Online NewsLetter

Attention Deficit Disorder Can Be Treated

While watching TV, Jason tossed a ball; while playing Monopoly, he had a Game-Boy in hand. Cheryl's fidgeting and her repeated trips to the pencil sharpener were an annoyance to her teacher. Mark, on the other hand, was a quiet child who day dreamed in the back of the room. While he completed most assignments, he frequently misplaced his work or forgot to turn it in. All three of these children were diagnosed as having attention deficit disorder (popularly known as hyperactivity) and successfully treated. ADD affects three to five percent of American children and one to two percent of adults. At one time or another, of course, virtually all parents think they have a hyperactive child. It's often a case of an energetic youngster feeling cooped up in an overly restrictive environment. ADD can primarily involve inattentiveness, hyperactivity, or both. Most children diagnosed with ADD, however, are hyperactive and impulsive. Nearly 90 percent are boys, although in adults the disorder seems to be equally common among males and females. Girls, who are less likely to display hyperactive symptoms, are also less likely to be diagnosed early. The hyperactivity can usually be observed from an early age; some mothers claim it even starts in the womb. In the words of parents, hyperactive children are "always on the go," or "driven like a motor." At play they are not necessarily more energetic than other children, but they seem to lack the controls that cause other children to slow down or stop for the sake of caution. Easily frustrated, they find it difficult to follow instructions, obey rules or pursue one activity through to completion. At school, the ADD child is likely to experience both academic and behavioral problems; he fidgets, interrupts others, blurts out answers inappropriately and can't wait his turn in line. Although often quite intelligent, such a child performs poorly or inconsistently on class assignments. Frequently harassed by parents and teachers and ridiculed or teased by other children, the ADD child is highly likely to develop a poor self image and related emotional problems, particularly depression and conduct disorders. To make diagnosis difficult, symptoms are not always consistent. The ADD child may be able to concentrate quite well on something that deeply interests her, and she may do better in a small group environment. Her attention, however, generally cannot be controlled by others. Some of the symptoms of ADD can be linked with depression, anxiety, impaired speech or hearing, mild retardation or traumatic stress such as sexual or physical abuse. Most American mental health professionals see ADD as a distinct disorder that can be reliably diagnosed and treated. Diagnosis requires a thorough evaluation including a physical examination, tests of vision, hearing, speech, IQ and academic achievement as well as laboratory measures of impulsiveness and attention. Most important are interviews with parents, teachers and the child himself. Most experts today believe that ADD is caused primarily by a biological dysfunction in the frontal lobe of the brain. The disorder has been shown to have a strong genetic component. Fathers of ADD children are more likely than average to have had attention deficit disorder during childhood. About 75 percent of attention deficit disorder patients can be helped through prescription of a stimulant drug such as methylphenidate (Ritalin), magnesium pemoline (Cylert) or dextroamphetimine (Dexedrine). While it may seem paradoxical to prescribe stimulants for hyperactivity, low doses of stimulants can improve concentration. Taken as prescribed, these drugs are neither "downers" nor "uppers". and they are not addictive. They can, however, have a slight effect on growth and cause poor appetite and sleeping problems. No medication can replace academic skills already lost as a result of the disorder or affect secondary problems such as depression or low self esteem. With increased concentration and self-control gained through the medication, however, the ADD patient can begin to attack other problems through psychotherapy, behavior therapy, family therapy and remedial academic work. An important first step is educating parents, teachers and other adults. With training, they can learn what to expect, and not expect, from the child. They can also learn to recognize the signs of loss of control so they can take preventive action. Children with ADD need structure and routine. They can be taught to make schedules and lists, to break assignments down into smaller tasks to be performed one at a time. At least when young, they often respond better when rules are clear, consistent and strictly applied. In school, they may do better in small groups, monitored closely. Assignments and directions should be brief and repeated often.

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Last modified: Tuesday, April 15, 2014

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