Attention Deficit Hyperactivity Disorder: A case study of child with attention deficit hyperactive disorder
Attention deficit
hyperactive disorder is a neurodevelopmental disorder that interferes with the
functioning and development that causes hyperactive and impulsive behavior as
persisted by symptoms of inattention, hyperactivity, or impulsivity.
The onset of ADHD is the child's
developmental period; ADHD begins in childhood and often lasts in adulthood.
Most children exhibit symptoms of ADHD before the age of 7, but few of them
remain undiagnosed until adulthood.
According to the survey,
in many cultures, the percentage of ADHD in children is about 5%, and in
adults, it is about 2.5%. This disorder seems to be present more in males than
females, with a ratio of 2:1 in children and 1.6:1 in adults.
The etiology of
ADHD can be characterized as follow:
·
Problem in brain anatomy
and dysfunction of the brain
·
It can also be passed
down through genes (inherited)
·
Significant head injuries
·
If the child had a
premature birth
·
If the parents have
exposure to drugs or toxins
The symptoms of ADHD can be classified into three categories as follow:
Case History
The client was a four years old boy. The client’s mother had C-section without complications. It was reported that the client’s mother was having a deficiency of blood in the 6th month of pregnancy. The client’s first cry was not delayed. His developmental milestones were not too delayed. He started neck holding at the age of 5 months. At the age of 7-8 months, he started sitting without support. He started crawling at the age of 8 months. The client started standing at the age of 12 months. At the age of 15 months, he started standing with support. He was not able to speak yet; however, he produced sounds and tried to make a one-word speech. The client had pneumonia at the age of 6 months. The doctor made him inhale medicine through an oxygen mask for one month. The client’s parents started noticing the problematic behavior at the age of 2.5 years. The client’s family assumed that he was unable to hear; for confirmation, they visited a doctor for a checkup of the client’s sense of hearing at the age of 3 years.
It was reported that he had no problem with his sense of hearing. For further assurance, the client’s parents brought him to another hospital, and there client had a Bella test to check the overall functioning of the client’s ear. It was reported that the result of this test was 100% positive. At the age of 3.5 years, the client was having tympanometry to examine the eardrum's functioning, and the result of this test was also positive. At the age of 3 years and ten months, the client was having regular speech therapy sessions for four days. The speech therapist recommended psychotherapy for the client. Then they consulted a psychiatrist; he recommended medicine for ADHD to the client. The client was taking medicines for 1.5 months. He took syrup for one month for the deficiency of iron. He used gestures to inform about the toilet. He liked to play with soap, keys, water, and cycling. He had no significant dislikes. He used to wear the same clothes for weeks or one month if he liked them. He used to eat the same kind of food for 2 or 3 days if he liked it. The client had some friends; he was more attached with two friends and mostly played with two of them. At the age of the sixth month, he watched many cartoons, mostly Jan cartoons on the laptop, for 2.5 years. Now he had less interest in watching cartoons on the laptop.
Family history
The client belonged to a middle-class family and had a joint family system. His father was 37 years old; by nature, he was humble and calm; for the client, he was playing a very supportive character and had a loving relationship with the client. The client was more attached to his father.
The client’s mother was 36 years old; she was also humble and calm but became aggressive in some situations; for the client, she was loving, caring, and supportive; however, she sometimes scolded the client.
The client had one younger brother. The client tried to take care of his brother and support him, but when his brother played with his father, the client got jealous and wanted his father’s attention. The client had a loving relationship with his grandfather.
Educational history
The client had admission to the normal schooling system where he stayed for 1.5 months, his mother accompanying him during school time. The client had no good relation with teachers (as they were busy with other students) and classmates. He just played there with bikes and cars, and whenever other students tried playing with the car, the client beat them, due to which he had no friends in the school.
Physical illness
The client had no physical illness; however, his developmental milestones were a little bit delayed.
Premorbid personality
According to the client’s parents, they started noticing the problematic behavior at the age of 2.5 years, and before that, the client was showing normal reflexes and had good senses. The client had normal behavior as other children of his age.
This is the case study of a four years old child and diagnosed with ADHD. The client belonged to a middle-class family and had a joint family system. The client had a healthy relationship with his family member; however, he sometimes got jealous of his younger brother. The client had admission to the normal schooling system, where he stayed for 1.5 months, but he left school due to his problematic behavior. The client had no physical illness; however, his developmental milestones were a little bit delayed. It was reported that the client started showing problematic behavior after the age of 2.5 years. He had an interest in laptops and cartoons.
According to
recent research, there is an association between maternal anemia during
pregnancy and ADHD (Wiegersma et al., 2019), as
in this case, the mother the client was having anemia in the 6th month of her
pregnancy.
The
precipitating factors that activate the problem are infection in infancy,
increased exposure to screen, and delayed milestones. In research, the
association between screen time and inattention was examined, and it was found
that there is a clear association between the two factors, increased screen
time causes more inattention problems (Tamana, Ezeugwu, Chikuma et al., 2019). In a study, the association of screen time
with attention and hyperactivity was investigated, and it was reported that
there is a dose-dependent relationship of screen time with attention and
hyperactivity (Montagni et al., 2016). A study was conducted to
investigate the effect of parental age and developmental milestones on ADHD,
and it was reported that parental age, developmental delay, and birth-related
variables might impact the severity of ADHD (Maitra & Mukhopadhyay, 2019).
Another research was conducted to determine the association between
streptococcal infection and neuropsychiatric disorder, and the result of the
study confirmed that streptococcal infection is a predictor of neuropsychiatric
disorders (Wang et al., 2016).
ADHD is also
linked with language problems, and language problems can also be a trouble for
the individual; having ADHD and ADHD can also increase language problems. A
study was conducted to measure the prevalence of language problems in children
with ADHD, and it was found that there was a high prevalence of language
problem in the children having ADHD and this problem cause poor academic
functioning (Sciberras et al., 2014). As in the present case, the language problem is the barrier
to learning. The language problem causes trouble in academics as well as in the
social domain of the individual. ADHD is a type of disorder that leads to
different behavioral problems such as tantrums or stubbornness; as defined
clearly in the definition of ADHD, this disorder causes numerous behavioral
issues. Stubbornness is usually counted as one of the components of ADHD.
ADHD can be
treated in several ways such as medication can be used as well as non-pharmacological
approaches such as behavior management, psycho-education (parent training),
occupational therapy, speech therapy as well as the; parental support also
plays an imperative role in treatment (Pfiffner, & Haack, 2014;
ATTENTION-DEFICIT, & DISORDER, 2011; Zwi et al., 2011).
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