Q. How can you tell if a child has ADHD or has just been catered to by his parents for too long? What differentiates ADHD from immaturity?
A. Many wiggly, active, bright and curious children are unfairly labeled as having Attention Deficit Hyperactivity Disorder (ADHD; or ADD when hyperactivity is not part of the diagnosis). Often these children- especially boys—are simply not yet ready for the structured learning and behavior required in the preschool and early elementary school years.
Each week I see children who are misunderstood, mislabeled, mismanaged and unfairly tagged "ADD" just because they can't sit still during circle time at school. This is especially true in school systems that reward sameness and undervalue difference. If your child gets tagged with the label "ADHD," you are a wise to question this diagnosis. Here are some important facts you should understand about ADD.
What is ADHD?
The main characteristics of ADHD are called the "big four:"
- Selective attention, the child only pays attention when he is interested
- Distractibility, having trouble focusing, especially on things that don't have apparent relevance to the child
- Impulsivity, the classic "He acts before he thinks" behavior
- Hyperactivity, as a photographer father once told me: "There is no such thing as a still shot."
Keep a diary of these big four characteristics of ADHD and see how your child does over time. With immaturity, you will notice steady improvement as your child learns to settle into a school routine. On the other hand, true ADHD, if left undiagnosed and untreated, can become worse with time, resulting in your child developing a poor attitude about learning.
As you can see, ADD (with or without hyperactivity) is a collection of traits that reflects the child's inborn, neurological temperament. Along with the negative traits associated with ADD, there are some positives. Depending on how they are perceived and shaped, these traits can work to the child's advantage or disadvantage.
A Closer Look
Let's dissect ADHD and you'll see what I mean:
A: It's not that children with ADHD can't focus their attention. Rather, their problem is with selective attention. They are often able to go into a state of hyperfocus, in which they concentrate deeply on things that hold their interest. Parents often note that children with ADHD show good concentration when doing their own thing, like playing video games. Yet assign them a task that lacks personal relevance, and they will tune out. Schoolwork very often seems trivial to young children, and so they "turn off" their attention.
But when channeled properly, this ability to hyperfocus can work to the child's advantage, now and later in life. The trick is to encourage their attention. When I coached Little League baseball, I would try to put children tagged with "ADD" as pitchers or catchers rather than "out in left field," since these children were more motivated to pay attention in positions on the team that required focusing.
D: Moving onto the "D." Treat ADD not as deficit, but rather as a difference. Try to match the school and teacher with your child's individual style of learning. If your child finds rote homework boring, make it come alive. Find some way to show its relevance to him. For example, children with ADHD often find history boring. Yet cast the lesson in the context of a play, with the child acting out a historical character and the homework comes alive and has relevance to him.
H: As far as the "H" goes, there are several easy strategies you can teach your child to counteract hyperactivity. For example, break large tasks of homework into smaller bites. Try to introduce a game element by setting a timer for your child to beat. Hyperactivity is a relative term. Your child might just be a very energetic child. So, try to find a way to tap into that energy. One of our children, for example, loved to learn her spelling words while jumping on a mini trampoline.
D: Finally, I want to reiterate that ADHD is a difference, not a disorder. Some children think, act and learn differently. They need a different style of parenting and teaching. Children with ADD have many positive traits, such as creativity, energy and spontaneity. They are often bright and curious children. I am sure that many famous people, had they lived today, would have been labeled ADHD. Look at Thomas Edison and Mozart. How dull and different history would be without their untiring genius!
Treatment for ADHD
One important "treatment" for children who have trouble focusing and sitting still at school is to start the child off with a brainy breakfast. Children need a balance of complex carbohydrates, protein and healthy fats. Try these combinations:
- Scrambled eggs, whole wheat toast and fruit
- Oatmeal, yogurt and fruit
- A breakfast smoothie, made with fruit, yogurt, milk, a chocolate-flavored protein powder and flax oil (This contains omega-3 fats—shown to help children with ADHD.)
Above all, stay away from the high-carb, low-fiber, low-protein breakfast of junk cereals and sugary pastries. In my medical practice, I have had many children lose the diagnosis of "ADHD" simply by sending them off to school with a balanced breakfast.
A final word of caution: If your child is diagnosed with ADHD by a doctor who recommends medication, be sure you use the pills plus skills approach. This means pills in addition to—but not in place of—a whole program of treatment. Pills alone will not help your child in the way that good nutrition, an understanding teacher and the proper match of school and child can.
Other helpful treatments include behavioral counseling, sit-still strategies and a popular new form of treatment called neurofeedback, which uses computer programs to train the child to focus better. A valuable resource that will give you a perspective on ADHD is my book, The ADD Book. My wife, Martha, insists that this is my autobiography. This book, co-authored by Dr. Lynda Thompson, Director of the ADD Centre in Toronto, will help direct you to the right treatment for your child.