System design
Designing a toolkit for children to become more self aware, toolkit for parents/teachers to make their children become more emotionally self regulated, Independent and confident human being and incorporating the craft like crochet into the curriculum through thorough understanding of ADHD and it's environmental effects.
System design | System thinking | Giga mapping | Systemic Asymmetry | Accessibility | Inclusivity | Neurodiversity | Systemic intervention | design solution
Project Duration
10 weeks
Mentor
Prof. S Guruprasad
Project type
Individual
Scope of the project
The aim of the module was to understand the systemic thinking and its application with respect to looking at a problem with the wholistic research approach rather than linear view of looking at problems.
The goal was to understand sociological point of view through systemic lens and understand the impact of ADHD on society and vice-versa and Designing the solutions which can melt into the system without creating the chaos.
Systemic process
Understanding the topic and setting the system boundary.
Identifying the relationship between all the elements present in the system and mapping it as subsystems
Mapping tensions and Identifying key drivers for mental disorder like ADHD
Coming up with Systemic solution.
Gap Identified
Lack of self awareness
Society's expectations are too high to achieve and It becomes barrier for an ADHDer to become more self aware and be more self regulated.
Systemic Bias
There a big cognitive and systemic bias in the society which works for the Neurotypical people and ADHDer are left un-noticed.
Stigma
People don’t always recognize ADHD as a serious condition.
Policy
An ADHD diagnosis, in and of itself, is not enough to qualify for disability benefits as Autistic, Dyslexic child do.
Proposed interventions
Making a toolkit for 8-10 years of children to make them self-aware.
Common struggle for children with ADHD that typically goes unnoticed is a lack of self-awareness. Self-awareness difficulties can negatively impact children’s social interactions and relationships.
Making a toolkit for parents and teachers for their kids/students to be self aware
Incorporating crafts like crocheting into curriculum to increase attention span and reduce hyperactivity.
Policy changes to have ADHD as an disability.
Smart watch for an ADHDer to keep reminding some important notes.
Kit for the Kid
Why Systemic thinking was necessary ?
ADHD comes in the umbrella of Neurodivergence and to understand the diversity in ambiguous way system thinking becomes necessary.
ADHD diagnosis is like Rocketship blasting off. It has become a everyday word for people to use like OCD, anxiety..
Differentiating between mental illness and disorder is yet to touch . It is genetic and not going go on their own.
Not only genetics but environmental factors and neurology plays a big role
Need to take ADHD seriously as it comes with one but goes with many other disorders
ADHD has become the controversial topic as it is either underdiagnosed or over diagnosed because of diagnosis criteria
Increasing prevalence
Disorder, not a disease
Multi- causal
Not one but more than one comorbidities involves
Misdiagnoed
Will help in understanding the whole system considering all the factors behind ADHD
System
Will help to understand occurrence , accumulations, feedback loop , asymmetry , elements and their interconnectedness of ADHD
Will help to know the reality
Understanding the topic and setting the system boundary
1
The research was conducted by going back and forth in data collection. The idea was to not only looking at periphery but going to the core to understand different behaviors and attitude towards ADHD.
Research study wanted to gather the data about...
Understanding ADHD mind
Policies
Cause of ADHD
Awareness of ADHD
ADHD diagnosis
Misconception around ADHD
ADHD treatment
Policies
Primary research :
I conducted In-depth interviews with an ADHDer , their parents and siblings , Psychologist, Ayurvedic doctors to get more knowledge about their life journey, Trauma, behaviors , society and them and their needs. Also went to Mental health institute to know how they are helping the children with disorders.
15 people were interviewed
including people with ADHD , parents and sibling of an ADHDer , psychologist, Ayurvedic doctor and BM institute of mental health.
Secondary research :
Research articles, literature reviews, social media like Instagram, you tube etc.. gave me more idea about challenges and multiple subsystems present in the bigger system.
Let me brief you about ADHD...
ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.
It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.
It is derived of genetics and external factors . It hits worldwide an average of 6–10% of children and 2.5–4% of adults . It also causes emotional self-regulation problems, executive impairment, and space and motor disorganization and may cause language problems in 30–40% of the cases
Thus, it is essential to understand the facts that interrelate ADHD with the cognitive and language development process, or particularly where and how ADHD neurobiological dysfunctions affect the dynamic of the neural network responsible for the receptive and expressive language structure in different child neurodevelopment levels.
ADHD means Attention deficit hyperactivity disorder.
Didn't understand right?
.
Don't worry let me explain...
ADHD from childhood to adulthood
Hyperactivity
Impulsivity
Inattention
Childhood
Adolescence
Adulthood
Childhood
Adolescence
Adulthood
Childhood
Adolescence
Adulthood
Restlessness
Impulsivity
Inattention
Types of ADHD
There are three types of ADHD
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Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
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Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity.
Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
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Combined Presentation: Symptoms of the above two types are equally present in the person.Because symptoms can change over time, the presentation may change over time as well.
Distractibility
Overlooks details
Forgetfulness
Difficulty regulating attention and focus
Diagnosed later in life
More likely to have internalizing disorders
Most common subtype among adult and females
Listening difficulties
Processing speed impacted
Loses objects
Fidgety and restlessness
Often diagnosed in early childhood
Often completes people's sentences
More common among males
More likely to have co-occurring externalizing disorders ( ODD and CD)
Often 'on the go' and has difficulty resting
Impulsivity
Difficulty waiting turn
Often talks excessively
Sleep issues
Sensory processing problems
High rate of co-occurring mood disorder
Working memory impacted
Self esteem impacted
Executive functioning impacted
Combined
Inattention
Hyperactivity
Want to peek into an ADHDers life?
ADHD and comorbidities
DID you know ADHD comes with other disorders also ?
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Let's just look at them !
Mood disorder
Anxiety disorder
Autism
Conduct disorder
Substance use disorder
Opposition defiant disorder
Dysthymia- persistent depressive disorder
Rejection sensitive dysphoria
Cyclothymia - mood disorder
Dyslexia
Bipolar disorder
Language disorder
Sleep disorder
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.
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There are more than this
In general, individuals affected by ADHD often have other behavior disorders that impact their ability to function successfully. The comorbidity of ADHD with other disorders is between 60% and 80%.
Diagnosis
The contemporary diagnosis of ADHD based on DSM-5 criteria requires the presence of 6 or more inattentive symptoms and/or 6 or more symptoms of impulsivity and hyperactivity in children. The criteria for ADHD are slightly different for adults: those aged 17 years and older need only demonstrate 5 symptoms to meet the criteria. DSM-5 further stipulates that symptoms must be present in 2 or more environments, begin prior to age 12, cause notable dysfunction, and not occur primarily in the context of a psychotic illness or be better accounted for by another mental disorder or medical condition.
much of the world uses ICD-10. ICD-10 refers to ADHD as hyperkinetic disorder (HD), and the diagnosis requires the presence of symptoms of both overactivity and inattention, present before age 6. Given inconsistencies in diagnostic criteria for the condition worldwide and over time, one may expect discrepant estimates of its prevalence from one region to another and over the years.
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Scales and tools such as the Child Behavior Checklist, Conners-Wells, Vanderbilt, Swanson Nolan and Pelham are helpful
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Brain imaging
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EEG or MRI
Current treatments
Behavior therapy
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Habit reverse therapy
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organizational and social skills training
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applied behavioral analysis (ABA) therapy
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Control strategies
Medication
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SSRI
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Ritalin
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Adderall
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Vyvanse
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Dexedrine
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Focalin
Let's see What's been going on around ADHD
Policy
The Delhi High Court has asked the AAP government to identify children suffering from ADHD.ADHD per se is not included as a disability under the Persons with Disabilities Act 2016.
Health Insurance
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The comprehensive health insurance offers coverage for Autism, Down's Syndrome, Global Developmental Delay (GDD), Attention Deficit Hyperactivity Disorder (ADHD), Intellectual Disorders, Speech Disorders, and even Epilepsy in kids.
ADHD Pharmacophobia in Some Indian Communities
While ADHD prevalence is quite high in India, parents remain hesitant to subject their children to ADHD drugs. In fact, of those prescribed with ADHD medications, 83.3% discontinue taking their medicines within the first month Reasons cited by parents for stopping the medication are: side-effects, lack of effectiveness, problems at the hospital, and fear that the child is becoming addicted, among others. Parents, though, especially in the lower-income classes, have shown willingness to tap non-pharmacological methods
Non-pharmacological solutions | ADHD India
In India, there are alternative solutions being advocated:
Psychosocial interventions – involve behavioral intervention, parent training, peer and social skills training, and school/classroom‑based intervention/training.
Body focused - body‑oriented activities such as yoga‑based, physical exercises, sleep and mindfulness‑based interventions such as using breathing exercises with music therapy or attention training.
Cognitive-behavioral training (such as play therapy).
Neuro cognitive training - computer-based attention and EEG biofeedback training like the CogoLand game launched by Singapore-based Neeuro Pte. Ltd. alongside researchers from the Institute of Mental Health (IMH), the medical school Duke-NUS, and Singapore’s Agency for Science, Technology and Research (A*STAR).
