Surviving and Thriving with Your A.D.D. Child

For a psychologist who treats children and adolescents, Attention Deficit Disorder (ADD), is an everyday concern. Recent statistics indicate that as many as 50% of children currently presented for mental health services may be affected by attentional problems. Moreover, ADD can be a difficult disorder to accurately diagnose and to effectively treat. Other childhood problems may impair functioning in only a few areas. However, ADD involves an inherited neurological defect that has the potential to hinder growth and development in all areas of life. My goal, for all ADD children that I treat, is to help them not simply survive their disorder, but to thrive, in spite of it.

Healthy development, in spite of ADD, involves several steps. The first is to understand that ADD is a biologically determined difficulty. Current medical technology allows us to take pictures of the brain. These images document diminished blood flow and reduced electrical activity in the frontal lobe of persons diagnosed with ADD. This disorder is not the result of poor child rearing practices or a child who simply insists on being naughty. Many parents spend so much time blaming themselves or their child, they have little energy left to cope with the disorder itself. Being clear on the origins of ADD helps to minimize unnecessary and unproductive guilt.

A second way children with ADD thrive is when they receive the maximum of health care resources, not the minimum. A thorough assessment of the child’s symptoms, behavior and functioning is needed. Moreover, such assessment needs to take place over multiple settings and situations, not in a five minute behavior sample in a physician’s office. It is also quite common for children with ADD to have additional diagnosis, e.g., learning disabilities. In addition to making sure the diagnosis of ADD is accurate, any additional disorders need to be identified and treated as well. Lastly, parents need to search for a physician who is invested in ADD patients and who is willing to do long term tinkering with their medications. Children change and grow and so do their medication needs.

A third area to look at is educational resources. All children with ADD need some special consideration, e.g., being able to take medication at school. Many ADD children, however, will require the maximum amount of special accommodations in order to thrive. These special helps include, but are not limited to, such things as resource room time, tutoring, front row seating, oral testing, text books on tape, homework charts and positive behavior contracts. Unfortunately, many schools, even good ones, will not automatically provide special help. Parents may have to become strong and assertive advocates to obtain needed accommodations for their child.

The fourth way in which ADD children can succeed is through parenting which accepts their handicap, and yet tries to maximize their potential. Parents must recognize, for example, that ADD may delay your child’s developmental growth by as much as 30%. A child may be nine years old chronologically, but function as a six or seven year old in reality. Expectations for that child will need to be adjusted accordingly. I frequently tell parents, “God has assigned you a long term, high maintenance project. The road can be rough, but the reward great.” One way for parents to make it down that “rough road” is to join a support group for families coping with ADD. This can help parents understand their child better as well as obtain much needed support for themselves. A church-based ADD support group and/or the local chapter of CHADD (Children and Adults with Attention Deficit Disorder) is usually a good place to start. In addition, bookstores, public libraries, the internet and ADD organizations all have a wealth of information and resources for helping children with ADD in the areas noted above. Understanding and utilizing this information can help both parent and child to thrive.

In closing, what kind of rewards might godly parents seeking to raise godly “special needs” children expect? All children are vulnerable, and in need of care, and ADD children even more so. In one of my favorite passages, Matthew 25, Jesus gives us an idea of how He views our acts of service to those who need our help. Although the passage focuses specifically on needy, persecuted believers living close to the time of Christ’s return, I believe there is a more general principle taught as well. Jesus states that the lovingkindness and care believers show to others, more needy and vulnerable than themselves, He considers as if done to Him. “Inasmuch as ye have done it unto one of the least of these…ye have done it unto Me.” Take heart, parents of ADD children, Christ Himself is in charge of the ledger books on this one!

Characteristics and Causes of A.D.D./A.D.H.D.

Attention disorders may be one of the most prevalent problems of childhood. Three to five percent of the child population (roughly 2 million school-aged children) has some type of attention disorder—or one attention disorder child per classroom. What’s going on?

While professional debate continues on the exact characteristics of attention disorders, clinical research strongly suggests that people suffering from inattention fall into two categories—those who are hyperactive and those who are not. Attention Deficit Hyperactivity Disorder (ADHD) consists of motor hyperactivity and impulsive behavior, while Attention Deficit Disorder (ADD) is characterized by inattention, disorganization and difficulty in completing tasks.

ADHD children behave in an impulsive and aggressive way. They often seem guiltless, are unpopular and perform poorly in school. They have little self-control and are very impulsive, noisy, disruptive, messy, irresponsible and immature for their age. If the image of “Dennis the Menace” comes to mind, you’ve got the picture.

