Join the discussion on key conclusions that can be drawn in the fields of education, learning strategies, learning problems, dyslexia, adhd, autism and more.
Through his long experience in these fields Ioannis Tzivanakis reports and considers relevant research news and their implications. With a subscription of his free Newsletter you will receive the newest edition of Research Insights and more.
CONTENTS: 1. The ADHD Spectrum: Causes And Treatment - 2. Theory Of Mind And ADHD - 3. New Studies On ADHD - 3.1 ADHD or mere immaturity? - 3.2 ADHD development in adulthood ... - 3.3 ADHD due to higher or unreasonable requirements? - 3.4 ADHD due to overly critical parents?
It is generally assumed that ADHD is a collective term for a spectrum of "problems". These problems have to do with impulsivity or with a difficulty in controlling behavior, thinking and acting. Furthermore, there are problems caused by a hyperactivity, an excess of energy, accompanied by a major need for movement which deviates from the norm. Nevertheless the opposite can sometimes be the case: hypo activity, an energy level that is lower than necessary for the situation or activity at hand. And last but not least, the 'A' stands for a difficulty in being attentive, or remaining attentive as long as one could... or should be able to!
As to the causes leading to the development of ADHD, there is no clear-cut answer on this issue. Rather, it is assumed that a broad combination of factors must be responsible. These include genetic factors and the under or late development of certain brain regions. For an age-appropriate maturity of the brain, two to three additional development years are required according to recent research findings. Furthermore, an inappropriate operation mechanism, an imbalance in the corresponding neurotransmitter chemistry and a dopamine deficiency are also mentioned.
In such cases, stimulants are prescribed. These are used to increase the amount of dopamine and norepinephrine in the brain as these chemical substances play an important role in thinking and being attentive. Psychotherapy is often used to deal with the everyday problems associated with ADHD. For example behavioral therapy: during which attempts are made to provide the person concerned with practical help in carrying out organizational tasks, whether at school, at home or at work. In cognitive behavioral therapy, mindfulness or meditation techniques are also proposed. Lastly, a more general and comprehensive family therapy is recommended, in which all the family members are taught how to support the person concerned through their use of communication and behavior.
It is recommended to draw-up a timetable for each day: thus creating a recurring structure and routine, including reminders for the tasks to be done, so as to ensure the utmost clarity and stability.
Even if the Theory of Mind (ToM) has been around for a few decades and is already regarded as very significant in the area of autism, by Simon Baron-Cohen and others since the 1980s, the popularity of this theory in understanding and treating ADHD is growing constantly.
Having a theory of the mind means possessing the ability to ascribe to oneself as well as to others, states such as thoughts, feelings, intentions, wishes, plans, hopes, and more. It is the ability to perceive, sense, and understand these states. It is called the “theory” of the mind, as such states are not directly observable.
For example, ADHD children between the ages of 8 and 12 display problematically low levels of executive function. These functions require a higher level of thought and represent the complete development of a theory of mind. (Executive and attentional contributions to Theory of Mind deficit in attention deficit/hyperactivity disorder (ADHD), Child Neuropsychology, 2016; 22(3): 345-65). For example, the ability to plan actions or to control one’s own emotions adequately, to develop working memory, attention control, and cognitive flexibility, the ability to move easily and successfully between different conceptual areas, e.g. between the color, number, size or shape of objects.
It is therefore very important to help people/ children to develop a sufficient theory of the mind by explaining to them and showing them correct behavior.
For example, by asking the person what the consequences or effects of his behavior are on others: "You laughed at him, how would you feel if he had laughed at you?"
In order to encourage the growth of social intelligence, understanding another person’s perspective is vital and should be promoted continuously in the corresponding situations.
A regular review of an ADHD child’s behavioral problems is crucial, as it serves to highlight the successful social interactions of the child, to praise and to establish correct behaviors.
CONCLUSIONS: While a child following a typical development is able to understand and demonstrate correct social behavior, an ADHD child needs specific, accurate and simple instructions. An inadequately developed theory of mind requires support for the development of intrapersonal intelligence, self-awareness and understanding, as well as interpersonal or social intelligence.
ADHD is a complex phenomenon since attention and behavior can be influenced by a multitude of factors within all the dimensions of human being. It would therefore seem advisable and worthwhile to take into account the latest research findings.
3.1 ADHD or mere immaturity?
It is becoming an accepted fact, thanks to recent research findings, that the overall mental development rate of people with ADHD is different or slower. According to Richard Morrow of the British Columbia University in Victoria (Canada), schoolchildren who are too immature mentally for their school class run a higher risk than their classmates of developing ADHD.
In addition, children who are physically old enough for their school class may not have the appropriate mental maturity required for their class level.
In both cases, when enrolling a mentally immature child in school, parents and teachers should ask themselves the following question: What is more important? To start school earlier or on time so that the child finishes at the appropriate age while risking the onset of ADHD and treatment or to take into account the child’s needs allowing him the time necessary to develop which could mean starting school later but with the appropriate mental maturity enabling the correct level of attentiveness, behavior and learning?
3.2 ADHD development in adulthood...
The image often associated with ADHD is one of young children and teenagers, however in many cases ADHD symptoms continue on into adulthood. There is now new evidence that ADHD may arise out of the blue during adulthood.
Researchers from London's King's College found that 70% of the young adults with ADHD, who took part in their study, did not show any symptoms of ADHD during their childhood. This raises questions as to the causes of ADHD development. The causes of ADHD development in adults may differ from those in children.
In the words of Prof. Louise Arseneault: "Our research raises a new light on the development and onset of ADHD, but it generates many questions about ADHD that emerges after childhood. How similar or different is later ADHD compared to ADHD that starts in childhood? How and why does ADHD emerge later? What treatments are most effective for later developing ADHD? These are the questions we should now try to answer. "
3.3 ADHD due to higher or unreasonable requirements?
Jeffrey P. Brosco, professor of clinical pediatrics at the Miller School of Medicine at the University of Miami, states that there may be a potential link between the growing spread of ADHD and higher learning requirements (as compared to learning requirements in the past).
Both the amount of time spent learning in schools and general educational criteria have increased considerably in the last 40 years. At the same time ADHD cases have doubled.
The teaching time for literacy and numeracy skills in children aged from 3 to 5 has seen an increase of 30% between 1981 and 1997. The time young children spend participating in full-day learning programs has increased from 17% to 58% between 1970 and 2000.
A 6-8 year old spent more than 2 hours a week doing homework in 1997. A decade earlier, the corresponding learning time was less than an hour.
"We feel that the academic demands placed on young children are detrimental to some of them. For example, if the kindergarten starts a year earlier, it doubles the likelihood that a child might need medication for behavioral problems." Brosco adds that at such an age, more time should be spent on playing, social relations, and stimulating the imagination.
3.4 ADHD due to overly critical parents?
In another study conducted by Erica Musser, assistant professor at Florida International University, 388 children with ADHD, 127 without ADHD and their families were studied over a three- year period. The researchers involved measured the changes in the children’s ADHD symptoms and the degree of criticism and emotional impact stemming from their parents.
For many ADHD children, the symptoms tend to diminish or even disappear with age. However for some this is not the case. According to the research above, published by the American Psychological Association, a significant reason for this may be that the parents of these children are more critical than others. "The finding here is that children with ADHD, whose parents regularly expressed a high degree of criticism, were less likely to experience a drop in symptoms over time," says Erica Musser.
Only persistent parental criticism seemed to be related to the continuity of ADHD symptoms among ADHD-diagnosed children.