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Depression in Children/ Malnutrition in Early Stage and ADD Children with Attention Deficit Disorder have been known by many different diagnostic names. Most of these emphasize either different aspects of the children’s behavior or different theories of the origin of hyperactivity. Some synonyms for hyperactivity are maturational lag, hyper-kinetic reaction, immaturity of the nervous system, and perceptual-motor problems. Two names for hyperactivity that are often misunderstood by parents are minimal brain dysfunction and minimal cerebral dysfunction. The terms “attention deficit disorder with hyperactivity” and “attention deficit disorder without hyperactivity” cover all these conditions. Although many scientific investigators use two abbreviations to distinguish between these two sub-varieties of the disorder (ADDH and ADD), it is better to simply use the abbreviation ADD to refer to this condition. In the overwhelming number of cases, hyperactivity is one of the symptoms of ADD. A variety of problems that were formerly called learning disabilities also have a new name: specific developmental disorder (SDD). Some developmental and situational depression in children is related to traumas-moving to a new school or concern over being accepted. But true depression is biological. Depressive illnesses aren’t due to weakness or a character flaw. They're biological illnesses related to imbalanced or disrupted brain chemistry. A child who’s biologically depressed is generally a child who has a genetic predisposition to depression and needs to be followed by a psychiatrist to ensure proper treatment. Can depression be mistaken for other disorders? A lot of kids who are depressed are misdiagnosed as attention deficit disorder-ADD-because symptoms can be similar. This misdiagnosis can be very problematic because the medications for each disorder are very different-and a child’s symptoms of depression may be masked if they are being medicated for ADD. What child and adolescent problems are related to depression? Some data suggest that a significant number of teenagers with psychological disorders use alcohol and drugs. Males in particular are less likely than females to seek help when they are depressed and are more likely to use alcohol and drugs. This actually makes the depression worse. Most adolescent suicides are related to depression or some kind of post-traumatic stress. A little over 11 percent of teenagers attempt suicide sometime in their lives. Studies show that girls attempt suicide more often then boys, with Hispanic girls attempting suicide more frequently than other girls. Another behavior that has become more common is self-mutilation. “Physical education teachers may encounter students who refuse to wear short sleeves in hot weather so no one will see scars on their arms.”(Plenk, 143) Problems such as anorexia and bulimia are also related to depression. All children show inappropriate behaviors at one time or another. In the lives of disturbed children, however, these behaviors are more intense, appear more frequently, and last longer. It follows, then, that disturbed children are different not in kind but only in degree. Acceptance of such an attitude helps mental health workers, teachers, and parents to be optimistic about treatment outcome, and this optimism transmits itself to the children and the adults in contact with the children. What causes the depression in young children and how it transforms and influences child’s life further on? Tyrants at home demand their rights in inappropriate ways, since their approach is always based on the premise that they will not succeed. “Their irrational demands, like staying up late or wearing the same T-shirt for a week, are often based on earlier unhappy experiences with rigid rules.
”(Aro, 47) They become fixated on achieving their goals aggressively and immediately, which hampers their future healthy development and creates problems in relationships. Part of this struggle for autonomy is the child’s need to experience the consequences of saying no. Will the caretaker become angry, punish, or not care? Children react differently depending on their temperamental makeup. Some will throw in the sponge and give up independence, exploration, and autonomy. They become overly dependent and anxious, avoid other children, and frequently show symptoms of depression. Many of these children are not referred for treatment as preschoolers as they appear to be so good. “Often they do not attend preschool or daycare, and intervention is sought only when they enter school and are not performing. Then the “goodness” is questioned.”(Kaslow, 25) In the best scenario, the no will be accepted and recognized as a stepping stone; appropriate compromises will be made, choices given, and alternatives suggested. Spending time with parents, preschool teachers, and therapists able to accept the child’s emerging autonomy and praise it or handle it constructively will help diminish the confusion between “Is it okay to be independent?” and “Will I lose love by doing my own thing?” The task of describing the characteristics of children with attention deficit disorder (commonly described as hyperactive) is in some ways a difficult one. The attributes are not unusual, but “many of the symptoms are present in all children to some degree at some particular time” (Schloss and Smith 89). It is important to emphasize that the characteristics listed are not abnormal in themselves; they are only abnormal when they are excessive. What characterizes ADD children is the intensity, the persistence , and the patterning of these symptoms. Only a clinician who has evaluated many children can accurately decide if a given child has attention deficit disorder. Parents who try to make the diagnosis alone are like medical students who, after reading the symptoms of diseases in their texts, think they have contracted smallpox, leprosy, and cancer within the space of a few weeks. Parents who suspect that their restless, poorly coordinated, distractible, and demanding child may be hyperactive should seek the service of a competent specialist for diagnosis and a determination as to whether treatment is indeed indicated. One characteristic of the ADD child that is almost always present is easy distractibility or shortness of attention span. This difficulty is not as obvious as hyperactivity but is of greater practical importance. The ADD child does not have stick-to-itiveness. Young children, in comparison to adults, are relatively lacking in the ability to concentrate and follow through on long and tedious tasks. The ADD child acts like a child younger than himself. He is the opposite of one who sits patiently in the corner painstakingly solving a puzzle and tolerating no interruptions. As a toddler and nursery school student, the ADD child rushes quickly from activity to activity, and then seems at a loss for things to do. In school his teacher reports: “You can’t get him to pay attention for long. He doesn’t finish his work. He doesn’t follow instructions” (DePaul and Stoner 62). In some ADD children, the distractibility may be concealed by the ability to stick with a particular activity for an unusually long period of time. Usually it is an activity they choose themselves. Sometimes it is a socially useful one, and sometimes it is not.
