ATTENTION DEFICIT: A CURSE AND DELIGHT
The basic characteristic of Attention Deficit Disorder (ADD) is difficulty in monitoring and regulating thinking, behavior, and emotion. Those suffering from ADD have great difficulty controlling their attention. When provided with education, understanding, support and management guidelines, individuals with ADD can experiences success, letting their positive attributes and behaviors emerge.
Robby sits in front of the television whenever he has the chance, watching "Teenage Mutant Ninja Turtles" crush and mutilate every other being in sight.
He momentarily notices something faint, distant, mildly annoying, but is sucked back into the action of the TV show. Again, he feels a distance annoyance, but again he is sucked back into the action. Once more, he feels the mild annoyance, which almost is familiar, but the action once more draws him back. He thinks he might have said "in a minute," but then that thought is gone. The action pulls at him again, and yet again he is drawn to it.
Bang! Loud yelling; the television action is terminated by the swat of his mother's hand. "Get to your room and don't come down until dinner!" This was familiar. "I'm in trouble again," he thinks, saying, "What happened? This isn't fair! I didn't even have a chance."
"I've told you to turn that off a hundred times; why do you make me come over here to turn it off for you? You don't care what I say, do you? Get to your room!"
This scenario can be played dozens of times a day. "Why are so many reminders needed?" "Why do I have to get to the point of yelling before he moves?" "Why does he keep frustrating me, fighting with his brothers and sisters?" "Why can't I be the nice parent I'd like to be?" These are only a few of the questions a parent like Robby's asks every day.
The basic characteristic of Attention Deficit Disorder (ADD) is difficulty in monitoring and regulating thinking, behavior, and emotion. Those suffering from ADD have great difficulty controlling their attention. Children with ADD cannot control their minds and emotions without help from others, so parents, teachers, or other adults may need to provide the controls these children lack. They may have to move the child from one activity to another, focus his attention on important information, or intercede before the child's impulsive behavior results in harmful or inappropriate speech or actions. Children with ADD cannot control themselves as well as other children their age can. They often act years younger than their peers.
Why do they have so much difficulty in attending to some tasks while at other times they appear absorbed in what they are doing? "Don't tell me my son can't pay attention! He can play video games all day long!" Our ability to attend isn't tested when we do something we like. The test occurs when we have to do something we find less interesting or appealing. Children with Attention Deficit Disorder have trouble initiating and sticking with tasks they find uninteresting. Conversely, they are strongly drawn to tasks of high interest. In fact, it is difficult to pull them away from high-interest activities.
But these children are not as inconsistent in their behavior as they appear to be. We can predict when they will be productive and when they will require external structure and control. They will be most productive when they are doing something which interests them or when they are interacting with an adult who gives them full attention. Predictably, activities in which their interest is low and which they have little adult monitoring (e.g. homework, chores) will present the most difficulty for the child with ADD. When such a child has to switch from a high-interest to a low-interest activity, he will require parental supervision.
What can we do to reduce parental stress in raising children with ADD? First, parents who suspect ADD should take their children to a diagnostician with special interest in this problem. Neuropsychologists and other clinicians can test for attention/organizational difficulties, as well as for receptive/ expressive language, memory, visual-constructional, intellectual and academic skills, and finally self-esteem, all of which provide clues to the child's strengths and weaknesses. Children who know what their strengths are can be taught to use them effectively and thus to compensate, at least in part, for their weaknesses.
If a diagnosis of ADD is made, the evaluator's report should discuss the type and extent of attention difficulties. The child may have ADD with or without hyperactivity, auditory rather than visual distractibility, difficulty in starting a task or in sticking with it, difficulty in switching from one activity to the next, problems in inhibiting familiar or desired behavior, and various organizational difficulties.
The evaluator can help parents understand that the child's behavior is not volitional, manipulative, or willful. Parents often need guidance in finding effective ways to help their child with his problems. Parent education groups offer support to those seeking better methods of dealing with their ADD children. A professional who is familiar with behavioral techniques for children with ADD can be very helpful to parents in developing a system for management that removes the parent from the direct control of the child's behavior.
Although there is controversy and emotion concerning the use of medication for children with ADD, such treatment when properly supervised has proved to be effective in the total management program for many. Each case must be treated on its own merits, and parents and professionals should keep an open mind on the subject of medication.
It is important to remember that despite their problems, these children are delightful. They often are bright, verbal, persistent, sensitive, engaging, and good-natured. They see things others cannot. They often are intuitive. When the child is supported effectively, he can interact more successfully and his positive attributes and behaviors emerge. Many of the characteristics so frustrating in childhood become strengths in adulthood (e.g. persistence, tolerance for conflict, tenacity in negotiations). And, as mentioned earlier, all of us perform best at tasks that interest us. While a learning disability involves a problem with learning, ADD is a problem with the application of abilities. The higher the interest, the greater the ability to apply one's skills. Children with ADD do better when they can choose their activities. College and jobs are more interesting than high school. Choosing a trade or a profession is more engaging than prerequisite skills classes.
We can be optimistic about the future for these children if we provide understanding, support, and management guidelines for them and their families.