I have been reading a wonderful book, DRIVEN TO DISTRACTION: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood by Edward M. Hallowell, M.D., and John Ratey. M.D. Attention Deficit Disorder is a concern for
anyone teaching, studying to become an educator or professional in the human service, or working in religious education in a parish.
This book brings to a general trade audience wisdom gained from peer-reviewed studies and research. Unlike some books on this topic, there is no ax to grind or ideology to defend. The authors have expertise in both the medical, cognitive, and
behavioral treatment of this problem. Much of the attention has looked at boys with ADD; their antics can test the patience of teacher, parent, or saint. Many think boys are overdiagnosed with this disorder. However, girls and adults may be
underdiagnosed. The authors offer screening tests and DSM IV criteria for ADD. These can be used as a first step and are obviously not valid for diagnosis.
There are helpful chapters on how ADD enters a family or a marriage and whose presence reverberates around all relationships. This knowledge forms a basis for connecting the person with ADD back into meaningful relationships with those who
can offer great support--if the problem is acknowledged, diagnosed, and talked about.
I discovered great wisdom in the chapter that teaches us how to discern the presence of ADD with anxiety, depression, substance abuse, borderline states, and family problems. Are these different manifestations of ADD + another condition or are there many different and unique disorders? Perhaps brain imaging studies and further research and understanding will lead to new categorizations in DSM V and VI.
There are 50 tips on how to manage ADD--each helpful and practical. I especially like this one: "Recharge your batteries. Related to number 30, most adults with ADD need, on a daily basis some time to waste without feeling guilty about it. One guilt-free way to conceptualize it is to call it time to recharge your batteries. Take a nap, watch TV, meditate. Something calm, restful, at ease." (p. 250). Those without ADD may find many of the approaches helpful!
For parents and teachers, there is a section on 50 classroom management tips. This chapter would be especially helpful to therapists who consult in schools. Is there a genetic link to ADD? Is it present at birth? Is is strictly a neurological disease? How do small environments or even the environment of our culture itself magnify or even cause the problem? All of these topics are examined in a classic book that will find a place in homes, schools, clinical centers, and parishes.
William Van Ornum
One point that I found very interesting in your article was the idea that boys may be over diagnosed with ADD, while girls are under diagnosed. I have heard this said before in one of my classes where we were talking about ADD. Some people think that just because young boys are usually more outgoing and outspoken compared to girls who are reserved and quiet, that they must have ADD, because they cannot sit in their seat for long. This is a very scary situation, and it clearly shows that we need to run more studies and research on ADD. Children should not be given medication for ADD if they might not have it.
Ever since she was little, everything seemed to be more difficult for her. She could never concentrate. She would have random temper tantrums in class when frustrated. She was seemingly unable to control her emotions. Because of these issues, it was more difficult for her to both excel academically and fit in socially.
Her uncontrollable behavior made her the subject of different forms of bullying by peers. Despite attending fairly accepting elementary and high schools, she was secretly ridiculed by people who did not understand her. I was always there to help and protect her, but I could not change her or how the world viewed her.
She was on medication to help her regulate her ADHD throughout childhood, but stopped by the end of high school. Her parents had opposing viewpoints towards the use of prescription drugs, a conflict which still lingers between them today.
I know there is a never-ending debate about whether medication should be used to treat ADHD and related disorders. Whatever your viewpoint, I ask that you remain considerate of people with these disorders. Many of you mentioned that you plan on becoming future teachers. As educators, please strive to educate others on this prevalent issue and be personally accepting of those individuals who struggle this way. It will be easy to become frustrated and place blame on those who make classroom management difficult. Try to look past that, as your students with these disorders could be the brightest and most beautiful people in your class.
As a side note, thank you very much for the book recommendation. I am happy to hear that so many people are interested in reading it and learning more about these disorders.
- Amanda P.
It is apparent in a few friends that I have, that their ADD sometimes gets the best of them, and is hard to control for them without medication. I can tell if a friend forgot to take their medication because during conversation, they would abruptly change topic or lose train or thought, or steer into a different subject. The quote I love from the article, "Recharge your batteries. Related to number 30, most adults with ADD need, on a daily basis some time to waste without feeling guilty about it. One guilt-free way to conceptualize it is to call it time to recharge your batteries. Take a nap, watch TV, meditate. Something calm, restful, at ease." (p. 250), is a good tip for anyone who suffers from ADD or ADHD. That tip even works for me sometimes. If ever I feel that I can’t focus or concentrate, it isn’t because I think I have ADD or ADHD, but it is because I am overwhelmed and need to relax and take a break in order to let my mind breathe instead of go crazy due to endless amounts of school or work I have sometimes. I believe that if a child is diagnosed early with ADHD or ADD, prescribing medication at such an early age can lead to an abuse of drugs or a dependency later on in life. I think doctors and psychiatrists should try their best to detect such a disorder early in life, but instead of turning to prescription drugs to “fix” it, focus on techniques to help a child direct their attention more, or listen more carefully, encourage and show them how to eliminate distractions when trying to concentrate on school work, or solving a puzzle, etc.
Secondly, I have a friend who has been diagnosed with ADD so when I read this article, i thought it would be interesting to talk with her about it so i get it from a first hand source. She is a side of a twin. She told me a story that occurred before she was diagnosed. While growing up, she always did better than her brother academically. Her mother said she thought her son may have had a learning disability which she later found out to be ADD. He had a hard time focusing and concentrationg so working under time constraints (timed tests) was always one of his weaknesses. After he was diagnosed, the psychologist asked of her progression but her mother brushed it off. Her mother said she never had a problem with her daughter even after the doctor explained the strong genetic relationship. Her mother continued to brush it off.
