Behavior Modification in Children with Attention Deficit Hyperactivity Disorder Introduction

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral developmental disorder that is associated with hyperactivity, inattentiveness, impulsivity, excessive motor activity and distraction. It affects people of all ages. ADHD is diagnosed in childhood from the age of seven and adolescents and most adults with the disorder link it to their childhood where it was either noticed or ignored.

The causes of ADHD are not established concretely in research studies although it is linked to genetic, hereditary or biological factors as well as environmental and social factors to a certain extent. Addressing ADHD in children is significant since early diagnosis and treatment of the condition during childhood can alleviate it.

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The prevalence rates of ADHD are high in children and if not dealt with during childhood it usually creates more problems in adolescent stage. Sufferers of ADHD are at risk of engaging in negative behaviors such as substance abuse as well as the onset of depression.

The use of behavior modification in addressing ADHD is very important since the medication alone cannot transform the sufferers whereas monitoring it is very difficult. This research project establishes the use of behavior modification in dealing with ADHD in children.

Summary of Articles Relevant to the Research Project

Article 1

Chang, H., Chang, C., & Shin, Y. (2007). The Process of Assisting Behavior Modification in a Child with Attention-Deficit Hyperactivity Disorder. Journal of Nursing Research, 15(2), 147-154.

The authors of the article are Chang Hsin and Chang Ching of the National Cheng Kung University as well as Shin of the nursing department in Kaohsiung Medical University Hospital. The objective of the article is to offer a description of the process of behavior modification for a child diagnosed with ADHD. The research involved a child who had not reported positive effects despite undergoing treatment of ADHD using medication.

The child was subjected to behavior modification together with medication for the next year with the medication based on the prescription of the doctor. The behavior treatment was based on the drafts of the doctors and experts with major techniques being punishment and skillful reinforcement. The information was collected from interviews with parents and teachers and other observation. The results from the research were:

The child improved in self discipline in his daily life.
His social interactions with friends improved.
He finished his school work and games on time.

The research establishes that behavior modification when carried out together with drug treatment improves the daily lives of children with ADHD. Good communication with parents and the psychological preparation are important in behavior modification while the overall support of the teachers and other social interactions are necessary for such children.

Article 2

Coles, E., Pelham, W., Gnagy, E., Burrows-Maclean, L., Fabiano, G., et al. (2005). A Controlled Evaluation of Behavioral Treatment with Children with ADHD Attending a Summer Treatment Program. Journal of Emotional and Behavioral Disorders, 13(2), 99-112.

This study was done by ten authors identified above. The purpose was to evaluate the effectiveness of behavioral treatment for children suffering from ADHD. The research study involved the manipulation of the presence of behavioral treatment for four children of ages 11 to 12 years.

The children involved in the research were enrolled at the Center for Children and Families located at the State University of New York in Buffalo for the summer treatment program of 2001 for duration of eight weeks.

The behavior treatment conditions were varied and changes in the behaviors in and out of the classroom assessed together with the levels of productivity in their academic work. The behaviors recorded included: obedience to activity rules, daily rates of compliance, interruptions, conduct problems, complaining, negative verbalizations and violation of rules. The findings were:

John showed a low rate of complaining during treatment which increased with withdrawal.
Anne’s classroom seatwork and rule violations worsened with the withdrawals but stabilized during the last three weeks of the project.
Trevor reduced negative behavior but never returned to his initial treatment level of functioning after the withdrawals.
Jeremy’s classroom rule violations were also low initially when behavior modification was being used, but the rate rose when it was withdrawn.

The study demonstrates the positive impact of behavior modification on children with ADHD but it is limited in terms of the sample size and the individual differences.

Article 3

DuPaul, G., & White, G. (2006). ADHD: Behavioral, Educational and Medication Interventions. Education Digest, 71(7), 57-60.

The study was done by DuPaul of Lehigh University Pennsylvania and White of Education Leadership program. The purpose of the report is to provide a guideline to educators on ways of dealing with children with ADHD. They report that educators spend much time dealing with students with special needs such as children with ADHD.

