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ADHD in children
("Hyperactive" Childrenâ€¦ â€“ or Hyperactive Culture?)
DSM III-R Criteria for
Attention-deficit Hyperactivity Disorder
314.01 Attention-deficit Hyperactivity Disorder (ADHD)
The essential features of this disorder are developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity. People with the disorder generally display some disturbance in each of these areas, but to varying degrees.
Manifestations of the disorder usually appear in most situations, including at home, in school, at work, and in social situations, but to varying degrees. Some people, however, show signs of the disorder in only one setting, such as at home or at school. Symptoms typically worsen in situations requiring sustained attention, such as listening to a teacher in a classroom, attending meetings, or doing class assignments or chores at home. Signs of the disorder may be minimal or absent when the person is receiving frequent reinforcement or very strict control, or is in a novel setting or a one-to-one situation (e.g., being examined in the clinician's office, or interacting with a videogame.)
Impulsiveness is often demonstrated by blurting out answers to questions before they are completed, making comments out of turn, failing to await one's turn in group tasks, failing to heed directions fully before beginning to respond to assignments, interrupting the teacher during a lesson, and interrupting or talking to other children during quiet work periods.
Hyperactivity may be evidenced by difficulty remaining seated, excessive jumping about, running in classroom, fidgeting, manipulating objects, and twisting and wiggling in one's seat.
At home, inattention may be displayed in failure to follow through on others' requests and instructions and in frequent shifts from one uncompleted activity to another. Problems with impulsiveness are often expressed by interrupting or intruding on other family members and by accident-prone behavior, such as grabbing a hot pan from the stove or carelessly knocking over a pitcher. Hyperactivity may be evidenced by an inability to remain seated when expected to do so and by excessively noisy activities.
When children play games with their friends, it is difficult for them to follow the rules of the games or to listen to other children. Impulsiveness is frequently demonstrated by not being able to await one's turn in games, interrupting, grabbing objects (not with malevolent intent), and engaging in potentially dangerous activities without considering the possible consequences, e.g., riding a skateboard over extremely rough terrain. Hyperactivity may be shown by excessive talking and by an inability to play quietly and to regulate one's activity to conform to the demands of the game.
In preschool children, the most prominent features are generally signs of gross motor over-activity, such as excessive running or climbing. The child is often described as being on the go and "always having his motor running."
You can observe inattention by watching those children shifting frequently from one activity to another. They say that, in older children and adolescents, the most prominent features tend to be excessive fidgeting and restlessness. In adolescents, impulsiveness is often displayed in social activities, such as initiating a diverting activity on the spur of the moment instead of attending to a previous commitment (e.g., joy riding instead of doing homework, or partying, daring games etc.)
Associated features. Associated features vary as a function of age, and include low self-esteem, mood lability, low frustration tolerance, and temper outbursts. Academic underachievement is characteristic of most children with this disorder.
Non-localized, "soft," neurological signs and motor-perceptual dysfunctions (e.g., poor eye-hand coordination) may be present.
Age at onset. In approximately half of the cases, onset of the disorder is before age four. Frequently the disorder is not recognized until the child enters school.
Impairment. Some impairment in social and school functioning is common.
Complications. School failure is the major complication.
Predisposing factors. Central nervous system abnormalities, such as the presence of neurotoxins, cerebral palsy, epilepsy, and other neurological disorders, are thought to be predisposing factors.
Disorganized or chaotic environments and child abuse or neglect may be predisposing factors in some cases.
Prevalence. The disorder is common; it may occur in as many as 3% of children.
Course. In the majority of cases manifestations of the disorder persist throughout childhood. Oppositional Defiant Disorder often develops later in childhood in those with ADHD. Studies have indicated that the following features predict a poor course: coexisting Conduct Disorder, low IQ, and severe mental disorder in the patients.
Familial pattern. The disorder is believed to be more common in first-degree biologic relatives of people with the disorder than in the general population. Among family members, the following disorders are thought to be overrepresented: Specific
Developmental Disorders, Alcohol Dependence or Abuse, Conduct Disorder, and Antisocial Personality Disorder.
Here are the diagnostic criteria for 314.01 Attention-deficit Hyperactivity Disorder.
It says that a criterion is met only if the behavior is considerably more frequent than that of most people of the same mental age, which I find somewhat challenging, since it seems to imply that one is â€œnormalâ€ if one acts like â€œmost peopleâ€.