In contrast, ADD children tend to be anxious, shy, socially withdrawn and somewhat unpopular. They tend to perform poorly in sports and in school, and often daydream and stare into space. They forget daily activities and are sluggish and drowsy. Terms like “space cadet” and “couch potato” fit well. But they are less aggressive, impulsive and hyperactive than ADHD children and have fewer relational problems, as well.

While all children on occasion will be impulsive or “hyper,” kids with attention disorders exhibit these characteristics all the time. They “misbehave” everywhere—school, church, grandma’s, the grocery store and home.

Diagnosing attention deficit disorders can be tricky. There is a big difference between suspecting a child has an attention problem and knowing for sure that the child has ADHD or ADD. Proper diagnosis and treatment by a competent professional is important for the long-term well-being of your child and your family. The following information is provided to help you determine whether you should seek professional help or if your child is merely tightly-wound and squirmy. For the sake of ease, the abbreviation ADD will be used for all types of attention disorders, unless a specific reference is being made.

Characteristics of ADD

Most experts agree that four characteristics or tendencies identify attention deficit disorders.

  • Inattention and distractibility. An ADD child has a difficult time focusing on the task at hand and sticking to it—he usually ends up daydreaming. He cannot concentrate on schoolwork or anything that requires sustained attention. Following through on instruction and completing a task is almost an impossibility, especially if the instructions involve multiple steps; and he gives the impression of not listening. But even more frustrating for the parent or teacher is this child’s ability to pay attention in certain circumstances, like when watching TV or playing video games. He may also shape up while at the doctor’s office or one-on-one with an adult. This adds to the problem. When parents and teachers see the child paying attention in one situation, they tend to conclude that he simply does not try in others, like when asked to do chores or follow instructions. The heart of understanding attention disorders is determining how much of the attentional choosing is conscious, and how much is biochemically determined. The problem is regulation of focus and attention.
  • Overarousal or hyperactivity. Some ADD children are excessively restless, overactive and easily aroused. This affects their emotions and body movement. It is important to remember that while hyperactivity used to be the primary description in attention disorders, it actually occurs in less than 30 percent of children who have ADD. (Sometimes hyperactivity is used to refer to the entire syndrome of attention disorders. Other times the term only describes overarousal. Keep these different uses in mind as you read various books and articles about ADD.) Hyperactive children have a tough time controlling their body movement, especially when they are required to sit still for a long time. This ranges from minor fidgeting to perpetual motion. Some hyperactive children also have restless sleep patterns. These kids are rarely focused—they will move from one thing to the next with little purpose. While a trip to the grocery store might be a mild adventure, a stop at the toy store can turn into an absolute disaster. Emotional variation also comes into play. An ADD child’s emotions fluctuate quickly, going from one extreme to the other. Whether they are happy or sad, the child’s feelings are expressed for everyone to notice. He may become very frustrated over a minor incident. But chances are he will forget the upsetting event just as quickly. This can be frustrating to a parent who is still bothered by the outburst and doesn’t understand why the child is no longer upset. This leads to the assumption that ADD children lack a conscience. But that’s untrue—they’ve just moved on to other thoughts and have put the outburst behind them.
  • Impulsivity. ADD children appear not to think before they act and have trouble weighing the consequences of their choices. They just can’t seem to wait—everything has to happen NOW. In young children, this may result in injury—an ADD child often literally leaps before he looks. He may jump off the back of the couch because it looks like fun, but not have the coordination to land safely. He may also fight frequently with his friends because of impulsive words and actions. He wants to be in charge socially because his dominance will prevent him from being bored; but his peers often find his aggressiveness irritating. In school, ADD children constantly interrupt the teacher, jumping up to answer a question before it is even asked. They tend to work impulsively, jotting down answers without thinking through the problems or thoroughly reading questions. You can often reason one-on-one with these children, with them logically analyzing the consequences of their actions. But put them back in the real world and they seem overwhelmed, resuming to act first and think later. ADD children have a lot of trouble following rules. They may know the rules and even be able to explain them. But 10 minutes later, when a parent or teacher isn’t looking, they are “at it” again. Their need for immediate gratification, coupled with the inability to stop and think, leads to impetuous non-thinking behavior. And from all appearances, these children just don’t seem to “get it.” Thus, they are often labeled willfully disobedient, inconsiderate and oppositional.Attention deficit disorder is not a problem of knowing what to do, it is a problem of not doing what the child knows.*
  • Difficulty with rewards. ADD children have problems working toward a long-term goal. They often want brief, repeated payoffs rather than a single, delayed reward. They want what they want right away, and even with repeated rewards, they do not respond to incentives as well as other children their age. And once the reward system is removed, the ADD child is likely to regress. Punishment also seems to have a limited effect on the child’s behavior. A scolding will usually work on the child’s behavior for only a few minutes before the misbehavior continues.
  • Difficulty with social skills. Many ADD children and teens misread social cues.
    This can affect the development of healthy interpersonal skills, leading to frustration and inappropriate or withdrawn behavior.

