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Attention-Deficit Hyperreactivity Disorder in Twins and HOW Often Siblings are Affected or Diagnosed

Barbara Maclure

Dr. Daniel Kuchinka

Keiser University

ADHD In Twins and Siblings


Attention-Deficit Hyperreactivity Disorder (ADHD) is also known as Hyperreactivity. This is a disorder that begins during childhood. According to studies, twins are more likely to acquire this condition than singletons. Besides, a child who has an identical twin with ADHD has got a higher chance of developing this disorder (Faraone & Larsson, 2017. The most common symptoms in this disorder include a continued inability to hear, the patient focusing on a specific task for a prolonged time, and the inability to control impulses. Children exhibiting this condition manifest these behaviors quite often and severely than their agemates. A person suffering from this hyperreactivity may experience difficulty in schoolwork, family life, personal tasks, or friendship. ADHD comprise one of the most known disorders during childhood. Furthermore, it is known to affect 3%-5% of school-aged children. ADHD is more prevalent in boy child than in a girl child (Burke & Loeber, 2015). Although the symptoms of this condition may disappear with advanced age, it can persist up to adolescence or even adulthood. It has been estimated that 2% of all adults’ exhibit ADHD.


Diagnosis of this condition is difficult because many children are sometimes hyperreactive, inactive, and impulsive. In the diagnosis of this condition, experts make use of the guidelines that are listed in diagnostic and Statistical Manual and Mental Disorders. The guidelines provide for a child manifesting behavior that is typical of this condition before they reach the age of seven (Lenzi F., 2018). This behavior is expected to last for about six months and has to occur regularly as compared to other children of the same age. The behavior must also be exhibited in two or more settings, like at home or school, instead of just a single setting. There is an existing controversy over the diagnosis of this condition. In America, physicians diagnose ADHD than in any other country globally. Critics have adopted this discrepancy as part of the evidence to disregard psychologists as well clinicians in showing that children with this condition are naturally nuisance or active to parents and teachers (Langer, Garbe, & Tobias Banaschewski, 2015).

How Twins get diagnosed

Children and grown-ups with this condition consistently manifest various degrees of hyperreactivity, impulsiveness, and inattention. Inattention in this case means that those people who exhibit this condition have difficulty in focusing their minds on a single item. A good example is that such people may be quickly bored by assignments or a given task within minutes, may have trouble listening, may make mistakes out of carelessness, and may as well indicate instances of daydream (Jain R, 2016). Children may concentrate on one task that is not interesting. Hyperreactivity also involves a constant motion, which may seem like out of a motor influence. At school, children may fidget or touch things always, disturb their peers and talk in a constant waylaid manner, and may as well make other children impulsive, thereby making them act before they can think. In this case, they may make comments that are not appropriate. While in class, they may interrupt conversations and engage in activities that are likely to cause harm to them. Children who have this condition may as well manifest learning problems that are severe due to their inability to pay attention, follow given instructions, or incomplete assigned tasks.

Additionally, their aggressive behavior makes them unpopular with other children. Following this, children suffering from this condition are usually criticized by others and are always corrected by their parents and teachers, who unknowingly tend to think that such behavior is done intentionally. The child’s poor academic performance, poor social relations, and negative feedback may make develop low self-esteem and other emotional challenges (Jain R, 2016).


It is not yet known even to scientists about the causes of ADHD (Freitag, C. M., & Retz, W. 2010). Nonetheless, scientists have disregarded theories that were highly regarded and accepted before. One theory is that of undetectable brain damage or minor brain damage, which is a result of birth complications or due to infections. Another theory that has been used to explain ADHD is the consumption of refined food addictive or sugar that has been refined. Scientists disregarded this theory on the account that there was no evidence to prove that all the children with ADHD had benefited from food colorings or diets that restricted sugar. Many scientists as well have disregarded the allegation that poor parenting cased ADHD. The majority of the scientists believe that this condition is biological, and its primary cause is an abnormality within the brain (Jain R. 2016). Studies have shown that in people exhibiting ADHD, the part of the brain that regulates the attention span is much less active as compared to other people who do not have this condition. Another thing is that the condition seems to be prominent within families, thus not ruling out genetic factors.

Stephen and Henrick (2010) provide that after decades of research, genes have come to be known to play a very critical role in the attention of ADHD as well as the condition’s comorbidity with other range of disorders. Adoption studies and family and twin studies reveal that this condition runs in families, and has got a very high probability for inheritability, which stands at 74%, and which is motivated by the search for susceptibility ADHD genes. According to Deeann Wallis (2016), today, it is generally agreed that ADHD has got a primary genetic base as well as a biological one. Nonetheless, despite the identification of various candidate genes, none has been found to have a significant impact, and therefore this condition has remained erosive.