The child may seem to lock on and be undetectable or unusually persistent. The activity may be repeated in a stereotyped and persevere- like manner. Such paradoxical behavior in an ostensibly distractible child may confuse a parent, who will ask, “How can he be distractible when he plays with his rock collection for hours on end?” What Causes ADD in Children? Knowledge about the origin of attention deficit disorder is very incomplete, but evidence from various scientific areas is beginning to indicate that the two major causes of ADD seem to be: (1) an exaggeration or an excess of traits that normally vary from person to person; (2) a genetically determined disorder. It is very important to emphasize first that most ADD children are not brain damaged. ADD children are sometimes referred to as brain damaged because ADD was first described in children who had suffered injuries to the brain. The term brain damaged not only is inaccurate but also is “understandably upsetting to parents, who interpret it to mean that something is irreversibly the matter with the child’s brain” (Kaslow 12). In the few instances in which brain damage is the cause, parents should be less pessimistic than they usually are. If brain damage is not the cause, what is? Recent scientific evidence supports what everyone’s grandmother knew: there are inborn temperamental differences among children. Studies of the growth of children from infancy to preadolescence reveal that children differ from their earliest days and that some of these differences tend to be associated with behavioral problems as the child grows up. For example, the difficulties that the ADD child is likely to have in infancy (colic, feeding problems, sleeping problems) are probably the result of inborn temperamental differences. What causes these differences? Child psychiatrists are not certain. A very good possibility is that they are caused by chemical differences in the brain. The brain is an extraordinarily complex interconnection of nerve cells. In some ways it is analogous to a telephone network, but with one major difference. In the telephone network the connections are electrical: electricity passes from one wire to another by physical contact. In the brain, however, the connections are chemical. One nerve cell releases a small amount of certain chemicals, which are picked up by a second cell, causing it to fire. These chemicals are called neurotransmitters. If there is too little of a particular neurotransmitter, the second cell will not fire because not enough of the neurotransmitter has been released by the first cell. Although the nerve cells themselves are intact, it is as if the connection were broken. There are different neurotransmitters in different portions of the brain. If the amount of one neurotransmitter is insufficient, the portion of the brain that it operates will not function correctly. ADD children are probably deficient in some neurotransmitters. In many ADD children the quantity of these transmitters probably increases with age. This would seem to be the likely reason that children improve as they grow older. Malnutrition during prenatal status as one of the probable causes of ADD. The causes of these presumed chemical differences are, again, unknown but there are two general possibilities: (1) anomalies in the development of the baby before the time of birth; (2) genetic differences. (Lease 13) Little is known about prenatal influences but there is some possibility that small birth size- and therefore prematurity- may sometimes lead to ADD symptoms. Similarly, other variations in the mother’s biological processes during pregnancy might result in fetal mal-development.
