About Case Studies of ADHD in Children

The cluster of symptoms currently recognized as ADHD (Attention Deficit Hyperactivity Disorder) was first recognized by practitioners in the early 19th century. Their initial observations concerned primarily individuals with neurological damage due to brain trauma. In the 1980s, clinicians defined ADHD based on six basic symptoms: hyperactivity, restlessness, impulsivity, aggression, distractibility and short attention span. With the publication of DSM-III in 1980, children could now be diagnosed with ADHD without the previously necessary presence of hyperactive behaviors. Clinical case studies are a useful tool for understanding ADHD and how treatment is practically utilized in therapy.

About ADHD

• The three behavioral characteristics commonly associated with ADHD are inattention, hyperactivity and impulsiveness. Children normally exhibit these behaviors more than adults, but if they are significantly pronounced, ADHD might be diagnosed. Approximately 5 to 10 percent of all school-age children worldwide have ADHD, and the disorder interferes with schoolwork and the interaction with classmates and peers. Longitudinal studies show that some children who are diagnosed with ADHD continue to exhibit the symptoms into adulthood.

Causes

• While the causes of ADHD are not known, there have been some clues. Magnetic resonance imaging (MRI) scans indicate that certain brain structures, including the prefrontal cortex and the basal ganglia, are smaller in children with ADHD, pointing to a neurophysiological cause of the disorder. These structures of the neural system have long been implicated in the regulation and planning of behavior, but the observed differences have so far been unclear. Evidence also suggests that hereditary factors play a role in ADHD. Children of parents with ADHD are more likely to develop it, and a child is much more likely to develop it if an identical twin does. Furthermore, several genes related to the function of dopaminergic neurons have been reported to be abnormal in people with ADHD.

Case Study Example

• H. Thompson Prout and Douglas T. Brown, in their book "Counseling and Psychotherapy with Children and Adolescents" describe the case of Jake, an 11-year-old boy who had been diagnosed with Attention Deficit Disorder. Jake was a bright and creative boy with average grades, who suffered from severe distractibility and a lack of organizational skills, all of which negatively affected his school work. In addition, Jake often lied about school work, which created many problems for the family at home. The school-based therapist saw Jake on a regular basis for four months, and also held additional sessions with his parents. The case report describes the primary goals the intervention, which focused on increasing completion of school work and cooperation at home. The therapist, together with the parents and teachers, developed a checklist of acceptable behaviors, and the parents were advised to learn proper responses to Jake's frequent oppositional behaviors. The case outlines the challenges that Jake, his family, his teachers, and his therapist encountered, as well as the progress that they all made.

Common Case Study Structure

• Most case studies in clinical psychology try to adherer to the same basic structure, which consists of an introduction of the subject, a description of the symptoms, syndromes and behavioral characteristics, followed by a detailed report about the treatment plan and the resulting outcomes. However, there might be some deviations depending on the researcher, the goals of the case study, and the methodology employed. Some case studies focus on a group of individuals as opposed to a single patient. Other case studies have a more biological focus, and will discuss pharmaceutical treatments and use language common to drug studies. Other case studies will focus on neurphysiological aspects, and may describe methodology in technical terms pertinent to MRI and other imaging techniques. It is important to consider goals of the research when attempting to understand the structure of the case study write-up.

Considerations

• Because there is such a variance in expert opinions about the causes and treatments of ADHD in children, it is important to research case studies in the context of overall literature on the disorder. Context, as well as the theoretical and clinical foundation that the researcher bases their report on is particularly critical when trying to do objective analysis and interpretation of clinical case studies.