Alternative ADHD Therapies: The “New” Ritalin

Introduction

Attention deficiency disorder (ADHD), is a behavioral disorder that is prevalent in small children that sometimes continues to the child’s maturity. The disorder is characterized by academic difficulties, learning difficulties, social difficulties and inability to be attentive. Currently, the disorder affects 8-10% of all the children and is among the most common diseases in children. According to previous research activities, the disorder affects boys more than it affects girls at a ratio of 1-4 (Michelson, 2003).

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There are three types of the disorder namely, (a) Pre dominantly inattentive, (b) Pre dominantly hyper active and impulsive. (c) Combined. In the pre dominantly inattentive case, the patient is always absent minded and rarely takes notice of events around him. In the pre dominantly hyper active the person is over active and sensitive. In the last combined case the person’s reactions highly vary, sometimes he overreacts while in other times he is seen to be passive (Rowland, 2002).

The disease is medicated with stimulants and drugs like Adderall, Adderall XR and Dexedrine. However, most of these drugs only give a short term solution, while the patient has to face the problems daily. With time, the drug becomes less effective due to addiction from continuous usage; the patient will be tempted to try other drugs to feel better (Harlow, 1982). Previous research on the relationship between drug abuse and ADHD indicate that, 15-30% of adolescents and 35-55% of adults with ADHD are self-medicating themselves. In a study by Cannabis Youth Treatment (CYT) reports showed that, ADHD patients include 38% of the users of marijuana (Harlow, 1982).

Diagnosis of ADHD

It is diagnosed through the evaluation of the various symptoms observable from a patient (Sinn, 2007). The first procedure includes;

  1. The patient should have at least 6 symptoms which persist for at least 6months. They may escalate to a level that is unmanageable and constraints development (Richardson, 2000). The patient may show the following:
    • Is frequently unable to give attention to details, makes careless errors.
    • When spoken to directly they don’t appear to pay attention.
    • During games time or when they are assigned a task they don’t concentrate.
    • They are frequently unable to follow through and fail to finish tasks.
    • They find it hard to plan and arrange assignments and activities coherently.
    • Always sidesteps assignments that need unrelenting mental effort.
    • They seem to be careless by losing essential things that may be used to carry out duties.
    • They are always unable to remember normal day to day activities.
  2. Must experience at least 6 of the following symptoms of hyperactivity-impulsivity that keep on for at least 6 months to a point that is unmanageable and inconsistent with progress in health level:
    • They always fiddle or writhe while sitting.
    • They find it hard to remain seated when there is need to do so.
    • Always run around excessively in unclear circumstances.
    • They are unable to play silently; they play with a lot of shouting.
    • They lack a plan and are ready to do anything or go anywhere any time.
    • They frequently talk too much.
    • They exclaim with answers to questions even before they are completed.
    • Impatient when required to be patient.
    • They are always interfering with others.

Medication on Treatment of ADHD

In most cases, the patient is treated using anti-depressants and psycho stimulants, for example, amphetamine. Unfortunately some of these drugs have terrible side effects like drowsiness, dry mouth etc. Sometimes, behavioral therapy or a combination of the two is used (Flanagan, Miller, 2010).

Research question

Attention deficiency disorder (ADHD) is a challenge to the society because, if the affected person is not correctly attended to, he may never be able to live a normal life.

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As a society, how can the use of behavioral therapy as a treatment be used to improve the life of ADHD patients in comparison to the use of drugs in treatment?

Hypothesis

If behavioral therapy is used in the treatment of those suffering from ADHD in comparison to medicine, then patients suffering from ADHD will have their lives improved in the long run. This is the framework within which our research will operate in. It helps us to define our study and take it to the next level (Flanagan, Miller, 2010).

Purpose of the research

The purpose of the research is to improve the life of those diagnosed with the disease, through the use of behavioral therapy, to improve their ability to learn progressively, participation to a good social life and pay attention. This may help to relieve families the stress brought about by the condition. On the other hand, the psychology profession will provide better services to the society (Cheuk, Wong, 2006).

Literature Review

Adolescents affected by ADHD have resorted to self-medication due to failure by the medical prescriptions. Unfortunately, the drugs used by the patients are hard drugs such as cocaine, marijuana and alcohol to keep them from the effects of ADHD. This is a situation that is worrying with the relationship between drug abuse and ADHD being reported at very high levels of 38% (Harlow, 1983).

Research data indicate that patients with ADHD prefer alcohol, marijuana and cigarettes to influence their mood. This trend indicates the need for alternative therapy in the treatment of ADHD. Medical reports show that, a third of the older adolescents and the young adults result to self-medication to feel high and influence their mood swings. Unfortunately, it is convenient for ADHD patients as it is available.

