Comparison of Therapies for children Diagnosed with ADHD

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Comparison of Therapies for children Diagnosed with ADHD

Participants

This study's participants will consist of 100 children (N=100) aged 4 to 6 years. This study will be conducted in the school where the children attend the class. The main reason behind selecting the school setting is because, in this setting, all the factors that affect work ethic, social interaction, and behavior will be considered. To conduct this study successfully, a class will be required to have 20-25 students, their teacher, and our professionals. All the participants will be kindergarten children with who ADHD has been diagnosed. We will ensure that the sample size is large enough so that we will be able to collect data that will support or dispute the research question. Using 100 participants surpasses the threshold; therefore, the data to be collected will have a weight to support or dispute the research question. We will use purposeful sampling criteria to find 100 students in the grade kindergarten aged 4-6 years. In qualitative research, it is essential to use purposeful sampling to get valuable data despite the limited resources. The children's choice will be based on pediatrician evaluations and diagnosis of ADHD. To get the participant, it will be ensured that they have not gone a treatment therapy before the start of the study. This is to facilitate the participant to be chosen randomly between methylphenidate treatment and behavioral therapy. The study will ensure that the parent consent of the children is taken. The participant will involve males and females.

Measures

In this study, the best research design is using qualitative experimental research. The main feature of experimental design is selecting the participant randomly; therefore, the research has a maximum control level. In many research for identifying a relationship between two or more variables, they embrace experimental research. This research amicably compares two or more groups. Experimental research consists of both of experimental group and the control group. This experimental group will consist of the children undergoing medication or behavioral therapy; on the other hand, a control group entails children undergoing Methylphenidate. The experimental group gives an independent variable of behavioral therapy. The research will relate behavior therapy's effects symptoms of ADHD and the effect of Methylphenidate therapy on the same symptoms.

Extraneous Variables

Many variables must be examined and recorded in observing and recording various issues related to ADHD children. No factors present in the children's classroom that may not have an indirect influence on the children's behaviors yet are not related to the ADHD symptoms. The presence of distractibility and peer influence are some of the core aspects that are likely to influence children's behaviors. The children can also be affected by the underlying situation related to ADHD and the comorbidities resulting from ADHD. Some of these variables cannot be fully monitored but can be closely checked concerning the study.

Instrument

The instrument used in this study to determine whether behavioral therapy is effective in Comparison to Methylphenidate therapy in treatment of ADHD is a numerical rating scale. Specifically, the study's scale will be the Children's Attentions deficit Evaluation scale. This scale was developed by different researchers that used the current literature in neurology, psychology, and education in modern practices of identifying other individuals' diagnoses. (Buyx, 2019) .The reliability of this scale is much dependent on the participant's faithfulness, but the validity of scale studies is so promising.

Using this scale in the schools and homes version plays an essential role in documentation of ADHD features in schools and home settings of children aged 2-6 years. In most instances, the ADHD scales is constructed for children symptoms who are older; thus, this scale will be used as it evaluates the targeted age of the study. To some extent, this scale will be unique as it will enable both parents and teachers to participate in the ADHD symptoms present in the numerical scale. This scale will be part and parcel of the pre-diagnosis for ADHD and the accomplishing the research of the parents and teachers with a repetition of a questionnaire. This will enable the comparisons of the child questionnaire before behavioral and Methylphenidate therapy and provide answers if a reduction of symptoms is noted concerning the administered treatment.

Intervention Description

Based on CDC, behavioral therapy is the first line of treatment for children under six years, and having been diagnosed with ADHD is behavioral therapy. Behavioral medicine is essential in monitoring any negative behaviors resulting from ADHD. The principle used by behavioral therapy is that the behaviors are usually learned, and destructive behaviors can be modified. Psychologists can assist parents and children in focusing on the negative behaviors that arise from ADHD and the role to play in changing those behaviors. Some forms of behavioral therapy entail cognitive behavioral, aversion therapy, cognitive behavioral, and system desensitization. When working with both the children and the parents, the therapist can use on-form therapy or combine multiple of them based on their effectiveness

Data Collection Procedure

This study's participants will be based on the recommendation of pediatricians. The participant will involve children aged 4 to 6 years diagnosed with ADHD who have yet to start the treatment. Before the participant's placement, it will be ensured that the parent's consent is obtained. Once the recommendation is made, and the parent signs the consent, the research will go to IRB to seek approval. The researcher will search the group using random means. Once the IRB verifies the approval, the participant will be grouped into two. Group A acts as control group, and group B acts as treatment group.

1. Group A

a. There will be the prescription of the methylphenidate dosage of the participant by the Physicians

b. The participant will be required to take Methylphenidate dosage every morning at 7 am before school. They will be taking the dosage at the same time

c. It will be ensured that all the participants don't miss the dosage of medication

d. All side effects of Methylphenidate will be closely monitored

2. Group B

a. In two months, the participant and parents will undergo eight behavioral therapy sessions with a well-trained psychologist.

b. The teachers and parents will provide the positive behaviors identified

c. The teachers and the parents will be required to have similar behavioral systems in the classroom and at home to have a consistency of participants.

d. It will ensure that the participant has a consistent discipline band adequate structure.

