MPM / Oliver Tambo Institute of Governance and Policy Studies

PhD (Psychology) / Department of Psychology. / Attention Deficit Hyperactivity Disorder (ADHD) is the most common diagnosed neurocognitive behavioural developmental disorder among school going–age children. ADHD in most instances is found to comorbid with internalising disorders such as anxiety and depression, therefore causing impairment on behaviour, emotions, academic, social and many areas of functioning. The existence of comorbid internalising disorders complicates the presentation of ADHD symptoms than if it was pure ADHD. The aim of the study was to explore the comorbidity of internalising disorders and ADHD symptoms. The study investigated whether children with ADHD have more symptoms of anxiety and depression than children without ADHD. The study went further to investigate whether children with ADHD have low self-esteem than children without ADHD. Also, that internalising comorbidities (anxiety and depression) are more prevalent in girls than in boys who have more externalising comorbidities which are Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) and anger issues. The null hypotheses further showed that, children with ADHD do not have more symptoms of anxiety and depression than children without ADHD. Moreover, children with ADHD have no lower self-esteem than children without ADHD. Also, internalising disorders (anxiety and depression) are not prevalent in girls than in boys who do not exhibit more externalising disorders which are Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and anger issues. The study was conducted in Lepelle-Nkumpi Municipality in Lebowakgomo sub circuit. A total of 250 children (94 boys and 156 girls, aged 6 – 12) who were purposively selected participated in the study. A total of 125 clinically diagnosed ADHD were matched to 125 control group for age and gender. Participants were assessed on a battery consisting of Parent/Teacher Disruptive Behavioural Rating Scale (DBD), which was used to assess the presence and degree of ADHD- related symptoms (inattention and hyperactive/ impulsive); Oppositional Defiant Disorder and Conduct Disorder and Beck Youth Inventory Second Edition (BYI II), which was used to assess emotional and psychological issues that children experience. ADHD scores obtained on the DBD scale were correlated with scores obtained on BYI II scale. The study only focused on learners from primary schools in Lepelle-Nkumpi in Lebowakgomo sub circuit. In this research study, children who were reported to have a history of neurological problems such as head injurie, epilepsy, cerebral palsy or severe psychiatric disorders were excluded from the study. The results were analysed using the analysis of variance (ANOVA) and post hoc benferoni analysis to determine the significant difference within ADHD subtypes. Results of the study showed that children with ADHD had comorbid internalising disorders (anxiety and depression) when compared to their neurotypical group. Both boys and girls with a clinical diagnosis of ADHD showed symptoms of anxiety and depression. More symptoms of anxiety and depression were observed within the ADHD-HI, ADHD-PI and ADHD-C subtypes. Comorbid internalising disorders (anxiety and depression) were also associated with impairments with ADHD symptom, in particular inattention. Children with ADHD also showed more symptoms of low self-esteem when compared to their neurotypical group. Both boys and girls showed significant difference level of low self-esteem in all ADHD subtypes (ADHD-HI, ADHD-PI and ADHD-PI). The results further revealed that both boys and girls equally showed symptoms of comorbid internalising disorders (anxiety and depression), whereas girls showed significantly more symptoms of externalising comorbidities such as ODD, CD and anger issues. In conclusion, the findings suggest that the comorbidity of internalising disorders in a clinically diagnosed child with ADHD worsens or complicates the child’s expected normal functioning unlike when the child was presenting with only ADHD. The results further suggest that a child with clinical diagnosis has double impairment as a result of many impairments which are occurring at the same time. Moreover, the existence of externalising comorbidities which are salient in girls with ADHD may require proper screening and assessment. / NRF

Attention deficit hyperactivity disorder, ADHD, är en av de vanligaste neuropsykiatriska funktionsnedsättningarna hos barn och ungdomar. Funktionsnedsättningen påverkar barnet i både skola, sociala sammanhang och i familjelivet. Detta påverkar i sin tur föräldrars liv. Syfte: Syftet med denna studie var att beskriva föräldrars upplevelse av att leva med barn med ADHD. Metod: Datainsamlingen genomfördes med semistrukturerade intervjuer med tre föräldrar till barn som har diagnosen ADHD samt text från fem föräldrars bloggar. Data analyserades med kvalitativ innehållsanalys med manifest ansats. Resultat: Fyra kategorier framkom i analysen: Att föräldraskapet är utmanande; Att känna sig missförstådd och frustrerad; Att känna trygghet och gemenskap samt Att känna lättnad när livet fungerar. Slutsats: Föräldrar upplevde utmaningar med föräldraskapet, men föräldrautbildning kunde bidra till att stärka föräldrar och öka deras kunskap att hantera vardagen och därigenom få ökad empowerment. Det skulle bidra till att de hade verktyg att stärka barnets självkänsla, vilket kunde öka barnets resiliens mot psykisk ohälsa och bidra till välmående genom livet för barnet och familjen med ADHD.

