Attention-deficit/hyperactivity disorder (ADHD) issue

Despite a global incidence of up to 17%, attention-deficit/hyperactivity disorder (ADHD) is undoubtedly one of the most common, intensively investigated, and diagnostically controversial conditions (Vrijen et al., 2016). Since then, three subtypes have been identified around the world: the primarily inattentive type, the hyperactive-impulsive type, and the combinational species. To define the subtype involved in the instance provided, a full investigation of the difficulties involved is required in order to manage the condition more effectively. The significance of the detailed examination of the presentation of the condition is because while it is common to find that patient will display symptoms including educational, emotional, and psychiatric impairment, only a few could be due to the disorders while the rest are as a result of an overlap with ADHD.

One of the issues that are apparent in the case scenario is that the patient is presenting with conduct disorder that is characterized by repetitive and persistent oppositional and dissocial disorder. The hyper state that has been reported is attributed to the fact that Aliyah is showing signs of negativistic, hostile, and aggression behavior and possibly demonstrating a violation of the basic rights of those around them (Albrecht, Uebel-von Sandersleben, Gevensleben, & Rothenberger, 2015). It is possible that other disorders are occurring concurrently, there are situations that one may antecede later in development. For Aliyah’s case, however, the condition is under the initial strategies where the child is showing impaired stress reactivity. They are thus less likely to respond to punishment that could be manifested by the lack of focus in school because of the interplay of sympathetic and parasympathetic branches for the regulation of arousal. The under arousal results in low energy generation with the complication of low serotoninergic activity and monoamine-oxidases likely leading to aggression (Albrecht et al., 2015). The information and pathophysiology processes will be apparent through carrying out individual research to understand the condition better.

It is clear that Aliyah has been diagnosed with ADHD but from the indications of the pediatrician, there is a need for further testing of the patient. The primary reason for carrying out more the testing procedures for the girl is that a clinical evaluation is critical. It is likely that the method used by the pediatrician was based on the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV) that necessitates that all screening-positive children be informed about the need for further testing (American Academy of Pediatrics, 2011). The reason for the sadness associated with the filing of the questionnaires designed for the clinical evaluation process is that the questions asked were personal and linked to the violent behavior. Usually, the questions asked include the possibility of the child showing anxiety, depression, hallucination, unusual thinking patterns, gross and fine motor skills coordination difficulties, and many other disturbing questions (Skounti, Mpitzaraki, Philalithis, & Galanakis, 2009). The reason for the sadness following the request for covering all the disorders was because the parent would usually be required to fill the Child-Behavior Checklist to determine the chances of other diseases being imminent. Among the issues that are usually asked include the evaluation of the child domains of the child’s psychopathology, the affective disorders, oppositional deficient disorder, and the possibility of somatic and conduct problems. The requirement that the parent fills out whether it is true Aliyah was suffering from any of those could have resulted in sadness because while it is likely that the parent was not aware of the child state, there was a chance that they could be suffering from an additional disorder (Skounti et al., 2009).

It is also important to identify the risk factors that are associated with the manifestation of the disease. Apparently, that scientists have not established what is the cause of ADHD and like many other diseases, it is possible that Aliyah’s condition is as a result of a variety of factors. Some of the identified risk factors that are associated with the disease include the genetic predisposition, which necessitates the need to question the parent of the need to carry out genetic testing. It is also important to question the possibility of the child growing up in a cigarette-smoking environment or the chance that the mother was involved in drug abuse drugs pregnancy (Centers for Disease Control and Prevention, 2017). Furthermore, the child could have been exposed to environmental toxins such as toxins during pregnancy or exposed to high amount of lead. The other critical concern in the assessment of Aliyah’s condition is the possibility of brain injuries being responsible for the disease. It is critical to discuss with the parent that while boys are more likely to have ADHD, females are more likely to have problems with inattention related to the disease. It is thus important to underscore the fact that the risk factors have to be identified and the patient assisted in identifying the other likely problems from inattention.

A key reason for the parent’s desire to share Aliyah’s story was the recipient of the letter to get feedback about the diagnosis, and assuming they could have been in a similar situation, discuss the possible treatment plans. Psychotherapy is a major factor in enabling the child to cope with the problems associated with the condition and that could be a pivotal aspect in the issuance of feedback related to the disease symptoms. According to the National Institute of Mental Health (2016), the inclusion of psychotherapy is likely to help patients and their associated families to better cope with the everyday problems associated with ADHD. Behavioral therapy is the type of treatment that serves to ensure that the person would change their behavior and in Aliyah’s case, it could involve practical assistance such as assisting them in completing their schoolwork. Aliyah would have to be trained on the techniques that they can use to monitor their low behavior and give them praise when they act in a preferred manner such as controlling their rage. Just as the parent would be seeking the feedback from her friend pertaining Aliyah’s case, it would be imperative to consider the need for positive and negative feedback from the parents and teachers as well. The input from such parties can help the patient to control her behavior and also learn about social skills. The behavioral therapy could further include the teaching Aliyah the need for mindfulness and meditation so that the patient learns about the techniques that they could use to improve focus and concentration and end up adjusting to the treatment mechanism (National Institute of Mental Health, 2016).

