What Does It Mean for Parents and Families when Their Child is Diagnosed
with This Condition?
by Anne S. Robertson
"What is ADD/ADHD?"
Some specialists estimate that anywhere from 3-10% of school age children
are affected by attention deficit disorder (ADD) or attention deficit
hyperactivity disorder (ADHD) (Goldstein, 1992; Rief, 1993). Behavioral
characteristics of attention deficit disorder include: being easily distracted,
difficulty listening and following directions, difficulty focusing and
sustaining attention, difficulty concentrating and staying on task, inconsistent
performance in school (some say the one common aspect of ADD/ADHD children
is that they are "consistently inconsistent"), being tuned out
or "spacey," disorganized or having poor study skills, and difficulty
working independently (Reif, 1993). Children with ADHD may have characteristics
similar to a child with ADD, but ADHD children may also demonstrate impulsive
behaviors, a high activity level, difficulty with transitions, being easily
over-stimulated or aggressive, social immaturity, a high frustration level,
and low self-esteem (Rief, 1993).
All children may have some of these behaviors, at an age-appropriate
level, or during a transitional phase, such as after the birth of a new
baby in the family. However, the ADD/ADHD child will show a pattern, over
a period of years, of having a number of these characteristics at levels
that are not situation- or age-appropriate.
The scientific study of the ADD/ADHD condition has been extensive although
the name has changed over the past few decades. In the past, children
who have had signs of this condition have been labeled as fidgety, minimally
brain damaged, hyperkinetic, or having minimal brain dysfunction (Goldstein,
1992). The American Psychiatric Association outlines the criteria for
defining ADD/ADHD, including the presence of at least 8 of 14 behavior
characteristics (Wodrich, 1994).
The diagnosis of ADD/ADHD should not be made quickly. It should include
information from a variety of significant adults in the child's life including
the parents, teachers, physician, and psychologist who specializes in
the field, as well as input from the child. It may also be helpful to
have a learning specialist involved since ADD/ADHD children frequently
have special education needs such as giftedness or difficulty in math.
As research continues, some specialists are encouraging people to think
of ADD/ADHD not as a disorder, but simply as a different style of learning
which, when supported, can enhance the student's innate abilities.
It is not unusual for ADD/ADHD children with high intellectual abilities
to go undiagnosed until middle school or junior high since they have learned
how to compensate enough to "get by" in elementary school (Goldstein,
1992). When a student is diagnosed later in life, research shows that
elementary teachers reports had often attributed these students
inattention and inconsistencies to boredom, laziness, or behavior problems.
However, the increased demands of secondary school make it difficult for
even the brightest student to keep up both academically and socially.
An accurate evaluation with appropriate support becomes essential for
these students to help them fulfill their potential and increase their
self-esteem, which may have already been damaged by behavior problems
or poor social relationships.
"Could I have prevented ADD/ADHD in my
When parents have a child with any type of problem, it is not unusual
for the parents to feel guilty or blame themselves. Parenting education
and support has been shown to be very helpful for families with an ADD/ADHD
child and its value cannot be overemphasized (Goldstein, 1992; Rief, 1993).
However, as scientists and medical professionals learn more about the
possible causes of this condition, there is growing evidence that parents
likely had little control over the cause of ADD/ADHD (Rief, 1993; Wodrich,
1994; Goldstein, 1992). The following are commonly accepted as the most
- Heredity/Genetic predisposition: Another member of the family--grandparent,
uncle, aunt, etc.--had a similar temperament or pattern of behavior.
- Biological/physiological causes: Possible chemical imbalance that
inhibits the efficiency of the neurotransmitters of certain portions
of the brain.
- Lead poisoning: Ingesting toxic levels of lead, either by mouth or
- Allergic/medical conditions: Predisposition toward asthma, food allergies,
and ear infections.
- Pregnancy/birth complications: Premature birth, lack of oxygen,
or history of prenatal exposure to drugs/alcohol.
- Brain injury: Present in a very small number of ADD/ADHD children.
- As researchers continue to look at the causes of ADD/ADHD, continued
advances will likely be made so that the diagnosis will not be confused
with other unrelated conditions.
"Will it go away?"
It was previously thought that the majority of children outgrew many
characteristics of ADD/ADHD by adolescence. Many parents and teachers
felt that if they could just get their child through the elementary school
years then ADD/ADHD issues would diminish. It is now clear that as many
as 75% of ADD/ADHD youngsters will continue to have problems related to
attention deficit throughout their adolescence and into adulthood (Wodrich,
1994). While the adolescent may not be as conspicuously hyperactive as
a younger child, he will likely still struggle, in excess of the normal
teenage experience, with impulsiveness and inconsistency, which will affect
school, family, and peer relationships. This may become particularly problematic
during unsupervised times with peers, and during a stage when parents,
teachers, and society in general have increased expectations of adult-like
As many as 65% of children who struggle with hyperactivity will still
have some ADHD characteristics as adults, and a much smaller number, 25%,
will continue to have significant difficulty related to ADD/ADHD during
adulthood (Wodrich, 1994; Goldstein, 1992).