A. A disturbance of at least six months during which at least eight of the following are present:
(1) often fidgets with hands or feet or squirms in seat (in adolescents, may be limited to subjective feelings of restlessness)
(2) has difficulty remaining seated when required to do so
(3) is easily distracted by extraneous stimuli
(4) has difficulty awaiting turn in games or group situations
(5) often blurts out answers to questions before they have been completed
(6) has difficulty following through on instructions from others (not due to oppositional behavior or failure of comprehension), e.g., fails to finish chores
(7) has difficulty sustaining attention in tasks or play activities
(8) often shifts from one uncompleted task to another
(9) has difficulty playing quietly
(10) often talks excessively
(11) often interrupts or intrudes on others, e.g., butts into other children's games
(12) often does not seem to listen to what is being said to him or her
(13) often loses things necessary for tasks or activities at school or at home (e.g., toys, pencils, books, assignments)
(14) often engages in physically dangerous activities without considering the consequences (not for the purpose of thrill-seeking), e.g., runs into street without looking
B. Onset before the age of seven.
Criteria for severity of Attention-deficit Hyperactivity Disorder:
Mild: Few, if any, symptoms in excess of those required to make the diagnosis and only minimal or no impairment in school and social functioning.
Moderate: Symptoms or functional impairment intermediate between "mild" and "severe."
Severe: Many symptoms in excess of those required to make the diagnosis and significant and pervasive impairment in functioning at home and school and with peers.
Here I would like to add, that in my personal opinion, the reason the child is in one category or another, that the deciding factor in terms of mild or severe lies not within the child, but the environment he/she lives in.
After reading about ADHD for three weeks, I have come to a very different point of view than the one I had when I started out this paper, or learned about ADHD a year ago. In fact, after tons of research on the internet, and reading books looking at this so-called disease from an anthroposophical point of view, also by talking to teachers at the Waldorf school and my sister in Germany, who is a kindergarten teacher with two decades of experience, I have come to the conclusion that I cannot present ADHD as a confirmed disease. In my opinion, it has been socially constructed. Therefore, in this paper, I will try to look at ADHD from a more critical and also fresh perspective.
When my son was in grade two, his teacher once casually mentioned that, if he was in public school, he most likely would be recommended to take Ritalin. From then on, I watched him closely, and noticed quite a few of the symptoms commonly associated with ADHD. An interesting point to mention here, I think, is that I in no way had I seen my son as having a â€œdiseaseâ€ or a â€œdisorderâ€ or, in fact, that there was anything wrong with him. I did realize that he takes more energy to raise than my daughter, but also that he has an abundance of love, enthusiasm, energy, and intelligence to offer and comes out with statements of wisdom far beyond his age. He does knock over things more than other children, is often daring in his actions, oblivious of the location of his extremities at times, which can be challenging, and is very porous to outside influences. But the reason for that, I believe, is not to be found in a disease. Some people, for reasons beyond our present knowledge, are born more open, receptive and sensitive to the invisible energies of life, and, unfortunately, cannot automatically chose those energies which are beneficial above the ones that are destructive. It is up to us as parents, teachers and adults in the lives of these children to help create an environment of strengthening, rather than labeling.
Here are some of the controversies I have found on this subject, the first being a paper written by Dr. Steven M. Nordby: Problems in Identification and Assessment of ADHD:
Disorders are social constructs (see, e.g., Berger & Luckman, 1967; Goffman, 1962; Szasz, 1960), and Reid, Maag, and Vasa (1993) use this idea to question the validity of ADHD as an identifiable disorder. Whalen (1989, cited in Reid et al.) points out that at some ages, 50% of children are seen by adults as hyperactive. Identification and assessment of ADHD remains complex. Parents and teachers should carefully consider social variables and also screen for giftedness before recommending assessment for ADHD
Rutter (1983, cited in Reid et al.) reports that ADHD is 50 times more likely to be diagnosed in the U.S. than in Britain or France. Response to CNS (central nervous system) medication provides an explanation for the existence of ADHD, and that "[t]he availability of the ADHD label may both enable and encourage diagnosis for difficult children" (Reid et al., p. 204).
The assessment process must consider possible preemptory and co-occurring disorders. Regardless of assessment outcomes, parents and teachers "should address any co-occurring learning disabilities, language differences, talent/giftedness, or retardation before they provide accommodations for ADHD" (Zentall, 1993, p. 150).
