PSY 314 Southern New Hampshire University Disorders of Child Adolescence Research Paper - Humanities
Could you please help me with a 2 page short paper on Over Diagnosis? This weeks subject is Attention Deficit Hyperactivity Disorder (ADHD).
Brief summary of what needs to be included in the paper:
How are behavioral and conduct disorders diagnosed? What factors potentially contribute to the over-diagnosis of these types of disorders? What long- and short-term implications does over-diagnosis have on a child? Substantiate your findings with specific examples and research.
The paper needs to be in APA format.
Here is a copy of rubric:
PSY 314v Short Paper Guidelines and Rubric
For this short paper, students should draw references and background support information from the two articles assigned as readings in this module—What Is Attention Deficit Hyperactivity Disorder? and DSM-5 Changes: Attention Deficit Hyperactivity Disorder (ADHD)—as well as the assigned video, American Children and Mental Health. Students should not simply let the resources serve as their own arguments and conclusions, but should compose a paper built around their own informed assertions and persuasive summary.
Prompt
In a two-page paper, address the following:
? How are behavioral disorders diagnosed?
? What factors potentially contribute to the over-diagnosis of these types of disorders?
? What long- and short-term implications does over-diagnosis have on a child?
? Substantiate your findings with specific examples and research.
Guidelines for Submission: This short paper assignment should follow these formatting guidelines: double spacing, 12-point Times New Roman font, one-inch margins, and APA style citations. Page length requirements: 2 pages.
Thank you
article_one.docx
article_two.docx
article_two.docx
video_that_goes_with_assignment.docx
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Article One
Attention Deficit Hyperactivity Disorder
What is attention deficit hyperactivity disorder?
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain
disorders and can continue through adolescence and adulthood. Symptoms include difficulty
staying focused and paying attention, difficulty controlling behavior, and hyperactivity (overactivity). These symptoms can make it difficult for a child with ADHD to succeed in school, get
along with other children or adults, or finish tasks at home.
Brain imaging studies have revealed that, in youth with ADHD, the brain matures in a normal
pattern but is delayed, on average, by about 3 years.1 The delay is most pronounced in brain
regions involved in thinking, paying attention, and planning. More recent studies have found that
the outermost layer of the brain, the cortex, shows delayed maturation overall,2 and a brain
structure important for proper communications between the two halves of the brain shows an
abnormal growth pattern.3 These delays and abnormalities may underlie the hallmark symptoms
of ADHD and help to explain how the disorder may develop.
Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder.
With treatment, most people with ADHD can be successful in school and lead productive lives.
Researchers are developing more effective treatments and interventions, and using new tools
such as brain imaging, to better understand ADHD and to find more effective ways to treat and
prevent it.
What are the symptoms of ADHD in children?
Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all
children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD,
these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child
must have symptoms for 6 or more months and to a degree that is greater than other children of
the same age.
Children who have symptoms of inattention may:
•
•
•
•
•
•
•
•
•
Be easily distracted, miss details, forget things, and frequently switch from one activity to
another
Have difficulty focusing on one thing
Become bored with a task after only a few minutes, unless they are doing something
enjoyable
Have difficulty focusing attention on organizing and completing a task or learning
something new
Have trouble completing or turning in homework assignments, often losing things (e.g.,
pencils, toys, assignments) needed to complete tasks or activities
Not seem to listen when spoken to
Daydream, become easily confused, and move slowly
Have difficulty processing information as quickly and accurately as others
Struggle to follow instructions.
Children who have symptoms of hyperactivity may:
•
•
•
•
•
•
Fidget and squirm in their seats
Talk nonstop
Dash around, touching or playing with anything and everything in sight
Have trouble sitting still during dinner, school, and story time
Be constantly in motion
Have difficulty doing quiet tasks or activities.
Children who have symptoms of impulsivity may:
•
•
•
•
Be very impatient
Blurt out inappropriate comments, show their emotions without restraint, and act without
regard for consequences
Have difficulty waiting for things they want or waiting their turns in games
Often interrupt conversations or others activities.