Setting the system boundary
Positive / Negative impact of environment on the people with ADHD
Identifying the relationship between all the elements present in the system and mapping it as subsystems
2
Subsystems | Giga map through interconnection of subsystems | Nature - Nurture
Subsystem cluster
Environment
Generalist
Evolutionary mismatch
Gender
Evolution
Maternal diet
Pre birth
Drug abuse
Early birth
Brain structure
Gene expression alteration
Relative plasticity
Delay response
Westernization
Structure
Culture
Gender
Schools
Teachers
Policy
Course structure
Architecture
Classmates
Family
Parents
Sibling
Evolution
One more interesting thing..
ADHD is evolutionary and the environment in which organism lives in is different than it actually evolved in
I know it's not easy to understand,
Then why wait ?
Let's dive deeperr...
The hunter versus farmer hypothesis is a proposed explanation of the nature of attention-deficit hyperactivity disorder (ADHD) first suggested by radio host Thom Hartmann in his book Attention Deficit Disorder: A Different Perception. This hypothesis proposes that ADHD represents a lack of adaptation of members of hunter-gatherer societies to their transformation into farming societies. Hartmann developed the idea first as a mental model after his own son was diagnosed with ADHD, stating, "It's not hard science, and was never intended to be."
A key component of the hypothesis is that the proposed "hyper focus" aspect of ADHD is a gift or benefit under appropriate circumstances. The hypothesis also explains the distractibility factor in ADHD individuals and their short attention span for subject matter that does not interest the individual (which may or may not trigger hyper focus), along with various other characteristics such as difficulty adhering to social norms, poor planning and organizing ability, distorted sense of time, impatience, attraction to variety or novelty or excitement, and impulsiveness.[citation needed] It is argued that in the hunter-gatherer cultures that preceded farming societies, hunters needed hyperfocus more than gatherers.
Hunter versus farmer hypothesis
Barkley ( Russell Alan Barkley is a clinical psychologist ) breaks executive functions down into four areas:
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Nonverbal working memory
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Internalization of Speech (verbal working memory)
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Self-regulation of affect/motivation/arousal
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Reconstitution (planning and generativity)
Barkley’s model is based on the idea that inabilities to self-regulate lie at the root of many challenges faced by individuals with ADHD. He explains that individuals with ADHD may be unable to delay responses, thus acting impulsively and without adequate consideration of future consequences―beneficial or negative.
the more you learn about the nature of defiance in children, the less you'll view it as “something wrong with your child” and the more you'll see it as a difficult situation or pattern of interactions with highly workable solutions.
RUSSEL BARKLEY
Barkley Model
Evolutionary mismatch and ADHD
behavior differences previously associated with the DRD4 gene, such as ADHD, might vary in effectiveness depending on the environment.
For people with ADHD, it may sometimes feel like the structure of what’s often described as civilized society is too rigid and sedentary. It’s an understandable viewpoint, considering that for 8 million years, since the earliest human ancestors, we’ve been nomadic people, wandering the earth, hunting wild animals for food. There was always something new to see and explore. This may sound like an ideal environment for someone with ADHD, and research may prove that hyperactive hunter-gatherers were indeed better equipped than their peers..
In evolutionary terms, hunter-gatherers were generalists, in that they needed to know how to do a little bit of everything to survive, which required flexibility and adaptability.
ADHDer were once adaptive became pathological. evolutionary mismatch’, in which current environmental demands do not fit with what evolution has prepared us to cope with. the environment of evolutionary adeptness (EEA) did not prepare children to sit still and concentrate for hours every day and that the difficulties that many children experience can be understood in terms of this mismatch .
Here comes the most important and awaited part...
NATURE & NURTURE
ADHD is a Neurodevelopmental disorder which means It is not only genetic but also the sociological factors play very important role in worsening the symptoms.
An individual’s personality and identify are molded and developed in response to their social environments and the people they meet. They are by taught others around them telling them what is right and wrong, including teachers, siblings and most importantly parents.
Giga mapping = Collecting + Connecting data
Let's draw the GIGA map which uses visualization as the primary technique to explore exceedingly complex situations, structures and systems
I know it's boring to read all the texts.. you can refer to Giga map to understand the interconnections of subsystem.. Enjoy !
Nature
Genetic factor
DRD4 , a gene that encodes that encodes the dopamine receptor D4, is associated with curiosity ,restlessness, novelty seeking behavior (20% of the population have this gene). genes can be changed based on the experience of mother or father. If a parent has ADHD, a child has more than a 50% chance of having it. If an older sibling has it, a child has more than a 30% chance.
Neurological factors
ADHD brains have low levels of a neurotransmitter. There are differences in the brain size, networks, neurotransmitters, and brain development of children with ADHD.
