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Attention deficit disorder in children

  • An ADD/ADHD child can pose a big challenge to his parents. Since he is very easily distracted, he needs help to cope with schoolwork. Mother's patience may wear thin because his hyperactivity constantly gets him into trouble.

"My son is hyperactive, he is always into something! He drives me up the wall!" is common complaint of many mothers of preschool or primary school kids. Is this so-called "hyperactive" a normal phase of a child's life? Or is it indicative of disorders such as Attention Deficit Disorder (ADD) or Attention Deficit Hyperactive Disorder (ADHD)?

Let us not be too quick to label every active child as ADHD, but let us be aware and informed, so that we can identify if a child is suffering from such syndrome.

An ADD/ADHD child can pose a big challenge to his parents. Since he is very easily distracted, he needs help to cope with schoolwork. Mother's patience may wear thin because his hyperactivity constantly gets him into trouble.

Parents of ADD/ADHD children may need the help and support of professionals like child psychologists or behavioral scientists. They need to learn different ways of teaching, and training the ADD/ADHD children. Early diagnosis and early intervention can bring about significant improvement.

Question: I hear so much about children who have ADD. Can you describe this problem for me and tell me how I might recognize it in my son?

Answer: The term ADD stands for attention deficit disorder, which is an inherited neurological syndrome. It refers to individuals who are easily distracted, have a low tolerance for boredom or frustration, and tend to be impulsive and flighty. Some of them are also hyperactive, and hence, they are said to have ADHD (attention deficit/hyperactivity disorder).

Children with ADD have a pattern of behavior that sets them up for failure in school and conflict with their parents. They have difficulty finishing tasks, remembering details, focusing on a book or assignment, or even remaining seated for more than a few minutes.

Some appear to be driven from within as they race wildly from one thing to another. They are often very bright and creative, yet they're seen as lazy, disruptive, and terribly disorganized. ADD children often suffer from low self-esteem because they have been berated as goof-offs and anarchists who refuse to follow the rules. They sometimes have few friends because they can drive everyone crazy – even those their own age.

As for how you can recognize such a child in your home, it is unwise for a parent to attempt to do so.

There are many other problems, both psychological and physical, that can cause similar symptoms. Disorders of the thyroid, for example, can make a child hyperactive or sluggish; depression and anxiety can cause the distractibility associated with ADD. Therefore, you must have assistance from a physician, a child developmentalist, or a psychologist who can confirm the diagnosis.

If you see in your child the symptoms I've described, I urge you to have him or her seen professionally. Again, you should not try to diagnose your child! The sooner you can get that youngster in to see a person who specializes in this disorder, the better.

Question: I understand that I can't diagnose my own son, but it would he helpful if you would list the kinds of behavior to look for in a child who may have ADD. You've described the condition in general terms, but what are the specific characteristics of someone who has this disorder?

Answer: Hallowell and Ratey, authors of an excellent text entitled Driven to Distraction, list twenty symptoms that are often evident in a person with ADD or ADHD. They are:

- Suggested Diagnostic Criteria for Attention Deficit Disorder
- A sense of underachievement, of not meeting one's goals (regardless of how much one has accomplished)
- Difficulty getting organized
- Chronic procrastination or trouble getting started
- Many projects going simultaneously; trouble with follow-through
- Tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark
- An ongoing search for high stimulation
- A tendency to be easily bored
- Easy distractibility, trouble focusing attention, tendency to tune out or drift away in the middle of a page or a conversation, often coupled with an ability to focus at times.
- Often creative, intuitive, highly intelligent
- Trouble going through established channels, following proper procedure
- Impatient; low tolerance for frustration
- Impulsive, either verbally or in action, as in impulsive spending of money, changing plans, enacting new schemes or career plans, and the like
- Tendency to worry needlessly, endlessly; tendency to scan the horizon looking for something to worry about alternating with inattention to or disregard for actual dangers
- Sense of impending doom, insecurity, alternating with high risk-taking
- Depression, especially when disengaged from a project
- Restlessness
- Tendency toward addictive behavior
- Chronic problems with self-esteem
- Inaccurate self-observation
- Family history of ADD, manic-depressive illness, depression, substance abuse, or other disorder of impulse control or mood

Question: My daughter has some of the symptoms you described, but she is a very quiet child. Are some ADD kids withdrawn and sedate?

