Introduction
My personal project aim is to investigate new media technologies. The ways in which new media technologies can be implemented to assist teenagers and young adults with ADHD in their daily lives. Teaching them to use their so called deficits as skills. Thus providing them with a location-aware, non-hierarchical, social network which supports the social and behavioural nature of those with ADHD. Focusing on their deficits as strengths, stopping them feeling misunderstood and isolated which often causes them to get into trouble.
The review of literature begins with an overview of ADHD, the research findings, conclusions and hypotheses. It then goes on to a review of the eitology of ADHD looking into the Hunter Concept in more detail. The correlation with ADHD and creativity is reviewed and the effect Green Time has on the condition.
The following chapters review assistive technology , social computing and locative media. Concluding with a discussion of the way in which these emerging technologies can be implemented.
What is ADHD - research findings, conclusions and hypotheses
There has been a wealth of literature written on ADHD. There have been many journal and press articles, research papers, books and Government and charity publications published on the subject. In addition to those are many internet sites both unofficial and official dedicated to ADHD Worldwide.
Background Information on ADHD
The American National Information Center for Children and Youth with disabilities (NICHCY) describes the core symptoms of ADHD as developmentally inappropriate levels of inattention, hyperactivity, and impulsivity. These problems are persistent and usually cause difficulties in one or more major life areas: home, school, work, or social relationships. Clinicians base their diagnosis on the presence of the core characteristics and the problems they cause.
Not all children and youth have the same type of ADHD. Because the disorder varies among individuals, children with ADHD won't all have the same problems. Some may be hyperactive. Others may be under-active. Some may have great problems with attention. Others may be mildly inattentive but overly impulsive. Still others may have significant problems in all three areas (attention, hyperactivity, and impulsivity). Hence the three subtypes of ADHD:
- Predominantly Inattentive Type
- Predominantly Hyperactive-Impulsive Type
- Combined Type (inattention, hyperactivity-impulsivity)
For instance, children with ADHD, without hyperactivity and impulsivity, do not show excessive activity or fidgeting but instead may daydream, act lethargic or restless, and frequently do not finish their academic work. Not all of these behaviours appear in all situations.
Of course, from time to time, practically every person can be a bit absent-minded, restless, fidgety, or impulsive. So why are these same patterns of behaviour considered normal for some people and symptoms of a disorder in others? It's partly a matter of degree. With ADHD, these behaviours occur far more than occasionally. They are the rule and not the exception.
According to the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association, ADHD can be defined by behaviours exhibited. Individuals with ADHD exhibit combinations of the following behaviours:
- Fidgeting with hands or feet or squirming in their seat (adolescents with ADHD may appear restless);
- Difficulty remaining seated when required to do so;
- Difficulty sustaining attention and waiting for a turn in tasks, games, or group situations;
- Blurting out answers to questions before the questions have been completed;
- Difficulty following through on instructions and in organizing tasks;
- Shifting from one unfinished activity to another;
- Failing to give close attention to details and avoiding careless mistakes;
- Losing things necessary for tasks or activities;
- Difficulty in listening to others without being distracted or interrupting;
- Wide ranges in mood swings; and
- Great difficulty in delaying gratification.
According to Barkley (1997) Children with ADHD show different combinations of these behaviours and typically exhibit behaviour that is classified into two main categories: poor sustained attention and hyperactivity-impulsiveness. For instance, children with ADHD, without hyperactivity and impulsivity, do not show excessive activity or fidgeting but instead may daydream, act lethargic or restless, and frequently do not finish their academic work. Not all of these behaviours appear in all situations.
According to the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) Attention deficit hyperactivity disorder (ADHD) is a neurological condition, which affects those parts of the brain which control attention, impulses and concentration. It is thought to affect 3 to 7% of school age children.1 2 3 Research has shown that boys are three times more likely to suffer from ADHD than girls.4
The best description for ADHD is that a child who suffers from this condition shows disruptive behaviours, which cannot be explained by any other psychiatric condition and are not in keeping with those of the same-aged people with similar intelligence and development. These behaviours are usually first noticed in early childhood, and they are more extreme than simple “misbehaving”. Children with ADHD have difficulty focussing their attention to complete a specific task. Additionally they can be hyperactive and impulsive and can suffer from mood swings and “social clumsiness”.
