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Mental Health Issues – ADHD Among Children

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Mental Health Issues – ADHD Among Children

The Issue

ADHD (Attention Deficit Hyperactivity Disorder) is a very common issue because U.S.

national statistics illustrate that approximately 4 to 12 percent of children are diagnosed with the

disorder (Johns Hopkins Medicine, 2022). This agency (a special needs school in an urban low-

income environment in Mississippi) has experienced an even higher pattern of ADHD among

children in the school because about 20 to 30 percent of them have ADHD. The agency helps

children with diverse mental health issues including Aspergers, anxiety, autism, mood disorders,

traumatic brain injuries, non-verbal learning disorder and ADHD. The agency has over 200

students and out of that number, 25 have been diagnosed with ADHD. The previous years have

shown the same pattern because each year, the new entrants have a considerable portion of

children with ADHD.

Children with ADHD have a higher risk for emotional, behavioral and mental concerns

and disorders. These risk factors make the child to have a high likelihood of adopting delinquent

behavior or engaging in interpersonal violence. The onset of ADHD in children is associated

with factors like strong mental health problems among their parents. Evidence shows that social

support, family climate and self-efficacy are preventive factors (Wustner et al., 2019). The

family climate was found to be the most effective means of preventive development of ADHD or

managing the condition compared to social support or self-efficacy. Wustner et al. (2019)

determined that creating a supportive family environment that does not expose children to the

social and behavioral problems linked with dysfunctional families can enable children who are

susceptible to ADHD to avoid developing that disorder. Social support ranks second as the other
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preventive measure because the child needs to have a conducive environment to enhance their

capability to adopt and practice appropriate social skills.

The key issue known about ADHD in this agency’s population is that they the children

with ADHD have impaired ability to develop or maintain social relationships. Upon conducting

further research, it has been identified that researchers like Bussing et al. (1998) also found that

ADHD children have problems forming social relationships. In this agency, most of the children

diagnosed with ADHD had problems developing social relationships and boys were affected

more than the girls.

Evidence for treating the issue

Providing parents with training on behavior management is an intervention that has been

studied by many scholars, researchers and professionals in the medical field and that has proven

to be successful. According to Friars and Mellor (2007), the program on behavior management

that is offered to parents of children with ADHD was effective in enabling them to manage their

children and help them overcome the negative outcomes (including violent conduct and anti-

social behavior) associated with their disorder. Other researchers like Pfiffner and Haack (2014);

Singh et al. (2010); Edwards (2002) and Webster-Stratton et al. (2011) have also determined that

providing training to parents concerning how they can manage the behavior of their children and

help to reduce the negative social relationships that most children with ADHD manifest. In all of

the studies mentioned in this section, self-management, non-stimulant medicines, and education

programs were also found to be treatment options that have helped a large population of children

with ADHD and rank as effective or potentially effective interventions to address the problem.
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Their common factors have shown that they are effective in treating the problem. When

executed individually, the interventions may help in managing the ADHD but there is need for

an effective framework that combines use of more than one of those interventions. For instance,

Froelich et al. (2002) found that parent training management has to be combined with cognitive

behavioral treatment to ensure better outcomes in the treatment process for children with ADHD.

The use of non-stimulant medicines with self-management procedures and education programs

have also been found to be interdependent in enhancing outcomes of treatment or management of

ADHD among children (Wustner et al., 2019).

Each of the research studies conducted concerning the issue of ADHD among children

has its limitations and strengths. For instance, the strengths of the study by Wustner et al. (2019)

have strengths such as the derivation data from the first longitudinal study to comprehensively

assess the wellbeing and mental health of children in Germany. The use of established measures

to assess the risk and protective factors linked with ADHD among children proved to be a

strength as well. The limitations in the Bussing et al. (1998) study is that it does not consider

some intervention options like non-stimulant medicines. Additionally, the study is not current

therefore its findings might be applicable to the 1998 period but are not relevant to the current

time period.

Applicability of the evidence to this agency

There are researchers like Duarte et al. (2022) who focused on a sample population of

children in urban low-income communities and sought to identify how to help them to address

the issue of ADHD as it applies to children in society. The study focused on a sample population

of 1408 participants (children and adolescents) and since that sample population was based on a

region with a high population of people (Itaborai, Brazil), when narrowed down to the context
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similar to the one in this agency, the population matches ours concerning income-level (Duarte et

al., 2022). However, there are other factors like ethnicity and race that do not match this

agency’s context and that factor will be addressed in the next subsection. Palcic et al. (2007) is

another researcher whose sample population, research focus and intervention measures matched

the ones for this agency because they focused on the possible influence of parent and teacher

involvement in addressing their issue of behavior of children with ADHD in classrooms and how

to overcome the challenges associated with the problem.

The intervention that was done in the study by Duarte et al. (2022) would have to be

adjusted to match the cultural context in the U.S. because the economic, social, legislative,

technological, political and social contexts between those two environments are different.

Regardless, it is important to recognize that the prevalence, cases and treatment of ADHD has

been adjusted in contemporary society to ensure that all affected people are provided access to

the same amenities despite their race, cultural practices, ethnic backgrounds or other such

factors.

