Volume : VII, Issue : III, March - 2017

Attention Deficit & Hyperactivity Disorder (ADHD) Participation Profile (APP): Primacies in Parent’s Perception

Nandgaonkar Hemant P. , Ferzandi Zarine D.

Abstract :

 The aim of the study was to develop the instrument for the evaluation of Level of Participation of the child with a diagnosis of Attention Deficit Hyperactivity Disorder. We derived 74 questions for caregiver–administered questionnaire to get insight into parent‘s perspective. Content Validity index of the item was 0.67. Reliability checked by computing Cronbach‘s alpha was .969, which indicates a high correlation between the items and the questionnaire, is consistently reliable. Based on factor analysis, we confirmed 20 items representing parent‘s viewpoint. BACKGROUND             Attention deficit hyperactivity disorder (ADHD) is a prevalent disorder of childhood.  The worldwide prevalence of ADHD in all age groups is 5.29%. But in children and adolescents, it is about 6% to 13% and is more common in males ADDIN EN.CITE JA.20112(JA., 2011)2247Dopheide JA. American Pharmaceutical Association 148th Annual Meeting201116–20 March 2011San Francisco, CA, USA.ENGLISH. In Asia, the prevalence of ADHD is 3.7% and in India that involves some 10 to 15% of the childrenADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM–1", "itemData" : { "PMID" : "2003469828", "abstract" : "Objective: To identify ADHD children, to show the prevalence of the disorder in the age group of 5– 12 years and to study their socio–demographic variables, associated medical and co–morbid psychological problems. Methods: This is a cross–sectional case study of ADHD children presenting to a child guidance clinic in a busy pediatric hospital over a one year period. The diagnosis of ADHD was based on DSM IV criteria. Results: Of the 238 children referred, 37 were diagnosed as ADHD. 64.9% of the referrals were from pediatricians. The prevalence of ADHD in pediatric clinic was 15.5%, the inattention subtype was predominant. The mean age of boys and girls with ADHD was 8.49 years and 6.82 years respectively. The male to female ratio was 6.4:1. Majority of patients were from middle socio–economic status belonging to Hindu families. 27.0% of children had developmental problems. Oppositional defiant disorder was the most prevalent while depression was the least prevalent co morbid problem. Conclusion: ADHD is prevalent in India and the bunch of these children are mostly presenting to the pediatrician. They need to be aware of the profile of this disorder for early detection and intervention.", "author" : [ { "dropping–particle" : "", "family" : "Mukhopadhyay", "given" : "M", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Misra", "given" : "S", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Mitra", "given" : "T", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Niyogi", "given" : "P", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" } ], "container–title" : "Indian Journal of Pediatrics", "id" : "ITEM–1", "issue" : "10", "issued" : { "date–parts" : [ [ "2003" ] ] }, "page" : "789–792", "title" : "Attention Deficit Hyperactivity Disorder", "type" : "article–journal", "volume" : "70" }, "uris" : [ "http://www.mendeley.com/documents/?uuid=1088001c–3278–46e4–925a–23e576798516" ] } ], "mendeley" : { "formattedCitation" : "(Mukhopadhyay, Misra, Mitra, & Niyogi, 2003)", "plainTextFormattedCitation" : "(Mukhopadhyay, Misra, Mitra, & Niyogi, 2003)", "previouslyFormattedCitation" : "(1)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation–style–language/schema/raw/master/csl–citation.json" }(Mukhopadhyay, Misra, Mitra, & Niyogi, 2003).             ADHD affects child’s participation in different life situations. It might be school, playground, family or any other community contexts. Most often times, the typical symptoms of impulsivity, inattention and hyperactivity, prevent the child from participating in many situations. Initial affectation because of this disorder might be low self–esteem, learning delay and poor social skills. However, later on it might lead to school exclusion, conduct disorder, substance abuse and criminal behavior. Also, it is well studied that sensory processing problem in children with ADHD is more usual than in typically developing youngstersADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM–1", "itemData" : { "DOI" : "10.5014/ajot.2010.09070", "ISBN" : "0272–9490 (Print)r0272–9490", "ISSN" : "02729490", "PMID" : "20608271", "abstract" : "We investigated the evidence for subtypes in children with difficulty processing and integrating sensory information. Fifty–seven articles