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Attention-Deficit/Hyperactivity Disorder
By Grant L. Martin, Ph.D.
L ook at any classroom, in any city or town. One thing will be consistent. Some children can't sit still. Others are highly distractible, forgetful, or inattentive. Some appear sidetracked by every little thing and don't seem to learn from their mistakes. Many of these children disregard rules, even when they are disciplined repeatedly. Others act without thinking, causing accidents and bringing on repeated reprimands. This collection of problematic features is called Attention-Deficit/Hyperactivity Disorder (AD/HD).
AD/HD is one of the most prevalent problems of childhood. The consensus of professional opinion is that approximately 3 to 5 percent of children have AD/HD. This translates to as many as two million school-age children. Every classroom in the country averages at least one AD/HD child! And these children are no different at home. AD/HD can make family life chaotic and stressful. No matter how hard parents of AD/HD children try to do the right thing, these children persist in daydreaming, missing homework assignments, and neglecting chores.
Types of AD/HD
Contrary to the popular stereotype of out-of-control children hanging from the rafters, there actually are several types of AD/HD. Some children are primarily impulsive and hyperactive. Others are inattentive and distractible. Then, there is a third group who have both impulsive and inattentive characteristics.
Children who suffer from the hyperactive type of ADHD are excessively noisy, disruptive, messy, irresponsible and immature. They typically exhibitaggressive conduct problems, are impulsive and may show some bizarre behavior. "Whirling dervish" or "Dennis the Menace" labels apply to these children. They have a higher risk for serious aggressive or negative conduct and they are more likely to act in antisocial ways.
In contrast, attention deficit children who are predominantly of the inattentive type tend to be anxious, shy, socially withdrawn, moderately unpopular, poor in sports and have low school performance. This student is often seen staring into space, daydreaming, forgetting daily activities, and he may appear to be low in energy, sluggish, or drowsy. He or she often has difficulty becoming sufficiently aroused and vigilant to pay attention to academic tasks.
This student may be described as a "space cadet" or "couch potato" and often seems lost in thought, apathetic and lethargic. He or she is less aggressive, impulsive and overactive than the hyperactive type, and has fewer problems in peer relationships. This category probably makes up the largest number of AD/HD children, yet may be the most under diagnosed because their problems do not scream out for help as loudly as those with hyperactivity.
Some children have a combination of both inattention and hyperactive-impulsive features. This child has most of the behavioral manifestations of inattention such as failure to give close attention to details, careless mistakes, and being easily distracted by extraneous stimuli. In addition, the child has trouble with hyperactive-impulsive behavior like fidgeting with hands or feet, inability to remain seated, needing to be on the go, interrupting others, and finding it difficult to await his or her turn.
Whether or not your child is diagnosed with AD/HD depends on the degree and frequency of the symptoms. All children are sometimes inattentive, impulsive or have high energy levels. But with attention deficit children, these symptoms are part of the daily routine rather than the exception. Also, these behaviors tend to occur at school, church, Grandma's house and the grocery store, as well as at home. The general rule is that these children are consistently inconsistent!
 Malfunctioning of certain neurotransmitters
in the brain make it harder for children
and adults with AD/HD to sort out or
regulate internal and external stimuli,
leaving them with difficulty concentrating
and focusing on what is most important.
AD/HD is one of the most thoroughly researched conditions of childhood. Yet the exact causes are still not known. The major evidence points to diminished activity in certain brain regions due to heredity as the most likely cause of most forms of attention disorder. In other words, most AD/HD children seem to arrive in the world with brain functioning that impacts their temperaments in ways that leave them difficult to manage.
Malfunctioning of certain neurotransmitters in the brain make it harder for children and adults with AD/HD to sort out or regulate internal and external stimuli, leaving them with difficulty concentrating and focusing on what is most important. The frontal region of the brain is responsible for memory, organization, inhibiting behavior, sustaining attention, initiating self-control, and planning for the future. When children with ADHD try to concentrate, this area of the brain actually has a decrease in activity! Like a car engine that is not receiving an adequate supply of fuel, its functioning is sporadic and uneven. Children without ADHD have an increase in activity in this portion of the brain when they attempt to concentrate.
Children without this genetic predisposition can develop AD/HD through illness or injury, but this rarely happens. There is also very little evidence that AD/HD can arise purely out of social or environmental factors, such as family dysfunction, diet, toxins, or faulty parenting. It is true that parental frustration and negative reactions toward your child can aggravate the problem, but they do not actually cause AD/HD. The ultimate cause of AD/HD appears to be an inherited condition affecting the biochemistry of brain function.
Diagnosis of AD/HD
If your child has some signs of AD/HD don't immediately rush to the conclusion that your child has AD/HD. But don't hesitate to seriously consider the possibility either. Take time to read a few articles or a book or two on AD/HD. Talk to other parents who have an AD/HD child. Prayerfully evaluate what you have learned about attention disorder and compare the information to the consistent behavior of your child. If the descriptions seem to match up, a professional evaluation may be appropriate. Here are some conditions or characteristics that suggest an evaluation could be helpful:
- Many of the symptoms of inattention, distractibility or hyperactivity/impulsivity described earlier have persisted for at least six months.
- AD/HD-type descriptions are very prominent in the day-to-day life of your child.
- Other parents or relatives have suggested to you that there might be something out of the ordinary going on with your son or daughter.
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