ISU topic: Inactive Attention Deficit Disorder in Children

By: Diana Thai

INTRPDUCTION:

Attention Deficit Disorder (A.D.D) has had immense media coverage over recent decades, making it one of the most known disorders among children. Although the media coverage may have broadened public awareness about the disorder; it is also responsible for a proliferation of false assumptions, myths and misconceptions about A.D.D, and the methods used to treat it. (Wender, 2000, p. 5) As awareness spreads, so does the tendency of uninformed people to claim that any child with a short attention span A.D.D. (Wender, 2000, p. 7) Because the symptoms of this disorder are so common among children, it is difficult to decide which child actually has the disorder. (Rief, 1998, p. 7). There are three types of A.D.D: inactive, hyperactive, and impulsivity. (Sheen, 2001, p. 12) The aim of this report is to accurately summarize the symptoms of inactive A.D.D, and educate the public of the realities behind the myths. Furthermore, it will outline the possible causes and challenges a student with inactive A.D.D faces, as well as practical solutions used to deal with these challenges. This report will refer to inactive A.D.D, simple as A.D.D.

There are many limitations to studying children with A.D.D, one major one being that many children with the disorder are not reported. (Ingersoll and Goldstein, 1993, p. 22) Unlike hyperactivity or impulsivity, the inactive type does not cause bursts of high amounts of energy or cause the impulse to act before thinking. These children do not exhibit disruptive behaviours that draw attention, so they can be overlooked or misinterpreted/misdiagnosed. (Ingersoll and Goldstein, 1993, p. 24) Another problem is that the children studied may possess other disorders which coexist with A.D.D. There are a number of other learning, medical, and psychiatric disabilities and social problems which exhibit the same symptoms. For example, a child who has a sleeping disorder may also have a short attention span and appear to be daydreaming. Hence, there are a large number of cases where A.D.D is only part of the diagnostic picture. (Sheen, 2001, 11) Also, because the children studied have unique circumstances, the data may be skewed or does not accurately represent all children who have A.D.D. Although the existence of A.D.D has been known for over a century, there are still many questions that remain unanswered, and because of this, the prevention or “cure” to the disorder is unknown (Conners,1999, 3) The unknowns of the disorder limit the report to assumptions and research findings.

DEFINITION:

Hundreds of studies conducted on children with A.D.D discovered that approximately 2 to 5 percent of children aged 5 to 12 have this disorder. (Wender, 2000, p. 8) Evidence also suggests that boys are 3 to 10 times more affected by this disorder than girls. (Wender, 2000, p. 9) A.D.D is usually confused with a learning disorder, because children with A.D.D fail to acquire skills in reading, spelling and math as they grow and mature. A common misconception is that children with A.D.D are unintelligent. However, it is largely emphasized that A.D.D does not affect intelligence or is related to mental retardation. (Ingersoll and Goldstein, 1999, p.10) Children with A.D.D develop unevenly, meaning they may be advanced in one subject, but behind in others. Until a program is arranged to take the child’s abilities into account, he or she will have great difficulty adjusting in a normal classroom.

Almost all children with A.D.D have difficulty with academic performance. (Conners, 1999, p. 4) Despite normal or high intelligence, children with A.D.D are often chronic underachievers (Ingersoll and Goldstein, 1993, p.64). Statistics reveal that by adolescence, one third of A.D.D children have failed at least one grade in school and almost 80 percent are more than one year behind in at least one basic subject. Most children with A.D.D will be placed in a special education class, where an arranged program will tend to their unique development. However if special attention is not provided, statistics reveal that children with A.D.D ...

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CAUSES:

The exact causes of A.D.D are undetermined, however, based on extensive research, it appears to be heredity or a neurological dysfunction in the brain. The brain is a very complex organ, where one malfunction can have devastating results. Many cases show that A.D.D children are four times more likely to have a relative with similar behaviours and school histories. Although heredity may be the most common cause based on evidence, it cannot explain all cases. Family history alone cannot explain the severity or likelihood of any disorder. (Sheen, 2001, p. 24) Most studies believed that there was a deficiency or inefficiency of neurotransmitters in the frontal lobe, the part of the brain responsible for attention and other tasks. Neurotransmitters are chemicals which are transmitted between neurons to perform a specific task. However, if these chemicals are deficient, this would result in a lack of activity in that portion of the brain. Thus, it is believed that due to a gene, A.D.D is inherited and abnormal chemical functioning in the brain, is the results.

