The Attention Deficit - Hyperactivity Disorder (ADHD) and the therapeutic effect of the music.

Kostas Mantzikos

Special Educator-Author

ABSTRACT

Many ancient Greek scholars such as Terpander, Arion, Isomenios, Empedocles, Pythagoras, Aristoxenus, Democritus, Damon, Celsus, Galen, and Theophrastus had applied music as a therapeutic agent in people with various body and mental illnesses. Recent investigations demonstrated the important role of music in persons with various developmental disorders (ADHD, autism, and Down Syndrome) which present deficits in various sectors such as language, communication, disposition, memory, and attention. The effect of music, in children with ADHD, has positive results in improvement in many fields in which they present such shortfalls. In this article through the bibliography we report the definitions of ADHD and music therapy, cognitive and psychological profile of these children as well as the effectiveness of music, in various sectors in which they exhibit deficits.

KEYWORDS: Children, ADHD, music, cognitive, psychological, profile.

INTRODUCTION

Attention Deficit Hyperactivity Disorder (ADHD), is a syndrome exhibited by a number of children who have excessive energy and kinetic activity compared to their peers. It mainly affects their ability to maintain their attention span as well as their interest in a given activity they are engaged in or their capacity to carry out the tasks assigned to them which are extremely reduced. Furthermore, their impulsive behavior deviates considerably in intensity and frequency from the same behaviour of their peers. Many times they also exhibit oppositional behavior and lack of collaborative disposal. In general, we could say that these children, although they have normal intelligence, often find it very difficult to meet the requirements of their environment and do not behave according to their developmental level (Kakouros, 2001).

Music therapy is the rehabilitation process in treating these patients, achieved basically through the impact of sounds. This therapeutic method is the production of musical sound and hearing. Music therapy is a certain method of psychotherapy that uses music as a communication medium. The produced and audible music emotionally charge the persons related to the psychotherapeutic effort (Antoniadou, 2011).

 COGNITIVE AND PSYCHOLOGICAL PROFILE OF INDIVIDUALS WITH ADHD

In ADHD there are several problems with speech as in pragmatics and prosody (Bloch, Aviram, Neeman, Braw , Nitzan, Maoz, & Mimouni - Bloch, 2015; Green, Johnson, & Bretherton, 2014). Additionally people with ADHD have largely locomotor hyperactivity and less sensory problems (Hartley & Sikora, 2009). Several studies (Brossard - Racine, Shevell, Snider , Belanger, & Majnemer, 2012; Fliers, Franke, Lambregts - Rommelse, Altink, Buschgens, 2010; Lavasani & Stagnitti, 2011; Pasini, & D 'Agati, 2009 a; Pasini, & D 'Agati, 2012 b) have shown that people with ADHD have poor performance in motor skills tests. Several surveys have shown that the ADHD incorporates deficits in executive functions, namely working memory, selective attention in behavioral inhibition, and action planning (Barkley, 1998; Kofler, Rapport , Bolden, Sarver, Raiker, & Alderson, 2011; lawrence, Houghton, Douglas, Durkin, Whiting, & Tannock, 2004; Nigg, 2009; Semrud - Clickerman, Walkowiak, Wilkinson, & Christopher, 2010).

On the other hand, children with ADHD show deficits in motivation and decision-making (Agapitou-Chalmpe, 2010; Castellanos, Sonuga - Barke , Milham, & Tannock, 2006; Toplak, Jain, & Tannock, 2005 a),and invariably exhibit deficits in mood regulation, at low agitation, and have a slow speed in the handling of information and reaction time to the stumuli (Nigg, 2009; Wu, Xiao , Sun, Zou, & Zhu, 2012). In this piece there is enough correlation of ADHD to autism (Asperger) (Miodovnik, Harstad, Sideridis, & Huntington, 2015; Nigg, 2009). Initially, the slow manner of information processing is because children displaying these two diversities find it difficult to immediately process a lot of information and require time to the process it all and instead do it piecemeal in order of input. Furthermore, the reason they are slow to react for example to a question is because children with ADHD, like autistic children deal with the question along with the answer and in doing so think of it as a reasonable picture in its totality prior to answering. Moreover the process is also exacerbated since children with ADHD have learning disabilities such as difficulties in mathematics and dyslexia (Agapitou-Chalmpe, 2010; Mahan, 2013; Nigg , 2009).