In her freshman year of college, my friend realized that she wasnt doing well as her friends even though they were taking the same classes. She started struggling with tests and realized that she was possibly experiencing the same thing that her brother was experiencing. She spoke to her mother about it and a counselor from special services and was diagnosed in the beginning of her sophomore year in college. She might now have to take an extra year to make up for the classes that she failed in her freshmane year.
Her stroy taught me alot in relation to this blog. One thing it confirmed was the strong genetic trait of ADD. As kayna mentioned, ADD is almost as genetic as height! Secondly, it draws me to the conclusion that boys could be diagnosed more due to a social issue. In this case, it seemed as if my friends mother didnt want her daughter to be diagnosed but was fine with her son being diagnosed. Another thing i learned from her story was that ADD can take a long period of time to be diagnosed, not because it is not a active trait but becuase people tend to brush it off anfd place their lack of concentration or focus on external factors
Thanks for bringing up the topic.
Thanks for your response. ADD and many other conditions are truly a cross and hopefully we can raise awareness here about this. I've worked with many people with ADD and this book captures what it really is like. (ADD/ADHD can often be confused with other conditions and some doubt its existence, and this sometimes creates even more problems for someone who suffers from it or for parents or a family. Your phrase "verbal hopscoth" to me captures what can happen in ADD. By the way, I have been reading your posts on the other blogs and am glad that your are among the contributors in some of the difficult discussions going on. amdg, bill
From what you have written on the book, I am inspired to read it and possibly purchase it for my classroom someday. There are so many misconceptions and misunderstandings about ADHD, hopefully this book can help to combat those.
I did a project on ADHD when I was taking the Exceptional Child, and I found many articles on the misdiagnosis of ADHD. I was just reading another article about how there are many children who are misdiagnosed with ADHD. The title of the article even states that there is the potential for about one million children in the United States alone to be misdiagnosed with ADHD. That is very scary because children with ADHD take medication to control it, but what if a child is misdiagnosed? The article says it does not know the long term effects of the drugs being used to treat ADHD, so what would happen if a child was just taking this medication even if he or she didn't need it and it harmed them? Like the psychiatrist who met with his patient for 15 minutes to change the patient's prescription, I think more time needs to be taken when working with children who potentially have ADHD in order to make sure that they will not be misdiagnosed.
http://www.sciencedaily.com/releases/2010/08/100817103342.htm
it's especially sad when a young woman is not diagnosed until college or even afterwards. One of the interesting and frustrating things I have learned about ADHD is that is it both OVERDIAGNOSED and UNDERDIAGNOSED at the same time. And sadly there ate persons who misrepresent themselves as having ADHD (read: fake) in order to get access to psychostimulant drugs. Thanks for the good points youd made. bvo
As my fieldwork experiences began in elementary schools, I came across more and more students with this disorder. Although at times, it was obvious that these particular students functioned differently, at others it was impossible to notice a difference between their behavior and that of other’s. I have caught on to several tips that, according to teachers, make all the difference.
For example, I have learned that the physical setup of the classroom is an important aspect when dealing with a child with ADD. The student should be seated away from doors, windows, and even other loud peers. He/she should be seated towards the front of the classroom where the teacher can easily prompt the child to say on task. Students with ADD should also be given breaks throughout the day. Any child that is forced to sit at a desk with no intermission would become antsy; and this is even truer when it comes to children with this disorder. Increased movement and physical activity will help the student stay on task throughout the day. This activity can be as simple as having the child run an errand for the teacher, or even putting away materials. It will help portray to the child appropriate ways and appropriate times to move around.
In addition, I have observed the importance of a strict behavior plan when dealing with students with ADD. According to an article from HelpGuide.org, children with Attention Deficit Disorder need “structure and clear expectations in order to keep their symptoms in check,” and behavior plans do just that. These plans will help students work on specific goals by providing them with positive reinforcement and direct feedback.
However, like the article shows, effects of ADD do not stop at the classroom door. It is a disease that strongly impacts all aspects of life: from family to relationships to jobs. However, where does this disease come from? In the past, some have felt that ADD is a result of poor parenting. However, scientists have done studies and brain imaging which have helped show that ADD does have a genetic factor. For example, Anita Thapar, a professor of psychiatry at Cardiff University, scanned the gene maps of more than 1,400 children. She and her team found that those with ADD were more likely than others to have small chunks of their DNA duplicated or missing (Kelland, 2010).
Article link: http://helpguide.org/mental/adhd_add_teaching_strategies.htm
While researching the topic a little further I found an interesting research study that was conducted. These authors had found that much of the research in the past 40 years suspected “that ADHD is largely an American disorder and is much less prevalent elsewhere. This impression was reinforced by the perception that ADHD may stem from social and cultural factors that are most common in American society.” (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525089/) There research found that this was untrue children in numerous different countries were affected by ADHD. The authors believe that the recognition of this idea could greatly increase the psychiatric care of children. I feel that ADHD may not be a product of the individual’s social and cultural environment but that may account for some of the under diagnosis and over diagnosis which occurs today. By finding out it is not solely an American disorder may give a little more understanding to society.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525089/
Their experiences further my belief that girls get under diagnosed for ADHD even more. If my two friends got all the way to high school without being diagnosed there is an obvious flaw in the system when it comes to referring girls who don’t show the hyperactive or impulsive sides of ADHD for an evaluation. This may just be because it is hard to recognize in girls. According to an article I read, the usual signs include things like “inattentiveness, poor school performance, and depressive affect” these things “elicit less attention from teachers and parents than characteristic ADHD symptoms seen in boys, such as disruptive behavior and acting out.”(Slovak, 2008, p.12) The symptoms that girls display are a lot less noticeable and don’t cause as much trouble to the teacher and parents alike. For example “teacher based reports indicated that boys with ADHD display more classroom symptoms of inattention than girls with ADHD.” (Slovak, 2008, p.12) Overall I believe that parents and teachers should be more aware and attune to girls who may be struggling in school and who seem inattentive at times. Although it may not be ADHD, the earlier a student gets diagnosed the earlier they can get help to succeed.
