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Attention Deficit Hyperactivity Disorder (ADHD) in Children: A Short Review and Literature

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Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often persists into adulthood. ADHD includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior. ADHD is estimated to affect about 6 to 7 percent of people aged 18 and under when diagnosed via the DSM-IV criteria. Hyperkinetic disorder when diagnosed via the ICD-10 criteria give rates of between 1 to 2 percent in this age group. Children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East; however, this may be due to differing methods of diagnosis used in different areas of the world. If the same diagnostic methods are used rates are more or less the same between countries. While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.
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International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 443
Review Article
http:// ijp.mums.ac.ir
Attention Deficit Hyperactivity Disorder (ADHD) in Children: A
Short Review and Literature
Bibi Leila Hoseini1, Maryam Ajilian2, *Habibolah Taghizade Moghaddam
1
,
Gholamreza Khademi4, Masumeh Saeidi5
1 Midwifery M.Sc., Instructor, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar,
Iran.
2 Ibn-e- Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
4Assistant Professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran.
5 Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of
children and often persists into adulthood. ADHD includes a combination of problems, such as
difficulty sustaining attention, hyperactivity and impulsive behavior. ADHD is estimated to affect
about 6 to 7 percent of people aged 18 and under when diagnosed via the DSM-IV criteria.
Hyperkinetic disorder when diagnosed via the ICD-10 criteria give rates of between 1 to 2 percent in
this age group. Children in North America appear to have a higher rate of ADHD than children in
Africa and the Middle East; however, this may be due to differing methods of diagnosis used in
different areas of the world. If the same diagnostic methods are used rates are more or less the same
between countries. While treatment won't cure ADHD, it can help a great deal with symptoms.
Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment
can make a big difference in outcome.
Key words: Attention-deficit/hyperactivity disorder; Children; Prevalence; World.
*Couresponding Author:
Habibolah Taghizade Moghaddam, Mashhad University of Medical sciences, Mashhad, Iran.
Email: Taghizademh1@mums.ac.ir
Received date: Jul 10, 2014 ; Accepted date: Nov 12, 2014
ADHD in Children
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 444
Introduction
Attention deficit hyperactivity disorder
(ADHD) is a disorder of childhood and
adolescence characterized by a pattern of
extreme pervasive, persistent and
debilitating inattention, overactivity and
impulsivity. It is believed to be one of the
most common reasons for mental health
referrals to family physicians,
aediatricians,paediatric neurologists and
child and adolescent psychiatrists.
Although originally thought to remit
during childhood, the symptoms of ADHD
have also been shown to persist in patients
through adolescence and into adulthood .
The disorder is often chronic, with one
third to one half of those affected retaining
the condition into adulthood . It interferes
with many areas of normal development
and functioning in a child’s life. Children
with ADHD are more likely than their
peers to experience educational
underachievement, social isolation and
antisocial behaviour during the school
years and to go on to have significant
difficulties in the post-school years (1).
Attention-deficit/hyperactivity disorder
(ADHD) is one of the most common
neurodevelopmental disorders of
childhood. The worldwide prevalence in
children ≤18 years has been estimated at
5.3% in a systematic review of 102 studies
from all continents, with a majority from
North America and Europe (2).
Attention deficit hyperactivity disorder
(ADHD) is characterized by pervasive and
impairing symptoms of inattention,
hyperactivity, and impulsivity according to
DSM-IV (3) . The World Health
Organization (WHO) (4) uses a different
namehyperkinetic disorder (HD)but
lists similar operational criteria for the
disorder. Regardless of the name used,
ADHD/HD is one of the most thoroughly
researched disorders in medicine. It has
been associated with a broad range of
negative outcomes in affected subjects
with a serious financial burden to
families and society, which characterizes it
as a major public health problem.
An understanding of the epidemiological
aspects of ADHD/HD may provide insight
into its distribution and etiology as well as
information for planning the allocation of
funds for mental health services. In past
decades, investigators from all regions of
the world have made substantial efforts to
define the prevalence of the disorder.
Several literature reviews have reported
highly variable rates worldwide, ranging
from as low as 1% to as high as nearly
20% among school-age children. Several
investigators have suggested that
prevalence rates in Europe were
significantly lower than rates found in
North America (2).
Alternative Names
Attention deficit disorder (ADD); ADHD;
Childhood hyperkinesis.
