Free Essay

Dual Diagnosis

In: Philosophy and Psychology

Submitted By shardik
Words 1349
Pages 6
Dual Diagnosis
Kimberly Holston
CRIS 305-B05
Liberty University
02/22/2016

Dual Diagnosis
There is an extremely difficult life path for a person the experiences substance and or alcohol abuse. That addiction journey can be riddled with anger, pain, loss, shame, anguish along with a host of many other agonizing and heart wrenching emotions. When the addicted person also carries a mental health disorder along this journey, it can become an even more treacherous and dangers path. These are indeed two very complex struggles for one human being. The combination of a person suffering an alcohol or substance abuse disorder and a mental illness disorder are identified has having a dual diagnosis. Dual diagnosis has different causes, difficulty in trying to diagnose and difficult to treat and it affects many in our world today. Most importantly, a dual diagnosis is most difficult on the individual who suffers with the disease.
Dual Diagnosis Definition and Types
What does dual-diagnosis actually mean? A dual diagnosis disorder occurs when an individual is affected by both chemical dependency and an emotional or psychiatric illness. Both chemical dependency and psychiatric illness may affect an individual physically, psychologically, socially and spiritually (The Dual Diagnosis Recovery Book, 1993). The most common mental health issues that coincide with addictions are ADHD, anxiety, depressions, bi-polar, schizophrenia, personality disorders, eating disorders and PTSD. The combination of a mental health illness and an addiction can exasperate the symptoms and triggers of the individual’s illness to dangerous physical and mental levels. These disorders combined can effect each disease and interact with each other dramatically because they are closely intertwined. It is difficult to determine which of the co-occurring disease is happens. Alcohol and drug abuse utilization can give a person the unhealthy belief that they can escape pain, ease anxiety and salve past traumatic events. This abuse can also mask the pain associated with their mental illness as well. Each has their own unique symptoms that they are trying to medicate. Estimates vary, but it appears that up to 50 percent of all alcohol and substance abuse problems mask other psychiatric problems (Gilliand & James, 2013).
Substance Abuse or Mental Health? Some individuals may have symptoms of mental health prior to their substance or alcohol abuse. Addictions and mental health disorders both originate in the brain. Alcohol and drugs are being used and abused to help one mask some of the symptoms of mental illness. Drugs do have the capability to worsen some of the symptoms of mental illness. Sometimes the symptoms of mental illness are contributed to the person being diagnosed with substance or alcohol abuse. Substance abuse and mental illness can occur in individuals simultaneously. Chemical dependency does not always appear first (The Dual Disorders Recovery Book, 1993). The symptoms of both diseases have a tendency to mimic each other. Each disorder can influence the progression of the other, a fact that complicates the treatment of both conditions (Doweiko, 2015). So, it is extremely difficult to identify which of these diseases may have pre-empted the other.
Dual Diagnosis Statistics
Currently 4 million individuals in the United States are thought to have a concurrent substance abuse and mental illness problem (Doweiko, 2015). The following chart spells out the risk associated with some of the major psychiatric illnesses in relation to the likelihood of substance abuse (The Dual Disorders Recovery Book, 1993):

If you have a diagnosis of …… | Your risk of substance abuse is: | Phobia | 2.4 times as great | Obsessive Compulsive disorder | 3.4 times as great | Major Depressions | 4.1 times as great | Panic Disorder | 4.3 times as great | Schizophrenia | 10.1 times as great | Manic Depressive disorder | 14.5 times as great | Antisocial personality disorder | 15.5 times as great |