ADHD Can Be Mistaken for Other Problems
Parents and teachers can miss the fact that children with symptoms of inattention have ADHD
because they are often quiet and less likely to act out. They may sit quietly, seeming to work, but
they are often not paying attention to what they are doing. They may get along well with other
children, whereas children who have more symptoms of hyperactivity or impulsivity tend to have
social problems. But children with the inattentive kind of ADHD are not the only ones whose
disorders can be missed. For example, adults may think that children with the hyperactive and
impulsive symptoms just have disciplinary problems.
What causes ADHD?
Scientists are not sure what causes ADHD, although many studies suggest that genes play a large
role. Like many other illnesses, ADHD probably results from a combination of factors. In
addition to genetics, researchers are looking at possible environmental factors, and are studying
how brain injuries, nutrition, and the social environment might contribute to ADHD.
Genes. Inherited from our parents, genes are the blueprints for who we are. Results from
several international studies of twins show that ADHD often runs in families. Researchers are
looking at several genes that may make people more likely to develop the disorder.4,5 Knowing
the genes involved may one day help researchers prevent the disorder before symptoms develop.
Learning about specific genes could also lead to better treatments.
A study of children with ADHD found that those who carry a particular version of a certain gene
have thinner brain tissue in the areas of the brain associated with attention. This research showed
that the difference was not permanent, however, and as children with this gene grew up, the brain
developed to a normal level of thickness. Their ADHD symptoms also improved.6
Researchers are also studying genetic variations that may or may not be inherited, such as
duplications or deletions of a segment of DNA. These copy number variations (CNVs) can
include many genes. Some CNVs occur more frequently among people with ADHD than in
unaffected people, suggesting a possible role in the development of the disorder.7,8
Environmental factors. Studies suggest a potential link between cigarette smoking and alcohol
use during pregnancy and ADHD in children.9,10 In addition, preschoolers who are exposed to
high levels of lead, which can sometimes be found in plumbing fixtures or paint in old buildings,
have a higher risk of developing ADHD.11
Brain injuries. Children who have suffered a brain injury may show some behaviors similar to
those of ADHD. However, only a small percentage of children with ADHD have suffered a
traumatic brain injury.
Sugar. The idea that refined sugar causes ADHD or makes symptoms worse is popular, but more
research discounts this theory than supports it.12 In one study, researchers gave children foods
containing either sugar or a sugar substitute every other day. The children who received sugar
showed no different behavior or learning capabilities than those who received the sugar
substitute.13 Another study in which children were given higher than average amounts of sugar or
sugar substitutes showed similar results.14
In another study, children who were considered sugar-sensitive by their mothers were given the
sugar substitute aspartame, also known as Nutrasweet. Although all the children got aspartame,
half their mothers were told their children were given sugar, and the other half were told their
children were given aspartame. The mothers who thought their children had gotten sugar rated
them as more hyperactive than the other children and were more critical of their behavior,
compared to mothers who thought their children received aspartame.15
Food additives. There is currently no research showing that artificial food coloring causes
ADHD. However, a small number of children with ADHD may be sensitive to food dyes,
artificial flavors, preservatives, or other food additives. They may experience fewer ADHD
symptoms on a diet without additives, but such diets are often difficult to maintain.12,16
How is ADHD diagnosed?
Children mature at different rates and have different personalities, temperaments, and energy
levels. Most children get distracted, act impulsively, and struggle to concentrate at one time or
another. Sometimes, these normal factors may be mistaken for ADHD. ADHD symptoms
usually appear early in life, often between the ages of 3 and 6, and because symptoms vary from
person to person, the disorder can be hard to diagnose. Parents may first notice that their child
loses interest in things sooner than other children, or seems constantly unfocused or out of
control. Often, teachers notice the symptoms first, when a child has trouble following rules, or
frequently spaces out in the classroom or on the playground.
No single test can diagnose a child as having ADHD. Instead, a licensed health professional
needs to gather information about the child, and his or her behavior and environment. A family
may want to first talk with the childs pediatrician. Some pediatricians can assess the child
themselves, but many will refer the family to a mental health specialist with experience in
childhood brain disorders such as ADHD. The pediatrician or mental health specialist will first
try to rule out other possibilities for the symptoms. For example, certain situations, events, or
health conditions may cause temporary behaviors in a child that seem like ADHD.