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Some researchers begin to classify malnutrition during prenatal stage as one of the probable causes of ADD due to the great emphasis that has been put on the brain’s function lately. In other words, a clear cause and effect relations can be observed in the general process of child’s development form the moment when this baby was conceived to the period when the kid is observed to show the Attention Deficit Disorder symptoms. Many scientists believe that brain chemicals are very vulnerable during its early formation period, which is 9 months before the baby is born. Although there are no definite conclusions made by the official medical bodies, only a few professionals can disagree with the common notion that mother’s diet, life style, and nutritional state have the great influence on the child’s future mental and physical abilities to perform. If one part of the brain doesn’t release enough chemicals to trigger the functional process in the other part, the natural balance between various processes such as concentration, work, and thinking is damaged if not completely destroyed. Malnutrition is only one of the indirect probable causes of ADD because it doesn’t effect the child instantly, but acts through influencing the brain’s chemicals instead. With regard to genetic origins combined with prenatal stage status, it has long been observed that ADD and reading problems sometimes run in families. It has also been learned that such traits as hair color, eye color, certain forms of mental deficiency, etc., are related to the production of particular chemicals of the body, and that the amounts and types of these chemicals are determined by the genes- the transmitters of inherited characteristics. Certain genes may also control the amounts of neurotransmitters and some genes result in too little production of the neurotransmitters. Neurochemists have some possible leads about which neurotransmitters may be insufficient in ADD children. These “chemicals are located in that portion of the brain that includes among its functions the regulation of attention” (Aro 27). An excess of these neurotransmitters might produce an increased ability to focus attention and to inhibit behavior, to control oneself. A deficiency in these neurotransmitters- which is probably the condition present in ADD children- would produce an under-activity of that portion of the brain, resulting in attention difficulties and some lack of self-control. This portion of the brain probably also acts to modulate the mood and increase appropriate reactions to things going on outside the child. Therefore, deficiency in neurotransmitters in this area would result in a decreased ability to focus attention; a decreased ability to check one's behavior -- to apply brakes; a decreased sensitivity to others' reactions to dos and don'ts, and approval or disapproval; and a decreased ability to modulate mood, that is, an increased tendency toward sudden and dramatic mood changes. Scientific evidence of the ADD cause and Effect Nature. As scientists have studied ADD children, they have begun to examine the psychological problems encountered among close relatives, particularly siblings and parents. They have observed two important things. First, the siblings of ADD children are more likely to have ADD problems than are the siblings of children without ADD. Second, as indicated above, the fathers and other close male relatives of ADD children report that they had such problems themselves as children. Investigators have tackled this problem in an ingenious way. They have studied adopted ADD children, or ADD children raised by foster parents, which permits them to separate the influence of genetic factors from the influence of family upbringing.
Such studies indicate, for example, that (1) full siblings of ADD children are twice as likely as half siblings to have ADD themselves; (2) many cases of special developmental disorder (learning disabilities) are genetic in origin (particularly among males); (3) ADD may sometimes be associated with other disorders that seem strongly affected by genetic factors. (Schloss and Smith 167) Another possible cause of ADD was proposed by a West Coast allergist (a physician specializing in the diagnosis and treatment of allergies, including asthma, hay fever, and allergic reactions to foods), who claimed that hyperactivity may be caused by the food mother eat during their pregnancy period. These claims received serious attention from a number of scientific investigators, who conducted controlled experiments on the effect of food additives. In controlled experiments, the investigator makes allowances for people’s expectation about a treatment. There are two reasons ADD children whose mothers were receiving a special diet might function better or appear to function better. First, their parents want to see a change and, therefore, do everything possible (although not necessarily very common) to bring up a positive results of the experiment. Because they are so eager to see improvement in their child, they may judge their diet inaccurately. Second, the mother placed on a special diet might really do better because she becomes the center of much more attention. A diet without food additives usually requires a great deal of home preparation of foods. To the extent that increased attention can (perhaps temporarily) improve a child’s behavior, an ADD child will actually do better under these circumstances. Finally, the size of the physiological contribution can vary. In some children they are very large, and no matter how the children are raised problems will appear. In other children there are only slight physiological contributions. With these children, problems will be minor unless there are substantial family problems. In these “instances one usually finds that the child has done reasonably well until serious family problems arose” (DePaul and Stoner 33). Sometimes one cannot be sure of the origin of the child's difficulties since serious family tensions have been present at least since the time of the child’s birth. No matter how the ADD child’s problems arise, they frequently lead to typical difficulties within the family. Some psychiatrists and psychologists see the family's stresses as being a cause of the ADD child’s problems. Children, like adults, respond to distress in terms of their type of personality. ADD children react by being moody, naughty, restless, but it is important to remember that it is adults’ responsibility to help their kids to grow being happy and healthy in al respects.
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