Most Common Non-genetic Factors that Causes the Development of ADHD

INTRODUCTION:
Now that we have entered an age of remarkable discovery about the human development,
old assumptions of dichotomy between nature versus nurture has been replaced by a complex
knot of symbiotic relations between genetics and the environment. This leads to the idea that all
mental phenomena are assumed to be a result of biological activity of neuronal circuits in the
brain. The development of these circuits may rely in part on genetic programs, but is also heavily
dependent on the individuals exposure and experiences within the environment (Pally, 2000).
The psychiatric condition, Attention Deficit Hyperactivity Disorder (ADHD) as
characterized by problems with attention, impulsivity, and overactivity, affects 3 to 7 percent of
school-aged children and anywhere from 2 to 4 percent of adults (Gottlieb, 2005). Once an
obscure footnote, the disorder has evolved into a household name with its increasing rate of
positive diagnosis (approximately 5% per year from 2003 to 2011) in a relatively short amount of
time. Because of this, numerous parents, teachers, and individuals are left to ponder on what
exactly causes ADHD among individuals.
To this date, the precise causation of ADHD is still unknown but a few definitive
explanations are widely accepted as an answer to the pending question. Most mental-health
professionals agree that ADHD is largely a genetic disorder that tends to run in families,
proposing that a genetic code tells the brain to wire itself differently (Gordon, 2008). A strikingly
strong familial pattern exists with statistics showing that as many as 50 percent of individuals
with ADHD also have parents or siblings who have the same condition (Silver, 2008). Heredity
may make the largest contribution to a childs tendency to have ADHD.

1
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

There are instances where heredity does not seem to be an agent (Gottlieb, 2005).
Research findings suggest that for the other percent of individuals where genetics do not
contribute to ADHD, something affected or influenced the brain during development (Silver,
2008). Complications during fetal development, exposure to high level of toxins and other
chemical substances, and psychosocial problems are the most common among non-genetic
factors that can cause ADHD.

BODY:
Complications during fetal development
The phase of fetal development is critical as the growth of a beings different organs and
body system structures rapidly takes place. Hence, during this exquisitely sensitive stage,
disturbances to materno-fetal (involving the fetus and its mother) environment can cause
complications which can heavily influence the fetus future state of health (Harding & Bocking,
2001). Such disturbances is most often exposure to harmful substances in the environment,
known as teratogens, and the poor condition of the mother because of the absence of prenatal
care and/or presence of infection or stress during pregnancy. The developing fetus is most
susceptible to the aforementioned factors during the third to eight week after conception, at
which point the nervous system and other major systems develop critically. Complications
incurred at this particular time may result to some major structural and physiological
abnormalities, including ADHD, upon the birth of the child. Indeed, several studies have shown a
considerable likelihood that mothers who experienced complications during pregnancy may
probably have children with ADHD (Barkley, 2000).

2
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

Specifically, as ADHD is considered to be a psychiatric condition, complications causing

interference in the development of the brain are more likely to cause ADHD. One of these
complications is the lack of oxygen during the pregnancy of the mother. Because of ischemichypoxic conditions, there is a decreased oxygen level in the blood circulation, provoking
significant structural and functional brain maldevelopment, which in turn leads to functional
problems, including ADHD (Permanente, 2012). Another complication is incurring physical
injuries during pregnancy (Gillberg, 2014). Damage to critical parts of the fetus brain, specially
the frontal part located in the area of the forehead and the parietal part of the brain located at the
uppermost area of the head may affect its role in the regulation of attention, which are deficits
seen in ADHD. High blood pressure also influences the occurrence of ADHD to the offspring
(Kooji, 2012). High blood pressure can hurt the connection between the uterus and the placenta
which serves the shock absorber; therefore damage to it will make the fetus more susceptible to
bumps and brain injuries. Moreover, women, who were treated for high blood pressure during
pregnancy with a medication called labetalol, are at considerably at risk to have a child with
ADHD.

