Attention Deficit Hyperactivity Disorder (ADHD)

Public Health Program Promotion for Attention Deficit Hyperactivity Disorder (ADHD)

Final Term Paper

Sonia Donaires

August 16, 2015

MPH 585, Programming and Evaluation in Public Health

Dr. Kelly Wheeler

Table of Contents

Introduction

Needs Assessment

Program Strategic Plan

Mission, Vision and Stakeholders

Program Goals

Logic Model

Planning Model Discussion

Inputs

Outputs

Outcomes -- Impact

Program Objectives for Plan Implementation

Tasks, Timelines, Responsible Leads/Partners

Program Pro Forma

Budgetary Needs

Program Evaluation Plan

Outcome measurements and standards

Program Strategies Summary

Introduction

The learning problem that some children face in the schools is the Attention Deficit Hyperactivity Disorder (ADHD). For Some teachers, it is a challenge to teach children with ADHD and for others it is a frustration. Most parents feel unable to give their support to their children and teachers. They end up being indifferent with their children. These children are difficult to teach and most of the time teachers and parents have certain frustration with them because of their misbehavior and lack of attention. The problem of children diagnosed with ADHD continues through adulthood and become severe if it is not treated. However, ADHD is not considered as learning disability but according to the Disabilities Education Act (IDEA) a child is eligible to receive special education services at the schools. ADHD fall into the category other than health impaired learning problems, and not under “Specific Learning Disabilities”. Research indicates that 30 to 50 percent of children with ADHD also have specific learning disabilities (Learning Disabilities Association of America, 2015).

Attention Deficit Hyperactivity Disorder is a condition that affects children in preschool and elementary and high school. It is estimated that between 3 and 5 percent of children that have Attention Deficit Hyperactivity Disorder (ADHD) cannot control their behavior and have difficulties to pay attention. There are approximately 2 million children in the United States with ADHD. It means that in a classroom of 24 to 30 children, it is likely that at least one will have ADHD (Learning Disabilities Association of America, 2015).

Needs Assessment

Attention Deficit Hyperactivity Disorder (ADHD) is another health problem in the United States that affects mainly children. Currently, the prevalence of children diagnosed with ADHD is children ages 0-17 years. There are nearly one in five high school age boys in the United States diagnosed with ADHD. There are approximately 6.4 million children ages 4-17 had received an ADHD diagnosis at some point in their lives, a 16% increase since 2007 and a 41% rise in the past decade (Schwarz, A. & Cohen, S., 2013).

In the school, children with ADHD most of the time are categorized as troublemakers, losing privileges and punished for misbehaving. In preschool, children have communication problems, poor motor coordination, problem with memory routine, stay on task, listen multiple instructions, problems of socialization, and difficulties to interact with other children. According the Diagnostic and Statistical Manual of Mental Disorders, a child with ADHD present the following symptoms:

· lack of paying attention instructional teaching

· difficulties to listen and making mistakes all the time

· trouble to focus on finishing activities and tasks

· lack of planning and organization work

· losses necessary tools to work tasks such as pencils, toys, homework assignments, books, and so on

· become easily distracted and forget things

· squirms in the chair, gets up, runs around, or climbs during class or in other situations where one should stay seated.

· very often “on the go” or acts as if "driven by a motor”

· talks too much and blurts out answers before questions have been completed

· cannot wait his turn

· Interrupts or intrudes on others’ conversations or games (Engler, 2006).

Attention deficit hyperactivity disorder (ADHD) is the most common mental health disorder that affects children nationwide in the United States. According the data from the National health Interview Survey 1998-2009 the percentage of children ever diagnosed with ADHD increased among boys and girls. The prevalence of ADHD varies by race and ethnicity. The prevalence of ADHD increases to 10% for children with family income less than 100% of poverty level and 11% for those with family income between 100% and 199% of poverty level. From 1998 through 2009, ADHD prevalence rose to 10% in the Midwest and South regions of the United States (Center for Disease Control and Prevention, 2011).

