Introduction

Disorders of attention and activity are amongst the most prevalent of

emotional and behavioral disorders affecting children and adolescents. They
are also currently considered the most controversial disorders in our society.
Children with attention problems create a special population of students with a
wide array of needs. The most commonly diagnosed childhood disorder among
students is Attention Deficit Hyperactivity Disorder, also known as ADHD
(Kronenberger & Meyer, 1996).
Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition
that involves problems with inattention and hyperactivity-impulsivity that are
developmentally inconsistent with the age of the child. A child’s academic
success is often dependent on his or her ability to attend to tasks and teacher
and classroom expectations with minimal distraction. Such skill enables a student
to acquire necessary information, complete assignments, and participate in
classroom activities and discussions (Forness & Kavale, 2001). When a child
exhibits behaviors associated with ADHD, consequences may include difficulties
with academics and with forming relationships with his or her peers if appropriate
instructional methodologies and interventions are not implemented.

I. Problem to be Investigated

a. Purpose of the study

The purpose of this report is to compare and contrast the different

research papers about Attention Deficit Hyperactivity Disorder (ADHD). By
analysis of the different findings, professionals, especially those who are in the
field of counseling will be better able to understand clients diagnosed with
ADHD. This knowledge will assist in the implementation of interventions designed
to assist clients in the development of their academic and social skills, which will
lead to success within the classroom, as well as with their peer groups.

b. Research Questions, hypotheses, proposition

This research report examines the findings of different research studies

about Attention Deficit Hyperactivity Disorder. The main question that this
research answers is: How are the findings of different studies alike? How do they
differ?

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 II. Background and review of related literature

Attention Deficit Hyperactivity Disorder (ADHD)

The term ADHD has been a common term that can be heard within the
school, which oftentimes used irresponsibly, giving label to children showing
hyperactive behaviour. Attention Deficit Hyperactivity Disorder (ADHD) is a
neurological condition that involves problems with inattention and hyperactivity-
impulsivity that are developmentally inconsistent with the age of the child. ADHD
is not a disorder of attention, as had long been assumed. Rather, it is a function
of developmental failure in the brain circuitry that monitors inhibition and self-
control. This loss of self-regulation impairs other important brain functions crucial
for maintaining attention, including the ability to defer immediate rewards for
later gain (Barkley, 1998a). Behavior of children with ADHD can also include
excessive motor activity. The high energy level and subsequent behavior are
often misperceived as purposeful noncompliance when, in fact, they may be a
manifestation of the disorder and require specific interventions. Children with
ADHD exhibit a range of symptoms and levels of severity. In addition, many
children with ADHD often are of at least average intelligence and have a range
of personality characteristics and individual strengths.
Children with ADHD typically exhibit behavior that is classified into two
main categories: poor sustained attention and hyperactivity-impulsiveness. As a
result, three subtypes of the disorder have been proposed by the American
Psychiatric Association in the fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV): predominantly inattentive, predominantly
hyperactive-impulsive, and combined types (Barkley, 1997). A child expressing
hyperactivity commonly will appear fidgety, have difficulty staying seated or
playing quietly, and act as if driven by a motor. Children displaying impulsivity
often have difficulty participating in tasks that require taking turns. Other
common behaviors may include blurting out answers to questions instead of
waiting to be called and flitting from one task to another without finishing. The
inattention component of ADHD affects the educational experience of these
children because ADHD causes them to have difficulty in attending to detail in
directions, sustaining attention for the duration of the task, and misplacing
needed items. These children often fail to give close attention to details, make
careless mistakes, and avoid or dislike tasks requiring sustained mental effort.

What causes ADHD?

ADHD has traditionally been viewed as a problem related to attention,

stemming from an inability of the brain to filter competing sensory inputs such as
sight and sound. Recent research, however, has shown that children with ADHD
do not have difficulty in that area. Instead, researchers now believe that children
with ADHD are unable to inhibit their impulsive motor responses to such input
(Barkley, 1997; 1998a).