Data Analysis

The research will be conducted in different demographics to have diverse participant groups. Male and females will be included in the study aged 4-6 years. The study will ensure that the participants are from different ethnic groups having the fulfillment of being diagnosed with ADHD yet not started the treatment. Descriptive studies will be implemented to analyze the demographic, as shown IN the table below.

In the analysis, ADHD symptoms score will be determined by ACADDES educators and parent questionnaires. The questionnaire will use a scale that ranges from 0 to 4. Zero indicates no sign of ADHD, and four exhibits ADHD behavior. The trial participants in the two available groups' scores will be done before that treatment when completion of the trial process is done. The analysis is supposed to run through ECADDES computer system that will convert scores from raw to standards and percentiles, thus making the score to be more efficient. The descriptive statistics will consist of standard deviation, Variance and inference methods will be a t-test used to analyze data collected from the questionnaire. Comparison will be made in both groups to examine whether experimental group participants in the behavior therapy outcomes differed from the stimulant Methylphenidate control group.

Results

The study is aimed at investigating the effectiveness of the treatment symptoms of ADHD between behavioral and Methylphenidate therapy. This research was guided by the hypothesis that stated non-pharmacology therapy is an appropriate therapy for ADHD compared to Methylphenidate stimulant therapy for children aged 4-6 years. Based on the literature review, it is clear that we can predict the real expectation of the results. For example, the CDC's study in 2018 indicated that less than 50 % of the children practicing stimulant therapy had initially practiced behavioral therapy. Of the children aged between 4-5 years, only one out of five was taking the medication to treat ADHD instead of recommending the use of behavioral therapy. This study also identified variations in the use of behavioral treatment from State to State. (Thyagarajan (2019) The study showed that all those states that opted to utilize behavioral therapy as the first line of treatment had decreased the number of children on the stimulate therapies. Most studies have put a lot of emphasis on combining behavioral therapy and stimulant medication. The current research also shows that pharmacological therapy is an effective method of treatment of the symptoms.

The figure below shows the expected results of the side effects of the different therapies;

This indicates that the method B score is higher than A, thus more effective in treating ADHD.

Discussion

Ethical Issues

In conducting any research, there are incidences of ethical issues to arise, especially when using minor children. When performing the study involving children, it is essential to identify what the targeted population will benefit from the research. The central issue that requires to be addressed is whether the investigation will bring harm to children. (Freitag & Buyx (2019). In this research, the participant in the control group will receive Methylphenidate therapy which cannot endanger the participant or put them at risk from the medication. The parents will be well informed of the side effect through consent, and if the side effects arise, the pediatrician will check the patient. Despite the research being conducted in a school setting, it will be ensured that confidentiality and privacy will remain intact. The researcher will not require to expose the information on the progress of the teachers who is part and parcel of the evaluation process.

Limitation of the study

The environment in which the research is conducted may become prone to biased results. The classroom environment may be subject to high stimulation from the children. It may be a rise in distractions that may result in poor results during the evaluation process. In addition, the person collecting the data may affect the performance. The teacher may score the students differently basing the criteria used, while the parents see them differently. The teacher and the parents can skew the score since they know the initial performance. To provide a resolution to this, it is essential to ensure that the participants are taken to classrooms where they are not familiar with their teachers.

References

Shellenberg, Stoops, Lile & Rush (2020). An update on the clinical pharmacology of Methylphenidate: therapeutic efficacy, abuse potential, and future considerations.  Expert Review of Clinical Pharmacology,  13(8), 827.

Jayamaha, Perera, Herath & Rodrigo (2018). A cross-sectional survey of adherence, perceived efficacy, and side effects of Methylphenidate among children at a teaching hospital in Sri Lanka.

Masi, Fantozzi, Villafranca, Tacchi, Ricci, Ruglioni & Cortese (2019). Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment.  Neuropsychiatric disease and treatment,  15, 663.

Sierawska, Prehn-Kristensen,Moliadze, Krauel, Nowak, Freitag & Buyx (2019). Unmet needs in children with attention deficit hyperactivity disorder—can transcranial direct current stimulation fill the gap? Promises and ethical challenges.  Frontiers in psychiatry,  10, 334.

Ghasemi, Nori & Abdi Zarrin (2019). The effect of parent management training (PMT) on the reduction of behavioral symptoms in children with attention deficit hyperactivity disorder (ADHD).  Quarterly Journal of Child Mental Health,  6(2), 9.

Bussalb, Congedo, Barthélemy, Ojeda, Acquaviva, E., Delorme & Mayaud (2019). Clinical and experimental factors were influencing the efficacy of neurofeedback in ADHD: a meta-analysis.  Frontiers in psychiatry,  10, 35.

Comparison of the Two Groups

Group A 3 2 3 4 4 Group B 4 4 4 3 4