Methods and Materials
The current study was a review survey
which was conducted to evaluate some of
children’s Attention deficit hyperactivity
disorder that is mentioned in science
website by studying articles and books
science texts.
To evaluate the texts, the singular or
combination forms of the following
keywords were used: “ADHD”,
“Prevalence”, “ADD”, Hyperkinesis” and
“Children”.
To evaluate the electronic Persian
databases the following websites were
searched: Google, Scientific information
database (SID), Ministry of healthcare,
Medical articles library of Iran (medlib.ir),
Iranian research institute for information
(Iran Doc), publication database (Magiran,
Iran medex), and also search in other
electronic databases such as Google
Scholar, Scopus and PubMed. Also, library
search was performed by referring to the
Hoseini et al.
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 445
journal archives of libraries, and
evaluating the available Persian and
English references such as text books and
also articles of research-scientific and
educational journals, and articles of the
annual seminar of medicine and
psychology.
Results
Symptoms
Symptoms of ADHD fall into three
groups:
Not being able to
focus (inattentiveness).
Being extremely active
(hyperactivity).
Not being able to control
behavior (impulsivity).
Some people with ADHD have mainly
inattentive symptoms. Some have mainly
hyperactive and impulsive symptoms.
Others have a combination of different
symptom types. Those with mostly
inattentive symptoms are sometimes said
to have attention deficit disorder (ADD).
They tend to be less disruptive and are
more likely not to be diagnosed with
ADHD.
Inattentive Symptoms
Fails to give close attention to details or
makes careless mistakes in schoolwork
Has difficulty keeping attention
during tasks or play
Does not seem to listen when
spoken to directly
Does not follow through on
instructions and fails to finish
schoolwork or chores and tasks
Has problems organizing tasks and
activities
Avoids or dislikes tasks that
require sustained mental effort
(such as schoolwork)
Often loses toys, assignments,
pencils, books, or tools needed for
tasks or activities
Is easily distracted
Is often forgetful in daily activities
Hyperactivity Symptoms
Fidgets with hands or feet or
squirms in seat
Leaves seat when remaining seated
is expected
Runs about or climbs in
inappropriate situations
Has problems playing or working
quietly
Is often "on the go," acts as if
"driven by a motor"
Talks excessively
Impulsivity Symptoms
Blurts out answers before questions
have been completed
Has difficulty awaiting turn
Interrupts or intrudes on others (butts into
conversations or games).
Different Symptoms
Boys and girls display very different
ADHD symptoms, and boys are much
more likely to be diagnosed with the
attention disorder. Why? It’s possible the
nature of ADHD symptoms in boys makes
their condition more noticeable than it is in
girls.Boys tend to display externalized
symptoms that most people think of when
they think of ADHD behavior, for
example: impulsivity or “acting
out”hyperactivity, such as running and
hittinglack of focus, including
inattentivenessphysical aggressionADHD
in girls is often easy to overlook because
it’s not “typical” ADHD behavior. The
symptoms aren’t as obvious as they are in
ADHD in Children
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 446
boys. They can include:being
withdrawnlow self-esteem and
anxietyintellectual impairment and
difficulty with academic
achievementinattentiveness or a tendency
to “daydream”verbal aggression: teasing,
taunting, or name-calling (Figur.1) (5-7).
Fig.1: Different ADHD symptoms in children
Epidemiology
The mean worldwide prevalence of ADHD
is between 5.29% and 7.1% in children
and adolescents (<18 years) (2, 8). The
prevalence of ADHD in Europe was
estimated at just under 5%, however, there
are still few global or European data on
rates of incidence, prevalence or
epidemiology of ADHD(2). Estimation of
the prevalence of ADHD may be
complicated by a range of factors such as
methodological and cultural differences,
and variability in identification and
medical classification systems used for
diagnosis (2).
Prevalence factors ADHD prevalence rates
may vary depending on several factors:
Age ADHD can affect children from pre-
school age2-4 and increasing recognition
is now given to the fact that ADHD can
extend beyond childhood and adolescence
into adulthood (8, 9-12). Gender a higher
prevalence is often reported in males
(8,13,14). Subtype of ADHD combined-
type ADHD is generally considered most
prevalent in all age-groups (15,16). ADHD
is often present alongside comorbidities
such as oppositional defiant disorder
(ODD) and anxiety disorder (9,16-19)
which may further complicate
understanding of true prevalence rates.
