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Attention Deficit Disorder: An Overview of Childhood ADD

By Michael Russell

Attention Deficit Disorder, or ADD, is identified by the American Psychiatric Association in children who show an inappropriate attention span, are too impulsive and sometimes are deemed hyperactive given their age. ADD can be diagnosed either with or without hyperactivity. Teachers and parents alike have received and will continue to receive a diagnosis of ADD for children who have problems academically, socially or emotionally. Around 20 percent of the population will eventually be diagnosed with ADD.

Children between eight and ten years old are the ones most likely to be diagnosed with ADD, having been referred to a doctor by teachers as well as parents. The younger the child is when diagnosed, the more serious forms of ADD they are likely to exhibit. In reverse, when older children are diagnosed, they generally exhibit a less serious form of the disorder. ADD shows up most readily in situations where the child is required to work independently or in a group setting. One-on-one situations or situations that are new to the child tend not to display ADD behaviors as much.

The American Psychiatric Association looks for these things in diagnosing ADD:

1. Inattention - does not finish things once started, appears not to listen, is easily distracted, cannot focus on schoolwork or anything requiring a longer attention span, does not stay with a play activity for long.

2. Impusivity - acts without thinking about consequences, moves excessively from one task to another, does not organize work though this is not because of any cognitive impairment, must have supervision, talks out in class, does not wait his or her turn in group situations.

3. Hyperactivity - ADD may be diagnosed with or without hyperactivity, but a hyperactive child will do at least two of these: run or climb excessively, cannot sit still and fidgets, cannot stay seated, moves around more than usual even when asleep.

4. ADD symptoms are usually seen before age seven.

5. The symptoms last at least six months.

6. The symptoms are not caused by schizophrenia, affective disorder or any type of profound mental retardation.

Those who deal with ADD children must work on improving the child's attention skills, impulsivity and possibly hyperactivity. The child's self-esteem and social skills will also need extra attention. Skills of a perceptual and conceptual nature will have to be worked on. ADD appears to affect children's responses to reinforcements and motivations as well. Many of these needs in ADD children are interwoven, and how one thing is handled will affect another.

There is no conclusive evidence as to the causes of ADD. ADD may be genetic, prenatal or physical. Due to the possible causes, many children are medicated as an answer to addressing the symptoms. There is no one medication that is successful in all children who exhibit ADD symptoms. The most common medications are Dexedrine, Ritalin and Cylert.

There are often other learning difficulties ranging from learning disabilities to emotional disturbance that ADD is often secondary to. The sooner a correct diagnosis is made and help begun, the better the odds of avoiding other complications.

The nature of this disorder would indicate that the child's attention skills will need a lot of work. Children must be able to pay attention for stretches of time in order to learn and succeed in school. They must learn to finish projects once they are started. They must learn to listen and be assisted to have as few distractions as possible. These children need to be assisted in building up their attention span.

Impulsivity in these children also needs assistance. School-aged children have to be trained to stop and think before they answer or start their work. This requires quite a bit of supervision initially, but must eventually become the student's responsibility requiring a larger degree of self-control.

If hyperactivity is present, it can interfere with learning. Children must learn to slow down and become aware of their situations and surroundings. One helpful activity is "The Turtle Imagery Procedure" in which the student says he or she will proceed like a slow turtle as part of a structured program. Other means of controlling hyperactivity include modeling of appropriate behavior by adults, watching themselves on videotape, role playing, biofeedback and relaxation techniques.

A large problem of children with ADD is socializing with peers. When children are unable to make friends or get along well with others, they begin to have negative feelings and impressions of themselves. There are other skill short-comings in both perceptual and conceptual areas that will need extra attention in the ADD student. A lot of the focus in this area is on the specific task being taught and utilizes a strong behavioral approach which emphasizes incremental learning.

Reinforcement response seems to be affected in ADD children. However, for any assistance to be successful, parents and teachers alike will need to find out what will be reinforcing for a particular student. Then a reinforcement schedule can be mapped out.

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