Currently, the federal agency Centers for Disease Control and Prevention reports that there are nearly one in five high school age boys in the United States with ADHD. 11 % of school-age children overall have received a medical diagnosis of attention deficit hyperactivity disorder (Schwarz & Cohen, 2013). In addition, the CDC conducts community-based studies to better understand the impact of ADHD. The Project to Learn about ADHD in Youth (PLAY) is a study being conducted over time in two communities: one school district in South Carolina and five schools districts in Oklahoma. Information from the PLAY study helps us better understand ADHD as well as the needs of children and families living with ADHD (CDC, 2014).

The American Academy of Pediatrics (APP) reports the existence of the treatment of children with Attention-Deficit Hyperactivity Disorder with special health care needs. Children ages 4-17 years receive about 4 in 10 children with ADHD treatment with medication alone, 1 in 10 received behavioral therapy, 1 in 10 were treated with both medication and behavioral therapy, and 1 in 10 received neither medication nor behavioral therapy. Overall, about 1 in 10 children took dietary supplements for ADHD (CDC, 2015).

The type of data is primary data collected through an interview survey nationwide in the United States. The date is a single step cross-sectional telephone survey of households with at least one resident child age 0-17 years at the time of the interview. It was a "complex sample design, with stratification by state and sample type (landline or cell phone) and with clustering of children within households" (CDC, 2013).

Actually, treatments for ADHD have the purpose to reduce the symptoms of children with ADHD and improving functioning. Treatments available are medical prescription by physicians, various types of psychotherapy, education, and training, or a combination of treatments. The program in development will be complementary to the current treatment of ADHD.

Program Strategic Plan for Attention Deficit Hyperactivity Disorder (ADHD)

Mission Statement

The mission of this program is to provide students with symptoms of ADHD to obtain specialized intervention and ensure learning success in the classroom.

Vision

My vision for this project is that every child who comes with a diagnosed of ADHD to school has the right to receive all necessary assistance to improve behavior and academic achievement.

Program Goal

To improve academic achievement, social, emotional, and behavioral functioning of all students with characteristics of ADHD.

Objectives

- To identify children with symptoms with ADHD (inattention, hyperactivity, and impulsiveness)

- To sensitize teachers and parents about ADHD children

- To identify the treatment that students already have or may need a diagnostic

- To establish strategies or methods for intervention

- To monitor behavior and academic progress

Step 1: Problem Definition

A long-term study of children with ADHD reported that there is 46% failed school, 11% have been suspended or expelled from the schools. This study also have shown that children with ADHD expulsed plus dropout resulted in a rate of 50%. That rate is alarming since children with ADHD compose up to seven percent of the population in the U.S. The three principal characteristics that interfere with the academic performance of children with ADHD are inattention, impulsivity, and hyperactivity. Children with ADHD have problems focusing on meaningful instruction time and prolonged tasks. On the contrary, they are involved in extraneous details or noises. “Hyper kids” in the classrooms usually lack the motor and verbal control. They are categorized as troublemakers because they cannot sit quietly. Impulsivity affects any task requiring a delay such as raising hands to answer questions, reading, listening to directions, asking questions, planning, and organizing. All of these symptoms imply that the academic progress of these children is poor. In additions, there is an estimated of 50% children with ADHD that have learning disabilities that affect spelling, reading, writing and math. They lack self-control and self-direction (Partners Resource Network, 2015)

Step 2: Conduct a capacity/ Inputs/Gaps Inventory

The target population of Attention Deficit Hyperactivity Disorder health promotion program is children with ADHD in the schools. Relevant stakeholders that might contribute to the program according the priority would be government organizations to obtain contributions, funds and materials necessaries in the process of planning, implementation, and evaluation. Also, the support of leaders of the community will help to organize a committee to support the project. Partners such as the Health Care Professionals that will benefit the program providing their services through doctors, psychologies, researchers, superintendent of the school district, principles, teachers and parents.