There are some interventions – like – therapy that have been proven to be effective in

diverse contexts but there is little evidence concerning their effectiveness in addressing the

problem in the context of low-income populations. Financial challenges remain a problem in

identifying the best way to help the affected individuals to address the mental health problems

faced by their children. ADHD relaxation training and stress management options that help the

children overcome their negative behavioral problems or social interactional challenges are

examples of interventions that could be executed and result in positive outcomes but in urban

low-income contexts like the one in this agency cannot be successful because of the costs.
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The existing gap in research is that the focus on previous research concerning the welfare

of children with ADHD in low-income settings has been on choice of one treatment option. Not

many research studies address the issue by focusing on the potential effectiveness of combining

several interventions to achieve the expected outcomes. The availables options in treating,

preventing or managing the issues linked with ADHD are known to many scholars, researchers,

and professionals but they (policy makers, the government, civil rights activists, medical

professionals, family members and friends), overlook the financial issues that vary based in the

environment where the individual has resided or is located. There is need for more research to be

conducted to determine how or why people from low income societies have no access to services

that could enable them to access effective measures that enable their children to manage their

ADHD issues in an appropriate manner.

Recommendations

The empirical evidence provided shows that the most effective intervention in enhancing

management of ADHD among children in this agency is parent training concerning their

capability to manage the behavior of their children. The study outcomes have shown that there is

no universal intervention program that can address the issue. Even though training parents on

how to manage the poor social relationships of their children might be effective, the

effectiveness of that procedure has to be linked with other interventions including medical and

non-medical interventions, social support, and the education program in schools. As has been

illustrated by researchers, scholars and professionals in the medical field like Johns Hopkins

Medicine (2022)), Wustner et al., 2019; Bussing et al., 1998; Friars and Mellor, 2007; Singh et

al., 2010; and Edwards, 2002) and other professionals in addressing the problems with ADHD,
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child associated with children with ADHD have to accommodate a combined effort to treat their

mental health issue.

The Outline

The intervention will follow a systematic process. First, the staff, parents, close relatives,

friends and other stakeholders have to be trained in addressing the challenges faced by the child.

Secondly. Costs associated with the initiative have to be taken into consideration. The scheduling

and budgeting framework has to associated with a rigid framework established through a

collaborative framework that involves reliance on the expertise of other parties from diverse

fields including the financial and professional development departments. Overall, the

effectiveness of the proposed framework is linked with skills, knowledge and experience of the

involved parties in ensuring that the children in this context access the right services to enhances

to enable them to manage their ADHD issue.

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References

Barkley, R. A., Edwards, G., Laneri, M., Fletcher, K., & Metevia, L. (2001). The efficacy of

problem-solving communication training alone, behavior management training alone, and

their combination for parent–adolescent conflict in teenagers with ADHD and

ODD. Journal of consulting and clinical psychology, 69(6), 926.

Bussing, R., Zima, B. T., Perwien, A. R., Belin, T. R., & Widawski, M. (1998). Children in

special education programs: attention deficit hyperactivity disorder, use of services, and

unmet needs. American Journal of Public Health, 88(6), 880-886.

Duarte, C. S., Lovero, K. L., Sourander, A., Ribeiro, W. S., & Bordin, I. A. (2022). The child

mental health treatment gap in an urban low-income setting: multisectoral service use and

correlates. Psychiatric services, 73(1), 32-38.

Edwards, J. H. (2002). Evidenced-based treatment for child ADHD:" Real-world" practice

implications. Journal of Mental Health Counseling, 24(2), 126-139.

Friars, P. M., & Mellor, D. J. (2007). Drop out from behavioral management training programs

for ADHD: A prospective study. Journal of Child and Family Studies, 16(3), 427-441.

Froelich, J., Doepfner, M., & Lehmkuhl, G. (2002). Effects of combined cognitive behavioural

treatment with parent management training in ADHD. Behavioural and Cognitive

Psychotherapy, 30(1), 111-115.

Johns Hopkins Medicine. (2022). Attention-Deficit / Hyperactivity Disorder (ADHD) in

Children. Hopkins Medicine Health. https://www.hopkinsmedicine.org/health/conditions-

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and-diseases/adhdadd#:~:text=Estimates%20suggest%20that%20about%204,sisters

%20within%20the%20same%20family.

Palcic, J. L., Jurbergs, N., & Kelley, M. L. (2009). A comparison of teacher and parent delivered

consequences: Improving classroom behavior in low-income children with ADHD. Child

& family behavior therapy, 31(2), 117-133.

Pfiffner, L. J., & Haack, L. M. (2014). Behavior management for school-aged children with

ADHD. Child and Adolescent Psychiatric Clinics, 23(4), 731-746.

Singh, N. N., Singh, A. N., Lancioni, G. E., Singh, J., Winton, A. S., & Adkins, A. D. (2010).

Mindfulness training for parents and their children with ADHD increases the children’s

compliance. Journal of child and family studies, 19(2), 157-166.

Webster-Stratton, C. H., Reid, M. J., & Beauchaine, T. (2011). Combining parent and child

training for young children with ADHD. Journal of Clinical Child & Adolescent

Psychology, 40(2), 191-203.

Wüstner, A., Otto, C., Schlack, R., Hölling, H., Klasen, F., & Ravens-Sieberer, U. (2019). Risk

and protective factors for the development of ADHD symptoms in children and

adolescents: Results of the longitudinal BELLA study. PloS one, 14(3), e0214412.