"What can be done now?"
Some of the information and statistics about hyperactivity can be worrisome.
It is important for parents to remember that the majority of adults with
ADD/ADHD are successful, contributing members of society. But it also
clear that there are several non-medical factors that can affect that
outcome. These factors include early diagnosis and treatment, intelligence,
family status, friends, activity level, ability to delay rewards, aggression,
and parenting style (Goldstein, 1992).
Once an assessment has determined that a child has ADD/ADHD, it is important
that a comprehensive plan of treatment be developed. Effective management
at school, within the family, and within peer relationships is important.
Most experts recommend a three-step plan that involves the school environment,
home environment, and medical support.
Parents can meet with the teacher and the district's special education
coordinator to request an Individualized Educational Plan (IEP) for their
child that will address the child's need for academic or behavioral support.
Parenting education and support is a critical component to consistent
management. Key elements to parental support include: understanding, distinguishing
between noncompliance and incompetence, giving positive directions, and
fostering success (Goldstein, 1992). While some ADD/ADHD children do not
need medication to help with managing their condition, many others do
during some stage in their life. Parents need to investigate the alternatives
available for their child and when medication would be helpful.
Drs. Sam and Michael Goldstein suggest the following ways of encouraging
success for your hyperactive child (Goldstein, 1992):
- Educate yourselves.
- Exercise effective management strategies at home.
- Foster parental unity.
- Develop positive parent-child relationships.
- Maintain family stability.
- Cultivate good friends.
- Get and use problem-solving training.
- Work toward school success.
- Do not ignore nonhyperactive problems.
- Seek appropriate medical treatment.
- Occasionally reviewing these areas and maintaining consistent progress
for your ADD/ADHD child in all categories will help with management.
"How will this affect our family and our
The impact that the ADD/ADHD child may have on the family will vary greatly
depending on the extent that the child is affected, the family culture,
and other siblings. If the family culture and the parents place a high
value on activities and athletic prowess, then it is likely that a very
active child will be admired and given appropriate outlets for physical
activity. The same may be true of an intensely emotional child in a family
that values dramatics and the arts. However, it may be very difficult
for a highly active or intense child if the family culture is more sedate
or less vocal. In a situation where the childs behavior is significantly
different than family expectations, it is easy when problems arise for
the ADD/ADHD child to become the family "scapegoat." Understanding
how the family culture can change to positively impact the childs
temperament is an important goal of parenting education.
Also, any parent with more than one child knows that children within
the same family can have vastly different personalities. Under the illusion
of "fairness," parents often feel that siblings should be treated
identically, have the same rules, and aspire to similar expectations.
There is evidence to suggest that parents shouldnt be quite as concerned
about equal treatment since children do understand, and think it is all
right, when parents treat them differently (Kowal, 1997). Learning to
understand and respect the different strengths in your children, and encouraging
their individual development, will likely help the siblings respect and
accept each other.
For more information on ADD/ADHD:
8181 Professional Place, Suite 150, Landover, MD 20785
Budd, Linda. (1993). Living with the active alert child. Seattle: Parenting
Kowal, Amanda. (1997). Study reveals that parents unequal treatment
of children may not be harmful [Online]. Available: http://npin.org/pnews/pnewo97/pnewo97b.html
Goldstein, Sam, & Goldstein, Michael. (1992). Hyperactivity: Why won't
my child pay attention? New York: John Wiley and Sons, Inc.
Kravets, Marybeth, & Wax, Imy. (1998). The Princeton review: The K&W
guide to colleges for the learning disabled. New York: Princeton Review
Rief, Sandra F. (1993). How to reach and teach ADD/ADHD children. West
Nyack, NY: The Center for Applied Research in Education.
Turecki, Stanley. (1989). The difficult child. New York: Bantam Books.
Wodrich, David L. (1994). What every parent wants to know: Attention deficit
hyperactivity disorder. Baltimore: Paul. H. Brookes Publishing Co.
Parent News for May 1998 Volume 4 Number 5, May 1998
Published monthly by the ERIC Clearinghouse on Elementary and Early
Childhood Education, University of Illinois at Urbana-Champaign, Children's
Research Center, 51 Gerty Drive, Champaign, IL 61820-7469. http://npin.org/pnews/1998/pnew598.html