Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD) is a situation that becomes apparent in some children in the preschool and early school years. ADHD is hard for these children to control their behavior and pay attention. It is estimated that between 3 to 5 percent of children have a disorder characterized by consistent inattention, hyperactivity, and impulsiveness. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.

ADHD was previously considered to be a neurological disorder, which usually shows up during the early childhood years. Children with ADHD find themselves unable to control their behavior and not able to close attention to lot of things.

All children cannot stay put at times. All may be inattentive and fantasize to pass the time away or may act without thinking at times, but when the child's hyperactivity, inattentiveness, poor concentration or impulsiveness start to negatively affect his performance in school, his demeanor at home or interfere with his relationship with other children, the presence of ADHD may be considered.

There are three types of ADHD based on the primary symptoms exhibited by an individual.

Hyperactivity-Impulsivity
Hyperactive children always seem to be constantly in motion. They dash around touching or playing with whatever is in sight, or talk incessantly. Sitting still at dinner or during a school lesson or story can be a difficult task. They squirm and fidget in their seats or roam around the room. Or they may wiggle their feet, touch everything, or noisily tap their pencil. Hyperactive teenagers or adults may feel internally restless. They often report needing to stay busy and may try to do several things at once.

Impulsive children seem unable to curb their immediate reactions or think before they act. They will often blurt out inappropriate comments, display their emotions without restraint, and act without regard for the later consequences of their conduct. Their impulsivity may make it hard for them to wait for things they want or to take their turn in games. They may grab a toy from another child or hit when they're upset. Even as teenagers or adults, they may impulsively choose to do things that have an immediate but small payoff rather than engage in activities that may take more effort yet provide much greater but delayed rewards.

Inattention
Children who are inattentive have a hard time keeping their minds on any one thing and may get bored with a task after only a few minutes. If they are doing something they really enjoy, they have no trouble paying attention. But focusing deliberate, conscious attention to organizing and completing a task or learning something new is difficult.

Homework is particularly hard for these children. They will forget to write down an assignment, or leave it at school. They will forget to bring a book home, or bring the wrong one. The homework, if finally finished, is full of errors and erasures. Homework is often accompanied by frustration for both parent and child.

The third type is combined type. These children display symptoms of the two earlier types.

Because all children may exhibit some of the symptoms stated above such as hyperactivity, inattentiveness and impulsiveness at times, strict guidelines have been set for diagnosing the disorder. Among the requirements for determining whether the symptoms indicate ADHD.

Symptoms of ADHD
The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child's life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.

Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child's self-control. A child who "can't sit still" or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a "discipline problem," while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, and sometimes daydream the time away. When the child's hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.

The symptoms of ADHD fall into the following two broad categories

Inattention

Failure to pay close attention to details or making careless mistakes when doing schoolwork or other activities

Trouble keeping attention focused during play or tasks

Appearing not to listen when spoken to

Failure to follow instructions or finish tasks

Avoiding tasks that require a high amount of mental effort and organization, such as school projects

Frequently losing items required to facilitate tasks or activities, such as school supplies

Excessive distractibility

Forgetfulness

Procrastination inability to begin an activity

Difficulties with household activities.

Difficulty falling asleep, may be due to too many thoughts at night

Frequent emotional outbursts

Easily frustrated

Easily distracted

Hyperactivity-impulsive behaviour

Fidgeting with hands or feet or squirming in seat

Leaving seat often, even when inappropriate

Running or climbing at inappropriate times

Difficulty in quiet play

Frequently feeling restless

Excessive speech

Answering a question before the speaker has finished

Failure to await one's turn

Interrupting the activities of others at inappropriate times

Impulsive spending, leading to financial difficulties

Causes of ADHD
There is little compelling evidence at this time that ADHD can arise purely from social factors or child-rearing methods. Most substantiated causes appear to fall in the realm of neurobiology and genetics. This is not to say that environmental factors may not influence the severity of the disorder, and especially the degree of impairment and suffering the child may experience, but that such factors do not seem to give rise to the condition by themselves.

