Editorial

ADHD - Out in Left Field

Editorial

These men are thought to have been members of this group as well as Sir Winston Churchill, a highly respected Prime Minister of the United Kingdom during World War II.  They also had intellectual flexibility due to their multiple interests and the speed of the diverse flood of ideas.  Boring is not a word that one would apply to this population, as they have many interests that drive their curiosity.  


They tend to be spontaneous, enthusiastic and maybe exasperating, often fun and outstanding.  Robin Williams is one such comedian who comes to mind.  Success is really part of their make-up when they find their passion, since frequently they are very gifted artistically and intellectually.  David Neeleman, bet you never heard of him, but he invented the electronic airline ticket and is the CEO of JetBlue Airways.  He believes his ADHD helps him to think outside of the box or very, very unconventionally.

Bobby stood out in the left field of the baseball diamond staring intently at what would appear to his coach, parents or anyone observing him to be the action of this afternoon’s practice game.  Actually his eyes were glued to a grasshopper rubbing its hind legs together.  His thoughts were a random jumble that flashed in nanoseconds and seemed to have actually have jumped and hopped just like the grasshopper, but hundreds of times faster if anyone had bothered to have tracked them.


“Coach sent me as far away from the kids as he could and let me stay…Where is my friend Jerry?…It looks like rain….Lucky guy is sitting on the bench….Is that a flower?…At least this year I got a baseball uniform….I’m bored….My shoe fell off…Where is my baseball glove?…Which hand do I wear it on?…I’m thirsty…Nobody can hit a ball this far out here and….I really like that bug….Last time we went out for ice cream….Why are they waving at me?…OH NO, not again…the inning is over…I can hear them say that the loser is up to bat    Just don’t cry like the last time….If I strike out maybe Coach will put me back on the bench with my friend Jerry.”

Attention Deficit (Hyperactivity) Disorder (ADD/ADHD) is often thought of as a neurological condition that makes it hard for individuals to control responses that involve speech, attentiveness and movement.  They may frequently have difficulty controlling or inhibiting spontaneous responses.  


The statement that kids will say the funniest things or the most embarrassing ones may often come from this source.  According to the National Institute of Mental Health we will find one child in each classroom of about 30 children with ADD/ADHD.  That child may not only be yours, but like many health issues it will affect people of every race, gender, age, social and economic level.  According to the American Medical Association 3.5 million children are affected by ADD/ADHD.

So what will these individuals look like behaviorally?  A lost curious little boy like Bobby, standing out in the baseball field, socially and physically inept, perhaps very bright, but needing lots of help to become successful in life.  Generally there are three subtypes to describe ADD/ADHD:

  1. Predominately inattentive;
  2. Predominately hyperactive-impulsive;
  3. Combined: inattentive and hyperactive-impulsive.

Here we have a basic label with a diffuse pattern of behaviors for the observer to be looking for.  One child might be inattentive, but very impulsive; the next is extremely hyperactive; while another seems too quiet and his mind is a million miles away.  Then there is an obsessive youngster that has a difficult time changing tasks, he only wants to do math or science or art projects.  Sometimes children exhibit evidence of problems in all three areas, but may be more heavily invested in one area rather than another.


These are children that can and do pay attention when they are hooked on something.  It is often very hard to get them to move on to another activity, but if they are bored they don’t or won’t stay on task.  They need to be viscerally engaged or they get restless or move into their heads for their daydreams which are far more entertaining, creative and exciting.  The outside world must challenge these youngsters and offer them something better to do.  


They get easily distracted and skip over details, make careless mistakes and seldom complete projects.  Listening to directions is difficult since their mind is often elsewhere.  Without full instructions they cannot really do or complete the task.  


They frequently make up their own rules before the directions have been given.  This leads to what looks like forgetfulness, apparent disorganization or lack of intelligence.  A comment by a classmate about a soccer game score can have them entering those numbers as history dates for homework.

Everyone now and again may become a bit absent-minded, impulsive or restless, but when it is the rule not the exception, look for the symptoms that point to ADD.  Occasionally we have all been with the girl or boy in constant motion.  It feels as if they are about to bounce off the walls, they wiggle, squirm, talk non-stop, run, blurt out an answer before the question was completed, interrupt, have difficulty waiting, speak rudely or tactlessly.  


When most children have reached four or five years of age they have learned some social control.  They understand and know there are times to sit quietly, be polite and mind what comes out of their mouth.  The average child starting school also knows that the “good behavior” will come with a reward which is a contributor toward building self-esteem.  For some of these young people the reward never comes and, here again, there is a lag in self esteem.

Let’s not look at their characteristics as all negative.  They may also be extremely bright, talented, gifted, imaginative and creative.  They may be the daydreamer, but so was Albert Einstein.  We are looking at a person that has a font of ideas when it comes to creating.  


