By: Eric M. Evans, writing from a student's perspective on life with ADD
When I was in high school (1993), I noticed that many of my teachers had no idea about one of the most common classroom problems: ADD. So I wrote this report as part of a project to try to teach some of the teachers. I'm not sure how effective I was, but it couldn't have hurt. This report is based more on the social side of ADD/ADHD. Some scientific data was used for the purpose of explanation. Those of you that read this document should not use it as a solid source of self-diagnosis. The information contained is mostly based upon my life with ADD and every case is different. If you suspect you may be a victim of ADD or ADHD, see a professional. And remember, never go with one opinion if you have doubts. Drug problems can result from a misdiagnosis. For more information or questions, you can e-mail me at ericmevans@yahoo.com. Feel free to pass around this paper.
ADD is very misunderstood, undiagnosed, and under taught. It disallows the ADD person to grow (socially and mentally), contribute, and disallows the ADD person to have a good self- esteem. I feel I must teach you, my teachers and peers, about ADD. This problem is here to stay, will not go away, and needs to be studied. ADD is an invisible handicap as opposed to a person in a wheelchair. ADD affects learning if not taken into consideration during the entire learning process. Left misunderstood, the ignorance of the problem can and does result in a person unable to function in the mainstream of life.
Attention Deficit Disorder (ADD) is a problem that stays with you until death and affects 5% to 10% of all children (Fowler, 1991): ten times more boys than girls. ADD and ADHD affect more children than any other childhood problem except asthma. It is estimated to be the largest single cause for first referrals to child guidance clinics throughout the country, making up as many as 40% of those cases. Many ADD cases are not diagnosed because the problem most often does not prevail in the doctors office. Current estimates suggest that approximately 50 to 65% of the children with ADD will have symptoms of the disorder as adolescents and adults (Fowler, 1991).
ADD is very misunderstood. It's apparent to me that in adolescence the person with Attention Deficit Disorder is in great danger of being misunderstood and misjudged, often as a result of the compensatory tactics used to win approval from teachers and peers. It's important for us to understand what's going on beneath all this so we don't judge the [person] on the basis of what's seen on the surface. I believe that ADD is still grossly under diagnosed, under recognized and under managed. And yet there are many who believe that physicians who are interested in this area reach for the prescription pad at the first sign of behavior problem. Let me assure you that really doesn't happen. The decision to use medication is arrived at after a great deal of consideration (Dr. Elliott).
ADD children are often described as "brats" or "space cadets". The ADD person is often called by such derogatory names indicating limited intelligence such as stupid, imbecile, slow, lazy, etc. The ADD person has difficulty with organization resulting in messy rooms and lockers, lost articles, and poor sense of time. Their main problem is difficulty concentrating on things that they believe to be boring (Phelan).
Not all ADD people are alike. Some are introverts and, therefore, quiet, and they keep to themselves. Others are very active, noisy, and interruptive. ADD girls tend to be more introversive than the boys. However, most people with ADD have good intelligence and some are even "gifted", there in lies the principle and tragic misunderstanding for any ADD victim.
ADD was not too long ago considered a condition which fell under the heading of "learning disabled", "brain damaged", "hyperkinetic", or "hyperactive". The newer term, attention deficit disorder (ADD), more clearly describes the condition. There are two types of the disorder: ADD and ADHD.
An ADHD (Attention Deficit Hyperactivity Disorder) person can show any of the following characteristics: fidgeting, squirming, difficulty remaining seated, easily distracted, difficulty awaiting turn, blurting out answers, difficulty following directions, sustaining attention, shifting from one uncompleted task to another, getting up in the morning, talking too much, interrupting, not listening, following multiple directions, and frequently engaging in dangerous actions. ADD, as opposed to ADHD, has some, but not all of the above characteristics. The ADD person has problems with impulsivity, bad handwriting, trouble with cutting, pasting, inconsistent grades, waking up, following multiple directions, and task completion. As a result of inconsistent grades, teachers often fall into a trap setting their expectations for a person based on the child's best performance (Adams). A paper by Ned Hallowell, M.D. explains it better. `How is it,' one of the teachers asked him, `that one week you can be one of the best students I've ever had and the next week act as if you weren't even in the room?'
