ADD
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The ADD/ADHD,
Hyperactive and Impulsive Child: Causes and Solutions

by Toni Hager, NDS, ©1999

Today, children are diagnosed ADD/ADHD, Hyperactive and Impulsive disorder in growing epidemic proportions.  

Is there a root cause?  Is it genetic, environmental or maybe neurological? What are the solutions?  What are the long-term effects?  This paper will discuss the neurological aspects of ADD/ADHD.

ATTENTION DEFICIT DISORDER (ADD)

The label ADD or ADHD refers to children who are experiencing attending problems. They are unable to "filter" out the extra "stuff".  Many of these children are hyper auditory, which means they hear the plane 30,000 ft. up, the door slam next door, the hum of electricity in your appliances or lights, the furnace or air conditioning come on.   Many things we don't notice, like that flickering light on the ceiling fan, don't bother us, but will drive the ADD child wild.  One of the reasons he/she doesn't stay in their seat is, unconsciously, he/she is trying to get away from all the distractions. 

It's not they don't have enough attention; they have too much and don't know where to direct their attention.

Is it REALLY ADD or something else?
Alternative Diagnosis—Maybe its not ADD

Symptoms

AD/HD
(DSM-IV)

Sensory Integration
Dysfunction
(Kranowitz)

Learning-related Visual Problems
(Berne, Getz)

Nutrition Allergies
(Rapp, Sabley, Zimmerman)

Normal Child Under age 7

Inattention (at least 6 necessary) 

Often fails to give close attention to details or makes careless mistakes

X

X

X

X

 

Often has difficulty sustaining attention to tasks or play activity

X

X

X

X

X

Often doesn’t listen when spoken to directly

X

X

X

X

 

Often doesn’t follow through on instructions or fails to finish work

X

X

X

X

X

Often has difficulty organizing tasks or activities

X

X

X

X

X

Often avoids, dislikes or is reluctant to engage in tasks requiring sustained mental effort

X

X

X

X

X

Often loses things

X

X

X

X

X

Often distracted by extraneous stimuli

x

x

x

x

x

Often forgets in daily activities

X

X

X

X

 

Hyperactive and Impulsive (at least 6 necessary)

Often fidgets with hands, feet or squirms in chair

X

X

X

X

X

Often has difficulty remaining seated when required to do so

X

X

X

X

X

Often runs or climbs excessively

X

X

 

X

X

Often has trouble playing quietly

X

X

 

X

X

Often “on the go”

X

X

 

X

X

Often blurts out answers to questions before they are completed

X

X

X

X

X

Often has difficulty waiting turns

X

X

X

X

X

Often interrupts or intrudes on others

X

X

X

X

X

Essentially, the label ADD describes symptoms.  The child receives the label based on prolonged occurrences of four or more, of the possible nine, symptoms before the age of seven.

These symptoms are:

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities;

  • Often has difficulty sustaining attention in tasks or play activities;

  • Often does not seem to listen when spoken to directly;

  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions); 

  • Often has difficulty organizing tasks and activities;

  • Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort ( such as schoolwork or homework);

  • Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools); is often easily distracted by extraneous stimuli;

  • Is often forgetful in daily activities;

  • Often talks excessively.

ATTENTION DEFICIT HYPERACTIVE DISORDER
The child who is ADD and also demonstrates these symptoms are identified as ADHD:

  • Excessive activity is the most visible sign

  • Often fidgets with hands or feet or squirms in seat;

  • Often leaves seat in classroom or in other situations in which remaining seated is expected;

  • Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness);

  • Often has difficulty playing or engaging in leisure activities quietly,

  • Is often "on the go" or often act as if "driven by a motor"

 When people think of impulsivity; they most often think about cognitive impulsivity, which is acting without thinking.  The impulsivity of children with ADD or ADHD is slightly different.  These children act before thinking, because they have difficulty waiting or delaying gratification.  The impulsivity leads these children to speak out of turn, interrupt others, and engage in what looks like risk-taking behavior.  The child may run across the street without looking or climb to the top of very tall trees.  Although such behavior is risky, the child is not really a risk-taker, but simply has great difficulty controlling impulse.  Often, the child is surprised to discover that he or she has gotten into a dangerous situation and has no idea of how to get out of it.  Below are some examples:

  • Often blurts out answers before questions have been completed;

  • Often has difficulty awaiting turns in games or other activities;

  • Often interrupts or intrudes on others (e.g., butts into conversations or games).

  • Many adults demonstrate these symptoms but were never identified and diagnosed. 

Today, these adults may have problems in relationships, always feel overwhelmed or confused, or have trouble getting or holding a job. A high percentage have drug and/or alcohol problems, never finished high school, or get arrested by age sixteen.  Our prisons are full of individuals who are ADD/ADHD or Learning Disabled.

Traditional solutions:

The popular medical solutions seem to advocate drugging the individual with amphetamines, which slow down the brain processes.  The two commonly prescribed drugs are Ritalin and Dexedrine.  These drugs affect the chemical make up of the brain (more specifically, they raise dopamine levels).  This appears to give the person added attention span while in actuality these drugs serve only to slow the brain function down, thereby slowing down the learning and processing abilities.  Medications also put a toxic load on the body and can cause severe damage to the vital organs. Second, so what is going on in the brain to cause these symptoms?

