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Home > Articles > Attention Deficit Disorder In Children: Developmental, Parenting and Treatment Issues |
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Attention Deficit Disorder in Children: "In approximately
half of the cases, onset of the disorder is before age four." Introduction
The Infant: Developing Trust The Todddler: Tolerating Separation The Pre-School Child: Individuation, Identity, and Self-Concept The Elementary School Child: Consolidation Stage How to Help Human growth and development, with the requisite learning of skills and mastery of cognitive and psychosocial tasks, unfolds in endlessly fascinating, complex patterns. If the child is to develop a healthy personality, then he or she must learn how to test reality, regulate impulses, stabilize moods, integrate feelings and actions, focus attention, and plan. 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.
Raising a child with Attention Deficit Disorder can be exceedingly
frustrating, emotionally draining, and expensive. Complicating the 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 understanding of why the child is having problems (which may, incidentally, mirror problems that the parent himself experienced as a child). The Infant: Developing Trust
During
the first several months of life, the infant faces several critical
developmental tasks, including learning how to regulate and calm him/herself
and how to use the senses to learn about the world and the people in
it. 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 behavior may 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. Not surprisingly, 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: Tolerating Separation
The second
psychosocial developmental stage faced by the young child is that of
separation. The separation process occurs in gradual steps, occurring
from about nine months to three and a half years.
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).
These developmental
tasks can present significant problems for children with attentional
deficits. The Pre-School Child: Individuation, Identity, and Self-Concept
"Who am
I?" asks the pre-school youngster, as s/he experiments with wildly different
roles and identities. 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, the 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.
Since a diagnosis
of Attention Deficit is usually not made until after the child
enters school, the atypical ways that these children react and respond
during the first years of life are perplexing and distressing to parents and other family members. The Elementary School Child: Consolidation Stage 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 often
begins to struggle. The child may lag behind his peers, academically
and socially.
Paradoxically,
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. How to Help
Attention Deficit Disorder is a neurobehavioral disorder that causes multiple problems for children. Typically, the child with ADD will experience difficulties in several areas of life, including learning, peer relationships, self-esteem, mood, behavior, and family relationships. 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 and/or psychostimulants. There are other medications which are used less frequently but also with good effect.
Therapy or counseling
is useful in helping the child and family deal with ADD-related
problems. If therapy is indicated, it is important that parents select a professional
who is knowledgeable about ADD and its impact on both child and family.
Living with a child with ADD/ADHD 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.
NOTE: This article is for information purposes only and is not to be substituted for medical advice from the professional of your choice.
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