ATTENTION DEFICIT DISORDER AND ADHD

Topics in Mental Health

By Shlomo Y. Radcliffe

What is Attention-deficit/Hyperactivity Disorder?

People with Attention Deficit Disorder may not be able to sit still, plan ahead, finish projects, or pay sufficient attention to written or oral communications..ADHD affects somewhere between 5 and 10% of schoolchildren, depending on measurements utilized. Attention Deficit Disorder is primarily a disorder of concentration. The sufferer may be highly intelligent but have trouble learning in school because of the inability to concentrate on the teacher\'s words or the material in a textbook. The child is easily distracted by sights, sounds and movements in the environment. Attention Deficit Hyperactivity Disorder is primarily a disorder of over activity. Inability to sit for long periods of time interferes with schoolwork, despite normal intellectual ability. The child leaves his seat, disrupts the class, shouts out impulsively and may fidget constantly. Children and adults with ADD/ADHD often have certain personality characteristics and/or disorders as well. For instance, the person may have trouble with social skills, may be prone to explosive anger, may lie frequently, may have sleep issues, may be highly anxious, may have tic disorders, may be depressed and so on. Fine and gross motor difficulties, eye-hand coordination, auditory processing skills and other neurological characteristics may also be affected. However, symptoms of ADD or ADHD are never the same with any two people. The disorder ranges from mild symptoms that barely interfere with a person\'s life to a complex symptom picture that can cause deficits in many areas.

 Diagnosing ADD/ADHD

 Symptoms for ADD/ADHD 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.
• Forgetting things that are necessary for a task or activity.

Symptoms for attention deficit disorder are often broken down into three groups: Type 1: Inattentive.  This group of ADD sufferer have symptoms of attention deficit – i.e. being easily distracted, daydreaming and losing focus. Type 2:  Hyperactive/Impulsive. This group of people with ADHD show symptoms of over-activity (fidgeting, running or pacing where inappropriate, always “on the go”) and impulsivity (acting without thought, interrupting others and 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.

Diagnosis for ADD/ADHD 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 diagnosis 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.

Treatments for Attention Deficit Disorder

Physicians will often recommend that attention deficit disorder be treated with special education, counselling and stimulant medication. Parent Education and Counselling is particularly effective. However, some treatments may have negative or harmful side effects. For instance, while stimulant medications have been found to have extremely positive effects in most children, some report negative effects on appetite, sleep and growth or a numbing effect on personality. It is important to monitor each child carefully to ensure that the positive effects of the medication are outweighing any negative side-effects.  Similarly, while special education can be a life-saver for many youngsters, some children will react to the segregated classroom with a damaged sense of self-esteem. Again, treatment must always be tailored to the individual. Visual and occupational therapy are helpful treatments that assist the child by placing attention skills inside of the person so she can control herself. Biofeedback that trains brain processes is an experimental treatment that my yield positive results in future research. Treatment of allergies has also been known help alleviate attention deficit disorder in some cases.

When making a decision as to which form of treatment to use, consultation with the following people is usually recommended: a behavioural optometrist for a developmental vision evaluation, an allergist regarding possible allergic reactions, a child psychologist who can help devise a behaviour modification program, a medical doctor who can assess the need for- and prescribe- medication and lastly an occupational speech therapist with expertise regarding sensory processing problems. Other professionals suggested to consider are: special education tutors who can provide specialized supplementary education when necessary and naturopaths who are experienced in alternative treatment of this syndrome. Although the treatment team seems large, it is also quite comprehensive, helping to create the most thorough and the most effective intervention for those children who have ADD/ADHD.