Between them, the referring pediatrician and specialist will determine if a child:
•
•
•
•
•
•
•
Is experiencing undetected seizures that could be associated with other medical
conditions
Has a middle ear infection that is causing hearing problems
Has any undetected hearing or vision problems
Has any medical problems that affect thinking and behavior
Has any learning disabilities
Has anxiety or depression, or other psychiatric problems that might cause ADHD-like
symptoms
Has been affected by a significant and sudden change, such as the death of a family
member, a divorce, or parents job loss.
A specialist will also check school and medical records for clues, to see if the childs home or
school settings appear unusually stressful or disrupted, and gather information from the childs
parents and teachers. Coaches, babysitters, and other adults who know the child well also may be
consulted.
The specialist also will ask:
•
•
•
•
Are the behaviors excessive, and do they affect all aspects of the childs life?
Do they happen more often in this child compared with the childs peers?
Are the behaviors a continuous problem or a response to a temporary situation?
Do the behaviors occur in several settings or only in one place, such as the playground,
classroom, or home?
The specialist pays close attention to the childs behavior during different situations. Some
situations are highly structured, some have less structure. Others would require the child to keep
paying attention. Most children with ADHD are better able to control their behaviors in
situations where they are getting individual attention and when they are free to focus on
enjoyable activities. These types of situations are less important in the assessment. A child also
may be evaluated to see how he or she acts in social situations, and may be given tests of
intellectual ability and academic achievement to see if he or she has a learning disability.
Finally, after gathering all this information, if the child meets the criteria for ADHD, he or she
will be diagnosed with the disorder.
How is ADHD treated?
Currently available treatments aim at reducing the symptoms of ADHD and improving
functioning. Treatments include medication, various types of psychotherapy, education and
training, or a combination of treatments.
Medications
Stimulants such as methylphenidate and amphetamines are the most common type of medication
used for treating ADHD. Although it may seem counterintuitive to treat hyperactivity with a
stimulant, these medications actually activate brain circuits that support attention and focused
behavior, thus reducing hyperactivity. In addition, a few non-stimulant medications, such as
atomoxetine, guanfacine, and clonidine, are also available. For many children, ADHD
medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and
learn. Medications also may improve physical coordination.
However, a one-size-fits-all approach does not apply for all children with ADHD. What works
for one child might not work for another. One child might have side effects with a certain
medication, while another child may not. Sometimes several different medications or dosages
must be tried before finding one that works for a particular child. Any child taking medications
must be monitored closely and carefully by caregivers and doctors.
Stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch.
Some medications also come in short-acting, long-acting, or extended release varieties. In each
of these varieties, the active ingredient is the same, but it is released differently in the body.
Long-acting or extended release forms often allow a child to take the medication just once a day
before school, so he or she doesnt have to make a daily trip to the school nurse for another dose.
Parents and doctors should decide together which medication is best for the child and whether
the child needs medication only for school hours or for evenings and weekends, too.
For more information about stimulants and other medications used for treating mental disorders,
see the NIMH Mental Health Medications webpage. The Food and Drug Administration (FDA)
website has the latest information on medication approvals, warnings, and patient information
guides.
What are the side effects of stimulant medications?
The most commonly reported side effects are decreased appetite, sleep problems, anxiety, and
irritability. Some children also report mild stomachaches or headaches. Most side effects are
minor and disappear over time or if the dosage level is lowered.
•
•
•
Decreased appetite. Be sure your child eats healthy meals. If this side effect does not go
away, talk to your childs doctor. Also talk to the doctor if you have concerns about your
childs growth or weight gain while he or she is taking this medication.
Sleep problems. If a child cannot fall asleep, the doctor may prescribe a lower dose of
the medication or a shorter-acting form. The doctor might also suggest giving the
medication earlier in the day, or stopping the afternoon or evening dose. Adding a
prescription for a low dose of a blood pressure medication called clonidine sometimes
helps with sleep problems. A consistent sleep routine that includes relaxing elements like
warm milk, soft music, or quiet activities in dim light, may also help.
Less common side effects. A few children develop sudden, repetitive movements or
sounds called tics. Changing the medication dosage may make tics go away. Some
children also may have a personality change, such as appearing flat or without emotion.