Exposure to Toxins and Other Chemical Substances

Intake of labetalol can help decrease the high blood pressure of the mother, but it can be
hazardous as it makes the fetus have a lower-than-normal blood pressure. And while not all drugs
and medications result to this deviance, anomalies which cause complications are commonly
associated with substance intake. Undeniably, many chemicals, such as nutrients in a wellbalanced diet, are essential for good health. Yet, there are also others which can put a child at risk
of developing abnormalities when exposure to them is enough. These chemicals, generally

3
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

known as toxins, enter through contamination in the air, the water and even the food the child
eats. Toxic substances have the capacity to disrupt the development of all the bodys organ
systems.
The brain is no exemption to this. In fact, when it is relatively immature, the brain is
particularly susceptible to adverse impacts on the formation of its basic circuits. When certain
substances reach dangerous levels at particular sensitive points in time, they can disrupt the
developmental process through toxic effects on the health of the brain cells as well as on their
ability to perform specialized functions. Their influence can weaken the foundational structure of
the brain, and result in permanent impairment, leading to a wide range of lifelong, adverse
impacts on learning, behavior, and health (National Scientific Council on the Developing Child,
2006). Thereby, a strong relationship can be established, with toxins causing development of
ADHD.
The changes that can cause development of the unusual hyperactivity and inattentive
behavior brought about by neurotoxicity can be attributed to enough contact (either of the
pregnant woman or the child) with a variety of chemical agents. One of the best discussed in
relation to brain damage and dysfunction is the infamous toxin, lead. The chemical element
found in paint, gasoline, batteries, cosmetics and even soil, places a child at great risk as it
accumulates, becoming present in the blood and bones, slowly poisoning the body overtime
(United States Environment Protection, n.d.). Though the effects of lead poisoning may still
depend on the amount present, the length of time it is available and the stage wherein it is in
contact with the brain development of the child, recent studies with strong evidence confirmed
that higher levels of lead in the blood do trigger ADHD. A further explanation by Association of
Psychological Science (2010) describes that lead attaches to sites in the brains striatum and
4
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

frontal cortex, where it acts on the genes in these regionscauses them to turn on or remain
inactive. Gene activity shapes the development and activity of these brain regions. By disrupting
brain activity, the toxin in turn alters psychological processes supported by these neurons,
notably cognitive control. Lastly, diminished cognitive control contributes to hyperactivity and
lack of vigilance. Studies have also shown a correlation between the possibility of ADHD in
children and the use of cigarettes and alcohol, especially during pregnancy (Iliades, 2010). Every
puff from a single cigarette smoke contains more than 4,000 chemicals, including ammonia,
arsenic, lead, cyanide, etc, will go through the mothers bloodstream which serves as the babys
only source of oxygen and nutrients (Nordqvist, 2011). Amongst the more than 4,000 chemicals,
both nicotine and carbon monoxide are considered most harmful as it collaborates to reduce the
oxygen supply of the fetus (Woolston, 2014), causing complications, giving rise to abnormalities,
as mentioned before. And even after birth, development may still be affected through
environmental risks of cigarettes as several scientists believe that secondhand smoking poses as a
factor for ADHD (Duke Medicine News and Communications, 2013). On the other hand, alcohol
intake directly risks the child to ADHD in utero or only during fetal development. Alcohol
devastatingly disrupts the development of the child, changing the structure of cell membranes
containing proteins responsible for normal functionality of neurotransmitters. Research has
shown that offsprings exposed to alcohol during pregnancy have 50% decrease of activity
dopamine neurons in their brains, which persisted to adulthood (Breecher, 1999). Dopamine
plays an important role of carrying signals between nerves in the brain, and links to many
functions, including movement, sleep, mood, attention and learning (Goldberg, 2014).

