The Lifelong Effects of ADHD on Personal Development

Attention Deficit Hyperactivity Disorder is a condition which causes them to have difficulty controlling their behavior and paying attention. Other problem areas are oppositional behavior toward adults and academic failure. These children face many more difficulties in early development than children without the disorder because they face crises with peers, trouble with their education, and tension and frustration in the home environment.

Regarding crises with peers, studies have shown that children that have ADHD had distorted perceptions of their own peer acceptance and rejection, social preferences and social impact. Many children who thought they were well-liked were in fact disliked by "normal" children for reasons directly related to the disorder, such as aggression and hyperactivity. Children with ADHD struggle during their years of education because of their behavior problems which are displayed in front of their peers and teachers.

Research shows that children who are diagnosed with ADHD have a significantly increased risk of becoming substance dependent in adolescence. Many of the characteristic traits and behavior issues of individuals with ADHD contributed to reliance on tobacco, alcohol and illegal substances.

Children with ADHD were also prone to holding inflated positive self perceptions in comparison to others. They are believed to inflate their perception of themselves most in areas which they are lacking due to their disorder. This is problematic for these individuals because they form a false sense of the way others see them and do not function appropriately in social situations.

One of the major problems that children diagnosed with ADHD face is forming healthy relationships with others. It is common for these children to find themselves rejected by others due to the difficult nature of the child's personality. Usually, the child's lack of solid relationships with peers is the cause of adults' frustration in dealing with them. Often, if the child had at least one true friend, some of the areas that he finds difficulty in would be lessened because he had someone that he could rely on and trust.

Results of many past studies show that other children do not find ADHD children as potential companions (Hoza, Mrug, Gerdes, Hinshaw, Bukowski, Gold, Kraemer, Pelham, Wigal, & Arnold, 2005). They tend to seek out children as friends who are mostly easy going. Peers more often associated hyperactive children with "bad kids", rather than "good kids" (Hoza, Mrug, Gerdes, Hinshaw, Bukowski, Gold, Kraemer, Pelham, Wigal, & Arnold, 2005). Factors such as the inability to pay attention and focus is strongly correlated with factors such as poor academic achievement and peer difficulties (Molina & Pelham, 2003).

Another commonality for children with ADHD is their inability to control their emotions and behavior and the problems that result. ADHD in children causes them to vent their frustrations and anger in more public and external ways than children without the disorder. These children are extremely impulsive and what they don't realize is that acting out in inappropriate ways causes them to be rejected and shunned by others who do not understand their reasons for acting out. Aggressive boys that have ADHD tend to inflate their self perception the most in the social and behavioral domains (Hoza, Gerdes, Hinshaw, Arnold, Pelham, Molina, Abikoff, Eptstein, Greenhill, Hechtman, Odbert, Swanson, & Wigal, 2004). The reason that they inflate their self perception is because their outright aggression actually causes people to dislike them but the person with ADHD doesn't realize that it's a problem and sees himself as normal, leading him to think that others like him. This is just one problem that arises because of behavior problem. Another serious issue is that many children with ADHD will grow into substance abusing adolescents and this is partly due to the fact that their behavior leads to social developmental problems. Early expressions of antisocial behavior, such as aggression and other conduct problems in childhood, are well-established prospective predictors of early substance use (Molina & Pelham, 2003).

Other commonalities between individuals with ADHD exist in the way that they cope and deal with stress. ADHD children are much more at risk of developing dependencies on substances as adolescents and adults than children without ADHD. ADHD adolescents were three times more likely to have used at least one hard drug at some point in their life, than normal adolescents (Molina & Pelham, 2003). Polysubstance use, the use of more than one drug at a time, is a higher risk in those with ADHD (Molina & Pelham, 2003). Often the frustrations of growing up with ADHD leads these individuals to release their stress in this unhealthy way.

Another risk for children growing up with ADHD is that due to their tendency to be rejected by friends, they may find their way of coping in becoming friends with the first person who ever shows interest in knowing them. This typically leads children with ADHD into peer groups which are not necessarily safe and healthy. It is possible that as these children are discouraged in their attempts to become friends with more "popular" peers, they will gravitate toward anyone willing to accept them ( Hoza, Mrug, Gerdes, Hinshaw, Bukowski, Gold, Kraemer, Pelham, Wigal, & Arnold, 2005).

