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ADHD in adolescent boys

ADHD in Adolescent Boys: A Research Proposal

Abstract

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The ADHD was identified as an independent variable (IV) in this study. Two dependent variables (DVs) were determined. Specifically, the academic performance and cognitive functioning of adolescent boys served as DVs in this survey. Additionally, the research expected to test the two following hypotheses. First, adolescent boys who were diagnosed with ADHD are more likely to exhibit lower levels of academic performance than those without ADHD. Second, male teenagers who were diagnosed with ADHD tend to display poorer cognitive functioning than those without ADHD. As a result, the research proposal was planned with the detailed description of assessment instruments and the procedure of future study. In summary, this paper discussed recent research findings and developed the research design with a focus on the exploration of differences between adolescent boys with ADHD and those without ADHD in terms of their academic performance and cognitive functioning.

Keywords: ADHD, gender differences, academic performance, cognitive functioning

Attention Deficit Hyperactivity Disorder (ADHD) was recognized as the one of the most common behavioral disorders in school-age children. Quite often, the main symptoms are inattention, impulsivity, and hyperactivity that are accompanied by other problems (Wehmeier, Schacht, & Barkley, 2010). Researchers noted that teenagers with ADHD were found to be more likely to be expelled from high school and experience difficulties in academic achievements. Besides, Kent et al. (2010) highlighted that this rate exceeds up to 40% of adolescents with ADHD who decided to drop out of high school (p. 453). A possible basis for explaining the presence of such problems in children with ADHD may be dysfunction of the cognitive functioning. Despite intensive attention to the study of gender differences in the symptoms of ADHD, the precise effects of ADHD in adolescent boys are not fully understood, but it is known that it could negatively influence cognitive functioning and may lead to a decrease in academic performance among male juveniles diagnosed with ADHD in comparison with those without ADHD.

Concerning the concept of ADHD, the defining role in its formation was developed by works in which the deficit of attention with an abnormally short period of its retention at some object or action was considered as the primary defect. Along with such typical symptoms of the syndrome as attention deficit, impulsiveness of motor and verbal reactions, hyperactivity in children with ADHD, the need for substantially more positive reinforcement for the formation of behavioral patterns was noted. Additionally, ADHD in the general systemic of mental development disorders in juniors is accepted as a relatively common form of deviation used to describe behavioral characteristics. The clinical manifestations of ADHD include psychomotor anxiety impulsiveness of conduct and thoughts, inability to learn from experience mistakes made, lack of attention, bad concentration, easy switching from one task to another without completing the assignment, absent-mindedness (Kent et al., 2010; Rucklidge, 2010). An attention disorder is regarded central for stating the conclusion of ADHD.

The severity of various symptoms of ADHD also differs with age. According to Ramtekkar et al. (2010), the symptomatic symptomatology is observed in 5-10 years old children and falls in the period of preparation for school and the beginning of training. The second peak of the symptoms of ADHD is the period of adolescence. Besides, this is due to the development and formation of more complex mental functions (Becker & Langberg, 2013). During adolescence, excessive cognitive performance in most cases decreases, impulsivity, and attention deficit persist. Thus, impaired attention is the main symptom of ADHD. To the greatest degree, such properties of attention as stability, ability to concentration and distribution suffer.

ADHD is manifested mainly in violations of maintained attention, for example, in the impossibility of performing long monotonous tasks, in the increase of the number of errors with longer duration of the task completion (Becker & Langberg, 2013). It was suggested that behavioral and cognitive disorders are associated with this syndrome with a constitutional predisposition of the neuroanatomic nature, which causes a decrease in inhibitory control, a violation of modulation of activity levels (Hasson & Fine, 2012; Cromer, Schembri, Harel, & Maruff, 2015). As a result, persistent deterioration of motivation for an activity, limitations in the development of behavior patterns are formed, adolescents with ADHD are more likely to fail than their peers, the former develop reactions of avoidance and isolation, and impulsiveness is intensified.

