Why JOHNNY WON'T BEHAVE Attention Deficit Disorder May Be the Real Classroom Cause for Daydreaming and Commotion-Making

Article excerpt

A little girl sits at the back of the room and daydreams through

the school day. Down the hall, a boy is driving a teacher to

distraction with his non-stop antics.

Do these kids need a trip to the principal's office for a good

talking to, or a visit to a doctor's office for a medical

evaluation and treatment?

More and more children are being diagnosed at an early age with

Attention Deficit Disorder and its cousin Attention Deficit

Hyperactivity Disorder.

ADHD is characterized by impulsive behavior and hyperactivity.

It occurs more often in boys than in girls. ADD is

characterized by an inability to focus, pay attention and organize.

The disorders, which are physiologically based, can be

accompanied by other conditions such as learning disabilities,

oppositional defiant disorder ("I'm not going to do it, and you

can't make me"), conduct disorder (breaking societal norms) and

anxiety disorder.

Both disorders can be treated with a combination of counseling

and behavior modification, and often medication such as Ritalin.

Left untreated, children with ADD and ADHD can become depressed,

anxious, have low self-esteem, and are at higher risk for

substance abuse, teen pregnancy and dropping out of school.

Attention deficit disorders occur in 3 to 5 percent of children,

researchers say, although some estimates put the number as high

as 10 percent.

Critics say the number is too high.

Child psychologist Wade Horn, a former president of the Children

and Adults with Attention Deficit Disorder national support

group, said ADD is "far too popular and kids are being

over-diagnosed. Parents shop for the diagnosis. They get mad at

you if you refuse."

Mary Ann Dyal, a counselor at Alimacani Elementary School in

Jacksonville, said she worries about the diagnosis.

"It is a pretty widespread problem," she said. "I'm almost

afraid we are over-labeling. It's almost the popular thing

right now to label children that way.

"We walk a thin line between wanting to identify children who

are ADD, but we don't want to get into the danger zone of

over-labeling these children as well. But I have seen some

dramatic improvements in children who were diagnosed."

Psychiatrist Edward Hallowell of Boston, author of Driven to

Distraction, said he doesn't think the disorders are being

over-diagnosed, although he said that some children are

misdiagnosed.

The difference between ADD/ADHD children and children who

misbehave is that ADD/ADHD children want to behave. "They want

to do well, to fit in, to shape up," Hallowell said.

The children who are misbehaving want to break the rules and

push the limits. However, the ADD child can't help himself.

"The good news is we have discovered this condition," he said.

"So children, instead of being given a moral diagnosis that they

are bad and moral treatment (i.e. punishment, ridicule or

physical punishment), are given a medical diagnosis and

treatment."

Stephen Commins, a pediatric neurologist at Nemours Children's

Clinic, said if there is over-diagnosis it is because of

misdiagnosis.

Neither ADD nor ADHD can be diagnosed in a single office visit,

Commins said. There is no simple test that detects either

disorder. Diagnosis is ultimately a judgment call.

"A child shouldn't be diagnosed as ADD or ADHD until everything

else has been ruled out," Commins said.

Other problems can mimic attention deficit disorders, he said. …