Research should continue on the way that ADHD affects children's social development. Although conclusions were drawn, changes will take place over time as teachers and parents become more educated in their methods of controlling these problematic behaviors. Perhaps once these children learn more healthy methods of releasing frustration and anger and ways to stay focused for longer periods of time, they will become more appealing as potential friends to other children.

It is important that for the next study on this topic, children are not confused as to what they are asked to do. They should be asked short, specific questions about their peers with ADHD so that the results will be more accurate. The method and results of the study related to ADHD and adolescent substance use was fairly straightforward and clear. The participants were consistent and since this was a longitudinal study, there is not question as to whether or not the results are accurate. They simply followed these individuals into their adolescence to determine whether their ADHD had increased their risk of using substances, more than individuals without ADHD. For future studies, it would be beneficial to follow a larger sample group. This way, there would be much more representational data. However, longitudinal studies are difficult to complete because some people cannot be located after so much time has passed. The results for this study showed strong correlations between the child's ADHD symptoms and later substance use. This data shows that the study is very reliable and later studies would be beneficial to discover whether positive changes are occurring for children diagnosed early with ADHD. Further research would also be beneficial regarding the study on children with ADHD who have inflated self perceptions. These explanations help others to understand why these children act the way they do in public and with their peers. As attempts are made in the future at controlling problematic social and behavioral problems, perhaps these children will be more accepted by their peers and will no longer need to inflate their self perception because the way they feel about how others seem them will become more accurate. For any future studies, it would help to include more sections of the self perception profile so that there would be more data to conclude

References

Hoza, B., Gerdes, A., Hinshaw, S., Arnold, L., Pelham, W., Molina, B., Abikoff, H., Epstein, J., Greenhill, J., Hechtman, L., Odbert, C., Swanson, J., & Wigal, T. (2004). Self-perecptions of competence in children with ADHD and comparison children. Journal of Consulting and Clinical Psychology, 72, 382-391. Retrieved October 10, 2005, from [https://library.unt.edu:9443/login?url=http://search.epnet.com/login.aspx?direct=true&db=pdh&an=ccp723382&scope=site].

Hoza, B., Mrug, S., Gerdes, A., Hinshaw, S., Bukowski, M., Gold, J., Kraemer, H., Pelham, W., Wigal, T., & Arnold, L. (2005). What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder?. Journal of Consulting and Clinical Psychology, 73, 411-423. Retrieved October 9, 2005, from [https://libproxy.library.unt.edu:9443/login?url=http://search.epnet.com/login.aspx?direct=true&db=pdh&an=ccp733411&scope=site].

Molina, B., Pelham, W. (2003). Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. Journal of Abnormal Psychology, 112, 497-507. Retrieved October 10, 2005, from [https://libproxy.library.unt.edu:9443/login?url=http://search.epnet.com/login.aspx?direct=true&db=pdh&an=abn1123497&scope=site].

Kristen Zadina is a student at the University of North Texas and a student teacher at an elementary school in the Frisco Independent School District in Frisco, Texas. She has a passion for reaching the hearts of young children and working to meet each child's individual needs. She enjoys about teaching content to students in a relevant way that gets them excited to learn.

Targacept Announces Top-Line Results Of Phase 2 Trial Of AZD1446 In Adults With ADHD And Provides Update On Status Of AZD1446 Development Program

Main Category: ADHD
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Targacept, Inc. (NASDAQ: TRGT) announced top-line results from a Phase 2 clinical trial of AZD1446 conducted by AstraZeneca in adults with attention deficit/hyperactivity disorder (ADHD). The study was one of several early clinical studies designed by AstraZeneca to obtain, in addition to safety and tolerability information, a signal of efficacy to guide dosing in potential later-stage development of AZD1446 in either or both of Alzheimer's disease and ADHD. AZD1446 is a selective modulator of the alpha4beta2 neuronal nicotinic receptor and was licensed by Targacept to AstraZeneca pursuant to a 2005 collaboration agreement.

The study was a multi-center, randomized, double-blind, placebo-controlled, cross-over trial that assessed the efficacy, safety and pharmacokinetics of two weeks of treatment with AZD1446 as compared to placebo. Each subject was classified as a user of nicotine products or a non-user of nicotine products. Non-nicotine users received placebo and two out of three oral AZD1446 dose regimens, and nicotine users received placebo and two oral AZD1446 dose regimens.