Nurture
The majority of children who have difficulties with the world around them are not primarily hyperactive but are reacting to an environment that does not provide them with the necessary ingredients for their development. An understanding of these developmental needs can only be gained when we assess the total life-space of a child, which includes school, family and the child himself. Children who receive little personal attention from their environment and get much of their entertainment from watching television are often bored and become restless, impulsive and aggressive. These children most often need people who they can trust, rather than drugs
Pre- birth
Preterm and early term birth increases the risk of ADHD by degree of immaturity. socioeconomic context modifies the risk of ADHD in moderately preterm births.
Family
Research even shows higher rates of divorce and depression among parents of a child with ADHD. Sibling often feel left out and Ignored as parents have to spend most of the time with ADHD kid. In todays world, because of the society parents feel certain kind of pressure for their kid to be best no matter what to sustain status. The fault is neither the parents not the child , the real problem is how lifestyle has changed over the period of time. Parents are stressed / depressed/ poor/ working and because of that they become proximally separated from the child and child starts to feel lonely. When a parent's behavior does not create a loving, supportive environment, a child's brain develops in altered form. Dysfunctional, irrational, and destructive behavior patterns are literally programmed into the child's brain, setting the stage for recurring issues throughout that child's life. Child need attuned relationship with their family.
Schools
After family schools becomes second family for the children and when it has negative influence on child , he suffers. Teachers play very important role in child brain development, teaching them discipline,. Yet there is little or less training given to teachers to understand child with ADHD and end up treating child badly. There has been seen many behavior based conflicts due to gaps in culture. Because of their uniqueness and as per the society , misbehavior Other children in the class starts to outcast them / bully them. Apart from all these classroom structure, course structure plays very important role in managing the symptoms of ADHD.
Identifying key drivers for mental disorder like ADHD
3
Gap Identification
Societal bias
Lack of self awareness
Lack of awareness
Stigma
Lack of accommodation
Criticism
Policy
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Societal bias - There is a huge gap of Self regulation in ADHD kid as it it always seen as a bad behavior not the disorder. Also there a big cognitive and systemic bias in the society which works for the Neurotypical people and ADHDer are left un-noticed. If notice but always as attention seeker , Sense less, rude and many more. Environment focuses more on the symptoms rather than looking at the context behind the particular behavior. In this Biased culture one need to sustain and for that one need emotional balancing.
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Lack of self awareness - Society's expectations are too high to achieve and It becomes barrier for an ADHDer to become more self aware and be more self regulated.
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Many people misunderstand this mental health condition, assuming it’s a character flaw rather than a neurological disorder.
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Stigma - People don’t always recognize ADHD as a serious condition. Some people may dismiss your needs or become annoyed and angry when asked to accommodate your condition.
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Lack of accommodation-People with ADHD don’t always get the accommodations they need to succeed in school and work.
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Criticism - A 2022 survey Trusted Source asked 162 people with ADHD about their experiences with criticism. Participants said they were most frequently criticized for behaviors related to focus, forgetfulness, organization, and time management
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Policy - An ADHD diagnosis, in and of itself, is not enough to qualify for disability benefits as Autistic, Dyslexic child do. As a child, you must have had measurable functional impairments (which show up as recurring poor performance in school) and as an adult, you must have measurable functional impairments that keep you from working.
Coming up with systemic solution
4
Your 4 emotional agility
Being aware of others
Managing emotions
Taking meaningful actions
Being self aware
Making a toolkit for 8-10 years of children to make them self-aware
Self-Awareness is understanding one's own emotions and their effect on others. Through self-awareness one can have healthy relationship with the self and others. ADHD Self-Awareness Begins with Honesty. Self-awareness starts with taking an inventory of your strengths and challenges: who you are and aren't, what you are likely to do or not, how you work versus how you wish you worked. Without self-awareness, you risk building a life or taking actions that won't work for you.
Common struggle for children with ADHD that typically goes unnoticed is a lack of self-awareness. Self-awareness difficulties can negatively impact children’s social interactions and relationships. The ADHD mind sometimes fails to recognize everyday social cues. For example, a teen with ADHD may brag about getting a good grade on a test to their friend who just failed the same exam. Children with ADHD may struggle to notice body language, tone of voice, mood, and facial expressions. In other words, children with ADHD often struggle to develop the skills to “read the room.” It’s a way to think about your thinking.
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Metacognition allows you to connect the dots, see the big picture, self-evaluate and self-monitor.
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Metacognition, also known as self-awareness, is a key executive functioning skill that coalesces in the late twenties for people with ADHD.
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People with ADHD typically require more time and effort to strengthen their metacognitive skills.
ADHD Kit for the Kid
Daily Affirmation cards
ADHD Kit for the Kid
Making a toolkit for parents and teachers for their kids/students to be self aware
Incorporating crafts like crocheting into curriculum to increase attention span and reduce hyperactivity.
The repetition of the crafts has been shown to release serotonin, a natural anti-depressant. crocheting makes people feel calmer, happier, and better able to focus.