Slovak, J.A. (2008). Identification and classroom strategies for girls with attention deficit hyperactivity disorder: development of a handbook for teachers (Dissertation ), Retrieved from http://books.google.com/books?id=32rUzaGOmHAC&printsec=frontcover#v=onepage&q&f=false
I am happy to see that you have posted this article! It was extrmemly interesting to read and I am drawn to this book, DRIVEN TO DISTRACTION: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood by Edward M. Hallowell, M.D., and John Ratey. M.D. It seems very fascinating to me and I am curious to continue reading the 50 tips on how to manage ADD you mentioned briefly. As a future teacher, I feel the need to read that section to earn methods to work and deal better with students who may have ADD in my classroom one day. Over the last couple of years the term ADD has truely sprung everywhere! It is a disorder that interests me and I am looking for answers as to why it is so common. It is an interesting, yet scary point that you and other make that children could be OVERDIAGNOSED. Overdiagnoses makes me think that there are children in the world who are taking medicine for something they do not have, which is awful.
I enjoyed reading about recharging your batteries. I think that as a future teacher it is important to keep this in mind as well as think outside the box to other methods like can work for students in our classrooms. I know that providing a student with a bouncy ball as a chair works fabulously because I have seen in a classroom observation.
This article inspired me to do some more research on the topic of ADD and I came across this website: http://www.add.org/site/PageServer
Anyone interested in gaining more knowledge on the topic should visit. Article are provided to address many different aspects of the disorder. One that I found interesting was titled A Tale of Two Children: From School-age Struggles to Adult Success written by Emmy Fearn, M.A.
http://www.greatschools.org/special-education/support/874-from-struggles-to-success.gs?page=1
It tells the story of a brother and sister who struggled with ADD in elementary school and throughout their education but today they are striving high! One is applying to law school, while the other is a freshman studying computer science. The article states that hard work, dedication, and structured education did the trick. As a future teacher, this makes me smile because I know I can provide that for a child one day!
There was another issue mentioned, on how there are males who are over diagnosed for having ADD and females who are underdiagnosed. I feel being diagnosed with having ADD or ADHD is “simple” this day in age. I even believe some people convince themselves they have ADD/ADHD or convince their doctors they have it, due to pressures in society. My generation and even future generations have been programmed to believe school and grades are essential for success in the future. With these pressures, people feel compelled to do whatever it takes to succeed and be the best when competing with classmates. If being the best means taking prescription drugs, which will allow a person to pull an all-nighter and study for a test resulting in a better grade, people will do it. The following article discusses the use of Adderall on a college campus in order to strive for academic success. http://abcnews.go.com/Health/MindMoodNews/adderall-psychosis-suicide-college-students-abuse-study-drug/story?id=12066619
Almost every week, I encounter a fellow Marist student using these types of medications recreationally. What I have noticed is that because these students would rather do just about anything else beside study, they wait to prepare for exams or papers until the night before the due dates. That night, they pop an Adderall they purchased from a friend with an actual diagnosis of ADHD and spend the whole night completing the assignments. To them, this is ideal because they are able to complete the assignments on-time without wasting any time at the bar the nights before the due date. Clearly, this is no way to learn.
A study completed at Louisiana State University sought to determine the relationship between ADHD meds, study habits, and academic achievement of ADHD-diagnosed undergraduate students. Although the drugs reportedly helped the students who took them, they admitted to being far worse than other students at managing their time and completing assignments. Preliminary data from the student suggested that learning good study habits alone could help the students with ADHD make up for the differences in academic success.
Perhaps instead of diagnosing and prescribing, we should do more to teach students, beginning at a young age, how to study and manage their time effectively.
If you're interested in this article, here's the link: http://jad.sagepub.com/content/early/2010/07/16/1087054710371168.full.pdf+html
This article (http://www.srmhp.org/0201/adhd.html)discusses the 700% increase in the use of psychostimulant drugs since 1990. As in “Generation Rx”, the article also discusses that there is no known biological cause of the disorder, and no universally accepted method of diagnosis. In fact, symptoms of ADHD are similar to those of children who are intellectually gifted and simply bored in the classroom because they are not being challenged. Should we really be prescribing medication to our kids based on a haphazard diagnosis?
Though I agree that ADHD is an important diagnosis that can greatly change a child’s schooling experience, I also think that a more definitive diagnosis needs to be developed. The drastic increase in the amount children being medicated is cause for concern. Even when a child is properly diagnosed with ADD or ADHD, I believe that medication should not be the go-to response. Changing the learning environment and working one on one with the child should be the first response. Medication should only be used when all alternatives have failed. I think that ADHD is a disorder that must be revaluated in terms of both diagnosis and treatment.
My son is another story. His diagnosis changed over the years. At one time he was considered retarded and was in the educable retarded classrooms. The school and psychologist determined he was ADHD and should be in that type of classroom. His schooling was a nightmare, no matter how much advocacy I did on his behalf. He was in 9 different schools as his program kept moving around. He was eventually dx as autistic and when he was 28 he had his first psychotic break . So he is dually diagnosed as autistic and schizophrenic. He had worked in supported employment for many years, but hasn't worked now for 2 years and is home all day. Pacing and saying: "Hi mom, how are you?" at least 100 times a day.
