You’ve always considered your son to be an active child; even as a toddler he was always on the go. He gets bored quickly if there isn’t structure or if he doesn’t like the activity (like homework!) and he prefers to do several things at once. He often interrupts people when they speak, but you’re confident that he can outgrow the behavior. However, his inability to sit still during dinnertime is increasingly annoying and of even more concern is the trouble he’s been getting into in school for calling out answers and leaving his seat without permission. You’re wondering – could he have ADHD (attention deficit hyperactivity disorder)?
Most children are first considered for formal assessment when their school performance is suffering. However, ADD/ADHD can occur in children of every intellectual level (from intellectually challenged all the way to intellectually gifted). The brighter the child, the longer it may take for teachers and parents to become concerned, since the child’s academic performance may not be as quickly or as severely affected by his disorder. Nonetheless, a child who has to work extra hard in order to counteract the effects of ADD/ADHD is usually feeling stressed, exhausted and irritable. These behavioral symptoms should be taken seriously – not just the child’s grades. In fact, no matter what the child’s grades are like, behavioral disturbances at home should also be taken seriously. Sometimes these are a result of parenting style, but sometimes they are caused by conditions inside the child. A proper assessment may lead to a diagnosis of ADD/ADHD or some other developmental condition or simply stress that the child has not been able to express to his parents. Parents should also seek assessment when their child seems to have trouble following instructions, remembering to do what he is told, taking turns, waiting patiently, organizing his schedule and belongings or sitting for age appropriate lengths of time. Don’t assume that a child doesn’t have ADD/ADHD just because he can spend hours sitting quietly in front of the T.V. or computer screen. The disorder only interferes with “boring” activities, not activities that stimulate the child. That is because ADD/ADHD is a brain condition that is essentially understimulated. In fact, medicinal treatment consists of stimulant drugs. Although normal people can tolerate boredom fairly well, those with ADD/ADHD have zero tolerance for boredom because their brains are stimulant hungry – boredom is actually painful for them. This is also why kids with ADD/ADHD tend to get into trouble when left in unstructured situations. They will create activity by getting into mischief. Highly structured programs help prevent this problem.
What is Attention Deficit Disorder?
Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder or ADHD, are behavioral conditions characterized by an inability to maintain focus for a long time and/ or an inability to keep still. These difficulties in managing attention and activity are more than what is expected developmentally from kids of the same age. The symptoms tend to also persist across all situations, thus a child with ADD or ADHD tends to be inattentive or disruptive, not just at school but at home as well.
ADHD affects somewhere between 5 and 10% of schoolchildren, depending on measurements utilized. Symptoms of ADD or ADHD are never the same with any two people. People with attention deficit disorder may not be able to sit still, plan ahead, finish things, or pay attention to what’s going on around them. Symptoms for ADD may include: having difficulty remaining in one place, difficulty waiting one’s turn in groups, blurting out answers before the question is complete, poor organizational skills, losing things, shifting from one uncompleted task to another, talking excessively, not listening to what is being said, being easily distracted, entering situations without thinking, having difficulty following instructions, fidgeting with hands and feet, squirming while seated, interrupting people often and forgetting things that are necessary for a task or activity.
Kids with ADD/ADHD may also have additional symptoms such as problems with anger, poor social skills, poor fine or gross motor skills, anxiety, sleep disturbances and mood issues. Sometimes ADD/ADHD occurs alongside other disorders such as Tic Disorders, Obsessive-Compulsive Disorder, depression and social phobia. Attention Deficit Disorder has an early onset, and usually manifests itself before a child turns 7 years old.
Symptoms for attention deficit disorder are broken down into three groups: Type 1: Inattentive. This group of ADD sufferer have symptoms of attention deficit – i.e. being easily distracted, daydreaming, losing focus. Type 2: Hyperactive/Impulsive. This group of people with ADHD show symptoms of overactivity (fidgeting, running or pacing where inappropriate, always “on the go”) and impulsivity (acting without thought, interrupting others, calling out). Type 3 is Mixed Inattentive and Hyperactive/Impulsive, where the person has a mixture of symptoms across both categories – that is, a mix of ADD and ADHD symptoms. Diagnosis is generally not made until the person concerned has eight or more of the above symptoms, and the symptoms have remained the same for at least six months.