Almost all of ADHD behaviors might be found in bright, talented, creative, gifted children. Until now, little attention has been given to the similarities and differences between the two groups, thus raising the potential for misidentification in both areas -giftedness and ADHD.
Suggestions are made to help differentiate ADHD and giftedness:
â€¢ Unlike gifted children, those with ADHD exhibit problem behavior in virtually all settings.
â€¢ Gifted students will concentrate on what interests them regardless of desires of parents and teachers, but ADHD students have brief attention spans in virtually all situations.
â€¢ Both ADHD and gifted students may question rules, but gifted students may create their own complex rules and expect others to follow them.
My research tells me that sometimes, children are being, diagnosed with ADHD by professionals have simply listening to parent or teacher descriptions of the child's behaviors, along with a brief observation of the child. Other times, brief screening questionnaires are used, although these questionnaires only quantify the parents' or teachers' descriptions of the behaviors Children who are fortunate enough to have a thorough physical evaluation (which includes screening for allergies and other metabolic disorders) and extensive psychological evaluations, which include assessment of intelligence, achievement, and emotional status, have a better chance of being accurately identified. (Parker, 1992).
Announcing the November, 1998, National Institutes of Health (NIH), ADHD-Consensus Conference, Planning Committee Chairman, Peter Jensen  , of the National Institute of Mental Health (NIMH), also a member of the Professional Advisory Board of Children and Adults with Attention Deficit Disorders (CHADD), wrote:
â€œâ€¦AD/HD has been surrounded by long-standing controversy. This controversy surrounds the actual diagnosis of AD/HDâ€”that is, whether the diagnosis simply â€˜pathologizesâ€™ normal child behavior and whether it is a function of large (school) classes, too busy parents, or the machinations of a medical/pharmaceutical cabal.â€
Here, Jensen defines the essence of the controversy--not Ritalin or amphetamines and the risks they bearâ€”all drugs bear risks-- but whether or not ADHD is a bona fide disease:
"Statistics show that following thorough multi-disciplinary family assessment, only 20-25 per cent of previously diagnosed children are given a confirmed ADHD diagnosis,"
"In our experience, many of the children misdiagnosed with ADHD in fact are assessed to be suffering from significant developmental and learning disorders; attachment problems, anxiety or depression.
Medication may be prescribed during assessment on the basis that "paradoxical" response to central nervous system stimulants indicates ADHD. However, Swanson et al. (1993) report that similar responses occur in children and adults with and without ADHD, so response to medication is of no value in diagnosis.
Coupled with the misdiagnosis was the nationally high rate of prescriptions of stimulant drugs prescribed by US doctors to treat ADHD â€“ due to a lack of knowledge about other possible therapies.â€
At this point, I became very interested in the prescription of drugs like Ritalin, and found a lot of information about it. Here are some excerpts.
In a testimony at Congressional Hearings on whether or not to fund research into pharmacological (drug) treatment for school problems, Dr. John D. Griffith , Assistant Professor of Psychiatry, Vanderbilt University School of Medicine, posited:
â€œI would like to point out that every drug, however innocuous, has some degree of toxicity. A drug, therefore, is a type of poison and its poisonous qualities must be carefully weighed against its therapeutic usefulness. A problem, now being considered in most of the Capitols of the Free World, is whether the benefits derived from Amphetamines outweigh their toxicity. It is the consensus of the World Scientific Literature that the Amphetamines are of very little benefit to mankind. They are, however, quite toxic. The committee remains troubled by the absence of long-term studies into the effect of stimulants on the individual, in particular young children, who may begin taking the medication at a very early age, and continue to do so throughout their formative years."
"There may be many children receiving stimulant medication when it is not necessary or warranted," the report said.
The fundamental issue before us, and before all countries of the developed world is whether or not ADHD is a bona fide, diagnosable disease or not. If not, if the children are normal, as I know them to be, they are not medical patients and no medical treatment is necessary, or justified. Rather, their unmet needs lie, as in generations-past, with their parents, teachers, and with their communities. I am against the treatment of ADHD and of all psychiatric conditions with Schedule II, stimulants because none are actual diseases having confirmatory, demonstrable/diagnosable, objective, abnormalities. For simplicityâ€™s sake, I urge all non-physicians to remember that the abnormality is the disease; no abnormality, no disease.