Having a child or children with disabilities of any kind is profoundly difficult and places great stress on marriages, especially if the marriage is wobbly to begin with. The stress manifests itself in parents who have stress related diseases and die at young ages. Divorce is common. My best friends in the network have died. My social life is restricted and I depend on my friends" understanding and patience. I never entertain company, other than my family, at home. My childrens" very peculiar behaviors are off-putting and some friends are afraid of someone with schizophrenia. While I am so accustomed to the unusual behaviors, they dont phase me, they make some people uncomfortable. I think some of this discomfort may be changing in people of my generation as they have grandchildren with disabilities. Another hard thing to deal with is the criticism of family and friends of one's parenting skills. Then there were some in the field who called mothers of autistic childfren, "ice-box mothers". I am more of an "earth mother" myself :-)
Case in point: A pediatrician diagnosed our daughter with ADHD four years ago and prescribed medication for her. But it didn't work all that well, and we had to deal with side effects like sleeplessness, anxiety, and irritability-not to mention social awkwardness. The doctor insisted that it was because my wife and I were not doing a good enough job raising her, which only added to our stress and concern. And still our little girl was falling behind in school and finding it harder and harder to make friends.
It wasn't until her younger brother was diagnosed with autism two years later that we began to suspect that something else may be going on. Sure enough, a couple of visits to a clinical psychologist resulted in a diagnosis of asperger syndrome. It seems that the pediatrician, because she was so accustomed to writing prescriptions for ADHD medication, completely missed the other signs.
Our girl is doing much better now that we have a more comprehensive plan in place that is helping her cope with the challenges of life on the autism spectrum. As for those two years of misdiagnosis-well, let's just say that we learned a lot!
So yes, ADHD is overdiagnosed, even in girls. It's tempting to go with the easy answer. But it's not always the right answer.
I especially found it interesting that people are often misdiagnosed with ADD. Goldman, Genel, Bezman, and Slanetz (1998) found that the disorder is often ''diagnosed inappropriately at times because of failure to do a thorough enough evaluation or to use established diagnostic criteria.'' While their research may be a little outdated now, this is still a very current problem. This only further stresses the importance of psychiatrists getting to know patients as discussed in your previous blog on the mental health care system today. It is imperative that we take our time in assessing individuals in order to fully help them, even if this means getting by on less pay.
Article: http://www.hkcss.org.hk/rh/rpp/HKPaediatricSociety20050630DxRx_ADHD_Council%20Report_JAMA_1998.pdf
Also I think an interesting fact about ADHD is that these children (or adults) have trouble focusing. Many times it is assumed that they cannot focus on anything but in reality they are focusing on everything and that is why it is difficult for them to concentrate on one thing at a time.
Some years ago, before my son's first breakdown, my children were studied by a dysmorphologist, Dr. Marilyn Jones. Dr. Jones determined that their condition was genetic. Their father and I were unable to pinpoint who in our families may have had these disabilities as two branches of the families were largely unknown.
Bill, thank you for your post and bringing this important subject up for discussion. I find the comments and perspective of the students to be very interesting and helpful.
Leo, Thank you for the kind wishes. I send you blessings too as your family meets the challenges ahead . Our Faith is a great support in carrying our crosses. Janice
I understand that many people may experience the symptoms of ADD, but maybe there is another cause for such behaviors. According to Generation Rx, diagnosing ADD in children is a very profitable thing for drug companies. Think about it. It starts a child on a drug that they will be hooked on for life, ultimately determining who they will be as a person, before they really even have a chance to grow up to find out. Also keep in mind that some people in the APA are also members of the FDA (I believe there is some clause or something somewhere that forgives this conflict of interest).
Face it, some kids are just hyper. My one neighbor is a great example of this. We were both the same age and my sister babysat for him occassionally. Let me tell you, he was off-the-wall, 100% certifiably hyperactive and what I considered to be insane at the age of 7! He pretty much bounced off the walls all day long and was a complete troublemaker. Then....he grew up. Now, he is a handsome, charming, CALM, young man. My neighbor also was able to release much of his energy through swimming and other sports. I think some people are just more energetic than others and maybe we can turn this around some how and use it to their advantage.
Maybe parents need to think of alternative ideas when it comes to engaging a "hyperactive" child, such as more interesting and hands on ways of learning. Sitting in a classroom for a long time for ANY ONE is boring and if you take a look around the room, everyone is shaking their legs. Generation Rx even acknowledges how parents can be worse than the children! If a psychiatrist does not think the child should be on Adderrall or Ritalin, some parents say, "Well, fine, I'll just find another doctor who will prescribe." I am not implying that all parents are like this, but some want to take the easy way out and will choose medication over behavioral methods. I also suspect that some of the parents want it and have their children pretend that they have ADD so that they can get prescriptions. I know that this occurs at my pharmacy. There is a woman who has the calmest children ever, yet her son is supposedly just starting on Ritalin? Yeah right. She is a huge drug addict and we suspect that she is just using his name to get the drugs.
I think that the book that you speak of sounds like it is a very informative book, but I really think that before people start talking about this, they should watch Generation Rx. It has interviews with many doctors, reporters, and even has footage of conferences where the researchers are so full of s***, they do not even know how to keep their story straight. For the Marist students reading this, talk to Dr. Dingman or Dr. Otte and I am sure they would talk to you about it.
I also agree with Lynde (#15). I was always fairly skeptical of ADD/ADHD and was hesitant to believe that people who are inattentive or hyperactive have a disorder specifically causing this. I am not saying that nothing is wrong, however, I do not believe that the problem lies simply in the fact that he or she has a brain abnormality specifically creating inattentive or hyperactive behaviors. What makes a person this way? What contributing factor/s is behind this matter?
