1,721,902 research outputs found
Developing a model of occupational therapy practice for children with attention deficit hyperactivity disorder (ADHD)
No full textThis thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 15/06/2005.This three-stage study led to the development of a delineation model of occupational therapy practice for children with Attention Deficit Hyperactivity Disorder (ADHD). Stage one explored the current practice of occupational therapy in the United Kingdom (UK) by conducting a national survey of 282 paediatric occupational therapists. Results indicated that there were only a small number of occupational therapists (8.5%) working in a designated service for children with ADBD. This result suggested that occupational therapy for children with ADHD is a small field of practice.
Stage two involved the consensus development on the role of occupational therapy for children with ADHD. Seventy-two paediatric occupational therapists participated in the study. The therapists' top six priorities of assessment and five priorities of intervention were identified. An occupational therapy delineation model of practice was developed by integrating data generated from this research, information from the literature review, and the author's clinical experience. In order to apply the model to clinical practice, a family-centred occupational therapy care package was developed.
The third stage evaluated the process and outcome of the devised care package by conducting a multi-centred efficacy study. Twenty occupational therapists from the four countries in the UK attended a 3-day course to learn to implement the care package. Following their training, they submitted data on a sample of 20 children with ADHD. The majority of these children (85%) showed improvement in their behavioural patterns after the implementation of the care package. Over half of the cases (65%) had statistically significant changes of scores in the ADHD Rating Scales. Parents also reported experiencing good family-centred care delivered by the research therapists. The whole study makes a significant contribution to occupational therapy knowledge by creating a new delineation model of practice for which the research undertaken offers some validation.College of Occupational Therapists (Byers Memorial Fund); Hospital Saving Association (PhD Scholarship Award 2001
Attention deficit hyperactivity disorder (ADHD) within a South Indian (Keralian) mainstream school context
No full textAttention Deficit Hyperactivity Disorder (ADHD) is a widely discussed special educational issue in Western contexts and developed countries. By contrast, limited information is available about ADHD in Eastern contexts and developing countries. In India in particular, the only available information is about the medical perspective of ADHD; little or no attention is given to social or educational perspectives. DSM IV criteria are the most commonly used standard assessment procedures. However, limited research is reported to discuss the potential cultural influences of this North American model. The present study examines the incidence and interpretation of ADHD within the context of five mainstream schools in Trivandrum, South India. It also explored cultural influences impact upon the cultural validity and reliability of DSM IV criteria when introduced into a South Indian context. In order to identify children with ADHD characteristics, culturally valid assessment tools such as behaviour checklist and behaviour rating scales, were developed from DSM IV (TR) symptoms criteria. Qualitative data was gathered from the five sample schools during the academic year of 2006-07 using a variety of methods including in-depth interviews (with 21 teachers), classroom observations (of 26 children), rating scale and document scrutiny. The case study method was adopted to gain in-depth information about the identified children. Informal interviews with parents (24) were also utilised to triangulate the information gathered from the school contexts. Qualitative data analysis techniques such as open coding and case analysis were used to assess children's behavioural characteristics and difficulties. The findings indicate that three percent of children (21) had ADHD characteristics within the sample schools. Some of the findings are consistent with the studies reported in Western contexts. There are also some contrasting results: a) most of the identified children had inattention rather than hyperactivity characteristics, b) a higher number of children with ADHD characteristics were from lower socio-economic backgrounds, c) teachers used coercive methods of physical punishments and sanctions as they interpreted the children's ADHD characteristics as a result of their lack of interest in learning. Most importantly, though DSM IV (TR) criteria are useful in identifying ADHD, two items of the 'symptoms' criteria were not identifiable within the present context of the sample schools. The findings suggest that socio-cultural factors do influence the validity and reliability of DSM IV criteria. The study has implications not only for further research but also for planning and policy making in the field of education for all. The conclusions suggest that an educational provision should be considered with regards to the varied and complex needs of children with special educational needs such as ADHD. Teacher education programmes should be enhanced with positive intervention strategies
Are language production problems apparent in adults who no longer meet diagnostic criteria for attention-deficit/hyperactivity disorder?