Although there is yet to be a cure that is effective for ADHD, there exist a variety of treatments that may be of great assistance to children suffering from this disorder. They comprise of counseling, medication as well as training in social skills. The use of drugs in medication is the most usual form of ADHD treatment and may be useful in reducing the symptoms of this disorder. Doctors also regard stimulants as safe, although they may bring side effects like nervousness, loss of appetite, insomnia, or stomachache (Swarze, Allan, 2013). Drug therapy is known to cause a slow growth rate, but during adolescence, a state of normalcy is restored. It is recommended that children take these drugs during school time, and only take them during weekends when schools are closed, to reduce the adverse side effects likely to arise. According to Geoffrey and Loeber (2015), the program of Stop Now and Plan (SNAP)would help children in problem, and emotional solving skills, prosocial, and as well as reduce parental stress.

The use of therapies for treatment is highly encouraged. Counseling, for example, has been found to help children recognize as well as deal with negative feelings. Social skills may effectively assist children to recognize the way their behavior affects others, and consequently assist them in developing more appropriate behavior (Lenzi FC., 2018). Children who have ADHD may as well benefit from a select category of academic tutors who can lead them in breaking down assignments given in school into parts to address them efficiently. In this case, the results indicate that independent processes may result in effective behavioral outcomes, with specificity concerning the mechanisms that are related to different treatment results (Geoffrey & Lieber, 2015)


Twin and family studies on ADHD condition in both adolescents have manifested an active component that is heritable 60-80% for all cases reported. According to Retz and Clein, (2010), the rate of remittance or persistence of this disorder in an individual’s lifespan shows a heterogenicity of the condition which may as well be found to be made of attentive and the ADHD combination. There can be no conclusion that can be made regarding the general inheritance pattern as family studies, as well as twin studies reveal different inheritance modes (Retz & Clein, 2010). However, studies agree on integrating sex differences concerning the genetic risk of ADHD. The two studies as well agree on the role of the environment in shaping ADHD+CD, which is another subtype of the condition. Another subtype with genetic roots is persistent ADHD during adulthood, which is a solid genetically influenced subtype of ADHD. There are different criteria for diagnosis, depending on the environmental factors and scale methods. Research has been ongoing on how to understand ADHD etiology to understand this condition better and as well treat it. However, the specific causes of ADHD are yet to be known, thus slowing effective diagnosis and treatment.


Burke, J. D., & Loeber, R. (2015). Mechanism of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys. Springer Science and Business Media.

Faraone, S. V., & Larsson, H. (2017). Genetics of Attention Deficiency Disorder. Open Access.

Freitag, C. M., & Retz, W. (2010). Family and Twin Studies in Attention-Deficit Hyperreactivity Disorder. Psychology and Psychiatry.

Jain, R. (2016). Current and Investigational Medication Delivery Systems for treating Attention-Deficit/Hyperreactivity Disorder. The Primary Care Companion for CNS Disorders.

L., C. D., T., B., C., S., C. M., & A., Z. (2017). A systematic review of the quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperreactivity disorder. European Child & Adolescent Psychiatry, 1283-1307.

Langer, I., Garbe, E., & Tobias Banaschewski, R. T. (2015). Twin and Sibling Studies Using Health Insurance Data: The Example of Attention-Deficit/ Hyperactivity Disorder (ADHD). Open Access.

Lenzi FC. (2018). Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews.

Retz, K. (2015). Attention-Deficit Hyperreactivity Disorder (ADHD) in Adults: Key Issues in Mental Health. Basel, Karger.

Rommel, A. S., Rijsdijk, F., Greven, C. U., & Kuntsi, P. A. (2015). A Longitudinal Twin Study of the Direction of Effects between ADHD Symptoms and IQ. Journal Pone.

Schwarz, Alan (Mar 31, 2013). “A.D.H.D. Seen in 11% of U.S. Children as Diagnoses Rise”. New York Times. Retrieved 2 August 203

Running head: APA STYLE TEMPLATE 1


Note: The running head is an abbreviated title of the paper. The running head is located at the top of the pages of a manuscript or published article to identify the article for readers. The running head should be a maximum of 50 characters, counting letters, punctuation, and spaces between words. The words “Running head” is on the cover page but not on the rest of the document. The running head title is all CAPS. Page 1 begins on the cover page. The entire document should be double-spaced, have 1″ margins on all sides, and use 12 pt. Times New Roman font.

