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What is ADD?


Attention Deficit Disorder, or ADD - ADHD, the most commonly diagnosed behavioral disorder of childhood (National Institute of Health) is estimated to affect 3 to 5 percent of school-aged children. Dr. Russell Barkley, Director of Psychology and Professor of Psychiatry and Neurology at the University of Massachusetts, a leading author, researcher, and diagnostician in the treatment of ADD has said:

"ADHD is real, a real disorder, a real problem, often a real obstacle. It can be heartbreaking and nerve-wracking".

As anyone who suffers from ADD, and anyone who cares for someone with ADD can attest, Dr. Barkley correctly states the emotional toll that this disorder can take. All aspects of daily living and family life are touched when a family member is affected with ADD. In this section we will provide information on how to identify ADD, how ADD is treated, the societal implications of ADD, methods and procedures to deal with the same, some common misconceptions of ADD, and we will provide resources for getting support and help.

On its most basic level, Attention Deficit Disorder or ADD consists of the symptoms of poor attention span and impulsive behavior. Hyperactivity may or may not be present. Is ADD treatable? The answer is "yes". Is ADD curable? At this present time, there is no cure for ADD.

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Children with ADHD or ADD may experience significant functional problems such as school difficulties, academic underachievement, troublesome relationships with family members and peers, and behavioral problems.

There is some evidence that there is a biological basis to ADD. In 1998, researchers at Stanford using Functional MRI (fMRI) on ADD children reported to have found a biological marker for ADHD specifically in the response of the brain to being medicated with Ritalin, with ADD brains responding differently to Ritalin medication than the brains of Non-ADD control groups.

Genetic evidence of the disorder indicates a strong possiblity of ADD being a hereditary condition.

What are the symptoms of ADD?

Some of the symptoms of Attention Deficit Disorder are as follows:

Inattention
Impulsivity
Hyperactivity
Appears not to listen
Fidgeting
Easily distracted
Impatient
Interrupting

The above list describes many children; in fact, most children exhibit at least some of these traits at times! Where is the line drawn between the kind of behavior that children show at one time or another and a diagnosis of ADD? And in any case, what kinds of things can a parent do to modify this kind of behavior?

How is ADD Diagnosed?

In determining a diagnosis of ADD, physicians carefully question parents and occasionally teachers and other care-givers regarding school and behavioral issues. Parents and caregivers are questioned directly and sometimes fill out lengthy questionnaires.

Note: The NIH has a full report regarding diagnosis of AD(H)D that can be summarized

How is ADD Treated?
Method of Treatment


A. Accept As Is: No Medical Treatment
This method may give the child a chance to learn from his or her own mistakes, without danger of medication problems or risk of curtailing the natural abilities of the child. However, given this course of treatment, the child may never reach his or her full potential. Research indicates that untreated ADD children have a much higher incidence of substance abuse and other problems.

B. Behavior Modification Only
Behavior modification is low in cost, and this method teaches the child to work with their strengths. Advocates of behavior modification state that a child that is treated with only medications will never learn self-control on their own. Behavior modification alone requires constant reinforcement, a difficult thing to achieve on a daily basis. There are no guarantees that the child will ever learn self-control.

Behavior Modification is an effective tool for all parents to have at their disposal. To understand more about what Behavior Modification is, and how it can be applied in every home, click here to find out.

C. Medication Therapies
Medication therapies provide an immediate response than other therapies do. This type of therapy allows the child to sustain focus and decrease hyperactivity. The downside to medication therapy is the potential side effects and the cost. In addition there may be social issues that arise from taking medications, especially if the doses are required during the school day.

Medications used to treat ADD:

Stimulants:

Ritalin
Desoxyn (methamphetamine)
Adderall
Dexedrine (methamphetamine)
Dexidrine
Ritalin (methylphenidate)
Cylert (pemoline)

Antidepressant Medications:

Tricyclics
Effexor (venlafixine)
Clonidine
Prozac (fluoxetine)
Paxil (paroxetine)
Welbutrin (bupropion)

Other Medications:

Depakote (valproic acid)

D. Multi-modal Treatment

The multi-modal treatment is a combination of medication and behavior modification. This method includes the advantages of both. Behavior modification is more accessible and made easier with the use of medication to help the child slow down and focus. This is considered the most effective form of treatment.

ADD Coaching is a combination of behavior modification and cognitive therapy. An ADD coach concentrates on working with the patient to help them learn coping and behavioral techniques.

Other forms of treatment include Neurotherapy, Neurofeedback, Biofeedback, Nutrition Therapy, Herbal Therapy. There isn't a great deal of research or reporting on these procedures however, and the results are not measurable.

E. Co-Occurring Disorders
It has been estimated (Dr. Larry Silver, "A Look at Learning Disabilities in Children and Youth) that 10-20% of children with learning disabilities also have AD(H)D. Other estimates have put this figure as high as 30%.

Do your children take responsibility for their actions? Can you effectively, as parents, teach your children responsibility and the understanding that others are affected by their actions? Answer these questions and learn more about how to best approach the subject of cause and effect, and responsibility, to your children.

Other side effects of ADD and the co-morbities include: Poor self-esteem, anger, developmental immaturity, and stress-related problems.

F. I suspect that my child has ADD. What do I do now?

If you've checked over the list of symptoms and you believe that you or your child fall under the criteria described, there are a number of avenues you can take. A professional assessment is needed. The primary next source would be your physician or pediatrician. You or your child should get a complete physical examination. Explain your suspicions to your doctor. Get possible referrals to a psychologist or psychiatrist, preferably one who specializes in Attention Deficit Disorder. The schools can be a good source, in fact, a very important source of both information and assessment. If you suspect that your child has ADD, you can ask your child's school for an assessment (after finding out what kind of procedures the school uses in such cases). Procedures vary from state to state, and sometimes from school districts to school districts.

Programs

1. Inpatient: hospitalization
2. Outpatient
3. Day Treatment
4. Residential Program

a. Emotional Growth School for ADD ADHD
Emotional Growth schools are highly structured environments that stress academics and teach coping skills through the use of conflict resolution. Children learn they can make choices and learn to accept responsibility through the use of modeling behavior and outdoor therapy. The length of stay is between 9 and 18 months, at which time they either return to the mainstream or attend a boarding school, if possible. Parents are involved with the school staff and the children throughout the child's attendance at the school.

b. Therapeutic Residential Boarding School for ADD ADHD
These schools are usually fully accredited schools with emotional growth programs. They stress holistic education: growth of the person through holding children responsible for their actions. There is no rehabilitation or physicians on staff.

c. Therapeutic Wilderness Program for ADD ADHD
A Therapeutic Wilderness program does not necessarily have academics; their goal can be to introduce the children to a different role. These programs use Outdoor Therapy to help build low self-esteem. They make obtainable goals for them to reach. The programs vary but they are about 6 to 8 weeks long. It is a very structured program with a goal of teaching the children coping skills and raising their self-esteem. Children go from this program to mainstream back into their public school or attend a small structured boarding school.

d. Residential Treatment School for ADD ADHD
A Residential Treatment Program or School provides a full professional staff that includes therapists, psychologists, and psychiatrists. They also have a small academic program. Many of the children in the program have been recommended there by mental health agencies that make the placements. It is a highly structured environment whose emphasis is on treatment and learning coping skills and independent living. Chemical dependence education and rehabilitation is also provided. Outdoor therapy is sometimes used to facilitate building social skills and self-esteem. Recovery programs are also available. Residential Treatment schools are secure schools.


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