Challenges in Diagnosis
Dual diagnosis can certainly present its challenges to the mental health care workers. When two serious illnesses exist in one person as the same time, each can complicate the other (The Dual Disorders Recovery Book, 1993). This fact can be attributed to making the front line mental health servers very difficult. When you look at the symptoms of drug and alcohol abuse, the can appear to mimic the symptoms of mental illness. These symptoms of both diseases are interchangeable and for the most part they exist together. It can be very difficult to differentiate between the diagnoses as to what the core illness may be. It can be very frustrating for the individual with the dual diagnosis because the addiction can cause barriers with the mental health diagnosis and the individual can continue to use drugs to cope with their mental illness. Alcohol and drug abuse can heighten the mental health illness. And if the alcohol or drug abuse is predominate illness, it may cause a mental health diagnosis. When a substance use disorder individual is hospitalized, the focus is primarily to get the client clean and concentrate on the chemical abuse rather than determining if the core of the illness is attributed to their mental health diagnosis.
The individual being helped may not be forth coming in regards to the history of their drug usage or any type of mental illness. And sometimes they might not be aware that they have or are experiencing a mental health illness. Some recovery centers only focus with the alcohol or drug addictions and not mental health and psychiatric hospitals deal with the mental illness and not the addictions. So, the dual diagnosed individual may get caught in the proverbial revolving door between the two entities and this could potentially cause the person to give up hope for any type of recovery.
The dual diagnosis client can present themselves with a unique form of denial. The form of interchangeable denial involves the utilization of one problem to defend the other. For example, if the healthcare worker focuses on the mental health disorder, the client will shift to their substance abuse disorder and vice-versa (Doweiko, 2015). This interchangeable denial ping-pong can cause the client to be treated ineffectively because it hinders the ability of the healthcare worker in making accurate diagnoses.
Treatment
It is paramount that the dual-diagnosis client gets effectively assessed so that the treatment is tailored to the individual and their specific needs. The dual- diagnosed client composes a high percentage of potentially violent mental illness (Gilliand & James, 2013). If they are undiagnosed, untreated, or undertreated these individuals could experience levels of medical illness, incarceration and homelessness.
To have a successful treatment program for the dual-diagnosed individual, the program will need to have a foundation of understanding the relationship between mental illness and substance abuse. This understanding will need to encompass the knowledge that both sides of the client will need to be treated. This is known as integrated intervention and it involves treating both of the illnesses at the same time.
Treatment for the dual-diagnosis client usually begins with a detox phase due to wanting to address the chemical dependency first. Once this phase occurs the psychological assessment can be performed either through individual therapy and group therapy. The first goal in working with a dual-diagnosis client is the establishment of a good therapeutic relationship (Dowieko, 2015). There are several types of behavioral therapy that can be utilized such as, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, integrated group therapy and individual psychotherapy. Certain medications can be used for both the substance abuse and the mental health diagnosis. Treating clients with a dual-diagnosis can be a very long and complicated process and therapists may have to endure extended periods of minimal progress on the part of the client and perhaps some regression (Dowieko, 2015). But through patience, commitment and time, recovery can produce hope, healing and empowerment.

References
Doweiko, H.E. (2015). Concepts of chemical dependency (9th ed.) Stamford, CT: Cengage Learning.

Gilliland, B., & James, R. (2013). Crisis intervention strategies. Pacific Grove, Calif.: Brooks/Cole Pub.

The dual disorders book: A twelve step program for those of us with addiction and an emotional or psychiatric illness. (1993). Center City, MN: Hazelden.

Similar Documents

Free Essay

Diagnosis

...for several years. In order to identify the etiology of the symptoms Matt was experiencing, Dr. Hemo referred him to the hematology-oncology department at his local hospital. The cause of these symptoms needed to be determined to reach a diagnosis. The phlebotomist drew the first blood specimen for the CBC, which indicated a problem. The results of the complete blood count showed that Matt’s blood count was below normal ranges. The MCV and MCHC tests showed that Matt’s RBC count was low. The low red blood count pointed to a diagnosis of anemia. After this series of blood tests, it was determined that he had cancer in his bone marrow and blood. Matt was diagnosed with chronic myelogenous leukemia. Matt started taking tyrosine kinase inhibitors to stop the cancer cells from growing. He takes the TKIs orally, and has experienced side effects including nausea and diarrhea. The feeling of unease often leads to emesis. Matt’s body experiences dehydration from the vomiting and the frequency of the loose bowel movements. At this time when his body is lacking the essential water and salts, he becomes very weak. Bone marrow transplantation is the next step that will be taken, to replace the damaged bone marrow. Matt is coping with his recent diagnosis with CML, but his friends are having a difficult time accepting the news. Matt’s friends are devastated, as they have heard of many cases of carcinoma ending in tragedy. They had older family members diagnosed with many forms of cancer,......