Recent literature suggests that not only does Attention-deficit Hyperactivity Disorder (ADHD/ADD) persist into adulthood, but it can also be accompanied by personality characteristics which cause emotional difficulties. In fact, adults diagnosed with ADHD can present with a profusion of difficulties. Several constructs appear to accumulate dynamically throughout development to place the adult with ADHD at risk for multiple emotional problems. These interwoven influences include familial characteristics, childhood emotional and academic difficulties, and inadequate coping skills to respond to adulthood pressures. This document, first, describes a developmental model for conceptualizing negative trajectories leading to nonadaptive coping and psychopathology and identifies personality factors of adults diagnosed with ADHD. This model provides clinicians and researchers with a better understanding of the complexity and challenges of adulthood ADHD in order to aid in diagnosis, treatment, and prevention. The purpose of this study is to examine personality factors common to adults diagnosed with ADHD and compares these characteristics with a group of adults diagnosed with a depressive disorder. Adults responding to a community advertisement who provided documentation of the diagnosis of Attention-deficit Hyperactivity Disorder were administered the MMPI-2. This ADHD group was compared with MMPI-2 profiles of a group of adults diagnosed with Major Depressive Disorder or Dysthymic Disorder. A cluster analysis procedure was performed and results are discussed.

The aim of this study was to explore the influence of yoga on learners with ADHD. In order to reach the aim of this study, an initial literature study was executed to describe ADHD and the practice of yoga. Particular aspects such as concentration, anxiety, self-esteem and aggression were highlighted. Semi-structured interviews with parents, teachers, learners and one yoga instructor were used to conduct the empirical study. Valuable data was also collected from the learners using projection tests and self-esteem questionnaires. Assessments were conducted at two points: during the situation analysis and at the outcome of the yoga intervention. Based on the data collected and analysed, findings were made and conclusions were drawn regarding the influence of yoga on learners with ADHD focusing on the aspects of concentration, anxiety, self-esteem and aggression. Recommendations for future research were then proposed. / Psychology of Education / M. Ed. (Guidance and Counselling)

Thesis (MMus)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: As a recent graduate, I feel that young educators are graduating from South African universities and are teaching in schools without adequate knowledge of the various learning disabilities and behavioural disorders that many children suffer from. In the context of the Arts & Culture or music classroom, educators especially suffer as they are taught to encourage creativity. However, how can one differentiate between creative behaviour and disruptive behaviour and be certain that bad behaviour is not a symptom of a behavioural disorder? Upon graduation and starting to teach in the southern suburbs in the Western Cape, the researcher was struck by the number of children diagnosed with behaviour disorders and taking the stimulant medication Ritalin. Yet the notion of medicating a child for a behavioural disorder is not agreeable to many parents and educators to whom the researcher has spoken while researching this topic. The general feeling seems to be that a child should be given space to be creative, but a teacher cannot control a class of at least twenty-five children who are all claiming their own creative rights. This research explores various steps that a music educator can take to control a class of both medicated and non-medicated learners. The effects of music on the behaviour of learners diagnosed with Attention Deficit Disorder (abbreviated to ADD) have been investigated in various ways over the years and these are described in this thesis. Likewise, information on various prescription medications and non prescription medications that are available in South Africa are presented to offer options to an educator/parent faced with a child demonstrating behavioural problems. There is also substantiation that by increasing the intake of essential fatty acids and adjusting a child’s diet, one can positively enhance behaviour and concentration. The researcher discusses the various foods that should be avoided and those should be enjoyed generously. The researcher observed learners who were considered problematic in the general classroom in the form of observation of behaviours before and after each musical activity. Class educators were asked to assist the researcher by further observing the selected children’s behaviour in the following lesson. / AFRIKAANSE OPSOMMING: As ‘n onlangsgegradueerde, voel ek dat jong onderwysers aan Suid-Afrikaanse universiteite afstudeer en onderrig in skole begin gee sonder voldoene kennis van die verskeie leergestremdhede en gedragsafwykings waaraan ‘n groot hoeveelheid kinders ly. In die konteks van die Kuns en Kultuur of musiekklaskamer is dit vir onderwysers besonder moeilik omdat hulle geleer is om kreatiwiteit aan te moedig. Die probleem is hoe om te onderskei tussen kreatief en ontwrigtende gedrag en hoe om seker te wees of slegte gedrag nie ‘n simptoom van ‘n gedragsafwyking is nie. Na graduering en die begin van haar onderrigloopbaan in die suidelike voorstede van die Wes-Kaap is die navorser getref deur die getal kinders wat die stimulant medikasie Ritalin gebruik. Tog sou die meeste ouers en onderwysers waarmee die navorser gepraat het gedurende haar navorsing nie die gebruik van medikasie vir gedragsafwykings verkies nie. Die algemene gevoel is dat die kind die geleentheid gegun behoort te word om kreatiefe te wees, maar ‘n onderwyser kan nie ‘n klas van minstens vyf-en-twintig kinders onder beheer hou wat almal hul kreatiewe regte eis nie. Hierdie navorsing ondersoek verskillende stappe wat ‘n musiekonderwyser kan neem om ‘n klas te beheer met leerlinge wat op en sonder medikasie is. Die effek van musiek op die gedrag van leerlinge wat gediagnoseer is met Aandagafleibaarheidsindroom (afgekort na AAS) is reeds in verskeie vorme oor die jare ondersoek en word in hierdie tesis beskryf. Inligting aangaande verskeie voorskrif en nie-voorskrif medikasie wat in Suid-Afrika beskikbaar is, word verskaf om opsies te gee vir ‘n opvoeder/ouer wat gekonfronteer word met ‘n kind wat gedragsprobleme demonstreer. Daar is ook bewyse dat deur om die inname van essensiële vetsure te verhoog en ‘n kind se dieet aan te pas, gedrag en konsentrasie positief beinvloed kan word. Die navorser bespreek die verskeie kossoorte wat vermy behoort te word teenoor dié wat vryelik geniet kan word. Die navorser het leerlinge waargeneem wie se gedrag as problematies in die algemene klaskamer beskou was, voor en na elke musikale aktiwiteit. Klasonderwysers is gevra om die navorser by te staan deur verdere waarneming van die kinders se gedrag in die volgende les.