No full textIn this study, we examined sentence production in a sample of adults (N = 21) who had had attention-deficit/hyperactivity disorder (ADHD) as children, but as adults no longer met DSM-IV diagnostic criteria (APA, 2000). This “remitted” group was assessed on a sentence production task. On each trial, participants saw two objects and a verb. Their task was to construct a sentence using the objects as arguments of the verb. Results showed more ungrammatical and disfluent utterances with one particular type of verb (i.e., participle). In a second set of analyses, we compared the remitted group to both control participants and a “persistent” group, who had ADHD as children and as adults. Results showed that remitters were more likely to produce ungrammatical utterances and to make repair disfluencies compared to controls, and they patterned more similarly to ADHD participants. Conclusions focus on language output in remitted ADHD, and the role of executive functions in language production
The 7Ms pedagogy model: Instructional design for learners with Attention-Deficit Hyperactivity Disorder
Get PDFThis thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.This study presents a new framework for designing pedagogy in an informed and controlled way. It considers the importance of progression of pedagogy during a learning episode, so that an instructor can modify the pedagogical approach as well as the content in a lesson. The significance and novelty of this research lie in the proposals to provide support for ADHD learners and assist them to overcome their academic weaknesses/challenges through appropriate pedagogically sound interventions. Therefore, in order to contribute to the development of a suitable pedagogical approach for children who diagnosed with ADHD, issues of having ADHD are discussed within the scope of the research. In this respect, an aetiological model of ADHD has been developed to identify different levels of impairments as well as to clarify areas in which educational pedagogies must address the limitations of ADHD learners. Early stage results described here consider evidence to determine the viability of two literature-based models, named the ‘6Ms pedagogy model’ and the ‘aetiological model of ADHD’. In identifying the need to explore an accurate pedagogical model for ADHD children, two models have been evaluated. The analysis is based on a combination of secondary analysis, qualitative, and quantitative data analysis, which covered data, collected from expert advice, including that from professionals, coaches, and teachers and from those involved in the education of learners with ADHD and parents. Evidence from findings on ADHD is married to a new model of pedagogy named the ‘7Ms pedagogy model’. The ADHD pedagogical model is then evaluated by SEN teachers serves to facilitate well-informed and targeted design decisions about pedagogy, which could provide children with support and help them overcome academic limitations.
Keywords: Attention Deficit-Hyperactivity Disorder; 6Ms Pedagogy Model; 7Ms Pedagogy Model; learning theories; aetiological model; typically developing learners (TDLs); and special educational needs (SEN)
An examination of the effects of stimulant medication on response inhibition: A comparison between children with and without attention deficit hyperactivity disorder
No full textThis study investigated whether methylphenidate is effective in improving response inhibition in children with Attention Deficit Hyperactivity Disorder (ADHD). Children with ADHD were compared with normally developing children on measures of response inhibition. Participants with ADHD were compared across two conditions--medicated and unmedicated. There was no significant difference between the inhibitory control of children with and without ADHD. Children with ADHD showed significant improvements in inhibitory control following methylphenidate. The findings of the present study contrast with previous studies which document reduced inhibitory control in ADHD, compared with normally developing children. Reports of methylphenidate improving functioning in children with ADHD are supported. Limitation and implications of the study are discussed
A Mixed Methods Exploration of Homeopathy for Attention Deficit Hyperactivity Disorder: Comparing Research Evidence and Clinical Practice
Get PDFBackground: Complementary and alternative medicine is increasingly evaluated from an evidence-based medicine perspective which includes clinical trials. It was
unclear to what extent these trials represented clinical practice and assessed treatments as given in the real world. Attention deficit hyperactivity disorder (ADHD) and
homeopathy were explored as an exemplar comparing clinical trials versus daily practice. Objectives: Evaluate, contrast and compare the homeopathy as practiced within research trials with the approach adopted by practitioners in their daily practice as a treatment for children diagnosed with ADHD. Methods: An explicitly mixed methods approach based in Grounded Theory spanning quantitative and qualitative
research techniques was adopted for this project. Data elements included a systematic review, individual patient data meta-analysis, practitioner survey, in-depth
interviews and participant-observation. Each method was rigorously implemented and analysed according to best practice; the results were then synthesised to develop
an explanatory model. Results & Conclusions: Although meta-analyses suggest there is little reliable evidence in favour of homeopathy for the treatment of ADHD, the trials conducted to date do not appear to have reflected clinical practice within the UK. The diversity of practice observed presents unique challenges for researchers who wish to improve the evidence base. A model of homeopathy as a process of individualisation is offered as a starting point for documenting observational studies and developing realistic evaluations, and an outline of a future comparative trial is provided
The Effectiveness of Precision Teaching when Working with Children with Attention Deficit Hyperactivity Disorder