A person with ADD is usually described as having a short attention span and as being distractible. The person has difficulty concentrating, listening, beginning or finishing tasks, and following multi-step directions. It will appear that the person is hearing what is being said, but is not listening. Sometimes this last characteristic is interpreted as being arrogant and irresponsible.
Since it's difficult to pay attention, pieces of information from school assignments, directions, or reading are missed.
ADD "students' reading comprehension may be poor; their ability to sustain the attention to digest and reflect upon what they have read may be limited. In mathematics, these students may be inattentive to operations signs on computational tasks, and they may also lack efficient strategies for solving multi-step problems."(Adams).
An ADD person can learn something one day and have totally forgotten about it by the next day. An ADD person might go over a spelling list and have it totally memorized; yet, the next morning it is forgotten. You might explain a math concept in school and the person knows it, but that night he/she will have totally forgotten what the concept is. On the other hand, this same person might remind you of something that he or she did two or three years ago in detail. There is no problem with long-term memory; short- term memory can be very short (Silver. p.5). This makes tests very difficult for people with ADD. It is just about pointless to cram for a test at the last moment since it will mostly all be forgotten. The trick is to study days before the test actually occurs and then review the information periodically during the remaining time until the test. The short-term memory problem is also mixed with and assisted by distractions.
Some people with ADD wander about, while others appear to daydream. For the ADD person, the hiss of a radiator, hunger pangs in the stomach, or the memory of last nights television program are equally as relevant, and perhaps more interesting, than the teacher's voice in the classroom.
Attention skills at home are difficult because of the rest of the family trying to do what they need to do. Sometimes a television or radio is turned on in another room. Noise from these are considered a distraction. What the ADD person needs is a sound screen.
Sound screens are important. That's why having the TV or radio on in the background may be advantageous. At first it may seem like a distraction, but in reality, if the TV or music forms a kind of `white noise' with an even level of intensity, it actually covers up discrepant noises that can be a distraction. The hum of a ceiling fan or motor can do wonders to soothe and focus you (Weiss. p.87).
I've learned that different noises help with different situations. In particular, I've found the music is very helpful when I am working with math. I have always enjoyed math but at the same time it was one of my worst subjects, that is, along with the rest. Having music on for some reason gave me a better understanding of what was going on. I'm thinking that since I am very analytical, my brain may tune into the beat of the music and begin to follow the rhythm therefore making order out of chaos. It seems to bring all of the different parts of my brain that are each trying to concentrate on something different together to form one brain instead of acting as many. I'm pretty sure everyone would require different types of music but you don't want something with too much randomness, screaming, or general talk. My personal choice is Pink Floyd. At times it can be best to use music that is sung in a different language that way you are less likely to try and sing along. In this case my Enigma works great. The key to concentrating is getting the mind on one channel and eliminating and background distractions (the sound of a voice or TV from another room kills my concentration every time).
Bottom line to your work environment: Allow yourself the freedom to work in the environment that feels best for you. Forget the guidelines generally taught in school or by parents. Your [ADD person] intuition knows better (Weiss. p.87).
Attention is a skill that can be applied or directed in a variety of ways. The inattentiveness of a person with ADD, then, can take several forms. The person may have difficulty with selective attention (deciding which is more important, the teacher or the fly), focusing attention, sustaining attention, and dividing attention (taking notes) (Fowler). The ADD person also suffers from cognitive fatigue. This is because the person tires easily in sustained cognitive effort. Learning can be a real struggle in the normal learning setting. It takes much effort to concentrate and attend. You pretty much get tired from thinking.
With the characteristic of impulsivity, a person with ADD often acts without thinking and has great difficulty waiting for his or her turn. The person may rush through assignments, shift excessively from one task to another, or frequently call out or ask irrelevant questions in class. In some cases that are more intense, the person will often interrupt others and have outbursts of inappropriate responses such as silliness or anger. When this person gets enjoyment out of something or flies into a temper tantrum, he or she can have great difficulty regaining control (Fowler).
