ADHD

(Posted March 17, 2008)

In the discussion regarding ADHD and medication, there seem to be two major beliefs:  one side says ADHD doesn’t exist, it’s just an excuse for poor parenting, and “drugging” children who “don’t fit in” is a convenient way to make life easier for parents and teachers.  The other side says ADHD is a real disorder of the brain, it’s physical, and that therefore medication is as valid a part of the treatment as insulin is for diabetes.  Still others say that while ADHD may be real, that’s no excuse to drug the children, that there must be other ways to handle this, or that the children simply have to learn to accept that they are different.

The problem is that many of the symptoms of ADHD are also “symptoms” of perfectly normal children:  everyone is at times easily distracted, even normal children like to run around in circles and bounce off the walls, they don’t always pay attention, they like to be goofy and silly, they tend to interrupt, they have a hard time waiting for their turn, they blurt out inappropriate things at the most inopportune time, they kick their feet, the list goes on and on.  That’s why it is so easy for people to either claim that ADHD is not real (because it looks like “normal” behavior) and/or for people to pathologize normal behavior and treat it as a disorder in need of medical intervention (drugs, therapy, etc.).

A feature on cnn.com – young people who rock – includes Blake Taylor who has written a book on living with ADHD.   While I haven’t read the book, there were a few comments on the article that I found interesting.  Unfortunately, there’s no way I can give proper credit to the authors – the commenting system does not require real names. (I edited some of the comments for length.)

Here’s “ADD Nurse” whose comment was posted February 28th, 2008 11:35 am ET:

Okay, enough about ADD drugs – especially by people who know not of what they speak. [..]

Yes, ADHD is probably over-diagnosed in children these days […] because well-intentioned doctors are often pressured into a diagnosis by parents who lack good parenting skills or are too busy with their own lives, and are overwhelmed by a kid “being a kid” and demand that the doctor prescribe a pill to magically cure the problem for them. We are also so obsessed with our two-income lifestyles that we expect our teachers to raise our children for us while at the same time achieving unrealistic academic standards, and so they get so overwhelmed by the normal excesses of children that they have to complain about behavior problems to the parents or the school psychologist. And that’s a fact.

Children who are ACCURATELY diagnosed with ADHD through proper testing and who receive treatment by a competent doctor under the guidance of loving, nurturing and FOCUSED parents do NOT walk around in a “drug-induced haze”. They simply function like normal children – which is what we do call “just being a kid.” They get to be “just a kid”, instead of an unhappy social misfit who doesn’t understand why they don’t fit in like normal kids. And medication is just one part of effective treatment, never meant to stand alone. Many of us with ADD can eventually function quite well without medication – but the medication is a God send when you are trying to learn all the modifications you have to make to your “impulsive” behaviors in order to live and succeed like a normal person and you need all the focus and “executive function” skills you can muster from your scattered, disorganized brain.

Medication is like the difference between stumbling around in the natural dark of night – and just simply turning on an artificial light source to see where you are going. Hopefully Blake’s book with finally give the unenlightened world some much-needed insight into the frustrating and unhappy world of children who really do have ADHD.

 

 Here’s “Olivia” (February 28th, 2008 10:53 am ET)

My son is just turning 17. He does not have ADHD although his behavior in middle school certainly suggested that diagnosis. He had poor impulse control and was disruptive in class; he was clearly very bright but “not working up to his potential”. He had friends, though, loads of them and did not display this behavior at home. We were thoroughly confused.

Comprehensive testing showed that, while not ADD or ADHD, he did have a Learning Disability — slow processing speed and some other executive functioning problems. He would NEVER be able to do arithmetic operations no matter how hard he tried. He would never be able to write at length longhand or to do well on a timed test. Without a clear diagnosis, he did not qualify for an IEP but he did (and does) qualify for “accommodations” under the Americans with Disabilities Act. Immediately, life changed at school: he was allowed to use a calculator for all computation, was allowed to use a note taking device at school and a word processor for homework and tests, and was granted extra time on exams. Within a month the disruptive behavior stopped. Turns out, he was being driven round the bend at school by his own inability to succeed no matter how hard he worked. He knew he worked as hard as the other kids, he knew he was as bright as his peers — but when he worked and worked and worked, often nothing came of it. His frustration and humiliation was causing the acting out. Once he had the accommodations in place and had learned to accept his need for them, the world opened up for him. He could work hard and succeed.

Now, for a child with ADHD, life is harder than for my son. ADHD does not turn itself off when a child leaves school. ADHD is on all the time. If you suspect or your child’s teacher or doctor suspects that your child has ADD or ADHD, do NOT allow your kid’s doctor to put him or her on meds because of observed behavior. Insist on having the child tested by a psychologist trained and licensed to do a full Psycho-educational work-up. (Don’t be put off by the bother — the test itself is a long process, 6-8 hours ,and you may need to fight for your school system to have the testing done. But legally, they must provide this testing and any accommodations the testing suggests.) If the diagnosis is ADHD, then consider the alternatives. Medication is one and may be the one you choose but perhaps careful behavior training may help enough to keep the child off meds with their associated side-effects, but “disciplining “your kids (i.e. I think that means punishing them) to “to get them to concentrate” or to stop being messy or to stop blurting things out in school or church is not the solution, ever. You would not put a child with a broken leg in time out for hobbling instead of sprinting, nor spank a blind child for failing to hit the bull’s eye in target practice.

