ArticlePDF Available

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

Authors:

Abstract and Figures

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.
Content may be subject to copyright.
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
References
Hoseini et al.
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 449
1. Thabet AM, Al Ghamdi H, Abdulla T,
Elhelou MW, Ostanis P. Psychiatry, 2002,
159:155662. Attention deficit
hyperactivity symptoms among Palestinian
children. EMHJ 2010; 16(5):505-10.
2. Polanczyk G, de Lima MS, Horta BL,
Biederman J, Rohde LA. The worldwide
prevalence of ADHD:a systematic review
and metaregression analysis.Am. J.
Psychiatry 2007; 164 (6):9428.
3. American Psychiatric Association:
Diagnostic and Statistical Manual of
Mental Diseases (DSM-IV), 4th ed.
Washington, DC, American Psychiatric
Publishing, 1994.
4. World Health Organization: The ICD-10
Classification of Mental and Behavioral
Disorders: Diagnostic Criteria for
Research. Geneva, Switzerland, World
Health Organization, 1993.
5. Adler L. Epidemiology, Impairments, and
Differential Diagnosis in Adult ADHD:
Introduction. CNS Spectrums: The
International Journal of Neuropsychiatric
Medicine 2008; 13(8): 4-5. Retrieved from
http://www.cnsspectrums.com/aspx/article_
pf.aspx?articleid=1703.
6. Attention-deficit/hyperactivity disorder
(ADHD) in children. (2013, March 5).
Mayo Clinic. Retrieved from
http://www.mayoclinic.org/diseases-
conditions/adhd/basics/complications/con-
20023647.
7. Attention-deficit/hyperactivity among
adults. (n.d.). National Institutes of Mental
Health. Retrieved from
http://www.nimh.nih.gov/statistics/1ADHD
_ADULT.shtml - See more at:
http://www.healthline.com/health/adhd/fact
s-statistics-infographic#6
8. Willcutt EG. The prevalence of DSM-IV
attention-deficit/hyperactivity disorder: a
meta-analytic review. Neurotherapeutics
2012; 9(3):490-9.
9. Kessler RC, Adler L, Barkley R, Biederman
J, Conners CK, Adler R, et al. The
prevalence and correlates of adult ADHD
in the United States: results from the
National Comorbidity Survey Replication.
Am J Psychiatry 2006; 163: 716-23.
10. Faraone SV, Biederman J, Mick E. The
age-dependent decline of attention deficit
hyperactivity disorder: a meta-analysis of
follow-up studies. Psychol Med 2006; 36:
159-65.
11. Lara C, Fayyad J, de Graaf R, Kessler RC,
Aguilar-Gaxiola S, Angermeyer M, et al.
Childhood predictors of adult attention-
deficit/hyperactivity disorder: results from
the World Health Organization World
Mental Health Survey Initiative. Biol
Psychiatry 2009; 65(1): 46-54.
12. Barkley RA, Fischer M, Smallish L,
Fletcher, K. The persistence of attention-
deficit/hyperactivity disorder into young
adulthood as a function of reporting source
and definition of disorder. J Abnorm
Psychol 2002; 111: 279-89.
13. Biederman J, Faraone SV, Monuteaux M,
Plunkett E, Gifferd J, Spencer T. Gender
effects on attention-deficit/hyperactivity
disorder in adults, revisited. Biol Psychiatry
2004; 55: 692-700.
14. Novik TS, Hervas A, Ralston SJ,
Dalsgaard S, Pereira RR, Lorenzo MJ.
Influence of gender on attention-
deficit/hyperactivity disorder in Europe
ADORE. Eur Child Adolesc Psychiatry
2006; 15 Suppl 1: I15-I24.
15. Faraone SV, Biederman J, Weber W,
Hatch M, Faraone SV. Psychiatric,
neuropsychological, and psychosocial
features of DSM-IV subtypes of attention-
deficit/hyperactivity disorder: results from
a clinically referred sample. J Am Acad
Child Adolesc Psychiatry 1998; 37: 185-
93.
16. Wilens TE, Biederman J, Faraone SV,
Martelon MK, Westerberg D, Spencer TJ.
