Children Who Have Difficulty Paying Attention Can Have ADHD

Question: Our son is twelve years old. Since he started grade 1, we have heard the comments “can’t keep his mind on the task at hand,” “slow,” “daydreamer,” “doodler,” “just can’t seem to get his work done,” “can’t concentrate.” When he was younger, he was often disruptive during class. We live on a farm, and he is expected to help out. He can’t be poky around cattle, or they will run him down. It seems like he is not able to understand this. We have to constantly nag him to get things done. He is now in grade 7. Please offer us some suggestions.

Answer:

The description that you gave about your son is fairly typical of children with Attention Deficit Hyperactivity Disorder, also called ADHD. I have previously written about this medical condition. I will discuss about it again here for you, and for many other parents who are still troubled by the diagnosis as well as the proper management.

ADHD is a fairly common condition in children. We still do not completely understand how it happens, and there is no reliable test to diagnose this condition. However, several things have become quite clear. There is a very strong genetic tendency. This means some siblings, parents, or other close relatives can have similar behaviour or difficulty, although they may or may not have been diagnosed with this condition.

Recent research has shown that ADHD is most likely caused by certain chemicals inside the brain. As you may already know, the brain contains numerous nerve cells. Each nerve cell sends out many nerve fibers to make connections with other nerve cells. The nerve fibers are used to pass information or message between nerve cells. These nerve fibers, however, do not touch each other. There is a very small gap, called the synapse, between the very ends of nerve fibers. One nerve cell sending a message along the nerve fiber needs to release a chemical at the end of the fiber. This chemical crosses the synapse, and the next nerve fiber will pick up the message. If there is any problem in the chemical, the message will never reach the second nerve fiber.

In our brains, there are a number of “control centres” located in the front part of the brain. These control centres send out nerve fibers to co-ordinate the brain’s function. It is now believed that the chemicals at the ends of nerve fibers from these control centres are not working properly, so that the rest of the brain functions on “auto-pilot,” with little or no control.

This is like having a great sports car, but without the steering wheel and brake. It can go very fast, but cannot control the speed or direction. Sooner or later it is not going to be able to negotiate some tough curves and gets into trouble.

Another example that I often use is the school band. Before the teacher comes out to conduct, the students can tune their instruments, but it is not music. However, when the teacher starts conducting, beautiful music begins to flow. The teacher is like the control centre of the brain. If the conductor is not present, there are lots of noise, but no music.

In a similar way, ADHD children who lack the control centres to co-ordinate when to do what, they have lots of activities, but often with very little useful results to show for.

Just like any other medical condition, some are affected more severely than others. Those who have mild ADHD may never be diagnosed, and they can function very well in society. They can do several things at the same time, and lead very productive lives. Those who have more severe problems that affect their education, social and family lives, would need proper diagnosis and management.

I have often heard the comments that ADHD is only an excuse for poor parenting. Those parents who live with these children know that it is not an excuse. They suffer everyday because of what their ADHD children do or didn’t do. I know it because I grew up with a brother who has severe ADHD.

If you ever wonder, what happens to these children when they grow up? Does Attention Deficit Hyperactivity Disorder continues into adult life? The answer is yes, but it tends to affect different people in different ways. Some have difficulty in their work because concentration and distraction continue to be a problem. Many have family and social problems. Their children have a very high chance of having ADHD.

In helping children with ADHD, one has to be flexible and find out which area the child needs help. Some need strategy to maintain concentration and reduce distraction. Others may want help with organization or study skills. Many would need help to socialize with their peers. Parents will need help to set rules at home.

There is no one single formula. Every child’s need is different. It is important for parents to work with teachers, school counselors, and physicians to design strategies that can help their particular child.

For some students, strategies alone will not work enough. They need medications to help with their concentration or impulsiveness. Children with attention problems may be able to get by in school until they reach higher grades. If they didn’t get help early enough, by the time they start to fail, it can be too late already.

Medications may be necessary when children are very impulsive and do things that can hurt themselves or others. Your son likely belongs to this group. Since you are living on a farm, he can be hurt easily by animals or farm equipments if he does not pay enough attention, or if he decides to do something dangerous.

I will not discuss a great deal on medications here. I want to point out that most ADD children who need medications will respond to stimulants (Ritalin and Dexedrine). One caution is that these medicines should be started at a low dose and increased gradually until the best result is reached. The dose should not be simply calculated according to the weight of the child. Each child’s condition and severity is different, and may require a lower or higher dose.