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The Origins of ADD

Characterized by poor attention skills, hyperactivity, and an inability to control impulses, Attention Deficit Disorder (ADD) impacts an estimated seven percent of the population (1)(2).  It is thought that ADD occurs due to missing neural connections and a lack of blood vessels in the pre-frontal cortex (2).  There has been research to suggest that the causes of ADD are due to a lack of dopamine receptors and transporters (2).  In recent years, there has been an increase in the number of children diagnosed as ADD (2).  Because of this, there has been an increase in research with the goal of determining the cause of ADD.  With this, several theories have emerged to explain the reasons behind ADD.  This paper is a critical examination of these possible origins.
 Research suggests that there is a genetic component to ADD (1)(2)(3).  Twenty five percent of children with ADD also have close relatives with ADD.  By contrast, this only applies to 5 percent of the general population (3).  One study suggested that up to 80 percent of ADD can be linked to genetic factors (4).  Currently, there is research being conducted to ascertain which genes are responsible for ADD (5).  So far, the genes that have been isolated are associated with dopamine receptors.  Most scientists who research ADD hypothesize that it is not a single gene that causes ADD but multiple ones.  The genetic explanation for ADD is logical because of the high correlation between parents and children with ADD.  That being said, there are probably other factors that can influence this disorder.

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Book Review for Scattered: How Attention Deficit Originates and What You Can Do About It

For my book review, I read Scattered: How Attention Deficit Disorder Originates and What You Can Do About It by Gabor Maté. Based on his own experience as someone with ADD and his clinical experience with patients, he covers the origins of ADD, how it impacts relationships, and possible ways for people with ADD to deal with the challenges the condition presents in life.
Maté defines ADD as those who exhibit at least two of the following characteristics: poor attention skills, deficient impulse control, and hyperactivity. He explains that the neurological origins of ADD are rooted in missing neural connections and blood vessels in the prefrontal cortex. Dopamine and endorphins are central in generating the creation of new neural connections. These connections increase with an increase in the amount of endorphins and dopamine released which occurs when one has joyful, happy experiences. Those who are deprived of these experiences develop fewer dopamine receptors and blood vessels in the right prefrontal cortex; ADD is the result. Maté argues that this means that those with ADD were deprived of the happy experiences that nurture these attributes and as a result develop ADD.
Maté posits that a person's first few months of life are particularly important in the development of ADD. During this time, infinite amounts of neural pathways are being formed. Stress placed on the child inhibits synapses to form which results in hyperactivity persisting longer than is typical for the child's age. For Maté, parents are central in the child's development of ADD. I agree that it is probably true that certain environments allow ADD to thrive more than others, but what about the child that has two devoted parents in a nurturing environment and is still diagnosed with ADD? If ADD were to be attributed entirely to environmental factors, all children with negative parenting experiences would be ADD. Maté's inclusion of the genetic prerequisite for ADD appears to serve as a safety net for his argument as the rest of the book is focused on the environmental factors, particularly the parent-child relationship. Of course no environment or parent-child relationship is perfect so it is always possible to argue that these factors are responsible for ADD, but to me it seems like biology would play a bigger part in this scenario than Maté leads the reader to believe. Perhaps if he had spent more time developing the biological side of the argument then it would not seem as though this was the case.
One aspect of the book that I found particularly interesting and that I thought connected well with the rest of the class was Maté's description of ADD in respect to society. Something I really enjoyed about our class discussions was that we constantly questioned our own experiences as well as many agreements that society seems to have reached when it comes to conditions such as ADD. Maté's own approach to ADD is very similar. He views ADD as a condition that results from a different organization of the brain than what is considered "normal." The strategies he poses are ways for people to compensate for this different organization in a world that is not forgiving of those who are atypical. Rather than jumping to the conclusion that those with ADD are in need of medication, he explores alternatives to medication and how the person with ADD as well as those around them can aide them in coping with their condition. What is particularly refreshing is that Maté insists that if patterns of behavior are changed, new neural pathways can be formed and the negative aspects of ADD can be mitigated, no matter what the age of the person. For me this course really challenged me to look at the nervous system from many different perspectives and to question my previously held notions of reality. In many respects, Maté asks his readers to do the same through the lens of ADD.
That being said, he also emphasizes the drastic improvement that medication can have on someone who is struggling with ADD. He points out that it is essential for the patient, whether it is a child or adult, to willing take the medication. Additionally, the doctor prescribing the medication must be knowledgeable about ADD and what an appropriate dose of mediation is for the individual. He stresses that although medication can be used as a way for people to keep focus, ADD should not be seen as a disease that needs to be cured. Furthermore, he suggests that medication should not be the only treatment for ADD, but rather one of many lifestyle alterations that aides in combating the challenges faced by those with ADD.
Another part of the book that I found particularly interesting was Maté's correlation between ADD and addiction. He explains that among those with ADD, there is also a high incidence of people with addictions. He notes that the rush that people get from their addictive behavior regardless of whether it is gambling, smoking, or shopping releases neurochemicals which make them "feel good." For people with ADD, it is thought that the addictive behavior can serve as self medication and a source of dopamine and endorphin release.
Although this book is at times an interesting analysis of ADD, I found that Maté relies too heavily on his own personal experience as someone with ADD and his relationship with his wife and children to draw conclusions. For the majority of the book, I felt that I was reading his autobiography as opposed to a book about ADD. Furthermore, I felt that he would go off on tangents in order to explain background information about the brain in general and it was only after several paragraphs that he would make a weak connection to how it related to ADD. This could have been because his book is aimed at a general audience with little background in neurobiology or psychology. However even if this is the case, his personal stories and anecdotes detract from the explanation of ADD and the strategies those with ADD can use to compensate for the differences in the organization of their brain compared with what is considered "normal." Despite the aspects of this book that I found problematic, Maté provides an interesting overview of ADD and how those with ADD can cope in our society.


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The Impact of Computer Use on Children's Neurological Development

In recent years, our society has been inundated with rapid technological developments particularly when it comes to computers.  Sociologists have noted the impact that the increase in computer use could have (and to some degree already has had) on our society as they begin to replace human contact (4).  Between 1996 and 1999 alone, the number of homes with internet access doubled (1).  On a neurological level, this is concerning because increased computer use may develop habits that strengthen certain areas of the brain and as a result do not allow others to strengthen to their full potential.  This is especially concerning when it comes to children because their brains continue to develop through adolescence.  In 1999, children were spending an average of 24 minutes more with the computer per day than just one year before (1).  How will this technology that previous generations have not been raised with impact the neurological development of children?  This paper is an exploration of the habits that computer use reinforces and the impact this has on the development of attention and chemical responses to emotions in the brain. 

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Autism and Music Therapy

Autism is a neurological disability which affects the development of the brain as it relates to social interactions.  In recent years, this disorder has gained attention in the American public due to the increase in the frequency of cases (3).  Once considered a rare disorder, it is now found in 5 or 6 per 1000 people compared to one in every 2000 in the 1960s (1).  Little is known about the cause of the disorder, however a myriad of strategies have been tested to mitigate its effects.  One of these methods that has proved to be particularly successful is the use of music therapy.  

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