ADHD is a neurodevelopmental disorder affecting a significant number of people. It is characterized by inattention and/or hyperactivity and/or impulsivity. It impacts various aspects of an individual's life. Rehabilitation is a holistic process, aiming at restoring and training an individual to improve their quality of life, increase independence, increase social participation and social inclusion. A combination of various rehabilitation strategies are used depending on the individual's needs, severity of the disorder, and developmental phase. Apart from the client, involving parents, caregivers, teachers, schools, and employers and co-workers ensure a consistent and effective rehabilitation process. This chapter focuses on the rehabilitation strategies like medication, behavioral training, psychoeducation, psychotherapy, social skills training, remediation methods, classroom management, parent training, coaching, support groups, lifestyle changes, and career and vocational guidance. Using timely intervention strategies and training enhances the rehabilitation process.
TopAttention Deficit / Hyperactivity Disorder
Attention deficit / hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects many children and adults. This is characterized by a persistent pattern of inattention and/or hyperactivity and/or impulsivity or the combined type. The symptoms can be presented in a combined or predominant style.
Farone (2001), describes ADHD as a “chronic, debilitating disorder” that could have impacts on many aspects of an individual’s life. The various areas of an individual’s life that are impacted are academic, social and interpersonal relationships. Weiss & Hechtman(1993) in a study stated that about 30-60% people who are diagnosed with ADHD continue to show significant symptoms of the disorder in their adulthood too. Mannuzza & Klien (1993), state that children with the disorder are at greater risks for negative outcomes like lower educational rates and employment opportunities.
Rehabilitation
Riggar & Maki (2003) in their Handbook of Rehabilitation Counseling have described the concept of rehabilitation as “a holistic and integrated program of medical, physical, psychosocial, and vocational interventions that empower a person with disability to achieve a personally fulfilling, socially meaningful, and functionally effective interaction with the world” (Banja, 1990). Sherwin Elisabeth, in the Oxford Handbook of Rehabilitation Psychology has described rehabilitation, “as a profession that assists persons with disabilities in adapting to the environment, assists environments in accommodating the ‘needs of the individual, and works toward full participation of persons with disabilities in all aspects of society, especially work”(Szymanski, 1985).
Rehabilitation counselling can also be described as a process which facilitates people with physical, psychological, developmental, cognitive and emotional disabilities to achieve their goals (personal, professional and living independently) in a holistic way. “The counseling process involves communication, goal setting, and beneficial growth or change through self-advocacy, psychological, vocational, social, and behavioral interventions” (Commission on Rehabilitation Counselor Certification - CRCC).
Maki (2012) has described some of the techniques and modalities used in the rehabilitation counseling process. They are: -
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Assessment and appraisal
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Diagnosis and treatment planning
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Career (vocational) planning
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Individual and group counselling treatment interventions
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Case management, referral, and service coordination
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Program evaluation and research
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Interventions to remove environmental, employment, and attitudinal barriers
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Consultation services
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Assistance in job analysis, job development and placement services
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Provision of consultation about and access to rehabilitation technology (Commission on Rehabilitation Counselor Certification, 1994)
Rehabilitation Strategies
The rehabilitation of persons with ADHD requires a “multimodal” approach. It consists of the client, parents, teachers, school, peer and environment to some extent. The rehabilitation process of a person with ADHD is a continuous and lifelong process, as each developmental stage of a person’s life could bring a different level of challenge and issues. The process of rehabilitation covers the medical, psychological, cognitive, social, physical, emotional and vocational aspects. Rehabilitation of persons with ADHD is essential to reduce the impact of the disorder, to improve quality of life and enhance personal and emotional wellbeing.
The rehabilitation strategies are used singularly or in combination depending on the diagnosis and the presenting complaints of the person with ADHD. Further, rehabilitation strategies, along with their applications and impact specifically for ADHD have been discussed.