Orit Inbar

ORIT INBARMA student at Haifa university .

Works at her private clinic in Pardes- Hanna
,with children having multiple disorders such as ADHD,SMD, AUTISM, DCD,
guide social groups ,groups to improve
writing ,readiness toward school.

Experience of parents of children with symptoms of ADHD   at the end of therapeutic intervention approach POET

 

ADHD

    Attention Deficit Hyperactive Disorder (hereinafter   ADHD   ) is a neurodevelopmental – behavioral disorder  , considered a chronic health condition, occurs during childhood and is manifested by difficulties to inhibit behavior, to maintain or to focus attention, and to regulate the level of activity in accordance with the environment (Barkley & Murphy, 1996).   For the diagnosis, requires six symptoms or more   of inattention and / or six or more symptoms of hyperactivity - impulsivity, or both together, appearing consistently over the past six months pre-diagnosis, and interfere substantially to the development of social functioning, academic  functioning  , or occupation. ADHD can be diagnosed from the age of four.   That is, early childhood  , during the  pre-school stage   (American Psychiatric Association, 2013).

 ADHD in young children

    Children with ADHD are at risk for experiencing emotional difficulties, behavioral problems, social problems, dysfunctional home life ,difficulties in classroom during learning and through leisure activities     (DuPaul, McGoey, Eckert, & VanBrakle, 2001).   Young children with ADHD show a delay in the development of play, often engage in psychomotor play,   have difficulty participating group activities and social interactions with peers( Alessandri, 1992).  Behavioral difficulties of children with ADHD also affect the functioning of daily routine areas such as eating and bathing Barkley, 1997;   Segal, 1999).)

 Executive functions

     Executive  functions are essential processes allow occupation and participation in the daily life of children (Katz & Maeir, 2011).   They include - flexible thinking, planning, inhibition, and self-regulation, which together form a regulatory capacity and cognitive control of complex behavior (Lambek et al., 2011) .The Executive  functions allow a child to be conducted of self-control and intentionally target (Barkley, 1997).  According to some theorists, Executive  functions are a key component in   ADHD  (  Barkley, 1997;  Brown, 2006).  Studies have found that compared with normative children, children with ADHD are of significant impairment in inhibition, working memory, emotion regulation, planning, cognitive flexibility and verbal fluency   (Berlin et al., 2004; Marzocchi et al., 2008).  Children with   ADHD find it difficult to perform impedance, impulse control or delayed gratification, find it difficult to maintain attention and effort over a chore, play the short game and switch between tasks, find it difficult to hold information in memory for contemporary use, find it difficult to act according to rules, find it difficult to regulate emotions, motivation and arousal and have difficulty in problem solving (Barkley & Murphy, 1996).  Considering the many difficulties  and their consequences, we can assume that the function of a child with ADHD , has an impact on the entire family.

 Parenting and family life

 Family is the main factor supporting the child with special needs (Segal, 1998).  Parents of children with ADHD report higher levels of stress arising from the behavior of the child and difficulties interacting with him (Breen & Barkley, 1988; DuPaul et al., 2001;  McCleary  , 2002;  Morgan et al., 2002).

 Parental Occupation Executive Training   (POET)   is a model for improving functional performance and management of young children with symptoms of ADHD guided by parents.  The model considers the Executive functions as a mechanism to impair the functioning of the children.  Therefore, the purpose of the model is to provide parents of children with knowledge and tools that would enable them to understand the central mechanism affects the functioning of their child, and acquire skills to help the child perform better in all areas of functioning   (Frisch, Tirosh and Rosenblum ,in development).   Providing strategies to parents of children having ADHD is  necessary , the importance of treating children with ADHD in the family context is critical  (  Firmin & Pillips, 2009). Bringing occupation and daily routine basis to work with families, increases the ability to influence effectively and help families handle better ( Segal, 1998).   In addition, the acquisition of knowledge and an increased feeling of parental control helps parents in reducing tension (   Mash & Johnston, 2001).