Learning Disabilities, whether ADHD or not, need to be attended to. They are a fact of your child’s life. Working with a good psychologist and insisting on proper testing can help to avoid medicating a child who is merely “spirited” or a child like my son whose disability is caused by a “wiring problems” in the brain but not the kind that can be helped with meds. Diagnosis and then acceptance of the diagnosed condition is the key to success –for Blake, for my son — for your child, too, I hope.

 

“Mike Nichols” (February 28th, 2008 3:35 pm ET)

I am now 60. When I was young, there was no name nor diagnosis for ADHD. Sometimes people refer to A.D.D. and A.D.H.D. with the former being less hyperactive than the latter, and that describes me.

I set fire to my grandfather’s house, the haystack in the back of my babysitter’s house and other weird things–just acting before I ever thought. I was always in trouble in school. The world’s solution to my activities and lifestyle was to beat me. I have received hundreds of spankings and pure beatings with a board.

I was usually bored in school, though quite bright. Example: In the 6th grade we got the Iowa Basic Skills Tests and I beat the whole school. My reward was being sent to the principal’s office and chewed out for being a ’slacker’ most of the time. I excelled in ANYTHING that was particularly interesting to me–notably math, science and English. In high school I took the SAT test and beat the whole school and got advanced placement out of college English while failing senior English. My reward? The English teacher never spoke to me again. The beatings never ceased until I graduated.

A.D.D. people are most easily identified, I believe, by their incessant interrupting of others. It’s because their mind races ahead and is easily distracted, but they know from experience that if they don’t say something, then something else will seize upon their mind and they will forget what they meant to say—which they have incorrectly surmised that everyone else in the room is dying to hear.

I only recently learned that A.D.D. is not really abnormal, but simply another way of life. No matter how much I have learned about it, however, I have not been able to defeat it; it slips up upon me unawares most of the time. I am also dyslexic somewhat.

I am compulsive/obsessive and if the subject is interesting, then I learn it faster than anyone and retain nearly everything, but if I don’t like the subject, then it is hopeless.

The net effect has been that I have taught myself most things in life by personal study, as I don’t follow instructions well. But I’m reasonably well adjusted and have a great family with 2 kids. (and grandchildren, which are God’s greatest prize)

Thanks, Mike Nichols

“Rob” (February 28th, 2008 12:22 pm ET)

I agree with ADD nurse. I am the father of two wonderful young boys. My 8-year-old son has been living with ADHD since age 4 and I’ve got to be honest here – I am so sick and tired of people who say, “get over it. They’re just a hyper kid. Don’t drug your children. ADHD is not real. Blah blah blah.” I want to make something perfectly clear. ADHD is a VERY real condition. My 5-year-son is a hyperactive kid, but he’s obviously not ADHD. He’s just a boy.

There is a distinct difference between run-of-the-mill hyperactivity and attention deficit hyperactivity disorder. The medication I give my ADHD child does not put him in a daze or turn him into a zombie. It simply allows his brain to process stimuli a little better before acting (i.e.: thinking about looking for cars before running out into the street chasing a ball). Without his medication, he may very well go after that ball without noticing the car barreling down the street toward him. If you have a ADHD child, you know exactly what I’m talking about.

A few ’specific’ rebuttals:

[…] John: What you describe as symptoms of ADHD (being bored, getting work done before everyone else) do not ring of ADHD to me. My son, without his medication, is practically incapable of doing schoolwork at all. Why? Because his mind is unable to focus on any one thing for an extended period of time. With his meds, he can ‘dial in’ and actually keep up with the rest of his class. I find your assertion that treating my son’s illness with medication will make him a drug addict terribly offensive. My son also takes medication for his asthma. Should I discontinue that line of treatment as well? […]

 

There are many helpful resources out there, online, books, videos, etc.  Here are three of my favorites (they all cover more than ADHD):

All Kinds of Minds (by Mel Levine) which, according to their mission statement, is “a non-profit Institute that helps students who struggle with learning measurably improve their success in school and life by providing programs that integrate educational, scientific, and clinical expertise.  [Their] unique philosophy and methods emphasize[s] team collaboration by parents, students, educators, and clinicians to better understand and nurture children’s individual learning profiles of strengths and weaknesses.”   You can get the book by the same title here.

How Difficult Can this Be? – a PBS video by Richard Lavoie, plus an excellent article that summarizes How Difficult Can This Be?  “This unique program allows viewers to experience the same frustration, anxiety and tension that children with learning disabilities face in their daily lives.”  Your local library most likely has a copy of the video (and if they don’t, they need to get it), or you can purchase it here

The Challenging Child – Understanding, Raising and Enjoying the Five “Difficult” Types of Children – a book by Stanley I. Greenspan. 

All three of these resources stress that it is not enough to recognize, diagnose the children, but that a (correct!) diagnosis is only the beginning, and never an excuse.  They give very specific examples and instructions, explanations.  All three also not only admit but emphasize that it is hard work, it won’t come easy, but it is so worth it.

For adults who recognize in themselves certain ADHD tendencies, there’s a book, Shadow Syndromes: The Mild Forms of Major Mental Disorders That Sabotage Us, which investigates how even a mild form of, in our case, ADHD can affect your daily life.  While I don’t like that they are awfully quick to recommend medication, Prozac in particular, for just about everything, I do think that the book has the potential to be eye-opening. 

  

 

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