The parents' focus should be on looking forward and finding the best possible way to help their child. Scientists are studying causes in an effort to identify better ways to treat, and perhaps someday, to prevent ADHD. They are finding more and more evidence that ADHD does not stem from the home environment, but from biological causes. Knowing this can remove a huge burden of guilt from parents who might blame themselves for their child's behavior.

Over the last few decades, scientists have come up with possible theories about what causes ADHD. Some of these theories have led to dead ends, some to exciting new avenues of investigation.

Environmental Agents Causes
Studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and risk for ADHD in the offspring of that pregnancy. As a precaution, it is best during pregnancy to refrain from both cigarette and alcohol use.

Another environmental agent that may be associated with a higher risk of ADHD is high levels of lead in the bodies of young preschool children. Since lead is no longer allowed in paint and is usually found only in older buildings, exposure to toxic levels is not as prevalent as it once was. Children who live in old buildings in which lead still exists in the plumbing or in lead paint that has been painted over may be at risk.

Brain Injury Causes

One early theory was that attention disorders were caused by brain injury. Some children who have suffered accidents leading to brain injury may show some signs of behavior similar to that of ADHD, but only a small percentage of children with ADHD have been found to have suffered a traumatic brain injury.

Food Additives and Sugar Causes

It has been suggested that attention disorders are caused by refined sugar or food additives, or that symptoms of ADHD are exacerbated by sugar or food additives. In 1982, the National Institutes of Health held a scientific consensus conference to discuss this issue. It was found that diet restrictions helped about 5 percent of children with ADHD, mostly young children who had food allergies. A more recent study on the effect of sugar on children, using sugar one day and a sugar substitute on alternate days, without parents, staff, or children knowing which substance was being used, showed no significant effects of the sugar on behavior or learning.

In another study, children whose mothers felt they were sugar-sensitive were given aspartame as a substitute for sugar. Half the mothers were told their children were given sugar, half that their children were given aspartame. The mothers who thought their children had received sugar rated them as more hyperactive than the other children and were more critical of their behavior.

Genetics Causes
Attention disorders often run in families, so there are likely to be genetic influences. Studies indicate that 25 percent of the close relatives in the families of ADHD children also have ADHD, whereas the rate is about 5 percent in the general population. Many studies of twins now show that a strong genetic influence exists in the disorder.

Researchers continue to study the genetic contribution to ADHD and to identify the genes that cause a person to be susceptible to ADHD. Since its inception in 1999, the Attention-Deficit Hyperactivity Disorder Molecular Genetics Network has served as a way for researchers to share findings regarding possible genetic influences on ADHD.

Applied Behavioral Analysis

Applied Behavioral Analysis (ABA)

Applied Behavioral Analysis (ABA) is the oldest and most fully researched treatment specifically developed for autism. ABA is a very intensive system of reward-based training, which focuses on teaching particular skills. If any autism-specific therapy is offered by your school and/or covered by your insurance, this will probably be the one.

Speech Therapy

Almost all people with autism have issues with speech and language. Sometimes these issues are obvious; many people with autism are non-verbal or use speech very poorly. Sometimes the issues relate not to articulation or grammar but to "speech pragmatics" (the use of speech to build social relationships). Across the board, though, speech and language therapy is likely to be helpful for people with autism.

Occupational Therapy

Occupational therapy focuses on building daily living skills. Since many people with autism have delays in fine motor skills, occupational therapy can be very important. Occupational therapists may also have training in sensory integration therapy - technique which may help autistic people manage hypersensitivity to sound, light, and touch.

Social Skills Therapy

One of autism's "core deficits" is a lack of social and communication skills. Many children with autism need help in building the skills they need to hold a conversation, connect with a new friend, or even navigate the playground. Social skills therapists can help out setting up and facilitating peer-based social interaction.