Africa
It is estimated that ADHD affects between
5.4-8.7% of children in Africa. Data
quality however is not high(20).
Germany
A 2008 evaluation of the “KiGGS” survey,
monitoring 14,836 girls and boys (age
between 3 to 17 years), showed that 4.8%
of the participants had an ADHD
diagnosis. While 7.9% of all boys had
ADHD, only 1.8% girls had it, too.
Another 4.9% of the participants (6.4%
boys: 3.6% girls) were suspected ADHD
cases, because they showed a rate ≥7 on
the Strengths and difficulties questionnaire
(SDQ) scale. The number of ADHD
diagnoses was 1.5% (2.4%: 0.6%) among
preschool children (36 years old), 5.3 %
(8.7% : 1.9%) at age 710 years, and had
its peak at 7.1% (11.3% : 3.0%) in the age
group of 1113 years. Among 14 to 17
years old adolescents the rate was 5.6%
(9.4%: 1.8%) (21).
Spain
Hoseini et al.
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 447
Rates in Spain are estimated at 6.8%
among people under 18 (22).
United States
In the United States it is diagnosed in 2-16
percent of school children. The rates of
diagnosis and treatment of ADHD are
much higher on the east coast of the
United States than on its west coast. The
frequency of the diagnosis differs between
male children (10%) and female children
(4%) in the United States. This difference
between genders may reflect either a
difference in susceptibility or that females
with ADHD are less likely to be diagnosed
than males.
Boys outnumber girls across all three
subtyping categories, but the exact
magnitude of these differences seems to
depend on both the informant (parent,
teacher, etc.) and the subtype. In two
community-based investigations,
conducted by DuPaul and associates, boys
outnumbered girls by only 2.2:1 in parent-
generated samples and 2.3:1 in teacher-
based input (23-29).
Exams and Tests
If ADHD is suspected, the person should
be evaluated by a health care professional.
There is no test that can make or exclude a
diagnosis of ADHD.
The diagnosis is based on a pattern of the
symptoms listed above. When the person
with suspected ADHD is a child, parents
and teachers are usually involved during
the evaluation process. Most children with
ADHD have at least one other
developmental or mental health problem.
This problem may be a mood, anxiety or
substance use disorder; a learning
disability; or a tic disorder. A doctor can
help determine whether these other
conditions are present.
Treatment
Treating ADHD is a partnership between
the health care provider and the patient. If
the patient is a child, parents and often
teachers are involved. For treatment to
work, it is important to:
Set specific, appropriate goals.
Start medicine and/or talk therapy.
Follow-up regularly with the doctor
to check on goals, results, and any
side effects of medicines. During
these visits, information should be
gathered from the patient and if
relevant, parents and teachers.
If treatment does not seem to work, the
health care provider will likely:
Confirm the person has ADHD.
Check for medical conditions that
can cause similar symptoms.
Make sure the treatment plan is
being followed.
Medicines
Medicine combined with
behavioral treatment often works
best. There are several different
ADHD medicines that may be used
alone or in combination. The health
care provider will decide which
medicine is right based on the
person's symptoms and needs.
Psychostimulants (also known as
stimulants) are the most commonly
used ADHD medicines. Although
these drugs are called stimulants,
they actually have a calming effect
in people with ADHD.
Follow the health care provider's
instructions on how to take ADHD
medicine.
Some ADHD medicines have side
effects. If the person has side
ADHD in Children
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 448
effects, contact the health care
provider right away. The dosage or
medicine itself may need to be
changed (30-34).
Risk factors for ADHD include:
Blood relatives (such as a parent or
sibling) with ADHD or another mental
health disorder
Exposure to environmental toxins
such as lead, found mainly in paint
and pipes in older buildings
Maternal drug use, alcohol use or
smoking during pregnancy
Maternal exposure to
environmental poisons such as
Polychlorinated biphenyls (PCBs)
during pregnancy
Premature birth
Although sugar is a popular suspect in
causing hyperactivity, there's no reliable
proof of this. Many things in childhood
can lead to difficulty sustaining attention,
but that is not the same as ADHD (6, 35).
Prevention
To help reduce your child's risk of ADHD:
During pregnancy, avoid anything that
could harm fetal development. Don't drink
alcohol, smoke cigarettes or use drugs.