Answer: Yes. ADD is not always associated with hyperactivity, especially in girls. Some of them are "dreamy" and detached. Regrettably, they are sometimes called "airheads".

Such a child can sit looking at a book for forty-five minutes without reading a word. One teacher told me about a girl in her class who would lose every article or clothing that wasn't hooked to her body. Nearly every day, the teacher would send this child back to the playground to retrieve her sweater or coat, only to have her return fifteen minutes later without it.

She had forgotten what she went after. A boy or girl with that kind of distractibility would find it extremely difficult, if not impossible, to get home night after night with books and assignments written down, and then to complete the work and turn it in the next morning.

Frankly, the "faraway" child worries me more than the one who is excessively active. She may be seen as a good little girl who just isn't very bright, while the troublemaker is more likely to get the help he needs. He's too irritating to ignore.

Those who are and are not hyperactive have one characteristic in common. It is distractibility. Even though they flit from one thing to another, the name attention deficit disorder is not quite on target. It's better than the old term ("minimal brain damage"), but there is also misinformation in the current designation.

The problem is not that these children have a short attention span. At times, they can become lost in something that greatly interests them to the point that they aren't aware of anything going on around them. Instead, they have an insatiable need for mental stimulation during every waking moment. The moment they become bored with what they are doing, they dash off in search of the next exciting possibility.

One father told me about his four-year-old son with ADD. He said, "If you let that kid get bored, you deserve what he's going to do to you." That applies to millions of children.

Question: Does ADD go away as children grow up?

Answer: We used to believe the problem was eliminated with the onset of puberty. That's what I was taught in graduate school. Now it is known that ADD is a lifelong condition, usually influencing behavior from the cradle to the grave.

Some ADD adults learn to be less disorganized and impulsive as they get older. They channel their energy into sports activities or professions in which they function very well. Others have trouble settling on a career or holding a job. Follow-through remains a problem as they flit from one task to another. They are particularly unsuited for desk jobs, accounting positions, or other assignments that demand attention to detail, long hours of sitting, and the ability to juggle many balls at once.

Another consequence of ADD in adolescence and adulthood is the thirst for high-risk activity. Even as children, they are accident-prone, and their parents get well acquainted with the local emergency room.

As they get older, rock climbing, bungee jumping, car racing, motorcycle riding, white-water rafting, and related activities are among their favorite activities. Adults with ADD are sometimes called "adrenaline junkies" because they are hooked on the "high" produced by the adrenaline rush associated with dangerous behavior. Others are more susceptible to drug use, alcoholism, and other addictive behaviors. Approximately 40 percent will have been arrested by eighteen years of age.

Some of those who have ADD are at higher risk for marital conflict, too. It can be very irritating to a compulsive, highly ordered husband or wife to be married to a "messie" – someone whose life is chaotic and one who forgets to pay the bills, fix the car, or keep records for income-tax reports. Such a couple usually need professional counseling to help them learn to work together and capitalize on each other's strengths.

Question: You've given us a pretty bleak picture. Is there anything good you can tell those of us who are raising an ADHD child?

Answer: There are some advantages to having attention deficit disorder. In a sense, even the word disorder is misleading because the syndrome has many positive features.

As Time reported "[ADD adults] see themselves as creative; their impulsiveness can be viewed as spontaneity; hyperactivity gives them enormous energy and drive; even their distractibility has the virtue of making them alert to changes in the environment. Kids with ADHD are wild, funny, effervescent. They have lots of life.

Let's not forget, also, that ADD can be treated successfully in many cases.

Question: We have a five-year-old son who has been diagnosed with ADD. He is really difficult to handle, and I have no idea how to manage him. I know he has a neurological problem; I don't feel right about making him obey like we do our other children. It is a big problem for us. What do you suggest?

Answer: I understand your dilemma, but I urge you to discipline your son. Every youngster needs the security of defined limits, and the ADD or ADHD boy or girl is no exception. Such a child should be held responsible for his or her behavior, although the approach may be a little different.

For example, most children can be required to sit on a chair for disciplinary reasons, whereas some very hyperactive children would not be able to remain there. Similarly, corporal punishment is sometimes ineffective with a highly excitable little bundle of electricity. As with every aspect of parenthood, disciplinary measures for the ADD child must be suited to his or her unique characteristics and needs.

This article was published with permission from Focus on the Family Malaysia. For more information, please contact:

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