) presents more evidence that social cognition is
3. Traumatic Brain Injuryclearly affected and children with ADHD can have
4. Spine and Brain Infectionsgreat difficulty in making clear interpretations of their
5. Early exposure to substances during pregnancyenvironmental interactions with others. These variables
6. Early exposure to leadclearly lead to inhibited social contact, and a
7. Less blood flow and lower brain activitydysfunction in psycho-social development. According
Because ADHD is a representation of physicalto Eric Erickson in Berger (2000), he clearly indicates
imperfections within the brain and actually manifests athat formalized school age children from 7 to 11 years
decrease of activity in the pre-frontal lobe regions;old need to develop confidence that allow them to feel
certain treatment options with amphetamines,as if they have mastered "Industry" (Berger, 2000). If
stimulants and non-amphetamines have been utilized tothis stage is not mastered, they may feel inferior
increase brain activity (Barkley, 2005). The size and(Berger, 2000). How can these children who are
anomalies within the brain have been verified andexcluded due to their ADHD manifestations of
examined through many technological processes suchbehavior, be given the chance to participate and prove
as Positron Emission Tomography and MRI scanningthemselves to resist negative aspects of "Inferiority?"
(Vance & Luk, 2000). Other physical abnormalitiesAs these children develop into adolescents and adults,
of development according to Barkley (2005), includeone can hypothesize when comparing ADHD behavior
appearances of slight deformities including; longer thanand social reactions with the Erickson Psycho-Social
average index finger, third toe that is longer thanFramework (Berger, 2000). Erickson states that
second toe, ears that are slightly lower upon the head,adolescents attempt to find their roles in the world and
no earlobes or a furrowed tongue. Up to 80% ofif they fail, role confusion develops (Berger, 2000).
children suffering with ADHD will continue to struggleConfusion for those suffering from ADHD would
with this disorder into adolescents and as many as 50come easily due to their exclusion from social groups
to 60 percent will continue to struggle into adulthoodand activities (Barkley, 2005). In order for adolescents
(Barkley, 2005). With the affects upon a child's school,to find their role and their identity; they must interact
family, and social environments a large emotional tollwith others and feel accepted in their participation
can be identified. Emotionally, children can feel isolated,(Berger, 2000). Further into adulthood Erickson in
angry, guilty, frustrated and many other emotions dueBerger (2000), indicates that as adult's, individuals will
to the disruption of relationships, opportunities and lackseek intimacy with others or become isolated. The
of clear decision making skills (Barkley, 2005). Many offactor of isolation relates to the extent in which those
these children can become depressed and exhibitdeveloping fear rejection and disappointment (Berger,
anxiety (Barkley, 2005). Many affective behaviors2000). Unfortunately, prior social experiences of those
include stubbornness, defiance and at times can besuffering from ADHD can be littered with social
verbally or physically violent to others (Barkley, 2005).rejection, feelings of disappointment and unacceptance
According to Barkley (2005) nearly 57% of preschooldue to impulsiveness and hyperactive behaviors
children are likely to be rated as inattentive and(Barkley, 2005). Furthermore, (Pope, Bierman, &
over-reactive by their parents up to the age of four.Mumma, 1999), these authors according to Nixon
As many as 40% according to Barkley (2005), may(2001), also claim that hyperactivity and the inattentive /
have these problems for up to three to six months,immature nature of a child's behavior with ADHD
concerning parents and teachers. According tocontributes greatly to interpersonal problems.
Lavigne, Gibbons, Christoffel, Rosenbaum and BinnsIn regards to social justice and cultural issues;
(1996), however, it is estimated that 2% of preschoolaccording to Bender (2006), African American children
children truly meet the criteria for ADHD, andmay be under represented and under diagnosed in
(Biederman, 1996), clarified that possibly 10 % of allregards to ADHD. Experts such as (Dr. Rahn Bailey,
children meet diagnostic criteria for ADHD (Singh,2006) according to Bender (2006), claim that as
2002). Barkley clearly indicates that the earlier thescience is pursuing new technological processes to
symptoms of ADHD appear and the length of timediagnose and treat ADHD, cultures like the African
they last in childhood will determine the severity of itsAmerican community are subjected to propaganda,
course and prognosis (Barkley, 2005). Individually theresuspicion due to past and current discrimination, and
are many distressing problems for children sufferingnegative stereotyping regarding mental illness; thus
from this disorder. Some features that Barkley (2005)forming cultural decisions to avoid diagnosis and
indicate are important to recognize as the individualtreatment of ADHD. This cultural-lens, based upon
child develops into school age include;discriminatory and fear based experiences with the
1. An emergence of high demanding ness of preschooldominant culture dis-allows ethical decisions to help and
ageassist African American children (Bender, 2006). These
2. Critical directive behavior by parents to controldecisions according to experts (Bailey, 2006), is
circumstancescontributing to high rates of African American children
3. Problems reported by preschool / formal schooldisproportionately over represented in remedial
staff regarding child's behaviorprograms and disproportionate amounts of African
4. Problems with learning and readingAmerican children over represented in the criminal
5. Decisions to withhold a child an educational gradejustice system (Bender, 2006). The issues of classism
6. Excessive temper tantrums / difficulty in getting childand impoverishment can also be a topic of concern
to do choresregarding those who suffer from ADHD. According to
7. Social exclusion from activitiesVisser & Lesesne, (2005), ADHD diagnosis among
According to Spira & Fischel (2005), within themales was reported significantly more often in families
pre-school environment at the age of 3 yrs. old,with incomes below the poverty threshold than in
children's attention controls, and self controlfamilies with incomes at or above the poverty
mechanisms begin developing. Increased self controlthreshold. Here again, poverty makes a clear and
and speech development continues from age 3yrs. oldconsistent statement of risk for our developing children.
(Spira & Fischel, 2005). Self control processesIn conclusion, I believe that ADHD seems to be an
continue to well develop through the age of 4yrs. oldelusive, devastating, developmental disorder. This
(Spira & Fischel, 2005). These processes workdisorder for my self is so destructive because of its
together allowing the child to maintain self-control andmanifesting elements of hyperactivity, impulsivity and
through 4 yrs. of age the child develops the ability toinattentiveness. These variables are processes that if
direct attention to relavent environmental stimuli (Spirarepresented to certain degrees are perfect for
& Fischel, 2005). Together, the maintaining ofdestroying social, educational, emotional and individual
attention and control over responses emerges and ofdevelopment across the life span. Because our lives
course is very important in identifying task's andare so dependent upon not just our biological
working functionally within the educational environment,construction but also our social and environmental
however; these processes indicated do not emergeinteraction; this disorder can be serious and
for those with ADHD due to the manifestation ofdetrimentally disruptive. I do however believe that new
hyper-activity and impulsivity around the age of 3 to 4technologies are hopeful in understanding this disability
yrs. of age, and inattention manifesting near 5 to 6 yrs.in greater measures. I also have gained ideas regarding
of age (Spira & Fischel, 2005). As children developthe new information regarding neuro-plastisity and the
into school age and adolescents, Barkley (2005)changing mind based upon therapeutic thought. I feel
indicated that 30 to 50 percent of children will bethis may be a possible frontier of research that should
retained one grade during their school years. Accordingbe a priority in better understanding how the brain can
to Vance & Luk (2000), 20 to 30 percent ofchange forms; especially the pre-frontal cortex regions.
children with ADHD will manifest comorbidity withL.J. Riley Jr. BSW, LLMSW
learning disorders; reading, arithmetic, writing or spelling.Reference
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