Therefore, inputs for Attention Deficit Hyperactivity Disorder would be necessary for the process of diagnosis that involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms of ADHD. Another part of the process may include a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child. Using the same standard across communities will help determine how many children have ADHD, and how public health is impacted by this condition. (CDC, n.d.) Primary resources that would benefit the project are:

· The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) is used by mental health professionals to help diagnose ADHD. Use of the DSM-5 criteria for ADHD to identify children with ADHD.

· Funding resources would include Children and Adult with Attention Deficit/Hyperactivity Disorder (CHADD) summer camps and programs tailored to meet the needs of children with ADHD and related disorders. More information: http://www.chadd.org/Membership/Summer-Camp-Award-Fund/Eligible-Camps.aspx

· Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA). The NIMH was designed to evaluate the leading treatments for ADHD, including behavior therapy, medications, and the combination of the two. More information: http://www.nimh.nih.gov/funding/clinical-research/practical/mta/multimodal-treatment-of-attention-deficit-hyperactivity-disorder-mta-study.shtml

· Individualized Education Programs (IEPs) of the U.S. established in the Individuals with Disabilities Education Act (IDEA 2004) was designed with the purpose to help kids succeed in school through a work team between parents and educators (Kids Health, 2015). More information: http://kidshealth.org/parent/growth/learning/iep.html?tracking=P_RelatedArticle

· 504 Education Plans of the U.S. established in the Rehabilitation Act of 1973 was designed to help parents of students with physical or mental impairments in public schools, or publicly funded private school, work with educators to design customized educational plans. These 504 plans legally ensure that students will be treated fairly at school (Kids Health, 2015)

Step three: Define Activities

Activities for the planning intervention strategies is important to consider the learner and the learning environment.

· Contact the key stakeholders of the community to gain support for the planning, implementation, and evaluation.

· Organized a committee of key persons interested in contributing with their time and be involved in the planning process. Principals, teachers, parents and volunteers from the community.

· Increase academic performance of children with ADHD

· Decrease the number of children with ADHD expelled from the schools

· Staff development for educator about the misconception about children with ADHD.

· Developing a program to inform symptoms, diagnosis, and treatment for children with ADHD for elementary schools.

· Develop a nutrition program to reduce the consumption of sugar for children with ADHD.

Step four: If …..THEN….Process

· If we gain the support of stakeholder from the government and community, then the coalition will be formed.

· If we organized a committee, then they will develop a Attention Deficit Hyperactivity Disorder (ADHD) plan.

· If we increase academic performance of children with ADHD, then children with ADHD will be successful.

· If we decrease the number of children expelled, then children with ADHD will have the possibility to be professional.

· If we reduce the misconception of teachers and parents, then it will increase the acceptance to teach children with ADHD and parents to get treatment for their child.

· If we develop a program to inform about symptoms, diagnosis, and treatment, then we will acknowledge people about children with ADHD

· If we develop a nutrition plan to reduce consumption of sugar for children with ADHD, then children with ADHD will have the possibility to reduce the hyperactivity symptoms.

Step five: Arrange Logic Model Components (below written in the graphic).

Step 6: Logic Model Narrative

The misconception about children with ADHD impedes a fair education and treatment in the schools. Lack of the use of the state plan intervention for children with ADHD has become impossible a satisfactory academic performance of ADHD children in the schools. In order to approach children with ADHD in the schools, the Attention Deficit Hyperactivity Disorder health promotion program is developed to reduce the prevalence of children with ADHD suspended or expelled from the schools. For this reason, the primary objective is to develop a series of activities that will ensure a fair treatment and education for these children. Also, the intervention of stakeholder and partnership with health professionals will address this issue. This step taken has the purpose to gain support from the community and the school districts to implement the ADHD program in the school districts.

Inputs:

· Staff- teachers and parents involved in the intervention of children with ADHD

· The support of principles to ensure implementation of the program

· Psychologists to identify children with ADHD

· Administrative support of the school district (superintendent)