If your child is struggling with ADHD, as a parent you are struggling also... to understand... to evaluate...to cope... to find solutions... to advocate... and to make important decisions about how to best protect and help your son or daughter. There are a host of strategies, some more controversial than others, that parents may want to consider to deal with ADHD. But the first step is to learn more about what it is, and then confirm if this is what your child actually has.
What is ADHD?
It is one of the most common mental disorders that develop in children. If left untreated, ADHD can lead to poor school/work performance, poor social relationships and a general feeling of low self esteem. ADD / ADHD or attention deficit hyperactivity disorder is a very real condition that is characterized by poor attention and distractibility and/or hyperactive and impulsive behaviors. At issue is how the brain sends and receives information.
The brain is made up of millions of interconnecting nerve cells called neurons, which need to communicate with each other for us to function. Neurotransmitters are chemical messengers that carry messages back and forth between neurons. Dopamine, for example, is a neurotransmitter that helps to regulate behavior. If you are missing adequate amounts of dopamine, neurons in the frontal cortex of the brain, which is responsible for attention, do not communicate effectively. In ADHD, there is something funky going on with this necessary inter- cell communication. Some evidence suggests ADHD may be caused by a genetic deficiency of specific neurotransmitters. It is also believed that the neuron receptors that recognize dopamine don't work properly in people with ADHD.
So in practical terms, you could say that these kids' brains have a processing problem, where mental commands like "focus", "store information", "evaluate", or "don't act" get lost in translation. The result is a frustrating disconnect between their intelligence...and their achievement; their character...and their behavior.
ADHD is often first detected when a child enters school, because attention and behavior issues stand out more in this structured setting. Imagine a classroom with several kids who can't sit still, who never seem to listen, who don't follow instructions no matter how clearly you present them, or who blurt out inappropriate comments at inappropriate times. Although they are often very bright, articulate, artistic and creative, or excel in sports...Hyper active kids are typically described as bouncing off the wall, disruptive, disobedient, disrespectful, or troublemakers. They may have trouble sitting still or waiting their turn. Their impulsive behaviors may lead them to "act before thinking". Their short attention span and distractibility become more noticeable. And their social relationships, grades and schoolwork, start rapidly going downhill as they fall further and further behind.
So far we've described the most common and easy-to-recognize face of ADHD. But what about a lesser known, less obvious, but equally debilitating version of this disability:
Inattentive, or "Winnie the Pooh" ADHD
If Hyper active kids are the "squeaky wheel that gets the grease", Inattentive kids are the "invisible silent sufferers" of ADHD. They both share the same deficiency of neurotransmitters...their brains both have a processing problem...they both have disconnects between their potential and their performance. But how this manifests itself outwardly is literally, like night and day.
Unlike Hyperactive children, Inattentive ADHD kids are usually described as well behaved, quiet and introverted, "space cadets" who are often in their own world, slow, lazy, irresponsible, easily bored, socially awkward, and sometimes helpless. They don't draw negative reaction, appear to be paying attention, have trouble speaking up for themselves, and so are overlooked and often undiagnosed. Though this type of ADHD is thought to occur more often in girls; boys can have it too. My son does.
If Hyperactive Kids are "Indiscriminate Fire on All Cylinders", Inattentive Kids are "Failure to Launch".
Normally, the brain's prefrontal cortex will speed upactivity when there is work to concentrate on. However, with Inattentive ADHD the prefrontal cortex actually slows downwhen asked to focus on work like reading or doing homework. This part of the brain looks normal when "at rest," but actually looks like it is starting to fall asleep when asked to "go to work." Look at it this way; when it's time to pay attention the Inattentive child's brain sends a command to "stick and stay", but instead receives permission to "wander away".
This has been documented and observed hundreds of times with subjects on an EEG. When at rest, the brainwave activity is pretty normal. But once the subject is asked to read, or to do a math worksheet, the subject's brainwave activity begins to look like the subject is falling asleep. And often times they do fall asleep! This makes it very hard to pay attention to school work, get homework done, listen to the teacher, clean your room, and basically "remain on task".
