M.Cur. / Please refer to full text to view abstract

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Background: In recent years the incidence of Attention Deficit/Hyperactivity Disorder (ADHD) has increased. Objectives: The primary aim of the study was to determine the treatment of children and adolescents diagnosed with ADHD in South Africa and more specifically the Eastern Cape. Methods: The study consisted of two parts, a retrospective drug utilisation study and a questionnaire survey. The drug utilisation study was conducted on chronic medication records of a private sector medical scheme administrator and contained records from 1994 to 2006. A total of 42 250 records representing 8 274 patients and 4 001 families, were analysed. The questionnaire survey was conducted in the Eastern Cape. The questionnaires were distributed by responsible pharmacists to parents of children receiving medication for the treatment of ADHD from his/her pharmacy. Fifty one completed questionnaires were analysed. Results: The average age of patients in the drug utilisation study were 14.28 (SD = 5.50) years. Males represented 77.37 percent of patients. Ritalin® 10 mg was the most frequently prescribed methylphenidate-containing product, followed by Ritalin® LA 20 mg. The two most frequently prescribed active ingredients apart from methylphenidate were fluticasone and budesonide. The two most common comorbid conditions were allergic rhinitis and asthma. The average age of patients in the questionnaire survey was 10.26 (SD = 2.51) years. Males represented 73.58 percent of patients. A third of patients had relatives previously diagnosed with ADHD. Ritalin® 10 mg was the most frequently prescribed methylphenidate-containing product. Conclusion: ADHD is a complex life-long disorder. It does not only affect the child diagnosed with the disorder, but also has effects on the family, schooling system and peer relationship. Therefore, more studies regarding the incidence and treatment of ADHD need to be conducted in South Africa.

This research was conducted to determine the effect of Phosphorus 6CH on Attention Deficit Hyperactivity Disorder (ADHD). Phosphorus 6CH is a simplex homoeopathic preparation that through repertorisation of DSM-IV diagnostic criteria of ADHD is found to be well indicated for this disorder. Homoeopathic trials have been conducted previously on complex homoeopathic preparations (Strauss, 1998; Smith, 2001) and have shown overall improvements in the symptoms of ADHD. The use of a simplex homoeopathic remedy has not been effectively documented prior to 2004. ADHD is a commonly diagnosed childhood disorder characterised by inattention, impulsivity, and possibly hyperactivity. Current management of this disorder is predominantly through the use of highly scheduled central nervous system stimulants, which may produce unwanted and serious side effects, and in some children may produce no response at all. A double-blind, placebo controlled clinical trial was conducted. Children between seven and eleven years of age with pre-diagnosed ADHD and taking no other medication for the disorder were included in the trial. Children were randomly assigned to either the medication or the placebo groups. Evaluations were conducted by means of the Barkley and DuPaul Teacher Rating Scale (BDTRS), completed by the child’s teacher, the Parent Symptom Questionnaire (PSQ), completed by the child’s parent or guardian, and the Children’s Checking Task (CCT), completed by the child. Evaluation was conducted before the trial, weekly after two weeks of liquid administration, and again a week after cessation of treatment. Statistical analysis revealed significant improvement in both the BDTRS and the PSQ scores, with the placebo group also showing improvement, although not to as significant a degree as the experimental group. In the CCT, no significant improvement was seen in the total scores of the tests, although there was significant improvement in the time taken to complete the tests. Because of the placebo effect having a large influence on the results of the study, more effective research would need to be done in order to establish whether Phosphorus did in fact account for the more significant improvement found in the experimental group. Further studies need to be conducted on the effect of homeopathic remedies such as Phosphorus, with variable dosage and potency being used. Since all children in the study showed a marked improvement due to the high level of attention met on each child by the teachers and parents involved, it is worth considering a study where no medication is used at all, but where children are given individualised attention and encouragement. It would be a valuable way to assess whether this attention would be sufficient to produce marked improvement in the children over a sustained period of time, or whether the attention given would ultimately no longer be enough but would have to be supplemented with medication. / Dr. Joanne Roohani Mrs. Carolina Henn

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Influences between quality of intimate heterosexual relationships, parenting style, and externalizing and internalizing behavior problems of children with Attention-deficit Hyperactivity Disorder (ADHD) were examined in a sample of intact and single parent families. The perspective on marital quality was expanded to include an examination of intimate adult relationships within single parent households. Associations between the quality of custodial parents' serious dating and/or cohabiting relationships, parenting style and the behavior problems of children with ADHD were studied. Results from this study found tentative support for previous findings that family functioning may mediate the development of conduct disorders among children with ADHD.

The relationships between muscle-tension level, motoric-activity level, and academic performance in the laboratory setting are investigated. Three participants were reinforced for reducing and increasing their tension levels, alternately, while engaged in a simulated academic task, and the effects of each on the rate of activity and academic performance were measured. Measures were also obtained on the rate of activity and occurrence of problem behavior in the subject's homes. Significant treatment differences were found which support a direct relationship between tension and activity level so that a decrease in EMG level was associated with a decrease in motoric activity, and an increase in EMG level was associated with an increase in motoric activity. The efficacy of using EMG biofeedback to train relaxation in children with activity-level problems to control their symptoms is supported, especially where such a technique can be used in a specific task-oriented situation.

The present study sought to alleviate the response cost inefficiency of the behavioral approach to controlling classroom hyperactivity by increasing the observer-student ratio via behavioral-electronic technology. A portable, integrated-circuit, counting and timing device was developed to enable immediate time-sequenced data recording and reinforcing of eight target behaviors by a single observer. A multiple-baseline design, across matched individuals was utilized to demonstrate the reinforcing effects. The results indicated a significant increase over mean baseline frequency in attention-to-task behavior for the group of eight students. It was concluded that by utilizing the behavioral-technological intervention strategy applied in this study, one observer could accurately monitor and reinforce eight students simultaneously and subsequently increase task attentiveness.

M.A. (Psychology) / Please refer to full text to view abstract