Attention Disorder Can Explain School Problems

He had so much difficulty concentrating in school that he spent more time daydreaming than studying and barely passed his classes.

She reread textbook chapters again and again without ever really comprehending them. She lost interest in school entirely as a teen-ager and began filling the void with alcohol.

Both reached adulthood without ever considering the possibility that there might be an explanation for their academic problems--something that had nothing to do with their intelligence or drive.

But when Steve and Karen, an Orange County couple who requested anonymity, saw that their son, Scott, was having problems in school too, they started asking questions.

For them, learning that Scott had attention deficit disorder was like finding the missing piece to a jigsaw puzzle.

After Scott, now 11, was given the diagnosis about three years ago, Steve and Karen were tested too. Both discovered that they had suffered from this often-misunderstood disorder since childhood--and that it wasn’t something they were ever going to outgrow.

But they also learned that effective treatment is available, and also that just knowing what they were dealing with would make a big difference in their lives.

Attention deficit disorder is a malfunction of the biochemistry in the brain. It affects an estimated 3% to 11% of the U.S. population and is, in most cases, hereditary, according to psychologist Joan Andrews, a Newport Beach marriage, family and child counselor.

Although hyperactivity is the symptom most often associated with the disorder, it can also be manifested in a great variety of ways, Andrews points out. These can include extreme lethargy and depression as well as excessive activity and compulsive behavior, she says.

Andrews, who gives weekly lectures on attention deficit disorder, said some who have it are “real spacey and distracted” and others can become so focused that they have trouble shifting their attention from one thing to another. Some are obsessively tidy; others are completely disorganized. Some are aggressive; others are withdrawn. And many fall somewhere in between those extremes, she said.

Because each person with attention deficit disorder will have a different set of symptoms, many cases remain undetected, she said.

She believes that no more than half of children with the problem have received a diagnosis of it.

Usually, children tested for attention deficit disorder are because they’ve been having problems concentrating in school. They may have difficulty reading, writing reports, sitting still and relating to peers.

“Most of these kids are aware that they’re not doing as well as they should, and they get very frustrated,” Andrews said. “They think, ‘I’m smarter than this, and I should be able to do better.’ And they keep hearing, ‘You’re not working up to your potential’ or ‘You’re lazy.’ By sixth grade, they get real tired and stop working. They’ve had it.”

By adolescence, attention deficit disorder tends either to disappear or to get worse, Andrews said. The signs that indicate it’s getting worse, however, are often dismissed as normal teen-age behavior. Teens who have it, though, may become extremely rebellious and antisocial, depressed or even suicidal if they don’t receive treatment.

In adults, the disorder shows up in more nebulous ways--a feeling that things are not quite right, difficulty getting organized, inability to control anger or cope with stress.

“Many adults with attention deficit disorder tell me, ‘All my life I’ve either felt stupid or crazy,’ ” Andrews said. Some, she noted, can go through years of therapy, yet make little progress.

Although the disorder is carried into adulthood in about half of all cases, she said, adults will seldom receive a diagnosis.

Steve and Karen, who are in their early 30s, might never have known had they not sought help for their son.

Karen said she became concerned about Scott--and frustrated with him--because he would be easily distracted and forgetful. He also was spending all his spare time on homework and still bringing home Ds.

Steve blamed Scott’s teachers for overloading him with assignments. And when Karen suggested that there might be more to the problem than that, Steve dismissed the idea, saying: “He seems fine to me. I was like that at his age, and I did OK.”

It was Scott’s second-grade teacher who suggested that he might have attention deficit disorder. She had seen him struggle with his classwork and break into tears when asked a question he could not answer. At her recommendation, Scott was taken to a pediatrician who referred the family to Andrews.

By the time they met with Andrews, Karen and Steve were taking their frustration with Scott’s difficulties out on each other. None of their efforts to influence his behavior with discipline had worked, and both were feeling inept as parents.

That changed quickly, however, once they started learning more about the role attention deficit disorder had played in their lives and how they all could benefit from treatment.

Medication isn’t always necessary, Andrews pointed out, because some people can learn how to structure their lives in ways that help them improve their concentration and maintain a sense of order without being compulsive. However, Ritalin and Dexedrine, both stimulants, are often prescribed for those who experience mood swings and depression, Andrews said.

Ritalin, which has long been the primary drug for treatment of hyperactivity in children, is controversial because it has caused serious side effects and, according to critics, has been prescribed merely to keep unruly children under control.

But Karen, Steve and Scott are all taking Ritalin, and they say that it, combined with the short-term family counseling Andrews provided, has helped them turn their lives around. (Andrews cautions that responses to medication vary with each individual and that stimulants don’t work for everyone.)

Observed Steve: “It helped my self-esteem to see that maybe this ‘attention deficit disorder’ has been the problem all my life. I had always told myself, ‘This is the best I can do.’ Then I realized maybe I can do better.”

He dropped out of college because he found it too stressful, and after he became an electrician, he would change jobs every year or two. He’d lose interest or get burned out by stress, he said. And often, he’d calm himself at the end of the day by drinking too much.