Presenting ADHD symptoms, subtypes,
and comorbid disorders in clinically
referred adults with ADHD. J Clin
Psychiatry 2009; 70: 1557-62.
17. Steinhausen HC, Novik TS. ADORE
Study Group. Co-existing psychiatric
problems in ADHD in the ADORE cohort.
Eur Child Adolesc Psychiatry 2006; 15:
i25-i29.
18. Yoshimasu K, Barbaresi WJ, Colligan RC,
Killian JM, Voigt RG, Weaver AL, et al.
Childhood ADHD is strongly associated
with a broad range of psychiatric disorders
during adolescence: a population-based
birth cohort study. J Child Psychol
Psychiatry 2012; 53: 1036-43.
ADHD in Children
International Journal of Pediatrics , Vol.2, N.4-3, Serial No.12, December 2014 450
19. Jensen PS, Hinshaw SP, Kraemer HC,
Lenora N, Newcorn JH, Abikoff HB, et al.
ADHD comorbidity findings from the
MTA study: comparing comorbid
subgroups. J Am Acad Child Adolesc
Psychiatry 2001; 40: 147-58.
20. Bakare MO. Attention deficit hyperactivity
symptoms and disorder (ADHD) among
African children: a review of epidemiology
and co-morbidities. African journal of
psychiatry 2012; 15 (5): 35861.
21. Erkennen B, Bewerten Handeln, Zur
Gesundheit von Kindern und Jugendlichen
in Deutschland (PDF; 3,27 MB) (in
German). Robert Koch Institute. 27
November 2008. Archived from the
original on 11 December 2013. Retrieved
24 February 2014. Kapitel 2.8
Aufmerksamkeitsdefizit-
/Hyperaktivitätsstörung (ADHS), S. 57.
22.Catalá-López F, Peiró S, Ridao M,
Sanfélix-Gimeno G, Gènova-Maleras R,
Catalá MA. Prevalence of attention deficit
hyperactivity disorder among children and
adolescents in Spain: a systematic review
and meta-analysis of epidemiological
studies. BMC Psychiatry 2012; 12: 168.
23. Rader R, McCauley L, Callen EC. Current
strategies in the diagnosis and treatment of
childhood attention-deficit/hyperactivity
disorder. American family physician2009;
79(8):65765.
24. Centers for Disease Control and
Prevention . "ADHD Home". United
States: CDC.gov, Oct 2013.
25. CDC (March 2004). "Summary Health
Statistics for U.S. Children: National
Health Interview Survey, 2002" (PDF).
Vital and Health Statistics (United States:
CDC) 10 (221).
26. Staller J, Faraone SV. "Attention-deficit
hyperactivity disorder in girls:
epidemiology and management". CNS
Drugs 2006; 20(2):10723.
27. Anastopoulos AD, Shelton, TL. Assessing
attention-deficit/hyperactivity disorder.
NewYork, NY: Kluwer Academic/Plenum
Publishers, 2009.
28. The worldwide-pooled prevalence of
ADHD for persons age 18 and under was
5.29%, based on a review of 102 studies
comprising 171,756 subjects from all world
regions. [Source: Polanczyk et al. (2007
June), The worldwide prevalence of
ADHD: a systematic review and
metaregression analysis, American Journal
of Psychiatry 2007:164(6): 942-8].
29. Global ADHD prevalence for males aged
5-19 is 2.2% and for females 0.7%, based
on a review of 44 studies covering 21
world regions.[Source: Erskine et al. (2013
December), Research Review:
Epidemiological modelling of attention-
deficit/hyperactivity disorder and conduct
disorder for the Global Burden of Disease
Study 2010, Journal of Child Psychology
and Psychiatry 2013;54(12): 1263-74.
30. American Academy of Pediatrics,
Subcommittee on Attention-
Deficity/Hyperactivity Disorder, Steering
Committee on Quality Improvement and
Management. ADHD: Clinical practice
guideline for the diagnosis, evaluation, and
treatment of attention-deficit/hyperactivity
disorder in children and adolescents.
Pediatrics 2011; 128:1007-22.
