How is a concerned parent to know whether their child’s behavior is normal, or whether it indicates he has ADD or some other problem? How can a worried parent navigate the confusing waters of meeting their child’s needs against the prevailing cultural norm of medicating them? With all the medication advertisements and pressure to medicate for everything, how can one know when--and when not--to seek medical attention?
It is my hope that the information in this article will empower you so that you can confidently make the best choice for your child. I will provide you with tools to help you weigh and consider what YOU--as the foremost expert on your child—know, so that you no longer need to passively accept an expert’s diagnosis (and the nearly inevitable prescription that comes with it).
As a case in point, I recently met with a young man who been labeled as ADD by medical professionals. They had tried, unsuccessfully, to help him overcome his symptoms through numerous medications. After learning that he often sits for hours on creative building projects, and that he frequently writes and acts out elaborate stories with multiple characters, often enlisting family members to help him fill the roles. He also reads for hours into the night. Considering the ADD/ADHD criteria which I will detail later, I was unable to concur with the findings of the MD’s.
To be clear, I am not saying ADD/ADHD are not legitimate concerns, but I do not believe they warrant the rampant diagnosis as is common today. Indeed, prescription demand for methylphenidate (commonly known as Ritalin®) has increased more than 2800 percent, rising from 1768 kg in 1990 to 50,000kg in 2010! For me, this indicates a society that has lost focus on self awareness and personal control as well as gained a reliance on chemicals. (http://www.justice.gov/dea/pubs/cngrtest/ct051600.htm) Another reason for this rise could be due to misdiagnosis and quick fix interventions. AD(H)D symptoms mirror very closely those of anxiety, traumatic stress syndrome and Post Traumatic Stress Disorder, though these are rarely considered as childhood concerns. I strongly encourage you to go to this page and read about some of the effects medications are having before just accepting that as an option. http://www.ssristories.com/index.php
One major indicator of an accurate ADD/ADHD diagnosis is time. From The Diagnostic and Statistical Manual IV-TR (DSM IV-TR) published by the American Psychological Association and the "Bible" of mental health diagnosing, any diagnosis of ADD/ADHD MUST have behavioral symptoms lasting LONGER than 6 months; some must be present in two or more settings; and some MUST have been present prior to the age of seven. For many kids labeled ADD, these tests cannot be met but the diagnosis is still given. So what do we do when the professionals we trust are not doing the right thing by our children? As good parents, we must educate ourselves and take action.
Criteria for ADD and ADHD
ADD/ADHD must have six or more of the following behaviors, seen in 2 or more settings, and present BEFORE the age of seven. They are:
(1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: (emphasis added)
(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
(2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: (emphasis added)
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts as if "driven by a motor"
(f) often talks excessively
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
Be cautioned that many of these behaviors are part of childhood and can pass quickly as the child develops. This is the reason for the six month minimum of observing the behaviors. For parents and educators, six months can be a long time to watch and try alternatives, but it is the better than a missed diagnosis and unneeded medication.
When considering whether anyone meets the criteria for a diagnosable disorder, the diagnosing professional is ethically bound to do a complete rule out any other factors. As parents, you are entitled to see this rule out of all other possible options. Ask questions, be informed, and make a researched decision regarding your child’s mental well-being.
I told you earlier of a recent conversation I had with a family and their “ADD” child. After listening to the history of loss and abandonment, the child’s intellectual prowess and ability to focus on long projects, I realized that this was a child suffering from complicated grief, anxiety, and stress (similar to an anxiety disorder) which can often be brought on by fear of failure or social panic due to their own inner insecurities. This anxiety inhibits the logic brain functioning, and triggers an adrenaline surge that makes sitting and focusing very difficult. Consider your own emotional and mental condition when faced with a sales presentation, public speaking event, or any stress-inducing moment, particularly when you are feeling less then acceptable for the event.
For a child, school can be a very frightening place. Demands and performance expectations increase the potential for failure. Social acceptance makes every action and outcome vital to your existence. Teachers are generally very nurturing, but can become a very threatening for a child in their roles of instructor, disciplinarian, evaluator for that class. The teacher and school officials demeanor might trigger fears in the child from associated memories unseen by the outside world. All of these factors lead to conditions of anxiety and not ADD.
Finally, I want to address what I feel is a deeper concern often completely over shadowed by the ADD/ADDHD prevalence, and that is the brain of the gifted child. I know that all parents believe that their children are exceptional, but the mind and behavior of the gifted child brings with it challenges for the teacher, the school, and the home. These children will mirror many of the characteristics of the ADD/ADHD child when they are not stimulated. Lack of mental engagement bores the gifted mind. These children wander, get mouthy when the teacher asks a question, or refuses to do work that they feel is tedious and below them. A few years ago I watched as a gifted child was doing a homework assignment and instead of filling in the missing word from the sentence, drew a picture of the word. Ultimately, this child wrote synonyms and antonyms for the word out of boredom with the task. In a classroom setting (or employment) these attempts to invigorate the mind and occupy the intellect are seen as defiant or obstinate, and can lead to misleading others. These behaviors will appear to be inattentive. Perception is that the child is unable to remain on task. The reality and the challenge, is that they are mentally bored and need stimulation. Their brains are different than the others in the class.
From "What to Expect When You’re Raising a Gifted Child: a handbook for parents of gifted children" Published by the Ohio Association for Gifted Children the following list outlines characteristic behaviors for the gifted child. Particularly focus on the similarities between the listed concerns in the AD(H)D lists and the Negative behavior list here.
Characteristic Positive Behavior Negative Behavior
Learns rapidly/easily Memorizes and masters basic facts quickly Gets bored easily, resists
Reads intensively Reads many books and uses library on own Neglects other
Advanced vocabulary Communicates ideas well Shows off, invokes peer
Retains a quantity of Ready recall and responses Monopolizes discussions
Long attention span Sticks with a task or project Resists class routine,
Curious, has a variety of Asks questions, gets excited about ideas Goes on tangents, no follow-
Works independently Creates and invents beyond assigned tasks Refuses to work with others
Alert and observant Recognizes problems Impolitely corrects adults
has a good sense of humor Able to laugh at self Plays cruel jokes or tricks
Comprehends, recognizes Able to solve social problems alone Interferes in the affairs of
High academic achievement Does school work well Brags, egotistical, impatient
Fluent, verbal facility Forceful with words, numbers Leads others into negative
leads peers in positive ways Individualistic asserts self and ideas Has few friends, stubborn in
has a sense of own uniqueness Self motivated, self-sufficient requires minimum Is overly aggressive,
direction or help authority
Behavioral concerns pose a problem for any parent or teacher regardless of the reason. Finding the correct cause and intervention is time consuming and requires investigation outside of the standard checklist diagnostic. As parents, we owe it to our children to do all we can for them, before we rely on a medication, if there is an alternate route or cause.
In coming posts, I will address the underlying causes of the challenging behaviors that these kids present and how parents can effectively assist the child in over coming these struggles. Many good kids are set off on terribly destructive paths and do not need to be, if the best options were presented and provided. Don't miss out on your opportunity to provide the best chance for your child. Take us up on our Success Strategies Harmonized package with Brainwave Optimization and see what living is really like.
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