ADD people sometimes have organization disabilities. They can process each piece of information but have difficulty integrating the pieces into a whole picture. They can answer the questions at the end of the chapter, but they're unable to explain what the chapter is about. They might do well on multiple-choice questions (where one has to recognize only pieces of information) but poorly on essay- type exams (Silver. p.4).
The person that is writing the exam may mix up the sequence of events. If the essay was based on a book, the ADD person will have understood the book, but in retelling or writing the story, he or she may confuse the sequence of thoughts or events, starting in the middle, going to the beginning, and then to the end--all of the letters are there but in the wrong sequence (Silver. p.4). I constantly battle with my organization. Along with my ADD I also have a touch of Obsessive Compulsive Disorder. I don't suffer from the OCD that causes me to wash my hands every second until they are raw, my OCD problem is with organization. One thing that really annoys me is my computer keyboard; it will have to be exactly parallel to the edge of my desk. But for some reason, no matter how hard I try, it just doesn't look parallel: even if I use a ruler. At times repetition will drive me crazy when my brain suddenly decides it wants me to repeat the previous action I did but then is never satisfied with the way I did it and therefore wants me to do it again. Luckily this problem doesn't occur as it once did. Mainly this is something I see during extreme tiredness or in high stress situations. I have been teaching myself to control it and so far I seem to be winning the battle, that is, until organizing my room or desk comes into the picture. It drives me nuts how I have stuff everywhere but at the same time it is a pain in the butt to get myself to put it all away. It is a constant battle between ADD and OCD.
Many, but not all, ADD people are hyperactive. The ADHD person runs or climbs excessively, has difficulty sitting, fidgets, and engages in physical activities not related to the task, such as frequent pencil sharpening, falling out of his or her chair, finger tapping, or playing with objects. This person makes excessive noises or talks in a loud voice.
On the other hand, some people with ADD are under active and often called lazy or spacey. People both with and without hyperactivity are often accident prone because they are not aware of what is happening around them. I had my own experience with my bike and a telephone pole.
ADD results in social skill deficits. The person with ADD is sometimes described as immature, lacking in self- awareness and sensitivity, and demanding attention. The person may frustrate easily and be inconsiderate, overly sensitive, or emotionally overactive. He or she may have difficulty expressing feelings, accepting responsibility for behavior, or get into frequent fights or arguments. Or, the ADD person may be the typical victim. He will allow himself to be picked on and sometimes physically attacked because of the difficulty in verbalizing a problem or complaint. They can become an easy target. This person often reacts to a social situation without first determining what behavior is desirable. Poor social skills are a result of ADD because of low self esteem, improper responses, and fear of criticism. The ADD person wants to be accepted but frequently goes about it in the wrong way. Many ADD children have more in common with younger children. The ADD person can still develop valuable social skills from interaction with younger children. Before ADD had been discovered, people with the problems that are now labeled ADD were called "late bloomers".
Social skills really impaired my ability to join in. The start of the 6th grade is when my life really went downhill. Up until then I was very talkative, enjoyed being with other people, and could easily make friends (when I didn't make a fool of myself). The start of 6th grade was the start of the tormenting that I received everywhere I whet. I quickly learned that I was no longer just one of the other students but the one to pick on. I quickly learned that I could live my life just fine without the need of friends or people to talk to so I crawled under my rock and let the outside world do whatever it wanted to with me. My self-esteem dropped to zero and I didn't really care. If you were lucky, you might have gotten a few words outta me. This way of life continued until my third semester in college. You can therefore imagine that I didn't gain many friends or date much for the majority of the time when all of that normally occurs. Unfortunately/fortunately at the start of my fourth semester in college I developed cancer. The reason I use the word fortunately is because it changed my life for the better. It started the slow crawl from under my rock. I've now started a new life and I'm doing better than ever before (Described in better detail at the bottom of the page).
It has been discovered that ADHD is the result of a lack of glucose (sugar) in areas of the brain that happen to control the small motor control and attention abilities. Hyperactivity is caused by a lack or activity in areas. ADD is very similar but not to such an extreme.