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 It is still unclear what the direct and immediate causes of ADHD are,
although scientific and technological advances in the field of neurological
imaging techniques and genetics promise to clarify this issue in the near future.
Most researchers suspect that the cause of ADHD is genetic or biological,
although they acknowledge that the child’s environment helps determine
specific behaviors.
Imaging studies conducted during the past decade have indicated
which brain regions may malfunction in patients with ADHD, and thus account
for symptoms of the condition (Barkley, 1998a). A 1996 study conducted at the
National Institutes for Mental Health (NIMH) found that the right prefrontal cortex
(part of the cerebellum) and at least two of the clusters of nerve cells known
collectively as the basal ganglia are significantly smaller in children with ADHD
(as cited in Barkley, 1998a). It appears that these areas of the brain relate to the
regulation of attention. Why these areas of the brain are smaller for some
children is yet unknown, but researchers have suggested mutations in several
genes that are active in the prefrontal cortex and basal ganglia may play a
significant role (Barkley, 1998a). In addition, some non-genetic factors have been
linked to ADHD including premature birth, maternal alcohol and tobacco use,
high levels of exposure to lead, and prenatal neurological damage. Although
some people claim that food additives, sugar, yeast, or poor child rearing
methods lead to ADHD, there is no conclusive evidence to support these beliefs
(Barkley, 1998a; Neuwirth, 1994; NIMH, 1999).
It has been suggested that food substances such as dyes, sugars, and
preservatives may play a role in ADHD. In addition, it has been suggested that
environmental toxins (i.e. lead) and allergens cause hyperactivity as well. A
once popular assumption was that ADHD was linked to the consumption of sugar
and caffeine, although this theory has since been discounted. None of the
above factors have been demonstrated to be a frequent cause of ADHD, but a
small number of cases pay these theories merit (Berger & Thompson, 1995).

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 III. Findings

The different studies collected are discussed in this chapter wherein their
similarities and differences shall be established.

One study conducted by Blachman & Hinshaw (2002) examined the

patterns of friendship amongst girls with Attention Deficit Hyperactivity Disorder
(ADHD) and found that although girls with ADHD were able to make friends to
some extent, they differed from comparison girls in terms of the likelihood of
making friends and the ability to maintain the friendships they did form.

Further research led to a study conducted by Bagwell, Molina, Pelham &

Hoza (2001). This research study investigated whether or not childhood ADHD
and persistence of the disorder are associated with later difficultly in adolescent
peer relations. The findings of this research article overall concluded that
impairments in peer relations for ADHD that are known to be common in
children, are also common in adolescence.
One research-based study conducted by Plumer (2005) investigated the
effects of Classwide Peer Tutoring (CWPT) and Peer Coaching with three
elementary-school students in grades 3 and 4. During the first phase of the study,
CWPT was implemented in each of the students’ classrooms. During the second
phase of the study, CWPT was continued and peer coaching was added. Peer
interactions were observed in both academic as well as social settings. The
results of the study found that when once CWPT was implemented, students
were actively and positively engaged with their peers while in academic settings
in the classroom community. However, increases in positive peer social
behaviours in a social setting were not observed. Furthermore, the addition of
peer coaching resulted in enhanced social behaviours in social setting such as
recess and lunch. Classwide Peer Tutoring and Peer Coaching are two examples
of strategies that can be implemented into both a primary or junior classroom as
a technique for increasing the positive social behaviours amongst students with
characteristics ADHD and their peers, therefore creating a more inclusive
classroom community. A research article written by Boudouris (2005), a grade 1
classroom teacher, set out to find the answers to questions such as “can general
education students help peers with learning disabilities in their classroom?” and
“is there a place in general education classrooms for students with severe
disabilities?” Boudouris (2005) also discusses the many programs that use peer
tutoring as an effective tool in the classroom as well as her experiences with the
implementation of peer tutoring in her own grade 1, general education
classroom. The results of this research overall indicate that peer tutoring
programs can benefit students of different ages and abilities in three ways;
academically, socially and emotionally. This finding compliments the findings of
Plumer (2005) as both research articles find peer tutoring to be an effective
strategy that teachers can implement in the classroom to encourage positive
social interactions between students with characteristics of ADHD and overall
create a more positive and inclusive classroom community.

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 A study conducted by Roffey (2013) suggests using a Circle Solutions
philosophy to increase inclusion in the classroom. This philosophy was developed
from Circle Time and its pedagogy includes using circle sessions to promote
equality and democracy, inclusion, respect, safety and choice, agency and
positivity. This study reported that in more than 100 schools in Australia that
introduced this intervention in the classroom reported noticing positive changes
in class ethos, relational skills and problem-solving, therefore creating a more
inclusive community in the general education classroom.
A study conducted by Nahmias (1995) reported that collaboration and
communication among school, home and professionals are essential to meet
the needs of students with ADHD. This study also reports that home and school
collaboration is an ongoing process that involves communication, reciprocity,
and mutual respect and has the student at the center of the goals. Furthermore,
the areas that require communication and collaboration with parents include
the assessment of the problem, planning, development of intervention strategies
and the monitoring of behavior (Nahmias, 1995).
One study conducted by Tan & Cheung (2008) provides research based
evidence that computer collaborative group work, when facilitated by an adult,
can raise peer acceptance of a student with ADHD. In order to conduct this
study, sociometrics testing of classmates was used to determine peers’
acceptance among a boy’s peer group before and after computer group work
sessions. During adult facilitated computer sessions, the facilitator used positive
reinforcement to increase positive social interactions and behaviours. Overall,
the results of this study indicated encouraging improvements as peer
acceptance among the boy’s classmates increased after the computer sessions.
Although this research reported on an isolated case, the results are promising
and indicate that collaborative group work can be implemented in a classroom
setting in order to encourage positive engagements and build an inclusive
community that supports students with characteristics of ADHD.
A research study conducted by Carbone (2001) suggests that by
surrounding a child with ADHD with well-behaved, attentive classmates will
automatically encourage positive peer interactions. Furthermore, according to
Carbone (2001) positive peer attention can directly influence the behaviour of
students with ADHD. Therefore, working with others in the classroom can be
beneficial for students with characteristics of ADHD and can support them in the
classroom community.
In a study conducted by King and Young (1982; cited in Wheeler &
Carlson, 1994) it was shown that students with ADHD are aware of their negative
social status and their problems with social functioning. Another study
conducted by Lahey (1982; cited in Wheeler and Carlson, 1994) showed that
students with ADHD consistently rated themselves as being more depressed,
having lower self-esteem, being less popular and having more behavior
problems than there non-ADHD peers. In the same study, students with ADHD
also rated themselves has having more physical appearance concerns, anxiety,
and general unhappiness compared to their non-disabled peers.
A study conducted by Campbell, Endman, and Bernfeld (1977; cited in
Wheeler & Carlson, 1994) also showed negative interactions with teachers.

