Introduction
Mike is a 15-year-old White high school student in the 9th grade. He lives with his family in the city and transits to school from home every day. He suffers from attention-deficit/ hyperactivity disorder (ADHD) which is a fairly prevalent condition in the United States. It is diagnosed early in childhood and persists up to adulthood in most victims. CDC (2021) data Indicates that millions of children in the US have been diagnosed with ADHD, with 3.3 million children aged 12-17 million years being diagnosed. 2.4 million children aged 6-11 years and 388,000 children aged 2-5 years are also affected, bringing the total to 6.1 million children (CDC, 2021). Boys have a higher possibility of being diagnosed (12.9%) compared to girls (5.6%) (CDC, 2021). ADHD mainly presents with behavior and conduct problems alongside anxiety in children with this condition.
Diagnostic Criteria
Mike is easily distracted and cannot adequately focus on activities that require his undivided attention. This has been a challenge since he was 4 years old when his mother noticed he could not concentrate in a conversation fully. Whenever she was talking to him and something unrelated to the conversation happened, he would lose focus, and the content of the dialogue would be lost to him. This is still a problem for him as he cannot focus on conversations effectively when a distraction presents itself.
Mike also fails to pay attention to instructions and makes mistakes regarding schoolwork, and this has massively affected his performance. The teachers always try to be explicitly clear on the tasks given to the students, but Mike seems to misunderstand them in almost every instance. This makes it difficult for them to teach him due to a lack of focus on instruction. Despite efforts geared towards improving his performance in academics over the years, including the employment of private tutors, mike is still underwhelming.
Mike forgets to do the chores required of him at home despite all the efforts by his parents to ensure he is reminded of his responsibilities regularly. These efforts include his mother’s insistence on having a duty rooster at the house for him and his siblings. This was geared towards ensuring they reminded each other and mike was aware of his responsibilities in general. These measures have been ineffective in ensuring Mike recalls what is required of him at home. The same situation is evident at his schools as the teachers and management, in general, have been unable to help him recall his duties.
Mike has difficulties focusing in a classroom and is almost always in motion. This makes it difficult for learning to occur seamlessly, eventually affecting his classmates. Mike randomly stands up in class and begins pacing about without any specific cause. Efforts geared towards calming him are usually largely unsuccessful due to the challenge encountered in reasoning with him. The inability to focus has been a constant feature in his life which has considerably reduced since his elementary school days. He makes deliberate efforts to minimize his attention challenges.
Mike also has trouble quietly carrying out activities and talks too much. This is a challenge in his schoolwork whenever there are group projects, and he cannot allow his colleagues to make meaningful contributions. He also interrupts teachers and blurts out answers during classes disrupting the teaching process. This makes it difficult for him to be teachable and for his colleagues to grasp the content. This aspect takes the greatest share of responsibility for his diminished results in school work.
Etiology
Genetics vulnerability and familial history are crucial factors in the occurrence of ADHD in children. Offspring with blood relatives suffering from ADHD are highly likely to suffer from the condition, and this demonstrates that familial history is involved (miller et al., 2020). People from the same families share massive genetic similarities transmitted across generations. Some of these genetic features account for the attention deficit and hyperactivity witnessed amongst family members. This is, however, not an absolute expectation as some mothers suffering from ADHD do not necessarily conceive children with the condition. This feature is, however, a high-risk factor and is expected to affect many families.
Exposure to environmental toxins such as lead and polychlorinated biphenyls (PCBs) is a massive risk factor in the occurrence of this condition. These chemicals are mainly found in paint and older buildings, amongst other areas that are not recommended for human residence. Lead and PCBs are responsible for causing genetic mutations to the genome of perfectly healthy children and provoking the occurrence of this condition (Awaga et al., 2020). These mutations are common in children between the ages of 4 and 15 years, causing the occurrence of attention deficit and hyperactivity. Lead is a neurotoxin that affects the brain, neurons, and the chemicals produced (sparks, 2020). Lead poisoning causes overstimulation of certain neurons and overproduction of some chemicals, hence the occurrence of the condition.