Talk with your childs doctor if you see any of these side effects.
Are stimulant medications safe?
Under medical supervision, stimulant medications are considered safe. Stimulants do not make
children with ADHD feel high, although some kids report feeling slightly different or funny.
Preschoolers are more sensitive to the side effects of methylphenidate, and some may experience
slower than average growth rates. Very young children should be closely monitored while taking
ADHD medications.17,18,19
FDA warning on possible rare side effects
In 2007, the FDA required that all makers of ADHD medications develop Patient Medication
Guides that contain information about the risks associated with the medications. The guides must
alert patients that the medications may lead to possible cardiovascular (heart and blood) or
psychiatric problems. The agency undertook this precaution when a review of data suggested that
ADHD patients with existing heart conditions had a slightly higher risk of strokes, heart attacks,
and/or sudden death when taking the medications. Recently published studies, however, have not
found evidence that using stimulants to treat ADHD increases the risk for cardiovascular
problems.20,21
The FDA review also found a slight increased risk, about 1 in 1,000, for medication- related
psychiatric problems, such as hearing voices, having hallucinations, becoming suspicious for no
reason, or becoming manic (an overly high mood), even in patients without a history of
psychiatric problems. The FDA recommends that any treatment plan for ADHD include an initial
health history, including family history, and examination for existing cardiovascular and
psychiatric problems.
One ADHD medication, the non-stimulant atomoxetine (Strattera), carries another warning.
Studies show that children and teenagers who take atomoxetine are more likely to have suicidal
thoughts than children and teenagers with ADHD who do not take it.22 If your child is taking
atomoxetine, watch his or her behavior carefully. A child may develop serious symptoms
suddenly, so it is important to pay attention to your childs behavior every day. Ask other
people who spend a lot of time with your child to tell you if they notice changes in your childs
behavior. Call a doctor right away if your child shows any unusual behavior. While taking
atomoxetine, your child should see a doctor often, especially at the beginning of treatment, and
be sure that your child keeps all appointments with his or her doctor.
Do medications cure ADHD?
Current medications do not cure ADHD. Rather, they control the symptoms for as long as they
are taken. Medications can help a child pay attention and complete schoolwork. It is not clear,
however, whether medications can help children learn better. Adding behavioral therapy,
counseling, and practical support can help children with ADHD and their families to better cope
with everyday problems. NIMH-funded research has shown that medication works best when
treatment is regularly monitored by the prescribing doctor and the dose is adjusted based on the
childs needs.23
Psychotherapy
Different types of psychotherapy are used for ADHD. Behavioral therapy aims to help a child
change his or her behavior. It might involve practical assistance, such as help organizing tasks or
completing schoolwork, or working through emotionally difficult events. Behavioral therapy also
teaches a child how to monitor his or her own behavior. Learning to give oneself praise or
rewards for acting in a desired way, such as controlling anger or thinking before acting, is
another goal of behavioral therapy. Parents and teachers also can give positive or negative
feedback for certain behaviors. In addition, clear rules, chore lists, and other structured routines
can help a child control his or her behavior.
Therapists may teach children social skills, such as how to wait their turn, share toys, ask for
help, or respond to teasing. Learning to read facial expressions and the tone of voice in others,
and how to respond appropriately can also be part of social skills training.
How can parents help?
Children with ADHD need guidance and understanding from their parents and teachers to reach
their full potential and to succeed in school. Before a child is diagnosed, frustration, blame, and
anger may have built up within a family. Parents and children may need special help to
overcome bad feelings. Mental health professionals can educate parents about ADHD and how it
impacts a family. They also will help the child and his or her parents develop new skills,
attitudes, and ways of relating to each other.
Parenting skills training helps parents learn how to use a system of rewards and consequences to
change a childs behavior. Parents are taught to give immediate and positive feedback for
behaviors they want to encourage, and ignore or redirect behaviors they want to discourage. In
some cases, the use of time-outs may be used when the childs behavior gets out of control. In a
time-out, the child is removed from the upsetting situation and sits alone for a short time to calm
down.
Parents are also encouraged to share a pleasant or relaxing activity with the child, to notice and
point out what the child does well, and to praise the childs strengths and abilities. They may also
learn to structure situations in more positive w ...
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