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Dysfunction in emotional development is also related to ADHD symptoms. Furthermore, for adolescents with this syndrome, emotional development disorders are peculiar (Wehmeier, Schacht, & Barkley, 2010). The most typical manifestations of ADHD are increased irritability, emotional lability, excessive response to various situations, underdevelopment of the motivational side of the activity, the presence of fears, anxiety, negativism, aggressiveness, and lack of care, indifference to the experiences of others, deformation of the system of interests and needs. For these children, a lower level of social maturity is typical compared to their peers, which is displayed by the inability to effectively build relationships, weak social adaptation, and greater exposure to stress factors. As a result, the perception of interpersonal relations, norms, rules, and social expectations of the environment are disrupted. Particularly, impulsiveness, obsession, excessiveness, disorganization and aggression characterize interpersonal communications of children with ADHD (Wehmeier, Schacht, & Barkley, 2010). The social immaturity of such youngsters is also manifested in the preference for learning activities.

Currently, the diagnosis of ADHD is based on the criteria of the International Classification of Diseases of the 11th revision (ICD-11) (Ramtekkar et al., 2010). Simultaneously with ICD-11, in the diagnosis the criterion proposed by American psychiatric organization DSM-V and recommended by WHO are applied (Ramtekkar et al., 2010). Both criteria are often adopted because the ADHD requires differential diagnosis with a number of other conditions and disorders. The existence of strict criteria allows standardizing the method of diagnosing children at risk of such a disease and enables to compare numerous findings in this sphere.

The attention of specialists is attracted by the development of the conceptual model of ADHD from the perspective of a gender approach in the context of several important points, in particular clinical manifestations, associated disorders, and diagnostic criteria. Despite the intense attention paid to exploration of gender differences in the symptoms of ADHD and related disorders, modern reviews show a great heterogeneity in clinical groups where boys predominate (Hasson & Fine, 2012; Kent et al., 2010; Ramtekkar, Reiersen, Todorov, & Todd, 2010; Rucklidge, 2010). Due to the incompatible identity of the groups in the studies, psychiatrists have a predominantly male concept of development of this disorder.

A number of reasons explain the relative predominance of ADHD among boys. Specifically, the influence of genetic factors, which implies higher vulnerability of male fetuses to different effects, as well as many other factors might explain the relative predominance of ADHD among male youngsters (Hasson & Fine, 2012; Sibley et al., 2010). In addition, boys with ADHD are registered more often because of their aggressive behavior, while inattention in girls is much less often accompanied by destructive conduct (Sibley et al., 2010). The high incidence of symptoms in boys may be due to higher vulnerability of the male fetus to pathogenic effects during pregnancy and childbirth (Rucklidge, 2010). Furthermore, in population samples, a less pronounced symptom of ADHD and a reduction in diagnostic thresholds in girls have been found (Ramtekkar et al., 2010). Particularly, female juveniles have a subtype with predominant attention deficit, whereas male ones have mixed forms of this disorder (Ramtekkar et al., 2010). Therefore, it is necessary to choose an appropriate assessment instrument for evaluation of ADHD symptoms among adolescent boys, which also includes the limits of the age norms.

It is generally accepted that ADHD influences to varying degrees all the components of school and family adaptation of the child. Unfortunately, the academic success of juniors depends on impaired attention, activity and impulse control (Wehmeier, Schacht, & Barkley, 2010). Many students with ADHD experienced serious academic difficulties because they could not use their cognitive skills in daily life to the fullest. Still, the motivational and data components of attention are vulnerable. The former is associated with a lengthy arbitrary attention keeping, and the latter is to recognize the figures and retain the marks for each cognitive task (Becker & Langberg, 2013). Hence, violations of the attention function lead to the inability to develop cognitive strategies for analyzing the conditions of tasks and focus on their implementation, which can result in the academic failure in future.

Currently, the function of attention is associated with the concept of brain control, such as functions of monitoring, regulation and control of the mental activity. In children with ADHD, these disorders manifest themselves as problems in maintaining a certain behavioral response during a relatively long period, as well as in distributing attention (Becker & Langberg, 2013). The disorders of cognitive functions among adolescents with ADHD are detected in violations of psychomotor functions (e.g. visual-spatial coordination, subtle movements and balance), working memory, attention, and visual learning among teenagers (Skogli et al., 2013). The results of the studies show that psychomotor disorders appear already at the preschool age. Thus, cognitive development is a crucial aspect among adolescent boys with ADHD, since it could also lead to lower academic performance.