Causes and sources of ADD

Although ADD continues to be one of the most thoroughly researched conditions of childhood, its exact causes are still not known. The neurochemical abnormalities that might underlie this disorder are difficult to document though research suggests that ADD has a biological basis. Many ADD children seem to arrive in the world with temperaments that leave them difficult to manage. Part of this predisposition may very well be inherited—very often kids are described as “a chip off the old block.”

But take heart. The symptoms of ADD are not externally created by parents. A child’s attentional problems do not result from faulty discipline. While it is true that parental frustration and negative reactions toward your child can aggravate the problem, guilt, anger and resentment can hurt a parent’s relationship with his child and hinder effective treatment. A nurturing home with clear and consistent structure is crucial to the treatment of ADD children. And while environmental conditions can play a role, the effects of changes in diet and other similar things show up more on an individual basis than in large numbers. There is very little evidence that ADD arises purely out of social or environmental factors, like dysfunctional families, vitamin deficiency, excessive amounts of sugar, lead poisoning, fluorescent lighting or faulty parenting.

Does my child suffer from ADD?

There is no simple test that determines a child has ADD. Diagnosis is a complicated process that requires the skill of a psychologist, psychiatrist, pediatrician or pediatric neurologist. A proper diagnosis orients the child and his parents or caregivers to the nature of his difficulties by providing information about his strengths and weaknesses, and any situations that would be particularly troublesome for him. It should also reveal his academic abilities, enabling him to get the most out of school.

Perhaps even more important, it is crucial to determine the presence of other problems—learning disabilities, mood disorder, anxiety disorder, conduct disorder, poor socialization, disruptive family relationships—and the evaluation will do this, as well. Treatment can then be appropriately provided for all of the child’s concerns.

A.D.D./A.D.H.D.: A Reason to Hope

I gave my son a goodnight peck on the forehead, left his room and headed for the kitchen. Though I hated to admit it, I needed to follow up on his chores. Discouragement flowed over me anew as I paused in the doorway. Crumbs littered the counter, and a streak of jelly meandered from a gooey knife. Poking from a lower cupboard, a box of sandwich bags served as a doorstop. Tipped against the open cookie jar, a forgotten bag of chips reminded me that all meals were not created equal.

I sighed in frustration. Why would a boy who had mastered his ABCs by age 2 struggle at 14 to put together a couple of sack lunches?

Incidents like this had slowly transformed our home into a place of defeat. My husband and I constantly wrestled with our approach to parenting and besieged each other with questions. Were these occurrences our fault or due to Jason’s poor choices? Was this a case of “I won’t” or “I can’t”? We simply didn’t know, and our anger and annoyance were increasing.

Why did Jason persistently fail to help out around the house? Was he just plain lazy? How would he ever make it in life if he couldn’t manage a few chores and some homework? And why were none of our lectures, constant reminders, rewards and punishments bringing about lasting improvement? Maybe it was just a phase, but we also had certain expectations.

Then panic set in. Jason was failing his first semester of high school.

As it so often does, in our dark moment, light appeared. We discovered the answer that had long eluded us as we struggled to understand what was happening to our son. The underlying cause for Jason’s troubles, and ours, was a neurobiological condition called Attention Deficit Disorder (ADD).

ADD and Attention Deficit Hyperactivity Disorder (ADHD) are believed to be caused by malfunctioning neurotransmitters in the brain. ADD and ADHD affect an estimated four percent to 12 percent of America’s schoolchildren—as many as 3.8 million. And while families may be reluctant to consider ADD as the reason for home and school problems during the teenage years, those who are willing to pursue a diagnosis and treatment may experience dramatic changes. We did.