31. American Psychiatric Association.
Diagnostic and statistical manual of mental
disorders. 5th ed. Arlington, Va: American
Psychiatric Publishing, 2013.
32. Bostic JQ, Prince JB. Child and adolescent
psychiatric disorders. In: Stern TA,
Rosenbaum JF, Fava M, et al., eds.
Massachusetts General Hospital
Comprehensive Clinical Psychiatry. 1st ed.
Philadelphia, Pa: Elsevier Mosby; 2008:
chap 69.
33. Knouse LE, Safren SA. Current status of
cognitive behavioral therapy for adult
attention-deficit hyperactivity disorder.
Psychiatr Clin N Am 2010; 33: 497509.
34. Prince JB, Spencer TJ, Wilens TE,
Biederman J. Pharmacotherapy of
attention-deficit/hyperactivity disorder
across the lifespan. In: Stern TA,
Rosenbaum JF, Fava M, et al., eds.
Massachusetts General Hospital
Comprehensive Clinical Psychiatry. 1st ed.
Philadelphia, Pa: Elsevier Mosby;
2008:chap 49.
35. Visser SN, Blumberg SJ, Danielson ML,
Bitsko RH, Kogan MD. State-Based and
Demographic Variation in Parent-Reported
Medication Rates for Attention-
Deficit/Hyperactivity Disorder, 2007-2008.
Prev Chronic Dis 2013; 10: E09.
... The characteristics of children who experience hyperactivity disorder are difficult to focus on children's attention to what they do, unsuccessful completion of tasks, difficulty maintaining attention when playing, concentration easily distracted, implusivity, difficult to queue, want to master social interaction and like to interrupt people, unable to sit still, sometimes climb, always moving, difficult to obey the rules and instructions even though he knows the rules and is able to explain but 10 minutes later he is unable to control his behavior, so that he repeatedly violates [9]. Therefore, in the school of hyperactive children in childhood, it is difficult to concentrate on their activities. ...
... This research was motivated by a previous study [9] regarding the lack of knowledge about the difficulties experienced by hyperactive children, teacher relations with hyperactive children, and the handling of teachers for hypernegative children. This study is a literature study which collects literature on hyperactive children and teachers who handle hyperactive children. ...
... This refers to finding challenges in sustaining attention and concentrating, and acts of impulsiveness. Hoseini et al., (2014) explain that ADHD is recognised as a chronic condition which not only affects numerous children, but it commonly persists through adulthood. The earlier the diagnosis, the earlier treatment can commence, and this can significantly affect the outcome. ...
Thesis
The study looks into the importance of the employment of Mindfulness Based Interventions in the school domain as a strategy to support students with ADHD. It also sheds light on the significance of the role of educators when teaching mindfulness, and the benefits that are reaped collectively as a school environment as a result of this. The research design used in this study is mainly exploratory with some descriptive elements. The methodology used for the interviews was semi-structured, which is a part of the qualitative approach. Data was collected through interviews with five professionals working in different roles within the education sector who have already integrated mindfulness as part of their educational practices. Hence already having familiarity with the subject matter, they are in a position to provide insight into how educators can integrate Mindfulness Based Interventions (MBI) through their teachings and on the overall benefits reaped from incorporating these practices within the school domain. These were: an NGO who has specialised in both children and adults with ADHD, a head of a college, a head of a school, a senior educator at the University of Malta, a qualified child carer who is also a mindfulness practitioner within a voluntary organisation (VO). All participants were recruited through snowball sampling, which is a non-probability method. --- Findings point toward the fact that the incorporation of MBI in the school domain would be highly beneficial for students with ADHD as they would help them to manage their emotions, impulses and behaviours more effectively. Additionally findings imply that benefits from mindfulness practices in the school domain are not limited to students with ADHD but could highly and holistically benefit all individuals that practice, and they would assist them in all aspects of their lives throughout their life time. Keywords: Students, ADHD, educators, mindfulness-based interventions (MBI), school domain.
... 4,5 . Meta-analisis yang dilakukan oleh Thomas, Sanders, Doust, Beller dan Glasziou (2015) 6 terhadap 175 kajian di seluruh dunia menunjukkan kecenderungan ADHD dalam kalangan kanak-kanak dan orang dewasa adalah sebanyak 7.2%. ...
