What if my child has ADD?

By Wendy Burt

With nearly five percent of school-age children being diagnosed with Attention Deficit Disorder (ADD), it's no wonder ADD has become a hot topic of conversation among pediatricians, teachers and counselors across the country.

Some believe that the percentage being reported is too low, leaving many children with ADD undiagnosed and therefore untreated. Still others argue that the number is too high - that parents, teachers and medical professionals are simply providing a 'catch-all' disorder for underachieving kids.

So how does a parent know if her own child has ADD? The following guidelines can help determine, understand and treat the disorder.

What is ADD?
The medical diagnosis of ADD is actually classified as Attention Deficit Hyperactivity Disorder, or ADHD. Although ADD is frequently used to describe ADHD without the hyperactive component, it is not an official medical diagnosis.

ADD/ADHD is a biologically based disorder with primary symptoms including some combination of inattentiveness or distractibility, impulsivity, and in some people, physical restlessness or hyperactive behavior.

Scientists now believe that in people with ADD the area of the brain that is responsible for controlling impulsive and disruptive behavior is underactive. Because ADD is considered biologically-based, as opposed to environmentally-created, parents should know that ADD is not caused by "spoiling" or underdisciplining.

What are the signs that my child has ADD?
Typical symptoms of ADD range from daydreaming and inattention to misbehavior. Children with ADD may appear disorganized, distracted, forgetful, and even disrespectful. In school-age children, teachers may report disruptive behavior, including:

  • Standing up or walking around during class
  • Losing school supplies or homework
  • Forgetting to turn in homework
  • "Spacing out"
  • Squirming in his/her seat

How is ADD treated?
According to Dr. Peter Jaksa, an ADD specialist, stimulant drugs, such as Ritalin, Dexedrine, and Aderall are usually considered quite safe. "Although they can be addictive to teenagers and adults if misused, these medications are not addictive in children," explained Jaksa in an interview with the Online Psych Forum. "They seldom make children 'high' or jittery. Nor do they sedate the child. Rather, the stimulants help children control their hyperactivity, inattention, and other behaviors."

"Ritalin and Dexedrine come in short-term tablets that last about three hours, as well as longer-term preparations that last through the school day," says Jaksa. "The short-term dose is often more practical for children who need medication only during the school day or for special situations, like attending church or a prom, or studying for an important exam. The sustained-release dosage frees the child from the inconvenience or embarrassment of going to the office or school nurse every day for a pill."

Although nine out of 10 children improve on one of the stimulant drugs, Ritalin and other stimulants have sparked a great deal of controversy. Some feel the drugs are overprescribed. Others feel that the drug's possible side effects - including weight loss, decreased appetite, temporarily stunted growth, and sleeplessness - are too risky.

Those in favor of medication argue that the benefits far outweigh the potential side effects, as long as the child's height, weight and overall development are watched.

"I'd heard the controversy about Ritalin, but we'd tried everything else with Mark and nothing worked," says Lynn Donnelly** of Long Island, referring to her preteen son. "When we finally put him on Ritalin, it was like night and day. He was calmer, more focused, and much easier to talk to. His grades improved but at no point did he appear medicated or lethargic - just more under control."

Medications aren't the only option. Accommodating the particular needs of the child is often beneficial.

"Michael has ADHD, hyperactive with a capital H," explains Amy Hall** of Fort Bliss, Texas referring to her 8-year-old son. "He is creative, passionate, fun-loving, strong-willed, and a force to be reckoned with. I finally have a good handle on what works and what doesn't for him around the house. Posting a daily weekday schedule gives him clarity about what to expect for the day. He would watch TV or play Nintendo non-stop if I let him so I have to be sure to limit both of those and set up time for reading, art, outdoor activities."

Teachers can also assist children with ADD by seating them in the front of the class, allowing for more time for certain projects, reducing the workload if necessary, and providing untimed tests, tutoring and note-takers. They may also help by writing down homework assignments and refocusing children during class when they appear to have let their minds wander.

"I copied a chapter of 'The ADHD Parenting Handbook: Practical Advice for Parents form Parents' by Colleen Alexander-Roberts for Michael's teacher since there is a section about establishing best learning environments, behavior modification ideas, self-esteem enhancers and how to deliver instruction to ADD kids," explains Hall. "The book advises what to do before school starts, building alliances with teachers, dealing with problems with teachers, choosing schools, home schooling, homework hassles and Federal Laws affecting children with ADHD/ADD. Working together with Mark's teachers has made a big difference in his grades."

How can I be sure that my child has ADD?
First and foremost, find someone with knowledge of and experience in ADD; a psychologist, psychiatrist, pediatrician, neurologist or clinical social worker. An evaluation should include interviews with you and your child. Developmental questions should include:

  • Was there any exposure to drugs or alcohol prior to birth?
  • When did the child learn to walk or crawl?
  • Were there any problems with the child's speech development?
  • Did the child have ear infections?
  • Have there been any head injuries, high fevers or seizure? (Head injuries and seizures can produce similar symptoms to ADHD.)

A good family history should also be taken, as the gene for ADD often runs through the family producing such things as obsessive-compulsiveness, depression, alcoholism and learning disabilities.

The clinician must also know if the child is or has been depressed, has anxiety problems, is hallucinating or delusional.

Another test that may be helpful is the TOVA or Test of Variables of Attention. As an extremely boring computer test, the TOVA requires the child to respond to a target stimulus by pressing a button, or to not respond when there's a non-target stimulus. Because the test is so boring, it helps to distinguish between children who have trouble with "boring," and those who do all right with it.

Perhaps most importantly, a physical exam should be performed to rule out thyroid problems, lead poisoning, mononucleosis, and attention problems caused by reactions to medications - such as allergies medications which may cause drowsiness.

Once you are certain that other physiological problems have been ruled out, you can begin addressing ADD with the methods that work best for your family.

**The names have been changed in order to maintain privacy.

Also see: Does Your Child Have a Cold or Are Allergies Setting In?

Wendy Burt is a writer based in Colorado. She is a frequent contributor to BlueSuitMom.com