Drugs prescribed for ADHD presently include: Ritalin (methylphenidate), Dexedrine (dextro-amphetamine), Adderall (mixed dextro- and levo-amphetamine) and, Gradumet, and Desoxyn (both of which are methamphetamine, aka 'speedâ€™. All of the above Schedule II stimulants can be dangerous and addictive,
The US Food & Drug Administration (FDA), Med Watch* program, a voluntary system for the reporting of post-marketing complications of drugs, reported the following adverse reactions (AR) from methylphenidate (Ritalin and all generic and proprietary forms), from 1990-1997:
569 hospitalizations--36 life-threatening.
949 central or peripheral nervous system occurrences
126 cardiovascular occurrences:
6 cases of "cardiomyopathy"
12 of "arrhythmia"
7 of "bradycardia" (slow pulse)
5 of "bundle branch block" (impairment of heartâ€™s conduction apparatus)
4 of "EKG abnormality"
5 "extrasystole" (heart rhythm abnormalities)
3 "heart arrest"
2 heart failure, right"
10 "hypotension," (low BP)
1 "myocardial infarction"
15 "tachycardia" (rapid pulse).
*Between 1997 and 2000 there have been an additional 26 deaths attributed to methylphenidate (all prescription forms of it) bringing the total reported to FDA, MedWatch for the decade, 1990-2000, to 186.
The next question I asked myself is: does ADHD have a biological base? Here is what Iâ€™ve found:
Buitelaar and Bergsma, 25;1:
The title of the Swanson and Castellanos,  Consensus Conference presentation was â€œBiological Bases of Attention Deficit Hyperactivity Disorder,â€ as if there was a biological basis or bases:
â€œIt has been shown that ADHD is associated with several abnormalities of the brain. The frontal lobes of the brainâ€¦are about seven percent smaller than average in children with ADHD.â€
Reviewing the brain scanning literature, they reported that the brains of ADHD subjects were, on average, 10% smaller than those of normal controls. What they neglected to say, until Baughman challenged Swanson (presenting), from a floor microphone, was that virtually all ADHD subjects, in the 12 years of brain scanning research reviewed, 1986-1998, had been on long-term methylphenidate/amphetamine therapy, and, that thisâ€”their medication--was the only physical difference between the ADHD subjects and normal controls, and the probable cause of their brain atrophy.â€
In Australia, according to Lynne Oldfield, the number of children on prescribed amphetamines for ADD rose from just 3,000 in 1991 to 16,000 in 1993.
In Britain, between 1993 and 1998, the number of child Ritalin prescriptions rose by no less than thirty-six times (Observer newspaper, 27 February 2000); and recent data showed a 20-fold increase in Ritalin prescription in Scotland between 1994 and 1999 (Nursery World, 12/10/00). Debate of the issue of whether or not ADHD and other psychiatric conditions/diagnoses are abnormalities/diseases, as psychiatry claims, are well-framed in the presentation of Jan Buitelaar and Ad Bergsma  to the Pompidou Group, December 8-10, 1999.
Here an excerpt:
Buitelaar and Bergsma, page 19, paragraph 2: Sociocultural factors and the treatment of ADHD. In: Council of Europe:
â€œFrom the standpoint of child psychiatry, ADHD is a categorical (absolute, unequivocal) diagnosis that may be conferred following a systematic evaluation and eventually using validated behavior checklists and interview procedures. ADHD is associated with functional and morphological abnormalities of the brain and is predominantly due to genetic factors.â€
The diagnostic tools of psychiatry: behavior checklists, structured interviews, achievement and aptitude tests, never seek or demonstrate actual physical abnormalities/diseases. And yet, having proven no such things, they claim: â€˜ADHD is associated with functional and morphological abnormalities of the brain and that it is due, predominantly, to genetic factors.â€™
Swanson, a psychologist, presenting for Castellanos , spoke at the ADHD Consensus Conference (1998) on the subject of â€œBiological Bases of ADHD: â€ In fact, there is no one or several biological bases of ADHDâ€”not anatomic, not genetic, and not physiologic. From a different standpoint, ADHD is viewed as a stigmatizing and harmful label attached to children who are difficult to handle.â€
I will now look into an anthroposophical (Waldorf school) point of view, which I found very enlightening. Starting with a more general statement, I quote Rudolf Steiner:
â€œWhat do we commonly find advocated? That children should have the same sort of relationship with each other as is usual among adults. But this is the most spurious thing that can be done in education. People must realize that a child has to develop quite different powers of soul and of body than those which adults use in their intercourse with each other. Thus education must be able to reach the depths of the soul; otherwise no progress will be made.â€
According to Eugene Schwartz in his important book The Millennial Child (Anthroposophic Press, Spring Valley, New York, 1999), childhood constitutes an â€˜endangered speciesâ€™. Signs are all around us of adult-driven intellectual agendas and a hyper-active, materialistic culture impinging ever more relentlessly on the lives of children at ever younger ages. One-quarter of British children aged under 4 now apparently have a television set in their room (Daily Mail, 30 June 2000). Martin Large, proprietor of the holistic British publishers Hawthorn Press, is currently putting the finishing touches to a follow-up book to his seminal book Whoâ€™s Bringing Them Up?, which looked at television and the pervasive, insidious harm it does to children.