Article
Full-text available
Kajian ini bertujuan meninjau samaada pergerakan gamifikasi atau kinaesthetic gamification (KG) boleh bantu mengurangkan masalah tingkah laku disruptif dalam kalangan kanak-kanak masalah pembelajaran (ADD/ADHD) sekolah rendah. Kajian berbentuk kuantitatif menggunakan kaedah tinjauan melalui soal selidik, temu bual dan pemerhatian dijalankan di Perak, Selangor dan Melaka. Persampelan bertujuan (purposive sampling) terdiri daripada 30 orang murid ADHD dan 30 orang guru pendidikan khas. Instrumen kajian terdiri daripada dua set soal selidik (murid ADHD dan guru), jadual pemerhatian dan temu bual berstruktur. KG ditadbir selama empat minggu. Dapatan kajian menunjukkan guru menangani masalah tingkah laku disruptif melalui pensyoran ubat-ubatan oleh ibu bapa murid dan pemberian token ekonomi. Hasil dapatan melalui pemerhatian menunjukkan tingkah laku disruptif berkurangan selepas menerima intervensi. Walau bagaimanapun, hasil analisis korelasi Pearson menunjukkan tidak terdapat hubungan signifikan antara emosi dengan masalah tingkah laku disruptif. Kesimpulannya, penggunaan teknik KG bagi mengurangkan masalah tingkah laku disruptif dalam kalangan murid di sekolah rendah yang mengalami masalah ADD/ADHD boleh dipertimbangkan oleh guru.
... According to Hoseini et al., 2014 the following preventive measures to reduce the risk of ADHD. To help reduce your child's risk of ADHD: ...
Article
Full-text available
Attention deficit hyperactivity disorder (ADHD) is characterized by impulsivity, hyperactivity and inattention. Up to 5% of primary school age children have ADHD. Both genes and environment play a major role in the aetiology of ADHD. If left untreated, children with ADHD demonstrate a range of poor long-term psychosocial outcomes. Principal management options include traditional food products, parent training programmes and school based interventions.
... Gender differences might be due to referral bias as males are more likely to present with more externalizing symptoms (such as hyperactivity or impulsivity and physical aggression) than females. However, females are more likely to present with more internalizing symptoms (such as being withdrawn, being in a state of anxiety, and having low self-esteem) than males [36]. Children living with single parents are five times more likely to have ADHD than children living with both parents. ...
Article
Full-text available
Objective: Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood with long-term outcomes. Although ADHD is the most studied behavioral disorders of childhood in developed countries, few studies have been conducted in Ethiopia. The aim of this study was to determine the prevalence of ADHD in rural parts of Ethiopia. Method: A cross-sectional study was conducted from May to June 2015 among children aged 6 to 17 years living in rural areas. A multistage cluster sampling technique was used to select 1302 participants. The Disruptive Behavior Disorder Rating Scale was used to collect the data. Logistic regression analysis was used to see statistically significant variables. Result: The prevalence rate of attention deficit hyperactivity disorder (ADHD) among children was 7.3%. Being male (Adjusted Odds Ratio (AOR) = 1.81, 95% CI: (1.13, 2.91)); living with a single parent (AOR = 5.0, 95% CI: (2.35, 10.65)); child birth order/rank (AOR = 2.35, 95% CI: (1.30, 4.25)); and low family socioeconomic status (AOR = 2.43, 95% CI: (1.29, 4.59)) were significantly associated with ADHD. Conclusion: The ADHD prevalence rate was found to be similar with global reports. Prevention and early management of maternal complications is important to reduce the prevalence of ADHD among children.