In the trial, AZD1446 did not improve core symptoms of ADHD, as compared to placebo, as measured by the primary outcome measure, the Conners' Adult ADHD Rating Scale-Investigator Rated Total ADHD Symptoms score (CAARS-INV). Based on this finding, Targacept does not expect AstraZeneca to progress AZD1446 as a treatment for ADHD. A decision by AstraZeneca as to potential future development of AZD1446 in Alzheimer's disease is expected in the coming months.

Positive results were obtained in the study on three of five tasks of the CogState computerized test battery, secondary outcome measures designed to assess important cognitive functions such as learning and memory. Non-nicotine using subjects who received 80mg of AZD1446 once daily showed an improvement on the Groton Maze Learning Task (p=0.031) and the International Shopping List Task - Immediate Recall (p=0.007). Non-nicotine using subjects who received 80mg of AZD1446 three times daily showed an improvement on the International Shopping List Task - Immediate Recall (p=0.010) and the International Shopping List Task - Delayed Recall (p=0.086). The p-values reported are not statistically adjusted for multiplicity. AZD1446 did not demonstrate similar superiority at any dose on any of these measures in the nicotine user dataset. Other secondary outcome measures of the study did not demonstrate a drug effect.

AZD1446 was generally well tolerated in the study, and no serious adverse events were reported. Further analyses of the full dataset from the trial are ongoing.

"While we are disappointed in the results on the primary outcome measure in this ADHD trial, we are encouraged by the memory and learning findings from the CogState test battery and believe they support further study of AZD1446 as a treatment for Alzheimer's disease," said J. Donald deBethizy, Ph.D., Targacept's President and Chief Executive Officer.

In addition to the trial in adults with ADHD, the AZD1446 program includes three other early clinical studies intended to inform a decision by AstraZeneca as to potential future development in Alzheimer's disease. Two of these studies have completed. In a four-week trial designed primarily to evaluate the safety and tolerability of AZD1446 when administered with donepezil, the most commonly prescribed Alzheimer's disease treatment, to Alzheimer's disease patients, AZD1446 exhibited a safety and tolerability profile acceptable for further development. As expected with a short dosing period and small number of subjects, AZD1446 did not show an effect on surrogate measures of cognition and global function in the study. In a separate trial designed to explore the effects of a single dose of AZD1446 in healthy volunteers with drug-induced cognitive impairment, pro-cognitive signals were observed on various secondary outcome measures, but neither AZD1446 nor the positive comparator donepezil demonstrated a statistically significant effect on the study's primary outcome measure. Results from a fourth trial, designed to evaluate the pharmacodynamic effect of AZD1446 and donepezil on brain response in Alzheimer's disease patients as assessed by electroencephalography (EEG), are expected early next year.

About the Phase 2 Trial in Adults with ADHD

The Phase 2 clinical trial in adults with ADHD was a double blind, placebo controlled cross-over study conducted by AstraZeneca at six sites in the United States. A total of 79 patients aged 18 to 65 years were randomized to study treatment, including 27 nicotine users and 52 non-nicotine users. Nicotine users received in random order 80mg of AZD1446 once daily, 80mg of AZD1446 three times daily and placebo, in each case for two weeks. Non-nicotine users received in random order two of the following three dosing regimens-80mg of AZD1446 once daily, 80mg of AZD1446 three times daily and 10mg AZD1446 three times daily-as well as placebo, in each case for two weeks. For both groups, consecutive dosing periods were separated by a three-week washout period, for a total study duration of twelve weeks. As a result of the cross-over design, each patient served as his or her own control.

About AZD1446

AZD1446 is a selective modulator of the alpha4beta2 neuronal nicotinic receptor. The compound was discovered by Targacept scientists as part of a now-completed research collaboration conducted with AstraZeneca under a 2005 collaboration agreement.

Source:
Targacept, Inc.

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ADHD - Review of Literature - Effects on Development Within Family, Education, and Social Systems

Attention Deficit Hyper Activity Disorder according to Singh (2002) is a developmental disorder that is brain based and most often affects children. This developmental disorder can be characterized as a disorder in which affects ones self control; primary aspects include difficulty with attention, impulse control, and activity levels usually diagnosed prior to the age of 7yrs. of age (Willoughby, 2003).

