If you answered "yes" to six or more of these questions, then she could have ADD, according to the criteria used by doctors (Diagnostic and Statistical Manual of the American Psychiatric Association).
Most people think that children who have ADD are hyper and impulsive. When this is the case, it is actually called ADHD (Attention-deficit/Hyperactivity Disorder). Recent evidence has shown that girls tend to not show the hyperactive component, and because they are not "causing trouble" in the classroom or at home, they are not diagnosed.
What happens when the girls are not diagnosed? They feel "different." They wonder what's wrong with them, why they can't keep friends, and consequently, their self-esteem suffers. Low self-esteem is that phrase that can cause a mother to break into a cold sweat. And no parent wants her child to feel ostracized. Unfortunately, these problems can get worse as time goes on, unless the problem is recognized.
My daughter was diagnosed with ADHD when she was only five. The fact that she was impulsive and hyperactive made hers a classic case. She could not even sit still for the kindergarten admission test and consequently had to be "held back" in Pre-K. Did the fact that the diagnosis was crystal clear make it easier to accept? No. We continue to struggle with the reality of it five years later.
It's still so difficult to stop and consider that those things that drive us crazy (not listening and obeying, losing things all the time, having to be reminded to do everything) are really not things she is doing to push her parents over the edge, but truly not her fault-even beyond her control.
In fact, she is often clueless as to why she has these difficulties and when she was younger and more physically impulsive, it would shake her world to realize that she was not in control. When she said: "I didn't mean to do that!" the look on her face confirmed it.
What is ADD? ADD refers to poor attention skills, impulsivity, and sometimes, also hyperactivity. About 5 percent of school-age children have been diagnosed with it, but certainly there are many more children (and their parents) who are wondering what the heck is wrong.
ADD is a neurobiological disability. The rate at which the brain uses glucose, its main energy source, was shown to be lower in persons with ADD, especially in the parts of the brain that are responsible for attention, handwriting, motor control and planning, according to information published by C.H.A.D.D. (Children & Adults with ADD). The main symptoms are inattention and impulsivity, not hyperactivity. As the children get older, the hyperness can lessen, but the other aspects tend to remain.
Dr. Kathleen Nadeau is often consulted for her expertise on the subject of ADD. She is director of Chesapeake Psychological Services of Maryland and has written several books on the subject. In a published interview, she stated that girls' symptoms may appear as: "Problems not usually linked with ADD: poor organization skills or messiness, sleep problems, shyness, poor social skills, disheveled appearance or grooming problems. They often are highly intelligent and creative but it doesn't show in their grades. They also may work long hours at homework but are not able to finish it. Many girls try to hide the fact that they are different. They avoid participation in the classroom. And because their attention is scattered, they don't always learn to get along with others. They may cling to one special pal or have trouble making friends."
Dr. Nadeau also says that "most of the children with ADD are gifted." I have heard that from doctors and experts over the years-that ADD children tend to be very imaginative, creative, and bright, but because they are so unfocused and appear to not care, are seen as poor students, and consequently, "slip through the cracks."
That always made me feel a bit better! I see that in my daughter. When something interests her, she sets a single-minded focus on it that could melt metal with its intensity, but give her a simple math problem and she launches into another stratosphere. Over the years, the teachers who had patience in abundance (more than me!) and took the time to get to know her, were able to inspire her and keep her interest. Certainly, a child with ADD or ADHD can cause the most well-meaning teacher to want to pull her hair out at times. (Parents too!)
From my own experience, children with ADD do best when they are in smaller classrooms, where they can get the extra attention they need. They should also be seated up front, where the teacher can get better eye contact. Many schools require their teachers to have a basic understanding of how to work with children who have ADD (they always need instructions repeated for one thing), but this is not always the case. I've had everything from a teacher who had studied ADD and the link between it and giftedness, to a teacher who had never encountered it and thought my daughter was just a goof-off.
There are some rights that you have as a parent, at least in the public schools that you should know about. The Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act of 1973 say that children with ADD must receive access to special education and/or related services when needed. This education must be designed to meet each child's unique educational needs through a tailored program (extracted from C.H.A.D.D., Educational Rights for Children With ADD).
C.H.A.D.D. recommends that if you feel your child has ADD, you should…
Incidentally, special support should also be provided by all colleges and universities that receive federal funding. Kathleen Nadeau cautions, however, that the quality of the support varies widely. If you have a college-age child, you should check out her book, called: A College Survival Guide for Students with ADD and LD, which includes 20 questions to ask the school to help you make the best decision.