were incorporated into a systematic literature review; only 4 articles provided direct evidence for subtypes. These studies did not provide a comprehensive assessment of all sensory functions and sensory–based motor functions (i.e., praxis) and included different diagnostic groups. Therefore, generalized conclusions about subtypes could not be drawn. The other 53 studies reviewed provided meaningful information about strengths and challenges that children with difficulty processing and integrating sensory information demonstrate, but these studies were limited in scope. A principal theme was the importance of conducting comprehensive assessments of sensory–based functions, including multiple measures of sensory integrative functions such as praxis, sensory modulation, and sensory discrimination in children and adolescents with various clinical disorders. In addition, more consistency in the use of specific assessment tools will allow for synthesis of data across studies.", "author" : [ { "dropping–particle" : "", "family" : "Davies", "given" : "Patricia L.", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Tucker", "given" : "Rebecca", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" } ], "container–title" : "American Journal of Occupational Therapy", "id" : "ITEM–1", "issue" : "3", "issued" : { "date–parts" : [ [ "2010" ] ] }, "page" : "391–402", "title" : "Evidence review to investigate the support for subtypes of children with difficulty processing and integrating sensory information", "type" : "article", "volume" : "64" }, "uris" : [ "http://www.mendeley.com/documents/?uuid=b9ebaf64–61e7–4ec9–9019–4f105b992ab8" ] } ], "mendeley" : { "formattedCitation" : "(Davies & Tucker, 2010)", "plainTextFormattedCitation" : "(Davies & Tucker, 2010)", "previouslyFormattedCitation" : "(2)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation–style–language/schema/raw/master/csl–citation.json" }(Davies & Tucker, 2010)ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM–1", "itemData" : { "DOI" : "10.1177/153944920202200102", "ISBN" : "0276–1599", "ISSN" : "1539–4492", "PMID" : "2002058934", "abstract" : "The researchers conducted this study to compare the sensory responses of children whose primary diagnosis was Attention Deficit Hyperactivity Disorder (ADHD) and children without disabilities on the Sensory Profile, a parent–reporting measure of children‘s sensory responses in daily life (Dun– 1999). Parents of 70 children 3 to 15 years old with a primary diagnosis of ADHD and parents of children without disabilities matched by age and gender completed the Sensory Profile. Researchers completed a series of Multivariate Analyses of Variance (MANOVA) with post hoc testing to compare the performance of the two groups of children. Children with ADHD differed significantly from children without disabilities in their sensory responsiveness based on Sensory Profile results. The Sensory Profile can contribute to diagnostic and program planning processes and increase understanding of the nature of the disorder of ADHD.", "author" : [ { "dropping–particle" : "", "family" : "Dunn", "given" : "W", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Bennett", "given" : "D", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" } ], "container–title" : "Occupational Therapy Journal of Research", "id" : "ITEM–1", "issue" : "1", "issued" : { "date–parts" : [ [ "2002" ] ] }, "page" : "4–15", "title" : "Patterns of Sensory Processing in Children With Attention Deficit Hyperactivity Disorder", "type" : "article–journal", "volume" : "22" }, "uris" : [ "http://www.mendeley.com/documents/?uuid=8d0d5423–2cbd–41eb–a926–2d4f88564fd0" ] } ], "mendeley" : { "formattedCitation" : "(Dunn & Bennett, 2002)", "plainTextFormattedCitation" : "(Dunn & Bennett, 2002)", "previouslyFormattedCitation" : "(3)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation–style–language/schema/raw/master/csl–citation.json" }(Dunn & Bennett, 2002)ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM–1", "itemData" : { "DOI" : "10.1111/j.1469–8749.2001.tb00228.x", "ISSN" : "0012–1622", "PMID" : "11409829", "abstract" : "This study investigates the presence of sensory modulation dysfunction (SMD) among children with attention–deficit–hyperactivity disorder (ADHD). Twenty–six children with ADHD (mean age 8.3 years, 18 males, 8 females), and 30 typically developing children (mean age 8.2 years, 21 males, 9 females) were tested using a laboratory procedure that gauges responses to repeated sensory stimulation by measuring electrodermal reactivity (EDR). Parental report measures of limitations in sensory, emotional, and