Avoid exposure to environmental toxins,
such as polychlorinated biphenyls (PCBs).
Protect your child from exposure to
pollutants and toxins, including cigarette
smoke, agricultural or industrial chemicals,
and lead paint (found in some old
buildings).
Limit screen time. Although still
unproved, it may be prudent for children to
avoid excessive exposure to TV and video
games in the first five years of life.
If your child has ADHD, to help reduce
problems or complications:
Be consistent, set limits and have clear
consequences for your child's behavior.
Put together a daily routine for your child
with clear expectations that include such
things as bedtime, morning time,
mealtime, simple chores and TV.
Avoid multitasking yourself when talking
with your child, make eye contact when
giving instructions, and set aside a few
minutes every day to praise your child.
Work with teachers and caregivers to
identify problems early, to decrease the
impact of the condition on your child's life
(2-9).
Conclusion
Attention-deficit/hyperactivity disorder
(ADHD) is a chronic condition that affects
millions of children and often persists into
adulthood. ADHD includes a combination
of problems, such as difficulty sustaining
attention, hyperactivity and impulsive
behavior. Children with ADHD also may
struggle with low self-esteem, troubled
relationships and poor performance in
school. Symptoms sometimes lessen with
age. However, some people never
completely outgrow their ADHD
symptoms. But they can learn strategies to
be successful. While treatment won't cure
ADHD, it can help a great deal with
symptoms. Treatment typically involves
medications and behavioral interventions.
Early diagnosis and treatment can make a
big difference in outcome.
Children with ADHD have trouble
functioning at home and in school and
often havedifficulty making and keeping
friends. If left untreated, ADHD may
interfere with school and work, as well as
with social and emotional development.
ADHD is more common in boys, whose
impulsivity and hyperactivity may be
evident. Inattentiveness is a hallmark of
ADHD in girls, but because they aren't
often disruptive in the classroom, they may
not get diagnosed.
Conflict of interest: None
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... It is clear from Table (6) and Chart (5) that there are statistically significant differences between the levels of opinions of the research sample members for each of the proposed designs in terms of interactive criteria, as the values of "Ka2" for the proposed designs ranged between (7.75 -43.32). They were all statistically significant, and the opinions of the research sample fell at the level of "I agree" for the designs (1,2,4), where the arithmetic mean values for these designs were (2.70, 2.57, 2.34). The relative weights were (89.88%, 85.71%, 77.98%), respectively, and the opinions fell at the level of "To some extent" for Design No. (3), with an arithmetic mean of (2.30) and a relative weight of (76.79%). ...
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ADHD) is a chronic condition that affects millions of children and often persists into adulthood. ADHD Children are always looking for things to interact with. In addition, awareness advertising message lack the interactivity and engagement factors, especially when the target audience are ADHD children. Therefore, Employing the awareness advertising message in interactive clothes is suitable for this group and helps them improve the psychomotor disorders they suffer from, because it modifies the behavioral patterns of them to reduce the negative psychological effects of the disease and to control their behavioral health patterns. The aim of this study is to help children with ADHD overcome the negative effects they are experiencing psychologically and socially. The research methodology is a combination of descriptive study and statistical analytical study, and the result of the research appears by studying the role of creating interactive clothes that attract children with ADHD and enriching its design with an awareness message and how it can help them interact with society and break social phobia. Followed by a statistical analysis of four practical designs