Words: 323 - Pages: 2

Free Essay

Dual Issues

...multiple countries. For example, a person with dual citizenship is said to have the rights and nationality of both countries where he is considered a citizen. There are several factors which an individual may acquire dual or multiple citizenship. According to Prof. E. San Juan, Jr. of Washington State University (2011), the ways of acquiring dual citizenship are the jus soli principle (the right of soil wherein those born in countries with this principle are considered a citizen of that country), the jus sanguinis principle (the right of blood which considers the bloodline of a citizen), marriage, naturalization, membership in supranational communities and other reasons. One concrete example is when a person is born in New York even though both his parents are natural-born Filipinos. The child, whether he likes it or not, would have to be a citizen of both countries because of the principle of jus soli present in the U.S. and the principle of jus sanguinis in the Philippines. This is a type of involuntary acquisition of dual citizenship; and that individual should make a choice sometime in his life between the two. According to Panopio (2005), countries that allow dual citizenship include the United States, Canada, Britain, Netherlands, Italy, Portugal, Switzerland, Greece, Cyprus, Israel New Zealand and many other countries. The Philippines only recently liberalized their citizenship laws by R.A. 9225. More commonly known as the Dual Citizenship Law, R.A. 9225 claims that......

Words: 1582 - Pages: 7

Premium Essay

Dual Realationships

...Dual Relationships and Boundaries Paper Survey of Professional Psychology 545 July 8, 2013 Dr. Terry Portis Dual Relationships and Boundaries Dual relationships are that of a relationship of some kind with a patient either the patient is a family member, friend, or known through business. Dual relationships are not that of a sexual manner as that does not constitute a dual relationship but more of crossing boundaries the same as accepting gifts or meeting outside the office (Zur, 1997- 2013). There are many forms of dual relationships but as long and the boundary in a sexual or more than doctor client relationship are not crossed (accepting gifts, hugging). In the scenario that was chosen the therapist/teacher is dealing with a dual relationship of his or her student confiding marital issues and at a later date asking for the professor to be him and his wife’s couple’s counselor. This is a situation in which the professional need to determine if this is a dual relationship, crossing boundaries, and meets ethical decision-making process. Definition of Dual Relationships Dual relationships are defined as professional and personal relationships that transpire involving a client and the therapist or psychologist (Pope & Keith-Spiegel, 2008).  Dual relationships in the field of psychology are any relationship where different roles are between a therapist and client. For instance dual relationship is the...

Words: 499 - Pages: 2

Premium Essay

Dul Diagnosis

...DUAL DIAGNOSIS DEVELOPMENTAL DISABILITY MENTAL RETARDATION Mental Retardation v Intellectual Disability: Current debate in the field Since 2001 the American Association on Mental Retardation has debated changing its name (AAMR to AAID) Intellectual Disability term used more widely in Europe International Association for the Scientific Study of Intellectual Disabilities (IASSIA)World Health Organization (WHO) Mental retardation term value as a diagnostic and specific clinical entity, entitlement programs, death penalty, etc. “Disability” is a common consistent term used across a variety of disabilities Intellectual disability does not necessary connote the developmental nature of the deficit Mental Retardation and Mental Health: Trends & Shifting Services: MR/DD are living in neighborhoods & communities, not segregated institutions Changing perspective of range & extent of psychiatric disorders in MR/DD Strain produced on both the MR & the MH systems- a messy system Use of generic & community services Needs- cross training and education, interagency collaboration & planning FEDERAL DEFINITION: DEVELOPMENTAL DISABILITIES: The term "developmental disability" means a severe, chronic disability of an individual that - (i) is attributable to a mental or physical impairment or combination of mental and physical impairments; (ii) is......

Words: 345 - Pages: 2

Free Essay

Dual Relationship

...Dual Relationship Mieisha Marshall, Alicia, Sara Cofield, and Candy Ladd Psych/545 November 17, 2014 Sharlie Hazen Introduction Making ethical decisions in the field of psychology can be very difficult especially when you are in the business of counseling. You have to worry about your client’s crossing that boundary while trying to escape a dual relationship. For instance, the scenario that was chosen by our group consist of a close friend of yours is having difficulty with her teenage daughter. She knows you are a psychologist who specialize in adolescents. She ask if you would be willing to help her daughter for a few sessions to straighten her out. You ask yourself, what should be done during this current situation. For one, the therapist and the client’s mother are friends. The client’s mother may be become too dependable on the therapist to fix the problem. In this paper, we will find the best approach for a dual relationship. Ethical issues involving dual relationships will be examined to clarify and analyze the relationship that the therapist and the client’s mom have. Therapist face many challenges in everyday life and in this paper, we will discuss challenges one may face in professional psychology. Concept of Dual Relationship When a therapist engages in more than one relationship with a client it is then classified as a dual or multiple relationship. If a therapist assumes a secondary role with a client like that of an employer, teacher, family......

