Attention-Deficit Disorder (ADD)

Attention-Deficit Disorder- General Information

Attention-Deficit Disorder (ADD), also called as “Minimal Brain Dysfunction (MBD)”, “Brain Damaged Syndrome”, “Hyperkinetic Impulsive Disorder”, and “AD/HD" (attention-deficit/hyperactivity disorder)” is a condition in young children and adults too. It is a neuro-problem that affects the behavior and developments of the victims. It was not recognized to be a disorder until the 20th century and George Still is credited for making it so. Other notable people are Heinz Werner and Alfred Strauss.

The Attention-Deficit Disorder (ADD) is of three sub-types a) In-attentive: (lack of focus, short attention span, easily distracted; b) hyperactive-impulsive (acts before thinking, restless, inability to sit quietly) and c) combined. Each of the above has their own specific symptoms.

Attention-Deficit Disorder (ADD) if left untreated can be disastrous for the child and the family as the child can develop conduct disorder problem (anti-social-personalities like alcohol, drug, crime and suicides), and damage their self-esteem. They can develop other disorders like mood (depression, anxiety), and learning. Their behavior can make their own families turn against them due to their disobedience, inability to socialize, trouble makers/slow learners at class.

Its cause is unknown and was earlier contributed to the upbringing and surroundings, brain injury/infection in the childhood, or the consumption of certain food and sugar (all refuted now). It is considered a biological cause involving the decreased activity/size of the brain. The brain controls the body’s activities including those that require attention which malfunctions when the frontal cortex region is affected; due to genetic/heredity factors. External factors like intake of drugs (cocaine, marijuana) or alcohol (especially during pregnancy) etc. might also affect, though not confirmed.

Attention-Deficit Disorder – Symptoms

Attention-Deficit Disorder is marked by symptoms of a) Inattention like day-dreaming, lack of focus and concentration, forgetfulness b) Iimpulsivity like interruption of other persons talking, excessive focus shifting in tasks and c) Hyperactivity like restlessness. These symptoms disturb their relationships and disrupts the atmosphere at school and home.

They develop aggressive/bullying nature and have high moods swings coupled with difficult behavior (anxious, irritable, hyper-active) thus leading to conflicts with their families, and people at school. They are easily bored and frustrated with tasks that require concentration. Therefore, they have poor academic performance and skills despite of their intelligence which is due to lack of focus/concentration.

They act before thinking, thus creating problems. They may be active; always on the move/restless; yet they lack motor skills and appear physically clumsy which further aggravates their being unwanted by their peers. Moreover, they have difficulty focusing attention to what is required at that particular mind. Hence, it is a sort of endless-shifting between topics/activities and the inability to absorb the activities and communications around him/her. This makes it a constant struggle and is chaotic, depressing, distressing for him/her which results in low confidence. Attention-Deficit Disorder is a neuro problem that affects the executive functions of the brain (short-term memory, organized thinking, distinguish the logical and emotional responses, thinking patterns, decision making and planning and executing aims/goals). Victims can develop the following problems; depression, learning disorder, restless leg syndrome, obsessive-compulsive behavior, substance abuse, anxiety disorder, antisocial behavior, and depression. Attention-Deficit Disorder has no specific demographic or socio-economic demarcations, although it affects more boys than girls. These symptoms are difficult to pin-point during infancy and are more prominent in toddlers. Although many symptoms die out as they grow up; the hyperactivity symptom diminshes while the impulsivity and inattention problems can persist.

Attention-Deficit Disorder – Treatment

Treatment of Attention-Deficit Disorder requires careful and proper diagnosis under behavioral and medical specialists, psychologists, pediatrician, neurologist, psychiatrist, social worker, family therapists, physicians, nurses, and pharmacists. It needs to be thorough and other disorders should be ruled out. It needs to be done in 3 phases a) evaluation (diagnosis), b) explanation of the problem to parents and child, and c) therapeutic intervention.

A thorough physical examination of the child’s condition is done via interviews with the family, friends, people at school and the child. There are various tests like the “Child Behavior Checklist (CBCL)”, “Conner's Parent and Teacher Rating Scale”, “Brown Attention Deficit Disorder Scale”, “Conner's Continuous Performance Test (CPT)”, “Integrated Visual and Auditory CPT”, “Conners Rating Scales (Teacher's Questionnaire and Parent's Questionnaire)”, “Wender Utah Rating Scale”, “Nadeau/Quinn/Littman ADHD Self-Rating Scale”, “Achenbach Child Behavior Rating Scales” and “Diagnostic and Statistical Manual IV-Text Revision (DSM-IV-TR)”. Here, the performance of the child is checked and compared with normal children to show any discrepancies.

Diagnosis of Attention-Deficit Disorder can be compounded by the presence of other similar problems like depression, bipolar disorder, substance abuse, learning disability, eating disorder, panic disorder, sleep disorder, Tourette's syndrome, vision or hearing or overactive thyroid problems.

Therapies like cognitive-behavioral and psycho-therapy can be applied wherein the behavior at school and home is monitored and attention-span time is checked. Self-monitoring techniques are taught. Support groups can help in this. It can be applied when medication is not an option or tolerated by the child. They help the child understand and identify their fears or distress and to overcome them. Moreover, they learn to express themselves and develop motor, communication and socializing skills.

Psychostimulant medications like dextroamphetamine (Dexedrine), pemoline (Cylert), and methylphenidate (Ritalin) are prescribed which may cause a side-effect of latent tics (involuntary motor movements-eye blinking/shrugging etc.) This generally goes away when the medication is stopped. Other side-effects are insomnia, loss of appetite, stomachaches and headache, and anger/anxiety.

Other medications include antidepressants like Norpramin, Pertofane and amitriptyline-Elavil, buproprion-Wellbutrin, fluoxetine-Prozac and drugs like clonidine, guanfacine, with side-effects like nervousness if not controlled, clonidine-Catapres and Strattera.

Others are selective norepinephrine reuptake inhibitors, major stimulant drugs (amphetamines and methylphenidate) and anticonvulsant drug (carbamazepine - Tegretol, Atretol). They help to decrease impulsivity, increase attention, and child is more receptive to the surroundings. Their side effects include persistent dry mouth, disorientation, sedation, and irregular heartbeat. The above medicines ought to be taken with care as there have been fatal cases (clonidine with methylphenidate -Ritalin) and non-fatal (heart) cases on taking clonidine alone. Hence, their intake needs to be supervised under a medical supervisor. Alternative treatments for Attention-Deficit Disorder include the like Electroencephalograph (EEG), biofeedback, Dietary therapy (Feingold diet), Herbal therapy, Vitamin and mineral supplements (calcium, magnesium, zinc, etc.), combined amino acids GABA, the Omega fatty acids, Homeopathic medicine, Auricular acupuncture and Psychosocial therapy.

Thus, Attention-Deficit Disorder is a disorder that can be treated and requires sacrifices, understanding, love and co-operation from family and friends. People with this have known to have succeeded in life like Paris Hilton for instance.