Attention Deficit Hyperactivity Disorder: A Parent's Perspective (1996)

As a parent and an educator who has spent the last 10 years struggling to assist her own ADHD child, Ms. Thompson gives readers suggestions for managing the challenges that face such children and for enhancing the quality of their lives. ATTENTION deficit hyperactivity disorder (ADHD) has had many names over the years: organic drivenness, fidgety Phils, post-encephalitic behavior disorder, minimal brain damage, minimal brain dysfunction, hyperkinesis, hyperactivity, attention deficit disorder (ADD), and attention deficit disorder with or without hyperactivity (ADD/ADHD).(1) A child with ADD without hyperactivity would exhibit all the distractibility of an ADHD child without the physical activity. Many of the current books available use ADD and ADHD interchangeably. For the purposes of this discussion, I will use ADHD, as that accurately represents my son's diagnosis and my experience as a parent. What Is ADHD? ADHD is a neurological syndrome whose classic, defining triad of symptoms includes impulsivity, distractibility, and hyperactivity or excess energy.(2) Studies indicate that approximately 3% to 5% of children in the U.S. can be diagnosed with ADHD. Among children with ADHD who have been referred to clinics, boys outnumber girls by a ratio of approximately 6:1.(3) ADHD has been defined in a variety of ways over the past 20 years, leading to confusion among education professionals. Most recently ADHD has been described as the display, with developmentally inappropriate frequency, of inattention, impulsivity, and overactivity.(4) To be considered symptoms of ADHD, the behaviors must initially have been exhibited in early childhood (prior to the age of 7) and displayed across a variety of settings (school, home, and play). To meet the diagnostic criteria of the American Psychiatric Association, the child must have been creating disturbances for at least six months, during which time at least eight of the following behaviors must have been exhibited: 1. often fidgets with hands or squirms in seat (though in adolescents this symptom may be limited to subjective feelings of restlessness); 2. has difficulty remaining seated when required to do so; 3. is easily distracted by extraneous stimuli; 4. has difficulty waiting for turns in games or group situations; 5. often blurts out answers to questions before the questions have been completed; 6. has difficulty (not due to oppositional behavior or failure of comprehension) following through on instructions from others; 7. has difficulty sustaining attention in tasks or play activities; 8. often shifts from one uncompleted activity to another; 9. has difficulty playing quietly; 10. often talks excessively; 11. often interrupts or intrudes on others (e.g., butts into other children's games); 12. often does not seem to listen to what is being said to him or her; 13. often loses things necessary for tasks or activities at school or at home (e.g., toys, pencils, books, assignments); or 14. often engages in physically dangerous activities without considering possible consequences (e.g., runs into the street without looking), but not for the purpose of thrill-seeking. At the age of 3, our son Karl exhibited all 14 of these criteria. He was and still is a textbook case of ADHD. At the time he was diagnosed, I would gladly have blamed myself for being a bad parent who did not provide enough discipline rather than admit that anything was wrong with my child. It was only through consultations with Karl's day-care provider, with my family physician, and with a psychiatrist specializing in the diagnosis and treatment of ADHD--as well as through my own research--that I began to realize that I must treat ADHD like any other neurological condition. If Karl had inherited family genes for epilepsy rather than ADHD, I would have provided him with whatever anti-seizure medication and treatment he needed to help him live a normal life. …