ADHD Treatment Research Proposal

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A research Proposal on the ADHD

 

 

 

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Introduction

Attentive–deficit hyperactivity is a psychological disorder that is well known, affecting both children and adults. Some of the associated symptoms that are associated with ADHD include inattention, hyperactivity, impulsivity, and difficulty in focusing. It is reported that in the United States, about 8.5% of children are affected by ADHD. In the treatment process, several ways have been put into place. Despite the treatment, many studies reported that some treatment methods have side effects. Therefore, knowing the method that least has the side effects is crucial. This research proposal will play an essential role as it will identify whether non-pharmacological intervention, behavioral therapy, and stimulant therapy have the same results in children aged 4 to 8.

 

Background of the study

Dr. George first identified ADHD when he was a pediatrician. He noted that his patients had uncontrollable impulsive behavior. There was an introduction of the drug Benzedrine, which was approved as it showed to improve ADHD symptoms in children. In 1950 there was the introduction of Ritalin drugs which were used in ADHD treatment in both children and adolescents. (Holland & Higuera (2017).The drug that is used in the treatment of ADHD to date is Ritalin. Despite the doctors treating patients with ADHD symptoms from the 1930s, there was no actual definition of ADHD. Still, it was given much attention in 1987 when the American Psychiatric Association (APA) redefinition of the disorder.

By 2020, approximately 7.1 million young children aging between 2-17 years with ADHD had been diagnosed. (Garbe (2018). Despite the prevalence of the disorder among children and adolescents, ADHD is also present in adulthood. In most cases, this disorder is noted when the child gets into the class and starts issues of failing to focus in the classroom. There are different forms of ADHD which entails hyperactive/impulsive type, inattentive type, or a combination of the two. There is a criterion that is customarily utilized in the treatment of ADHD. The parents and the teacher are required to document the children’s symptoms for a time frame of six months. Research shows that ADHD is more common in males than women. One of the interventions utilized is stimulant therapy, considered standard treatment for children after reaching an appropriate age. The stimulus, for example, the medication, is said to have side effects which can be either mild or severe. Some noticeable side effects include upset stomach, appetite change, heart abnormalities, tics, and weight loss. Although the treated symbols are 70-80% treated, there can be the utilization of other alternative therapies that don’t require the use of stimulant medication and play an essential role in minimizing ADHD symptoms.

The current research shows that approximately 9% of young children residing in United States are affected by ADHD. Using stimulant therapy is the primary treatment method for the symptoms. The current research also show that pharmacological therapy is an effective method of treatment of the symptoms. Between 2013 and 2019, there were over 5873 articles written about ADHD. The term “young children ” was added to minimize the research and behavioral therapy benefits and stimulants’ side effects. In addition to this expression, the number of articles was reduced to 500 and 200, while about 50 articles were related to the behavioral therapy treatment of children.

To identify the gap in the research conducted to date, we shall look at the importance of behavioral therapy and Methylphenidate treatment.

Use of behavioral Therapy

Before the stimulant therapy initiative in children with ADHD, there was a recommendation for using behavioral therapy, an idea embraced in American Academy of Pediatrics (AAP). The main aim of behavioral therapy was to help the kids gain self-control, self- instruction, problem-solving ability, and modeling. Children with that ADHD has been diagnosed said to have a high likelihood of developing emotional problems in their life. Behavioral therapy is capable of helping children in their early stages cope with the symptoms not only in childhood but also in their adult life. A study by Thyagarajan shows that involving the parent and provider in behavioral therapy in school-based children is crucial. This becomes important for the parent to be taught the behavioral therapy technique.

The study that CDC did in 2018 indicated that less than 50 %of the children practicing the stimulant therapy had initially practiced the behavioral therapy. Of the children aged between 4-5 years, only one out of 5 was taking the medication to treat ADHD instead of recommending the use of behavioral therapy. This study also identified variations in the use of behavioral treatment from State to State. (Thyagarajan (2019) The study showed that all those states that opted to utilize behavioral therapy as the first line of treatment had decreased the number of children on the stimulate therapies. Most studies have put a lot of emphasis on combining behavioral therapy and stimulant medication. A study done in 2019 in 170 elementary schools indicated that combining both therapies improved results.

Methylphenidate Treatment

This is the therapy that is most prescribed for children having ADHD. Several articles show the adverse effects that are associated with the use of this therapy. One of the side effects that the study indicates concerning this therapy is Insomnia. One study found a change in the sleep pattern for the children who have undergone this treatment, especially when the therapy is done over a prolonged period. In 2019 a study was conducted on 71 children who had gone the treatment for six months. There was an indication that about 87% had a side effect. Some of the recorded side effects included irritability, Insomnia, and anorexia. Most studies showed that despite Methylphenidate being embraced, it had many side effects.

