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Paying attention to attention deficit disorder

By Michael Ceo



For children struggling with attention deficit disorder, a common learning disability, as well as their families, teachers, physicians and friends, ADD can be a source of enormous frustration and anguish.


People with ADD have difficulty focusing attention and completing tasks. They are easily distracted, seem scattered and disorganized, and are somewhat impulsive. The dilemma of attention deficit disorder is a pervasive experience of failing at tasks but feeling powerless to fix it. Without treatment, this chronic helplessness and inability to measure up can lead to anxiety and depression.


To understand this disorder, I turned to Dr. Toby Behrmann, a local clinical psychologist who specializes in diagnosing and treating ADD. He emphasized that the disorder involves difficulties processing information and is distinct from one's intelligence. Very smart people can struggle with ADD.


"While IQ measures the level of complexity of someone's thinking, people with ADD have trouble absorbing information or staying on task," Dr. Behrmann said.


ADD is seen as a "soft" neurological disorder that involves the functioning of the brain, unlike other structural neurological disorders that may show up on a CAT scan. Since the neurons that make up the brain do not develop until age 8, ADD cannot be accurately diagnosed until then. Dr. Behrmann added that distraction in children may also be caused by anxiety or agitated depression, so it would be important to rule out these possibilities in making a diagnosis.


A key question to ask is whether a child is mastering the tasks of everyday life that are appropriate to his/her age, specifically in the activities of home, school, chores and friendship. If a child is successful and there is ADD, there need not be urgency.


Since attention deficit disorder is a relatively recent diagnosis, it has been the source of considerable controversy and confusion especially for teachers and parents.


The disorder has likely been around forever, but since our workforce and society has generated ever-increasing expectations for people to be educated, work in teams, be self-motivated and detail oriented, there is more attention being given to attention deficit. Perhaps in past generations, people with ADD simply worked in manual trades with close supervision where such higher order mental functioning was not as crucial to get by as it is today.


What causes ADD? According to Dr. Behrmann, 10-20 percent of ADD may be caused by birth trauma, food sensitivities or environmental factors, but it is mostly genetic much like any other trait. One third of suspected ADD cases simply resolve themselves by the time a child reaches adolescence.


To learn more about clinical studies about the effects of and treatments for ADD, I turned to another local child psychologist, Dr. Robert Verdile.


He explained that when the active functioning of the brain is examined during a research procedure called a PET scan, people with ADD show differences. Normally when solving a problem, the entire brain is engaged in an activity. But when the brains of people with ADD are examined, only the sections of the brain involved with the problem "light up." This difference may explain why the medications for ADD work so well because they stimulate activity of the whole brain. Two of the medicines are short-acting stimulants called Ritalin and Concerta. Much like eyeglasses, said Dr. Verdile, medication for ADD is not curative but helps people function better.


In another study that evaluated the effectiveness of various treatments for ADD -- including behavior management, parent training, counseling, special education and medication -- the outcome proved conclusive. It turned out that careful medication was most effective in improving functioning while other treatments helped indirectly.


Clearly, understanding, knowledge and awareness of ADD need to be brought to bear if you suspect this condition either in a child or an adult. If so, talk over your observations with a physician or mental health professional.



If you suspect ADD in your child:


  1. Give your child one thing to do and have him/her report back to you when the task is completed. For example, ask the child to take clothes out of the laundry basket and put them in the washer.


  1. If your child accomplishes this task, try to make it more complicated by adding a second or third step to it. Help the child organize by printing out on separate cards or making a simple list of two or three steps that the child needs to follow, with the final step reporting back to you. The child can carry the cards or list with him or her.


  1. Next, review each task on the cards or list and determine if it was completed.


  1. Observe what happened. If the tasks were not completed, what specifically took place? Did the child go off and chase the cat or start playing in the middle of the list? The results of this exercise can help a mental health practitioner determine if ADD or another learning disorder is present.