Thesis (M Sport Sc (Sport Science))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The influence of a six-week perceptual-motor and attentional skills programme, combined with teaching strategies, on the motor proficiency and attentional abilities of children diagnosed with ADHD was investigated. The five case study individuals (ranging for Grade 1- 7) took part in a six-week Purposeful Play Programme. Baseline, pre-test and post-test scores were obtained from the Bruininks- Oseretsky Test of Motor Proficiency (BOTMP) and Attention-Deficit Hyperactivity Disorder Test (ADHDT). All five case study individuals showed a significant improvement on their motor proficiency during retention tests as well as improvements on some of the behavioural soft signs of hyperactivity, impulsivity and inattention. / AFRIKAANDE OPSOMMING: Die invloed van ʼn sesweek perseptueel-motoriese en aandagvaardigheidsprogram, gekombineer met onderrigstrategieë, is op die motoriese vaardighede en aandagvermoëns van kinders gediagnoseer met ATHS, bestudeer. Die vyf gevallestudie individue (tussen Graad 1- 7) het aan „n sesweek Purposeful Play Programme deelgeneem. Die basislyn-, voor- en natoetstellings is verkry vanaf die Bruininks- Oseretsky Test of Motor Proficiency (BOTMP) en Attention-Deficit Hyperactivity Disorder Test (ADHDT). Al vyf gevallestudie individue het ʼn beduidende verbetering in motoriese vaardigheid getoon tydens retensietoetse asook verbetering in sommige van die gedragstekens van hiperaktiwiteit, impulsiwiteit en afleibaarheid.

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2006. / Attention-Deficit Hyperactivity Disorder (ADHD) is a common disorder affecting 4% to 5% of South African children. Recent studies revealed that 30% to 70% of children continue to experience problems related to ADHD in adulthood. Adults are becoming increasingly more aware of adult ADHD as a result of public awareness campaigns in the media. Their first line of action is to visit their family physician, but the question arises whether these practitioners are ready to take on the patients with ADHD. The aims of this study were to determine the familiarity, attitudes and practices of general practitioners in South Africa with regard ADHD in both children and adults and whether there are differences in children and adults with regard to depression and generalised anxiety disorders as comorbid disorders. The study also briefly explored the training models of general practitioners in South Africa. The research questions are addressed by means of a survey approach, using quantitative measures. An email message with a cover letter, explaining the purpose of the research project, provided a link to a Web-based questionnaire. It was broadcast to 6704 general practitioners on the database of the company MEDpages, who managed the broadcast. A questionnaire attached to an e-mail message was sent to all Departments of Family Health at universities in the country to obtain information with regard to the training models of general practitioners. This was followed up with structured telephone interviews if no response was received. The questionnaire was completed by 229 respondents. The data were statistically analysed using Statistica Version 7.0. The results revealed a significant need among general practitioners to increase their knowledge base with regard to ADHD, more so with regard to adults. Their knowledge and training with regard to depression and generalised anxiety disorders were significantly more extensive with regard to adults as opposed to children. Training with regard to ADHD in adults was almost non-existent. It was recommended that the limited knowledge base of general practitioners with regard to ADHD should be addressed by adapting the curriculum of undergraduate medical students and providing opportunities for continued medical education that focus on the diagnosis and management of ADHD in both children and adults. General practitioners should acknowledge the educational psychologist as an equal partner within a multi-disciplinary team

