A review on the current issues related to Attention Deficit Problems
Attention-deficit disorder (ADD) is a neurobehavioural developmental problem that is increasingly becoming a major problem in today’s world than it was in yesteryears. The trend at which more and more people are being with ADD is worrying. This disorder is not age-bound as it affects both children and adults. Principally the illustration of ADD is by the presence of attention disorders and hyperactivity, with every incidence taking place alone occasionally (Biederman, 1998). The symptoms of this disorder may seem to be an innocent and an irritating occurrence to viewers, but if left unattended, constant and invasive outcomes of ADD warning signs can negatively influence an individual’s abilities in life. Academic abilities of one are thwarted, lowers one’s morale in the workplace, maintaining fulfilling relationships is a problem, and one has low self-esteem.
ADD is the most widely researched and diagnosed psychiatric problem among children. It impairs the lives of three to five percent of kids in the world with symptoms commencing at the time they reach seven years of age (Nair et al., 2006, para.1). The symptoms of ADD can prolong all through one’s adult life. The clinical management of ADD usually incorporates blending of medical prescriptions, behavior changes, modifications of way of life, and professional counseling sessions. It is possible to easily misdiagnose ADD because its symptoms resemble those of other disorders and most clinicians lack adequate exposure to evaluation and management of the condition.
Many controversies exist regarding the clinical diagnosis and management of ADD disorder. The debate revolves around educators, media, guardians, medical experts and various stakeholders. The varied views range from the belief that genetic and physiological bases for the problem exist, it is verily not in existence, and diverse opinions relating to the application of stimulant medicines in treating the condition. The majority of healthcare providers acknowledge that this disorder is genuine and they have focused their attention on its diagnosis and treatment.
The role of executive functions
The current research in understanding ADD has recognized the role of executive functions as the key difficulties in this disorder rather than just the warning signs of hyperactivity and impulsivity. Executive functions (EF) involve the mechanisms of the brain that “activate, organize and manage other functions.”(National Resource Center on ADIHD, 2003, para.1). It is beneficial in assisting persons in explaining short and long-term outcomes of their behaviors and prepare for possible consequences. It enables persons to reasonably evaluate their actions and make essential changes if those behaviors are not giving the intended outcomes. Deterioration of the executive functions, which are located in the brain’s frontal lobes, has serious consequences on an individual’s ability to carry out effectively various day-to-day activities. Brown (2005, p.20-58), a clinical psychologist and a reputable authority on executive functions, illustrates five clusters of cognitive factors that represent a way of conceiving the executive functions.
Organizing, Prioritizing and Activating for tasks
Even though most of us relate ADD with impulsive and hyperactive actions where the involved persons are too fast to talk or do something, problems initiating tasks are the major complaints of those diagnosed with ADD. Despite the fact that they behave impulsively in some situations, those with this disorder usually are bitter about procrastination being a primary problem, especially in circumstances when they are supposed to accomplish tasks that are not essentially interesting to them. Most of the time these persons grieve that they continue postponing delicate activities until the activity becomes urgent. In scenarios when they have to encounter awful outcomes in the short term, is when they are capable of getting themselves well stimulated to start the task. Individuals with ADD have more difficulties than others in sorting out and allocating priorities to different assignments. They often find themselves in trouble when they are unable of undertaking tasks according to the specified directions.
Focusing, Sustaining and Shifting Attention to Tasks
People affected with ADD syndrome often complain of their inability to focus their attention on an assignment and remain focusing for a longer period. Occasionally they have difficulties in selection of things. It is particularly overwhelming to them to focus on a specific stimulus that needs their attention. Such scenarios may be a voice on the cell phone or the inscriptions on a printed paper. Everyone having this disorder experience periodically this problem in selection and keeping of focus.
Most individuals with ADD have persistent difficulty in keeping their concentration on reading, particularly when there has been an allocation of the printed material, instead of being self-selected. The same persons, who experience persistent problems by being distracted and changing assignments, may experience the opposite problem: they exhibit inability to halt focusing on one specific thing and redirect their attention to another urgent situation, a situation that is often termed “hyperfocus.” Individuals are usually locked to some chores, scene, or sound of their interest while totally disregarding or failing to attend to other things that are of equal necessity. The task of sustaining successful concentration needs the skill of selecting the most essential of the many inside and outside stimuli and purge out those that infringe on alertness. Yet it similarly needs the capability to change one’s attention to attend to other matters.
