Occupational Profile: Condition Description
Definition
Attention Deficit Hyperactivity Disorder (ADHD) is a mental health disorder that is expressed by extensive impulsivity and deficient attentiveness (Gallagher, 2014). The disease normally refers to the childhood onset; however it can persist into adolescence. The relevant disorder has a significant impact on a patient’s life (Davies & Tucker, 2010).
Nathan’s mother reported that her son began showing the first signs of anxiety and irritability at the age of five when he experienced a strong stress connected with the change of the family environment. The expressions of the restlessness developed in the course of years that made Nathan’s mother address a doctor. Nathan’s condition was diagnosed as ADHD (Gallagher, 2014).
Etiology
The causes of ADHD can vary in every particular case. It is presumed that the disease has the neurological and biological basis. Some researchers believe that ADHD is most likely to be provoked by the generic factors. Unhealthy lifestyle including the addiction to alcohol, cigarettes and drugs represents another condition favorable for the disorder’s appearance. Among other factors that can influence ADHD development, one can point out various brain infections and inherent metabolite malfunctioning (Gallagher, 2014).
Incidence & Prevalence
Nowadays, ADHD is a widespread disease that is present in the three to five percent of children. The experience shows that the disorder has more prevalence in boys; however it can be equally present in both sexes. The disorder does not pass from one person to another (Davies & Tucker, 2010). Therefore, in the case of Nathan it was developed internally.
Signs & Symptoms
The symptoms of ADHD can vary in accordance with the expression degree. The most typical characteristics of the relevant condition are emotional excitement, poor attentiveness, exceeding nervousness. People with ADHD have a lot of difficulties organizing the space around them; thus they tend to lose things. One can also point out the visual and motor disorder persistent in ADHD patients. These people are often clumsy, they experience difficulty balancing. Social skills of ADHD patients are frequently poorly developed. It takes them a lot of effort to get on with their classmates or colleagues (Selikowitz, 2009).
Prognosis
The research shows that ADHD has a considerable impact on a patient’s life regardless the quality of treatment or its complete absence. Thus, half of the young patients with ADHD continue possessing the same symptoms in their grown-up lives. Nevertheless, the well-time measures taken can prevent the possible complications and allow a patient to perform a more successful integration in the adult stage (Selikowitz, 2009).
Medical Management
The ADHD can be diagnosed by several specialists such as a neurologist, a pediatrician, a physician, or a psychiatrist. Parents might also determine the disorder on condition that they are aware of the relevant symptomatic. Gallagher points out three aspects that are necessary to be present with a child in order to diagnose ADHD. First of all, the condition is to appear before a child is seven years old. Secondly, the minimum duration of the symptoms presence is to be not less than half a year. Finally, the condition is to have a negative impact on at least two spheres of the child’s life, such as school and family, for example (Gallagher, 2014). The medical management, as a rule, implies the usage of the relevant medications along with various behavioral and educational therapies. However, scientists emphasize the temporality of the relevant treatment, as it does not help to avoid the potential negative expressions (Selikowitz, 2009).
Prevention
No preventative measures capable of reducing the risk of ADHD are currently available.
Implications for Occupational Therapy
Analysis of Occupational Performance
Precautions
In Nathan’s case, one of the primary precaution that his mother stated was the difficulty in hand-writing the boy experiences. Therefore, one should take into account the peculiarity of his abilities when giving him any kind of written tasks. He also finds it hard to control his emotions, particularly the negative ones, so one should think of a thorough preparatory work before beginning the therapy.
Areas of Occupation Impacted by the Condition
ADHD is a condition that has an influence on practically every aspect of a patient’s life. In the case of Nathan, the boy experiences difficulties both of social and educational character. His mother reports his problems to control emotions when he is at home. She also complains of the decreased performance level at school. Nathan’s teacher’s points out his incapacity to integrate into the team activities when the children spend time at the playground. One of the principal problems is that Nathan fails to organize himself and the space around him. According to his tutors, his work place is never in order which negatively affected his learning opportunities.
Occupational Performance Components
ADHD has an influence on various groups of skills, including the motor skills, the process skills, and the social interaction skills. Motor skills are considerably affected by ADHD. The research shows that the relevant condition might determine the disruption of both minor and gross motor skills. Therefore, the patients with ADHD frequently experience difficulties while writing. The Occupational Therapy (OT) is to include the relevant assessment tools to examine the patient’s coordination, agility, and speed (Gallagher, 2014).
The influence of ADHD on the process skills results in the attentiveness decline and the incapacity to focus on an issue for a long time OT is to include the relevant assessment tools to examine a patient’s coordination, agility, and speed (Gallagher, 2014). Therefore, the behavioral checklists are to be regularly recompleted taking into account the fact that a patient’s condition might vary depending on the particular time and place. The emotional imbalance has a negative effect on a child’s social skills and his integration into the society. Thus, it is highly important to gather all the information available in order to have a complete idea of a patient’s interactive abilities.
