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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