After watching Generation Rx (which is clearly biased), my previous beliefs were solidified. I was amazed to hear how drug companies planned to target the only untouched population (children) right before ADD/ADHD sprang up and became such a popular diagnoses in the 80s. In Dr. Fred Baughman's book, The ADHD Fraud: How Psychiatry Makes "Patients" of Normal Children, he discusses how most parents are never shown blood or brain scans of their child's supposed chemical imbalance simply because there is no imbalance. There is no data supporting a chemical imbalance causing ADD/ADHD (Baughman, 2006). Through my research, I have found many different studies claiming various things about the brains of children with ADHD. One found that the hippocampus is enlarged and the prefrontal cortex is smaller than normal (unknown,2009), another claims that the
prefrontal cortex, caudate nucleus and globus pallidus are all smaller in boys with ADHD than those without ADHD (NIMH, 2009). I'm not necessarily convinced. To me, these studies are not entirely reliable considering that they all seem to find issues with different areas of the brain. This leads me to my point. Because there are so many POSSIBLE areas of the brain associated with ADD/ADHD, perhaps these children have other issues that are being hidden through symptoms such as hyperactivity, inattentiveness, impulsivity, etc.
Accordingly, I think today's society is too quick to jump the gun and say that a child showing any of these symptoms should be diagnosed with ADD/ADHD. There are so many possible explanations for these behaviors. Perhaps the child has anxieties, so he or she becomes fidgety when worried, which can be all the time if the child has an anxiety disorder. What if the child has a processing disorder in which they have trouble learning, so instead of trying to listen and gaining nothing, they tune the teacher out and daydream instead? I don't believe the girls are underdiagnosed, but the other way around. Because boys are in general more active and restless (especially young boys), they are often evaluated as being too disruptive, noisy, jumpy. Maybe the child has no backyard at home and is too often inside, so he becomes hyperactive from the buildup of energy. Maybe the student has a sensory impairment in which he/she receives too much stimulation and cannot block out distractions and focus. What if the child has a metabolic issue causing an excess of energy that the child feels the urge to release? Maybe the child has despression or is going through a difficult stage in their life that is causing them to be inattentive to matters within the classroom because they are constantly thinking or worrying? Possibly school is the only place in which the child receives attention, so any attention whether good or bad, is better than none. What if the child's brain is perfectly fine, but is developmentally delayed, so that the child needs a few extra years to mature to the level of most children his/her age? I think you get my point. I'm just throwing out examples of what CAN be the cause of a child who is very hyperactive or inattentive.
On the other hand, I also think there is another large contributor to ADHD symptoms that is not due to a physical abnormality of the brain. I believe that some people displaying these symptoms of ADHD have many insecurities. I'm sure we all know someone who is constantly seeking attention, and goes about it in the wrong types of ways. Many times someone who is very insecure, intends to cover it up by acting in opposition, seeking approval from peers. A young girl or boy may struggle with insecurities, be it from academic failure, physical appearance, or something other, and in an attempt to escape from these insecurities, they act up as the class clown being disruptive in order to make his/her peers laugh and approve of them. Attention seeking behaviors, in my opinion, most often come from people who struggle with insecurities and want to feel the approval of others.
Consequently, I don't believe that teachers, psychologists, or anyone else should assume that children have ADD/ADHD. Perhaps they should take a deeper look into what can be causing these behaviors to show up. With so many what ifs and no definite answers regarding ADD/ADHD and the brain, I feel strongly that psychologists and psychiatrists should evaluate their patients critically and try to work out underlying problems. Dr. Robert Mendelsohn MD states that, "No one has ever been able to demonstrate that drugs such as Cylert and Ritalin improve the academic performance of the children who take them" (Shirley's Wellness Cafe). If this is the case, there should not be so many students on medicine for ADD/ADHD. Yes, perhaps the child is calmer, but if they are making no learning gains, clearly there is still something blocking this knowledge acquisition other than the displayed symptoms. Hyperactivity has been addressed succesfully in many cases using behavioral and cognitive behavioral therapy(Kendall & Braswell, 1993), and I feel strongly that these remedies should be increased and stronger programs for them should be implemented since ADD/ADHD diagnoses are on the rise.
Baughman, F.A. Jr. (2006). The ADHD Fraud: How Psychiatry Makes "Patients" of Normal Children. Retrieved from http://books.google.com
Kendall, P.C. & Braswell, L. (1993). Cognitive-Behavioral Therapy For Impulsive Children Second Edition. Retrieved from http://books.google.com
http://nyp.org/enews/ADHD.html
http://www.healthyplace.com/adhd/nimh/subtle-brain-circuit-abnormalities-confirmed-in-adhd/menu-id-888/
http://www.shirleys-wellness-cafe.com/ritalin.htm#fred
After tutoring for 6 years, I worked with 2 students who have ADHD; one boy and one girl. This allowed me to experience the disorder first hand and see how it affects children of different genders in different ways.
One thing I was extremely interested in was the relationship these children had with their siblings and their parents. They seemed to be treated as inferiors and many would roll their eyes at them in frustration. I often received notes from their teachers, decribing the progress of the students and what they still needed to accomplish. What surprised me was the attitudes of the people in the students' lives. The teachers treated the students almost like they were incapable of completing the necessary work, using ADHD as an excuse.
By working with these students one-on-one I was able to understand their strengths and weaknesses and use them in my favor. Every once and a while, one of the students would get up and get a tissue, sharpen her pencil, use the bathroom, or perform some other activity that required her to get up from her seat. Her teachers acknowledged this behavior as negative, claiming the student was unable to learn if this was being done. What I actually found was that this behavior was helpful. It allowed the student to regroup her thoughts and "recharge her batteries" in a way. The same goes for the other student I worked with.