Evaluation Tools
Nowadays, there is a wide range of assessment tools that can be used in OT. Patient’s social competence can be properly evaluated via Social Skills Rating System (SSRS), Self-Awareness Assessment, and Components of Social Competence Observation Scale. The situation is less favorable when one deals with the assessment of the process skills. However, Test of Playfulness can be applied to get a general idea of the issue. There are numerous tools for examining the motor skills dependently on the particular aspect. Thus, Children’s Handwriting Evaluation Scale (CHES) is aimed at assessing the writing abilities, whereas Test of Visual-Motor-Skills-Revised (TVMS-R) is efficient for examining the visual aspect.
Intervention Plan
Problem List
- Poor attentiveness;
- Emotional instability;
- Disorganization;
- Social maladaptation;
- Motor skills disorder.
General Treatment Goals to Consider
- Maximal level of concentration;
- Maximal level of self-organization;
- Maximal level of self-control;
- Maximal social integration;
- Maximal development of motor skills.
Treatment methods/intervention
The treatment of an ADGD child should imply a strong partnership with the parents and the OT practitioner. Efficient OT should consider the psychological peculiarities of a patient (“Occupational Therapy Practice Framework Domain and Process”, 2014). It is highly important that OT focuses on the development of the child’s social skills helping him to form a basis for his future relationships with the people around him.
The patient’s social integration’s occupations can include various team tasks that are to be completed in a relaxing and comfortable atmosphere. The activities used by OT should be aimed at developing both minor and gross motor skills; thus it can be playdough projects or finger painting. Preparatory tasks might be aimed at calming the nervousness level, so that OT can suggest listening to relaxing music and any kind of resistive activities. Educational interventions can be represented by self-instructive activities and the short-term tasks (Hahn-Markowitz, Manor, & Mayer, 2011). OT is to be performed throughout the entire school period of Nathan’s education. As far as his condition does not require the isolation from the society, he should be integrated into the Individualized Educational Model. Hence, his therapy will include regular consultations with the occupational therapists that will monitor the child’s condition and determine further measures.
Typical system of care
In the case of Nathan, the direct medical intervention is not required; thus his system of care will imply the Individualized Educational program where he will be assisted by OTA that will guide him throughout the entire way. Twice a year the boy will be supposed to complete the relevant checklists that will help his OTA pursue his progress and make the necessary alterations. The treatment expenses of any person with ADHD are to be covered by the private insurance (Selikowitz, 2009).
Further Investigation
The self-esteem issue in ADHD children can be addressed via the introduction of various activities, such as short-term projects where a child is likely to show good results and to develop his communicative skills. Ball handling skills and balancing can be integrated into the corporate framework by introducing relevant team competitions and games. The development of the child’s motor skills is to be performed implicitly while the child is concentrated on the activity itself (Gallagher 2014).
Adaptations
The Tools for Parents Handbook is a perfect tool for developing a sensory competence. The book can be used by parents and teachers in order to engage the child in the exploring process. The handbook offers several exciting topic such as Sensory Tools Survey, Child’s Sensory Needs, Getting Ready, Can’t Sit Still, Scissors, Pencils and Computers, Playgrounds and Parks, Heavy Jobs, Making Friends and others. Each of the topics implies the usage of a certain tool. In Nathan’s case, this book will be particularly useful as it is likely to help the boy develop his minor and gross motor skills. The variety of tools available also permits the organization of varied team activities that can be beneficial for the improvement of the boy’s social competence. Some of the book’s aspects, such as Homework Place, are apt to help the boy become more self-organized.
Reference List
Davies, P.L., & Tucker, L. (2010). Evidence Review to Investigate the Support for Subtypes of Children With Difficulty Processing and Integrating Sensory Information. The American Journal of Occupational Therapy, 64(3), 391-402. Web.
Gallagher, S. (2014). A Third-Grader with Attention Deficit Hyperactivity Disorder. In K. Sladyk & S.E. Ryan (Eds.), Ryan’s Occupational Therapy Assistant: Principles, Practice Issues, and Techniques fifth edition (pp. 204-222). Thorofare, New Jersey: Slack. Web.
Hahn-Markowitz, J., Manor, I., & Mayer, A. (2011). Effectiveness of Cognitive–Functional (Cog–Fun) Intervention With Children With Attention Deficit Hyperactivity Disorder: A Pilot Study. The American Journal of Occupational Therapy, 65(4), 384-392. Web.
Occupational Therapy Practice Framework Domain and Process. (2014). The American Journal of Occupational Therapy, 68,1. Web.
Selikowitz, M. (2009). ADHD. New York, New York: Oxford University Press. Web.