Although people with ADHD can be very successful in life, without identification and proper treatment, ADHD may have serious consequences, which can include4:
- Under- performance at school
- Depression
- Problems with relationships
- Problems finding and keeping a job
- Criminal behaviour
Early identification by a healthcare professional is therefore very important to ensure that the child can fulfil his/her full potential.
Children with ADHD tend to display the following behaviours: -
- Hyperactivity
- Impulsive behaviour
- Inattention
- Social clumsiness
- Poor coordination
- Disorganisation
- Mood swings
- Specific learning disabilities such as dyslexia
- Language problems
- Difficulties with handwriting / written work
In people with ADHD, behavioural problems are seen in several places i.e. not just at school. Some children with ADHD have significant problems with concentration and attention but are not necessarily overactive or impulsive. It was thought until recent years that children outgrew ADHD in adolescence. However, it is now known that in approximately one third to one half of children with ADHD, the symptoms continue into adulthood.5
This is Netdoctor.co.uk’s response to the question “What are the symptoms of adult ADHD?”
Like childhood ADHD, adults share the symptoms of inattention, impulsiveness and hyperactivity. For some adults, the hyperactivity part of things calms down and is more controllable as they get older.
Research has shown that the experience of ADHD varies with age and symptoms can be quite different for people as the years go by.
Adults can experience ADHD in different ways, but some of the common symptoms include:
· concentration problems
· forgetfulness and poor short-term memory
· lack of organisation
· problems with creating and maintaining routines
· lack of self-discipline
· impulsive behaviour
· depression
· low self-esteem
· restless mind
· restlessness
· poor time management
· impatience and frustration
· poor social skills
· saying inappropriate remarks
· Feelings of underachievement.
Etiology of ADHD
There are many researched domains on the etiology of ADHD. Neurochemical, biological/gestational, evolutionary/genetic origins for the disease have been explored.
The neurochemical, focuses on the role of specific neurotransmitters that connect the neuronal circuits underlying attention. Neurological studies are converging on the conclusion that a dysfunction in the orbital limbic pathways of the frontal area is the probable impairment that gives rise to the primary features of ADHD (Barkley 1990,).
Most investigators in this area endorse a biological predisposition to the disorder (Barkley 1990, p.104). Barkley further discusses the biological origins in pregnancy, birth complications, toxins, infection, and heredity..
The evidence that some forms of ADHD have a genetic component come from a number of family aggregation, adoption, and twin studies over the past 30 years reviewed by DuPaul (1990). In the case of ADHD it would seem that hereditary factors play the largest role in the occurrence of these symptoms in children (Barkley, p.104). The development of ADHD need not have a hereditary origin, but heredity does correlate to a small percentage of this disease. Comings (1994) proposed that a site on the D2 gene coding may likely be responsible for ADHD and related syndromes.
Genetic studies on the segregation analysis of the twin and adoption studies suggest that there is a heritable component in some children and adults (Biederman, 1994:Faroane et, al. 1994, 1995). Multiple genes on chromosome 3 are related to compulsivity and aggression, (L.A. Phelps, Personal Communication Oct 20,1997). Phelps goes on to say that 80% of ADHD subjects have a first degree relative who is also ADHD. The review of literature by Lombroso (1994) clearly suggests that there are genetic factors involved in the etiology of many childhood psychiatric disorders. If the gene for this disorder can be identified then a greater degree of understanding and treatment may ultimately result for those afflicted with this disease.
Barkley discounts the fact that ADHD can arise purely from social and/or environmental factors. These factors, however, can contribute to the manifestation of the symptoms in each individual case. This is reflected in the treatment process being centred on social/environmental accommodations.