Before Jason’s diagnosis, his chronic forgetfulness, lack of perseverance and self-enforced isolation were sucking the joy out of his final years at home. After discovering and treating his ADD, his self-confidence returned, his interest in college and career resurfaced and he smiled a lot more. We had missed that.

Undiagnosed until high school

Many children with ADD are tested and diagnosed in their early school years. In our case — largely because Jason had a laid-back personality, maintained straight A’s until he reached seventh grade and spent long hours in front of the computer — we were blinded to the possibility that he might have trouble staying focused on tasks.

Beginning in seventh grade, however, Jason’s academic performance deteriorated steadily, and by Jason’s freshman year in high school, my husband and I were no longer shocked to see D’s and F’s on Jason’s progress reports. Missing assignments, forgotten books and low test scores became the norm. Teacher conferences confirmed what we already knew: Jason was not performing anywhere near his potential.

At home, Jason never remembered his chores, rarely completed them according to our expectations and had adopted “don’t worry” as his standard response to every attempt on our part to discuss what was going on. We had a feeling his trite motto was thinly covering his own deep concern about the way things were progressing.

One day on the Internet, a story linking ADHD with giftedness caught my eye. Surprisingly, similarities exist between the behaviors identified with ADHD and those typical of bright, talented, creative children. While I knew Jason was not hyperactive, his early school performance had convinced me he was very bright. Eagerly I searched one Web site after another about attention deficit disorders. The more I read, the more I wondered if we were living with the symptoms of an attention problem. I even printed out one person’s testimony and showed it to Jason. He was so discouraged at that point he read it reluctantly. His half-hearted response, “Yeah, that’s pretty much how I feel,” became a glimmer of hope as we called our doctor.

Armed with recommendations from our physician and friends, we prayerfully chose a psychologist to test Jason. The evaluation included parent, teacher and counselor observations; intellectual, academic achievement and attention testing; and a review of Jason’s school records.

On the day we met with the psychologist to receive the diagnosis, both my husband and I were anxious but hopeful. Perhaps we were about to discover the key to helping our son. We were also torn. In a way, we hoped he wouldn’t have a disorder he’d be required to manage throughout life. But on the other hand, if he did have ADD, perhaps with treatment he would improve and regain what he had lost personally, academically and socially. When the psychologist confirmed Jason’s ADD, we were relieved.

Choosing to medicate

The decision whether to use medication to manage ADD can be difficult and can be chosen only case by case. Psychostimulant drugs, used because they enhance neurotransmitter function, are typically taken for years, and their long-term effects are unknown. Still, we chose to give medication a try.

Our physician recommended Adderall, which Jason takes before and after school, and although he’s had no problems with the drug, he is re-evaluated twice a year. The psychologist who tested him for ADD has been helping him with organizational and self-confidence issues associated with his being undiagnosed for so long.

His teachers are part of the solution as well. We chose to inform them of Jason’s ADD, soliciting their input regarding his in-class performance while on medication. Their e-mails reveal their enthusiasm for the changes they are observing and their willingness to help.

Since we know that some people show little or no improvement with medical therapy, we were thrilled when Jason’s response to Adderall was both immediate and positive. “It’s like putting on the right pair of glasses after having blurred vision for years,” he said after just two days on his medication. If he misses a dose, he says he feels fuzzy.

Relief and joy

Our lives are quite different from the norm before Jason’s diagnosis. His report cards contain all A’s and B’s. His chores are done thoroughly and willingly. He remembers to wear his dental retainers and take his lunch when he heads out the door. His teachers report no missing assignments, and his cooperative attitude is greatly appreciated by his brother, father and me, as well as those at school.

We are seeing exciting social changes as well. Jason’s more attentive persona seems to be facilitating new friendships with both guys and gals. He’s again attending youth group and learning to play golf. He’s decided to take a summer school math class in order to be eligible for computer programming. And, because his grades and attitudes demonstrate responsibility, we are gladly allowing him to get his driver’s license.

Discovering Jason’s ADD has enabled each of us to enjoy his teen years and anticipate great things ahead as God shows him, and us, the unique purposes for which Jason was created.

The lunches? I still check them sometimes. Old habits die hard, I guess. But now I do so with great anticipation. There they are — packed and waiting, side by side on the second shelf of the refrigerator. The kitchen? No more jelly streaks on the counter. The place looks like a home décor photo from a women’s magazine. Well, almost.

Copyright © 2001 Cynthia Schnereger. Used by permission. This article first appeared in the September, 2001 issue of Focus on the Family magazine.

Life Counseling Center LLC. | 2021