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Research activities by researchers such as, Natalie Baker developed alternative methods like the use of electrodes e.g. Neuro feedback (NF). This is a neurobehavioral treatment used to help the patient gain cognitive self-discipline. The doctors use electrodes to identify brain activity patterns and advice the patient on how to use the skills in typical real life situations (Harley, 2007).

Theories used

In relation to our current research this theories help us in our research development. One of the theories is the social construction theory of ADHD. It claims that, ADHD is a social disorder that reveals itself after the patient has suffered extreme social situations. These situations are perceived to be extreme in the eyes of the society. Based on this, the founder of this theory supposes that it should not be taken as a medical condition. They also argue that the disease was invented and not discovered (Anastopoulos, 2006).

The next theory involved in the construction is the anti-motion sickness medicine. Those in support of the theory claimed that ADHD was triggered by complications from the inner ear. They explained that, the major cause of the condition was due to balance and coordination problems resulting from the inner ear (Beck, 1964). According to this theory, treatment could be done using a combination of various medications e.g. the use of multivitamin and the stabilizing medicine such as the anti-motion sickness drugs (Beck, 1995). Unfortunately, this theory was criticized due to the lack of a direct relationship between the hearing system and the parts of the brain that coordinate reasoning (Beck, 1995).

Physiology

There are physiological causes of ADHD, they include brain cyst, minimal brain damage that may be caused at birth, anemia and post trauma sub clinical disorder. On the other hand, the physical environment matters to the patient’s progress. Where the patient faces continuous ridicule for his poor condition and criticism from his immediate neighbors, the condition may worsen to acute levels (Harlow, 1983).

In previous research activities, there have been attempts to develop alternative treatments to the use of medication. One such treatment is the Neuro feedback (NF). It is described as a neuro behavioral treatment that treats the patients by training them how to manipulate brain activity patterns (Flanagan, & Miller, 2010). The patient is shown how to take advantage of the patterns to carry out duties in normal life. The process in this treatment involves, using electrodes connected to a computer, then connected to the patient’s head.

The Electroencephalographic consists of brain waves, information is retrieved by using computers in identifying and transforming the desired brain waves in to virtual and audio information. This is modified in to a computer game. In this computer games, the electrodes placed in the patients head will identify desirable brain waves. At this point the character in the game goes to the right direction. This will accordingly influence the patient as the player of the game (Kazdin, 1997).

The patient is encouraged to play the game over and over again for a long time so that their brains can learn to produce the desired brainwaves at the appropriate moment. It is then assumed that, due to the consistent use of the program, the patient cognitively becomes able to apply these intuitions in her/his normal life situations (Anastopoulos, 2006).

In another research conducted by Fuchs, comparison was done between 22 children who received NF (neurofeedback) to 11 children using stimulants. The research was successful and results showed that, when psychological tests were conducted at the end of the research, the treatment had brought significant improvement in their IQ. This shows that, behavioral therapy can be more effective in treating ADHD when used with drugs (Barkley, 2007).

The physical aspect of the body, this involves the physical environment from where the patient stays. The physical environment often has toxins and may cause infections in the body. In this context, the patient is supposed to be treated for the cause of the disease and not the symptoms of the disease. If the symptoms are treated then the disease will recur after a short while (Chabot, Serfontein, 1996).

Another form of treatment used for a long time now is the use of the food supplements. It was used in the past by Dr. Heinrich Hoffman in 1845 to treat children with hyperactivity disorders. According to his reports he was able to only treat 50% of the children. This is a significant number of children and this was enough prove that food supplements could treat this cases. Apart from that an article from the UK explained ADHD as a complex multifactorial disorder. It displayed that some characteristics of ADHD show some hidden elements of ADHD had recognized fatty acids (Chabot, Serfontein, 1996).

In this context Laurie in his article ‘has diet taken a place in the table ‘proves the existence of food supplements that may be used as alternative treatment in treating children suffering from ADHD. There is also a conclusive review of the literature by the psychologists and nutritionists in New York, in the use of food supplements in the treatment of ADHD (Cheuk, Wong, 2006).

Abnormal psychology

In some cases the student will prefer a slight change in their environment, especially those reported to be having ADHD. This is called sensory modulation; it reflects a slight change in the physiological activities to enhance psychological adaptation to the external environment. In a study done by Kathleen Washington and others, the class environments in the case study are a physical change in the environment. When the therapy balls are used in place of chairs, the students in that class performed better than they did previously. They can increase their written work productivity while using a therapy ball in class. When both teachers and students were asked for an opinion they supported the use of therapy balls (Mulligan, 2001).

The therapy balls serve as an incentive to most of the students being preferred by 87% of them; furthermore, their use is consistent with the general rules of the school. This case study gives a solution to the students with ADHD for their need for more concentration. When the teachers were asked for their opinion on the use of the therapy balls, they were in full support of its use. The students with ADHD are also seen to spend 75% of their time in the sit which is more than they usually do.