Martin will conclude, having reviewed the considerable available research, that children should ideally not start watching television, or begin using computers, until at least the age of 7.
Even relatively conventional neuroscientists, like Professor Susan Greenfield of Oxford University, are beginning to suggest that an increasingly ubiquitous â€˜Information Technologyâ€™ may entail profound long-term risks, including â€˜the potential loss of imagination, the inability to maintain a long attention span, the tendency to confuse fact with knowledge, and a homogenization of an entire generation of minds. These risks could even actually change the physical workings of the brainâ€™ (The Independent [Monday Review], 19 June 2000, emphasis added).
Rudolf Steiner was pointing out comparable dangers nearly a century ago. In a lecture given in Torquay in 1924, he said, â€˜Before the change of teeth, the child is, quite literally, wholly "sense-organ"... If something takes place in the childâ€™s environment..., the whole child will have an internalized picture of it. The results of such an â€œimplanting tendencyâ€ in the early years will then remain through the rest of his life. Everything that you do yourself passes over into your children and makes its way into them.â€™ On this view, the environments to which we expose our young children have a quite fundamental influence on their whole being - physically, emotionally, and spiritually. And it therefore behooves us to take great care in how we create those environments - a task which is becoming increasingly important as modern cultureâ€™s assaults upon young children become ever-more strident, universal and unavoidable.
Against the cultural backdrop just described, it is little wonder that mental health problems are at record levels amongst children (Nursery World, 6 April 2000, pp. 8-9); that the anxiety-driven hot-housing atmosphere of mainstream educational settings is now demonstrably leading to severe psychological and emotional problems (e.g. The Independent, 6 July 2000, p. 5; Nursery World, 22 June 2000, pp. 4-5); and that, as child psychotherapist Peter Wilson estimates, about one-quarter of British children in their mid to teenage years are displaying symptoms of extreme stress, depression or anxiety (quoted in Natural Parent, 1, 1997, p. 22).
Yet rather than so-called â€˜Attention Deficitâ€™ and â€˜Hyperactivityâ€™ â€˜disordersâ€™ being valid medical-diagnostic categories, these symptoms are far better understood as childrenâ€™s understandable and, paradoxically, even healthy response to the routine violence that modern technocratic culture is doing to our childrenâ€™s healthy development â€“ and not least the unbalanced over-intellectual â€˜left-brainâ€™ distortions of its early educational practices. Until we possess the wisdom and insight to recognize, learn from, and then respond appropriately to this malaise at a cultural level (not least via protecting young children from the soul-assaults of modern â€˜deadâ€™ technology and inappropriate educational practices), childrenâ€™s so-called â€˜behavioural difficultiesâ€™ will inevitably continue to escalate â€“ Ritalin or no Ritalin.
It should be clear from the foregoing that a truly human response to childrenâ€™s challenging behaviour is to seek meaning in it â€“ to listen deeply and respectfully to its manifest symptoms in order to get as close as we can to understanding that behaviour, and then fashioning appropriate healing responses to it.
It was Carl Jung who poignantly wrote: â€˜We should not try to "get rid" of a neurosis, but rather to experience what it means, what it has to teach us, what its purpose is. We do not cure it - it cures usâ€™ Childrenâ€™s â€˜mental healthâ€™ problems are often, or even always:
â€¢ a manifestation of childrenâ€™s struggle towards meaning-making;
â€¢ a meaningful process, typically operating at many levels, rather than some kind of â€˜abnormal malfunctionâ€™ of the (physical) brain.
