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Chapter 8 focuses exclusively on ADHD, a complex disorder with a broad spectrum of involvement. It is also one of the most widely researched of neurodevelopmental disorders; yet pinpointing its causal mechanisms and attention pathways has not proved as straightforward as at first it appears. Core issues of concern centre on the disorders heterogeneity, the presence of co-morbid disorders (e.g. anxiety, learning disabilities, conduct disorder), and cognitive variability across development. Recent findings clearly support the hypothesis that ADHD should be viewed as a continuum of impairment rather than a discrete clinical disorder. The chapter concludes that weakness in EF processes, particularly planning, inhibition and maintenance of focus, are the key to ADHD, but notes that no convincing explanation is apparent for the frequent co-occurrence of inattentive and hyperactive behaviors.

Characterized by developmentally atypical levels of inattention, activity, and impulsivity, attention deficit/hyperactivity disorder (ADHD) is a prevalent disorder affecting 5%-8% of the school-age population. This chapter reviews school-based, psychosocial, or academic interventions for children affected by ADHD. It shows that there are empirically supported strategies for school social workers to use for children affected with ADHD. Most of these strategies would be classified as falling into more intensive and indicated forms of intervention, and this may be appropriate given the nature of the disorder- and child-specific symptom patterning and impairments. There is a need for school social practitioner proficiency in functional behavior assessment, and for a variety of behavioral and contingency management methods.

Attention Deficit Hyperactivity Disorder (ADHD) is the most common disorder of childhood-adolescent brain health. Here, we take an integrative neuroscience approach to personalized medicine. The goal of this approach is: 1) to identify promising markers that bridge cognitive and brain measures, as well as genomics; these currently have value for supporting diagnostic and personalized treatment decisions in clinical practice. These markers are sensitive and specific for distinguishing ADHD, focusing on the triad of inattention, hyperactivity and impulsivity. These markers are assessed with straightforward cognitive tests that relate to brain function and genes affecting dopamine. The same markers are also implicated in predicting response to stimulants. A different set of markers capturing alterations in emotion, feeling and their regulation shows promise in identifying comorbid internalizing conditions, such as anxiety, and externalizing conditions, such as conduct disorder.

In the U.S. the prevalence rate for the diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) in children and adolescents is nearly 8%, and worldwide rates are 5%. This chapter reviews the evidence basis for the treatment of ADHD. The evidence for treatment of ADHD mainly centers around medication (particularly the psychostimulants) and one type of psychosocial treatment: behavioral therapy. Controversy exists about which should be the first-line intervention. These interventions are also evaluated against how well they address risk factors for the development of ADHD and an afflicted youth's ongoing adjustment. Recommendations for future research are explored, such as establishing whether there are certain, discrete subpopulations of ADHD that warrant particular treatment approaches.

This chapter presents the evidence base for clinic and school-based interventions for four common childhood disorders or related symptom patterns: attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), disruptive behavior disorders, and anxiety disorders and related symptoms. It shows that within the existing base for each disorder, psychosocial interventions include an array of behavioral approaches. The psychopharmacology evidence base is strongest for ADHD, weaker for other disorders, and virtually nonexistent for anxiety disorders. Adjunctive studies examining a combination of psychosocial and psychopharmacological interventions were rare, with the largest and most sophisticated one for ADHD.

This chapter highlights how the strengths- and skills-building model can be used with adolescent disruptive behavior disorders, which include Attention Deficit Hyperactivity Disorder, Conduct Disorder, and Oppositional Defiant Disorder. Solution-focused therapy and motivational interviewing can be used together to build strengths and motivation and to get teens to take responsibility for the change process. Cognitive-behavioral therapy is then offered to address cognitive or behavioral deficits that may have played a role in the disruptive behavior.

Intracellular signaling activities in vascular smooth muscles (VSMs) are central in the control of blood vessel diameter and the regulation of peripheral vascular resistance and blood pressure. Several studies have examined the molecular mechanisms underlying VSM contraction under physiological conditions and the pathological alterations that occur in vascular diseases such as hypertension. Vasoconstrictor stimuli activate specific cell surface receptors and cause an increase in intracellular free Ca²⁺ concentration ([Ca²⁺]_i), which forms a complex with calmodulin, activates myosin light chain (MLC) kinase, and leads to MLC phosphorylation, actin-myosin interaction, and VSM contraction. In unison, activation of protein kinase C (PKC) increases the myofilament force sensitivity to [Ca²⁺]_i and MLC phosphorylation, and maintains VSM contraction. Identifying the subcellular location of PKC may be useful in the diagnosis and prognosis of VSM hyperactivity states associated with hypertension. Targeting of vascular PKC using isoform-specific PKC inhibitors may work in concert with cytokine antagonists, antioxidants, and matrix metalloproteinase inhibitors, and thereby provide new approaches in the treatment of VSM hyperactivity states and certain forms of hypertension that do not respond to Ca²⁺-channel blockers.

