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Crystal Key

Professor Thomas

English 1201.525

19 March 2019

Understanding ADHD

When my son was five and a half years old, he was diagnosed with Attention-

Deficit/Hyperactivity Disorder (ADHD). His father and I struggled with his behavior immensely

during our child’s kindergarten year due to him always being in trouble, not listening, and he

couldn’t ever sit still no matter what the situation was. He would get in trouble for climbing on

the teacher’s desk and jumping off it, running around the classroom during an activity, and other

things my husband and I didn’t think were ‘normal’ actions for a child. Toward the end of the

school year his teacher suggested we get him evaluated before he went on into first grade.

She said, “I believe Joseph may have some form of ADHD and if you don’t get him some

help, I’m afraid he will struggle throughout school. His grades will suffer, and his self-esteem

will deteriorate as a result of always being in trouble.”

We hesitated because we did not want him on medication for any reason at all. We asked

him, “What seems to be the issue with why you are unable to follow simple instructions?”

His response was, “I don’t know, it’s like there’s something inside my head and I just

can’t get it out.”

After listening to him explain himself so simply and from such a deep level at his young

age it broke my heart. I felt sad when I thought of all the negative attention and regression he
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endured on many occasions throughout his first year of school. How can the caregivers of the

children with this disorder fully understand the ADHD brain, what causes it to malfunction, what

can help it function better, and the most effective forms of discipline strategies to use in altering

its symptoms?

In reference to Timothy J. Silk, Charles B. Malpas, Richard Beare, Daryl Efron, Vicki

Anderson, Philip Hazell, Brad Jongeling, Jan M. Nicholson, and Emma Sciberras in their journal

article titled A Network Analysis Approach to ADHD Symptoms: More than the Sum of Its Parts

they explain that ADHD is a neurological disorder. Their statement is, “Attention-

deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a

worldwide prevalence in children of approximately 5%” (Silk, Timothy J., et al. 2). The initial

step for a diagnosis is an evaluation performed by a specialist. A pediatrician will usually send

the referral for a child and the child’s family to be evaluated. This type of evaluation is carried

out through a series of tests and questionnaires. The testing is put together by a

neuropsychologist or a psychologist, these specialists organize the in-depth material used to

determine how well the patient pays attention, whether they have trouble focusing, or if they act

on impulse. The child’s family is also interviewed about what type of behaviors are displayed at

school and other settings as well as in the home, sleeping patterns could play a part in supporting

their findings that may lead to a possible diagnosis as well. Another form of testing is through

magnetic resonance imaging (MRI) which is used to identify any abnormalities in specific areas

of the brain. Those who do not have first-hand experience in dealing with a child who has been

diagnosed with ADHD on a regular basis may only think of them as just acting like a kid. It

could be crucial for certain individuals to grasp the reality of ADHD being a real neurological
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disorder and that positive reinforcement, therapy, and medication help to alleviate its symptoms

allowing these children and their families to become less dysfunctional and more productive.

First of all, we should be clear on what is uncommon in the ADHD brain and what parts

are affected as a result. The mishap is partially due to the fact that there is less gray matter

volume in the brain. Recent studies have been conducted using (MRI). According to the article

Neuroanatomical Correlates of Attention-Deficit– Hyperactivity Disorder Accounting for

Comorbid Oppositional Defiant Disorder and Conduct Disorder written by Daimei Sasayama,

Ayako Hayashida, Hidenori Yamasue, Yuzuru Harada, Tomoki Kaneko, Kiyoto Kasai, Shinsuke

Washizuka, and Naoji Amano state, MRI scans “indicated significantly smaller regional gray

matter volume in regions including the bilateral temporal polar and occipital cortices and the left

amygdala in subjects with ADHD” (Sasayama, Daimei, et al. 394). In layman terms, gray matter

is composed of neurons (brain cells) and these neurons aid in the processing and delivering

information throughout the brain. Gray matter volume consists of most the cells that the brain is

made up of. These cell bodies contain sections of the brain which are responsible for self-control,

decisions, and emotions. There are definitely some misfires going on that cause the symptoms

associated with ADHD to surface, these symptoms include “runs excessively, fidgets, driven by

motor, interrupts, difficulty organizing, loses things, forgetful, easily distracted, difficulty

sustaining attention, avoids mental effort and does not follow instructions” (Silk, Timothy J., et

al. 9). Those who have been diagnosed with ADHD and are untreated struggle immensely,

especially in school. There is no cure for this disorder, however there are medications that

interrupt the flawed areas so they are able to serve their purpose in a functional way to help

manage the symptoms.


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Fig. 1 This image represents the difference in gray matter volume between the ADHD brain and

the normal brain (Sobo).