Maternal drug use amongst pregnant women is responsible for the occurrence of ADHD in their children in some instances and drug use is, therefore, a major risk factor. Drug abuse has teratogenic effects on the developing brain of the fetus and interferes with the neurotransmitter mechanisms (Little et al., 2021). Drugs such as alcohol and tobacco cause the increase in the production of neurotransmitters that cause the brain to be hyperactive and attention deficient. Children born to alcoholic mothers are mostly diagnosed with this condition early in life, and it persists to adulthood.
Functional Impairment
Mike’s life has been massively affected in all sectors due to the ADHD condition that massively affects his life. The condition has caused his academic results to massively deteriorate since the lower grades in school. He cannot focus in class for long without getting distracted or starting an unrelated discussion that affects his colleagues. This effect on his education is also accentuated by his diminished ability to take instruction from any authority, including his teachers and parents. His parents have made countless efforts towards improving his grades by employing private tutors and changing schools for their son. These efforts have not guaranteed the desired results since mike’s performance is not a result of poor teaching but the condition affecting him.
Mike’s social life is shambolic due to the condition he suffers from as he can barely maintain friendships. Most of the friends he has had over his life think he does not care about their welfare without realizing that his condition makes it difficult for him to give them the attention they deserve. Mike does not have a girlfriend like other students his age because the girls consider him weird and he is afraid of approaching them. Mike’s relationship with his parents and siblings is usually tense due to the fear he might endanger his life and that of his family members due to his recklessness associated with forgetfulness. Mike does not indulge in substance use but neglects his safety due to his hyperactivity that involves involvement in hazardous events such as recklessly crossing the road.
Treatment
ADHD is mainly treated through the administration of medicines and therapy, with the two approaches being used in unison. Medications administered for ADHD include methylphenidate, lisdexamfetamine, dexamfetamine, atomoxetine, and guanfacine (NHS Choices, 2019). These medicines alter the performance of the brain, interfering with the production of crucial neurotransmitters. Essentially, these medicines regulate the production of chemicals responsible for attention deficit and hyperactivity. The drugs enable a person to focus in a conversation or class longer without losing focus. The drugs make a person less hyperactive and empower them to suppress the urge to disrupt events around them without provocation. Some medicines are prescribed for daily intake as they better the lives of patients in general, while others are recommended for use when in a school environment.
Therapy changes the behaviors of ADHD patients and follows the requirements of various theoretical frameworks. Therapy mechanisms include psychoeducation, where parents are encouraged to discuss the condition with their children, and behavioral therapy where various adults manage the conduct of ADHD patients in their care. Therapy also involves training in basic social skills to enable ADHD patients to communicate with other people with minimal interference from their condition (NHS Choices, 2019). Cognitive-behavioral therapy is a mechanism that influences how children perceive their condition, enabling them to eventually alter their conduct in a manner that benefits them. Therapy also involves the education of parents on the ADHD situation and this betters their ability to relate with their children easily.
References
Awaga, Abdel Hamed, Hammad, Mohammed, & Yassa. (2020). Lead as a risk factor for attention deficit hyperactivity disorder (ADHD) in children. Zagazig Journal of Forensic Medicine, 18(1), 21–33. Web.
CDC. (2021). Data and statistics about ADHD | CDC. Centers for Disease Control and Prevention. Web.
Little, B., Sud, N., Nobile, Z., & Bhattacharya, D. (2021). Teratogenic effects of maternal drug abuse on developing brain and underlying neurotransmitter mechanisms. NeuroToxicology, 86, 172–179. Web.
Miller, M., Iosif, A.-M., Bell, L. J., Farquhar-Leicester, A., Hatch, B., Hill, A., Hill, M. M., Solis, E., Young, G. S., & Ozonoff, S. (2020). Can familial risk for ADHD be detected in the first two years of life? Journal of Clinical Child & Adolescent Psychology, 1–13. Web.
NHS Choices. (2019). Treatment – Attention deficit hyperactivity disorder (ADHD). NHS. Web.
Sparks, M. M. (2020). Using the National Health and Nutrition Examination Survey to explore the relationship between food insecurity, childhood lead poisoning, and attention deficit hyperactivity disorder in children. Oregon State Library. Web.