of clothes that were designed as an interactive game and the addition of an awareness message that helps children with ADHD on psychological and emotional balance by feeling comfortable and adding the possibility of interacting with clothes and playing through them, helped to get out of the state of boredom that (ADHD) child usually feels, as well as making him/her distinguished in the society, and able to make new friendships. Keywords Attention deficit hyperactivity disorder (ADHD), ADHD children clothing, awareness advertising message, interactive cloth, Psychomotor Disorders. ‫الملخص‬ ‫ا‬ ‫االنتباه‬ ‫ونقص‬ ‫الحركة‬ ‫فرط‬ ‫ضطراب‬ (ADHD) ‫تستمر‬ ‫ما‬ ‫ًا‬ ‫وغالب‬ ‫األطفال‬ ‫ماليين‬ ‫على‬ ‫تؤثر‬ ‫مزمنة‬ ‫حالة‬ ‫هو‬ ‫أطفال‬ ‫يبحث‬ ‫حيث‬ ‫البلوغ‬ ‫مرحلة‬ ‫حتى‬ (ADHD) ‫تفتقر‬ ‫ذلك،‬ ‫إلى‬ ‫باإلضافة‬ ‫معها.‬ ‫للتفاعل‬ ‫أشياء‬ ‫عن‬ ً ‫عادة‬ ‫اإلعالنية‬ ‫الرسالة‬ ‫فرط‬ ‫باضطراب‬ ‫المصابين‬ ‫األطفال‬ ‫من‬ ‫المستهدف‬ ‫الجمهور‬ ‫يكون‬ ‫عندما‬ ً ‫خاصة‬ ‫والمشاركة‬ ‫التفاعل‬ ‫عوامل‬ ‫إلى‬ ‫التوعوية‬ ‫على‬ ‫ويساعدهم‬ ‫الفئة‬ ‫هذه‬ ‫يناسب‬ ‫التفاعلية‬ ‫المالبس‬ ‫في‬ ‫التوعوية‬ ‫اإلعالنية‬ ‫الرسالة‬ ‫توظيف‬ ‫فإن‬ ‫لذلك‬ ‫االنتباه.‬ ‫ونقص‬ ‫الحركة‬ ‫والتصميم‬ ‫التراث‬ ‫مجلة‬-‫الرابع‬ ‫المجلد‬-‫يونيو‬ ‫والعشرون‬ ‫الواحد‬ ‫العدد‬ 2024
... Attention deficit hyperactivity disorder (ADHD) is a chronic disorder of childhood and adolescence characterized by a pattern of extreme pervasive, persistent, and debilita ting inattention, overactivity, and impulsivity [1]. It is a common childhood behavioral disorder [2], estimated to affect around 11 percent of children ages (4 through 17) [3], and it is a neurocognitive behavioral developmental disorder that is characterized by a persistent pattern of inattention or hyperactivity-impulsivity [4]. ...
... As Children with ADHD are more likely than their peers to experience educationa l underachievement, social isolation, and antisocial behavior during the school years and to go on to have significant difficulties in the post-school years. [1] The process of designing children's clothing requires a designer who studies the psychological aspects and motor motives of the child and what suits each category, especially ADHD children. ...
... It is clear from Table (6) and Chart (5) that there are statistically significant differences between the levels of opinions of the research sample members for each of the proposed designs in terms of interactive criteria, as the values of "Ka2" for the proposed designs ranged between (7.75 -43.32). They were all statistically significant, and the opinions of the research sample fell at the level of "I agree" for the designs (1,2,4), where the arithmetic mean values for these designs were (2.70, 2.57, 2.34). The relative weights were (89.88%, 85.71%, 77.98%), respectively, and the opinions fell at the level of "To some extent" for Design No. (3), with an arithmetic mean of (2.30) and a relative weight of (76.79%). ...
... Usually, inattention is referred to the as the behavioural issued associated with childhood but studies show that it is chronic that begins at early age and may sustain in adulthood (Barkley et al., 1998). Hoseini et al. (2014) considers inattentiveness a chronic behavioural problem that may affect adulthood age as well. ...
... Studies indicate that inattentiveness is chronic issue; it means that is starts from childhood and remains consistent in adolescence as well (Hoseini, 2014;Landsberg, 2005). Studies also indicate that the outcomes of inattentive behaviour can lead to less development of children socially, mentally and academically (Hughes, 2009;Hapsari et al., 2020). ...
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... Attention deficit hyperactivity disorder (ADHD) is a disorder of childhood and adolescence characterized by a pattern of extreme pervasive, persistent and debilitating inattention, over-activity and impulsivity [1]. The essential feature of ADHD is persistent pattern of hyperactivity-impulsivity and inattention that interferes with functioning or development of the child [2]. ...
... In the study most of the children were male (78.8%), having a male: female ratio of 3.71 which is similar to the estimated sex ratio for ADHD in worldwide study [1]. ...