ADD is the direct result of the over-stimulation of a speeded-up culture. Conventional study results even suggest that "daydreams" belongs to the domain of attention-deficit disorder!
When my children were just toddlers, my sister sent me a book on raising children from a Waldorf point of view. From this book, I translated a few passages:
â€œOne symptom of ADHD is the inability to be quiet and concentrated when listening, thinking and observing. The child chases from one impression to the other without pause. And in their emotional world? Here we can observe a lack of impulse control. The children cannot stem their outpour of emotions. They seem to have no distance to others and their boundaries, they kiss or hug indiscriminately, when ordinarily, there should be a sense of shyness in this particular situation.
The primal matrix of a healthy inner emotional life is like the circulation of air in breathing: taking in, quietly holding for a moment, and then letting go. This rhythmical cycle is also inherent in our emotional landscape: an emotion rises, is experienced, and dissolves again. If one was to ask oneself which phase is disturbed in children with so-called ADHD, then the answer would be: the middle phase, the conscious experiencing of emotions, after they arrive and before they disappear again. This moment of quiet, of experiencing fully, is underdeveloped.
Hyperactive children, when they see the handle of a window, for example, start yanking on it until it breaks. Then they might throw it down, and seek out the next thing. Their actions seem unmotivated and senseless. If one looks closer, though, it becomes apparent that this isnâ€™t so. With their willingness to act they participate in what they sense and feel; the child likes the experience of something falling down, breaking and the sound it makes. The only disturbance is that the child has no willpower, no control in the realm of thoughts, emotions or motion. Their concentration is split, their impulse follows this and follows that without clear coordination or leadership. Even small children find it difficult to imitate things that are sensible, because they lack inner quiet and concentration.
In all three areas of the soul their control function is disturbed, i.e. the Self-function. They donâ€™t lack interest, emotion or mobility, but those qualities are not really within the control of the child. The child gives the impression to be the pawn of his/her emotions and interests.
The outstanding quality of these children is their ability to surrender themselves completely to the world. Interestedly, they follow everything they see, they are emotionally open and spontaneous, but their willpower is easily distracted, and makes them willing to approach many things too quickly and eagerly. But they must evolve in all areas that have to do with self control and self discipline.
The question is: why is this condition so prevalent now compared to 20, 30 years ago?
Not only our children are affected; hand in hand goes the rise in a certain weakness of will in adults. Security and comfort have become a way of life. Children hardly ever see their parents do things with their own hands, most of our work in the household and elsewhere can be done by machines, everything can be bought pre-made. Therefore they have few models for controlled and concentrated chores that make up a typical day, which they could imitate, participate and practice daily. Because of that, even toddlers experience a poverty of meaningful, regular engaged physical inspiration and action.
The same holds true in their emotional life. Overall cultural anxiety, dissatisfaction, stress and a continuous rushing around are a common picture in most peopleâ€™s lives. The things children need in order to feel emotionally held and accepted are often sacrificed in the process.
Adults have a hard time concentrating themselves, listen with half an ear to the stories of a child, while they make dinner or catch up on their phone calls. Stress makes superficial; anxiety is a hindrance to deep reflection. We buy new things and throw old one out quickly â€“ there is no healthy relationship to things around us, there is disinterest and a general lack of commitment, also to be observed in our relationship to our planet.
Add to that environmental factors â€“ like the baby who is being pushed in her pram facing a crowd of people, traffic, noise, supermarkets aisles, instead of facing the image of her mother. One impression chases the other: sound, images of people and things, smells â€“ nothing has time to settle and absorb, so the small children can quietly take it in. Concentration and sensitivity are already being splintered, impressions forced to superficiality by virtue of their abundance and speed. Frequent changes of homes, steady supply of technical toys which donâ€™t further a childâ€™s imagination, and many other things we unthinkingly expose our children to and which inhibit their ability to focus on one thing for an extended period of time. For example, when children watch a TV program like sesame street, they take in 600 different scenes within 30 minutesâ€“ a big contribution to the destruction of childrenâ€™s imagination. There is nothing more harmful for hyperactive children than to watch television. Because whoever suffers from a lack of control, becomes even more so through watching TV. It is impossible to digest the abundance of images thrown at a young child, it erodes even more the already existing weakness of will and concentration. The rapidly changing scenes donâ€™t allow for emotional attachment, and donâ€™t encourage participation. Of all things in our modern world, watching television is maybe the biggest contributor to hyperactivity. Once they are used to the fact that those fast, interesting things simply fall into their lap and that they have to do nothing for them, childrenâ€™s will becomes weaker, and therefore their ability to control themselves.