5
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

Psychosocial Problems
It had been formerly established that chemicals in the surroundings play an enormous
role to the development of a child. But a child also grows in an environment of relationships
(National Scientific Council on the Developing Child, 2006). Naturally, a major part of the
process is the childs continuous give-and-take with a human companion that offer experiences
which are individualized to the childs unique personality; that build on his or her own interests,
capabilities, and initiative; that shape the childs self-awareness; and that stimulate the growth of
his or her heart and mind. Such relationships affect virtually all aspects of their development
intellectual, social, emotional, physical, behavioral, and moral. The quality and stability of a
childs human relationships in the early years lay the foundation for a wide range of later
developmental outcomes, including sound mental health, motivation to learn, and ability to
control aggressiveness (National Scientific Council on the Developing Child, 2004). In
consequence, without any nurturing relationships, the environment, psychosocially speaking, can
trigger development of ADHD.
The psychosocial factors than bring about the maladaptive condition or behavior in
children can be separated into two: socially and psychologically, with the former heavily
depending on interactions and the latter, on experiences. Socially speaking, the level or amount
of support that parents, peers, and community influences behavior (Lange, 2005). Secure
relationships with the caregiver shape the development of important capabilities in children
including greater social competence and fewer behavior problems. Current research suggests that
the additional time in an out-of-home care and away from the caregiver is associated with
aggression and persistent disobedience. Other studies have shown that the quality of the motherinfant relationship influences gene expression in areas of the brain that particularly regulate

6
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

social and emotional function and can eventually lead to changes in the brain structure. This
institutes that the nature of the relationship also can have long-term effects (into adulthood) to
the mechanism of the body (National Scientific Council on the Developing Child, 2004). With
everything said, ADHD can develop in children that may have been neglected socially because
of habituation or dysfunctional brain development influenced by lack of stimulus from the
primary caregiver. On the other hand, psychologically speaking, experiences may increase risk of
ADHD, especially through trauma (Lange, 2005). Young children are highly vulnerable
emotionally to the adverse influences of parental mental health problems and family violence.
One of the extensively documented researches is the experience of having a mother with clinical
depression (National Scientific Council on the Developing Child, 2004). Such negativity impacts
the childs emotional development, social sensitivity, and concept of self, all of which are
manifested through behavior, development and brain function. Children who grow up are
seriously troubles families, especially those who are vulnerable temperamentally, are prone to
development of conduct problems and behavioral problems, such as ADHD. Parenting
capabilities as well as the manner the parents discipline or punish a child may also exacerbate or
regress the development of ADHD. Inconsistency of rules and over punishment may raise the
risk for ADHD. When parents constantly change and manipulate rules in the house there is a
tendency that the child may have a hard time addressing these changes leading to delayed self
regulation skills (Barkley, 1988).

CONCLUSION:
Though Attention Deficit Hyperactivity Disorder (ADHD) is largely accepted as a genetic
disorder, non-hereditary factors also account for a considerable percent of a childs growth,

7
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

especially during the fetal phase. The multifaceted psychiatric condition can be triggered by
many factors of complications, toxicity and psychosocial interactions. Toxin exposure can be
harmful enough to alter chemical levels in the childs body, destroying cells, and in turn changes
the formation of the brain, affecting its functionality. Common toxins associated with
development of ADHD are lead, which is acquired through accumulation from paint, soil,
gasoline and batteries, nicotine and carbon monoxide, which are acquired through smoking and
are most fatal during the fetal phase, and alcohol. These toxins, in turn, with other kinds of
disturbances can cause complications during pregnancy. Complications that may eventually
cause ADHD vary from lack of oxygen, physical injuries, and high blood pressure. All contribute
differently but commonly affect the development of the brain. Lastly is the effect of poor
psychosocial interactions that primarily affect the child after fetal phase. Socially, early unstable
relationships with the caregiver may give way for the child to develop the maladaptive
behaviour. Psychologically, events which can prove to be traumatic to a vulnerable child may
also affect his behaviour.
While it is true that nothing can be done to change how genetics predetermine the
possibility of a child to have ADHD, taking note of the non-hereditary factors can give ideas as
precaution

to lessen the risks of developing ADHD. An overall healthy lifestyle and

environment should be maintained, especially during pregnancy. As early as possible, good

prenatal care should be established. Regular check ups is important so that signs of certain
conditions that could lead to complications may be addressed properly. A proper meal with 70
grams of protein a day is essential. Protein is used to help build the cells in the mothers body
and in the body the unborn baby. It also provides energy (Welton, 2014). Undercooked eggs and
meat, unpasteurized dairy products and raw seafood should be avoided as they may contain

8
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

bacteria that could harm the child if ingested. Certain fishes may also contain high levels of lead,
mercury or other contaminants (Dewar, 2014). And equal balance of regular exercise and
relaxation can do well to the body and to lessen the risk of developing conditions which can
cause complications. Alcohol, smoking and use of other recreational drugs must be strongly
avoided. Caution must also be done when taking medications as some medicines do contain
drugs that may be harmful to the fetus. Environmental dangers must be eliminated if possible.
Pregnant or not, constant exposure to heavy metals should be addressed quickly. Cleaning
products, pesticides, and solvents containing strong chemicals which can be easily ingested
should be kept far away from children. Thorough care through good parenting is also crucial to
the psychosocial health of the child.