To many parents, this is something that can highly stigmatize the family. Although this may depend on the nature of the community the family comes from, the disease is not known as many families are not aware of its existence. Due to the challenge faced by parents with such cases in the family, a treatment that involved the whole family was developed (Anastopoulos, 2006).

Cognitive section

Cognitive-behavioral paradigms use Aaron Beck’s model of 1964, in this model he based the treatment in the emotional understanding of the patient. This information is used to make the patient understand himself better and the reason for his shortcomings in social, academic and attention abilities in life. For example, a teacher with an attitude that, ‘this kid is stupid’ will be trained on how to identify personal talks that are pessimistic. This may help the person to improve on decision making techniques and avoid dogmatic tendencies in his decision-making. Through this process, the individuals are empowered to improve on problem solving techniques. The individuals are encouraged to give priority to important things such as education (Harley, 2007).

In the treatment of a patient using Cognitive-behavioral paradigms, some close people to the patient are involved. They are supposed to understand her/his mistakes to avoid on the frustrations brought about by repetition of instructions daily. The friends, family members and parents are taught on how to avoid criticism against the patient. Lastly the patient is taught on all her weaknesses. These may improve the healing process of the patient by avoiding self-blame from past mistakes (Harley, 2007).

The parents are supposed to watch on their body language, for example, the general statements about the character of the child e.g. my child is stupid. It is at this stage before diagnoses were; the parents and the teachers are almost giving up on the child because of the day to day conflict caused by poor response from the student (Abikoff, 1991). The teachers are tied of giving punishments as the child does not seem to get out of trouble. This at some point weighs in so much on the parties involved. The school psychologist has to take charge of the situation by helping both parties through guidance and counseling. It may help to solve on the conflict between the teacher, student and the parents (Cheuk, Wong, 2006).

The next type of treatment is the mindful-based cognitive therapy for children. This is a physical group psychotherapy meant for children aged between 9-13 years. The program was developed to improve the ability of children with ADHD to develop their social ability. In a case study, this is achieved through a heightened watchful environment on what the child needs most. The children are put in a group to ensure that they are at ease with themself. Then a program is formulated to improve on the various skills that the children are supposed to learn on. Activities are incorporated that may help to develop memory and other necessary skills. The children are then put through a 3 month session where, each child is taught for 30 minutes on school going days daily for 3 months (Cheuk, Wong, 2006).

At the end of the training, the children are put through tests to measure their alertness, memory, their learning ability and their ability to be socially active with other children. These tests showed that, the children had improved significantly with about 50%. This program proves that, children suffering from ADHD may have an alternative form of treatment that may be used in the place of medical prescriptions (Cheuk, Wong, 2006).

In this collection of literature, the patients of ADHD may be treated using drugs. However drugs have the challenge of side effects that may be very hard for the patient to take. Fortunately, an alternative has been developed and the patients may use behavioral therapy for treatment. The advantage of using behavioral therapy is that the child with ADHD may get full support from the friends, parents and teachers (Anastopoulos, 2006).

This is like a new experience to the patient; the therapy is interesting e.g. the use of videogames to improve on the memory of the child. In most of the research work done the treatment by using drugs has proved to have less effectiveness. According to previous research reports the treatment through drugs is effective only for a short time as compared to the treatment through therapy (Abikoff, 1991).

Methodology: Case study

In this case, we look at the methods that may be used to develop the study. According to the nature of the study, a case study is a convenient method for the project as it uses locally available resources, is cost effective and convenient. I chose 30 pupils from the local school with 5 of them having been suspected to having ADHD (Kazdin, 1997). The students mainly came from a poor back ground in the local community around the school.

The children were first taken through a psychological test on their level of attention, their ability to socialize with the others and level of intelligence. We used observation, tape recording, note taking, using questioners for teachers and pupils and carrying out psychological tests to collect data. The information would be recorded after every 10 minutes for 30 minutes every day for 2 weeks. The information was collected for the 3 weeks. N =30.

The data collected from the study included the following.

General information

General information

Correlation(r) = [NΣXY – (ΣX) (ΣY) Square root ([NΣX2 – (ΣX) 2][NΣY2 – (ΣY) 2])]

Twenty-one of 30 children were ethnic minorities. The results on the response of the children were collected every day with consistent training. The results were consistently collected after the first, the second and the third week. A follow up check on the children was put in place after the child had finished the sessions for up to 3 months. On completion of the period, the children were taken through a psychological evaluation to determine the level of improvement in their learning abilities, any changes in the level of social interaction and ability to attentively concentrate.