They are the ones with multiple ideas in a brain storming session or new insight in the fields of science, music, business, art.  After all they don’t see what everyone else or others see.  The artistic views of Salvador Dali and the thousands of inventions of Thomas Edison would have been lost if not for their particular gifts and talents.

These men are thought to have been members of this group as well as Sir Winston Churchill, a highly respected Prime Minister of the United Kingdom during World War II.  They also had intellectual flexibility due to their multiple interests and the speed of the diverse flood of ideas.  Boring is not a word that one would apply to this population, as they have many interests that drive their curiosity.  


They tend to be spontaneous, enthusiastic and maybe exasperating, often fun and outstanding.  Robin Williams is one such comedian who comes to mind.  Success is really part of their make-up when they find their passion, since frequently they are very gifted artistically and intellectually.  David Neeleman, bet you never heard of him, but he invented the electronic airline ticket and is the CEO of JetBlue Airways.  He believes his ADHD helps him to think outside of the box or very, very unconventionally.

The standard of practice is a class of drugs identified as stimulants; this does not constitute a cure, but may in some cases improve symptoms of ADD/ADHD.  As with any drugs there are side effects and risks.  According to Dr. Gabor Maté, even though, when we observe a hyperactive child on the move, his thoughts may be moving quickly too, but the part of the brain that sorts thoughts and ideas is moving slowly; the prefrontal cortex.  


The job of the prefrontal cortex is to sort and organize stimuli coming in, as well as school assignments placing everything in its proper place.  If it is slow or not functioning, as in the case of Bobby’s mind, there is a flood of information and no adequate means of organizing or sorting it out.

Ritalin was first introduced in the 1950s it was not until ten years later that it was introduced as a treatment for ADD/ADHD.  After almost half a century there still has not been a study with regard to the efficacy of Ritalin or any of the other stimulant drugs being used.  Young people with ADD/ADHD often take this medication for years and there is evidence that such long term use on children, whose brains are developing, may cause neurological permanent changes.  


Additional studies indicate that growth can be stunted by the use of these stimulants as well as an increased risk of addiction or future abuse with their prolonged use.  According to John Ratey, M.D. of the Harvard Medical School, addiction is not a concern with the adults he has treated.

Over the years new stimulant drugs have made their début.  Some come in two forms: both long and short acting formulation.  It depends on what best suits the individual.  Do they need their medication administered once or several times a day?  When do they peak?  How fast do they metabolize the drugs?  


Listed below are some of the other stimulant medications: Adderall, Adderall XR, Concerta, Dexedrine, Dexedrine Spansules, Focalin, Metadate, Methylin, and Ritalin SR.  Sometimes an antidepressant, like Strattera which affects the levels of dopamine and works for 24 hours in the body, is effective particularly for those who have trouble getting moving in the morning.

The side affects that plague the children and of course concern parents range from increased nervousness, problems sleeping, weight loss due to loss of appetite, dizziness, nausea, social withdrawal or lack of spontaneity, depression, and tics.  


Stimulants may exacerbate a preexisting heart condition so the current thinking is to have a child given an electrocardiogram (EKG) before starting the medication or if already on one of these medications to test to see if they may need medication to prevent a sudden fatal heart failure.  There is also some new evidence that children with heart problems may have a predisposition to ADD/ADHD.

Are there alternative treatments for ADD/ADHD?  Of course there are.  Hypnosis is an ancient process that works very well with children.  The focus is on the subconscious part of the mind and therefore brings issues to the surface that may have been obscured due to life situations.  Those practicing Hypnosis look for the underlying causes or unresolved emotional issues such as fear, anger, anxiety, trauma, or guilt.  


When the issues are resolved then the symptoms recede and the child is able to lead a normal social and academic life.  Often the traumas were in the past and then there were layers of more recent ones that are like new coats of paint piled on top.  What the child does is repeating a loop of behavior (fear, anger, anxiety, trauma, or guilt) and the parents may be simply overwhelmed by family, career and health issues.

In some classrooms students are stressed because they are not taught how to learn by a means that they can understand.  The teacher may present the lesson visually and orally; we have a kinesthetic learner: therefore this will be a very stressful day and acting out will probably be part the result.


Rather than dealing with the symptoms or making students compliant, as often the medications appear to do; with Hypnosis the behavior is permanently improved.  Frequently there is a very deep emotional release involving forgiveness of themselves, parents, siblings, extended family and classmates or friends.

Gary Craig has developed a tapping technique called Emotional Freedom Technique (EFT) that is a refinement of the original work created by Dr. Roger Callahan.  Those practicing EFT also look for the underlying causes or unresolved emotional issues.  These practitioners consider that their work is a form of neurological rewiring.  EFT can do a great deal to alleviate the past and therefore give a child a new tool to utilize in the present.

Dr. Sandra Landsman:
810 Saturn Street Jupiter Florida 33477, U.S.A
561-575-0547; DrSandyLandsman@bellsouth.net, www.DrSandy.biz

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