 

Gap in Literature

In most of the research that was done regarding Methylphenidate and behavioral therapies in children, no information concerning pre-school children and also prevalence of the treatment in this age group. The research tends to show the presence of the symptoms that arise when a person experiences school life. An article published by the childhood & development Disorder identified several gaps. There is a gender gap when studying ADHD as the studies gravitate toward males in the population. In availability of the voice of the children diagnosed with ADHD is also a big gap. It is worth noting that children cannot make medical decisions; thus, their voices are not heard based on their opinion. Listening to what they may feel after therapy could play a significant role in treatment. After the therapy, few studies follow up with the children to see the lifelong impact.

 

Research Question and Hypothesis

Research Question

The research to be conducted is to answer whether non-pharmacological therapy is the best alternative in treating attentive deficit hyperactivity disorder compared to using Methylphenidate stimulant therapy in children between 4-8 years.

Hypothesis: Research and Null

Using Behavioral therapy in treating school children between 4-8 years is as effective as Methylphenidate stimulant therapy, evidenced by the behaviors of the teachers and the parents grading the study participant. Null Hypothesis: No difference exist between behavioral therapy and Methylphenidate interventions in the school children aged between 4 and 6 years.

 

Nature of the study

In this study, the dependent variables in the behaviors will be keenly observed in the group participant on each treatment type. The qualitative independent variables present in the research are non-pharmacological treatment and Methylphenidate. The variable of operationalized will become the behavioral assessment to be completed by the teachers and parents regarding each participant’s progress. Teachers and parents are required to grade the critical factors while determining the effectiveness of the independent variables.

The nature of the study is qualitative experimental based. It will involve random selection of the participants so that the researcher will have maximum control. In the experimental study, only two variables are used to show their relationship. There is an experimental group and also a control group. In this regard, the experiment group is children treated with behavioral therapy, while on the other hand, the controlled group is children undertaking Methylphenidate. The experiment group that is exposed to independent variables is behavioral therapy. The research will be able have a comparison on the effects behavioral therapy symptoms of ADHD and the impact of behavioral treatment compared to Methylphenidate therapy.

 

Study significance

The paramount significance of this study is identifying whether non-pharmacological behavioral therapy is of the same effects on ADHD symptoms compared with stimulant therapy, Methylphenidate. Implementing non-pharmacological interventions such as behavior therapy in the first line of medication in preschool and school-aged children can play an essential role in reducing stimulant use. Suppose the symptoms can be managed using non-pharmacological therapy such as behavioral therapy. In that case, the children cannot be at risk of the side effects associated with the use of the drugs. Many side effects result from the use of stimulant therapy. Some of these side effects are long run. It has come to my attention that most of the therapy have a short-term follow-up after the therapy. This research will not only help identify some of the short-term side effects of the use of the therapy on ADHD symptoms but also track the individual’s progress. Some side effects which are said to be a result of the stimulant therapy will be looked at and dealt with amicably. This study is also essential since it will allow adolescents to speak their minds regarding the different therapies. Since the technology keeps improving, this study will look at the cheapest and most economical treatment.

References

Attention-deficit/hyperactivity disorder (ADHD). (2018).

Baum, Newman, Weinman, McManus, & West, (Eds.). (2018). Cambridge Handbook of Psychology, Health, and Medicine.

Behavioral Therapy: Definition, Types, and effectiveness. (2016, November 14).

CDC: AAP guidelines on behavioral therapy and ADHD in young children are not followed by most patients. (2015). Brown University Child & Adolescent Psychopharmacology

Charach & Fernandez (2013, May 28). Enhancing ADHD Medication Adherence: Challenges and Opportunities. Current Psychiatry Reports, 15, 371.

Helseth, Washbush, Gnagy, Onyango, Burrow-MacLean, Fabiano, Nicols-Lopez, K. (2015, April). Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls.

Holland & Higuera (2017). The history of ADHD: A timeline.

Khajehpiri, Mahmoudi-Gharaei, Faghihi, Karimzadeh, Khalili, & Mohammadi (2014). Adverse reactions of Methylphenidate in children with attention deficithyperactivity disorder: Report from a referral center. Journal of research in pharmacy practice, 3(4), 130-6.

Kholi, R(n.d.). The Early Childhood Attention Deficit Disorders Evaluation Scale (ECADDES) [Scholarly project].

Kraut, Langner, Lindemann, Banaschewski, Petermann, Petermann, Garbe (2018). Comorbidities in ADHD children treated with Methylphenidate: a database study. BMC Psychiatry, 13.

Lynch, A. (2016, August 19). Identifying Knowledge Gaps in ADHD Research. Journal of Childhood & Developmental Disorders,

McCarney, S. (1995). Early childhood attention deficit disorders evaluation scale (ECADDES).

Palinkas, Horwitz, Green, Wisdom, Duan & Hoagwood (2015, September). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research.

Thyagarajan (2019). A case study using cognitive-behavioral therapy-management of ADHD. Indian Journal of Health & Wellbeing, 7, 471-477.

Vigliano, Galloni, Bagnasco, Delia, Moledo, Mana & Cortese (2016, May). Sleep in children with attention-deficit/hyperactivity disorder (ADHD) before and after 6-month treatment with Methylphenidate: a pilot study. European Journal of Pediatrics, 175.

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