Surveys by (Arnold, Demeter, Mount, Frazier , Youngstrom, Fristad, Birmaher, Findling, Horwitz, & Kowatch, 2011; Biederman, Newcorn, & Sprich, 1991; Leirbakk, Clench - Aas, & Raanaas, 2015; Miller, Chang, & Ketter, 2013; Perrin, & Last , 1996; Plizka, 1989; Reeves, Werry, Elkind, & Zametkin, 1987; Werry, Reeves, & Elkind, 1987) have shown that children with ADHD can display Bipolar Disorder, and Anxiety Disorder. It is in fact reported that children with ADHD have difficulty socializing in various environments, such as for example in the schoolyard and neighborhood playground (Kofler et al, 2011; Myers , 2008; Rich, Loo, Yang, Dang, & Smalley, 2009).

Toplak and Tannock (2005b) support that children with ADHD have problems in their perception of time. Surveys have shown how children with ADHD may present with oppositional defiant disorder and Conduct Disorder (Bendiksen, Aase, Svensson, Friis , Myhre, Reichborn - Kjennerud, & Zeiner, 2014; Frick, Lahey, Christ, Loeber, & Green, 1991 · Ghanizadeh, 2011; Matthys, Vanderschuren , Schutter, & Lochman, 2012; Mordre, Groholt, Kjelsberg, Sandstad, & Myhre, 2011; Satterfield, Faller, Crinella, Schell, Swanson, & Homer, 2007;Werry et al, 1987) .

THE EFFECT OF MUSIC IN ADHD

As aforementioned children with ADHD show deficits in mood and stimulation. Surveys have shown that when children with ADHD hear certain music it has a positive effect on their mood and stimulation (Husain, Thompson, & Schellenberg, 2002; Nantanis & Schellenberg, 1999; Panksepp & Bernatzky, 2002; Thompson, Schellenberg, & Husain, 2001).

Music therapy has had a positive effect on improving existing deficits in attention and memory in children with ADHD having deficits in these areas (Canadian Association for Music Therapy, 2006; Morton, Kershner, & Siegel, 1990). In their research Pelham, Hoza, Sams, Gnagy, Greiner and Waschbush (1994) found that 30% of children with ADHD had higher rates to complete their work after listening to rock music.

Many children with ADHD have a number of negative behaviors. Some of these negative behaviors are: anxiety, depression, low self-esteem and self-perception, decreased motivation and low self-efficacy. This may be due to low self-esteem caused by the gap between parents' expectations and teachers (Barber, Grubbs, & Cottrell, 2005; Frankel, Cantwell, Myatt, 1999; Hechtman, Weiss, & Perlman, 1980; Mazzone, Postorino, Reale, Guarnera, Mannino, Armando, Fatta, De Peppo, & Vicari, 2013; Slomkowski, Klein, & Mannuzza, 1995; Treuting, & Hinshaw, 2001). Rickson and Watkins (2003) have shown that music could definately influence these emotional and psychological states.

Music does not only have a beneficial effect on emotional and psychological situations involving these children, but it also affects development of speech and language skills (Ludlam, 2011).

CONCLUSIONS

Many studies demonstrating how music has healing properties and positive results in various physical and mental illnesses and people who have various developmental diversities as (ADHD, Autism, Down Syndrome, and Williams Syndrome) have been performed.

Music as a therapeutic agent has the power to help children with ADHD to improve various sectors experiencing shortages, as the awareness of themselves and their environment, their self-esteem, to verbal and nonverbal their communication skills, social their skills, their ability to express their feelings, their capacity for more attention to work and improve memorization skills. Through the study of the literature, the results are encouraging. Therefore, it is necessary to further study the role of music during the education of children with ADHD in special education schools and institutions, but also in general.