Below is a summary of the common symptoms of ADD:
- Short attention span, mind tends to wander
- Frequent forgetfulness
- High rate of unfinished projects
- Gets painfully bored when task isn’t interesting or when there is a lack of structure
- Makes careless errors in schoolwork
- Is easily distracted
- Doesn’t follow through on chores or instructions, appears not to listen
- Disorganized; loses and misplaces things frequently
- Difficulty in concentrating on tasks, a high rate of unfinished projects
- Excessive activeness or excessively high energy levels
Common symptoms of ADHD include:
- Constantly being on-the-go
- Frequent fidgeting and running about
- Impulsive behavior like blurting out answers in class
- Trouble waiting in-line or other slow-moving situations
- Talks excessively and interrupts others
There are no laboratory tests that can measure ADHD; as a behavioral condition, psychologists and medical practitioners rely mainly on observation, interview and teacher reports to get a clear picture of the patient’s state. Diagnosis can be made by a paediatric specialist (a medical doctor who specializes in the diagnosis and treatment of ADD/ADHD or by a psychologist whose speciality is assessment and diagnosis). Sometimes the family doctor can make a diagnosis as well. Teachers cannot diagnose ADD/ADHD although they may suspect its presence and they are also a vital source of information for those who provide the assessment. Teachers can often refer parents to those who can diagnose. Finally, friends and relatives CANNOT diagnose ADD/ADHD – specialized tests and measurements are required in order to make a diagnosis in addition to behavioural data collected from parents, teachers and others.
What Causes ADHD?
The exact origins of ADHD are still under debate, and many controversies surround the different theories being pushed forward by various research groups and experts. The most accepted explanation so far is that ADHD is a neurological condition related to both the lack of specific chemicals in the brain, and brain structural issues that inhibit attention and self-control. This biological basis is most favored, as ADHD appears to be a genetic condition that begins as early as infancy. However, many researchers also believe that diet, lifestyle and environmental conditions have a lot to do with the symptoms of ADHD. They argue that ADHD is a fairly recent phenomenon, and the condition was rarely reported 50 years ago. ADHD is also rare in poor and developing countries, suggesting that there is something in the way we approach life today that promotes symptoms of inattention and inactivity. In particular, some scientists blame the high sugar content of the modern diet, as well as the rampant used of preservatives and artificial ingredients for ADHD. Excessive use of technology, such as the television, computer and gaming consoles have also been considered as culprits. Additionally, poisonous chemicals in the air, water and food products are also believed to cause neurological impairment.
How is ADHD Treated?
Once a diagnosis is obtained, parents have a variety of treatment options that they can consider. Both behavioral and biological interventions are usually recommended.
Psychostimulants such as Ritalin have been found to be effective in increasing an ADHD child’s attention span and improving performance at school. Some parents prefer to try alternative treatments such as homeopathy, herbal medicine and nutritional supplements. Some parents will try the natural approach for some months and, if results are not satisfactory, then try psychotropic medication.
Cognitive-Behavioral techniques are used to help manage inattention and impulse control. Children and adult ADHD sufferers can be taught specific techniques to help reduce symptoms and enhance functioning.
When making a decision as to which form of treatment to employ, consultation with the following people is recommended: a behavioural optometrist for a developmental vision evaluation, an allergist regarding possible allergic reactions, a child psychologist who can devise a behaviour modification program, a medical doctor who can assess the need for and prescribe medication and an occupational speech therapist with expertise regarding sensory processing problems. Other professionals to consider are special education tutors who can provide specialized supplementary education when necessary and naturopaths who are experienced in the alternative treatment of this syndrome. Although the treatment team seems large, it is also comprehensive, helping to create the most thorough and effective intervention for those children who have ADD/ADHD.
Bringing Out the Best in the ADD/ADHD Child
Raising a child with ADD/ADHD requires superb parenting skills. Being “Average-Joe-Parent” just won’t do with this population. For a set of easy-to-acquire top parenting skills, see Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe. While your doctor and other members of the professional team are addressing your child’s symptoms, you as a parent can keep the following points in mind:
- The ADD/ADHD child is not purposely disobedient or unruly. He is dealing with inner compulsions and forces; he would like it if he could be easier going, more flexible, happier and relaxed, but he just can’t get there. He needs your love, support, patience and understanding.
- Keep expressions of anger to an absolute minimum with this population. They lack the ego-strength (self-confidence) to handle anger and often react with depression, withdrawal, aggressiveness, acting out and other forms of intense emotional turmoil and dysfunction. Learn how to discipline without using anger at all.
- Your child might benefit from reading self-help books on ADD/ADHD – there are now many available, written for children and teenagers.
- Consider experimenting with Bach Flower Therapy as a treatment for ADD/ADHD. Bach Therapy has no side-effects of any kind, yet can often effectively reduce many of the symptoms of ADD/ADHD such as impulsivity, immaturity, hostility, depression, anxiety, restlessness, lack of concentration/attention and more. (You can find more information on the Bach Flower Remedies online and throughout this site.) Your naturopath may also recommend other alternative and dietary interventions.
- Consider enrolling your child in social skills or anger management programs providing sheltered group activities or individual activities that will build personal confidence and self-esteem such as karate lessons, drum lessons, art lessons, cooking classes etc. These needn’t be formal classes – if you can provide extracurricular activities yourself at home (like teaching your child to cook or sew) – that’s great! ADD/ADHD children often grow up to be adults with exceptional creativity and unique gifts. As long as their self-esteem remains intact and they develop ways of working around their deficits, they are capable of being highly successful professionally and personally.