What Is ADHD?

--Steve Hagberg (educator and parent)

I felt a cleaving in my Mind--
As if my Brain had split--
I tried to match it--Seam by Seam--
But could not make them fit.

The thought behind, I strove to join
Unto the thought before--
But Sequence ravelled out of Sound--
Like Balls--upon a Floor.

--Emily Dickinson (1864)

Probably all of us can identify with the poem above as being true for us occasionally, when our thoughts become tangled and disjointed, but for the child or adult with ADHD this is the normative experience. They face the daunting task of trying desperately to bring their scattered thoughts together in an attempt to understand and control their universe. This latter is important, because an ADHD child is constantly seeking to control everything in his environment to bring it into line with his perception of the universe.

"ADD is a neurological syndrome whose classic defining triad of symptoms include impulsivity, distractibility, and hyperactivity or excess energy. About 15 million Americans have it today; most of them do not know that they have it. The condition occurs in children and adults, men and women, boys and girls, and it cuts across all ethnic groups, socioeconomic strata, levels of education, and degrees of intelligence, It used to be thought that this was a disorder of childhood alone, and that one outgrew it during adolescence. We now know that only about a third of the ADD population outgrows it; two-thirds have it through adulthood. ADD is not a learning disability or a language disability or dyslexia, and it is not associated with low intelligence. In fact, many people who have ADD are very smart. It's just that their smartness gets tangled up inside. Undoing the tangle...can take more patience and perseverance than they can consistently bring to bear." (Hallowell and Ratey, p.6)

Technically, the correct diagnostic label in use today is attention-deficit hyperactivity disorder (ADHD) which lumps hyperactivity into the collection of symptoms, but attention-deficit disorder (ADD) is often used as well to describe the same package of behaviors. The label is not exact and can be confusing in some cases, since it is not a lack of attention but attention inconsistency that is the problem--ADHD individuals have a remarkable to "hyperfocus" at times. Also, the hyperactivity may or may not be present in all cases--some individuals display a dreamy and passive appearance on the outside. And finally, the use of "disorder" to describe the syndrome implies that this is a pathological condition to be treated and cured, while the truth is that the problems created by the ADHD are often accompanied by some startling benefits--creativity, intuitiveness, high energy, enthusiasm, and empathy for others. The truth is that an ADHD child can perhaps most correctly be termed a "special-needs" child.

ADHD is linked to an imbalance in the chemicals used to regulate mood, behavior and energy level in the body. As such, it oftentimes is partially correctable with appropriate doses of medication. This is never a complete answer to the problem, but medication often makes the symptoms manageable enough to where the ADHD individual can begin, with counseling, the process of consciously developing skills to deal with his symptoms.

ADHD is not the result of poor parenting. Because it is biological in nature, the analysis of the problem based on behavior is often misleading. Well-meaning individuals will often suggest that "a good, swift swat" or "firm, consistent discipline" are the answers to the problems of dealing with the ADHD child. This completely misses the point. While a diagnosis of ADHD should never be allowed to become an excuse for misbehavior, in dealing with inappropriate behavior a parent or care giver must be careful to try and determine the actual motivation for such behavior. While ADHD children are sinners by birth like the rest of us, they are prone to impulsive and seemingly rude behavior which is nearly impossible for them to control (or even understand as wrong). The frustration of constantly living on the ragged edge of control breeds angry, often violent outbursts. The insecurity caused by never really being sure that they have a handle on things provokes demands for attention and reassurance that can be misinterpreted as merely selfish behavior.

There are many, both inside and outside the Christian community, that feel that ADHD is just another example of an invented syndrome that is then used as an excuse for a child's poor behavior, or poor performance academically, or both. Unfortunately, arriving at a diagnosis of ADHD for a child is not a simple matter of administering physical or psychological tests and getting a definitive result. There is no clear line of demarcation between normal behavior and ADHD behavior. An ADHD individual is simply more intensely characterized by certain traits and behaviors--such as distractibility, restlessness, and impulsivity--than the rest of the population. Lacking any other apparent cause for the behaviors in medical conditions like hyperthyroidism, clinical depression, or family disturbances, ADHD is a strong consideration. But only a professional trained in working with ADHD should make the final diagnosis. Ignorance of the syndrome can lead to a non-diagnosis, but an equally dangerous problem lies in over-diagnosing the problem.

"In addition to making sure that no other medical condition is causing the symptoms, on e must recognize that ADD is a comparative diagnosis. It depends not just upon the presence of symptoms but upon the intensity and duration of those symptoms. Most children are distractible, impulsive, and restless some of the time. The vast majority of children do not have ADD, and one must be very careful not to make the diagnosis so easily that it loses meaning or becomes a fad." (Hallowell and Ratey, p.43)

As a corrective reaction to secular psychology assigning biological motivation to behaviors we consider sinful choices, many in the Christian community deny any biological causation for behavior. This flies in the face of scientific and medical evidence which shows that our behavior is often not simply a matter of our conscious choices, but affected greatly by a complex interaction between external situations, emotions, and the body's own chemical balance. Truly, we are "fearfully and wonderfully made." (Psalm 139:14)

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