Overview of ADHD in School and Adulthood

 ADHD is a common diagnosis throughout the United States, but there are many misconceptions about this neurodevelopmental disorder. Throughout this paper, I will review how ADHD manifests in school, how ADHD can manifest in adulthood, and three long term effects of ADHD medications. ADHD will manifest itself in school differently, just like how it will affect every child differently. During school, inattentive symptoms might be making careless mistakes, being easily distracted, or having trouble finishing school work. Hyperactive symptoms would be having trouble staying seated, fidgeting or squirming, or being interruptive during lessons. With that being said, educators need to realize that not every high-energy child will have ADHD. Within one grade, every student’s age can vary by two years. While this may not seem like a big difference, it can make a huge difference in a child’s maturity level and a child’s ability to self-regulate. But, if the student is not having real difficulty or impairment at home or at school, they might not have ADHD (Miller). But, if these symptoms are persistent, and are causing the child to fail in school, it is important that the child is tested and learns how to manage their symptoms as soon as possible.

 Unfortunately, the outcome studies for people with ADHD are not the best. Compared to classmates, students with ADHD are more likely to be held back in school, to be suspended, and to drop out completely. In fact, about one third of students with ADHD have dropped out of high school. Overall, people will ADHD will complete two years less of post-secondary schooling and only five percent will earn a bachelor’s degree, compared to the 40 percent of people without ADHD who will earn a bachelor’s degree. With this being said, if the student starts to work with a counselor, and learn to manage and cope with their symptoms, the outcome of a successful adulthood will increase. While about 50 percent of people with ADHD continue to show symptoms into adulthood (Rabiner, 2006), there are three predictors that are related to successful adult outcomes. The first predictor is school performance, meaning doing well in school. The second predictor is the absence of conduct problems before the age of 10 and the third predictor is getting along well with peers (Jones, Greenberg, & Crowley, 2015). If educators see student’s failing in any of these areas, it is imperative that an appropriate intervention be put in place. By looking out for risk-taking behaviors, educators will be able to help improve every student’s ability to succeed.

 About half of people with ADHD exhibit risk-taking behaviors that including stealing, vandalism, and drug use. By stopping these behaviors as early as possible, children can grow and thrive into adolescence and adulthood (Kaminski & Claussen, 2017). It is important to look out for risk-taking behaviors because the primary symptoms of ADHD (inattention, hyperactivity, and impulsivity) are not really the main problem or indicator for negative adult outcomes. The behavioral, social, and academic difficulties that may arise increase the risk for negative adult outcomes. If doctors and therapists work together with parents in preventing the development of these academic, social, and behavioral problems, children will have a much more successful adjustment in both adolescence and adulthood (Cuffe et al., 2015).

 Since ADHD medications are stimulants, and many young children take them to help manage their symptoms, many people are worried about how these medications will affect their children or themselves. The three long term effects of ADHD medication that this paper will be reviewing is blood pressure and heart problems, growth suppression, and the abuse of medications. The medicine given to people to treat ADHD are stimulants, which can increase heart rate and blood pressure. Consequently, there is some concern that these medications can cause cardiovascular problems. Research has found that ADHD medication is safe for people to take, and there is only a cardiovascular risk if the person already has an underlying heart problem. Despite this, because stimulants raise blood pressure and heart rate, doctors and medical professionals need take precautions when prescribing these medications and they need to monitor patients who may have a risk for heart problems (Nissen, 2006). Counselors should also be monitoring their students or clients and taking note if they see any changes to alert the client’s physician or psychiatrist about. The effect of ADHD medications on growth has been an ongoing conversation. Unfortunately, there is conflicting evidence if long-term use of ADHD medications suppress growth. Some studies find statistically significant outcomes in agreement that medications suppress growth (Charach et al., 2006), while others find the opposite (“MTA Cooperative Group,” 2004). One theory about why ADHD medications might affect a child’s size has to do with the side effects of medication, which is appetite loss. When kids eat less, they don’t get as many nutrients and they don’t grow as quickly (Harstad et al., 2014).

 Another long-term effect of ADHD medication is the potential cause for abuse, because snorting pills produces a cocaine-like high (“ADHD Update,” 2006). One thing that is important to note is that if one does not have a history of substance abuse, it’s unlikely they’ll abuse these medications. But, children with ADHD who are unmedicated have the highest rates of substance use and abuse. More than 80 percent of people who abuse these medications. But, this group also has a diagnosis of conduct disorder or substance abuse, so their risk for selling or using drugs was already higher. Society tends to focus on primary symptoms of ADHD (inattentiveness, hyperactivity, etc.), but, as stated previously, doctors, therapists, and parents really need to be focusing on secondary symptoms, like risk-taking and behavioral problems, which are the characteristics that lead to substance abuse (Wilens et al., 2006).

 ADHD is a completely manageable neurobiological disorder when treated with therapy and medication, if necessary. With the right people looking out for the child’s best interest, adolescents will grow into successful adults with a great future to look forward to. When educators, physicians, and counselors work hand in hand, and utilize appropriate intervention plans, negative risk-taking behaviors can be managed and even stopped, which will help the child be successful in all areas of life.

