What is it? What causes it? How to treat it. General Attention Deficit Disorder information
Attention Deficit Hyperactive Disorder (ADHD) has received a lot of attention in the media and amongst families and schools over the last years. Teachers talk about how difficult it is to teach children who are hyperactive, who find it difficult to focus, stay in their seats, complete class work. Children with ADHD may talk or daydream more than most children.
There is a range of opinion and beliefs regarding attention deficits. The kids who are “climbing the walls” are ADHD. Kids are active, why label them? Does not everybody have a bit of ADHD? Doctors are prescribing pills to fix everything too easily. Pharmaceutical companies are just making money off medicating children to behave. And, if parents just knew how to manage their kids, they would not have these problems.
ADD or ADHD? Attention Deficit Disorder (ADD) is without hyperactivity, for those who daydream excessively. Attention Deficit Hyperactive Disorder (ADHD) often refers to high activity levels and impulsivity. In general usage, the terms are interchanged or simply referred to as ADD.
ADD refers to a group of individuals for whom paying attention is significantly more effortful and causes more grief than for most people. ADD is a neurological wiring difference and is often found in families. Children as well as adults can suffer the consequences of ADD. Other conditions that are often connected with ADD can be social difficulties, learning difficulties, executive functioning difficulties (planning and organizing) and fine or gross motor difficulties.
Difficulty focusing on a lecture or work that involves sustained mental effort, poor attention to details, impulsivity, excessive daydreaming, being easily distracted, restless, fidgety, always in motion, loosing things easily or being poorly organized are common symptoms. These problems in turn cause significant stress for those trying to function in a classroom or at work with distractions and where concentration is necessary to do one’s best.
ADD is better called an attention management problem. The first thing parents tell me is that children who may be more active, restless, impulsive or daydream can concentrate just fine when playing computer games or doing something they are interested in. They may also be some engrossed in what they are doing they do not hear anything going on around them.
ADD is a group of symptoms whose sum interferes with ones social, academic or family life in a significant way. We may all have some symptoms, but we function and manage ourselves quite well. A good assessment by qualified psychologist is the best way to identify the presence of ADD. Currently, the DSM-IV which is the Diagnostics and Statistics Manual for identifying ADD, describe three types: Attention Deficit Disorder-Inattentive type, Attention Deficit Disorder-Hyperactive Impulsive type and Attention Deficit Disorder-Combined type.
Research consistently shows that the best interventions for those with ADD are a combination of workplace or classroom supports in conjunction with medication. Although medication is often a last resort and not one that most families welcome; the relief, the ability to complete tasks on time, increase academic and social competence, the end of always being in trouble or late, and the increasing confidence and feelings of being normal, are worth it.
The adults I have worked with reflect on the thrill of finally feeling normal, regret they were nor helped earlier in school and the unfairness of the enormous stress and energy used to cope, with simple tasks like completing homework or getting ready to go somewhere, without medication.
For school aged children, classroom strategies are put into place first. When they fail to be enough to support the child adequately and the child is now demonstrating significant academic interference, social pain, or the compounding side effects of peer and teacher frustration, an assessment is completed. A child psychiatrist may then be recommended for a consultation to learn more about what can be done, answer questions, and explore options. If medication is chosen, adequate follow up is important, as all children are different. Different medications may need to be tried before the right match is achieved.
What causes ADD? Multiple studies have been conducted to discover the cause of the disorder. Research clearly indicates ADD tends to run in families and the patterns of transmission are largely genetic. Other factors may contribute to the development of ADD such as low birth weight, prenatal maternal smoking, and toxins such as lead or additional prenatal complications. Some research shows that children under severe stress during developmental years can develop ADD.
Is ADD a long-term condition? ADD persists through adolescence to adulthood in the majority of cases, although the motor activity tends to diminish with puberty and replaced with restlessness. Adults tend to have learned coping strategies and compensate. A key to a good outcome is early identification and treatment.
Children with ADD are at risk for academic underachievement, problems in social relations, risk for antisocial behavior patterns, self-medication, teen pregnancy and adverse driving consequences. Adults often feel like underachievers, struggle with work demands, confidence, organization and relationships.
Those with ADD are under constant stress trying to manage their inattentive minds. Imagine all day putting effort into staying on task, when your brain keeps pulling you away. Trying and re trying to sustain your attention while listening, always feeling hopelessly unorganized and foolishly inadequate with things that for others seem to come naturally. Trying to remember something but any small interference distracts your attention and you loose what you are trying to remember. Waiting in lines, taking turns and staying seated are more annoying than for most people. Feeling impatient and bored when someone is giving instructions and directions and then missing the information you wanted! Always loosing your pencils, books, coats, gloves, wallet and important papers. Daily stressors build and create a sense of inadequacy, lost confidence and underachievement.
What is multi-modal treatment? Multi-modal treatments are the most effective way to deal with ADD. This means more than one treatment. The most effective to date have been classroom accommodations and interventions in conjunction with medication. Each alone is less effective. The most common classroom treatments are: Reminders, shortened tasks, immediate and consistent consequences and rewards, movement allowances, individualized instructions, seating proximity, organizational support, and positive attitude.
What medications are used to treat ADD? There are currently 20 different types of medications on the market just for ADD. The most common is Ritalin. Basically, the medication stimulates the focus center of the brain to improve concentration. The medication works quickly often within 20 minutes and last from 3 hours to all day depending on the type of medication. It is important to follow –up regularly to make sure the medication is effective, to modify they type of medication if needed or to discontinue.
What are the side effects? Main side effects sleep problems and appetite loss. The side effects usually go away after a few weeks. Any medication has side effects. Doctors, parents and those with ADD must determine if the risks of medication outweigh the benefits to academics, social life, confidence and self-esteem. For one out of five, medication does not help at all.
Won’t medication cause drug dependency? No, in fact the opposite is true. Children without proper treatment may seek to self medicate with substances that are addictive. Research has shown that 30% of untreated children with ADD go on to develop substance abuse difficulties. Common self-medication substances are coffee, colas, energy drinks, pot and cocaine. Ritalin is not addictive. Remember, treating ADD is like having glasses for improving sight or insulin for improving sugar balance in the blood. Medicine helps the body do what it should do naturally, focus and pay attention to salient information.
What are some natural ways to treat ADD? It has been shown that fish oils, Omega 3 especially DHA (500mg), ginko biloba, protein, meditation and exercise are helpful in reducing ADD symptoms.
Vivian Huizenga is a Canadian Licensed Educational Psychologist specializing in dyslexia and ADD working as a counselor and learning support provider at IICS.