The other major issue that is apparent in the case scenario is that it is critical that the patient is diagnosed, possible after the parent does some balancing of the benefits and the drawbacks of carrying out the diagnostic procedures. Apparently, it is established that many psychiatric conditions do not have a cure and it could be the primary discouraging factor a diagnosis. In fact, the realization that there is a chance that one’s condition could worsen or improve without diagnosis and treatment would create a further dilemma as to whether it is necessary to carry out the diagnosis of the disease (Child Mind Institute, 2017). The uncertainty is usually more common with a psychiatric condition as compared to the physical disorders. Furthermore, the label of having a child who has a mental condition could be a huge demotivating factor for the parent. However, the realization that preventing the opportunity for a diagnosis could be placing others at risk of uncontrolled anger from the patient, the need for a diagnosis was apparent, hence the step that the parent took for Aliyah. Thus, from weighing the benefits and the adverse effects, it became necessary to consider the need for a diagnosis.

It is also critical to outline that among the key issues that are involved in the case will be the need for ensuring that Aliyah is able to relate better and improve her performance at school. It was thus mean that the classroom setting is made to be a conducive environment for the patient so that she can thrive and concentrate better. It is suggested that in such conditions, the teacher’s perspective would play a huge role in the success of the intervention that will be implemented. The teacher would thus have to mobilize other educational stakeholders to ensure that the patient is as close to them as possible even when their personal security is threatened. It is also essential to encourage the affected student to sit at the front of the class to minimize the possibility of distraction by other students. The teacher should also ensure that those who sit next to Aliyah are quiet and hard working to motivate her to focus on her studies. Through the implementation of these techniques, it will be possible to warrant that Aliyah will thrive in the learning environment (Murdoch Childrens Research Institute, 2015).

Thus, when issuing feedback to the parent, it is also vital to cover the need for her to seek an intervention from a health facility to help in managing the condition. Parents would have to be involved in the behavioral therapy process through training from a healthcare provider (Centers for Disease Control and Prevention, 2017). Medications would also have to be provided to Aliyah though it has since been identified that there is a chance for side effects from the medication. Awareness and observation for signs of sleep problems, tics, a decrease in appetite, delayed growth, moodiness and irritability and headaches are enough to warrant that the child is experiencing side effects associated with medication (Child Mind Institute, 2017). In any of this cases, it will be important to consult the advice of the physician on the development and the appropriate course of action.

In summary, the case of Aliyah is one of the many that presents a variety of cases that need to be addressed amicably. Through the analysis of literature, it will be possible for the parent to understand the condition affecting the child and the need for the correct diagnosis. There is also a chance that there are other disorders complicating the primary condition and all have to be factored. The treatments patterns could involve both behavioral therapy, classroom interventions and medication, but a close attention needs to be paid to the occurrence of side effects.

References

Albrecht, B., Uebel-von Sandersleben, H., Gevensleben, H., & Rothenberger, A. (2015). Pathophysiology of ADHD and associated problems — Starting points for NF interventions? Frontiers in Human Neuroscience, 9, 359. http://doi.org/10.3389/fnhum.2015.00359

American Academy of Pediatrics. (2011). ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 128(5), 1007–1022. http://doi.org/10.1542/peds.2011-2654

Centers for Disease Control and Prevention. (2017). Attention-Deficit / Hyperactivity Disorder (ADHD). CDC. Retrieved from https://www.cdc.gov/ncbddd/adhd/treatment.html

Child Mind Institute. (2017). Side Effects of ADHD medication. Child Mind Institute, Inc. Retrieved from https://childmind.org/article/side-effects-of-adhd-medication/

Murdoch Childrens Research Institute. (2015). Tips for managing ADHD in the classroom. The Children’s Attention Project. Retrieved from http://www.education.vic.gov.au/Documents/school/principals/participation/tipsmanagingadhdinclass.pdf

National Institute of Mental Health. (2016). Attention Deficit Hyperactivity Disorder. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

Skounti, M., Mpitzaraki, K., Philalithis, A., & Galanakis, E. (2009). Clinical evaluation of children testing positive in screening tests for Attention-Deficit/Hyperactivity. Eur. J. Psychiat, 23(2), 115–120. Retrieved from https://www.google.co.in/#sclient=psy-ab&hl=en&site=&source=hp&q=Clinical+evaluation+of+children+testing+positive+in+screening+tests+for+attention-deficit%2Fhyperactivity+&oq=Clinical+evaluation+of+children+testing+positive+in+screening+tests+for+attention-deficit%2Fhyperactivity+&aq=f&aqi=&aql=&gs_l=hp.12...1086.1086.0.2456.1.1.0.0.0.0.0.0..0.0.crf0..0.1.Zzm_EesjiEg&pbx=1&bav=on.2,or.r_gc.r_pw.,cf.osb&fp=3942bf17b4ee91c1&biw=1366&bih=648

Vrijen, C., Hartman, C. A., Lodder, G. M. A., Verhagen, M., de Jonge, P., & Oldehinkel, A. J. (2016). Lower Sensitivity to happy and angry facial emotions in young adults with psychiatric problems. Frontiers in Psychology, 7, 1797. http://doi.org/10.3389/fpsyg.2016.01797