It has also been discovered that ADD can only be inherited. Older theories such as ADD was caused from brain damage due to being dropped as a baby or caused by drug intake during pregnancy, are not true.
The detection of ADD is difficult because it can't be detected with a blood test or x-ray. A test requires a long observation of the person, EEGs, MRIs, or a PETscan.
The observation of a person is the most common form of diagnoses. But to diagnose a person without knowing the behavior of the person in the past requires about nine months of observation. During the nine months, the person has to show a certain number of characteristics.
EEGs, record the amount of electrical activity that is happening in the brain. An MRI is an x-ray the shows the brain's anatomy. But it is not a routine assessment. A more recent way to diagnose ADD or ADHD is to use a PETscan. The PETscan measures the different amounts of brain activity and what kind of activity is going on at the moment (Fowler).
It is sometimes believed that a cure has been found to stop ADD. There is no such thing as a cure. There are only a crutches. Drugs such as Ritalin and Dexedrine are used to treat ADD/ADHD. The most common of the two is Ritalin. The reason for this is because it has little or no side affects. However, in some people it may cause a stunting of growth, a great increase of sleeplessness, or decrease in appetite. Other drugs are used in case any side affect should happen to appear.
Another belief is that everyone grows out of ADD. No one grows out of ADD. An ADD person can only learn to compensate for their problem therefore creating an illusion that the problem is gone.
There are many instructions that a teacher should follow if they suspect or know that someone in their classroom has ADD. Here is a list of eight recommendations for giving instructions to students:
- Maintain eye contact with the ADD student during verbal instruction.
- Make directions clear and concise. Be consistent with daily instructions.
- Simplify complex directions. Avoid multiple commands.
- Make sure the ADD student comprehends before beginning the task.
- Repeat in a calm, positive manner, if needed.
- Help ADD students to feel comfortable with seeking assistance because most ADD students WON'T ask.
- These students need more help for a longer period of time than the average student. Gradually reduce assistance.
- Require a daily assignment notebook if necessary. Make sure the student correctly writes down all assignments each day.
School administrators must accept the fact that there is such a thing as Attention Deficit Disorder and that it is a bona fide learning disability. They must resist the temptation to simplify their lives by shunting the problem aside as a purely medical problem (Dr. Elliot).
ADD is tragically misunderstood by the public. This is a problem, because people think that if the problem involves the brain, it must mean brain damage. There is no damage in the brain. ADD is sometimes called a central nervous system dysfunction, which indicates a malfunctioning of the brain rather than actual tissue damage. Some professionals hold that even the use of the term dysfunction is problematic because its diagnosis is not exact (Hallahan, 1991, 123). ADD will affect the 10% of the child population for their entire lives. No one grows out of it; there are only crutches.
I have mentioned self esteem several times in my paper. The lack of self esteem is all pervasive. It affects decision making, participation in groups, presentations, sports, and any type of social involvement. The ADD person needs constant reinforcement and encouragement. Verbal rewards make a big difference. Teachers, parents, and peers need to be taught about ADD/ADHD because in any large group, ADD/ADHD will be present.
UPDATE:
Now in 1998, much has happened since I wrote this paper and everything fortunately has so far lead to a happy ending. I struggled through school as usual, using every means available to help me wade my way to the end of each semester. My compensation abilities were growing very slowly. Tutors found here and there helped improved my overall standing but it was still a big struggle; I never felt in control and my self esteem was low so I'd always try to hide and find the easy way out of things. Then on Valentines Day 1995 I was diagnosed with cancer and unfortunately it was in its late stages. YIKES! I went through some surgery and 4 months of high-dosage chemo. In May of 1995 the x-rays and CAT-Scans (mmmm love that barium) showed everything to be clear! It seems that chemo did more than kill the cancer, it also brought out the me that existed before I crawled into the shadows back around the 6th grade. In a way, I'm actually glad that I was able to experience everything I went through, that is, as long as it doesn't come back. Before the treatment, you were lucky if you ever hear me say a word. Now sometimes it's difficult to shut me up. Along with my self esteem came my ability to compensate for my ADD. When I started back in school, it was like a new beginning. My grades went up and I started making more friends. I started college as a Computer Science major and graduated with the CS major and a Minor in Math. I was at one point deciding weather I wanted to just add math as a second major (I had always been bad at math). Unfortunately this would have lead to another semester so I decided a minor was enough for the moment. More than just school was improving. Along with my increased compensation came more opportunities. During my last three semesters in college, I had a year long internship with Ceridian Corp. (aka Control Data, payroll company) and a 6 month internship with Monsanto. To top it all off, I was able to bring my average by graduation up to above a "B" and hired right out of school as an Applications Developer/Tester at Anheuser Busch. My position at Anheuser Busch was brought to my attention by the co-op director at my college. If I never got cancer in the first place, I would have graduated on time and the opportunity to work for such a great company probably would have never involved me. I'm just glad that everything happened when it did.
