Clinical, Psychological and Social Aspects of Attention Deficit Hyperactivity Disorder in Children

Attention Deficit Hyperactivity Disorder is not a recent discovery. The essential feature of Attention Deficit Hyperactivity Disorder is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. In India, the prevalence of Attention Deficit Hyperactivity Disorder is estimated at 10% to 20% in school age children. Attention Deficit Hyperactivity Disorder is frequently associated with the co-morbid features of Specific Learning Difficulty, autistic features, mental retardation or slow learners. In India, the multimodal approach has been adapted in the treatment of Attention Deficit Hyperactivity Disorder. An eclectic approach involving the paediatrician, psychiatrist, psychologist, occupational therapist, speech therapist, family and teachers is most effective in dealing with Attention Deficit Hyperactivity Disorder. Parents play a vital role in facilitating and maintaining developmental gains in children with Attention Deficit Hyperactivity Disorder. In the Indian setting, there is a lack of evidence on the child with Attention Deficit Hyperactivity Disorder and parental aspects involved. Review of literature reveals a lacuna in the areas relating to the various developmental and parental issues involved in Attention Deficit Hyperactivity Disorder. Hence, the investigator felt a pressing need to explore these un-tread areas. In light of the above, the research opined that an amalgamation of the various clinical, psychological and social factors relating to Attention Deficit Hyperactivity Disorder in India should be studied. This study attempts to portray the Indian child with Attention Deficit Hyperactivity Disorder and strives to identify parental issues, if worked upon, may provide a comprehensive management program for Attention Deficit Hyperactivity Disorder. The aim of this study has necessitated the researcher to arrive at the objectives of examining the family history, birth history, developmental history and educational history of children with Attention Deficit Hyperactivity Disorder. Cognitive factors, presence of co-morbid features, symptom intensity and maladaptive behaviours were also assessed. Parental aspects including Quality of Life, Parental Stress and Self esteem were also studied. In accordance with the objectives mentioned above, appropriate hypotheses were formulated. The research design adopted for his study is causal comparative as well as descriptive in nature. The survey method and psychological assessment was implemented to procure the required data. Two hundred and two children with Attention Deficit Hyperactivity Disorder, diagnosed by DSM IV, and their parents (One hundred and seventy two fathers and Two hundred mothers) residing in TamilNadu, India, were chosen by means of purposive sampling technique. Detailed structured interview was used to obtain details of the child from parents and caregivers. Detailed psychological analysis was conducted to obtain the cognitive profile of children with Attention Deficit Hyperactivity Disorder. The tests used include the Seguin Form Board, the Binet Kamat Intelligence Scale, the Bender Visual Motor Gestalt test protocol, screening for learning difficulty, the Vineland Adaptive Behaviour Scale and the DSM-IV to assess the symptoms of Attention Deficit Hyperactivity Disorder. The questionnaire method elicited the necessary data from the parents. The standardized questionnaires used included the World Health Organization Quality of Life- Bref (1996), Parental Stress Scale by Judy.O. Berry (1997) and the Rosenberg’s Self Esteem Scale (1965). The data was collected from children and their parents referred to the Child Guidance Clinic, Kanchi Kamakoti CHILDS Trust Hospital, Chennai, TamilNadu, India, over two sessions, each session lasting for one hour. The compiled data was statistically analysed using frequency distribution, chi-square, binomial test, t-test, F-test, analysis of variance, correlation, cluster, factor and discriminant analyses. The profile of the Indian child with Attention Deficit Hyperactivity Disorder is similar in most aspects to the west. It is noted that children with Attention Deficit Hyperactivity Disorder- combined type are more commonly diagnosed than statistics in western literature. This requires a comprehensive epidemiological study