A lot of times school is where these symptoms become the most apparent and

psychiatrists have turned to stimulant medications to help alleviate the symptoms; the child is

then able to focus, learn, and follow directions better. Without medicine, neurotransmitters are

unable to thoroughly travel throughout the brain and when a message is sent from one neuron to

another, the receptor does not accept the message which makes the brain unable to process the

information adequately. Therefore, the ADHD symptoms are the outcome of the unprocessed

information. In the article How Stimulants Help ADHD written by Keath Low, she mentions,

“the reason the stimulants are helpful in reducing symptoms of ADHD appears to be that they

make these neurotransmitters more available, therefore improving activity and communication in

those parts of the brain which operate on dopamine and norepinephrine and signal for specific

tasks” (Low). She also provides proof that the activity between neurotransmitters is adjusted with

the assistance of medication, she explains, “brain imaging studies have demonstrated that when
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on stimulant medication, there's evidence of increased metabolic activity in the prefrontal cortex,

specific subcortical regions, and the cerebellum—all important centers for executive function”

(Low). Some professionals are also concerned that a lack of fatty acid intake could partially be

the cause of ADHD symptoms. They suggest a certain prescription strength of a vitamin called

vayarin has the potential to alleviate hyper or high energy activity. Vayarin is a combination of

omega-3, dha, and epa. Omega-3’s are basically fatty acids which are derived some certain foods

such as fish, flaxseeds, and walnuts. They offer a huge realm of benefits for people of all ages

and it is known to help reduce impulsivity and hyperactivity specifically for ADHD. The head of

pediatrics at The Osher Center for Integrative Medicine, Sandy Newmark who specializes in the

treatment of ADHD recommends an intake of 1000mg of omega 3’s every day for the

management of symptoms (Hallowell et al). Medication is of great importance to maintain a

more stable functioning of the neural network, it can help reduce the symptoms and aid in the

learning ability of the patient but not only is behavior an issue at school, it can be problematic at

home too.

The conduct of a child with ADHD at home can be just as frustrating for the parents as

well as the child and in most cases, there comes a point when the caretakers have exhausted all

forms of discipline that are acceptable, and they don’t know what to do anymore. When a child

with ADHD is scolded, they seem to shut down, isolate, or lie compulsively. Harsh

consequences can also lead the child to resort to other rebellious behaviors and can even teach a

child to become more deviant, so instead, an ‘undo and redo’ approach should be taken into

consideration with the consequences. An example of this is, “The consequence for carelessly
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spilling milk, for example, might be that your child cleans up the mess (undoing), and then pours

another glass and sets it in a safer place (redoing). No need to blame or yell” (Taylor). Parents

themselves, can experience temper tantrums when their kids don’t listen, and they set an example

for their children’s behavior by the way they react or respond. When a parent appears to be calm

and collected while initiating a response to a behavior then the child is most likely to remain the

same and absorb more of the information. Disciplining a child in the physical form could break

down their self-esteem and possibly make them fear their parent. Although there is a such thing

as a healthy fear, kids with this brain disorder do not take it into account while thinking or acting

out on impulse. Striking them is only a fix it here and now to gain their compliance. It is not an

effective long-term form of discipline, especially if it is the most common result of unacceptable

behaviors because this line of reaction only teaches the child to be aggressive. A more genuine

approach such as praise and less scolding would account for drastic improvements.

Positive reinforcement can be extremely effective for a child with ADHD since their

brains are wired differently. A recent study that author James Janford Li writes about in his

article titled Children’s Sensitivity to Reward Moderates the Association of Negative and

Positive Parenting Behaviors in Child ADHD Symptoms explains that children who have been

diagnosed with ADHD seem to possess a much higher reward response than the average

‘normal’ child. This study was concluded from questionnaires filled out by parents and children,

some of the children had been diagnosed with ADHD and others had not. The results shown said

those with ADHD have a much higher reward responsivity. Li states his findings as, “In

particular, children with ADHD display a stronger proclivity towards smaller and more
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immediate rewards over larger, delayed ones” (Li 1586). This could be because they have more

difficulty in sustaining attention so an immediate reward grabs their focus compared to having

something taken away until they comply or carry out specific tasks that may take time. In other

words, positive parenting can go a long way to instill good behaviors in kids with this disorder

because of their higher reward response.