No full textA two-dyad multiple baseline design was used to determine if Precision Teaching (PT) was effective in improving the target skills of sight word recognition for two boys aged six and eight (Group A) and multiplication for a 12-year old boy and a 10-year old girl (Group B). The participants were all diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and attended the Kauri Centre. SAFMEDS (Say All Fast Minute Each Day Shuffled) cards containing words or sums were used. Correct and incorrect responses were recorded on a Standard Celeration Chart. Group A also read from a reader, recalled facts about books previously read to them, and copied a passage of writing, while Group B answered sums on multiplication, division, and word problem worksheets. These measures were used to see if PT in a target skill had any effect on other classroom activities. Furthermore, aggressive behaviour, off-task behaviour, and responses to instructions were observed to determine if any changes occurred following the implementation of PT. The arrival of a new teacher, however, confounded these results. PT is a very effective method for teaching target skills to ADHD children, however there is limited application of this skill to other classroom activities and no new behaviours emerged as a result of the PT process. Future research could look at teaching this population other skills using PT and/or using PT to help other children experiencing reading or maths difficulties
The identification and management of ADHD offenders within the criminal justice system: a consensus statement from the UK Adult ADHD Network and criminal justice agencies
Get PDFThe UK Adult ADHD Network (UKAAN) was founded by a group of mental health specialists who have experience delivering clinical services for adults with Attention Deficit Hyperactivity Disorder (ADHD) within the National Health Service (NHS). UKAAN aims to support mental health professionals in the development of services for adults with ADHD by the promotion of assessment and treatment protocols. One method of achieving these aims has been to sponsor conferences and workshops on adult ADHD.
This consensus statement is the result of a Forensic Meeting held in November 2009, attended by senior representatives of the Department of Health (DoH), Forensic Mental Health, Prison, Probation, Courts and Metropolitan Police services. The objectives of the meeting were to discuss ways of raising awareness about adult ADHD, and its recognition, assessment, treatment and management within these respective services. Whilst the document draws on the UK experience, with some adaptations it can be used as a template for similar local actions in other countries.
It was concluded that bringing together experts in adult ADHD and the Criminal Justice System (CJS) will be vital to raising awareness of the needs of ADHD offenders at every stage of the offender pathway. Joint working and commissioning within the CJS is needed to improve awareness and understanding of ADHD offenders to ensure that individuals are directed to appropriate care and rehabilitation. General Practitioners (GPs), whilst ideally placed for early intervention, should not be relied upon to provide this service as vulnerable offenders often have difficulty accessing primary care services. Moreover once this hurdle has been overcome and ADHD in offenders has been identified, a second challenge will be to provide treatment and ensure continuity of care. Future research must focus on proof of principle studies to demonstrate that identification and treatment confers health gain, safeguards individual's rights, improves engagement in offender rehabilitation programmes, reduces institutional behavioural disturbance and, ultimately, leads to crime reduction. In time this will provide better justice for both offenders and society
Can task-switching training enhance executive control functioning in children with attention deficit/-hyperactivity disorder?
No full textThe key cognitive impairments of children with attention deficit/-hyperactivity disorder (ADHD) include executive control functions such as inhibitory control, task-switching, and working memory (WM). In this training study we examined whether task-switching training leads to improvements in these functions. Twenty children with combined type ADHD and stable methylphenidate medication performed a single-task and a task-switching training in a crossover training design. The children were randomly assigned to one of two groups. One group started with the single-task training and then performed the task-switching training and the other group vice versa. The effectiveness of the task-switching training was measured as performance improvements (relative to the single-task training) on a structurally similar but new switching task and on other executive control tasks measuring inhibitory control and verbal WM as well as on fluid intelligence (reasoning). The children in both groups showed improvements in task-switching, that is, a reduction of switching costs, but not in performing the single-tasks across four training sessions. Moreover, the task-switching training lead to selective enhancements in task-switching performance, that is, the reduction of task-switching costs was found to be larger after task-switching than after single-task training. Similar selective improvements were observed for inhibitory control and verbal WM, but not for reasoning. Results of this study suggest that task-switching training is an effective cognitive intervention that helps to enhance executive control functioning in children with ADHD
Occupational therapy for children with attention deficit hyperactivity disorder (ADHD), Part 2: A multicentre evaluation of an assessment and treatment package
No full textIn this study, a family-centred, occupational therapy
assessment and treatment package was delivered to improve
the behavioural patterns of children with ADHD aged 5-10
years. There were two principal research questions:
1. Is a defined family-centred occupational therapy
assessment and treatment package carried out over
3 months effective in producing significant changes
in the behavioural patterns of children with ADHD
aged between 5 and 10 years?
2. Does a family-centred care approach elicit positive
parental perceptions of the care that they and their
children have received
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