Paying attention to attention
deficit disorder
By Michael Ceo
01/21/2003
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.