 Overall, I thoroughly enjoyed working on this presentation, because I was able to learn so much more about ADHD, which affects many students on my caseload. I believe that our presentation went well, but I could have done a better job while presenting my section. That Monday was a very busy day for me, because I was also presenting at a conference with another classmate and professor. Therefore, I was solely focused on that, and not on this presentation. I am disappointed in myself that I did not manage my time better to be able to prepare for both presentations, and I feel as though I let my peers down. I knew the material that I needed to present on, but I did not practice as much as I should have. Because of this, I often found myself looking down at my notes to see what I needed to say next. Not only is reading my slides and notes boring, but it is also unprofessional. I should have utilized visual aids to remind me of what I needed to say and use my notes as guidance. Along with this, I feel as though I was talking too fast, which is something that I have needed to work on for a long time. I gave the audience a lot of statistics, but little time to digest and think about the information.

 My groupmates did an amazing job at facilitating discussion and conversation throughout the presentation, which is something that I neglected to do. Looking back, I should have paused after giving a few statistics and ask the audience to share what they thought about these numbers. This way, it would give them time to reflect on the information I presented to them while also thinking about what these numbers might mean for people diagnosed with ADHD. During a quick meeting before we presented, I told myself to remember to ask questions during my part of the presentation. Of course, I completely forgot to do this, and just presented on what I wrote in my notes. Next time, I need to ensure that I am incorporating discussion questions into my slides and notes, so I remember to ask the audience. If I could re-do this presentation and create discussion questions to go along with my portion of the presentation, it would have flown much better with my groupmates portion.

 While preparing for this presentation, my group and I decided early on that we needed to include a multicultural section. I am very happy that we all agreed to do this, because I think it created the most discussion. Not only were we surprised by the results we found, but the audience was also surprised. For example, when we discussed that minority students are often underdiagnosed, many people in the class were shocked by this. I think that this was the best part of the presentation because it facilitated discussion and also educated people on the biases we hold as a society. Because minority students are over-diagnosed for many disorders, people tend to generalize that to all disorders. Before researching ADHD, I tended to believe this too. I was shocked when I read that ADHD was underdiagnosed, but after further research it made more sense. We may be underdiagnosing ADHD, but we are over diagnosing other disorders, like ODD or CD. I am glad that my group was able to present this important information to the class, so that in the future they can look out for this in their clients.

 I believe that my group members and I were able to work well together to present useful and informative material to our class. We worked on this presentation for a long time to ensure we had accurate information and information that would teach the class something different about ADHD. My groupmates did a great job at presenting their parts of the presentation to the class and facilitated great discussion throughout. Personally, I know that I needed to practice my part of the presentation more. In the future, I will organize and manage my time better so that I can also facilitate a better discussion and not look at my notes as often as I did.
 

References

• (October, 2006). ADHD update: new data on the risks of medication. Retrieved from https://www.health.harvard.edu/mind-and-mood/adhd-update-new-data-on-the-risks-of-medication.
• Charach A, et al. (2006). Stimulant treatment over 5 years: effects on growth. Journal of the American Academy of Child and Adolescent Psychiatry, 45(4), pp. 415–21.
• Cuffe, S.P., et al. (2015) Attention-deficit/hyperactivity disorder and psychiatric comorbidity: functional outcomes in a school-based sample of children. Journal of Attention Disorders. doi: 10.1177/1087054715613437.
• Harstad, E., et al. ADHD, stimulant treatment, and growth: a longitudinal study. Pediatrics 134(4), 935-944. doi: 10.1542/peds.2014-0428
• Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early social-emotional functioning and public health: the relationship between kindergarten social competence and future wellness. American Journal of Public Health, 105(11), 2283-90.
• Kaminski, J. W., & Claussen, A. H. (2017). Evidence base update for psychosocial treatment of disruptive behaviors in children. Journal of Clinical Child and Adolescent Psycholog,  46(4), 477-499.
• Miller, C. What’s ADHD (and what’s not) in the classroom. Retrieved from https://childmind.org/article/whats-adhd-and-whats-not-in-the-classroom/.
• MTA Cooperative Group. (2004). National institute of mental health multimodal treatment study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder. Pediatrics, Vol. 113, No. 4, pp. 754–61.
• Nissen SE. (2006). ADHD drugs and cardiovascular risk. New England Journal of Medicine, 354(14), pp. 1445–48.
• Rabiner, D. (2006). Long term outcomes for children with ADD/ADHD. Retrieved from http://www.helpforadd.com/long-term-outcomes/.
• Spencer TJ, et al. (2006). Does prolonged therapy with a long-acting stimulant suppress growth in children with ADHD? Journal of the American Academy of Child and Adolescent Psychiatry, 45(5), pp. 527–37.
• Wilens TE, et al. (2006). Characteristics of adolescents and young adults with ADHD who divert or misuse their prescribed medications. Journal of the American Academy of Child and Adolescent Psychiatry, 45(4) pp. 408–14.