REFERENCES

Agapitou-Chalmpe, B. (2010). The hyperactive child in preschool and first school age: theoretical and practical approach. Athens: Pedio Publications.

Antoniadou, S.M. (2011). Τhe relationship between music and children' s with autism treatment (Unpublished master’s thesis). University of Ioannina, Ioannina, Greece.

Arnold, L. E., Demeter, C., Mount, K., Frazier, T., Youngstrom, E., Fristad, M., … Kowatch, R. (2011). Pediatric bipolar spectrum disorder and ADHD: comparison and comorbidity in the LAMS clinical sample. Bipolar Disorders,13 (5-6), 509–521.

Barber, S., Grubbs, L., & Cottrell, B.. (2005). Self-perception in children with attention deficit/hyperactivity disorder. Journal of Pediatric Nursing, 20, 235-45.

Barkley, R.A. (1998). Attention- Deficit/ Hyperactivity Disorder. In E.J. Mash and R.A. Barkley (Eds.). Treatment of Childhood disorders (p.p. 55-110). New York: The Guilford Press.

Bendiksen, B., Aase, H., Svensson, E., Friis, S., Myhre, A. M., Reichborn-Kjennerud, T., & Zeiner, P. (2014). Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 2(3).

Biederman, J., Newcorn, J., Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. The American Journal Psychiatry, 148, 564-577.

Bloch, Y., Aviram, S., Neeman, R., Braw, Y., Nitzan, U., Maoz, H., & Mimouni-Bloch, A. (2015). Methylphenidate mediated change in prosody is specific to the performance of a cognitive task in female adult ADHD patients. The World Journal of Biological Psychiatry, 16(8), 1-5.

Brossard-Racine, M., Shevell, M., Snider, L., Belanger, S. A., & Majnemer, A. (2012). Motor skills of children newly diagnosed with attention deficit hyperactivity disorder prior to and following treatment with stimulant medication. Research in Developmental Disabilities, 33(6), 2080–2087.

Canadian Association for Music Therapy. (2006).  Specific applications of musical techniques in music therapy. Retrieved April 12, 2016, from Canadian Association for Music Therapy Web site: (http://www.musictherapy.ca/methods.html).

Castellanos, X.F., Sonuga-Barke, E.J.S., Milham, M.P., & Tannock, R. (2006). Characterizing cognition in ADHD: beyond executive dysfunction. Trends in Cognitive Sciences, 10 (3), 117-123.

Fliers, E. A., Franke, B., Lambregts-Rommelse, N. N. J., Altink, M. E., Buschgens, C. J. M., Nijhuis-van der Sanden, M. W. G., et al. (2010). Undertreatment of motor problems in children with ADHD. Child and Adolescent Mental Health, 15(2), 85–90.

Frankel, F., Cantwell, D.P., & Myatt, R. (1999). Do Stimulants Improve Self-Esteem in Children with ADHD and Peer Problems? Journal of Child and Adolescent Psychopharmacology, 9, 185-94.

Frick, P. J., Lahey, B. B., Christ, M. A. G., Loeber, R., & Green, S. M. (1991). History of childhood behavior problems in biological relatives of boys with Attention-deficit Hyperactivity Disorder and Conduct Disorder. Journal of Clinical Child Psychology, 20, 445-451.

Ghanizadeh, A. (2011). Overlap of ADHD and oppositional defiant disorder DSM-IV derived criteria. Archives of Iranian medicine, 14(3), 179-82.

Green, B.C., Johnson, K.A., & Bretherton. (2014). Pragmatic language difficulties in children with hyperactivity and attention problems: An integrated review. International Journal of Language & Communication Disorders, 49(1), 15-29.