Physical Therapy

Autism is a "pervasive developmental delay." Many autistic people have gross motor delays, and some have low muscle tone (they're unusually weak). Physical therapy can build up strength, coordination, and basic sports skills.

Play Therapy

Strange as it may sound, children with autism need help learning to play. And play can also serve as a tool for building speech, communication, and social skills. Play therapists may have training in particular therapeutic techniques such as Floor time or The Play Project - or they may incorporate play therapy into speech, occupational or physical therapy.

Behavior Therapy

Children with autism are often frustrated. They are misunderstood, have a tough time communicating their needs, suffer from hypersensitivities to sound, light and touch ... no wonder they sometimes act out! Behavior therapists are trained to figure out just what lies behind negative behaviors, and to recommend changes to the environment and routines to improve behavior.

Developmental Therapies

Floor time, Son-rise, and Relationship Development Intervention (RDI) are all considered to be "developmental treatments." This means that they build from a child's own interests, strengths and developmental level to increase emotional, social and intellectual abilities. Developmental therapies are often contrasted to behavioral therapies, which are best used to teach specific skills such as shoe tying, tooth brushing, etc.

Visually Based Therapies

Many people with autism are visual thinkers. Some do very well with picture-based communication systems such as PECS (Picture Exchange Communication). Video modeling, video games and electronic communication systems also tap into autistic people's visual strength to build skills and communication.

Biomedical Therapies

Biomedical treatments may include pharmaceuticals, but most often biomedical treatments for autism are based on the DAN approach to autism therapy. Doctors trained in the DAN, "protocol" is likely to prescribe special diets, supplements, and alternative treatments. The FDA or CDC has approved none of these treatments, but there are many anecdotal stories of positive outcomes.

Autism

Autism is a behavior disorder, characterized by impairment in social communication, social interaction, and social imagination. Those with autism often have a restricted range of interests and display repetitive behaviors and mannerisms, along with altered reactions to the everyday environment. Autism is a lifelong developmental disability that affects the way a person communicates and relates to people around them. Children and adults with autism are unable to relate to others in a socially meaningful way.

Different people with autism can have very different symptoms. Health care providers think of autism as a “spectrum” disorder, a group of disorders with similar features. One person may have mild symptoms, while another may have serious symptoms. But they both have an autism spectrum disorder. It is well known that autism occurs in differing degrees of severity and in a variety of forms. The term's Spectrum and Continuum of disorders are commonly used to group people together that have a shared difficulty in making sense of the world.

Their ability to develop friendships is impaired, as is their capacity to understand other people's feelings. People with autism can often have accompanying learning disabilities. There is also a condition called Asperger's syndrome, which many experts - but by no means all - believe falls at the higher-functioning end of the autistic spectrum. All people with autism have impairments in social interaction, social communication and imagination.

This is referred to as the triad of impairments, Social interaction like difficulty with social relationships means appearing aloof and indifferent to other people. Then Social communication like difficulty with verbal and non-verbal communication that means not really under-standing the meaning of gestures, facial expressions or tone of voice and Flexibility in thinking and behaving like difficulty in the development of play and imagination that means having a limited range of imaginative activities, possibly copied and pursued rigidly and repetitively.

Dyspraxia Learning Disability

Dyspraxia
Dyspraxia is refers to difficulties with coordination and the organization of movements. People with Dyspraxia have difficulty planning and completing intended fine motor tasks. It is estimated that as many as 6% of all children show some signs of Dyspraxia, and in the general population, about 70% of those affected by Dyspraxia are male. They have particular difficulties with complex tasks that require a high level of coordination.

The term dyspraxia in the Greek "dys" means bad and "praxis", means action .Dyspraxia is usually apparent in childhood that manifests as difficulty in thinking out, planning out, and executing planned movements or tasks. Dyspraxia can affect different areas of functioning, varying from simple motor tasks such as waving goodbye to more complex tasks like brushing teeth.


The Dyspraxia younger persons will have delayed motor milestones such as crawling, walking, and jumping. Older persons may present with academic problems such as difficulty with reading and writing or with playing ball games.