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Background: ADHD is characterized by developmentally inappropriate, persistent problem in attention and /or excessive motor restlessness and /or impulsivity that significant interfere with functioning. Population surveys suggest that ADHD occurs in most cultures in about 5% of children and about 2.5% of adults. The neuropsychological theories of attention-deficit hyperactivity disorder (ADHD) suggests that its symptoms arise from a primary deficit in executive functions. Aim: To study the correlation between the clinical profile of children with ADHD with frontal lobe functions in children of ADHD. Methodology: A total of 33 ADHD children of age group 5 to 12 years attending OPD were included in the study after qualifying the inclusion and exclusion criteria for the study. DSM-5 criteria were used to make diagnosis of ADHD and severity was assessed using Conner’s Rating Scale-Revised (CRS-R) Parent short version and assessed for frontal lobe functions using FAB battery, EXIT-25 Battery and NIMHANS battery for children. Results: Around 3/4th participants in the study showed frontal lobe dysfunction which were comparable with severity of ADHD. Conclusion: ADHD is a neuro-developmental disorder with impaired executive functions in a large number of patients.
... The study also considers the challenges and risks associated with integrating BD and AI into ADHD care, proposing strategies to mitigate these. This research is significant Treatment typically involves a combination of behavioral and pharmacological approaches, tailored to individual patient needs (Hoseini, et al.,2014;Black, Grant, 2014). ...
Chapter
Technological advancements are revolutionizing the healthcare sector, notably in the treatment and management of attention deficit/hyperactivity disorder (ADHD). This shift from traditional therapeutic and pharmacological interventions towards a more data-driven approach marks a significant change in ADHD care. The integration of big data (BD) and artificial intelligence (AI) has introduced innovative and effective methods for ADHD management. These technologies not only bring analytical accuracy but also an empathetic understanding of patient needs, enhancing the quality of life through improved screening accuracy, early diagnosis, and the facilitation of remote treatments. This chapter explores a novel method that synergizes BD and AI to enhance the screening, diagnosis, treatment, and monitoring of ADHD. It critically analyzes the increased efficiency and effectiveness in identifying and managing ADHD through a comprehensive literature review and an online questionnaire to forty-eight experts from the healthcare industry. The research underscores the indispensability of BD and AI in developing new clinical approaches, particularly in the backdrop of escalating ADHD cases and broader mental health challenges. The findings align strongly with theoretical expectations, demonstrating significant advancements over previous methodologies. By introducing a strategic technological model that optimally utilizes BD and AI in ADHD care, this research not only proposes an advanced support system for patients but also promotes public health and sustainable, equitable ADHD care practices. Furthermore, it highlights the profound implications for future ADHD studies, potentially revolutionizing the realms of ADHD screening, diagnosis, treatment, and monitoring.
... Most of these studies were school-based (74%), with only 10% being populationbased 2 . According to the studies between 2001 -2010, the incidence of ADHD was estimated to increase America, while remaining relatively stable in Asia, but increased 5% in Europe 3,4 . Using electronic search engines to identify studies done between Vol.5• No.2• June 2019 2000 -2013, a meta-analysis of 739 studies estimated the prevalence to be variable, from 0.04% -24.5% 5 . ...
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Introduction: DSM-5 defines Attention-Deficit/Hyperactivity Disorder as having a persistent pattern of hyperactivity or inattention. This affects social, emotional, cognitive, and academic performance, behavioural skills in children and adolescents. The suffering child should have more than 6 symptoms of a particular type. Due to aetiology of Dhee Dhriti and Smriti, which results in imbalance of Kala and Karma and leads to incorrect interaction of the senses with their aims (Asatmyendriyartha Samyoga), gives rise to inattention, hyperactivity and impulsivity. Considering the nature of symptomatologic manifestation, it can be correlated with Unmada, more specifically Vata-Pittaja Unmada. Ayurveda addresses ADHD with both internal medicines and external therapies. Mentosoothe compound is such a polyherbal compound it contains Medhya, Balya, Deepana and Rasayana drugs in extract form. Aim of the present study to evaluate the efficacy of mentosoothe compound in the management of Attention-Deficit/Hyperactivity Disorder. Objective of the study is to promote cognitive performance with improvement in the quality of life by providing an effective and safe treatment option. Materials and Methods: The present study will be conducted as a randomized clinical study including minimum 40 patients, divided into two groups. Mentosoothe compound A and Mentosoothe compound B will be given to groups with fixed dosages. Assessment will be done on every 15th day during 2 months of clinical trial and final follow up will be done one month after completion of clinical trial. Result: The results will give the data on comparative effectiveness of the Mentosoothe compounds on ADHD. Discussion and Conclusion: The outcome of this trial will render a way forward to effective management of ADHD in children.