Hartley, S.L., & Sikora, D.M. (2009). Which DSM-IV-TR criteria best differentiate highfunctioning autism spectrum disorder from ADHD and anxiety disorder in older children? Autism, 13 (5), 485-509.

Hechtman, L., Weiss, G., & Perlman, T. (1980). Hyperactives as young adults: self-esteem and social skills. Canadian Journal of Psychiatry, 25, 478-83.

Husain, G., Thompson, W. F., & Schellenberg, E. G. (2002). Effects of musical tempo and mode on arousal, mood and spatial abilities. Music Perception, 20, 151-171.

Kakouros, E. (2001). The hyperactive child. Athens: Ellinika Grammata Publications.

Kofler, M.J., Rapport, M.D., Bolden, J., Sarver, D.E., Raiker, J.S., & Alderson, R.M. (2011). Working Memory Deficits and Social Problems in Children with ADHD. Journal of Abnormal Child Psychology, 39(6), 805-17.

Lavasani, N. M., & Stagnitti, K. (2011). A study on fine motor skills of Iranian children with attention deficit/hyper activity disorder aged from 6 to 11 years. Occupational Therapy International, 18(2), 106–114.

Lawrence, V., Houghton, S., Douglas, G., Durkin, K., Whiting, K., & Tannock, R. (2004). Executive function and ADHD: a comparison of children's performance during neuropsychological testing and real-world activities. Journal of Attention Disorders, 7(3), 137-149.

Leirbakk, M.J., Clench-Aas, J., Raanaas, R.K. (2014). ADHD with Co-Occurring Depression/Anxiety in Children: The Relationship with Somatic Complaints and Parental Socio-Economic Position. Journal of Abnormal Child Psychology, 4, 137.

Ludlam, S.K. (2011). The use of music therapy to support speech and expressive language development for pre- school children with special needs. (Unpublished Master’s thesis). Massey University, Wellington, New Zealand.

Mahan, T. (2013). Connection Between Dyslexia and ADHD. Available at: http://goo.gl/xcdAgq

Matthys, W., Vanderschuren, L., Schutter, D. & Lochman, J. (2012). Impaired Neurocognitive Functions Affect Social Learning Processes in Oppositional Defiant Disorder and Conduct Disorder: Implications for Interventions. Clinical Child & Family Psychology, 15 (3), 234-246.

Mazzone, L.,  Postorino, V., Reale, L.,  Guarnera, M.,   Mannino, V.,  Armando, M.,  Fatta, L., De Peppo, L.,  & Vicari, S. (2013). Self-Esteem Evaluation in Children and Adolescents Suffering from ADHD. Clinical Practice & Epidemiology in Mental Health, 9, 96-102.

Miller, S., Chang, K.D., & Ketter, A.T. (2013). Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder Comorbidity in Children and Adolescents: Evidence-Based Approach to Diagnosis and Treatment. Journal of Clinical Psychiatry, 74 (6), 628-629.

Miodovnik, A., Harstad, E., Sideridis, G., & Huntington, N. (2015).  Timing of the diagnosis of attention-deficit/ hyperactivity disorder and autism spectrum disorder. Pediatrics, 136(4), 830.

Mordre, M., Groholt, B., Kjelsberg, E., Sandstad, B., & Myhre, A.M. (2011). The impact of ADHD and conduct disorder in childhood on adult delinquency: A 30 years follow-up study using official crime records. BMC Psychiatry, 11(1), 1-10.

Morton, L. L., Kershner, J. R., & Siegel, L. S. (1990). The potential for therapeutic applications of music on problems related to memory and attention. Journal of Music Therapy, 27, 195-208.

Myers, B. (2008). Social Problems Often Associated with Attention Deficit Disorder. Available online at: http://goo.gl/uPPFLz

Nantanis, K. M., Schellenberg, E. G. (1999). The Mozart effect: An artifact of preference. Psychological Science, 10, 370-373.