Article
Full-text available
According to the literature sources and information obtained from the specialists in the field, we found the lack of diagnostic measures for attention deficit hyperactive disorder (ADHD). At present, the hyperactive children behavior correction system is being actively reformed in Ukraine. One of the aspects of its modernization is the improvement and updating of the methodological base, primarily, the diagnostic methodology one. ADHD rating scales are actively used at all stages of ADHD treatment from diagnosis to correction of behavior. That is why its arrears important to increase the number of methodological tools of a psychologist during diagnostics.Purpose: improvement and adapted of the “Strengths and Weaknesses of ADHD symptoms and Normal behavior” (J.M. Swanson) rating scale for the use in Ukraine.Methods: calculation of psychometric characteristics of the Ukrainian version of the SWAN scales: correspondence of the empirical data to the normal distribution law (Gaussian function), internal consistency and reliability of parallel forms (by correlation analysis by r-Pearson criterion).Results. We processed 76 questionnaires, the age category of children ranged from 6 to 13 years (class “The Intelligence of Ukraine”, children with existing CPR, inclusive and classic classes). Questionnaires were filled in by teachers who were able to observe students’ behavior. The following psychometric indicators of the Scale were calculated: internal consistency (r = 0.77 at p ≤ 0.01 for the scale “Inattention” and r = 0.86 at p ≤ 0.01 for the scale “Hyperactivity” and “Impulsivity”) and the reliability of parallel forms (between the scales “Inattention” and “Hyperactivity/Impulsivity” according to the “SWAN” rating scale method (r = 0.53 at р ≤ 0.01) and the sum of the points according to the scales “Hyperactivity” and “Impulsivity” in “Rating scale of ADHD” (Suxotina, N.K. & Egorova, T.I.) (r = 0.56 at р ≤ 0.01)).Conclusions. The obtained results are satisfactory, so the “Strengths and Weaknesses of ADHD symptoms and Normal behavior” rating scale is ready for use in Ukraine. We see further potential for the development of the problem in those goals that could not be realized due to the lack of resources and quarantine, namely: increasing the number of sample, checking retest reliability as well as expert and constructive validity.Key words: ADHD treatment, hyperactive children, inclusive education, impulsivity, inattention. На основі літературних джерел та інформації, отриманої від фахівців, встановлено відсутність засобів діагностики розладу дефіциту уваги з гіперактивністю (РДУГ). Нині в Україні активно реформується система корекції поведінки дітей. Однією зі сторін модернізації є покращення та оновлення методичної бази, перш за все діагностичної, і саме рейтингові шкали активно використовуються на всіх етапах лікування РДУГ: від діагностики до корекції. Саме тому актуально збільшити кількість інстру-ментів психолога під час діагностики.Мета статті полягає в адаптації американської «Рейтингової шкали сильних та слабких сторін РДУГ та нормальної поведінки» (Дж.М. Свонсон) до вітчизняного вжитку.Методи. Використано обрахування психометричних характеристик україномовної версії шкали «Рейтингової шкали сильних та слабких сторін РДУГ та нормальної поведінки», таких як відповідність емпіричного розкиду закону нормального розподілу (функція Гауса), внутрішня узгодженість та надійність паралельних форм (кореляційний аналіз за критерієм r-Пірсона).Результати. Оброблено 76 анкет, вік дітей становить від 6 до 13 років (клас «Інтелект України», діти із наявною ЗПР, інклюзивний та звичайний класи). Анкети заповнювали вчителі, які мали змогу спостерігати за поведінкою учнів протягом місяця. Обчислені внутрішня узгодженість (r = 0,77 за р ≤ 0,01 для шкали «Неуважність», r = 0,86 за р ≤ 0,01 для шкали «Гіперактивність та імпульсивність») та надійність паралельних форм (прокорельовано показники за шкалами «Неуважність» та «Гіперак-тивність/Імпульсивність» за методикою SWAN (r = 0,53 за р ≤ 0,01) із сумою показників за шкалами «Гіперактивність» та «Імпульсивність» за опитувальником «Шкала оцінки РДУГ» (r = 0,56 за р ≤ 0,01)).Висновки. Отримані результати є задовільними, тому методика готова до українського вжитку. Подальший потенціал розвитку проблематики вбачаємо у тих цілях, яких не змогли досягнути через брак ресурсів та карантин, а саме у перевірці ретестової надійності, експертної та конструктної валідності, збільшенні кількості вибірки.Ключові слова: адаптація опитувальника, гіперактивні діти, інклюзивна освіта, імпульсивність, неуважність.
