According to barkley 1981, hyperactivity is the developmental disorder of age appropriate attention span, restlessness and rule governed behaviour that develops in late infancy or early childhood before 6 years of age. It is pervasive in nature and is not accounted by neological, sensory, motor impairment and severe emotional disturbances. According to himshaw 1995, children with adhd have difficulties getting along with peers. Whalen 1985 emphasised that they know socially correct actions hypothetically but not in real life situations. According to barkley 1990, 15-30% have learning difficulties with maths, reading and spelling.
The DSM IV lists three subtypes of adhd. Predominantly inattentive type, predominantly hyperactive-impulsive type and the combined type; which the majority of children have. According to anna Richards 2003, those with the inattentive type also known as add tend to do a great deal of day dreaming. Add doesn’t include hyperactivity therefore, these children go unnoticed. These children are at risk of their needs being completely ignored. The vast majority to suffer from this type are females. To diagnose this type of adhd, 6 symptoms of inattentive have to persist for 6 months and must be inconsistent with developmental level.
According Barkley 1992, they have difficulties with focused attentions. According to tannock 1998, pet scans show a problem in the frontal area of the brain. in the hyperactive impulsive type, there must be 4 symptoms of hyperactive impulsivity for 6 months. In order to diagnose the combined type, 6 or more symptoms of inattentive and 6 or more symptoms of hyperactivity impulsivity must be persisted for 6 months or more. According to faranone 1998, they are likely to develop conduct problems, attend special education classes and have poor social skills.
According to barkley 1989, they are 3-6 time more in males than in females. The prevalence rate varies between 2-7% in USA, Germany and New Zealand but the rate is higher in india and china. According to Barkley 1996, the DSM-IV criteria have no age and gender adjustments. It also doesn’t not include a guideline about appropriate behaviour. According to barkley 40% of parent with children with adhd have similar symptoms. 35% of siblings are also affected as well. Twin studies by martin 2002 found a 70-80% concordance risk in MZ twins. This clearly highlights a large genetics components of ADHD.
Feingold 1973, suggested flavour, colouring and additives are contributing factors however the US govt confirmed no dietary links. Before treatment commence, professionals establish the type of adhd and the severity of the symptoms. Bradley 1938 suggested there are improvements with amphetamines but medication is not always effective. Psychotherapy/counselling is used to teach the child new skills, it also helps to decrease impulsivity and aggressive behaviour. Play therapy is sometimes used in young infants to measure impulsivity and also help improve the child’s social skills.
Behaviour modification is by far the most effective treatment of adhd especially for the combined type as it targets desired behaviour to change. Parents are also advised in how to keep the home safe, and taught ways to respond to child’s behaviour, parenting classes. In schools, educational interventional programmes are designed to help child concentrate, teacher training, individual/group classes. With age the hyperactivity but the attention problems persists into adolescence and adulthood. By adulthood 1/3 to ? are normal. According to Gadow 2001, add in adults are recognised and may develop other psychiatric disorders.