Increased excitability and impulsiveness are the causes of difficulties in acquiring the usual social skills. The latter manifests itself in a sloppy task, in incontinence in words, deeds, and actions, in excessive persistence in defending one’s interests (Becker & Langberg, 2013). With age, the manifestations of impulsiveness change. Besides, a number of authors emphasize gender differences in the form of aggression in boys, pointing to the patterns of internalization of violence, including depressive symptoms, social isolation and psychosomatic manifestations (Wehmeier, Schacht, & Barkley, 2010). Knowledge of the rules does not appear to be a significant motive for one’s own activities. Hence, there is a need to clarify whether these differences in male juveniles are critical for their academic achievement and cognitive functioning in comparison with their peers without ADHD.

As a result, the key purpose of the current research study was to explore effects of ADHD among adolescent boys on the academic performance and cognitive functioning because it would explain whether children with ADHD are different from those without ADHD. Specifically, this study is aimed at supporting the findings of Kents et al. (2010), which revealed that rates of failure in academic performance are higher for teenagers diagnosed with ADHD. In addition, the current research provides a support for Becker and Langbergs (2013) suggestion about association of deficits of cognitive processes with ADHD in young adulthood. Thus, it is predictable that adolescent boys with ADHD will show significantly lower levels of success as well as worse cognitive functioning by contrast to those kids without ADHD.

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Subsequently, ADHD was recognized as an independent variable (IV) in this survey. The academic performance and cognitive functioning were dependent variables (DVs) of this research. Furthermore, the current study expected to test two hypotheses as follows. First, adolescent boys who were diagnosed with ADHD are more likely to exhibit poorer levels of academic performance than those without ADHD. Second, male teenage who were diagnosed with ADHD tend to display lower rates of cognitive functioning than their peers without this disorder.

Method

Participants

The research will use 56 adolescent boys with an average age of 15 years old with minimum and maximum age of 12 and 18 respectively. The overall study sample will be divided into two groups, particularly the first one will consist of teenage males who were diagnosed with ADHD and the second group will include only boys without ADHD. All subjects will be also requested to sign a consent form. Additionally, they will not be compensated for the participation since they will volunteer to engage in the given research.

Materials

ADHD assessment. ADHD Rating Scale-IV will be used to assess and identify whether participants have ADHD symptoms or not. In their auricle, Skogli et al. (2013) highlighted this measure as the reliable ADHD assessment. Hence, this instrument comprises two subscales such as Hyperactivity-Impulsivity and Inattention. An 18-item questionnaire requires to response each statement on the 4-point scale using (0) never or rarely, (1) sometimes, (2) often, and (3) very often as answers. Therefore, this assessment measure needs converting received answers to percentile score, which varies based on age and gender of participants.

Academic performance assessment. To examine academic performance during the last year, the School Report Cards will be used. The latter will be utilized for assessing GPA in each key academic course, including English, math, social studies, and art. The school-reported grading will be assessed on a zero to 100-point scale.

Cognitive functioning assessment. For assessment of cognitive functioning, the Cogstate Brief Battery (CBB) will be applied. The instrument allows estimating psychomotor function, working memory, attention, and visual learning among adolescents (Cromer, Schembri, Harel, & Maruff, 2015). For measuring these aspects of cognitive functioning, CBB contains four tasks respectively. To complete the tasks, participants should respond by selecting No or Yes answers. All four tasks will record the accuracy of answers on each trial.

Procedure

Before the commencement of the experiment, all the subjects will receive consent forms to sign as a testament to their understanding and commitment to the procedure of the current study. Depending on the assessment measure, different tasks will be undertaken during the research. The first task will be aimed at assigning each participant to either ADHD group or without ADHD group. Afterwards, based on their results on ADHD Rating Scale-IV test, they will be divided into two groups. Then, they will be asked to complete School Report Cards and CBB test. Applicants will not receive feedback about the tests they completed. Hence, this study will investigate differences in academic performance and cognitive functioning between adolescent boys who were diagnosed with ADHD and those without ADHD. After completing all tasks, the subjects will receive appreciation for their participation in the research.

Conclusion

In summary, discussion of research findings showed that ADHD could negatively affect cognitive functioning that may lead to a decrease in academic performance among adolescent boys diagnosed with ADHD in comparison with those without ADHD. Therefore, it is important to clarify whether male teenagers with ADHD are different from those without ADHD in terms of their academic success and cognitive performance. Thus, the current paper included two main hypothesis and proposed the method procedure for the future research in this regard.

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