Dreading report card day

by Diane Forrest, RN

This is the first in a series of articles that we will cover and some life lessons to share as well.

Thursday was report card day for my cousin's son.  She had been on pins and needles all week wondering about his grades.  For the last couple of years she has been concerned about his falling grades, particularly in math and science.  She had spoken with other parents and began to wonder if her son was showing symptoms’ of Attention Deficit Disorder (ADD).

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), defines three attention deficit hyperactivity disorder (ADHD) subtypes: predominantly inattentive, predominantly hyperactive-compulsive, or combined. Although symptom severity varies, ADHD can be devastating, wreaking havoc with attention and causing irrepressible energy and impulsive behavior that can strain family relationships and impair achievement at school.

Because ADHD symptoms—inattention, impulsivity, and/or hyperactivity—affect a child's ability to learn and get along with others, some people think an ADHD child's behavior is caused by a lack of discipline, a chaotic family life, or even too much TV.

Other signs and symptoms are:

·       easily distracted,

·       miss details,

·       forget things,

·       frequently switch from one activity to another

·       have difficulty focusing on one thing

·       become bored with a task after only a few minutes, unless they are doing something enjoyable

·       have difficulty focusing attention on organizing and completing a task or learning something new

·       have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities

·       not seem to listen when spoken to

·       daydream, become easily confused, and move slowly

·       have difficulty processing information as quickly and accurately as others, and

·       struggle to follow instructions.

Children who have symptoms of hyperactivity may:

·       fidget and squirm in their seats,

·       talk nonstop,

·       dash around, touching or playing with anything and everything in sight,

·       have trouble sitting still during dinner, school, and story time,

·       be constantly in motion, and

·       have difficulty doing quiet tasks or activities.

Children who have symptoms of impulsivity may:

·       be very impatient

·       blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences

·       have difficulty waiting for things they want or waiting their turns in games

·       often interrupt conversations or others' activities.

·       ADHD was first recognized in the 70's.  It is first noticed around the age of 7.  It is diagnosed by a series of tests.  First, the parents are given a test about their child's behavior, then the answers are compared.  Then the child is monitored for 6 months for a trend in continuous behavior.  Physical testing is done such as blood tests and even EEGs.

The cause of ADHD has not been determined. In fact, research suggests that ADHD is largely a genetic disorder.   Some other factors include:

·       exposure to Pesticides,

·       smoking while pregnant,

·       lead exposure,

·       food additives,

·       tv.video games - those who spent more time in front of a screen had more attention problems than those who did not,

·       bad parenting,

·       brain injury ( not considered a major risk factor),

·       diet ...adolescents with diets high in fat, refined sugar, and sodium were two times as likely to be diagnosed with ADHD as other kids,

·       genetics,

·       over diagnosis, and

·       sugar - the idea that refined sugar causes ADHD or makes symptoms worse is popular, but more research discounts this theory than supports it.

Treatment:

Individualized treatment program should be developed for children with a goal of:

·       maximizing function to improve relationships and performance at school,

·       decrease disruptive behaviors,

·       promote safety,

·       increase independence and improve self esteem.

Treatment usually begins with therapy, then stimulant drugs such as Ritalin or Allderall, then antidepressants.  The child is then monitored and reevaluated for effectiveness of the plan and any changes made accordingly.

Outcome:

ADD is a chronic condition, meaning it will last a lifetime.  There is no cure.  Medications help with the symptoms.  There are many things that can be done to help the child learn to live with the condition, mainly retraining, making notes, charts, checklists. Keeping a schedule and be organized. There are also support groups.



We just want to have fun...



As for my cousin, her son does not have ADD, he is simply a 14 year old boy who has no interest in math or science.  Hopefully my cousin and her son will make it through his high school years without too much trauma.