I think much more research must be done in this area and many more training programs for family members, teachers, and anyone else who has a relationship with someone who has ADHD must be created. More people need to understand that people with ADHD can still learn and that high expectations should still be set for them. Even the slightest change or accommodation can make a huge difference.
http://www.youtube.com/watch?v=xehHwkPpevk
By no means, am I implying that people do not suffer with problems associated with ADD/ADHD, but since I and others here have mentioned this movie, I figured it is worth sharing the link! Please take a look at it and explore both sides of the story. Also, the movie discusses not just ADD medication, but anti-depressants in adolescents as well.
I apologize for straying from the original topic, which was the book DRIVEN TO DISTRACTION: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood. It must be helping people, because on Amazon, 129 people gave it 5 stars. Dr. Hallowell also has a website that is worth looking at. (Check out: http://www.drhallowell.com/books/driven-to-distraction-recognizing-and-coping-with-attention-deficit-disorder-from-childhood-through-adulthood/) .
I have personally never read the book, but what makes it more valuable is the fact that these men have ADD (or if you don't believe in that, as some of you have said, they at least have suffered with the symptoms), so they know a great deal of what it is like to live life with hyperactivity, inattention, etc.
I like the advice mentioned here about making time to relax and enjoy TV, books, etc, but that shouldn't get too excessive. In fact, that is a problem. Of course, we all need time to decompress, but our society "decompresses" WAY too much. Too many children are inside playing video games instead of riding bikes or playing catch outside. Too many kids are listening to their iPods as they lay in bed doing nothing instead of running outside and playing kickball with the neighborhood children. Our energy needs to eventually come out of us some way! I suspect those are some of the kids that act up in school.
Do not get me wrong, we all need to recharge. For example, I am constantly in motion during the week with driving to school, attending classes, working, etc. I have even displayed symptoms of ADD sometimes (which I think a lot of people display in varying degrees). I noticed that if I do not exercise regularly throughout the week, I am completely scatterbrained. I misplace things, I forget to do homework assignments, I plan to walk upstairs to grab a cup of tea and end up walking downstairs with something completely different and unrelated, then I have to walk all the way back upstairs to get what I originally wanted, and the process repeats over and over.
When I exercise, though, I am on top of my game. My grades are always better and I have much more focus and drive to complete all of my assignments successfully and with high-quality. It's as if physically exercising stimulates my mind and makes things much more clear. It also teaches me time management because I have to schedule my day around when I can exercise. I have been doing this throughout most of college and it has helped me manage my life tremendously. I give this example because, as I referred to in my previous post, people who have these symptoms need to get their energy out in a physical, positive, and appropriate way.
Then, because I have accomplished everything I've needed to accomplish in a timely manner, I can "recharge my batteries" guilt free as well and sit back and watch episodes of Seinfeld and The Office. Now that is happiness, my friends:)
Thanks Dr. V for a thought-provoking, controversial, and interesting topic!
According to Dr. Theresa Cerulli ''The genetics are strong. ADD is almost as inheritable as height.'' Thus, if a child has the disorder it is more than likely that one of their parents has it as well. By being proactive in diagnosing this disorder, children may be able to socialize better with their peers and do better in school. It is important for early intervention to occur so that children do not have to struggle. This is a very important topic to discuss and we should continue to educate others on this disorder.
(2007, April 12). Genetic link has more parents being diagnosed with ADD: Experts say disorder runs in families. Retrieved from:http://www.thebostonchannel.com/r/11731794/detail.html
Although it appears that diagnosis is fairly steady around the world, I still wonder- as others have brought up- if we are mistaking kids being kids for hyperactivity. Medication is certainly necessary for some individuals to maintain focus, but I think that we should be putting more effort into changing their behavior without prescriptions before resorting to medication. It would be interesting to see if any research shows the effectiveness of medication versus behavior therapy.
Faraone, S.V., Sergeant, J., Gillberg, C., & Biederman, J. (2003). The worldwide prevalence of ADHD: is it an American condition? World Psychiatry, 2(2), 104-113. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525089/
This book sounds extremely interesting! I think it is very important for people, especially future teachers to read the book you mentioned. It is important for people to read about how people with ADD cope from childhood through adulthood. This book could be a real eye-opener to people who are unaware about ADD. Broadening people’s knowledge about this disorder will lead to fewer incorrect judgments about people with ADD. The 50 tips mentioned on how to manage ADD would be so helpful for teachers and future teachers to read. Maybe they can find some tips that they could use in the classroom to make their students with ADD feel more comfortable. The 50 classroom manageable tips would allow you to give the child with ADD the best school experience to your ability. The student's disorder is often used as an excuse to give an explanation for a student doing poorly in school. This is not okay! It is extremely possible for a student with ADD to do well in school. We, as teachers, need to try our hardest to meet the needs of all students, and stop making excuses to cover up failures.
As a future teacher, I would definitely want to get my hands on this book. As a teacher, you have to be aware of the problems your students might have. In order for them to perform at their fullest potential, it is important to be able to recognize any symptoms they might have for any behavioral problem. Learning how to deal with these problems, and hopefully fix them, would be extremely beneficial for a teacher to know before it is too late. The example that Dr. VanOrnum portrayed to us, I found very interesting. Not only does this book have insightful knowledge on how to cope with ADD for children, but for adults too. Im not saying it's good to worry when reading the symptoms of ADD and assume you have all of these sypmtoms. I am saying as a parent and teacher, if you notice a quiet child/student struggling in school, it might be wise to do a little research to see if there is anything that can be done.