Words: 1525 - Pages: 7

Premium Essay

Diagnosis

... Part 1: DIAGNOSIS Name of Client: “Jasmin” DSM-5 Diagnosis: Gender Dysphoria in Adolescents and Adults Code: 302.85 (F64.1) INTRODUCTION Jasmin “Jas” is a 19 year old girl. Jasmin was born on March 20, 1995 in Buliaw 1, Cotabato City. Her parents name was Mr. Michael and Mrs. Meriam. Jasmin’s mother is an Overseas Filipino Worker in Kuwait and her father is a businessman. Jasmin is the eldest among the four (4) siblings. She took her elementary education in Agape, Elementary School, Cotabato City. Her secondary education in Kabacan National High School and she is now pursuing her tertiary education in University of Southern Mindanao, Kabacan, North Cotabato. When Jasmin was still a kid, her parents decided to divorce because of some reasons. Jasmin’s father left home and find another wife. Also, Jasmin’s mother find another man and both Jasmin’s mother and step father live together with Jasmin and with their new 3 children. Two boys and a girl. Suddenly, Jasmin’s mother and step father decided to separate and have their own home together with their new children. Jasmin was left to Telican, Jasmin’s grandmother. Few years after, Jasmin’s mother, Meriam decided to go to abroad specifically in Kuwait. Because of the absence of parent’s guidance, Jasmin felt so sad and she thought that she was left alone. But despite of this, Jasmin was so thankful that Telican, her grandmother loves Jasmin very much. Since kindergarten, Jasmin felt the incongruence between what she......

Words: 4115 - Pages: 17

Free Essay

Medication and Dual-Diagnosis

...paper explores four articles about research on the complicated relationship between mental health and substance use disorders. I focused my research on the relationship between depression, including post-partum, and alcoholism. In this paper, I will explain why my client, Rhonda is considered dually diagnosed, I will explain the health problems that can occur from using alcohol and the effects alcohol has on the brain and body, I will explain how alcohol impacts depression, and last, I will explain the specific problems that exist in treating the dually diagnosed individual. An individual who has any combination of a mental disorder (anxiety, depression, bipolar disorder) and addiction (drugs, alcohol, sex, gambling) is considered to be dual diagnosed. (Foundations Recovery Network, 1995) In one article, Paljärvi (2009) states “experimental studies have found that alcohol intoxication can produce even severe depressive symptoms during heavy drinking episodes.” Becker (2012) states in his article, “Alcohol has anxiety-reducing properties and can relieve stress, while at the same time acting as a stressor and activating the bodies stress response systems.” According to Evans and Sullivan (2001), individuals with a history of alcohol dependence, especially those early in recovery and those who are older, show significant cognitive impairments. Individuals with major depression also have significant cognitive deficits and the two together cause double the difficulties in......

Words: 2258 - Pages: 10

Free Essay

Dual Use

...infective viruses poses a threat to man and should be banned. This threat is defined, as “Dual use”. Although, altering the structure of viruses does have beneficial purposes it is ultimately not worth the risk and outweighed by its dangers. Dual Use is beneficial in advancing science or improving public health but is often misused for malevolent ends such as bioterrorism. Bioterrorism is not a new threat, Pathogens and micro organisms have been used as weapons for hundreds of years, dating back to the fourteenth century when Tartars threw the corpses of plague victims over the city walls of Kaffa before its siege and in the eighteenth century when British soldiers distributed blankets used by smallpox victims to Native Americans with the objective of contaminating them (SERB). This history of vile behavior in regards to bioweapons has not seemed to stop as technology advanced, some would say it has even gotten worse. When discussing the issue of bioterrorism one must keep in mind that it doesn’t mean all dual use scientists are bioterrorist, legitimate scientists typically conduct a research that is in the dual use field for positive purposes. “Just because a research project may have dual use concerns, that doesn’t mean that it will be misused as a bioweapon or that the researchers conducting the research are bioweaponeers” (SERB). However as research continues and advances on dual use the greater we risk-assisting bioterrorist succeed in their plans. This is because......