How to Recognize A Child with Inattentive ADHD
My son Gabriel had always been popular (if somewhat shy and reserved), well liked by his teachers, and an honor roll student in an academically demanding school. He was obsessed with, and a master at, all manner of fast paced computer games. Then, in 3rd grade, inexplicably, he crashed and burned.
Not to overstate it, it was one of the worst years of his and my life. Suddenly he couldn't seem to keep up...fell further and further behind...began to think of himself as stupid...started to dread school and homework...refused to even try...and just wanted to mentally drop out. His Dad thought it was "just a phase" and I was overreacting. His teacher thought Gabriel was sweet, but a little slow and disorganized. Since 1st grade I had felt a growing concern that something was amiss (Gabriel's handwriting, verbal skills, comprehension, and standardized test scores were not where I thought they should be). But his teachers thought I was worried unnecessarily, and since he appeared to be doing well, I pushed my misgivings aside. That is, until 3rd grade where, suddenly, he began this painful and catastrophic nosedive.
Bewildered and anxious, I searched high and low for answers until I finally pieced together enough information to realize that Inattentive ADHD was the root of Gabriel's difficulties. Do any or all of the following characteristics describe your child?
11 Signs Your Child Might have Inattentive ADHD
Becomes overwhelmed easily; can only concentrate on one thing at a time.
Has trouble starting and/or finishing tasks (often forgets to do homework, family chores, may take "forever" to finish homework).
May daydream while getting dressed in the morning; fixed stare may mask wandering mind.
Is distracted by internal thoughts and external stimuli. (The brain can be on 16 channels, but the body appears exhausted.)
Is easily bored...does not like to read...seems "hypnotized" by the hyper stimulation of fast action video games and TV shows
Has a lethargic and apathetic appearance; even when the person thinks fast, he fatigues quickly; is often called lazy and unmotivated.
Does not get needs met in the classroom because he or she doesn't disrupt others; tends to be quiet, shy or withdrawn resulting in cognitive deficits getting overlooked.
Has social skills problems (may be quiet, withdrawn, or possibly shy; has trouble with small talk and figuring out rules of social interaction; has a problem reading social cues; tends to be lonely and aloof). Unfortunately, this passivity can cause the person to be an attractive target for bullies.
Does not perform up to potential; is slow at processing; appears confused or stressed; has difficulty with synthesizing and organizing ideas; is slow responding to questions.
Is repeatedly rescued; uses learned helplessness and passive manipulation; feels powerless; becomes chronically dependent.
Could be on an emotional roller coaster (anxious, depressed, explosive temper, grumpy, sarcastic, rude, or abrupt).
OMG. Looking at this compiled list of typical behaviors I finally understoodwhat was going on with my son. It was so accurate it was almost scary. I tried to enroll his teacher's help, and she listened and nodded politely, but didn't have a clue what I was talking about. I went to his guidance counselors. They advised me that the fastest way for them to intervene and help was for me to get a formal diagnosis from his pediatrician.
If You Suspect Inattentive ADHD, Have Your Child Evaluated and Diagnosed.
These are tests that are commonly used to confirm a diagnosis of ADHD.
Parent-completed Child Behavior Checklist
Teacher Report Form (TRF) of the Child Behavior Checklist
Conners Parent and Teacher Rating Scales
ADD-H: Comprehensive Teacher Rating Scale
Barkley Home Situations Questionnaire (HSQ)
Barkley School Situations Questionnaire (SSQ)
My son had the Woodcock-Johnson Cognitive Skills test and an evaluation by his pediatrician. While I had conflicted feelings about placing such a potentially negative label on my son, I was relieved to finally have a real medical diagnosis. With this in hand, I was able to tap into help and resources previously unavailable at his school. And at last I could begin to come up with a viable plan to help my son manage and meet the considerable challenges of Inattentive ADHD head on.