This chapter provides an overview of evidence-based practice methods, for school social workers and other school counselors, in the assessment and treatment of attention-deficit/hyperactivity disorder (ADHD). Step-by-step procedures and guidelines for assessment and treatment interventions are discussed. Resources that will assist school social workers with specific intervention procedures and methods are cited. These resources contain in-depth information supported by evidence-based research and intervention methods that are cited in the reference list for this chapter. Some examples and one case scenario that will assist school social workers with the development of a framework for understanding how to develop an intervention plan for school children diagnosed with ADHD are provided.

Neurodevelopmental disorders are a diverse group of behaviourally-relevant multifactorial disorders related to an impairment of growth, maturation, or development of the central nervous system. The role of the hippocampus, however, has only recently been acknowledged. These disorders affect memory, emotion, cognitive abilities, and behaviour. Individuals with neurodevelopmental disorders might have comorbid disorders including intellectual impairment, seizures, and anxiety. The hippocampus is known to be vulnerable to hypoxia, stress, and malnutrition, and thus plays a clinically relevant role in children born preterm, after having experienced febrile seizures, fetal alcohol, or cocaine. Hippocampal dysfunctions are also known to be inherent as seen in Angelman syndrome, fragile-X syndrome, or Down syndrome. Complex interactions between environmental conditions and genetically predispositions are discussed in relation to neurodevelopmental disorders such as autism spectrum disorder, attention-deficit hyperactivity disorder, or Gilles de la Tourette syndrome in which hippocampal alterations are reported as well. However, even in normal brain development, there is a relationship between hippocampal structure and cognitive function as pointed out at the beginning of this chapter. Here, the structure–function relationship of the hippocampus within these complex syndromes and findings of developmental impairments are reviewed. The introduction of magnetic resonance imaging (MRI), particularly with volumetric analysis, but also of functional imaging methods such as functional MRI (fMRI), positron emission tomography (PET), or single-photon emission computed tomography (SPECT) facilitated the study of hippocampal changes associated with deficits in children in recent years.

This chapter discusses the application of solution-focused brief therapy (SFBT) to externalizing behaviors in youth. This represents a broad category of behaviors characterized and described as aggressive, antisocial, or disruptive behavior. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders includes as disruptive behavior disorders attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). These disorders are briefly described here.

Congenital hypothyroidism (CH) affects approximately 1 in 3,500 newborns. There is a female preponderance. In areas of iodine insufficiency, the incidence is higher, since iodine is a key element in the synthesis of thyroid hormone. Approximately 85% of CH cases are sporadic, whereas 15% are hereditary. Thyroid hormone is essential for normal pre- and postnatal brain development. The importance of in utero thyroid hormone status is demonstrated by the fact that maternal hypothyroidism during pregnancy is known to result in cognitive and motor deficits in the offspring (Forrest 2004; Zoeller and Rovet 2004). Congenital hypothyroidism is already expressed in fetal life; maternal T4, transferred via the placenta, is not sufficient for normal brain development (Forrest 2004; Haddow et al. 1999; Opazo et al. 2008; Pop and Vulsma 2005). Prior to newborn screening, CH that went undiagnosed and untreated for more than 3 months was associated with permanent and significant mental retardation, as well as behavioral problems. Outcome is now significantly better. Children with CH have normal intelligence, although subtle and specific cognitive and behavioral problems occur. Congenital hypothyroidism can be caused by primary hypothyroidism, due to a defect of the thyroid gland, or by central hypothyroidism secondary to defective hypothalamic or pituitary regulation of thyroid hormone. Several types of primary thyroid abnormalities may occur. Thyroid dysgenesis is the result of a missing, ectopic, or hypoplastic gland. Proteins that are crucial for normal thyroid gland development include the thyroid transcription factors PAX8, TTF1, TTF2, FOXE1 and the thyroid stimulating hormone (TSH) receptor gene. Thyroid dyshormonogenesis is generally due to an autosomal recessive genetic defect in any of many stages of thyroid hormone synthesis, secretion and transport (Moreno and Visser 2007). One in 50,000 children has autosomal dominant thyroid hormone resistance (RTH) due to a mutation in the gene encoding for the TRb thyroid receptors (Hauser et al. 1993; Weiss et al. 1993). Iodine deficiency can also cause CH (endemic cretinism) (DeLange et al. 2000). Gaudino and colleagues (2005) determined the etiology of CH in 49 non-athyroid cases.