Words: 521 - Pages: 3

Premium Essay

Dual Nationality

...Dual Nationality When I am asked the question of where I come from, I have trouble defining my country and explaining who I am. I feel like I am stuck between two countries across the globe, and two different cultures because I was raised outside of my birthplace. Therefore I seem to have trouble determining what is my true home. Yet the country that I was raised in cannot be my true home either because there I am considered an expatriate. So, am I supposed to be Indian American? But aren’t they the Native Americans? This is why I have learned to simply answer this question with “Dual Nationality.” Experiences are events that in my opinion are what shapes a person and make the person that one is. I am a compilation of my experiences and with each new experience that I have gained; I became a different and a new mature person at every stage. The experiences that I have gone through are like the stairs of my life. The end of the stairs is when I will be successful with my goals and ambitions. All of the places that I have been to and all of the places that I have lived in are a part of my life, a memory that helps me to become who I am today. Born in India, I came to the United States of America at the young age of two. The only English word that I knew was “chocolate.” Even though my parents were well educated but they never though of talking to me in English because they wanted to preserve my first language of Punjabi. My experiences started at the age of 4 when I had to...

Words: 740 - Pages: 3

Premium Essay

Dual Credit

...Dual credit is a process that allows high school students to enroll in college level classes to earn both high school and college credit. These classes can be very beneficial to high school students, as they get a head start in their college education. In the essay “Dual Credit in the Community College” Dr. David Lydic is uncertain about dual credit being effective and chooses to research information over the topic. “I often feel like I am in the minority in doubting dual credit, so I decided to take this opportunity to research more on the subject.” Lydic was fascinated and amusingly shocked by the information found on dual credit but still continues to doubt about it. “Why, then, am I not completely convinced?” Even though Dr. Lydic does not see much value in dual credit courses, they have proven to be a great learning experience for many high school students. The dual credit programs are a hot topic for both secondary and higher education institutions and these programs are experiencing dynamic growth. “During the 2006-07 legislative session, the Texas Legislatures even passed a law that every school district must implement a program under which students may earn the equivalent of at least 12 semester college credit hours in high school.” Therefore many colleges now accept dual credits transfers from high schools. As college tuitions continue to soar, students in high school could use dual credit to their advantage. Dual credit classes are cheaper and......

Words: 646 - Pages: 3

Premium Essay

Dual Diagnosis

...Dual Diagnosis Jana Hall Liberty University Abstract There is so much yet to be learned by researchers in regards to understanding the intertwining connections between mental illness and substance use disorders. This essay is barely scratching the surface in describing the complexity of the two. In order to know how to treat an individual who exhibits symptoms of both a substance use disorder and a mental illness, it must first be determined which came first, the mental illness that lead to the substance use disorder or the SUD which exacerbated the underlying mental illness. I’m sure you have heard the saying, ‘Which came first, the chicken or the egg?’ Well, this seems to be the dilemma for the experts in their respective fields of study in determining the most effective form of treatment for those who have been given a dual diagnosis. Unfortunately, individuals who have this diagnosis have become the norm in today’s day, rather than the exception. Dual Diagnosis It was widely believed at one time that substance use disorders and mental illness were seldom found in an individual. Since that time, it has been discovered, through epidemiological studies done on individuals who struggle with both mental illness and substance use disorder, that this is not true. A majority of those diagnosed with a mental illness also concurrently have a substance use disorder (Doweiko, 2015). ). Some of the mental illnesses that are challenging mental health professionals......

Words: 1340 - Pages: 6

Free Essay

Dual Career

...Dual-career marriages and families are common, and is one in which both heads of the household pursue careers and at the same time to maintain a family life together. One of the biggest benefits is the economic reward it brings; when there are two incomes coming into the household, it makes paying bills and obligation easy. However, there is much negativity that follows. Maintaining a relationship can be a challenge for couples with high-powered and demanding careers, but the advantages provide some motivation. A dual-career relationship allows both partners to explore career opportunities that may not be possible without the support of a spouse. For example, one partner can pursue a position that does not pay well to gain experience and expertise in a field without worry about household bills and living expenses. Both partners have an opportunity to explore the possibilities in their chosen professions with the advantage of a dual-paycheck household. Dual-career marriages also have increased financial benefits. Both spouses bring an income into the household, providing financial benefits for both. The dual-career relationship allows the couple to invest the household earnings, purchase a home and provide for children. They also spend less on utilities on average because there are less household members in the family during the day. The division of household duties is major issue for most dual worker couples. It is said that 80 percent of couples, women perform 70 to 80......