There are primarily three sub-types of ADHD. Inattentive sub-type 1 is ADHD which those who manifest inattention without the presence of hyperactivity and impulsivity (Barkley, 2005). There is also ADHD sub-type 2 with symptomolgy related to hyperactivity and impulsivity (Barkley, 2005). Finally there is ADHD combined sub-type (Visser & Lesesne, 2005). For the purpose of my paper, I will utilize information that represents all subtypes in various degrees and the affects of these difficulties upon the individual, educational, family, and social development as well as issues of social justice and cultural issues for those children who suffer from this disorder.

Historically the modern symptoms of ADHD were first identified (Barkley 1996, Rafalovich 2001, & Stubbe 2001), by English physician George Still in 1902 (Neufeld & Foy, 2006). Rafalovich (2001), explains that in a series of historical events from 1917-1918 in North America that led to an encephalitis outbreak there was a dramatic increase in research of characteristics that are similar to modern day ADHD symptomology. Through out the early years of research there was even research and investigations into medical conditions which promoted swelling in certain aspects of the brain, which many believe led to impulsivity and hyperactivity (Stubbe, 2000). As research evolved so did the diagnostic criteria for the disorder; shaping identifiable factors believed to contribute to the causation of ADHD (Barkley, 2005). Physiologically, there seems to be less dopamine and nor-epinephrine within the brains of those with ADHD and four genes that regulate dopamine have been identified as ADHD causal agents; however a definite causal agent has not been confirmed (Barkley, 2005). Brain activity is considerably lower in the pre-frontal lobe regions in those with ADHD and there is also decrease in blood flow (Hans, Henricksen & Bruhn, 1984), (Barkley, 2005). According to Barkley (2005), psychological characteristics of ADHD are that it is about the "behavioral inhibition." These children do not benefit from what may happen later based upon what they do now; which can be compared to a "time near sightedness", (Barkley, 2005). They have difficulty identifying their past, preparing for the future, organizing, scheduling, and working independently, with social and occupational issues (Barkley, 2005). It is these difficulties when intermingled with the development of the individual that could clearly cause great difficulties especially when enrolled in formalized schooling and onward into the demands of school and adulthood.

The prevalence rates regarding the diagnosis of ADHD has been from ranges of 4 % to 18 % depending upon the community, types of populations, and areas of analysis (Visser & Lesesne, 2005). ADHD is one of the most common childhood disorders with 2.5 million children with this disorder (Barkley, 2005). Estimates show (Biederman, 1996), that nearly 6 % of boys and 1.5 % of girls have ADHD (Singh, 2002). It cost nearly 3.3 billion dollars to medically treat ADHD every year in the United States (Visser & Lesesne, 2005). Currently causation factors under consistent follow up according to Barkley (2005) include;

1. Genetics

2. Premature Birth

3. Traumatic Brain Injury

4. Spine and Brain Infections

5. Early exposure to substances during pregnancy

6. Early exposure to lead

7. Less blood flow and lower brain activity

Because ADHD is a representation of physical imperfections within the brain and actually manifests a decrease of activity in the pre-frontal lobe regions; certain treatment options with amphetamines, stimulants and non-amphetamines have been utilized to increase brain activity (Barkley, 2005). The size and anomalies within the brain have been verified and examined through many technological processes such as Positron Emission Tomography and MRI scanning (Vance & Luk, 2000). Other physical abnormalities of development according to Barkley (2005), include appearances of slight deformities including; longer than average index finger, third toe that is longer than second toe, ears that are slightly lower upon the head, no earlobes or a furrowed tongue. Up to 80% of children suffering with ADHD will continue to struggle with this disorder into adolescents and as many as 50 to 60 percent will continue to struggle into adulthood (Barkley, 2005). With the affects upon a child's school, family, and social environments a large emotional toll can be identified. Emotionally, children can feel isolated, angry, guilty, frustrated and many other emotions due to the disruption of relationships, opportunities and lack of clear decision making skills (Barkley, 2005). Many of these children can become depressed and exhibit anxiety (Barkley, 2005). Many affective behaviors include stubbornness, defiance and at times can be verbally or physically violent to others (Barkley, 2005).