The article suggests that medical and psychosocial treatments help but responses to medication vary with individual differences hence requiring monitoring.

They suggest the need for staff to be updated with medical research with behavioral interventions in the classroom of antecedent based strategies such as modified lengths of assignments, posting of rules and peer tutoring among others, and consequent strategies based on reward systems and reinforcements as well as academic interventions.

They suggest the establishment of a support system for children with ADHD which includes increased time during testing, preferential seating in class, choice of a quiet place for testing purposes and increased length of assignments.

Article 4

Ibrahim, E. (2002). Rates of adherence to pharmacological treatment among children and adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology, 17(2), 225-231.

The author of the article is Ibrahim El-Sheikh, a psychiatrist based at the King Fahad National Guard Hospital in Riyadh in Saudi Arabia. He asserts that although the pharmacological interventions for children and adolescents with ADHD are effective, the failure to comply with prescribed medication poses a great challenge to children and adolescents.

The objective of the research was to investigate the rate at which the children and adolescents diagnosed with ADHD and involved in the research were able to adhere to prescribed medication. The research involved a total of 51 children and adolescents of ages 7 to 16.6 years diagnosed with ADHD. The research entailed interviews and the checklists provided to the parents and teachers for compliance. The results of the research were:

There were high rates of adherence to treatment reported by the patients for the one week and three months period.
After the three months period, the reports of the parents showed stability in the adherence of the children and adolescents to the medication.

The implications of the findings were that the characteristics and functioning of the families played a key role in the adherence and the behavior modification therapy lessons attended by the participants. The whole research establishes the need for behavioral modification when coupled with medication. However, the study was limited to participants from intact family structure while the duration of three months was short and did not allow long term evaluation.

Article 5

Logan, A. (2007). Controlling ADHD. Canadian Journal of Health and Nutrition, 9(229), 86-88.

The author of the article is Logan, a lecturer on depression, learning, nutrition and behavior at the Harvard medical school. The purpose of the study was to evaluate the alternative care that is given to children suffering from ADHD. The author asserts that the alternative care provides relief in the long term compared to the remedy of pharmaceutical medication.

The alternative care includes behavioral modification in the form of reinforcements and rewards systems which can be used by teachers and parents. According to the author, the alternative care not only enables children with ADHD acquire coping skills but also adaptive thinking, improved communication skills and management of emotions. The author also suggests that adherence to proper diet and nutrition serves as a form of treatment for children suffering from ADHD.

Conclusion

The research project under consideration involves children suffering from ADHD due to the complexity of the condition that results from a lack of clear cause, mixed symptoms and high prevalence. ADHD is treatable in childhood but failure to be diagnosed and treated earlier in life causes more adverse effects especially as the sufferers advance to the adolescent stage.

This paper has provided the summary of the relevant scholarly articles for more in depth analysis and evaluation of the condition. The general consensus from the articles is that behavioral modification program is an effective way of managing ADHD in children especially if the program is coupled with medication.

Reference List

Chang, H., Chang, C., & Shin, Y. (2007). The Process of Assisting Behavior Modification in a Child with Attention-Deficit Hyperactivity Disorder. Journal of Nursing Research, 15(2), 147-154.

Coles, E., Pelham, W., Gnagy, E., Burrows-Maclean, L., Fabiano, G., et al. (2005). A Controlled Evaluation of Behavioral Treatment with Children with ADHD Attending a Summer Treatment Program. Journal of Emotional and Behavioral Disorders, 13(2), 99-112.

DuPaul, G., & White, G. (2006). ADHD: Behavioral, Educational and Medication Interventions. Education Digest, 71(7), 57-60.

Ibrahim, E. (2002). Rates of adherence to pharmacological treatment among children and adolescents with attention deficit hyperactivity disorder. Human Psychopharmacology, 17(2), 225-231.

Logan, A. (2007). Controlling ADHD. Canadian Journal of Health and Nutrition, 9(229), 86-88.

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