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Classrooms that contained students with ADHD had higher rates of negative
teacher-child interactions among all students.
Castellanos et al. (2002). This study, carried out between 1991 and 2001,
reported that the brains of ADHD children are smaller compared to those of
controls. The study is significant because of the size of the sample (291
participants) and because one third of the patients never received medication.
Three groups were constituted: 49 unmedicated patients, 103 medicated
patients, and 139 controls. Thus the authors had the opportunity to make
numerous comparisons: unmedicated versus medicated, unmedicated versus
controls, medicated versus controls, and ADHD versus controls. The most
important — and legitimate — comparison was between unmedicated patients
and controls. However, compared to the controls, the unmedicated patients
were two years younger, shorter and lighter.
Castellanos et al. state that height and weight did not correlate with brain
size in their study. Yet in that study these variables were significantly correlated
with the diagnosis of ADHD. Thus, although finding three biological differences
between the ADHD children and controls, the researchers only focused on brain
size. Height and weight have never been shown to be part and parcel of ADHD,
but the results from this study suggest otherwise.
Mostofsky, Reiss, Lockhart, and Denckla (1998). In this study, seven of the
12 boys diagnosed with ADHD had a prior history of psychotropic drug use. No
discussion appears in this article about the potential problems with such use.
Baumgardner et al. (1996). All of the ADHD children in this study were also
diagnosed with Tourette’s syndrome, making them atypical of the children being
diagnosed with ADHD in North America. No medication history is reported.

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 IV. Summary and Conclusion

a. Brief Summary
There have been several studies conducted to fully understand Attention
Deficit Hyperactivity Disorder. ADHD is a neurological condition observable to
children. It is associated with other disorders. Although toddlers and preschoolers,
on occasion, may show characteristics of ADHD, some of these behaviors may
be normal for their age or developmental stage. These behaviors must be
exhibited to an abnormal degree to warrant identification as ADHD. Even with
older children, other factors (including environmental influences) can produce
behaviors resembling ADHD.
The criteria set forth by the fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSMIV) are used as the standardized clinical
definition to determine the presence of ADHD (see attached DSM-IV Criteria for
ADHD). A person must exhibit several characteristics to be clinically diagnosed as
having ADHD:
 Severity. The behavior in question must occur more frequently in the child
than in other children at the same developmental stage.
 Early onset. At least some of the symptoms must have been present prior
to age 7.
 Duration. The symptoms must also have been present for at least 6 months
prior to the evaluation.
 Impact. The symptoms must have a negative impact on the child’s
academic or social life.
 Settings. The symptoms must be present in multiple settings.

b. Discussion of the Implications of the Findings

Different research studies conducted about ADHD have great

impact in the field of counseling as well as in education. Understanding their
similarities and differences will yield assistance in the development of
interventions designed to assist clients in the development of their academic
and social skills, which will lead to success within the classroom, as well as with
their peer groups.

c. Limitations

The cause of ADHD still remains mysterious even though several

studies have tried to explain its occurrence to children. It has been observed as
well that the fields specialized to assess this disorder have not been strongly
established. There is a need to further train personnel specialized in the said field.

d. Suggestions for Further Research

Further and deeper researches about the relationship of having ADHD

children with existing discipline and parental control at home are encouraged.

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Appendixes

Table of DSM-IV Criteria for Attention Deficit/Hyperactivity Disorder

Source: American Psychiatric Association: Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition. Washington, DC, American
Psychiatric Association, 1994.

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