However, I do believe that many parents put their children on drugs to “solve” the problem. The stories that I hear from my fieldwork of children that go on medication are numerous. Children that go on medication generally improve their grades, but their entire personality changes as they become lethargic or may seem depressed. Most parents do not want their children to seem different or odd, so some parents would rather medicate their children immediately then wait or see if the symptoms persist or get worse. Also, some parents would rather give their children a pill everyday then look for alternative solutions (like counseling, a different school setting, different exercises etc) that do not change the child’s personality or brain activity. Interestingly enough, according to an article written by Wolraich, M., Lindgren, S., Stromquist, A., Milich R., Davis C., Watson, D., (1990) it is difficult to diagnose ADD because of the varying symptoms. Also, physicians, teachers, psychologists, and parents in most cases have differing opinions on ADD and whether children should be medicated. In fact, half of all cases in their study had parents, teachers, physicians and psychologists alike taking different viewpoints on the symptoms of a particular child and whether stimulant medication would help the child. Personally, I would look for alternative methods as a future teacher to accommodate my students needs. The student would not stand out because each student would be doing work and participating in activities that suited his or her intellectual level and needs. Overall, I think that in recent times people are too quick to diagnose ADD and want an easy fix, such as medication to solve the problem, when in fact the medication in long term can possibly make the “problem” even worse or create other symptoms.
Wolraich, M., Lindgren, S., Stromquist, A., Milich R., Davis C., Watson, D., (1990) Stimulant medication used by primary care physicians in the treatment of attention deficit hyperactivity disorder. Pediatrics. 86(1), 95-101.
It is interesting how you note that ADD affects all of the relationships surrounding the individual. I have encountered many people throughout my lifetime with ADD and ADHD and it truely does affect all aspects of their lives. Whether this be socially unable to sit through a movie or conversation or at school/work when trying to complete an assignment. It is important to recognise this fact in order to help the individual and those surrounding the individual so that they can live up to their full potential. I love that there are useful tips on how to manage ADD and how those without ADD can use these tips too. Being able to do these activities together (people with and without ADD) will allow people to strengthen relationships. Being that I am currently studying education, I am interested to read more about the section in the book that explains 50 classroom management tips.
The best way to view, treat, and live with ADD or ADHD is to become educated. However, information on the subject can be as jaded as the controversy surrounding it. One effective article that does cover the many facets of the condition is http://www.metrowestdailynews.com/lifestyle/health/x617855106/Over-the-Counter-Nutrition-key-for-kids-with-ADD-ADHD . The major point of view is that of a nutritionist but does provide refreshingly unbiased, conspiracy free, and straightforward information that is readily usable.
Many people wonder, as I do, where does this disorder stem from? Is it genetic or environmental? Do we over diagnose individuals with ADD? Should we medicate those who we believe have this disorder? Is there something that can be done to prevent Attention Deficit Disorder? So many questions but so little answers exist.
The issue of ADD has always been of interest to me. I have known many people who have been diagnosed with Attention Deficit Disorder, and more recently Attention Deficit Hyperactivity Disorder. Some of these people I believe are accurately diagnosed, while others I tend to question the diagnosis, which causes fear within me because these individuals are being medicated. What if they are misdiagnosed and taking a medication that is not needed? In the past three years of my college career I have done many hours of fieldwork in elementary school classrooms. One year I was placed in a special education classroom and my concern about ADD heightened after this experience. There were only seven students in this classroom, several diagnosed with ADD, only at the average age of seven. I observed the students closely and found that one little boy, who I was told had ADD would finish his work several minutes early and would sit at his desk after completing the task. During the time he waited for the other students to complete their work, this little boy would sit there, not moving much and very somber. It made me question his diagnosis. Could this little boy at the age of seven really have ADD? He did not show many symptoms. I began to believe that this boy was misdiagnosed and was being deprived of an education, where instead of sitting around waiting he could be challenged to advance his knowledge. It saddened me to think that this boy was being misdiagnosed and I could only hope that he was not being medicated for this diagnosis. It also made me think about the sever effects that a misdiagnosis could have on a child, such as the case with this little boy who was being deprived of a more rigorous education that could further his knowledge. Although this frustrated me, what saddened me more was the teacher’s lack of patients for these students. As an educator of special education it is important to remember that these students have a disorder in which they cannot control and demonstrate behaviors that other students normally would not. In such situations it is important for the educator to have patients for these children to avoid frustration and instead try to scaffold the student in expanding his or her knowledge. Although I felt much frustration towards what was going on in that classroom, I learned much about how the environment affects students with ADD. The teacher explained to me that it is important to eliminate as many distractions as possible, therefore a child that is diagnosed with ADD should be placed in a small class size of no more than ten students, should never be placed near a window or a door, should be placed towards the front of the classroom, and the seating area should be designated away from centers and isolated to one section of the room, all of which made perfect sense and seemed to be a reasonable solution.
As I observed this classroom and many more, it became evident to me that environment has a huge role on ADD, however, that does not mean that I am ruling out the effects of genetics. As E.H. Cook and his colleagues had written through the article, Assoiation of Attention-Deficit Disorder and the dopamine transporter gene, “Attention-Deficit Hyperactivity Disorder has been shown to be familial and heritable.” The response of ADHD patients to medications that inhibit the dopamine transporter led Cook and his colleagues to consider the dopamine transporter as a primary candidate gene for ADHD. Research has proven that indeed ADD and ADHD can be linked to genetics as well as environmental, however, there has not been enough proof to solve the issue and research is still being conducted.