The evolutionary perspective lies in the fact that right brain development, or lack thereof, was especially important during our pre-agricultural evolutionary period (Shelley-Tremblay & Rosen, 1996). During this time our existence was more dependent on our ability to hunt. ADHD was perhaps beneficial during past evolutionary periods (Hallowell & Ratey, 1994). The genetic code was most likely valuable to survival in pre-agricultural human beings. The evolutionary perspective does not explore the possibility that these changes may be the first indicators of a threshold to new functions in the evolutionary development of the brain.
The ‘Hunter Concept’
Thom Hartmannn is an award-winning, bestselling author, international lecturer, teacher, radio talk show host and psychotherapist. Hartmann believes ADHD is not a disease or a disorder but merely a difference in the way people think. He came up with a metaphor to help describe his son Justin’s mind when he was diagnosed with ADHD.
“Justin, then 13 and a budding biologist, was devastated when a doctor told him he had a “brain disease” and would never go to college. Hartmann chose to explain it differently: he told Justin that the world was made up of hunter-gatherers and farmers and that 100,000 years ago the hunter-gatherer was vital to sustain humankind. He was prepared to risk his own life to get food and he was easily distracted by things, making him a good hunter and guard. As the world evolved and many of the risks were eliminated, the need for the hunter type diminished. He explained to Justin that he was “a hunter — and the world has been taken over by farmers. You can learn to be a farmer or you can take farmer pills.”
Hartmann (1993) later created and popularised ‘The Hunter Concept’ in the book ‘ADD - A Different Perception’ and In Hartmann’s ‘Beyond Add: Hunting for Reasons in the Past and Present ‘(1996).
In an article for The Times Online Abigail Rayner (2003) reports that what had started out as a metaphor was later backed up with science. Jay Fykes, a cultural anthropologist, found that the theory was exhibited in the different ways that American Indian tribes had evolved: “The Athabaskan are displaced hunters: give them a spear and a horse and they ruled the world, but when they tried to live in boxes and drive around in boxes and work in boxes, their society fell into crisis. The Pueblos had always been a thoughtful, fairly well-organised society and they did pretty well in modern America.”
In an online article entitled ‘Attention Deficit Hyperactivity Disorder and Green Time’ published on an information and resources site for parents and children 4ADHD St Clair writes
“ Dr. Richard P. Ebstein, a molecular geneticist and laboratory director at the Sarah Herzog Memorial Hospital in Jerusalem, has isolated the gene called DRD4 that seems to be a factor in ADHD.”
A couple of years ago Dr Robert Moyzis, of the University of California in Irvine, found that early human beings with ADHD traits were more likely to survive. The traits were associated with the DRD4 7R gene that is present in about half of ADHD individuals. Many other ADHD experts have disagreed with Hartmann’s theory, but they agree that the syndrome does exist in children and adults and cannot be ignored.
I
http://www.4-adhd.com/greentimeadhd.html hosts research projects with the conclusion exercise and working outside in a green environment reduces symptoms of ADHD.
The correlation between Add and creativity has been argued for several years. According to Crammond (1995) Being ADHD you see things that others miss. There are traits commonly associated with ADHD that are also associated with highly creative people. These are inattention, daydreaming, sensation seeking, and inability to finish projects, hyperactivity, enthusiasm and playfulness, difficult temperament, deficient social skills, academic underachievement, hypersensitivity to stimulation and mood swings
Russell A Barkley’s book ‘ADHD and the Nature of Self-Control’ reviews the diagnostic criteria (DSM-VI) of the disorder. It identifies the inadequacies of current conceptualisations and presents a new range of hypotheses about the nature of the disorder and construct of behavioural inhibition. The book provides an insight into the day-to-day adaptive functioning problems of children and adults affected by the disorder.