attentional dimensions were administered using the Short Sensory Profile, the Leiter International Performance Scale–Revised, Parent Rating subscales, and the Child Behavior Checklist (CBCL). Compared to the typical sample, the children with ADHD displayed greater abnormalities in sensory modulation on both physiological and parent–report measures. The children with ADHD also displayed more variability in responses. Within the group with ADHD, levels of SMD were highly correlated with measures of psychopathology on the CBCL. Implications of findings relate to the importance of considering sensory processing abilities in a subgroup of children with ADHD.", "author" : [ { "dropping–particle" : "", "family" : "Mangeot", "given" : "S D", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Miller", "given" : "L J", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "McIntosh", "given" : "D N", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "McGrath–Clarke", "given" : "J", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Simon", "given" : "J", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Hagerman", "given" : "R J", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Goldson", "given" : "E", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" } ], "container–title" : "Developmental medicine and child neurology", "id" : "ITEM–1", "issue" : "6", "issued" : { "date–parts" : [ [ "2001" ] ] }, "page" : "399–406", "title" : "Sensory modulation dysfunction in children with attention–deficit–hyperactivity disorder.", "type" : "article–journal", "volume" : "43" }, "uris" : [ "http://www.mendeley.com/documents/?uuid=2a8dcf33–6fdb–4ac6–ad71–eb7771ebf16a" ] } ], "mendeley" : { "formattedCitation" : "(Mangeot et al., 2001)", "plainTextFormattedCitation" : "(Mangeot et al., 2001)", "previouslyFormattedCitation" : "(4)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation–style–language/schema/raw/master/csl–citation.json" }(Mangeot et al., 2001). Participation in activities at home, school and in the community is being a significant part of childhood. It will be useful to know what the parents’ are finding difficult to handle related to his/ her successful participation in day–to–day activities. Most often, it is a basis for giving intervention.  We wanted an outcome measure that quantifies the level of participation of the children with a diagnosis of ADHD after giving Ayres Sensory Integration®. From the literature review and clinical experience, we realized that there is need to design a tool to find out priorities in parents’ perceptions about the child’s participation in the day–to–day activities. METHOD After preparation of the protocol, it was submitted to Institutional Ethics Committee, Seth GS Medical College, King Edward Memorial Hospital, Mumbai and got approval from the ethics committee. Trial design: psychometric design using cross section survey Participants & recruitment: “Informed consent was obtained from all individual participants included in the study.” We conducted study at Occupational Therapy Training School and Centre, Seth G.S. Medical College, K. E. M. Hospital, Mumbai, India. We enrolled parents of typically developing children and parents of children with a diagnosis of ADHD between age of 5 years and 12 years from Mumbai and Thane district. We got referral of Children with a diagnosis of Attention Deficit and Hyperactivity Disorder (ADHD) from Child Guidance Clinic of Department of Psychiatry, Department of Pediatric and Pediatric Research Laboratory. The participants were with an average intelligence. We excluded clients with behavior defiance from the study. For checking validity of the questionnaire, we recruited professionals from the diverse institutions in Mumbai. We selected the participants by universal sampling. To check the face validity of the questionnaire, we recruited 20 professionals (Occupational Therapist, Pediatrician, Psychiatrist, and Psychologist). For checking discriminant validity, we administered the questionnaire on the parents of typically developing children and parents of children with ADHD. In addition to newly developed questionnaire (APP), we administered Sensory Processing Measure and ADHD rating scale IV: Home Form to screen the children before starting Occupational Therapy. 

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Cite This Article:

Nandgaonkar Hemant P., Ferzandi Zarine D., Attention Deficit & Hyperactivity Disorder (ADHD) Participation Profile (APP): Primacies in Parent¥s Perception, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾3 | March‾2017

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