Various perspectives on ADD/ADHD

Have you heard of the DSM (Diagnostic and Statistical Manual)?  It's the bible of psychiatric diagnosis.  Essentially, if this book (current version = DSM-IV-TR) doesn't list it, we're supposed to pretend it doesn't exist.  Or at the very least, insurance companies won't cover the treatment of it.

Within the DSM there is a category called "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence," where you will find learning disabilities, autism spectrum disorders, and my topic for today--ADD/ADHD.  The DSM criteria for an attention deficit diagnosis are too long to list here, but suffice it to say that they include behaviors and symptoms we are all familiar with:

• Has difficulty sustaining attention or following through
• Trouble with organization and/or loses things
• Often avoids engaging in tedious tasks that will require sustained mental effort
• Interrupts others, has trouble waiting their turn
• Fidgets, has difficulty remaining seated, or is generally restless

I work with a whole school full of kids who fit this profile, and in all honesty, it describes many of the adults I know. (You could probably say the same.)  But I think we're all pretty well-versed in what ADD is, so my real emphasis here today is "My child has ADD/ADHD, now what?" or maybe even "So what?"  It all depends on your perspective.


It's all about perspective

The history on ADD is that comparable symptoms were first recognized after WWI in soldiers with head injuries, so initially the medical field made the unfounded assumption that these behaviors were strictly the result of brain trauma, even when none had been reported.  There were several revisions to this theory over the decades, based on the prevailing medical science of the day, but I think it's most important to focus on what we know today to be true: that attentional difficulties seems to be passed down in families; that symptoms sometimes diminish with pharmaceuticals and/or age; that there are positive characteristics associated with this condition as well as negative; and that the causes and neurological configurations of ADDers are so diverse that the label is really just a convenient term used to refer to a collection of recognizable behaviors.  

In this article I would like to share a number of current professional perspectives, approaches and resources, as well as some of my own.


Amen Clinics: Using brain scans to get to the bottom of things

Dr. Daniel Amen uses SPECT imaging--a 3D, 360-degree computerized model--to identify which parts of a patient's brain are not operating optimally.  From his research he has theorized that there are 6 different kinds of ADD (not to mention 7 types of anxiety and depression and 5 types of obesity).  His clinics focus on helping patients improve daily functioning through diet, exercise, self-control strategies and more, and yes, sometimes medication, depending on the circumstances.  His most famous book, Change Your Brain, Change Your Life, was a bestseller when released in 1999, yet his work remains controversial within the psychiatric community.


In my experience, using basic methods like improving nutrition and increasing exercise have had undeniable effects on students with ADD/ADHD.  It seems like the common sense that parents have been using all along. If a child is naturally hyperactive, giving them lots of sugar will only compound the problem.  If a child is naturally hyperactive, increasing their access to activities such as sports will help them expend some of that excess energy.  I'm not quite sure what the controversy is about.


Check back on Wednesday, December 15th for a continuation of this article.