In the controversy of nature vs. nurture, A.D.D is caused by nature and how the child is treated affects the severity of the problem. A common misconception is that A.D.D children gain the disorder through poor child rearing tactics. According to studies, “Child rearing tactics which are excessively harsh and punitive - or, conversely, too lax - only make a situation worse.” (Ingersoll and Goldstein, 1993, p. 30) Other factors which disrupt a family, such as violence and alcohol, also make it harder for an A.D.D child to develop. Child rearing practicsa re not the main cause of A.D.D. (Ingersoll and Goldstein, 1993, p. 25) Ingersoll and Goldstein add, “On the other hand, parents who set clear, consistent limits and who despense appropriate consequences for behaviour provide a firm foundation for good development.” (Ingersoll and Goldstein, 1993, p. 30). Thus, children born with A.D.D cannot be prevented, so they must be nurtured to grow and develop into effective members of society. (Rief, 2003, p. 56)

IDENTIFYING CHILDREN WITH A.D.D:

Many people assume there is a simple test for A.D.D, however, all children are unique and specific documentation is collected and analyzed. For example, school reports. (Conners, 1999, p. 85) The Canadian Psychiatric Association provides guidelines to identify A.D.D children. Although all A.D.D children are unique, these guidelines provide a set of common standards by which professionals can make a diagnosis. Some of the guidelines include the following,

“A. A disturbance of six months or more, during which most of the following behaviours are present. The child:

Often fidgets with hands or feet or squirms in seat
Has difficulty remaining seated
Is easily distracted by extraneous stimuli
Has difficulty following through on instructions from others (not due to oppositional behaviour or failure to understand)
Often loses things necessary for tasks or activities at school or at home (for example toys, pencils, books, assignments).

B. Onset of these problems occurs before the age of seven.”

These guidelines are often referred to by professionals such as teachers and counselors who suspect children with A.D.D. Although, children with A.D.D are usually described as having a short attention span and easily distracted, the words attention and distracted are not synonymous. (Fowler, 2000) The word distracted refers to a short attention span and difficulty to focus and finish a task. The word attention incorporates five stages. The first and second stages include being able to focus on something that requires immediate attention. The third stage requires the person to remain attentive on the task at hand. The fourth and fifth stages incorporates being able to resist any distraction and ability to shift attention when needed. (Fowler, 2000) The word distractible indicates that one of these stages is disrupted. . (Fowler, 2000) During the attention process, a child may have trouble starting a task, understanding the directions, or even finishing the task. An observer can determine which stage the child cannot comprehend by carefully monitoring the child.

CHALLENGES:

Children with A.D.D need a lot more stimulation and variety than other students, making the tedious work in school difficult to complete. When an A.D.D sufferer undergoes a repetitive task he or she is unable to sustain attention. (Rief, 1998, p.64) Current public school structures are evolved around school assignments and repeated tasks, making it difficult for children with A.D.D to succeed. Although, in order to get into post secondary education and thus the knowledge for specific jobs, a high school diploma is needed. Children with A.D.D have a lower potential to obtain the job they desire, because they do not have a high school diploma or the marks to “prove” their intelligence. (Wender, 2000, p 34) Needless to say, the basic school structure in most schools is not adequate for children with A.D.D and do not reflect their full potential. (Wender, 200, p.23)

In addition to academic challenges, social problems develop as well. Sufferers of A.D.D frequently fail to make eye contact, listen, or notice important social cues causing others to feel ignored. (Sheen, 2001, p. 44) According to A.D.D specialist Dr. Lawrence H Diller, “They lack awareness of what is going on in a group and the effect of their behaviour on the group. A.D.D individuals don’t read facial cues or body language and miss other social cues.” (Sheen, 2001, p. 45) This inability to function as part of a group further isolates A.D.D sufferers. The effects of children being isolated from their peers can be devastating. Psychologists Robyn Freedman Spizman notes, “Research indicates that children without friends, who are isolated from their peers are at risk of continuing problems with their peers, poor academic achievement and poor adjustment to school.” (Sheen, 2001, p. 46)

TREATMENT:

