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When an attentional problem is present, with the hallmark symptoms of distractibility, hyperactivity/restlessness, and/or impulsivity, the child’s ability to master some or many of these tasks will be more difficult. Complicating the situation is the fact that many children with attentional problems also have other learning problems.
The parental role has always encompassed difficult periods, when parents feel confused and worried about how well they are fulfilling their responsibilities. However, raising a child with Attention Deficit Disorder can be exceedingly frustrating, emotionally draining, and expensive. In many instances, the child’s ADD-related problems cause ongoing problems in the parent-child relationship that can set the stage for an unhappy, guilt-ridden relationship between the child, parents (and siblings) that may persist, sometimes through life. The strain from raising these ‘difficult kids’ takes a toll on many marriages, especially when parents differ in their approach to the child.
family situation is the fact that Attention Deficit Disorder is often
genetically transmitted from one generation to the next. Thus, we
often find an ADD child being raised by an ADD parent who was never
diagnosed and who has a very limited un derstanding of why the child
is having problems (which may, incidentally, mirror problems that
the parent himself experienced as a child).
The ability to organize sensations and to feel tranquil may pose problems for babies who are later diagnosed as having attentional deficits. These babies are often described as "hyper-excitable", "colicky", "irritable", and/or "unsoothable" by their parents.
These infants are often very active, easily distracted, and over-reactive to stimuli. Their be havior might appear to be chaotic or unpredictable. They may also be extremely sensitive to sensations— visual, auditory or tactile. Parents’ efforts to soothe these babies with words, songs, or stroking may be met with tensed muscles, arching back, and loud crying.
parents often respond to a ‘difficult’ baby with confusion and alarm.
The inter-relationship between nurturing parent(s) and child is critical.
When parents have a child with whom they cannot cope, they usually
assume it is their "fault"— that they are failing as parents. These
feelings of failure can set the stage for problematic, guilt-laden
parent-child interactions that continue through life.
The toddler is also beginning to connect feelings and behavior. He is learning to take the initiative to get his needs met. He is developing ideas and concepts, along with awareness that objects have functions (i.e. cups are to drink from, refrigerators hold food). Finally, the youngster is beginning to accept limits, which in turn helps him to learn what he can and cannot do. As a correlate, he needs to learn to tolerate frustration. Finally, he needs to learn how to recover from the stress of disappointments and adapt to changes in his environment.
tasks can present significant problems for children with attentional
deficits. Typically, these youngsters have difficulty tolerating frustration
and may be emotionally over-reactive. Parents describe them as "all-or-nothing"
children who have difficulty calming themselves. They tend to "fall
apart" easily, dissolving into tears of frustration when needs or
wants are not met immediately.
Individuation, Identity, and Self-Concept
Not surprisingly, pre-school youngsters often have great difficulty distinguishing between reality and fantasy. As they try on different identities (teacher, policeman, father, mother), their ability to think magically is an asset. Nothing is impossible when you are four or five!
As the child begins to develop a solid identity, his self-concept is also emerging. Each child’s self-concept consists of images and beliefs about the self, including easily-verifiable facts ("I am a girl", "I have black hair") and less-verifiable but strongly-held beliefs and image about the self ("I am smart/dumb", "I am lovable/unlovable", "I am good/bad").
During the pre-school years, the common behavioral signs exhibited by many children with attentional deficits—high activity levels, poor persistence, interpersonal/peer group problems, and difficulty modulating behavior and impulses, with aggression, tantrums, silliness, bossiness, and impulsivity, are often beginning to create problems for the youngster. He may be fearful, confused, manipulative, or avoidant. Attention deficit and other learning disabilities are strong contributors to the emergence of over-anxious disorders of childhood, including school phobias.
Since a diagnosis
of Attention Deficit is usually not made until after the child has
entered school, the atypical ways that these children react and respond
during the first years of life are perplexing and distressing to parents,
teachers, and other family members. Confused parents often send strong
disapproving messages to the child that he can behave and stay under
control if he tries hard enough. Concerned family members often criticize
both child (for being bad) and parents (for being ineffective), creating
even more stress between parents and child.
The Elementary School Child:
As the child shifts from pre-school to elementary school, he consolidates the gains made during the previous stages (i.e., basic trust, separation, and individuation). The major psychosocial tasks of childhood have been dealt with, freeing the latency-aged child to focus his energy on learning in school along with the development and refinement of interpersonal relationships.
The school, as the vehicle for teaching academics and social skills, now occupies a central role in the child’s life. Vast amounts of factual data must be learned. The child must learn how to read, write, do arithmetic, be a good friend, and be a good student. The elementary aged youngster’s tasks include learning how to relate appropriately to adults (aside from parents) and children (who are not siblings).
After entering the educational system, the child with attentional deficits will often begin to struggle. The child may lag behind his peers, academically and socially. Often, ADD youngsters have "social deficits" in that they have difficulty accurately interpreting and processing social information and cues. This "social deficit disorder," coupled with impulsivity, may lead to the development of socially unacceptable behaviors.
many children and adults with Attention Deficit Disorder are also
exquisitely sensitive to feedback from others. As the child becomes
aware of his differences from others, is shunned or teased by peers,
is criticized by teachers for being unable to remain in control, the
child begins to develop a negative self image, low self-esteem, depression
and anger. What significant others (parents, teachers) tell the child
about himself has a powerful impact on his developing self-concept.
The child begins to view himself as he is viewed by others. Told repeatedly
that he "could do better if he would only try", he begins to feel
that "I am worthless because I cannot always control my behavior." Sadly, these negative feelings about the self often persist through
Medication helps to relieve many symptoms of distractibility and hyperactivity in about 75% of children. Most children are treated with psychostimulant medications (Ritalin, Cylert, Dexedrine). Others respond to a carefully titrated blend of antidepressant medication (the most commonly prescribed is imipramine) and/or psychostimulants. There are other medications which are used less frequently but also with good effect.
Therapy or counseling can also be useful in helping both child and family deal with ADD-related problems. If therapy is indicated, it is important to select a professional who is knowledgeable about ADD and its impact on both child and family. Depending on the child’s problems, therapy may include a variety of interventions, including social skills training, compliance training with parents, psychosocial education of parents and child, anger management training, cognitive therapy to improve self-esteem and mood, and family therapy with parents and siblings.
Finally, living with an ADD child can offer special charms and delights. These children can be very perceptive and sensitive to the plight of others. They are intensely curious, creative and inventive. Many are very affectionate. Most of their ‘problems’ arise from the fact that they process emotional and intellectual information somewhat differently from ‘normal’ children. Our culture places great value on conformity, especially in the training and education of children. If the child with ADD is raised and educated with an appreciation of his or her uniqueness and strengths, then that child can grow up into a healthy, productive adult.
NOTE: This article is
for information purposes only, and is not to be substituted for medical
advice from the health care professional of your choice.