In her work to help school-age girls with ADD, Dr. Nadeau has just published a book, titled: Understanding Girls with Attention Deficit Hyperactivity Disorder, which she co-authored with Drs. Patricia Quinn and Ellen Littman. Here is another "test" you and your daughter can take, excerpted from the website.
Check those that apply to you:
I forget to bring my homework.
I'm often late for school and other activities.
My thoughts wander when I'm trying to listen in class.
I often get headaches and stomachaches.
I get annoyed when someone is making noise near me.
I spend a lot of time looking for lost things.
I often say I'll do something in a minute, but my parents say I never do it.
I could play video games for hours.
Even when I know the material, I can't remember it when I'm taking a test.
When most have finished an assignment, I'm still working on it.
I have trouble remembering all the directions from an assignment.
It's hard to concentrate unless it's something I'm interested in.
Sometimes other girls don't like me, but I don't know why.
If you and your daughter answer "true" to most of the questions, you may want to consult an expert.
What will the treatment involve when you do consult an expert? The most prevalent treatment is medication, especially Ritalin, although other medications are used (Dexedrine, Cylert, Desoxyn and Adderol).
Although the phenomenon of ADD is pretty widely accepted, the use of medication to treat it continues to be a raging controversy. Ritalin is the brand name for a stimulant that enhances dopomanine flow in the brain and increases impulse control and attention span. It is very daunting when you face the prospect of giving your "baby" drugs every day. There are even some frightening side effects to consider (insomnia, headaches, weight loss, rebound effect. As it wears off, the condition can worsen: motor tics.).
The doctors like to say that medication does not control the behavior, but rather reduces the symptoms. You've probably heard some parents tell horror stories about how Ritalin turned their child into a "zombie" or neutralized her personality.
Then, you hear the success stories of how children who were failing in school are now doing great, and they are able to have friends and are flourishing.
As a mother of a child who has ADHD and a writer, I've been smack in the middle of the controversy. For instance, take this excerpt from a review I did for Profit Magazine, called Your Drug May Be Your Problem, by Dr. Peter Breggin.
"We remain deeply concerned about the number of children already diagnosed and being administered Ritalin and other stimulants. When we drug millions of children to make them more compliant and easier to manage at home and in school, it says much more about our society's distorted values than about our children."
Dr. Breggin does not believe that there is any solid evidence to support ADD as a genuine disorder, and he claims there is a big propaganda movement to push the drugs on doctors and parents.
We've tried it both ways-with Ritalin and without. It is like night and day with my daughter. She is much calmer and able to focus better with it. Still, when I did that interview-I freaked! I immediately requested a meeting with our doctor and was quite impressed with his response to me. I did feel reassured by the length of history behind the drug-and lack of long-term consequences (at this point anyway). Still, even he said, we really can't know exactly how these drugs work in our systems and on our minds.
There are other avenues some parents take, such as counseling, to help the children recognize and deal with these behaviors. I am hopeful that when my daughter is older and more mature, that I will be able to phase her off the drug and use more behavior-management strategies. It's difficult to weigh the worries concerning medication with poor school performance, low self-esteem and lack of impulse control.
I'm glad that the publisher has asked me to do a series on ADD-so that I can try to dig up the latest data for readers' sakes as well as my own!
The best advice I can give "from the trenches" is not to jump into anything. Get opinions and second opinions. Don't let anyone rush you into anything, including doctors and teachers. Try to find the best school environment. We always did better in smaller, private (and yes, expensive) schools. Where we are now, the only private school in our area has turned out to be a disaster, as they have no experience in dealing with this. In this case, I'm expecting to turn to the public school, even though the bigger classrooms scare me. My daughter is having a very tough time with math, so my hope is that through the laws that protect us, she will be able to get specialized (and smaller ratio) help in this area. Even though, it means swallowing hard to allow her to be labeled as needing that help…a tough thing for any parent to accept.
Support groups are set up in many areas-and you can find these through your local schools, your doctor or the local chapter of C.H.A.D.D. It is very helpful to hear how other parents are helping their kids to live with attention deficit disorders, how they are dealing with schools and teachers, and just plain staying sane in the process!
If you have something to share about ADD or have had success with any form of treatment, please share it with other moms here.