    The current thesis is a quantitative research carried out in order to extend Frisch's dissertation , which is an intervention study of the POET's model  (Frisch, Tirosh and Rosenblum ,in development).  This research bases the perception that there is a great contribution of qualitative research to understanding the experience of parenting a child with ADHD  ( Segal, 1998).

The current thesis will focus on the experience of parents of children with symptoms of ADHD, 6-12 months after intervention according to the POET's model (Frisch, Tirosh and Rosenblum ,in development).The thesis  wishes to understand the daily experience of families ,having  a child with ADHD , What is the impression of parents according to child's functioning, following therapeutic intervention, what are the feelings of parents about their ability to help their child handle daily routine and what is the experience of the relationship parent - child at the end of the intervention.

References

American Psychiatric Association. (2013). DSM 5. American Psychiatric Association.‏

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive                 functions: constructing a unifying theory of ADHD. Psychological bulletin,       121(1), 65.‏

Barkley, R. A., & Murphy, K. R. (2006). Attention-deficit hyperactivity disorder: A                clinical workbook (Vol. 2). Guilford Press.‏

Berlin, L., Berlin, G., Bohlin, A., & Rydell,. (2004). Relations between inhibition                ,executive functioning, and ADHD symptoms: A longitudinal study from age 5 to 8 years. Child Neuropsychology, 9(4), 255.

Breen, M. J., & Barkley, R. A. (1988). Child psychopathology and parenting stress in       girls and boys having attention deficit disorder with hyperactivity. Journal of            Pediatric Psychology, 13, 265–280.

Brown, T. E. (2006). Executive functions and attention deficit hyperactivity disorder:        Implications of two conflicting views. International Journal of Disability,          Development and Education53(1), 35-46.‏

DuPaul, McGoey, Eckert, & VanBrakle,. (2001). Preschool children with attention-            deficit/hyperactivity disorder: Impairments in behavioral, social, and school           functioning. Journal of the American Academy of Child Adolescent Psychiatry,  40(5), 508

Firmin, M. W., & Phillips, A. (2009). A qualitative study of families and children     possessing diagnoses of ADHD. Journal of Family Issues, 30(9), 1155-1174

Johnston, C., & Mash, E. J. (2001). Families of children with attention-deficit/       hyperactivity disorder: Review and recommendations for future research.                  Clinical Child and FamilyPsychology Review, 4, 183–207.

Katz, N., & Maeir, A. (2011). Higher-level cognitive functions enabling participation:        Awareness and cognitive functions. In. N. Katz (Ed.), Cognition, Occupation and Participation Across the Life Span (pp.13-40). Bethesda: American   Occupational Therapy Association

Lambek, R., Tannock, R., Dalsgaard, S., Trillingsgaard, A., Damm, D., & Thomsen,          P. H. (2011). Executive dysfunction in school-age children with      ADHD.  Journal of attention disorders15(8), 646-655.‏

Marzocchi, G. M., Oosterlaan, J., Zuddas, A., Cavolina, P., Geurts, H., Redigolo, D., .       Sergeant, J. A. (2008). Contrasting deficits on executive functions between             ADHD and reading disabled children. Journal of Child Psychology and          Psychiatry, 49(5), 543-552. (Lambek et al., 2011)

McCleary, L. (2002). Parenting adolescents with attention deficit hyperactivity      disorder: Analysis of the literature for social work practice. Health & Social              Work, 27, 285–292.

Morgan, J., Robinson, D., & Aldridge, J. (2002). Parenting stress and externalizing          child behaviour. Child & Family SocialWork, 7, 219–225.

Segal, R. (1998). The construction of family occupations: A study of families with            children who have attention deficit/hyperactivity disorder. Canadian            Journal of       Occupational Therapy, 65(5), 286-292.

Segal, R. (1999). Doing for others: Occupations within families with children who           have special needs. Journal of Occupational Science, 6(2), 53-60.