According to Barkley (2005) nearly 57% of preschool children are likely to be rated as inattentive and over-reactive by their parents up to the age of four. As many as 40% according to Barkley (2005), may have these problems for up to three to six months, concerning parents and teachers. According to Lavigne, Gibbons, Christoffel, Rosenbaum and Binns (1996), however, it is estimated that 2% of preschool children truly meet the criteria for ADHD, and (Biederman, 1996), clarified that possibly 10 % of all children meet diagnostic criteria for ADHD (Singh, 2002). Barkley clearly indicates that the earlier the symptoms of ADHD appear and the length of time they last in childhood will determine the severity of its course and prognosis (Barkley, 2005). Individually there are many distressing problems for children suffering from this disorder. Some features that Barkley (2005) indicate are important to recognize as the individual child develops into school age include;

1. An emergence of high demanding ness of preschool age

2. Critical directive behavior by parents to control circumstances

3. Problems reported by preschool / formal school staff regarding child's behavior

4. Problems with learning and reading

5. Decisions to withhold a child an educational grade

6. Excessive temper tantrums / difficulty in getting child to do chores

7. Social exclusion from activities

According to Spira & Fischel (2005), within the pre-school environment at the age of 3 yrs. old, children's attention controls, and self control mechanisms begin developing. Increased self control and speech development continues from age 3yrs. old (Spira & Fischel, 2005). Self control processes continue to well develop through the age of 4yrs. old (Spira & Fischel, 2005). These processes work together allowing the child to maintain self-control and through 4 yrs. of age the child develops the ability to direct attention to relavent environmental stimuli (Spira & Fischel, 2005). Together, the maintaining of attention and control over responses emerges and of course is very important in identifying task's and working functionally within the educational environment, however; these processes indicated do not emerge for those with ADHD due to the manifestation of hyper-activity and impulsivity around the age of 3 to 4 yrs. of age, and inattention manifesting near 5 to 6 yrs. of age (Spira & Fischel, 2005). As children develop into school age and adolescents, Barkley (2005) indicated that 30 to 50 percent of children will be retained one grade during their school years. According to Vance & Luk (2000), 20 to 30 percent of children with ADHD will manifest comorbidity with learning disorders; reading, arithmetic, writing or spelling. If a child is diagnosed with ADHD and Conduct Disorder the percentages increase for a co morbid learning disorder (Vance & Luk, 2000). One theoretical position (Velting & Whitehurst, 1997), is that according to Spira and Fischel, (2005) those children with ADHD do not acquire the literacy skills necessary for early reading and learning. Furthermore, it is hypothesized that the frustration due to lack of ability perpetuates acting out behaviors consistently witnessed by school staff of children with ADHD (Spira & Fischel, 2005).

As children move through adolescents it is abundantly clear that with vast developmental changes; finding ones role identity as clarified by Eric Erickson (Berger, 2006), relational dating, peer pressure, and other demands of adolescents become extraordinarily difficult with individual difficulties of impulsiveness, hyperactivity and inattentiveness (D. Moilanen CMSW, Personal Communication, January 25, 2007). According to Gordon (2006), adolescents continue to have many difficulties especially;

1. Disorganization

2. Planning long term assignments

3. Completing homework

4. Complying with parental rules.

5. Sustaining attention and focus

Because adolescents are seeking to find a competent and healthy identity, conflicts with parental and academic systems can leave an adolescent to feel diminished, angry and frustrated before the entry into adulthood (D. Moilanen CMSW, Personal Communication, January 25, 2007).

Adulthood brings new challenges and according to Jaffe, Benedictis, Segal & Segal, (2006), the following are just a few of the challenges for adults living with ADHD;

1. Managing money

2. "Zoning out in conversations"

3. Speaking without thinking

4. Procrastination

5. Becoming easily frustrated

Eric Erickson in Berger (2006) clarifies his theory of Psycho-Social Development and indicates that as early adults we want to find intimacy or we will face isolation. It seems clear that these adults due to their disability will continue to confront difficulties with their families, social relationships, and negative individual perceptions onward into adulthood. These difficulties could place them at risk to become isolated.

The individual within their family is greatly impacted by this developmental disorder. According to Barkley (2005) ADHD is 25 to 30% acquired by heredity, and if a parent has ADHD the child is 8 to 10 times more likely at acquiring the disorder. Barkley (2005) also indicated that parents at the beginning of preschool attend and manage their child fairly well, however; parents tend to lose what they feel as control over their child the further the child develops through school. Parents can feel drained, overwhelmed and exhausted; even feeling depressed, and begin blaming themselves for their child's behavior (Barkley, 2005). Over time these difficulties can lead to perceptions by parents that may be less than positive (Maniadaki, Sonuga, Kakouros, & Karaba, 2006).