There have been a number of reports and articles written on the impact that ADHD has on the social interactions of those who suffer with the disorder. There are three major symptoms of AD/HD that can affect the way individuals get along with other people:
Inattention -- an individual has difficulty with paying attention, organization and following through on tasks
Impulsivity -- an individual has difficulty with talking or acting before thinking, or with self-control
Hyperactivity -- an individual is unusually active or restless
Add.about.com has published an on-line article ‘Communication skills (Bailey 2006). This provides insight into into ADHD symptoms and how they can become barriers in achieving effective communication. The article gives tips and suggestions but there is no evidence or references to support the statements made by Bailey. Research of literature in this area is needed and books highlighted for further reading are
‘Right-Brained Children in a Left-Brained World : Unlocking the Potential of Your Add Child’ by Jeffrey Freed, Laurie Parson, Laurie Parsons; Simon & Schuster,1997.Right-Brained Children in a Left-Brained World offers a step-by-step program that shows parents how to work with, not against, the special abilities of the ADD child.
‘ADHD and Teens : A Parent's Guide to Making It Through the Tough Years’ by Colleen Alexander-Roberts, Paul T. Elliott; Taylor Publishers,1995. ADHD (Attention Deficit Hyperactivity Disorder) is the most common behavioural disorder in American children. Teens with ADHD have an extremely high risk of failing in school, becoming drug abusers or alcoholics, breaking the law, and becoming teenage parents. This manual offers practical advice to help parent scope with these problems.
Windows into the A.D.D. Mind: Understanding and Treating Attention Deficit Disorders in the Everyday Lives of Children, Adolescents and Adults by Daniel G. Amen; Mindworks Press, 1997.
Visual Thinkers, Gifted People with Learning Difficulties, Computer Imaging, and the Ironies of Creativity, THOMAS G. WEST, ISBN 1-57392-155-6. West is a columnist, who has also been a manager and consultant in computer systems, energy research, and international technology. He directs the Visualization Research Institute of Washington, DC. In the Mind's Eye profiles gifted individuals who used non-traditional methods in their work as it explodes many myths about conventional intelligence and charts new vistas for today's computer visualization technologies. West examines the learning difficulties experienced by these people and others, and how recent neurological research shows an association between visual talents and verbal difficulties. In the Mind's Eye probes new data on dyslexics and ADHDers to see how computers enhance the creative potential of visual thinkers, as well as interactive computer applications to all levels of education and work.
Assistive Technology
Lindi Johnston’s research paper ‘How Assistive Technology Helps Overcome Learning Disabilities’ explores the various types of learning disabilities. Johnston looks at how assistive technology can play a beneficial role in those students’ lives that suffer from learning disabilities. The chapters relevant to my research are other disorders and the impact that ADHD has on social interactions.
Johnston states ADHD is a common inattention disorder that is characterised by inattention, impulsivity and hyperactivity. The learning difficulties experiences by those who have ADHD are poor organisational skills, problems categorising and memorising information, weakened interpersonal relation (poor social skills) a poor self concept, low co-ordination and motor functions and short attention spans.
According to Johnston the types of assistive technology available are
· pda (personal data assistant) for those who suffer organisation and memorisation problems
· Headphones for those who have social skills deficits. They are used to block out distractions.
· Amplification systems to aid concentration
· Varial speed tape recorders for adaptive listening
· CD-roms can be used for direct interactions
Social Computing
Social software networks and mobile software have seen a massive rise in popularity in the last few years. Social software comes in many different forms, the most well known being Web logs (aka blogs), wikis and social networking and tagging sites.
Blogs are easily updated online personal journals which are arranged in diary format. Blogs are accessible for all to read and leave comments on.
Wikis are online encyclopaedia s that can be extended and edited by users. The most popular of them being Wikipedia which was started in 2001, it currently contains 1,507,723 articles.
Social networking - My space. In May 2006 - Comscore’s Media Matrix reported that My Space had 51.4 Million unique visitors making it the 7th most frequented website in the world. Based on its size it would be the 12th largest country in the world.
Social Tagging sites such as del.icio.us and Blink list allow users to share their favourites/bookmarks with others. The bookmarks are tagged with keywords which enables the user to search for resources via others’ tags. This puts information in a social context, so you can find resources that others found useful and how they categorized them.