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Introduction: DSM-5 defines Attention-Deficit/Hyperactivity Disorder as having a persistent pattern of hyperactivity or inattention. This affects social, emotional, cognitive, and academic performance, behavioural skills in children and adolescents. The suffering child should have more than 6 symptoms of a particular type. Due to aetiology of Dhee Dhriti and Smriti, which results in imbalance of Kala and Karma and leads to incorrect interaction of the senses with their aims (Asatmyendriyartha Samyoga), gives rise to inattention, hyperactivity and impulsivity. Considering the nature of symptomatologic manifestation, it can be correlated with Unmada, more specifically Vata-Pittaja Unmada. Ayurveda addresses ADHD with both internal medicines and external therapies. Mentosoothe compound is such a polyherbal compound it contains Medhya, Balya, Deepana and Rasayana drugs in extract form. Aim of the present study to evaluate the efficacy of mentosoothe compound in the management of Attention-Deficit/Hyperactivity Disorder. Objective of the study is to promote cognitive performance with improvement in the quality of life by providing an effective and safe treatment option. Materials and Methods: The present study will be conducted as a randomized clinical study including minimum 40 patients, divided into two groups. Mentosoothe compound A and Mentosoothe compound B will be given to groups with fixed dosages. Assessment will be done on every 15th day during 2 months of clinical trial and final follow up will be done one month after completion of clinical trial. Result: The results will give the data on comparative effectiveness of the Mentosoothe compounds on ADHD. Discussion and Conclusion: The outcome of this trial will render a way forward to effective management of ADHD in children.
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Background Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed neuropsychiatric disorder in childhood, but the frequency of the condition is not well established in many countries. The aim of the present study was to quantify the overall prevalence of ADHD among children and adolescents in Spain by means of a systematic review and meta-analysis. Methods PubMed/MEDLINE, IME, IBECS and TESEO were comprehensively searched. Original reports were selected if they provided data on prevalence estimates of ADHD among people under 18 years old in Spain and were cross-sectional, observational epidemiological studies. Information from included studies was systematically extracted and evaluated. Overall pooled-prevalence estimates of ADHD were calculated using random-effects models. Sources of heterogeneity were explored by means sub-groups analyses and univariate meta-regressions. Results Fourteen epidemiological studies (13,026 subjects) were selected. The overall pooled-prevalence of ADHD was estimated at 6.8% [95% confidence interval (CI) 4.9 – 8.8%] representing 361,580 (95% CI 260,550 – 467,927) children and adolescents in the community. There was significant heterogeneity (P < 0.001), which was incompletely explained by subgroup analyses and meta-regressions. Conclusions Our findings suggest that the prevalence of ADHD among children and adolescents in Spain is consistent with previous studies conducted in other countries and regions. This study represents a first step in estimating the national burden of ADHD that will be essential to building evidence-based programs and services.
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To review literature from Africa on the epidemiology of ADHD as well attention deficit hyperactivity symptoms and associated co-morbid conditions among African children. A literature search was done through Pubmed/MEDLINE and Google Scholar using then following terms, "attention deficit", "hyperactivity disorders", "epidemiology", "co-morbid conditions", "Africa". Nine studies met the inclusion criteria with four studies coming from South Africa, two each from Democratic Republic of Congo and Nigeria respectively and one from Ethiopia. The prevalence of ADHD varied with rates of between 5.4% and 8.7%, amongst school children, 1.5% amongst children from the general population between 45.5% to 100.0% amongst special populations of children with possible organic brain pathology. Common associated co-morbid conditions were oppositional defiant disorder, conduct disorder as well as anxiety/depressive symptoms. Published data from Africa is limited. For effective healthcare policy further studies are needed to define the magnitude and burden of ADHD and other childhood neurodevelopmental disorders in Africa.
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Introduction In early typical language development, children understand words before they are able to use them in speech. Children with autism spectrum disorders (ASD) generally show impairments in both the comprehension and the production of language. However, the relative degree of delay or impairment in each of these sub-domains may also be atypical and remains less well-understood. Materials and Methods This study was a causal-comparative with 30 children (15 girls and 15 boys) with ASD and 30 normal children (15 girls and 15 boys) of 3 kindergartens of Mashhad, and children were elected with random sampling. Kindergartens were selected of areas (1, 4, 6) of Mashhad, Iran. Data analysis was done using SPSS 16 and t-student test. Results Results of t- tests showed significant differences between the two groups, autistic and normal children in the expressive language skill, cognitive and received language skill (P<0.05). There is a big difference between the mean scores of Newsha test in subjects with autism compared to standard scores. Conclusion According to the findings of the present study, the language disorder in children with autism compared to normal children is significantly higher.