The development of joint attention reflects and contributes to the early developmental processes necessary for social engagement and social competence in infants. Results of longitudinal studies suggest that the tendencies of infants to initiate joint attention (IJA) bids could be predictive of some aspects of social engagement and social competence during childhood. Observations further suggest that more frequent IJA bids during infancy could be used as a marker of at-risk children's vulnerability to poor social outcomes. IJA measures may be useful in identifying children who are likely to have hyperactivity and attention problems, or those who may have stronger resistance to the negative impact of moderate attachment disturbances. Measures of joint attention could provide unique data on processes affecting developmental continuity, risk, and social outcomes for children.

Attention problems are highly prevalent, with rates of occurrence depending on the definition used, and make up to 50% of child psychiatric cases. Previous behavior genetic studies of attention problems have analyzed either twin, family, or adoption data, and reported heritability estimates ranging from 0.55 to 0.98. Adoption studies can provide a direct test for the presence of shared environmental factors by examining the similarity between unrelated siblings growing up in the same family; however, the power will be relatively low in small samples. Previous studies reported that adoptees show an increased incidence of attention problems, as high as 13–21% in some samples. This chapter discusses the results of a study showing that both mothers and teachers rate boys as having more attention problems. Separating the overall score into the aspects of inattention and hyperactivity follows the overall picture in that boys seem to show more of these behaviors than girls. For both sexes, the behaviors were rated as relatively stable during the grade-school years.

This chapter examines violence and aggressive behaviour in psychiatric populations. The result indicate that two major psychoses, schizophrenia and mood disorders, can involve increased aggressive behaviour. Mental and behavioural problems originating in childhood, such as mental retardation and hyperactivity, may also include excessive aggressive behaviour. This chapter explains that intermittent explosive disorder, which includes outbursts of assaultive behaviours, has many characteristics resembling those of seizures associated with aggression. It also explores various treatment methods for brain dysfunction.

This chapter focuses on the story of Brian Schaffer, who was diagnosed with attention deficit hyperactivity disorder (ADHD) at the age of seven, to show how difficult it is for any child to prevail under the Individuals with Disabilities Education Act (IDEA). Brian's case was brought after Congress amended the IDEA in 1997, and again in 2004, in various ways that were supposed to benefit students with disabilities. Yet Brian's case reveals a cumbersome legal process that rarely produces success even for children with highly involved parents and qualified legal counsel. This chapter discusses two reasons why Brian's case is crucial for all parents challenging an individualized education program (IEP). First, the Supreme Court has held that the burden of proof should fall on parents when challenging the adequacy of their child's IEP. Second, the lower courts that handled this case interpreted the Rowley adequacy standard as creating a very low threshold for a school district despite the 2004 IDEA amendments.

The most research-oriented part of the book, Chapter Three, describes how yoga has proven to be beneficial not only for physical health and wellness, but also for emotional well-being and optimal cognitive functioning. The emotional benefits of yoga directly lead to its physical benefits in reducing the symptoms of disorders that are caused or magnified by stress. This chapter outlines yoga’s potential in relieving performance anxiety, improving concentration, and increasing the likelihood of achieving a flow state in performance. Finally, research on attention, cognition, and the benefits of yoga for students with ADHD and other behavioral disorders demonstrates the usefulness of yoga techniques to increase retention and focus in the music lesson.

Attention deficit/hyperactivity disorder (ADHD) affects ~3–6% of the school-age population in the USA. Symptoms of ADHD have been found to be relatively consistent from childhood through adolescence, whereas adults with ADHD tend to exhibit more symptoms of inattention than hyperactivity. Women and girls with ADHD have generally been insufficiently studied. Whereas core symptoms of ADHD are largely similar between boys and girls, girls exhibit less hyperactivity and comorbid conduct disorder. The precise aetiology of ADHD is unclear, and multiple biopsychosocial risk factors may act independently or in concert to produce disorder. Genetic vulnerability, pre- and perinatal exposures, and psychosocial factors have been found to increase risk of the disorder and its persistence. Childhood ADHD is associated with negative outcomes, such as school underachievement and substance use disorders. Rates of persistence of ADHD from childhood into adolescence and adulthood range widely depending on definition of ADHD and source of reporting of symptoms.

This chapter considers childhood ADHD and its pharmacological treatment with amphetamine drugs as a case of biopolitical performance enhancement. It takes up the child’s body in the historical extension of psychiatry from an institutional to a pharmaceutical mode to accent the increasingly dominant role of chemical molecules in managing and optimizing human development and capital. Drawing on recent feminist scholarship on the biological body, it speculates on the possibility of a neurofeminism to match the natural and cultural complexity of ADHD as a phenomenon folded into and grown out of the plastic body of the child.