Now, however, he seldom drinks, he said, and he’s content with his job because his mood swings are under control and he feels better about himself. He also noted that exercise has also helped stabilize his emotions.

Karen, who has long struggled with hyperactivity, has also found an inner calm she had never experienced before. Before she was treated for attention deficit disorder, she was compulsive and extremely sensitive. “I couldn’t calm down,” she said. “I was always on a merry-go-round. I didn’t know how to rest. And my self-esteem was so low that my feelings were hurt easily. I couldn’t stand up for myself.”

Since she started taking Ritalin, she has had fewer bouts of depression and has not felt as “frazzled.”

“I’m content to sit at home for a day,” she said. And that’s no small feat for a woman who used to, as Steve said, “go until she dropped.”

Andrews pointed out that when both partners have attention deficit disorder, “the little things tend to be magnified.” Communication can also be a problem because the disorder makes it difficult for some to think things through and say what they mean. The mood swings of both partners also put stress on the relationship.

When attention deficit disorder is diagnosed, couples can stop blaming each other for the short circuits that make them feel disconnected.

“People don’t understand why they act the way they do. When they understand that it’s chemical, they deal with it differently,” Andrews says.

For example, Karen used to become angry with Steve when she would ask him to arrange an evening out--call a sitter, make a dinner reservation--and he’d forget to do it.

“It was like asking him to climb Mt. Everest,” she said. “When he’d forget, it made me feel like he didn’t care, but he really did.”

Steve said the task of arranging an entire evening overwhelmed him. Now that Karen understands that, she makes the arrangements. But Steve has learned that his wife feels more desirable when the idea of spending some quiet time together comes from him.

Karen said she and her husband are also communicating better. She used to carry on one-way conversations when they went out to dinner, she said. Now she’s less likely to monopolize the conversation and Steve is more attentive and talkative.

As their relationship has improved, they’ve become more confident--and patient--as parents. Karen says they don’t yell at Scott the way they used to because they now understand that he isn’t being careless or willful when he forgets--rather, he just needs help finding ways to remember.

They’ve seen significant changes in Scott since he began receiving treatment. He’s completing most of his schoolwork in class, and he’s bringing home A’s and Bs. And Scott, who used to play by himself, has started bringing home friends from school.

“I wish more children could get help,” Karen said. “Their whole quality of life would be 100% better.”

Focusing on Attention Deficit Disorder Throughout each day, one’s ability to focus attention is the key to being able to filter the deluge of activities, commercials and information that rolls in at an MTV rate. Usually, the brain will accept the information and store it away, but sometimes the brain refuses to listen.

Attention deficit disorder (ADD) is a term often associated with children who are hyperactive, refuse to follow directions or pay attention. Although most people see these behaviors as a part of being young, they can have adverse consequences. The syndrome can affect educational performance to the extent that a child is unable to complete school assignments, whether reading, writing or arithmetic. In adults, ADD can create a world of unfinished tasks and personality problems.

Symptoms of ADD can also be attributed to depression, response to stressful events (e.g., parental divorce or a death in family) or a change in residence or school. Whatever the cause, whenever the behavior of a loved one causes stress in the family, it is best to consult a specialist for diagnosis and counseling.

Characteristics of Attention Deficit Disorder In children: * Inability to focus attention. * Overly aggressive or disruptive behavior. * Inability to get along with others. * Violent temper tantrums. * Undiagnosed or inadequately treated dyslexia. In adolescents, same as children, plus: * Poor sleeping. * Obstinate outbursts. * Extreme rebelliousness or antisocial behavior. * Suicidal tendencies. In adults, same as adolescents, plus: * History of crime or violent crime. * Difficulty concentrating on work. * Compulsive behaviors such as overeating or overspending. * Inability to control anger or other responses to stress.

Common Myths * The parents are at fault for the child’s behavior. * ADD is the result of a dysfunctional or abusive family situation. * Behavior disorders are best treated with physical punishment. * People who have ADD will never get better.

If Your Child Has ADD * Request a learning-disabilities evaluation for him or her. * Review the proposed educational plan for your child. If you think it is inadequate, speak to the school principal about your child’s special needs. * Eliminate foods with high levels of preservatives, food coloring or additives from the family diet. * Consult a specialist.

Prevalence of ADD in the Nation’s Students Attention deficit disorder may or may not be accompanied by other developmental disorders. According to 1987 figures, the most recent available, 5% of all students in the United States primary and secondary schools and colleges were classified as having ADD alone. The numbers for those who have ADD along with a learning disorder are much higher, however.

Here’s a breakdown of the figures:

Total students ages 6 through 21: 40 million Attention deficit disorder alone: 2 million (5%) ADD and unspecified disability: 700,000 ADD and specific learning disabilities: 575,000 ADD and serious emotional disturbance: 100,000 ADD and other health impairment: 5,000 ADD and mental retardation: 20,000 ADD and developmental disorder: 1.4 million Total with either ADD alone or ADD and another disability: 3.4 million Sources: Learning Disabilities Assn. of California; United Parents; Department of Education; Professional Group for ADD and Related Disorders Researched by April Jackson / Los Angeles Times