9
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

BIBLIOGRAPHY
Barkley.
(1988).
Attention
deficit
hyperactive
http://ccvillage.buffalo.edu/Abpsy/lecture23.html

disorder.

Retrieved

from

Bocking, R., & Bocking, A. (2001). Fetal Growth and Development. Cambridge,
UK: Cambridge University Press.
Breecher, M. (1999). Is There a Link Between Prenatal Alcohol Exposure and ADHD? WebMD.
Retrieved October 18, 2014, from http://www.webmd.com/add-adhd/childhoodadhd/news/19991115/link-between-prenatal-alcohol-exposure-adhd
Duke Medicine News. (2013). New Childrens Center Studies Association Between ADHD and
Secondhand Smoke. Duke Medicine News. Retrieved October 18, 2014, from
http://corporate.dukemedicine.org/news_and_publications/news_office/news/newchildrens-center-studies-association-between-adhd-and-secondhand-smoke
Gillberg, C. (2014). ADHD and its many associated problems. United Kingdom: Oxford
University Press.
Goldberg, J. (2014). Attention-Deficit/Hyperactivity Disorder: Causes of ADHD. WebMD.
Retrieved October 18, 2014, from http://www.webmd.com/add-adhd/guide/adhd-causes
Gordon, J. (2008). The ADD and ADHD cure: The natural way to treat hyperactivity and refocus
your child. Hoboken, NJ: John Wiley & Sons, Inc.
Gottlieb, D., Shoaf, T., & Graff, R. (2006). Why is my childs ADHD not better yet?:
Recognizing the undiagnosed secondary conditions that may be affecting your childs
treatment. New York, NY: McGraw-Hill.
Iliades, C. (2010, August 31). 10 theories about ADHD causes. Retrieved from
http://www.everydayhealth.com/adhd-awareness/theories-about-adhd-causes.aspx
Kooji, S. (2012). Adult ADHD: Diagnostic assessment and treatment. Germany: Springer
Science & Business Media.
Lange, G., Sheerin, D., Carr, A., Dooley, B., Barton, V., Marshall, D., . . . Doyle, M. (2005).
Family factors associated with attention deficit hyperactivity disorder and emotional
disorders in children. Journal of Family Theory, 27, 7696.
United States Environmental Protection Agency. (n.d.). Learn about lead. Retrieved October 16,
2014, from http://www2.epa.gov/lead/learn-about-lead
National Scientific Council on the Developing Child. (2004). Young children develop in an
environment of relationships. Working Paper No. 1. Retrieved from
http://www.developingchild.net

10
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB

National Scientific Council on the Developing Child. (2006). Early exposure to toxic substances
damages
brain
architecture.
Retrieved
October
18,
2014,
from
http://www.developingchild.net
Nordqvist, C. (2011). What Chemicals are in Tobacco Smoke? What is Cigarette Smoke?
Medical
News
Today.
Retrieved
October
20,
2014,
from
http://www.medicalnewstoday.com/articles/215420.php.
Pally, R. (2000). Mind-Body Relationship. Albany, New york: Boyd Printing
Company.
Permanente, K. (2012, December 10). ADHD linked to oxygen deprivation before birth.
Retrieved
from
Science
Daily
website:
www.sciencedaily.com/releases/2012/12/121210080833.htm
Silver, L.B. (2008). Attention deficit/ hyperactivity disorder: A clinical guide to diagnosis and
treatment for health and mental health professional. Arlington, VA: American
Psychiatric Publishing, Inc.

11
Berdijo, L., Custodio, D., Ferriols, R., Midel, D., Viloria, F., 2OTB