Education in the family and school environments, essential for treating ADHD
Fundación MAPFRE has started up the first online school specializing in the attention deficit hyperactivity disorder (ADHD), headed by Dr. Russell A. Barkley, Clinical Professor of Psychiatry at the Medical University of South Carolina (USA). Targeting both parents and professionals, this initiative is being run in collaboration with Fundación Educación Activa and includes a range of activities, such as the 13th Conference on ADHD held in Madrid, with the participation of leading experts.
Through multiple teaching materials, all of them freely accessible online, Doctor Barkley and his team of collaborators outline the latest findings on ADHD, as well as guidelines for action to be taken both in the family environment and in educational centers. Firstly, Doctor Barkley seeks a clear definition of ADHD, tracing views from the earliest sketchy theories of the late 18th century, right up to the latest conclusions reached thanks to neurology. In his view, it is essential to understand the nature of the disorder so as to avoid confusing it with other pathologies such as autism, Asperger syndrome, psychosis or other problems.
In the 1980s, more attention was paid to the attention deficit problem than to hyperactivity, as it was considered more relevant. But ten years later it was admitted that both pathologies occurred together in most cases and the name attention deficit hyperactivity disorder, as it is now known, was adopted. The combination of attention deficit disorder and hyperactivity is a neurobiological dysfunction characterized by the immaturity of the systems that regulate movement, impulses and attention. Doctor Barkley, who is constantly researching this pathology, is of the opinion – together with other specialists – that ADHD is “actually a deficit disorder of the brain’s executive functions, rather than a simple inability to pay attention”.
“It is a problem of the brain’s executive functions, rather than a simple inability to pay attention”
Why does it affect academic performance?
Many children and adolescents affected by ADHD often develop problems in the field of education. For this reason, they may be classified as maladjusted or conflictive, due to ignorance of this pathology that affects their behavior. In fact, these are the issues of greatest concern to parents and those that most often lead them to seek treatments. Doctor Barkley says that almost 50 percent of children with ADHD may need to receive some kind of special educational support, given that, otherwise, they are three times more likely to drop out of high school.
The academic problems are not only due to attention-deficit difficulties, but also to the responses of those affected to the multiple stimuli they receive in adolescence, such as friendship, sexual awakening or peer pressure to consume addictive substances. Learning difficulties and not sleeping well can also contribute to poor academic performance, since around 20-25 percent of children suffer from sleep disorders.
A responsible diagnosis of the disorder has to take into account at least nine symptoms of hyperactive, impulsive behavior over a period of at least six months, occurring at some point in childhood or adolescence. At the same time, these symptoms must appear in different situations, so that if “a child only has difficulty concentrating on doing their homework assignments in the evening, or only has difficulty putting on their pajamas, ADHD will not be diagnosed, since the problems solely arise in one specific situation.” The important thing, says Dr. Barkley, is that “the symptoms have to be varied, frequent, and disabling, in addition to developing during childhood or adolescence.”
Referring to early infancy (0 to 6 years) these symptoms would be: shunning playing with other children, a preference for games that involve movement, taking toys apart and showing scant interest in playing, delays in speech development, difficulty in learning colors, numbers and letters, difficulty depicting and recognizing the human figure, emotional immaturity and constant tantrums and minor accidents.
In Spain it is estimated that the number of people affected by ADHD ranges from five to seven percent of the child and adolescent population, with three times as many boys as girls.
Understanding what cannot be seen
The relationship between ADHD and the impact on those around sufferers was on the agenda at the 13th Conference on this disorder held in Madrid. Presided over by Infanta Elena, Fundación MAPFRE Project Director, it brought together eleven top specialists in a series of round tables that addressed issues such as the present state and the future prospects of studies into ADHD, impulse control disorders, eating disorders, cannabis and alcohol use disorder, tackling conflictive behavior in the family, epilepsy and ADHD, as well as dealing with the disorder within the family.
Francisco Horcajadas, psychiatrist in the Addictive Behavior Unit at the Doce de Octubre Hospital (Madrid), stressed that “the consumption of both alcohol and cannabis by people with ADHD exacerbates their impulsivity and lack of attention, and may lead to further mental problems.” One more reason to encourage a favorable environment for these patients, given that, in the view of Josep Antoni Ramos Quiroga, coordinator of the ADHD Program at the Universitari Vall d’Hebron Hospital (Barcelona), this is a disorder that “must be treated day after day with psychological assistance.” Ramos Quiroga stated that the incidence of the problem in Spain is five percent of children and adolescents. A group which society does not treat as well as it should, for, in the opinion of the psychologist Natalia García, head of psychology at the PSIKIDS center, “it is hard to understand what you cannot see.” For this reason, she stressed the importance of furthering the education of those who live with the patient.
In this regard, Fernando Garrido, Manager of Fundación MAPFRE’s Social Action Area, adds that “together with the family assistance programs, the Online School provides a course divided into five sections for parents and another ADHD specialization course, so that professionals can round out their training on this disorder.” The latter consists of 15 conferences by Doctor Barkley, each lasting up to two hours, and all kinds of teaching aids that pass on the most recent discoveries on ADHD. The specialization course, with a diploma to be earned, offers over 100 hours of teaching material and lasts between four and six months.
Affects over five percent of children and adolescents
This fact was put forward at the 13th Conference on Attention Deficit Hyperactivity Disorder held in Madrid by Josep Antoni Ramos Quiroga, psychiatrist and coordinator of the ADHD program at the Universitari Vall d’Hebron Hospital, who stressed the importance of the family environment within the treatment. Focused on impulse control disorders and their relationship to ADHD, the Conference, brought together many experts: the attention coordinator at the Eating Disorders Clinic of the Gregorio Maranon Hospital, Ignacio Basurte; the psychiatrist at the Addictive Behavior Unit of the Doce de Octubre Hospital, Francisco Horcajadas; and the head of the Child and Adolescent Psychology Department in PSIKIDS, Natalia Garcia.
They all agreed on the importance of an early diagnosis “which reduces the risk of developing behavior disorders” related to food, something those affected may use as an “escape route” from their anxiety problems. Given the “difficulty in recognizing the symptoms”, the experts emphasized the importance of “providing sound information to families, as well as guidelines for treating this disorder.” They therefore were highly appreciative of this online school initiative specializing in ADHD implemented by Fundación MAPFRE.