How Can the ERG Help?
ADHD typically requires a three pronged approach to treatment. The most common treatment approach is medication. However, medication is limited and often people require additional assistance in study skills strategies, executive functioning, organization, and working memory. At the Educational Resource Group, we identify each client’s specific pattern of processing weaknesses and tailor a program to meet individualized needs. Academic coaching is particularly helpful in overcoming executive functioning difficulties. For more information on how our center can help you or your child, contact us today.
What is Attention-Deficit Disorder?
ADD is officially called Attention-Deficit/Hyperactivity Disorder, or AD/HD (American Psychiatric Association, 1994), although most lay people, and even some professionals, still call it ADD or A.D.D. (the names given in 1980) or ADHD . The disorder’s name has changed as a result of scientific advances and the findings of careful field trials; researchers now have strong evidence to support the position that AD/HD [ A.D.D. or ADHD ] [as we will refer to the disorder throughout the remainder of this Briefing Paper] is not one specific disorder with different variations. In keeping with this evidence, AD/HD [ A.D.D. OR ADHD ] is now divided into three subtypes, according to the main features associated with the disorder: inattentiveness, impulsivity, and hyperactivity. The three subtypes are:
- AD/HD (A.D.D. OR ADHD) Predominantly Combined Type
- AD/HD (A.D.D. OR ADHD) Predominantly Inattentive Type
- AD/HD (A.D.D. OR ADHD) Predominantly Hyperactive-Impulsive Type
These subtypes take into account that some children with AD/HD [ A.D.D. OR ADHD ] have little or no trouble sitting still or inhibiting behavior, but may be predominantly inattentive and, as a result, have great difficulty getting or staying focused on a task or activity. Others with AD/HD [ A.D.D. OR ADHD ] may be able to pay attention to a task but lose focus because they may be predominantly hyperactive-impulsive and, thus, have trouble controlling impulse and activity. The most prevalent subtype is the Combined Type. These children will have significant symptoms of all three characteristics.
What Causes AD/HD (A.D.D. OR ADHD)?
AD/HD [ A.D.D. OR ADHD ] is a neurobiologically-based developmental disability estimated to affect between 3-5% of the school age population (Professional Group for Attention and Related Disorders,1991). No one knows exactly what causes AD/HD [ A.D.D. OR ADHD ]. Scientific evidence suggests that the disorder is genetically transmitted in many cases and results from a chemical imbalance or deficiency in certain neurotransmitters, which are chemicals that help the brain regulate behavior. In addition, a landmark study conducted by the National Institute of Mental Health showed that the rate at which the brain uses glucose, its main energy source, is lower in subjects with AD/HD [ A.D.D. OR ADHD ] than in subjects without AD/HD [ A.D.D. OR ADHD ] (Zametkin et al., 1990).
Even though the exact cause of AD/HD [ A.D.D. OR ADHD ] remains unknown, we do know that AD/HD [ A.D.D. OR ADHD ] is a neurologically-based medical problem. Parents and teachers do not cause AD/HD [ A.D.D. OR ADHD ]. Still, there are many things that both can do to help a child manage his or her AD/HD [ A.D.D. OR ADHD ]-related difficulties. Before we look at what needs to be done, however, let us look at what AD/HD [ A.D.D. OR ADHD ] is and how it is diagnosed.
What Are the Signs of AD/HD (A.D.D. OR ADHD)?
Professionals who diagnose AD/HD [ A.D.D. OR ADHD ] use the diagnostic criteria set forth by the American Psychiatric Association (1994) in the Diagnostic and Statistical Manual of Mental Disorders; the fourth edition of this manual, known as the DSM-IV, was released in May 1994. The criteria in the DSM-IV (discussed below) and the other essential diagnostic features listed in the box labeled “Defining Attention-Deficit/Hyperactivity Disorder” are the signs of AD/HD [ A.D.D. OR ADHD ].
As can be seen, the primary features associated with the disability are inattention,hyperactivity, and impulsivity. The discussion below describes each of these features and lists their symptoms, as given in the DSM-IV.
A child with AD/HD [ A.D.D. OR ADHD ] is usually described as having a short attention span and as being distractible. In actuality, distractibility and inattentiveness are not synonymous. Distractibility refers to the short attention span and the ease with which some children can be pulled off-task. Attention, on the other hand, is a process that has different parts. We focus (pick something on which to pay attention), we select (pick something that needs attention at that moment) and we sustain (pay attention for as long as is needed). We also resist (avoid things that remove our attention from where it needs to be), and we shift (move our attention to something else when needed).
When we refer to someone as distractible, we are saying that a part of that person’s attention process is disrupted. Children with AD/HD [ A.D.D. OR ADHD ] can have difficulty with one or all parts of the attention process. Some children may have difficulty concentrating on tasks (particularly on tasks that are routine or boring). Others may have trouble knowing where to start a task. Still others may get lost in the directions along the way. A careful observer can watch and see where the attention process breaks down for a particular child.
Symptoms of inattention, as listed in the DSM-IV, are:*
- often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities;
- often has difficulty sustaining attention in tasks or play activities;
- often does not seem to listen when spoken to directly;
- often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions);
- often has difficulty organizing tasks and activities;
- often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework);
- often loses things necessary for tasks or activities (e.g., toys, school assignments,pencils, books, or tools);
- is often easily distracted by extraneous stimuli;
- is often forgetful in daily activities.
* (American Psychiatric Association, 1994, pp.83-84)