Another group with the same number of children participants were put through medication and no therapy was administered. The children are exposed to the same environment as the other group. On the evaluation of the two groups after a consistent 3 weeks, it was discovered that the children exposed to consistent therapy showed improved abilities and consistent progress in abilities to learn. Improved social tendencies and higher attention levels as compared to the other group of children at levels of [F (2, 2, 24) =7.875, p=0.025, Cohen’s d=52]. They showed a strong improvement while the other who used drugs showed negligible changes. Reduction in attention problems accounted for 52% of the average change in behavior.

Discussion

From the evidence gathered it is clear that ADHD is a very complex disorder and most of the people are not aware of its existence. The treatment of the disease may be developed further in the use of medicine. There should be a variety of drugs to be medicated depending on the compatibility of the patient to the drug; this may help to reduce on side effects. Apart from that, the use of therapy can be made much more effective through the creation of awareness and more support from the parents, teachers and the patients (Anastopoulos, 2006).

The use of the other forms of treatment like the use of Neuro feedback is still in its development stage as the services are not available to most of the people. For the welfare of the society, there is need to create awareness for the disease to minimize frustration levels in the society due to ignorance on existence of the disease. The government has to improve on the investment in research activities to enhance treatment. The evidence is clear, from the various studies done behavioral therapy is better as it doesn’t have side effects (Barkley, 2007).

Conclusion

In the research carried out, there is enough evidence to prove that an individual suffering from ADHD could be treated without using drugs. We see it in the case study of the children that after having the therapy they significantly improved in their social, attention and memory. This can be used to improve the life of people living with ADHD. It can also restore hope to the parents who have given up on their children without the knowledge that their children have this kind of problem. In the case of Dr. Heinrich Hoffman in 1845, we see him treat at least 50% of his patients suffering from ADHD and restore them to a better life (Harlow, 1983).

The use of cognitive, physiological and abnormal section psychology is used to give the various alternative methods of treatment. These methods give an analyzed solution that may help in the treatment of ADHD. In the psychology field, this is a step further in making the world a better place for those diagnosed with ADHD. Although there is need for more research in the development of the treatment further, and advance in technology for treatment of ADHD (Beck, 1964). The hypothesis can be assumed to be successful given the evidence from the hypothesis, ‘If behavioral therapy is used to treat those suffering from ADHD in comparison to medicine, then patients suffering from ADHD will be able to improve their life in the long run.’

References

Abikoff, H. (1991). Cognitive training in ADHD children: Less to it than meets the eye. Journal of Learning Disabilities, 24, 205 – 209.

Anastopoulos, A. D., Rhoads, L. A., & Farley, S. E. (2006). Counseling and training parents. Journal of education, 32, 75.

Barkley, A.K. (2007). Attentiondeficit hyperactivity disorder: A handbook for diagnosis and treatment. New York Times, 25, 453-479.

Beck, A. T. (1964). Thinking and depression II: Theory and therapy. Archives of General Psychiatry, 10, 561 – 571.

Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: The Guilford Publishers.

Chabot, R., Serfontein, G. (1996) Quantitative electroencephalographic profiles of Children with attention deficit disorder. Journal of Biol Psychiatry, 40, 951-63.

Cheuk, D., Wong, V., (2006). Attention-Deficit Hyperactivity Disorder and Blood Mercury Level: a Case-Control Study in Chinese Children. Journal of Neuropediatrics, 37, 234- 40.

Flanagan, R., & Miller, J. A. (2010). Specialty competencies in school psychology. New York: Oxford University Press.

Harley, J. (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 894 – 918.

Harlow, H. F. (1983). Fundamentals for preparing psychology journal. Journal of Comparative and Physiological Psychology, 55, 893-896.

Harlow, H. k. (1982). Consensus Conference: Defined Diets and Childhood Hyperactivity. JAMA journal, 248, no. 3, 290–2.

Kazdin, A. E. (1997). Parent management training: Evidence, outcomes, and issues. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1349 – 1356.

Michelson, D., Adler, L., Spencer T. (2003). Atomoxetine in adults with ADHD: two randomized. Placebo-controlled Journal on Biol Psychiatry, 112-20.

Richardson, A. J., and Puri, B. K. (2000). The Potential Role of Fatty Acids in Attention-Deficit hyperactivity Disorder. Journal of Prostaglandins Leuko Essent Fatty Acids, 63, No. 1–2, 79–87.

Rowland, A. S., Lesesne, C. A., and Abramowitz, A. J. (2002). The Epidemiology of Attention-Deficit hyperactivity Disorder (ADHD): A Public Health View. Journal of MentalRetard Development of Disabilities, 8, no. 3, 162–70.

Sinn, N., and Bryan, J. (2007). Effect of Supplementation with Polyunsaturated Fatty Acids and Micronutrients on Learning and Behavior Problems Associated with Child ADHD. Journal of Development of Behaviour Pediatrics, 28, no. 2, 82–91.

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