Attention Deficit Disorders
ADHD, or “Attention deficit hyperactivity disorder,” is a diagnosis, or actually a set of diagnoses, that involve symptoms of inattention, hyperactivity, and behavioral impulsivity. The “predominantly inattentive” subtype of ADHD (frequently referred to simply as “ADD”) pertains to symptoms such as difficulty maintaining focus on a task, being easily distracted or confused, missing details, forgetting things, daydreaming,
not seeming to listen when spoken to, or struggling to follow instructions. The “predominantly hyperactive-impulsive” subtype refers to symptoms such as fidgeting or squirming in one’s seat, talking nonstop, being constantly in motion, touching or playing with everything in sight, blurting out inappropriate comments, experiencing difficulty waiting one’s turn, or acting impulsively, without regard for consequences.
ADHD is most commonly diagnosed in children and adolescents who are exhibiting problems with academic achievement or disruptive classroom behaviors. Although this article primarily describes these younger folks, it should be noted that many symptoms of ADHD can and do persist into adulthood.
One of the problems for many of us, when it comes to thinking about ADHD, is the fact that we all have to exert effort to maintain attention or, at times, to refrain from acting on impulses. Because of this, it’s often difficult for us to consider that, for some folks, the effort it takes to direct their attention or behaviors may be much greater than it is for the rest of us. We may dismiss these individuals as “undisciplined,” “poorly motivated,” or “not caring,” and the notion that they may need extra help in overcoming real obstacles may strike us as coddling, “enabling,” or making excuses for behaviors that we believe they should be able to fix on their own. What’s worse is that folks with these problems often see themselves in a similarly negative light.
Not all problems with attention result from ADHD. They may represent emotional difficulties, anxiety or mood disorders, specific learning disorders that cause work to be difficult and effortful, or, in some cases, endocrine or other medical disorders. A comprehensive assessment for ADHD must evaluate for all of these. This is extremely important, because different conditions require different treatments. Interventions that are based on an incorrect diagnosis, including an inaccurate knee-jerk assumption of ADHD, will not be helpful, and may actually be counterproductive.
Therapeutic remediation strategies for students with ADHD encompass a number of pharmacological and behavioral approaches. Stimulant medications are often extremely helpful by making it easier to maintain focus. Other types of medications are sometimes used for symptoms of hyperactivity and/or impulsivity. But psychiatric medications, as important as they are, need to be combined with the therapeutic application of behavioral strategies, which may include training in study skills and self-monitoring strategies. For students, these measures may be enhanced by recruiting teachers to do such things as seating individuals with ADHD at the front of the classroom, where it will be easier for them to maintain focus; or by signaling the student in some pre-arranged way when the teacher notices that the student’s attention is wandering.
Numerous books, such as Driven To Distraction and Answers To Distraction (both by Edward Hallowell, M.D. and John Ratey, M.D.), and support organizations, such as Children and Adults with Attention Deficit/Hyperactivity Disorder (“C.H.A.D.D.”), can provide additional information about ADHD. Such sources may be extremely useful for parents by increasing their knowledge about the disorder and by helping to locate and identify mental health specialists who are competent to diagnose and treat ADHD. These sources should never be used in place of appropriate professional consultation.