Attention Deficit Disorder in Alolescents

Page 1

Attention Deficit Disorder in Adolescents

Imagine being easily sidetracked and losing your train of thought in mid-conversation. Imagine being unable to focus and having inconsistent school work and career performance. Imagine losing your keys or forgetting what you were going to do next on a daily basis. Today, more so than ever before, there are children, adolescents, and adults who are being diagnosed with either ADD or ADHD. "Estimates on how many Americans are ADHD-afflicted vary, from 1% on the low end to as much as 6%, which equals about 10 million people. Accordingly, several studies show that 80% of ADHD children grow into ADHD adolescents." (Health and Medicine Week, 2004, p.1) According to Larry Silver he states "follow up studies show that about 80% of children with attention deficit disorder no longer have problems after puberty." (Silver, L. B., Brunstetter, R. W., 1986, p.610) Since Larry Silver's publication, it has become clear that, "in most cases, ADHD does not resolve once children enter puberty. For the majority of children diagnosed with ADHD, as many as 65%, the diagnosis persists into adolescents." (Wolraich, M; Wibbelsman, C; Brown, T; Evans, S, 2005, p.2) These figures depicting the percentages of ADHD persisting into adolescents seem to contradict each other. The problem is the amount of studies on ADHD in adolescents and adults, because predominantly most studies had been conducted on children. Assessing adolescents with ADHD is much more difficult than with younger children. With young children, the parents are closely supervising their every move. At school they spend most of the day with 1 teacher who observes the child's academic performance and social interactions. These observations by the parents and teacher enable the assessment of ADHD in younger children. Adolescents, on the other hand, are changing classrooms and teachers all day long. These teachers only see the student for a short time and

Page 2

are also responsible for many more students than the elementary school teachers. Not only do adolescents not have close observation by one teacher, they are involved in many more extracurricular activities where the parents are not directly involved. Parents are not there to watch their adolescents at soccer practice, band practice, or the many other school functions that keep adolescents busy. Parents only observe a small amount of social interactions and peer relationships. The adolescents' need for privacy and independence make it even more difficult for parents to see how their child is really doing.

"Attention deficit hyperactivity disorder (ADHD) is a developmental disability with a childhood onset of symptoms that typically results in a chronic and pervasive pattern of impairment in school, work, social, marital and daily adaptive functioning. It is characterized by deficits in sustained attention and resistance to distraction, behavioral impulsivity and lack of self-control, and in some cases problems regulating one's activity level." (Murphy K., 2005, p.607) Children, adolescents or adults may experience these symptoms, keeping in mind that ADHD is the most common mental disorder in childhood. Meeting deadlines, following tasks through to completion, failure to plan ahead, having mood swings and a quick temper are all impairments adolescents and adults suffer. Individuals with ADHD need to have a basic understanding of all of the facts of this neurobiological disorder. ADHD adults and adolescents live with frustrations caused by persistent shortcomings, ineffectiveness and discouragement. They need to be reminded that they are not "stupid" or "have mental problems." ADHD can be compared to poor eyesight or asthma. These people are born with these disorders, just like an ADHD disorder, and are not at fault for having the disorder. People perceive the ADHD person

Page 3

as being capable and intelligent. That is why it is often referred to as the "invisible" disability. People cannot see a major reason why the ADHD person has negative or inconsistent behaviors that are probably caused by a subtle neurological condition in the prefrontal cortex of the brain. ADHD adolescents report enduring negative messages from their teachers, parents, friends, and bosses. They need to be told that ADHD is a highly treatable condition. If managed properly, the individual can have dramatic improvements in life functioning.

Stimulant medication is the treatment of choice for ADHD disorders. These medications increase attention span by decreasing the hyperactivity or the easily distractedness found in people with this disorder. Stimulants that are most commonly used are methylphenidate (Ritalin, Ritalin LA, Ritalin SR, Concerta, Foralin, Methylin, Methylin ER, Metadate ER, and Metadate CD) and amphetamine compounds (Adderall, Adderall XR, Dexadrine, Dexadrine Spansule, and Dextrostat). "Stimulants have been shown to be effective for about 70% of adolescents and seem to operate in a dose-dependent manner in improving cognition and behavior." (Wolraich, M; Wibbelsman, C; Brown, T; Evans, S, 2005, p.10) A recently approved non-stimulant agent is Atomoxetin (Strattera). It seems to be working for co-occurring