Article
Full-text available
Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in both children and adolescents. It is characterized via a constant pattern of inattention and/or hyperactivity-impulsivity that reduce both academic performance and interpersonal contact. Toxoplasma Encephalitis (TE) is neurological complication caused by the parasite, this condition can occur Due to the high prevalence of chronic Toxoplasma infections in the general population. Toxoplasma gondii being found to be linked to several psychiatric diseases, and some of the neurotransmitters associated with these diseases also being associated with Limited studies have been done in respect to toxoplasma gondii infection as a risk factor for ADHD. Objectives: The goal of the study is to elucidate the Association between toxoplasma infection and ADHD. Methods: this is a case control study done AL-Husseini hospital in holy Karbala during the period from December 2019 to June 2020 , with 90 participant comprising of 45 patient with ADHD ,45 control. sera from all participants were tested for specific serum human toxoplasma IgG , IgM and determined by enzyme linked immunosorbent assay (ELISA) using commercial kits. Results: The results of the current study revealed that no significant association between toxoplasmosis seropositivity and ADHD patient, p-value> 0.05. But positive significant association between maternal history of toxoplasmosis and ADHD p-value= 0.005. Conclusion: no support for the hypothesis that related toxoplasmosis as a risk factor for ADHD development, but maternal history of toxoplasmosis could be associated with ADHD.
Article
Full-text available
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.
Article
Full-text available
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.
Article
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.
Article
Objective: Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates. Method: A screen for adult ADHD was included in a probability subsample (N=3,199) of 18-44-year-old respondents in the National Comorbidity Survey Replication, a nationally representative household survey that used a lay-administered diagnostic interview to assess a wide range of DSM-IV disorders. Blinded clinical follow-up interviews of adult ADHD were carried out with 154 respondents, oversampling those with positive screen results. Multiple imputation was used to estimate prevalence and correlates of clinician-assessed adult ADHD. Results: The estimated prevalence of current adult ADHD was 4.4%. Significant correlates included being male, previously married, unemployed, and non-Hispanic white. Adult ADHD was highly comorbid with many other DSM-IV disorders assessed in the survey and was associated with substantial role impairment. The majority of cases were untreated, although many individuals had obtained treatment for other comorbid mental and substance-related disorders. Conclusions: Efforts are needed to increase the detection and treatment of adult ADHD. Research is needed to determine whether effective treatment would reduce the onset, persistence, and severity of disorders that co-occur with adult ADHD.
Article
The most recent Global Burden of Disease Study (GBD 2010) is the first to include attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) for burden quantification. We present the epidemiological profiles of ADHD and CD across three time periods for 21 world regions. A systematic review of global epidemiology was conducted for each disorder (based on a literature search of the Medline, PsycInfo and EMBASE databases). A Bayesian metaregression tool was used to derive prevalence estimates by age and sex in three time periods (1990, 2005 and 2010) for 21 world regions including those with little or no data. Prior expert knowledge and covariates were applied to each model to adjust suboptimal data. Final prevalence output for ADHD were adjusted to reflect an equivalent value if studies had measured point prevalence using multiple informants while final prevalence output for CD were adjusted to reflect a value equivalent to CD only. Prevalence was pooled for males and females aged 5-19 years with no difference found in global prevalence between the three time periods. Male prevalence of ADHD in 2010 was 2.2% (2.0-2.3) while female prevalence was 0.7% (0.6-0.7). Male prevalence of CD in 2010 was 3.6% (3.3-4.0) while female prevalence was 1.5% (1.4-1.7). ADHD and CD were estimated to be present worldwide with ADHD prevalence showing some regional variation while CD prevalence remained relatively consistent worldwide. We present the first prevalence estimates of both ADHD and CD globally and for all world regions. Data were sparse with large parts of the world having no estimates of either disorder. Epidemiological studies are urgently needed in certain parts of the world. Our findings directly informed burden quantification for GBD 2010. As mental disorders gained increased recognition after the first GBD study in 1990, the inclusion of ADHD and CD in GBD 2010 ensures their importance will be recognized alongside other childhood disorders.
Article
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.
Article
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.
Article
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.