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This article describes a comprehensive meta-analysis that was conducted to estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD), as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). A systematic literature review identified 86 studies of children and adolescents (N = 163,688 individuals) and 11 studies of adults (N = 14,112 individuals) that met inclusion criteria for the meta-analysis, more than half of which were published after the only previous meta-analysis of the prevalence of ADHD was completed. Although prevalence estimates reported by individual studies varied widely, pooled results suggest that the prevalence of DSM-IV ADHD is similar, whether ADHD is defined by parent ratings, teacher ratings, or a best estimate diagnostic procedure in children and adolescents (5.9-7.1 %), or by self-report measures in young adults (5.0 %). Analyses of diagnostic subtypes indicated that the predominantly inattentive type is the most common subtype in the population, but individuals with the combined type are more likely to be referred for clinical services. Additional research is needed to determine the etiology of the higher prevalence of ADHD in males than females and to clarify whether the prevalence of ADHD varies as a function of socioeconomic status or ethnicity. Finally, there were no significant prevalent differences between countries or regions of the world after controlling for differences in the diagnostic algorithms used to define ADHD. These results provide important support for the diagnostic validity of ADHD, and argue against the hypothesis that ADHD is a cultural construct that is restricted to the United States or any other specific culture.
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Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976–1982 remaining in Rochester, MN after age five (n = 5,718). Among them we identified 379 ADHD incident cases and 758 age-gender matched non-ADHD controls, passively followed to age 19 years. All psychiatric diagnoses were identified and abstracted, but only those confirmed by qualified medical professionals were included in the analysis. For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were estimated using the Kaplan–Meier method. Corresponding hazard ratios (HR) were estimated using Cox models adjusted for gender and mother’s age and education at the subject’s birth. The association between ADHD and the likelihood of having an internalizing or externalizing disorder was summarized by estimating odds ratios (OR). Results: Attention-deficit/hyperactivity disorder was associated with a significantly increased risk of adjustment disorders (HR = 3.88), conduct/oppositional defiant disorder (HR = 9.54), mood disorders (HR = 3.67), anxiety disorders (HR = 2.94), tic disorders (HR = 6.53), eating disorders (HR = 5.68), personality disorders (HR = 5.80), and substance-related disorders (HR = 4.03). When psychiatric comorbidities were classified on the internalization-externalization dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR = 10.6), or externalizing-only (OR = 10.0) disorders. Conclusion: This population-based study confirms that children with ADHD are at significantly increased risk for a wide range of psychiatric disorders. Besides treating the ADHD, clinicians should identify and provide appropriate treatment for psychiatric comorbidities.
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Attention-deficit/hyperactivity disorder (ADHD) is commonly thought to be a pediatric disorder whose symptoms attenuate or disappear in adulthood. In fact, similar to 4% of adults in the United States have ADHD, and many of these adults are unaware that they have the disorder. Because symptoms of ADHD manifest differently in adults and children, physicians who are familiar with childhood ADHD have difficulty identifying the disorder in adults. Adults with ADHD themselves may be poor informants about their symptoms and impairments. A high prevalence of mood and other co-morbid disorders in adults with ADHD can also complicate diagnosis and treatment. Adults with ADHD experience high rates of anxiety disorders, mood disorders, substance use disorders, and impulse disorders. Adult ADHD is related to impairments in executive functioning and adaptive functioning; these patients have unique deficits related to their roles as parents, caregivers, and employees. Physicians should use impairments to guide treatment design. Early identification and treatment of ADHD can alter the developmental course of co-morbid disorders. Unfortunately, metrics for impairment in adult ADHD are still in their infancy. This Expert Roundtable Supplement represents part 1 of a 3-part supplement series on adult ADHD led by Lenard A. Adler, MD. In this activity, Thomas J. Spencer, MD, reviews the epidemiology of adult ADHD in the US and around the world; Mark A. Stein, PhD, reviews data on the impairments resulting from adult ADHD; and Jeffrey H. Newcorn, MD, discusses the differential diagnosis of adult ADHD and common co-morbidities.