According to a report by the NIH (National Institute of Health), there are no long-term studies of the effects of individuals on medications for more than eighteen months; and, treatments are inconsistent.

Neurodevelopmental causes:

The root causes are in Neurological Dysorganization.  The brain's job is to receive, process, store and utilize information gathered from the environment.  It gathers information through its three main sensory channels of vision, auditory and tactile.

Impairments such as near-sighted, far-sighted, astigmatism, a "lazy" eye, or convergence problems, obviously effect the quality and quantity of information the brain receives.

Many children have a history of ear infections or fluid build-up due to food sensitivities (see the Allergic Child Article) these hinder development of normal receptive language (understand language) and expressive language (spoken language). What they hear is muffled (like listening underwater), distorted, inconsistent sounds or words, or they only hear certain frequencies (usually low range).  The child really didn't hear the words or tone of the voice. The receptive problem makes it difficult to follow directions, attend to what is said, learn through verbal instruction, utilize phonics, and interact socially. Expressive problems are reflected in articulation, resonation or phonation difficulties.

In the development of tactility, there are two common areas where problems can occur.  The first involves the ability to appropriately process sensations of light touch, pressure and pain; the second involves proprioception.  Proprioception is the brain=s unconscious awareness of where the body is in space. When this stage is skipped the brain is unlikely to know specifically where the body is, the individual may bump into things, fidget or squirm around, and to a degree, engage in physically dangerous activities without considering the consequences.

To determine if your child may have a problem with tactility, ask yourself these questions. Does my child exhibit the above mentioned symptoms?  Does he have a high tolerance for pain (e.g., not knowing where he got the bruises on his arms or legs after playing)?  Is the individual appropriately ticklish (not ticklish at all or so ticklish they can=t stand to be touched)?  If your answers are yes, your child may not have completed all of the developmental levels dealing with proprioception. 

Processing (both auditory and visual) is another area that is often found to be underdeveloped.  Auditory and visual processing affects the short-term memory.  This is the brain=s ability to understand, categorize, and interpret its world.

A child with low processing appears not to be listening to what is being said, has difficulty following directions from others, is unable to remain seated, is easily distracted, has a short attention span, shifts from one activity to another never completing the previous ones, or loses things easily.  Many are "Driven crazy" by certain textures, sounds, or tags in their cloths. Many are unable to control their bladders, overeat or never get hungry, never complain (the compliant child), and struggle to learn and function with daily life. The brain is unable to hold together enough information to make sense of it and react appropriately (see auditory and visual processing article).

Long-term memory inefficiencies may also be an issue with the ADD/ADHD child.  This is related to a concept known as dominance.

Think of dominance as the brain's file cabinets.  If the child is right handed, then he/she should use the right eye, ear, hand and foot to take in information as efficiently as possible.  Your stronger eye or ear isn't necessarily the dominant one.  If for some reason, he/she uses the opposite eye or ear, then that information is stored on the opposite side of the brain (wrong file cabinet), sometimes causing problems recalling that information. 

An alternative to medication is to look at what is causing the impulsivity, and then eliminate it.  Many times food sensitivity are found to be an issue. Food sensitivities are generally not as obvious as allergies, so they are often called the hidden problem.  Some times the child is hyper sensitive to smell or odors.

Researchers are now saying ADD is genetic or a neurotransmitter problem.  The dopamine levels that Ritalin react to is a neurotransmitter.  The brain utilized neural plasticity, redundancy and the branching effect.  This means another area of the brain can take over the job of an area not working; and, that each area of the brain is capable of performing more than one job. The brain has a need for organized specific input which is provided by the necessary frequency, intensity, and duration. 

Fortunately, developmental problems can be identified, addressed, and often eliminated. It is important to remember that the symptoms are not the real problem.  It is essential to look at what is really causing these symptoms.  Once the root causes are identified, they can be addressed, and eliminated.  The way to address and eliminate the causes is through specific stimulation. 

Solution:

CAN LEARN empowers parents with the knowledge, techniques, and expertise that enable them to assume primary responsibility for their child's maximum growth and development.  CAN LEARN provides families with individualized home programs that can include homeschool programs for children with labels like ADD/ADHD, Learning Disabled, Dyslexic, Dysgraphic, Short-attention Span, Processing Disorder, normal learner, accelerated, and gifted.

This solution is obtained by determining the levels of development that have been missed or underdeveloped. An individualized therapy program is then written that will stimulate the brain and central nervous system to a higher level of function. Re-evaluations are done every four months to adjust and modify the program as the neurological dysorganization is eliminated.

The real tragedy is many individuals are attempting to cope with unidentified neurological dysorganization that does not need to exist.

References: 

  • American Psychiatric Association, 1994, pp. 83-84

  • Jaquith, J.M., The ADD/ADHD Child, Journal of the National Academy for Child Development (1996) Vol. 10, No. 2)

  • Is This Your Child?: Allergies and Your Family  Dr. Doris Rapp , 2757 Elmwood, Kenmore, NY. 14217

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PARENTS NOTE: "Programs and activities are recommendations only and are not medical, therapeutic or psychological prescriptions. They are based on the experience of a Neurodevelopmentalist and represent suggestions to the family. Every parent needs to assume the responsibility for their own child and make their own decisions as to the techniques and methodologies to use with their child. "
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