What Is Attention Deficit Disorder?

Attention deficit disorder (ADD) is a common childhood behavioral disorder, but it can be difficult to diagnose and even harder to understand. What should you do if your child has ADD, and how can you help your child deal with this disorder?

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Symptoms

Children who have ADD may know what to do, but they are not always able to complete their tasks because they are unable to focus, impulsive, or easily distracted. For example, children with ADD often cannot sit still or pay attention in school.

Estimated to affect 3% to 5% of children in the United States, ADD can create problems for these children at home, at school, or in their relationships with friends. According to the National Institute of Mental Health (NIMH), two to three times more boys than girls are affected by ADD, but the reason for this difference is not clear.

But what is ADD? You may be more familiar with the term attention deficit disorder, or ADD. This disorder was recently renamed ADD and includes three subtypes:

• being easily distracted
• an inability to pay attention to details
• not following directions
• losing or forgetting things like toys, notebooks, or homework
  

• fidgeting
• squirming
• blurting out answers before hearing the full question
• difficulty waiting
• running or jumping out of a seat when quiet behavior is expected

To be considered for a diagnosis of ADD, a child must display these behaviors before age 7 and the behaviors must last for at least 6 months. The behaviors must also be negatively affecting at least two areas of a child's life (such as school, home, or friendships) for a child to be diagnosed with ADD.

All children have difficulty paying attention, following directions, or being quiet from time to time, but for children with ADD, these behaviors occur more frequently and are more disturbing to the children and those around them.

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Known Causes

There is no one cause of ADD that has been identified, but researchers have been looking at a number of possible genetic and environmental links. Research shows that some children may have a genetic predisposition toward ADD. Other children may experience abnormal fetal development that affects the areas of the brain controlling attention and movement. Although scientists are not sure whether this is a cause of the disorder, they have also found that certain areas of the brain (in the frontal lobes and basal ganglia) are about 10% smaller in size and activity in children with ADD.

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Does It Coexist With Other Disorders?

An added difficulty in diagnosing ADD is that it often coexists with other problems.

Mood disorders, such as depression, are commonly seen in children with ADD. Some children may have depression as a result of having ADD, whereas others may have a mood disorder that exists independently of ADD.

Many children with ADD also have a specific learning disability, which means that they might have trouble mastering language or other skills, such as math, reading, or handwriting. Although ADD is not categorized as a learning disability, its interference with concentration and attention can make it even more difficult for a child to perform well in school.

Nearly half of all children with ADD (mostly boys) also have oppositional defiant disorder, which is characterized by stubbornness, outbursts of temper, and acts of defiance.

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Conventional Treatment

Taken in normal doses, stimulants can result in possible side effects, such as decreased appetite, stomachaches, irritability, and insomnia, but the long-term effects of taking these drugs are not yet known. Side effects are usually dose-related.

Medications that can help a child with ADD control impulsive behavior and attention are more effective when combined with behavior treatment. Behavior treatments include setting up a reward system for appropriate behavior.

Special parenting skills are often needed because children with ADD may not respond as well to typical parenting practices - especially if punishment is the lone practice.

Children with ADD should learn how to self-reinforce their positive behaviors and learn how to problem-solve. Children who take medications and practice these behavior techniques do better than those who rely on medication alone.

In addition to these treatments, alternative treatments such as herbs, biofeedback, vitamins, minerals, and dietary solutions have been used to treat ADD but have not yet undergone the testing needed to determine their effectiveness.

What You Can Do to Help Your Child
ADD affects all aspects of a child's home and school life. Specialists recommend parent education and support groups to help family members accept the diagnosis and to teach them how to help the child cope with frustrations, organize his environments, and develop problem-solving skills.

It is essential that you offer your child positive reinforcement to encourage his progress. You may want to establish a praise-and-reward system that will emphasize your child's strengths to help build his self-esteem.

As your child's most important advocate, you should become familiar with his medical, legal, and educational rights. Federal laws mandate education interventions for many children with ADD. Adjustments may be necessary for your child in the classroom. He might be able to pay better attention, for example, if he sits in the front of the room.

Here are more ideas about how you can help your child, both in the classroom and at home:

• Modify the environment. Ask your child's teacher to limit open spaces in the classroom, which may encourage hyperactive behaviors.
• Provide clear instructions. Ask your child's teachers to have your child write down his homework assignments in a notebook. Both you and your child's teacher should keep oral instructions brief and provide written instructions for tasks that involve many steps.
• Focus on success. Provide formal feedback (such as a star chart) to reinforce your child's positive behaviors, and reward his progress even if it falls a little short of the goal.
• Help your child organize. Encourage your child to establish daily checklists, and remind him to check his homework notebook as the end of the school day to make sure that he takes the correct supplies and textbooks home.
• Help your child control impulses. Urge him to slow down when answering questions and to check his homework before turning it in at school.
• Foster your child's self-esteem. Encourage performance in your child's areas of strength, and provide feedback to him in private. Do not ask your child to perform a task in public that is too difficult.
• Design a specific behavior program. Focus on a few of your child's unacceptable behaviors with clear and consistent consequences that your child knows. These consequences should not be publicly humiliating. Use hand signals to warn your child that his behavior is inappropriate.
• Encourage active learning. Teach your child to underline important passages in his school books as he reads and to take notes in class.