Attention deficit disorder: the facts and the myths

Kenya was 11 years old when her behavior became a cause of concern for her family. According to her doctor, she was "bouncing off walls and blurting [things] out," which are usually characteristic of children with attention deficit hyperactivity disorder, perhaps better known as AD/HD.

Instead of prescribing drugs for Kenya, Dr. Patricia Jones, a licensed clinical psychologist, examined her diet and discovered that the wiry-framed girl was consuming a lot of sugar. "Nobody thought to monitor her food intake," says Dr. Jones. She later observed that when Kenya was limited to two sweets per day, her fidgety behavior ended.

There are many myths and misunderstandings associated with attention deficit disorder (ADD) and attention deficit hyperactivity disorder (AD/HD). But one thing is for certain: Both disorders, which strike both children and adults, can have a negative effect on day-to-day social and/or academic functions.

According to James P. Comer, M.D., a Maurice Falk Professor of Child Psychiatry at Yale Child Study Center, ADD and AD/HD are both complicated brain-based disorders that are not widely understood. As a result, many times the conditions are misdiagnosed in African-American children, he says, because school officials don't recognize symptoms associated with ADD.

ADD is the inability to focus or to pay attention. Most commonly found in girls, a child with ADD quite often feels like he or she can't keep pace and can't pay attention long enough to perform a certain task. This often leads to other problems, such as low self-esteem. The symptoms of AD/HD include erratic behavior. It's usually found more often in males. "The activity [associated with AD/HD] is more troublesome to the people around the child, such as the teacher and other children," says Dr. Comer.

Prior to the age of 7, experts say that some behavior patterns displayed by children often could be developmental, and not ADD or AD/HD. Doctors are now realizing that other facets of a child's behavior can often be disguised as ADD or AD/HD. For instance, a child with sleep apnea, or irregular bedtime hours, might not be getting enough rest at night, making it harder to concentrate during school. Nutrition is another issue that doctors are now considering before a case of ADD or AD/HD can be accurately diagnosed. A third possibility is whether or not the child has any allergic reactions. All of these factors can impact a child's overall behavior.

Critics of ADD and AD/HD allege that they are not true illnesses, but rather a natural part of the exuberance of childhood. Further, they criticize parents for turning to prescription drugs to deal with the problem. According to the FDA, doctors prescribe drugs for the disorders--including Ritalin, Concerta and Methylin--to 2 million children each month. Earlier this year (February 2006), federal health advisors issued a strong advisory warning on drugs used to treat ADD and AD/HD, as they may be linked to an increased risk of death and injury.

Although the cause of ADD and AD/HD is still unknown, one hypothesis suggests that environmental toxins, especially prenatal exposure to alcohol or tobacco smoke, may be at fault. Other theories focus on poverty, poor nutrition and lack of discipline from parents. Experts say many parents with children diagnosed with ADD or AD/HD believe the poor parenting myth and eventually blame themselves.

"At first you do blame yourself," say Barbara Neal whose son, Martin, was diagnosed with ADD. When Martin was 12 years old, Neal began receiving complaints from his teacher, who gave her frequent reports of an overly playful, talkative child who would often disrupt the class. Martin was held back a grade at one private school that he attended. His parents transferred him to another school, where Martin exhibited similar behavior, which resulted in more complaints from his new teachers. "He was not paying attention during class and not doing his work," recalls Neal. "He was later diagnosed as having attention deficit disorder, and they wanted to put him on Ritalin. It was just so frustrating. They hurried and prescribed the drug, and they didn't really know what the problem was."

While Martin was taking Ritalin, Neal did see a change in her son. "He was like a little zombie," she says. "I gave it to him for one week and then I threw the pills away." After that, she says she spent extra time going to Martin's school and following up with his teachers regarding homework assignments. Today, Martin is 23 years old, attends college and has a job. His mother feels that her son's problems were just a part of a phase that he went through and quickly outgrew. "Some teachers weren't really willing to work with him," she says.

Medical researchers say most instructors, although well-intentioned, are not prepared to work with children who have special needs. Delores Wedgeworth has a 25-year record of teaching students with developmental disorders and students who do not have ADD or AD/HD. "Most teachers are taught to teach in the middle, or children who are operating at an average developmental level," says Wedgeworth. "Some cannot change their teaching technique to accommodate a student."