Many people don’t even see ADHD as being a real medical or neurological disorder and

perceive it as kids just act their age. They may also seem to think the symptoms are a result of

ingesting too much sugar, bad parenting, or doctors pushing medications for a kick back from

pharmaceutical companies. “ADHD does not exist as a real psychiatric disorder; rather it is an

unfortunate labeling of normal childhood behavior promulgated by ineffectual parents,

incompetent teachers and the pharmaceutical industry” (Fritz 8). However, sociologists believe

more and more kids have been diagnosed with ADHD ever since Ritalin was discovered and

they believe it stems from the selfishness of doctors and pharmaceutical companies to make

more money. Even if people do side with this disorder as a reality, a lot of them do not think it is

logical or safe to pump a child full of psychiatric medication because it only disrupts their

cognitive development. “Another concern is that the brain reacts to being constantly bathed in

this drug, and we know very little about what kind of compensating reactions there are and how

they affect brain function in the long term” (McClure). Stimulants are a controlled substance and

can and have been abused. The use of these stimulant drugs can be a contributing factor that

contributes to substance abuse later in life. It is not the answer for controlling behavior issues

associated with ADHD and there is a whole lot more to it, such as deeper emotional issues that
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need to be addressed and dealt with, so counseling is a much better resort to turn to other than

medication. Not only that, this is an issue that the child, their immediate family, teacher(s), and

school principal need to work on in a collaborating effort to manage the symptoms effectively. It

causes stress along with many other negative outcomes in the lives of everyone who is involved

with these kids if it is not handled or maintained in a decent manner. Still, those who do not see

ADHD as true mental disorder believe that an old-fashioned spanking would correct any child’s

behavior that is disruptive.

In sum, understanding the ADHD brain and its malfunctions with the assistance of

medication, behavioral therapy, and positive reinforcement are the available tools to potentially

manage its symptoms. Although it is unlikely to increase the amount of gray matter volume in

the brain, psychiatrists can definitely help stimulate the brain stem with the use of medicine.

Behavioral therapy may guide the child in the direction of making responsible conscientious

decisions. This type of counseling trains the child to learn how to interrupt their thought process

so they’re able to think before carrying out any actions. The parent’s form of discipline could

make a difference in the behaviors and reactions of the child as well. If they’re praised, which

gives them a reason to focus on more positive things then it is very likely they will gravitate

towards making better choices out of habit that make them feel good. Of course, what works best

for one person may not work for the next as we are all unique, so this very well may become an

ongoing process in catering to each individual’s needs.


Works Cited

Fritz, Gregory K. “The Time Is Right to Dispel Myths about ADHD.” Brown University Child &

Adolescent Behavior Letter, vol. 16, no. 9, Sept. 2000, p. 8. EBSCOhost,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=ehh&AN=3525635&site=eds-live. 22 Mar. 2019

Hallowell, Edward, et al. “Can a Daily Fish Oil Supplement Help Curb Symptoms of

ADHD?” ADDitude, ADDitude, 20 Mar. 2019, www.additudemag.com/fish-oil-for-adhd-

symptoms/.

Li, James Janford. “Children’s Sensitivity to Reward Moderates the Association of Negative and

Positive Parenting Behaviors in Child ADHD Symptoms.” 2017,

doi:10.31219/osf.io/wrbsx. Ohio Link. Sinclair Library, Dayton, OH. 12 Mar. 2019

Low, Keath. “How Do Stimulants Help ADHD?” Verywell Mind, www.verywellmind.com/how-

do-stimulants-for-adhd-work-20895. 14 Mar. 2019

McClure, Laura, and Laura McClure. Ideas.ted.com, Ideas.ted.com, 8 Mar. 2016,

ideas.ted.com/the-neuroscience-of-adhd. 1 Mar. 2019

Sasayama, Daimei, et al. “Neuroanatomical Correlates of Attention-Deficit-Hyperactivity

Disorder Accounting for Comorbid Oppositional Defiant Disorder and Conduct

Disorder.” Psychiatry and Clinical Neurosciences, vol. 64, no. 4, 2010, pp. 394–402.,

doi:10.1111/j.1440-1819.2010.02102.x. Ohio Link. Sinclair Library, Dayton, OH. 27

Feb. 2019
Silk, Timothy J., et al. “A Network Analysis Approach to ADHD Symptoms: More than the Sum

of Its Parts.” Plos One, vol. 14, no. 1, 2019, doi:10.1371/journal.pone.0211053. Ohio

Link. Sinclair Library, Dayton, OH. 27 Feb. 2019

Sobo, Simon M.D., simonsobo.com/adhd-and-other-sins-of-our-children. 2 Apr. 2019

Taylor, John, and John Taylor. “Stop Ignoring, Start Interrupting for Better

Discipline.” ADDitude, ADDitude, 2 Aug. 2018.

www.additudemag.com/positivediscipline-techniques/ 21 Feb. 2019