Regulation Alertness, Sustaining Effort and Processing Speed
Persons with ADD syndrome often complain of constant drowsiness until they fail to keep their eyes awake for long particularly when the situation demands they have to keep still and stay calm. Often, they rarely experience this difficulty when they are carrying out activities that require intense activity. When one has been mentally overtaxed, there is the likelihood that such individuals may feel drowsy. Many people with ADD complain of being tired during the day since they have problems getting into sleep. This is the converse of the similar difficulty: severe problems in regulating alertness. This disorder has its dual aspects in regulating a person’s alertness. They are stuck in whichever activity they are engaged in and are therefore unable to come out from complete consciousness to start sleeping, or they fall asleep so soundly that attempts to wake them up are futile.
On top of the difficulties in regulating alertness and attention, many individuals with ADD complain of inabilities to sustain effort for duties. Even though they may harbor inexhaustible pool of steam for duties particularly of interest to them, they tend swiftly to fall inadequate of energy in activities that need sustained efforts with less short-term outcomes.
They suffer from tiresomely slow processing speed that determines how much they can conveniently perform certain tasks and in other circumstances; they have difficulty in slowing down to avoid committing errors. They often show slow response time for certain cognitive tasks, on the other hand reduce their speed in performing challenging tasks to increase their efficiency.
Utilizing Working Memory and Accessing Recall
Individuals with ADD syndrome have chronic difficulties in attending to one or many tasks online while paying attention to others too. They often complain of impairment of their working memory that distracts their receptive and expressive features of communicating amongst themselves and with other people. They have a difficulty in sustaining a reciprocal dialogue when a weakening of the working memory takes place.
Another feature of the working memory focuses on the retrieval of stored information from the long-term memory. These malfunctioning of the working memory impede effective performing of tasks. This disorder makes the affected individuals have an inadequate search engine for triggering information stored in the long-term memory and assimilate them in meeting the challenges of the current situation.
Monitoring and Self-Regulating Action
ADD is described as involving problems with hyperactive and impulsive actions. Most individuals diagnosed with this condition tend to carry out actions minus a thorough forethought, or are seriously impatient and hyperactive. They have trouble in reducing speed when undertaking tasks coupled with inability to sufficiently managing their actions. Children diagnosed with ADD are usually wild, restless, and impetuous, incapable of effectively controlling their speech and bodies, hence they need more supervision from the caretakers.
The affected children experience slow aspects of their development as compared to their peers. They are substantially behind in the skills of monitoring and controlling their actions. They often are impulsive and do not reduce their speed enough to give a listening ear to others or undertake assignments effectively. Studies have discovered the “impaired ability to inhibit” as a key difficulty in the ADD warning signs of hyperactivity and impulsivity. Nevertheless, to put more emphasis on inhibition as the key problem in ADD is to overlook the important correlation linking holding back actions and participating in activities.
The adults also suffer from this condition too especially in the aspects of communication. They experience problems in self-monitoring and context monitoring in the process of communication. They have the desire to interact with others, but frustration creeps in themselves, and of course the others participating in the conversation, since they pay no special attention to the progress of the conversation.
Environmental and Ecological factors influence ADD
According to the recent twin studies carried out, roughly nine percent to twenty percent of the variance in ADD symptoms ascribed to environmental factors (Sherman et al., 1997). Environmental factors increase the severity of ADD, particularly the level of impairment and suffering the individual goes through. Such factors always compound with others to severe the condition. The abuse of cigarettes and alcohol for the period of pregnancy makes the child susceptible to contract ADD. The correlation that links ADD to smoking is attributable to nicotine substance that causes deficiency of supply of oxygen to the fetus in the womb. The probability of women affected with ADD smoking is high; hence, due to the high genetic constituent of ADD syndrome, they are at an increased risk of conceiving children with this disorder. Hurdles occurring during pregnancy and conception, which include situations of premature delivery, may also be a significant factor in this.
A high risk of ADD is also attributable to the environmental problem of exposure to high levels of lead in the bodies of children. The contact with this poisonous chemical may occur through paintings and old buildings. Exposure to lead impairs the normal execution of executive functions, which includes making of plans, working memory and the ability to counteract the current task with a new forthcoming one. ADD syndrome patients have often complained of increased incidences of head injuries. These environmental factors act together to exhibit behaviors related to the Attention Deficit Problems.
