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News & Views - Dec, 1998 Issue #55

Understanding And Dealing With
Attention Deficit & Hyperactivity Disorders

By: Michael G. Conner, Psy.D.
Portland, Oregon

(Dr. Conner is a licensed psychologist in Oregon. He is the Clinical Director for SageWalk, The Outdoor School and Treatment Program, the Director of Program Planning and Development for Mentor Research Institute and he maintains a private practice in clinical and medical psychology in Portland, Oregon. Prior to this he was a professional forester and engineer with the US Forest Service). 

(This article is a condensation. The full article can be found on www.OregonCounseling.org. – Lon) 

Attention Deficit Hyperactivity Disorder (ADHD) is by definition a disorder that first occurs in childhood and may persist into adulthood.  A person with ADHD has difficulty moderating and controlling their behavior. They appear consistently driven, internally pressured and have difficulty remaining focused while participating in activities that many of us would find easy. The key to recognizing ADHD is an awareness of what constitutes age appropriate behavior in different environments. 

There is good reason to be concerned whether a child has ADHD. The behaviors and symptoms can make normal adjustment difficult. 

Attention Deficit Hyperactivity Disorder is one of the most misunderstood diagnostic categories in mental health.  What is most apparent about children with ADHD are the differences in their attention and activity level. These differences are dramatically noticeable when these children are required to maintain their attention during dull, boring and repetitive tasks. 

There are a growing number of adults who believe they have ADHD. The diagnosis of ADHD in an adult requires an evaluation of how that person functioned as a child.  Such retrospective diagnoses are in most cases extremely difficult, if not impossible.  If the person has any knowledge of the disorder or  investment in being diagnosed, it will be very difficult for the adult to give an accurate report. 

Diagnosis of ADHD is not a simple matter although many parents, teachers and some mental health professionals are quick to make it.  For many parents, having a diagnosis of a problem behavior pattern and hearing the problem can be treated with medication is not only a relief but can help restore balance to an otherwise disruptive home environment. 

Many scientists and mental health professionals argue that the symptoms used to diagnose ADHD are overly inclusive and end up diagnosing children with ADHD who are not disordered.  It is worth noting that the observed symptoms of ADHD in a particular child will vary considerably across settings and caregivers. Symptoms in large classrooms with boring topics that provide little interaction produce more ADHD symptoms that in smaller classrooms with more frequent one-on-one interactions and more interesting activities. 

ADHD is a controversial diagnosis with little or no scientific or medical basis.  There is no solid evidence that ADHD is a genuine disorder or disease of any kind.  In fact, there are a growing number of scientists and mental health professionals who feel that ADHD is not really a disorder but rather part of the human condition.  Many professionals believe the diagnostic system used to classify the behavior of inattentive overly active children does more harm than good.  Many diagnostic labels have been created that describe children who have a low attention span, impulsive tendencies, and difficulty maintaining “normal” activity levels in response to a demanding situation.  The question is whether or not these behaviors are abnormal and represent a disorder. 

ADHD does not appear to be a condition that involves abnormally high distractibility, but rather a lack of persistence in responding to tasks that, * Are not interesting, * have no intrinsic appeal,  and * have minimal immediate consequences. Medication is by far the most common treatment for ADHD.  The number of children diagnosed and treated with medication for ADHD has increased 7 fold in the past 3 years. Several million children are being treated with Ritalin, stimulants and antidepressants on the grounds that they have attention deficit-hyperactivity disorder and suffer from inattention, hyperactivity, or impulsivity. 

Interestingly, there is no proof of any physical abnormalities in the brains or bodies of children who are routinely labeled ADHD. They do not have known biochemical imbalances or “crossed wires.” Medications used to treat ADHD do not correct known chemical abnormalities, they create new ones.  The stimulants used to treat ADHD are addictive and can cause serious brain abnormalities. Non-medication alternatives exist. 

There is a great deal of research to confirm that environmental problems can cause ADHD-like symptoms.  But regardless of the cause, the impact of inattention, hyperactivity and impulsivity can be detrimental to normal development.   Educational systems, employers and social expectations can be rather rigid.   Conflict and failures shape our sense of life, self-esteem, our ability to learn and our ability to get along with others. 

Information And Steps That Parents Can Take That May Help 

Consult with a qualified mental health professional or educational consultant who is competent and experienced at diagnosing and treating ADHD. 

Get more than one professional opinion. Consult with at least one professional who supports the use of medication and at least one professional who is opposed to the use of medication unless absolutely necessary. 

Become fully aware of medication side effects before giving any medication to your child. Information regarding side effects can be found in the full article at http://www.OregonCounseling.org.

In order to a make a diagnosis, it is important to: 

* Explore all of the possibilities that could explain the child’s behavior. 

* Determine if there are any problems such as learning disabilities, conduct disorders, depression, anxiety or medical concerns. 

* Fully evaluate the family structure, classroom situation, and any special conditions or problems. 

* Evaluate the child’s thinking and academic abilities. 

* Evaluate the extent to which a youth may have ADHD or may be amplifying their symptoms to manipulate or control their environment. 

Copyright © 1998, Woodbury Reports, Inc. (This article may be reproduced without prior approval if the copyright notice and proper publication and author attribution accompanies the copy.)

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