The treatment of A.D.D is complex and inexact. (Sheen, 2001, p. 29) In the absence of firm evidence of the causes of A.D.D, the treatments are difficult to prescribe. (Ingersoll and Goldstein, 1993, p. 85) Research studies have proven that some treatments involving stimulants, such as Ritalin, are effective and have been used for over four decades. (Sheen, 2001, p. 29) Stimulant drugs help children with A.D.D to focus attention and regulate activity level, by directly effecting neurotransmitters. (Ingersoll and Goldstein, 1993, p. 89) Unlike popular belief, stimulant medication does not mask the symptoms of A.D.D, but corrects the biochemical condition which interferes with attention. (Ingersoll and Goldstein, 1993, p. 89) According to researches, the side effects of stimulant drugs when properly employed, is generally quite safe and minimal. (Ingersoll and Goldstein, 1993, p. 90)

Other treatments, such as behaviour modification, have also been proven affective on children with A.D.D. Behaviour modification is based on the idea that specific behaviours are learned through its effects and consequences. (Berne, 2002, p.45) For example, behaviours that are reinforced with positive criticism will most likely occur more frequently then those that do not. Negative consequences which are unpleasant weaken the behaviour, making it less likely to occur again. (Berne, 2002, p. 15) The consequences do not need to be dramatic, however timing is critical. (Berne, 20011, p. 18) Consequences need to be reinforced immediately following the action, where the behaviour is most strongly affected by it. (Ingersoll and Goldsten, 1993, p. 102) Praise should also be varied to keep children with A.D. D interested.

A classroom setting which involves many distractions, such as windows and noise, are not suitable for children with A.D.D. (Rief, 2003, p. 18) Accommodations can be made in classroom to help keep A.D.D sufferers on task. For example, the child’s desk should be seated away from high traffic areas and near the teacher. (Rief, 2003, p. 21) An ideal classroom would involve predictable schedules, clear rules and is highly organized. (Berne, 2002, p. 40) Furthermore, school work should correspond to the child’s abilities. (Wender, 2000, p. 97) Some children only require the use of one of the treatments, where others require the use of all to be thoroughly effective. Never the less, each child is unique, and it may be a matter of trial and error before a treatment is diagnosed.

CONCLUSION:

The aim of this report was to provide a good introduction to A.D.D and issues surrounding the disorder. Society has established a set of standards for its children; specific levels of performance and achievements are expected of children, such as proper public behaviour and education. (Ingersoll and Goldstein, 1993, p. 209) Those who have attention problems often cannot grasp information, thus disappoint them and those around them; despite their efforts. Constant disappointment can lead to devastating emotional consequences, thus caregivers must constantly provide positive responses. (Sheen, 2001, p 32) Children with A.D.D represent a large percent of children in general, creating enough information to provide a guideline to identify who has A.D.D and who does not. Teachers must approach their lessons with a creative mind and capture the attention of children with A.D.D. (Sheen, 2001, p. 68) It is challenging for the sufferer as well as those around him or her, thus they must work together to ensure that the child is learning to his/her full potential. Even though it is challenging, caregivers should not spend time and money without being informed of the issues surrounding A.D.D. Since there is no “cure” to this disorder, there are different methods used to treat it. Although the symptoms of A.D.D sufferers may sound very difficult to deal with and different from the seemingly average person, with the right information and treatment, a child with A.D.D is, for the most part, able to live a “regular” life.

Works Cited:

Berne, Samuel. (2002). Without Ritalin: A Natural Approach to A.D.D. New York: Keats Publishing.

Conners, Keith. (1999). Attention Hyperactivity Deficit Disorder: In Adults and Children. Salt Lake City:Compact Clinicals

Fowler, Mary. (2000, April 20). Attention-Dificit/Hyperactivity Disorder. Kid Source Online. Retrieved April, 23, 2004, from the World Wide Web:

http://www.kidsource.com/NICHCY/ADD1.html

Ingersoll, Barbara and Golstein , Sam. (1993). Attention Deficit Disorder and Learning Disabilities: Realities, Myths and Controversial Treatments. America: Doubleday.

Rief, Sandra. (1998). The A.D.D/A.D.H.D Checklist: An Easy Reference for Parents and Teachers. America: Prentice Hall.

Sheen, Barbara. (2001). Attention Deficit Disorder. San Diego: Lucent Books.

Wender, Paul. (2000). A.D.H.D: Attention-Deficit Hyperactivity Disorder in Children and Adults. New York: Oxford University Press.