Research shows that parental perceptions within the family can clearly have implications regarding how a child is treated and the negative affects and perceptions that affect the child's developmental stages (Maniadaki et al., 2006). According to Maniadaki et al., (2006), parental perceptions do have significant impact upon children suffering from ADHD due to the likelihood of the parents not obtaining mental health services for their children; the difficulty parents had identifying the impact the child's behavior would have on the child's development; and the parents inability to identify the severity of the child's symptoms, all have dramatic affects on the child's developmental processes. Siblings can also have negative perceptions of the child's behavior, affecting the degree of support siblings bring to each other within a family. According to Gordon (2006), siblings can feel sorry for their sibling with ADHD or they can get angry and resentful. These reactions create dynamic challenges for any family and or individual dealing with ADHD. Other possible hindering perceptions by parents within the family system can be identified by comparing Erickson's, Psycho Social Developmental Perspectives (Berger, 2000). According to Erickson, children from the age of 3 yrs. old to 6 yrs. of age will develop through a series of challenges to parents, taking the "initiative" or "failing," bringing feelings of "guilt" (Berger, 2000). When the child's challenging behavior takes place however, as Camparo, Christensen, Buhrmester & Hinshaw, (1994) states, that parents may not allow these children to have the benefit of the doubt, due to past excessive behavior under normal circumstances, and the parents may see their child as an "easy target." According to the evidence, miscalculating the child's natural challenging behavior could take place and disallow the child to develop in a healthy, "guilt free" way, having significant affects on their psycho-social development. Excessive amounts of guilt can produce significant amounts of anxiety and depression (Burns, 1990). These negative processes in variable degrees can clearly lead to negative affects on social and emotional processes (Burns, 1990).

Other family processes affecting ADHD and development according to Peris & Hinshaw (2003), is that core symptoms of impulse control and inattention are primarily heritable, and parental practices do not warrant significant (Barkley, 1998; Hinshaw 1994; Johnston & Mash, 2001), causation for ADHD. However, the family interaction patterns and external influences may have a significant impact on severity and the developmental course of ADHD (Peris & Hinshaw, 2003). Furthermore, evidence suggests (Barkley, 1985; Battle & Lacey, 1972; Buhrmester, Camparo, Christensen, Gonsalez, & Hinshaw, 1992; Campbell, 1973; Cunningham & Barkley, 1979; MacDonald, 1988; Mash & Johnston, 1982; Tallmadge & Barkley, 1983) that mothers of ADHD children are less affectionate. Other disturbing findings indicate that parents can be more critically demanding and parents independently report a greater tendency to blame their ADHD child for problems they actually had with their spouses; thus proving further that family systemic patterns can play a major role in the perpetuation and affects of ADHD upon child development (Camparo et al., 1994). Of course these processes clearly affect a school-age child within their families and external systems in ways which reduce a child's self worth, confidence, and abilities to properly interact and function within their environment; proving this, Dumas & Pelletier (1999) indicated that pre-adolescents were found to have lower levels of self esteem in areas of scholastic competence, behavioral conduct, and social acceptance.

According to Barkley (2005), those with ADHD, at times do not give themselves time to evaluate their emotions objectively before a reaction, fail to separate their feelings from fact. Being able to internalize our emotions, evaluate them, and analyze them before displaying them publicly assist in self control and is difficult for those suffering from ADHD (Barkley, 2005). Those who suffer from ADHD develop a pattern of social rejection due to inappropriate interactions beginning during formalized schooling according to Barkley (2005). According to Nixon (2001), those children suffering from ADHD lack significant social skills that affect the quality of their interactions, such as; verbal & physical aggression, disruptive attempts to enter new groups, negative classroom behaviors, being quick tempered and violating the rules. Nixon (2001) presents more evidence that social cognition is clearly affected and children with ADHD can have great difficulty in making clear interpretations of their environmental interactions with others. These variables clearly lead to inhibited social contact, and a dysfunction in psycho-social development. According to Eric Erickson in Berger (2000), he clearly indicates that formalized school age children from 7 to 11 years old need to develop confidence that allow them to feel as if they have mastered "Industry" (Berger, 2000). If this stage is not mastered, they may feel inferior (Berger, 2000). How can these children who are excluded due to their ADHD manifestations of behavior, be given the chance to participate and prove themselves to resist negative aspects of "Inferiority?" As these children develop into adolescents and adults, one can hypothesize when comparing ADHD behavior and social reactions with the Erickson Psycho-Social Framework (Berger, 2000). Erickson states that adolescents attempt to find their roles in the world and if they fail, role confusion develops (Berger, 2000). Confusion for those suffering from ADHD would come easily due to their exclusion from social groups and activities (Barkley, 2005). In order for adolescents to find their role and their identity; they must interact with others and feel accepted in their participation (Berger, 2000). Further into adulthood Erickson in Berger (2000), indicates that as adult's, individuals will seek intimacy with others or become isolated. The factor of isolation relates to the extent in which those developing fear rejection and disappointment (Berger, 2000). Unfortunately, prior social experiences of those suffering from ADHD can be littered with social rejection, feelings of disappointment and unacceptance due to impulsiveness and hyperactive behaviors (Barkley, 2005). Furthermore, (Pope, Bierman, & Mumma, 1999), these authors according to Nixon (2001), also claim that hyperactivity and the inattentive / immature nature of a child's behavior with ADHD contributes greatly to interpersonal problems.