That is the short version of my life thus far since 1993. I haven't really edited it so sorry if I have any horrid errors that I didn't pick up on. It will sometime soon all be replaced by an expanded version on its own page. Until then, you'll just have to live with this version. Thank you to all of you that have been sending me e-mails in response to my paper. Those of you claiming ADD doesn't exist: lack of knowledge can be very dangerous.
Works Cited
- Conner, Jean, gen. ed., Challenge. ? vols. Boston: 1992. Vol. 6: The Proactive Teacher and the Student with an Attention Deficit: A Partnership for Success, by Phoebe Adams and Carol Curtin.
- Conner, Jean, gen. ed., Challenge. ? vols. Boston: 1987. Vol. 1: No Title!, by Dr. Richard Elliott.
- Kupper, Lisa, gen. ed., NICHCY Briefing Papers. Washington DC: 1991. Attention Deficit Disorder, by Mary Fowler.
- Hallahan, Daniel and Kauffman, James. Exceptional Child. Allyn & Bacon: 1991.
- [Phelan, Thomas] Attention Deficit Disorder Fact vs Myth. Illinois: IAHADD.
- Silver, Larry B. Attention Deficit-Hyperactivity Disorder and Learning Disabilities. New Jersey: CIBA-GEIGY, 1990.
- Weiss, Lynn Dr. Attention Deficit Disorder In Adults. Texas: Taylor Publishing Company, 1992.
Bibliography
- Conner, Jean, gen. ed., Challenge. ? vols. Boston: 1992. Vol. 6: The Proactive Teacher and the Student with an Attention Deficit: A Partnership for Success, by Phoebe Adams and Carol Curtin.
- Conner, Jean, gen. ed., Challenge. ? vols. Boston: 1987. Vol. 1: No Title!, by Dr. Richard Elliott.
- Copeland, Edna D., Ph.D. and Love, Valerie L., M.Ed. Attention Without Tension. 3 C's of Childhood, Inc.: Atlanta, Georgia, 1992.
- Kupper, Lisa, gen. ed., NICHCY Briefing Papers. Washington DC: 1991. Attention Deficit Disorder, by Mary Fowler.
- Hallahan, Daniel and Kauffman, James. Exceptional Child. Allyn & Bacon: 1991.
- Hallowell, Ned M.D. The Emotional Experience of Attention Deficit Disorder. 1992.
- Lerner, Carol M.S.; Agopian, L.; Ansell, C.; Barker, N.; Bibace, C.; Brown, N.; Ford, K.; Milford, M.; Mills, L.; Mitchell, S.; Morton, J.; and Thornberry, N. Attention Deficit Disorders: "A Guide for Teachers". Florida: CH.A.D.D., 1988.
- [Phelan, Thomas] Attention Deficit Disorder Fact vs Myth. Illinois: IAHADD.
- Silver, Larry B. Attention Deficit-Hyperactivity Disorder and Learning Disabilities. New Jersey: CIBA-GEIGY, 1990.
- Weiss, Lynn Dr. Attention Deficit Disorder In Adults. Texas: Taylor Publishing Company, 1992.
- Zentall, Sidney Ph.D. Identification, Assessment, and Management of ADHD Youth in Educational Contexts. "Fourth Annual Conference on Attention Deficit Disorders." Chicago, Illinois: CH.A.D.D., 10/15-17/1992.
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