Words: 379 - Pages: 2

Premium Essay

Dual Diagnosis

...Dual Diagnosis Lloyd Bell Liberty University Lynchburg That give me an idea of how many people have found this document helpful. Thanks Dual Diagnosis Those who suffer from a concurrent mental illness and Substance Use Disorder (SUD) are often categorized as dual diagnosed (Doweiko, 2015, p. 317). While this is not a hard concept to understand it can be very difficult to assess, properly diagnose, and treat such an individual.   Scalise (n.d) points out that it is crucial to properly assess the client because the presenting problem may be different from the underlying issue. This is where concurrent disorders can “throw a monkey wrench” in the process of assessing risk and formulating a treatment plan. Since it can be difficult to distinguish which symptoms are from which condition the professional must be careful to gather as much background information as possible to begin assessment. However, with those suffering from symptoms and withdrawals due to SUDs it could take as long as 2-8 weeks to get an accurate diagnostic picture (Doweiko, 2015). Addictive Cycle The addictive cycle is a vicious cycle that has stages which include experimentation, occasional use, regular use and ultimately dependence ( Scalise, n.d). One of the greatest factors mentioned by Scalise (n.d) that leads to perpetuating this cycle is unmet needs. In the case of those who suffer from a dual diagnosis it is crucial to understand that the underlying needs may...

Words: 714 - Pages: 3

Premium Essay

Psychiatric Diagnosis

...THE RELIABILITY OF PSYCHIATRIC DIAGNOSIS Psychiatry is the branch of medicine that recognizes and treats mental illness. This science follows a medical model that is considered successful in classifying abnormal behavior. Psychiatrists need medical training in order to diagnose and treat mental disorders following the Diagnostic and Statistical Manual of Mental Disorders. However, for more than two centuries, there has been an anti-psychiatry movement that questions the reliability and helpfulness of psychiatric treatments. Many psychiatrists such as Maurice Temerlin(1968) and David Rosenhan(1973) supported some of the objections and criticisms of the anti-psychiatry movement. Rosenhan questioned the reliability of psychiatric diagnoses and accused diagnostic labels of impairing medical judgement. David Rosenhan carried out the study “On Being Sane In Insane Places” through which he wanted to prove that psychiatric diagnoses are not reliable (Rosenhan, 1973). For the first part of the study, eight sane participants (pseudo-patients) pretended to have auditory hallucinations in order to be admitted to psychiatric hospitals in different states across the United States. Participants for the experiment included three psychologists, one psychiatrist, a graduate student, a housewife, a pediatrician, and a painter. The only false information given for admission was their name, job, and the claim of recent auditory hallucinations. All other details regarding......

Words: 2004 - Pages: 9

Premium Essay

Diagnosis and Treatment

...Running head: DIAGNOSIS AND TREATMENT Diagnosis and Treatment BEH 225 6-11-11 University of Phoenix Diagnosis and Treatment I will be talking about today is (ADHD) Attention-Deficit/Hyperactivity Disorder or (ADD) the definitions of (ADHD) (ADD) is the child being hyper and being impulsivity and it may be both of a combination. The issues can be diagnosed as the (ADHD) the individual would be out of control in the normal range for the child age and the growth (University of Maryland Medical Center, 2011). In diagnosed of the ADHD ADD it does appear in the child behavior for the mental disorder the doctors can diagnosed the problem it first at school when the child does not pay any attention the teacher and will lose the interest in playing games or looking at TV and do not pay any attention to the parents and the homework. The child goes out of control they act up in the store with the parents (Psych Central 2011). The cause of the child and adult (ADHD), (ADD) it is inherited by a relative who has the same problem the individual brain it has lower dopamine in the brain. The children has ADHD ADD has thinner brain tissues in the brain and it the gens does show the various and not lasting as the child grow up in the brain of the child the brain will grow to a normal level as the thickness and the problem will decreased for the child having ADHD or ADD there is some work that need to......

Words: 884 - Pages: 4