The purpose of this study was to examine the ability of the Cognitive Assessment System (CAS) and the NEPSY, A Developmental Neuropsychological Assessment, to differentiate between the subtypes of Attention Deficit/ Hyperactivity Disorder (AD/HD). The CAS and NEPSY are neuropsychological instruments which provide norms for AD/HD children in general. This study examined the performance of the two subtypes of AD/HD on the CAS and NEPSY. In addition, this study examined the performance of the two AD/HD groups on the Screening Test for Auditory Processing Disorders (SCAN). Since AD/HD children tend to have difficulty with language, the SCAN was used to determine if any of the AD/HD subjects had auditory processing difficulties that might impact their performance on the CAS and/or NEPSY subtests. The sample consisted of 118 children between the ages of 8 and 12 years of age. Using the DSM-IV criteria, the children were diagnosed as having three types of AD/HD: A Predominantly Hyperactive-Impulsive Type (AD/HD-HI), a Predominantly Inattentive Type (AD/HD-I) and a Combined Type The subtypes were also identified by the Attention Deficit Disorders Evaluation Scale-Home Version (ADDES-H). Only two subtypes, AD/HD-I and AD/HD-C, were identified by the ADDES-H. There were not enough AD/HD-HI subjects to include in the study. Therefore, this study focused on the AD/HD-I and AD/HD-C subtypes. A binomial logistic regression analysis was conducted on the AD/HD-I and AD/HD-C subtypes with selected subtests of the NEPSY and the four PASS Scales of the CAS. Results indicated a significant difference between the AD/HD-I and AD/HD-C groups on the Tower subtest of the NEPSY and the Planning Scale of the CAS. The Tower and the Planning Scale are both purported measures of executive functioning; however, results of the Planning Scale were in an unexpected direction. No significant difference was found between the two AD/HD groups on the other subtests examined. The results of the SCAN analysis suggested there were no significant differences in auditory processing between the two AD/HD groups. Recommendations for future research are discussed.

The purpose of this study was twofold: to determine the construct validities of comparable AD/HD instruments that were developed according to our current, DSM-IV classification system for AD/HD; and to identify potential +neurocognitive and socioemotional markers for AD/HD. The sample consisted of 145 children ages 8 to 11 years of age who were diagnosed with Attention Deficit Hyperactivity Disorder (AD/HD), or Central Auditory Processing Disorder (CAPD). Children were administered a battery of neurocognitive tests and completed a self-report measure of personality. Parents completed several, AD/HD instruments pertaining to their children. The AD/HD instruments used in this study were the Attention Deficit Disorder Evaluation Scale-Home Version (ADDES), Attention Deficit Hyperactivity Disorder Test (ADHDT), and the Attention Problems and Hyperactivity scales from the BASC-Monitor (BASC-M). Of interest was how each AD/HD instrument compared to the DSM-IV, particularly in terms of the cross-consistency of AD/HD subtype classifications. The findings showed that the AD/HD instruments classified participants differently from the initial, DSM-IV entry diagnosis. Rates of agreement were better for some of the AD/HD instruments than for others yet there was little overall consistency. The neurocognitive measures used in the study were the Cognitive Assessment System-Basic Battery scales. The socioemotional measures used in the study were two parent-report scales from the BASC-M (Internalizing Problems and Adaptive Skills), and the child report scales from the BASC-Self Report of Personality. Results showed that the neurocognitive measures were relatively insensitive to AD/HD symptomatology while a nearly opposite trend was observed on the socioemotional measures. For the most part, participants classified as the ADHD-Combined Type (ADHD-CT), (regardless of which AD/HD instrument was used) had the most significant impairment in areas of social functioning and emotional symptoms across parent and self-reports.