In regards to social justice and cultural issues; according to Bender (2006), African American children may be under represented and under diagnosed in regards to ADHD. Experts such as (Dr. Rahn Bailey, 2006) according to Bender (2006), claim that as science is pursuing new technological processes to diagnose and treat ADHD, cultures like the African American community are subjected to propaganda, suspicion due to past and current discrimination, and negative stereotyping regarding mental illness; thus forming cultural decisions to avoid diagnosis and treatment of ADHD. This cultural-lens, based upon discriminatory and fear based experiences with the dominant culture dis-allows ethical decisions to help and assist African American children (Bender, 2006). These decisions according to experts (Bailey, 2006), is contributing to high rates of African American children disproportionately over represented in remedial programs and disproportionate amounts of African American children over represented in the criminal justice system (Bender, 2006). The issues of classism and impoverishment can also be a topic of concern regarding those who suffer from ADHD. According to Visser & Lesesne, (2005), ADHD diagnosis among males was reported significantly more often in families with incomes below the poverty threshold than in families with incomes at or above the poverty threshold. Here again, poverty makes a clear and consistent statement of risk for our developing children.

In conclusion, I believe that ADHD seems to be an elusive, devastating, developmental disorder. This disorder for my self is so destructive because of its manifesting elements of hyperactivity, impulsivity and inattentiveness. These variables are processes that if represented to certain degrees are perfect for destroying social, educational, emotional and individual development across the life span. Because our lives are so dependent upon not just our biological construction but also our social and environmental interaction; this disorder can be serious and detrimentally disruptive. I do however believe that new technologies are hopeful in understanding this disability in greater measures. I also have gained ideas regarding the new information regarding neuro-plastisity and the changing mind based upon therapeutic thought. I feel this may be a possible frontier of research that should be a priority in better understanding how the brain can change forms; especially the pre-frontal cortex regions.

L.J. Riley Jr. BSW, LLMSW

Reference

Barkley, R. A., (2005). Taking Charge of ADHD: The Complete Authoritative Guide for

Parents. New York: The Guilford Press.

Bender, E., (May 19, 2006). Scare tactics may deter blacks from ADHD help. Psychiatric News, 41 (10) 16. Retrieved January 20, 2007 from [http://pn.psychiatry]

online.org/cgi/content/full/41/10/16.

Berger, K. S., (2001). The Developing Person: Through the Life Span. New York:

Worth Publishing.

Burns, D. D., (1999). The Feeling Good Hand Book. New York: Plume Books.

Camparo, L., Christensen, A., Buhrmester, D., & Hinshaw, S., (1994). System functioning in families with ADHD and non-ADHD sons. Personal Relationships, 1, 301-308.

Dumas, D., & Pelletier, L. (1999). Perception in hyperactive children. Maternal Child

Nursing, 24, 12-19.

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L.J. Riley Jr. is a writer of metaphorical and childrens literature, motivational poetry and an advocate for those in need. L.J. graduated from Davison, Michigan in 1988 and joined the U.S. Army where he served as a combat veteran. College career includes; a Phi Theta Kappa graduate from Mott Community College, a Maize and Blue Scholar Award Winner from the University of Michigan Flint, a National Scholarette Nominee, a published recipient in the National Deans List, a Golden Key Honors Graduate, and a recipient of the Howard and Judy Simms Fellowship at the University of Michigan School of Social Work in Ann Arbor, Michigan. He resides in Burton, Michigan and can be contacted at Compassionpwr@juno.com