The message of hyperactive children seems clear: they are a simple indication, a sign of our times. It is more than necessary to create in our children and in our own lives, moments of inner calm, collection and quiet. A special needs teacher once told this story: in his group was a child who was nearly unable to sit still. At the end of lesson though, the teacher would always recite the following poem:
Only when I think of light
Does my soul shine.
Only when my soul shines,
Does earth become a star.
Only when earth becomes a star,
Am I truly human.
At this point, this child sat still and an overall quietness descended upon his restless self.
This inner disquiet is nearly impossible to heal without a basic spiritual milieu, because inner quiet is the model for outer quiet. Our children mirror through their pain and problems something which concerns us as adults. They show our own dysfunctions in a stronger form. We can learn much about our time and culture if we learn to help them. Again and again do we experience children healing within a year or two, if we as parents commit to changing our style of life, maybe support them through natural medicine, and watch them turn back into joyful children.
(Michaela Gloeckler, â€œA Little Guide for Raising Healthy Childrenâ€)
Art Therapy approaches
What these children most need, in my opinion, are opportunities to learn self-mastery, to receive unconditional positive regard and tools to achieve inner quietude. Art therapy is a great way to provide these conditions. Within a group setting, opportunities for being successful in their individual art is being created, while at the same time the process of symbolizing feelings can strengthen their communication skills.. Since there is no achievement pressure, as is in their school setting, and a space of safety and unequivocal acceptance, art therapy can be very healing for ADHD children. In group activities (murals, carousel, building bridges out of construction material) a setting is created which enables them to learn respectful behaviour and interaction with their peers. Children who find it difficult to communicate their feelings, especially their anger and shame about themselves, find ways to communicate without having to put words to their feelings. The experience of having been successful by doing art is tremendously important for their self esteem. Another important point of art therapy is, that it provides a chance for the participants to completely get absorbed in the art making process, which has a similar effect on them as meditation would for an older age group. It gives them, as Pat Allen writes in his book â€œArt Making as Spiritual Pathâ€ the direct experience of something greater than them, of what Michaela Gloeckler calls the â€œspiritual milieuâ€. They can learn to come to rest, and hopefully gain a tool for life in making art. Very often my son, after coming home from school, walks straight to the art making table in our house, and starts making art for 30 minutes or so. He will draw his day at school, other children, when heâ€™s angry, heâ€™ll put lots of energy into his art. When done, heâ€™ll come out and start playing or sits on my lap for a cuddle.
Eugene Schwartz.The Millennial Child (Anthroposophic Press, Spring Valley, New York, 1999),
(Nursery World, 12/10/00).
(The Independent [Monday Review], 19 June 2000,
Rudolf Steiner. The Study of Man, Lecture IV
Koriath, U., Gualtieri, M. D., Van Bourgondien, M. E., Quade, D., & Werry, J. S. (1985). Construct validity of clinical diagnosis in pediatric psychiatry: Relationship among measures. Journal of the American Academy of Child Psychiatry, 24, 429-436.
Webb, J. T., & Latimer, D. (1993). ADHD and children who are gifted. Reston, VA: The Council for Exceptional Children. (ERIC Document Reproduction Service No. ED 358 673)
The US Food & Drug Administration (FDA), Med Watch*
Jan Buitelaar and Ad Bergsma  to the Pompidou Group, December 8-10, 1999.
American Psychiatric Association. (1987). The diagnostic and statistical manual of psychiatric diagnoses (3rd ed., rev.). Washington, DC: Author
American Psychiatric Association. (1994). The diagnostic and statistical manual of psychiatric diagnoses (4th ed.). Washington, DC.
National Institutes of Health, (ADHD-Consensus Conference, Planning Committee Chairman, Peter Jensen , 1998)
Berger, P. L., & Luckman, T. (1967). The social construction of reality. New York: Doubleday-Anchor.
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