The blue information in this paper is informational and should be deleted when using the document as a template for your own paper. Edit the black writing with your own information for your paper to keep the correct format.

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APA Style Template: Insert Your Title Here

APA (American Psychological Association) Style is most commonly used to cite sources within the social sciences. APA Style is used when writing papers in the psychology programs offered at Keiser University. This document serves as an APA Style template for students to use when writing their own papers, as well as a resource containing valuable information that can be used when writing academic papers. For more information on APA Style, learners can refer to the Publication Manual of the American Psychological Association (American Psychological Association, 2010a).

The author demonstrates in the first section of this paper, how an introduction effectively introduces the reader to the topic of the paper. In APA Style, an introduction may not have a heading. For example, this section did not begin with a heading titled “introduction”, similar to the following section, which is titled “writing an effective introduction”. The following section will explain in greater detail a model that can be used to effectively write an introduction in an academic paper. The remaining sections of the paper will continue to address APA Style and effective writing concepts including section headings, organizing information, writing effective paragraphs, writing a conclusion, and the reference list.

Writing an Effective Introduction

An effective introduction often consists of four main components including: (a) the position statement, thesis, or hypothesis, which describes the author’s main position; (b) the purpose, which outlines the objective of the paper; (c) the background, which is general information that is needed to understand the content of the paper; and (d) the approach, which is the process or methodology the author uses to achieve the purpose of the paper. This information will help readers understand what will be discussed in the paper. An effective introduction can also serve as a tool to grab the reader’s attention. Authors may choose to briefly reference sources that will be identified later on in the paper as in this example (American Psychological Association [APA], 2010a; APA, 2010b; Walker, 2008).

In an introduction, the writer will often present something of interest to capture the reader’s attention and introduce the issue. Adding an obvious statement of purpose helps the reader know what to expect, while helping the writer to focus and stay on task. For example, this paper will address several components necessary to effectively write an academic paper including (a) how to write an introduction, (b) how to write effective paragraphs, and (c) how to properly use APA style.

Level One Section Heading is Centered, Bold, Upper and Lowercase

Using section headings can be an effective method of organizing an academic paper. The section headings should not be confused with the “running head”, which is a different concept described in the cover page of this document. Section headings are not required according to APA Style; however, they can significantly improve the quality of a paper. This is accomplished because section headings help both the reader and the author as will soon be discussed.

Level Two Section Heading is Flush Left, Bold, Upper and Lowercase

The heading style recommended by APA consists of five levels (APA, 2010a, p. 62). This document contains two levels to demonstrate how headings are structured according to APA Style. Immediately before the previous paragraph, a Level 1 Section Heading was used. That section heading describes how a Level 1 Heading should be written, which is centered, bold, and using upper and lowercase letters. For another example, see the section heading “Writing an Effective Introduction” on page 3 of this document. The heading is centered, bold, and uses upper and lowercase letters (compared to all uppercase in the running head at the top of each page). If used properly, section headings can significantly contribute to the quality of a paper by helping the reader who wants to understand the information in the document, and the author who desires to effectively describe the information in the document.

Section Headings Help the Reader

Section headings serve multiple purposes including (a) helping the reader understand what is being addressed in each section, (b) readers may be more likely to maintain an interest in the paper, and (c) they can help readers choose what they want to read. For example, if the reader of this document wants to learn more about writing an effective introduction, the previous section heading clearly states that is where information can be found. When subtopics are needed to explain concepts in greater detail, different levels of headings are used according to APA Style.

Section Headings Help the Author

Section headings help the reader, and they also help the author organize the document during the writing process. Section headings can be used to arrange topics in a logical order, and they can help an author manage the length of the paper. In addition to an effective introduction and the use of section headings, each paragraph of an academic paper can be written in a manner that helps the reader stay engaged.

Organizing a Paragraph: Use Your FEET

Writing a scholarly paper can be a daunting experience for many graduate students. This may be especially true for online students who commonly complete one paper per week, in addition to numerous discussions. All of which require comments supported with evidence from peer-reviewed journal articles, and examples of how theoretic principles can be applied by practitioners. The FEET model was created to help students and others compose effective paragraphs, which in turn will result in quality academic papers. The FEET acronym applies to four components of a scholarly paragraph including Focus (F), Evidence/Example (E), an Explanation (E), and a Transition (T). The following will address how scholarly writers can “use their FEET”.