Developmental verbal Dyspraxia (DVD), a type of Dyspraxia, can manifest as early as infancy with feeding problems. Children with DVD may display delays in expressive language, difficulty in producing speech, reduced intelligibility of speech, and inconsistent production of familiar words.


Symptoms of Dyspraxia

· poor balance and coordination

    vision problems
    perceptual problems
    poor spatial awareness
    poor posture
    poor short-term memory
    difficulty planning motor tasks
    difficulty with reading, writing, and speech
    emotional and behavioral problems
    poor social skills

Oral Dyspraxia

Oral Dyspraxia is a difficulty with planning and executing non-speech sounds, such as blowing, sucking or individual tongue and lip movements. This may indirectly affect speech and swallowing skills.

Verbal Dyspraxia

Verbal Dyspraxia is a speech disorder that affects the programming, sequencing and initiating of movements required to make speech sounds.

Motor Dyspraxia

Motor Dyspraxia is a difficulty in planning, sequencing and then executing the correct movement to perform age appropriate skills in a smooth and coordinated manner at will or on command.

Dyspraxia Diagnosis

The diagnosis of Dyspraxia is based on observation of a person’s symptom and on results of standardized tests. Findings from a neurological or neurodevelopment evaluation may also be used to confirm a suspected diagnosis. The process of making a diagnosis of Dyspraxia can be complex for a number of reasons. Dyspraxia may affect many different body functions, it can occur as a part of another syndrome, and symptoms of Dyspraxia overlap with similar disorders such as dyslexia.

There is no cure to Dyspraxia, however early intervention can help a person learn to deal with his or her difficulties. Depending on the severity of the disability, work with occupational, speech and physical therapists can greatly improve a person's ability to function and succeed independently.

Beginning at an early age, it is vital that parents offer their child patience and encouragement. It can be very frustrating to have difficulty communicating or moving, and a parent can ease that frustration by offering help and support in overcoming these difficulties.

All people with Dyspraxia need help practicing simple tasks and can benefit from step-by-step progress into more complex activities. Encouraging easy physical activities that develop coordination can increase confidence. It is also important to encourage friendships to broaden a person's experience and understanding of social relationships.

Dysphasia Learning disabilities

Dysphasia Learning disabilities

Dysphasia is an inability to associate meaning with words. Receptive dysphasia indicates a disorder in understanding spoken language. Expressive dysphasia is a disorder in using language for effective oral communication

Dysphasia is a speech disorder in which there is an impairment of speech and of comprehension of speech.The term dysphasia has been eclipsed by the modern usage of the term aphasia. The term of word Dysphasia comes from the Greek.It is caused by brain damage, usually in the left side of the brain which is responsible for language and communication.

Dysphasia has been eclipsed by the modern usage of the term "aphasia" particularly in the field of speech and language pathology so as not to confuse with the swallowing disorder dysphagia. Aphasia literally means no speech. But the speech impairment in aphasia could range from complete absence of speech to difficulty in naming a few objects.

Aphasia has been the focus of scientific study only since the mid-nineteenth century. Although aphasia can be caused by a head injury and neurological conditions, a disruption of blood flow to the brain, which affects brain metabolism in localized areas of the brain. The onset of aphasia is usually abrupt, and occurs in individuals who have had no previous speech and language problems.

Aphasia is at its most severe immediately after the event that causes it. Although its severity commonly diminishes over time through both natural, spontaneous recovery from brain damage and from clinical intervention, individuals who remain aphasic for two or three months after its onset are likely to have some residual aphasia for the rest of their lives. The severity of aphasia is related to a number of factors, including the severity of the condition that brought it about, general overall health, age at onset, and numerous personal characteristics that relate to motivation.