Nigg, J.T. (2009). Cognitive Impairments Found With Attention-Deficit/Hyperactivity Disorder. Available online at: http://goo.gl/QJqGVM

Panksepp, J., & Bernatzky, G. (2002). Emotional sounds and the brain: The neuroaffective foundations of music appreciation. Behavioural Processes, 60, 133-155.

Pasini, A., & D’Agati, E. (2009a). Pathophysiology of NSS in ADHD. The World Journal of Biological Psychiatry, 10, 495–502.

Pasini, A., & D’Agati, E. (2012b). Motor examination in children with Attention-Deficit⁄Hyperactivity Disorder and Asperger Syndrome. Acta Paediatrica, 101, 15-18.

Pelham, W. E., Jr., Hoza, B., Sams, S. E., Gnagy, E. M., Greiner, A. R., & Waschbush, D. A.  (1994). Rock music and video movies as distracters for ADHD boys in the classroom: Comparison with controls, individual differences, and medication effects.  Poster session presented at the annual meeting of the Society for Research in Child and Adolescent Psychopathology, London.

Perrin, S., & Last, C. G. (1996). Relationship between ADHD and anxiety in boys: Results from a family study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 988–996.

Plizka, S. (1989). Effect of anxiety on cognition, behavior, and stimulant response in ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 28, 882-887.

Reeves, J.C., Werry, J.S., Elkind, G.S., & Zametkin, A. (1987). Attention deficit, conduct, oppositional, and anxiety disorders in children: II. Clinical characteristics. Journal of the American Academy of Child & Adolescent Psychiatry,26, 144-155.

Rich, E.C., Loo, K.S., Yang, M., Dang, J., Smalley, S.L. (2009). Social functioning difficulties in ADHD: Association with PDD risk. Clinical Child Psychology and Psychiatry, 14(3), 329-44.

Rickson, D. J., & Watkins, W. G. (2003). Music therapy to promote prosocial behaviours in aggressive adolescent boys – A pilot study.  Journal of Music Therapy, 4, 283-301.

Satterfield, J.H., Faller, K.J., Crinella, F.M., Schell, A.M., Swanson, J.M., & Homer, L.D. (2007). A 30Year Prospective Follow-up Study of Hyperactive Boys With Conduct Problems. Journal of the American Academy of Child & Adolescent Psychiatry, 46(5), 601-10.

Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A., Butcher. B. (2010). Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD-predominately inattentive type, and controls. Journal of Autism and Developmental Disorders, 40, 1017–27.

Slomkowski, C., Klein, R.G., & Mannuzza, S. (1995). . Is self-esteem an important outcome in hyperactive children? Journal of Abnormal Child Psychology, 23, 303-15.

Thompson, W. F., Schellenberg, E. G., & Husain, G. (2001). Arousal, mood, and the Mozart effect. Psychological Science, 12, 248-251.

Toplak, M.E., & Tannock, R. (2005b). Time Perception: Modality and duration effects in attention- deficit/ hyperactivity disorder (ADHD). Journal of Abnormal Child Psychology, 33 (5), 639- 654.

Toplak, M.E., Jain, U., & Tannock, R. (2005a). Executive and motivational processes in adolescents with Attention-Deficit-Hyperactivity Disorder (ADHD). Behavioral and Brain Functions, 1 (8), 1-12.

Treuting, J.J., & Hinshaw, S.P. (2001). Depression and self-esteem in boys with attention- deficit/hyperactivity disorder: associations with comorbid aggression and explanatory attributional mechanisms. Journal of Abnormal Child Psychology, 29, 23-39.

Werry, J.S., Reeves, J.C., & Elkind, G.S. (1987). Attention deficit, conduct, oppositional, and anxiety disorders in children: I. A review of research on differentiating characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 26 (2), 133-143.

Wu, J., Xiao, H., Sun, H., Zou, L., Zhu, L.Q. ( 2012). Role of dopamine receptors in ADHD: A systematic meta-analysis. Molecular Neurobiology, 45(3), 605–620.

Original article on Greek Language:

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