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Updated October, 2003
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INTRODUCTION
While the focus is on children, ADD can exist through the life
span, and may first be spotted in the teen or adult years. Though I am focusing on the
earlier years, the reference material will include books for all ages.
WHAT IS ADD?
Attention Deficit Disorder is a physiological condition
that exists from birth. The cause is not clear, but there is often a genetic basis.
ADD is best defined by the symptoms it can cause. These
include: a short attention span, easy distractibility, a low frustration tolerance,
impulsive behavior, hyperactivity, disorganization and immaturity.
ADD can exist with other conditions such as learning
disabilities, or it can be present without any other difficulties.
WHY THE CONCERN ABOUT ADD?
ADD can cause serious problems. Each child is, of course,
different and the difficulties due to ADD can vary from mild to quite significant. These
difficulties have an impact on learning, peer relations, family life and self-esteem.
Therefore, if ADD is suspected, the possibility that it exists should not be ignored.
THE SPECIFIC PROBLEMS
Under "What is ADD?" above, I listed many of the
symptoms. Those symptoms are more than words, because they translate into significant
behavior patterns. Understanding the relationship between the symptoms and the behavior is
the beginning of understanding ADD and your child.
Let me give you some examples. A short attention span
means that the child's attention wanders from the topic very quickly. Because he/she is
easily distracted, anything going on around him gets the attention. If the teacher is
presenting material and the mind wanders, it is difficult or impossible to follow the
lesson. Therefore, little is learned, homework is not understood, and all too often, the
child is told he is "not trying."
Often the child is impulsive and easily frustrated. That
is a tough combination because he may give up quickly and then say or do something he
shouldn't. For example, the child might be too aggressive, or blurt out answers rather
than wait his/her turn.
Organizational skills are often poor. This means the
necessary books won't come home, the assignment will be lost, and often the completed
assignment will disappear before it gets handed in.
The child is frequently immature. His behavior, fine motor
coordination and social ability may well be one or two years behind his chronological age.
Hyperactivity is another frequent symptom, and it makes
the child hard to slow down. Sitting still in one place is impossible, which often makes
him disruptive in class.
MUST THE CHILD BE HYPERACTIVE?
No. As noted, hyperactivity can be a symptom, but ADD
often exists without the child being hyperactive.
IF YOU THINK YOUR CHILD HAS ADD
When you think that your child has ADD, you want to learn
what symptoms he/she shows and how it is affecting school life. This information generally
comes from a school conference. The next step is to learn about ADD. As you learn about
the condition, you may find answers to your child's behavior that you had not been able to
explain. This could include the low frustration tolerance or the inability to sit still
and do homework.
Next, it is very important to have your child evaluated by
someone familiar with the condition. This is because there is no test that is diagnostic
of ADD. Rather, the diagnosis is made by information gathering and speaking to the child.
The evaluation first consists of gathering information
about the child and his family. We need material from the school and history from the
parents. The more the doctor knows before seeing the child, the more accurate the
evaluation will be. This is because a child may not say much in the office, and even a
hyperactive child can sit still for a short time. Therefore, it is very important to know
the facts from people who have had the opportunity to know and observe the child for some
time.
Certain conditions such as anxiety or depression have to
be ruled out before deciding the problem is due to ADD. Sometimes neuropsychological
testing may be helpful. While these tests do not diagnose ADD, the test results may
suggest ADD, and at the same time rule out such things as a learning disability or
depression. If these tests are necessary, they will be recommended during the evaluation.
With all this information, a diagnosis can usually be
made.
TREATMENT
The total approach including educational, psychological
and medical must be considered. Special educational programs with resource or tutorial
help may be indicated. The psychological area includes helping the child improve
self-esteem and/or helping the child and family understand ADD and the stresses it can
cause.
Medication, when appropriate, is the most effective
treatment currently available. To use or not to use medication is always the parent's
choice. However, do not make a decision without first talking to a psychiatrist, pediatric
neurologist, or pediatrician. Too many parents have negative opinions of medication based
on false rumors or sensationalism in the media. It is important to learn about
medications, the potential positive results, and possible side effects. You will then be
able to make an informed decision.
The most commonly used medications are Ritalin, Dexedrine,
Cylert and Norpramin. They are not habit-forming or addictive. The most common side
effects include headache, stomachache, decreased appetite and difficulty falling asleep.
Positive results include an amazing change in ability to
concentrate, marked improvement in academic work, less frustration, and the ability to be
calm and focused. This leads to improved self-esteem and a much calmer family life.
It is my feeling that the key to the successful use of
medication is a close working relationship between the parent, patient, and physician.
This allows for monitoring of side effects, careful dose adjustment, and the easy
availability of guidance when it is necessary.
RESOURCES AND USEFUL MATERIAL
The Connecticut Association for Children with Learning
Disabilities (CACLD) works with children and families with learning disabilities and/or
attention deficit disorder. CACLD is under the leadership of Beryl Kaufman, Executive
Director and her associate, Val Lux. CACLD has an extensive selection of books on ADD for
sale, has numerous conferences during the year, and an endless fund of general
information. For membership information call 203-838-5010.
BOOKS - CHILDREN AND TEENAGERS
There are many good books on ADD. I find the following to
be very complete, easy to follow, and inexpensive.
1. The Hyperactive Child, Adolescent and Adult: Paul
Wender, M.D., Oxford Press 2000
2. Your Hyperactive Child: Barbara Ingersoll, Ph.D.,
Doubleday 1988
3. Taking Charge of ADHD: Russell Barkley, Ph.D., Guilford
Press, NY 1996
4. ADD and the College Student: Patricia Quinn, M.D.,
Magination Press, NY 1994
BOOKS FOR ADULTS
1. Driven to Distraction: Edward Hallowell, M.D., Pantheon
Books, NY 1994
2. Woman with ADD: Sari Solden, MS, Underwood Books, CA
1995
3. You Mean I'm Not Lazy Stupid or Crazy by Kelly and
Peggy Ramundo
4. ADD on the Job: Lynn Weiss, Ph.D., Taylor Publishers,
Dallas 1996
VIDEO
Understanding Attention Deficit Disorder: Simon Epstein,
M.D., a 45-minute tape discussing ADD in children and adults. It is available from CACLD.
The cost is $25. It is available in many Connecticut local libraries.
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