Leon Cych a consultant of emerging technologies in education believes blogs can be used for regular writing practice and the compilation of coursework. Saving the collection of books, writing and projects.
What Are Location-Based Services?
Location-based services (LBS) are applications that leverage the user's physical location to provide an enhanced service or experience. Location awareness can be used, for example, for mapping and navigation, shipment tracking, finding points of interest or a even virtual tour guide. Location awareness differentiates mobile applications from traditional PC and wired Internet services. GPS, RFID, Bluetooth are used in many locative media projects.
Ben Russell is the author of Headmap.org.uk (a blueprint for wireless technology, location aware devices) and one of the founders of the Locative Media Lab. In Russell’s on-line article for Vodafone Receiver Magazine, he discusses the social qualities of locative communication.
My research of social software led me to some motivating and innovative projects. Socialight was one of them.
Socialight is a mobile social networking system that was designed by students on an Interactive Telecommunications Program at New York University. Users initially join online and at first glance it looks like a run of the mill social networking site. However on closer inspection Socialight has much more exciting capabilities than it first lets on.
All users current locations are tracked by Socialight's central server. When two users are located in the same physical area they are notified of this. The user can view the other's profile and decide whether or not they wish to utilize the option of communicating with the other user. Teens and young adults with ADHD could really benefit from this adhoc networking as it takes the embarrassment of approaching a stranger in an attempt to initiate conversation with them.
There are a number of additional features which could also benefit an ADHD user. Socialight has a 'tap and tickle' function which requires little concentration to manipulate. This can be used to say "hi!" or give a 'nudge' to a friend. You can even make up your own secret morse code like vibing messages. The sticky notes feature could be an invaluable asset to a user with ADHD who suffers from memory problems
References
Barkley, R, A. (1997). ADHD and the Nature of Self-Control. New York: The Guilford Press 8. 1-350.
American Psychiatric Association DSM IV diagnostic criteria
Barkley, RA, ADHD: a handbook for diagnosis and treatment. New York 1998. Guilford Press
Wolraich ML (1996). Comparison of diagnostic criteria for ADHD in a countrywide sample. Journal of the America Academy of Child and Adolescent Psychiatry; 35:319-324
Green C and Chee K. (1997) Understanding ADHD – A Parent’s Guide to Attention Deficit Hyperactivity Disorder in Children. Vermillion Publishing
Murphy KR and Barkley RA. (1996). The prevalence of DSM-IV symptoms in adult licensed drivers. Implications for clinical diagnosis. Comprehensive Psychiatry; 37:393-401
NETDOCTOR http://premium.netdoktor.com/uk/adhd/adult/facts/article.jsp?articleIdent=uk.adhd.adult.facts.uk_adhd_xmlarticle_004624
Hartmann, T (1993) The Hunter Concept
Hartmann, T (1996) Beyond Add: Hunting for Reasons in the Past and Present
DuPaul, G.J. (1991) ’Parent and teachers ratings of ADHD symptoms:Psychometric properties in a community-based sample.’ Journal of Clinical Child Psychology
http://www.4-adhd.com/greentimeadhd.html
Lindi Johnston (2005) How Assistive Technology Helps Overcome Learning Disabilities
http://tiger.towson.edu/~ljohns15/research/paper.htm
Hartmann, T (1993) later created and popularised ‘The Hunter Concept’ in the book ‘ADD - A Different Perception’ and In Hartmann’s ‘Beyond Add: Hunting for Reasons in the Past and Present ‘(1996).
London Times on-line Is it ADHD that’s eating the boss? September 15 2004
http://timesonline.co.uk
Crammond, B. (1995). The Coincidence of Attention Deficit Hyperactivity Disorder and Creativity (RBDM 9508). Storrs, CT: The National Research Center on the Gifted and Talented, University of Connecticut
St Clair, J. 4adhd
Russell, B.(2003) Vodafone Receiver Magazine.
www.socialight.com