Symptoms of Dysphasia

Has difficulty gaining meaning from spoken language

Demonstrates poor written output

Exhibits poor reading comprehension

Shows difficulty expressing thoughts in verbal form

Has difficulty labeling objects or recognizing labels

Is often frustrated by having a lot to say and no way to say it

Feels that words are “right on the tip of my tongue”

Can describe an object and draw it, but can’t think of the word for it

May be depressed or having feelings of sadness

Has difficulty getting jokes

Global Aphasia

The symptoms of global aphasia are those of severe clinical neuropsychology and cognitive neuropsychology combined. There is an almost total reduction of all aspects of spoken and written language, in expression as well as comprehension. Improvement may occur in one or both areas over time with rehabilitation.

Wernicke's Aphasia

Wernicke's aphasia in clinical neuropsychology and cognitive neuropsychology, is a type of aphasia often caused by neurological damage to Wernicke's area in the brain. This is not to be confused with Wernicke's encephalopathy or the Wernicke-Korsakoff syndrome. If Wernicke's area is damaged in the non-dominant hemisphere, the syndrome resulting will be sensory dysprosody - the lack of ability to perceive the pitch, rhythm, and emotional tone of speech.Speech is preserved but language content is incorrect. This may vary from the insertion of a few incorrect or nonexistent words to a profuse outpouring of jargon. Rate, intonation and stress are normal. Substitutions of one word for another are common. Comprehension and repetition are poor.

Broca's aphasia

Broca's aphasia in clinical neuropsychology and agrammatic aphasia in cognitive neuropsychology, is an aphasia caused by damage to anterior regions of the brain, including the left inferior frontal region known as Broca's area.

Sufferers of this form of aphasia exhibit the common problem of agrammatism. For them, speech is difficult to initiate, non-fluent, labored, and halting. Intonation and stress patterns are deficient. Language is reduced to disjointed words and sentence construction is poor, omitting function words and inflections

Conduction aphasia

Conduction aphasia, also called associative aphasia, is a relatively rare form of aphasia, thought to be caused by a disruption in the fiber pathways connecting Wernicke's and Broca's areas. The arcuate fasciculus has previously been implicated as this fiber bundle, however more recent evidence suggests that the extreme capsule connects Wernicke's and Broca's areas

Transcortical Sensory Aphasia

Transcortical Sensory Aphasia, or TSA, is a type of Aphasia where sufferers have poor comprehension, but have fluent, grammatical speech. Patients can communicate well and are capable of good repetition. The main problem lies within the brain in a region known as the Temporal-occipital-parietal junction, located behind Wernicke's area. This disruption causes TSA sufferers to have Semantic paraphasia wherein aphasics do not use the correct word, but use another word of similar content . Lesions of the left posterior temporo-occipital lobe associated.

Transcortical Motor Aphasia

Transcortical Motor Aphasia (TMA) results from an injury to the anterior superior frontal lobe. The injury is typically caused by a cerebrovascular accident (CVA), commonly referred to as a stroke. The area of insult is sometimes referred to as a watershed region, a region surrounding Broca's area. The insult typically involves the left hemisphere as most people are left hemisphere dominant for language.

Diagnosis Dysphasia

As an aid to accurate diagnoses immediately following stroke, it is important to differentiate aphasia from cognitive disorders such as confusion and disorientation. To this end, brief, but general testing of the language functions can be incorporated into broader testing that might determine other cognitive functions. Evaluators must remember that language is the medium though which most of these other functions are observed. Therefore, language should be assessed first; if extensive aphasia is present, then only cautious interpretations of other cognitive functions may be given. At present, there are few available objective and standardized measures for testing during the acute phases of disorders such as stroke.

A number of standardized measures are available that provide an inventory of aphasic symptoms. These tests are useful in providing baseline and follow-up assessments to measure progress in treatment, as well as to guide the treatment itself. A fairly general feature of aphasia tests is that individuals without aphasic symptoms should perform with almost no errors on them. Tests are available to measure the extent and severity of language impairments as well as to provide information about functional skills and outcomes. Finally, there are assessments designed specifically to look at quality of life with aphasia.