Focus (F)

A paragraph begins with a sentence that describes the Focus (F) of the paragraph. Others may refer to this as the thesis or main idea. For example, the first sentence of this paragraph clearly lets the reader know this paragraph will address the “Focus” of the paragraph, or the letter “F” in the FEET acronym. Once the Focus of the paragraph has been made, evidence and/or examples can be provided.

Evidence and Example (E)

The second component of a paragraph contains Evidence (E), an Example (E), or both. These components of the FEET model will require further explanation as they leave the writer with a few options, depending on the content of the paragraph. Evidence is a description of a research article that supports the author’s main point or Focus of the paragraph. For example, if plagiarism is the Focus of the paragraph, the author might state “Marsh, Landau, and Hicks (1997), as well as Walker (2008) agree plagiarism can occur even when it is not intended if sources are not properly cited”. The previous sentence provided Evidence to support the Focus of a paragraph discussing plagiarism and the use of citations. Similarly, an Example provides the reader with a description of the Focus of the paragraph in a pragmatic fashion. To further explain the Evidence or Example, an Explanation is needed.

Explanation (E)

An Explanation (E) is the author’s interpretation, description, or analysis of the Evidence or Example. An effective Explanation might include a discussion of the strengths and weaknesses of the arguments made in a research article, or simply be the author’s own words to describe the research and its implications. In other words, how the Evidence or Example applies to the Focus of the paragraph. Some paragraphs might include an Example and an Explanation, others might call for Evidence with an Explanation, or perhaps a paragraph might need to include a combination of all three. This is decided by the author. What must be included in every paragraph is some form of an Explanation for the reader, to let them know what the author is attempting to accomplish in the paragraph. It is a common mistake for students to simply cite a source and never explain the research or why it was cited. This final component of the FEET model is the Transition.

Transition (T)

The Transition (T) sentence creates an effective flow between the current paragraph and the subsequent paragraph. The link helps the reader understand what will be discussed in the next paragraph. For example, the previous paragraph ended with a sentence that described how this paragraph would discuss the “final component of the FEET model”. This sentence effectively transitioned from one Focus or topic to the next. When ending a major section of a paper, it may not be necessary to provide a Transition. For example, this section is now complete, so I will simply end here.

Summary and Conclusion

A summary and conclusion section, which can also be the discussion section of a research paper, is the final opportunity for the author to make a lasting impression on the reader. The author can begin by restating opinions or positions and summarizing the most important points that have been presented in the paper. For example, this paper was written to demonstrate to readers how to effectively use APA Style citations and formatting when writing academic papers. Various components of an APA Style paper that were discussed or displayed in the form of examples include a running head, title page, introduction section, levels of section headings and their use, in-text citations, the FEET model, a conclusion, and the reference list.


American Psychological Association. (2010a). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

American Psychological Association. (2010b). Ethical principles of psychologists and code of conduct. Washington, DC: Author. Retrieved from

Marsh, R. L., Landau, J. D., & Hicks, J. L. (1997). Contributions of inadequate source monitoring to unconscious plagiarism during idea generation. Journal of Experimental Psychology: Learning, Memory, and Cognition, 23(4), 886-897. doi: 10.1037/0278-7393.23.4.886

Walker, A. L. (2008). Preventing unintentional plagiarism: A method for strengthening paraphrasing skills. Journal of Instructional Psychology, 35(4), 387-395. Retrieved from

Always begin a reference list on a new page. Use a hanging indent after the first line of each reference. To do this in Word follow these steps: 1) go to “Paragraph” settings on your tool bar, 2) press the drop down arrow, 3) select the “indents and spacing” tab, 4) in the “indentation” row press the drop down arrow under “special”, and 5) select “Hanging”. This process will help you format all of your reference entries. The reference list is in alphabetical by first author’s last name. A reference list only contains sources that are cited in the body of the paper, and all sources cited in the body of the paper must be contained in the reference list.

The reference list above contains an example of how to cite a source when two documents are written in the same year by the same author. The year is also displayed using this method for the corresponding in-text citations as in the next sentence. The author of the first citation (American Psychological Association, 2010a) is also the publisher, therefore, the word “Author” is used in place of the publisher’s name.

When a digital object identifier (DOI) is available for a journal article, it should be placed at the end of the citation. If a DOI is not available, a uniform resource locator (URL) should be used. The Marsh, Landau, and Hicks (1997) reference is an example of how to cite a source using a DOI. The Walker (2008) reference is an example of how to cite a source using a URL.

Created by Daniel G. J. Kuchinka, Ph.D.

Created by Daniel G. J. Kuchinka, Ph.D.

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