Social factors always work in collaboration with other factors in interacting with the cognitive basis of the actions related to patients with ADD. The relationships that the children have with their caretakers have an intense consequence on the self-regulatory and attention skills of the young ones. Foster children often show warning signs that closely relate to ADD. Children who have suffered from violence and emotional torture are more susceptible to contracting ADD. Various problems in the home that contribute to this include: congested families having too many members, divorce by the parents that have forced the parents to separate, and children being taken care of by single parents. In addition, parents failing to give their kids due attention and neglects them, disagreements in the home that causes disharmony in the home, and when children are forced to endure serious financial constraints in the family are risk factors in contracting ADD. Poor child-rearing practices by the caretakers such as corporal punishment and inefficient supervision are potential risk factors in contracting ADD.
Benefits and Threats of ADD
While detection criteria and management of ADD involve focusing on the threats of an individual being hyperactive, impulsive or his or her lack of attention, the disorder has numerous benefits to the society in the persons affected. Not all ADD patients will manifest these beneficial traits of character. The positive traits include: creativity, appealing character, warm-heartedness, an excellent judge of personality, comical, flexibility, intuitiveness, sensitivity to the adjacent surroundings, zealous, trusting and forgiving, exhibition of high energy, dedication in accomplishing tasks, easy forgiveness when wronged, not afraid to take risks, and tries to outdo himself or herself next time when undertaking the same tasks (Winkler, 2008).
On the other hand, ADD complications do not lack potential threats to the well-being of the society. Patients with ADD have a limited attention span, experience problems in proper listening of sound, inefficient search engine for retrieving stored information, unsystematic, sluggish, gets sidetracked easily, low memory that makes it hard to remember, restless movements, and impulsive behavior.
The development of some medications is intending to curb the escalation of ADD. However, the use of these prescriptions has serious side effects. Nonetheless, clinicians maintain their use since despite their negative effects; they have shown remarkable improvements in patients.
Management of ADD
Cognitive-behavioral therapy is an approach used by psychotherapists to resolve difficulties relating to malfunction emotions, actions, and cognitions by a result-oriented, methodical course of action. The focus is to change aspects of one’s habits and behavior by raising the rate of socially acceptable behaviors and reducing the rate of socially unacceptable behaviors. Incorporation programs specifically made for adults, teenagers, and children with ADD syndrome further reduce the impacts of the negative effects. These programs have a rewards-consequences structure. Constructive responses (appraisal or any type of instant incentive), are often accorded for purposes of good behavior demonstration. Therefore, the individual will tend to improve this behavior to get the same praises from his or her superiors.
Undertaking cognitive behavioral therapy is a convenient way to manage varied difficulties of emotions, nervousness, and character traits, feeding habits, addiction to drugs and alcohol, and psychotic disorders. The treatment of attention-deficit problems is manual, for the most part, with particular brief techniques for precise psychological disorders. Patients with ADD are usually restless; hence, the therapy assists them to keep alert enough to accomplish challenging assignments. An example of application of this is a child with ADD doing homework he or she should be allowed to move around, rise or chew gum because this helps in coping with the situation.
Conclusion
The problems associated with ADD mental disorder, if left unattended, have the potential of creating confusion in the mind of the victim. It lowers the concentration span, demanding tasks seem overtaxing, and tendencies of individuals being impulsive and hyperactive crops in. A major development in the understanding of ADD condition has been the recognition that its warning signs correspond to the deterioration (in a neuropsychological term) of “executive functions.” Executive functions illustrate the brain circuits that prioritize, amalgamate, and control other cognitive functions. This has distinguished the myths and the truths in understanding the concepts of Attention Deficit Problems.
Reference List
Biederman, J. (1998). Attention-deficit/hyperactivity disorder: a life-span perspective. The Journal of Clinical Psychiatry, 59 (7), 4-16.
Brown, Thomas E. (2005). Attention Deficit Disorder: The Unfocused Mind in Children and Adults. New Haven, CT: Yale University Press Health and Wellness.
Nair J, Ehimare U, Beitman BD, Nair SS, Lavin A. (2006). Clinical review: evidence-based diagnosis and treatment of ADHD in Children. Web.
National Resource Center on ADIHD. (2003). What is Executive Function? Web.
Sherman DK, Iacono WG, McGue MK. (1997). Attention-deficit hyperactivity disorder dimensions: a twin study of inattention and impulsivity-hyperactivity. Journal of the American Academy of Child and Adolescent Psychiatry, 36 (6): 745–53.
Winkler, M. (2008). Advantages of ADHD. Web.