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Attention deficit Hyperactivity disorder (ADHD) is a central nervous disorder with a childhood onset and has both cognitive and behavioral consequences (American psychiatric association, 2008). The prevalence of ADHD is estimated to be occurring in 3% to 7% of school age children (American psychiatric association, 2008). People experiencing ADHD experiences chronic problems with hyperactivity-impulsivity and/ or inattention. The condition is life span disorder and affects children as well as adults. ADHD is multietiological condition and therefore the diagnosis of children with ADHD is a multifaceted process (Mace & Prager, 2009). The symptoms associated with ADHD can also be exhibited by children with biological and psychological symptoms. Treatment of people diagnosed with ADHD cannot be underestimated. Currently, treatment of ADHD includes stimulant medication and behavioral therapy. The latter involves the use of contingency paradigms such as reward (R) and response costs (RC) (Ghanizadeh & Haghigi, 2010). Combined approaches in treatment of ADHD are more superior than either method administered alone. The comprehensive ADHD treatment is referred to as "Multimodial" and requires behavioral, psychological, educational and medical intervention (American psychiatric Association, 2008).
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Statement of the problem
As stated earlier comprehensive ADHD treatment requires the use of combined approaches in order to achieve the desired effects. However there has been contradicting literature regarding the effectiveness of medication in the treatment of ADHD. Stimulant medication is reported to have restrictive effect on the child's emotional expression. This type of side effect has been referred to as personality blunting whereby the child does not feel like himself/herself. There are non-stimulant medications such as atomoxetine which are also used for treatment of ADHD (Rubiner, 2009). Stimulant medication is widely used while non-stimulant medication is usually used where there are significant side-effects in response to stimulant medication are realized in a patient under medication (Rubiner, 2009). There have been contradicting reports regarding the benefits arising from the use of stimulant and non stimulant medication among patients experiencing ADHD. Therefore it is important to establish the benefits that arise from the use of medication for the treatment of ADHD. There is also need to establish the best possible combination of treatment of ADHD among school going children (Perwein et al 2008). The use of medical intervention is considered to be more effective if applied in combination with other interventions.
Attention deficit disorder is a psychiatric disorder that is common in children and adolescents characterized by inattentiveness, hyperactivity and impulsivity (Ghanizadeh and Hagigh, 2010).Emotional dis-regulation is an important aspect of ADHD. In fact most of the children who have been referred to child psychiatry as a result of display of intolerable aggressive behavior. In addition to this children with ADHD are antisocial, have a low self esteem and do not perform well in their academics. These children may further engage in criminal behavior. Therefore treatment is quite necessary in ensuring that these children are able to secure a desirable future, as earlier explained the management of ADHD is best done through a comprehensive approach which involves the use of medical, psychological and behavioral interventions. This research however targets the use of medication in the management of ADHD.
Stimulant and non stimulant medication is used in the management of ADHD. Both types of medication have been used successfully in the management of ADHD. However psycho-stimulant medication is more widely used in the treatment of ADHD. It is estimated that around 70-80% of children experiencing ADHD respond positively to psychostimulant medications (Castle et al, 2007). The response usually depends on the individual with some experiencing extraordinary improvements while others display modest changes. The use of medication in controlled environments ensures that improvements are realized quite easily.
Medicine alone is a proven treatment for ADHD among children however its use and application is much more enhanced by use in combination with other interventions (Castle et al 2007). As mentioned earlier stimulant medication is commonly used for treatment of ADHD while non-stimulant medication is used by those people who want to avoid stimulant medication probably due to possible side-effects. The FDA has approved atomoxetine commonly referred to as strattera a no-stimulant medication to be used in treatment of ADHD. Most types of ADHD medication have side effects which differ with the individual. All side effects resulting from the use of medication for the treatment of ADHD should be reported to the doctor. Stimulant medication acts either through blocking re-absorption of dopamine and norepinephrine or increase in release of these chemicals (Waltkins, 2002). This increases the sensitivity of neurons and work on different mechanisms.
Generally stimulants seem to have the desired effect of decreased inattention, impulsivity, flexibility and over-activity (Waltkins, 2002) Stimulants are known to remedy daytime sleepiness associated with narcolepsy, anti-depressant energizing. The effects of stimulant medication can be dramatic; a child experiencing ADHD can show dramatic improvement to the extent that these children cannot be differentiated from the other normal children (Perwein et al, 2008). Associated disruptive behavior even where the child was violent has shown tremendous progress. The effects generated by the stimulant medication are almost immediate and parents and teachers may notice improvements right away. The use of non-stimulant medication such a stratera also known as atomoxetine is relatively important to those individuals with side effects to non stimulants. In addition the stimulant is a good medication to antidepressants and blood pressure medication.
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Although, medication in itself may be effective and sufficient for the treatment of ADHD, other types of intervention will come in handy in ensuring that children experiencing ADHD recover fully (Mace & Prager, 2009). The most commonly used stimulant medication are of two types these are the Methylpheidate and Amphetamines. The most commonly used amphetamines include Dexedrine and Adderall, Methylphenidate drugs include Focalin, Ritalin and Concerta (Waltkins, 2002). These are short acting drugs and their effects can be seen within a short time as opposed to non-stimulant medication which could take long before the effects are realized. Short acting drugs can be discontinued as other types of interventions are applied (Mace & Prager, 2009). In other cases both of these medications will not work, in such cases doctors may prescribe a non -narcotic antidepressant which could also lead to almost similar results. However, this is not common because most physicians will encourage caregivers, teachers and those around the patients to initiate other intervention which could also result to improvements.
Hypothesis: Students who have ADHD and are using medication will have higher grades on their report cards than students who have ADHD and are not using medication.