I strongly believe that ADD is at times over-diagnosed and at too young of an age. In addition, as a college student it has become more evident that students are being diagnosed for a disorder in which they do not possess. First, when a child, especially a young boy, is diagnosed at a very young age with ADD it leads me to question the diagnosis. When we were young children at the age of seven was it not normal to have extreme energy, to want to run around and never take a break? Of course, this was normal. The diagnosis of high energy and constant movement used to be called, being a child; however, that diagnosis is now being classified as ADD. We are no longer allowing children to be children and are instead diagnosing them and medicating them to provide a lower energy level, which at a young age is perfectly normal. Also, as a college student, I am aware of many fellow students who are “diagnosed with ADD.” Is it possible that so many college students developed this disorder and need to be medicated, or are students able to receive medication through manipulation?
As mentioned in the article there is a section in the book on 50 classroom management tips that is expressed would be especially helpful to therapists who consult schools. As I am very interested in school psychology I became even more interested in reading this book, especially this section. I plan on purchasing this book and reading about ADD in order to educate myself further on recognizing and coping with Attention Deficit Disorder from childhood through adulthood.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1801209/
I found an article that said that children could be misdiagnosed with ADHD for another reason. They say that “children who are young for their grade may get an inappropriate diagnosis because teachers mistake their immaturity for ADHD” (CNN Health). The studies say that “being young in a grade more than doubles the likelihood of receiving an ADHD diagnosis or treatment” (CNN Health). This made me think that maybe maturity level could have to do with boys being overdiagnosed with ADD/ADHD because boys are supposed to mature slower than girls.
You also mentioned that people think that girls are underdiagnosed. I can understand way this is, too. Many times girls are not the ones who are loud and act out in class. For this reason, girls with ADD/ADHD may not be diagnosed with it if they do not act this way. I found out that there are gender differences in ADHD. Girls have different symptoms than boys, so their ADHD can go unnoticed. For example, “Girls with ADHD aren’t usually hyperactive…they tend to have the attention-deficit part of the disorder” (apa.org). Since hyperactivity is pretty obvious, boys can be diagnosed more often.
I think overdiagnosing ADD/ADHD is a serious problem. Children should not be given medication unless they really need it. I have never been a fan of medications being used to treat mental issues unless it is absolutely necessary. This is because I have heard that certain mediations can cause different problems. I have heard that some medications can stunt growth. Also, in one article, it said that some ADHD medications could lead to “possible cardiovascular problems” (CNN Health).
http://thechart.blogs.cnn.com/2010/08/18/nearly-1-million-adhd-misdiagnoses-study-says/
http://www.apa.org/topics/adhd/gender.aspx
I wonder if the book also has a chapter on how to treat ADD. I know that it has been suggested that stimulant drugs such as Ritalin can be helpful on the medication front. Also combining medication with training in cognitive and social skills issues is also helpful. I was also glad to see that they are focusing on diagnosing more girls with the condition since it usually has been an over diagnosis with boys.
I am not saying at all that the problem of ADD or ADHD does not exist; however, I do think that the diagnosing children so early on, is not the answer either. The book looks to be an interesting set of suggestions that may help mold classroom management for teachers dealing with children that display hyperactivity. I think that instead of sending a child to a consultation, teachers should maybe use different management techniques at least until the child becomes of an age in which their maturity cannot be matched with their symptoms.
Every time I have watched a documentary, had a discussion in class, or did research of my own it was always mentioned that boys are over diagnosed or more diagnosed than girls. Although a lot is unknown about the biological and cognitive causes of ADD one reason it has gained controversy is the natural differences between boys and girls. Biologically there are differences in the brain of males and females. Due to these differences each gender acts differently in different situations. Our society has a certain standard as to how students should act in a classroom and this standard is more conformed to the natural behavior of girls. So, when boys have a hard time acting the way they are expected to, such as being too fidgety or active or having a hard time concentrating while sitting in a desk during a lecture, it is assumed they suffer from ADD of ADHD. The book The Wonder of Boys but Michael Gurian goes into great detail about the differences between males and females and much more interesting concepts about gender differences.
Another controversial issue is that not only are boys over diagnosed they are also over medicated. I don’t know that much about the issue to say these things for certain but, from the information I have been provided from a variety of sources it seems as if medication is the most used strategy to manage ADD. This book appears to have many helpful strategies to work with students with ADD without having to medicate them. For this reason I would like to read this book because I am sure I will have students in my future class who may be considered to have ADD. In certain situation medication is necessary however I do believe that it is over used which is also where the issue of students who do not have ADD using the medication in recreational ways comes into play. As a teacher I hope to help students who may be thought to have ADD to deal with his or her disability in a way in which they don’t need medication.
While I do think many people are wrongly diagnosed or diagnosed to quickly, as future teacher I need to be familiar with techniques to help keep the kids under control and help children concentrate. I like the idea of taking time to recharge your batteries. Children with ADHD need to take breaks and not sit for a long time on one subject. A child that is asked to sit and complete one subject for an extended period of time will get bored and might begin to become restless. The little break will help a student regain focus for the remainder of the lesson.
I have a friend who has ADD. She was diagnosed at a young again and without hesitation prescribed medication. As I observe her and listen to her relentlessly talk about how she has ADD and praise the fact that she has medication; it utterly irks me. Labeling a child ADD or ADHD plus prescribing medication becomes a crutch for children. As I see with my friend, she is quick to rely on her medication as well as blame it for her inabilities. After learning about the book DRIVEN TO DISTRACTION: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood by Edward M. Hallowell, M.D and John Ratey. M.D, I am overly excited to inform my friend about it! From the sound of things, I believe the book is filled with an abundance of useful information that is beneficial for all people.