ATTENTION DEFICIT DISORDER  (ADD / ADHD)

Billy was only seven years old, and already a terror in school. His parents were constantly being called and told of his wild and unruly behavior – fighting with the other kids, running around the room during class, screaming at the janitor and kicking the adults who tried to bring him under control. When he did sit still, it was only for short periods, and he was busy fidgeting during the entire time. Things were not much different at home – attested to by the holes in the wall in Billy’s room, the scratches on the car, torn books and battered toys.

Billy’s parents knew that they applied reasonable discipline in their home. Their other children did not have behavior problems. They also knew their son was a well-intentioned child. His behavior was damaging family relationships and the marriage. Thanks to the advice of the school psychologist, they had him tested. They discovered Billy had Attention Deficit Disorder (ADD), a chemical imbalance in the brain that affects between five and ten percent of the male population. Billy’s problem was more visible because it was accompanied by hyperactivity (ADHD).

Attention Deficit – Hyperactivity Disorder is commonly diagnosed in boys between age 5 to 12, but often it is bypassed because the active and aggressive behavior is dismissed with words such as “He is just being a normal boy.” Girls are diagnosed far less frequently. When they are identified, the hyperactivity component is often missing. Girls tend to be quietly inattentive – described as “dreamers” with wandering minds and difficulty in concentrating.

The most common core features of ADD-ADHD are:

Poor impulse control and difficulty delaying gratification

Difficulty in maintaining sustained attention to tasks

Excessive activity and physical restlessness (for those with the hyperactivity component)

No one fully knows what causes ADD – ADHD. It is NOT caused by poor parenting, family problems, poor teachers or schools. Rather research is showing that the roots are probably genetic. If one person in a family has ADD-ADHD, there is a 25% to 35% chance that at least one other family member has it (as compared with 4% to 6% for the general population).

ADD-ADHD appears to be related to biological factors which influence neurotransmitter activity in certain parts of the brain. The National Institute of Mental Health has conducted research showing a link between a person’s ability to pay attention over sustained periods and the level of glucose in certain parts of the brain. People with ADD used less glucose in those brain areas associated with attention control. Another 1996 study by Dr. Xavier Castellanos found physical differences in the brains of boys ages 5-18 having ADHD, when compared with a similar group not having ADHD.

For many years it was thought that ADD-ADHD was a childhood disorder, and would fade away as the youngster neared adulthood. That theory no longer holds. Experts now realize that most ADD kids never outgrow the problem. The disorder which had such a profound impact on their early years continues to accompany them throughout their lives. The traits remain– difficulty in concentrating and a tendency to be impulsive.

ADD-ADHD adults typically go through a shock when they recognize what caused them so much difficulty throughout their lives. As youngsters, no one knew about ADD. They were simply considered lazy, stupid or rebellious. Once the adult recognizes the situation, he or she can take action to make positive changes.

The National Attention Deficit Disorder Association recently announced guidelines for the diagnosis and treatment of ADD and ADHD. They include:

Provide patients with a complete physical, mental and developmental assessment before reaching the diagnosis of ADD

Never use medication as a diagnostic tool

Become familiar with ADD research and diagnostic techniques

Refer patients to professionals who specialize in ADD assessment and treatment.

Experience has shown that the most effective treatment for persons diagnosed with ADD or ADHD is a combination of medication (when necessary) along with therapy or counseling to help the individual learn coping skills and adaptive behaviors.

Medication is usually used to help normalize brain activity. Some of the drugs prescribed by physicians are Ritalin, Dexedrine, Adderall – stimulant medications shown to be most effective with people having ADHD.

Behavior therapy is helpful in teaching people ways to modify behaviors and to deal with the emotional impact of having ADD or ADHD.

Thomas Whiteman and Michele Novatni authored a book entitled Adult ADD. They point to areas where work is needed most, and in each instance recommend that it be done via “baby steps“:

Organization: Learning to organize oneself by using written schedules, setting priorities and not procrastinating; keeping space and “stuff” organized by reducing clutter – learning to throw away things which are no longer useful, using storage containers, etc.

Relationships: ADDs are often poor listeners. The tendency to be impulsive can harm marriages. The authors advise ADDs to practice attentive listening, giving gifts of attention and accepting self.

Work: The job can be an area of particular frustration for the ADD or ADHD individual, especially if there is a need for prolonged concentration, attention to detail paper work, or limited physical activity. The authors suggest ways to adapt to worksite limitations. Enlightened supervisors sometimes allow adaptations where a creative and spontaneous ADD employee can contribute valuable work to the company by allowing adjustments to the work situation.