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July 20, 2002, I gave birth to the most beautiful, amazing baby girl I had ever seen. An indescribable feeling of pure love washed over me. As Aubrey grew, she was a normal, happy baby. She never was really much of a problem other than she was always on the go, up and walking at 8 months, but by the time Aubrey was 3, she had a reputation. She was often in trouble for getting into stuff, making messes, climbing, running, and just plain being wild. My family and friends felt that if I would just discipline her, she would straighten up. They told me she was too spoiled. I got to the point where I did not want to associate with people because there was sure to be a fight regarding my parenting skills and my unwillingness to beat my child. When Aubrey was 5, I put her into a private kindergarten program. Her behavior problems became worse and new behaviors started to show as she was put into a classroom setting. I took Aubrey to a psychologist and was told that my child was fine. At the age of six, as Aubrey went to first grade, her behavior problems became even more apparent. She could not perform simple functions like staying seated in her chair during lessons. She was unable to stay on task no matter what she was asked to do. The teacher, over-burdened with 20 plus children in her classroom, had no time for Aubrey and as long as Aubrey was not bothering other students, she was left to wander through the class doing whatever she wanted. It was heart wrenching to watch as she struggled to get though the day. I felt so helpless because I did not know how to help her. Her work was never chosen to be placed on the wall, she was never invited to play with the other children, she was never chosen to be the helper of the day, and she was often left out because of her behavior. Now I had something much worse to worry about: her self-esteem. I began pushing for help from the school administration. It took months of me constantly asking to get the school to set up a meeting to discuss what was going on with my daughter. The outcome was a not what I wanted to hear. They said they wanted to watch Aubrey for a while longer and see what happens. By the time first grade was over, I was at my wit's end, and her teacher had had enough. The school administration would not help at all, and Aubrey's relationship with teachers and administration continued to deteriorate, so the next school year we moved Aubrey to a new school. Second grade and third grade were no better. I had to do something. My daughter needed help, and so did my family. Crying, I picked up the phone and made an appointment with Aubrey's Pediatrician. He gave me a set of questionnaires, one for me and my husband to fill out, and one for Aubrey's teacher to fill out. It took a few days to get the results, but when the results came in they were life changing. Aubrey had Attention Deficit Hyperactive Disorder, or ADHD. It was unbelievably amazing. The medication made drastic improvements in her ability to focus almost immediately. Suddenly, attitudes changed. The comments about Aubrey's misbehavior stopped. I could actually look forward to the end of the school days because her teachers would comment on how wonderful the day had been. It I felt such relief knowing that Aubrey really did have a problem. I was not crazy. I was not a terrible parent. Aubrey had ADHD.
Nobody can understand what it is like to raise a child with Attention Deficit Hyperactive Disorder, or ADHD, except a parent of a child with ADHD. It is beyond overwhelming, with constant guilt making it even harder to deal with. People not familiar with ADHD tend to write it off as bad parenting or lack of discipline. Children with ADHD are often labeled as troublemakers, spoiled, or even dumb. Even with all the evidence supporting the existence of ADHD, there are still many people who do not believe it to be a true disorder, and parents are often ridiculed for using medications to manage it. ADHD is not caused by bad parenting, and parents should not be blamed for their children having a biological disorder. To understand more about ADHD, it is essential to understand the biological differences associated with the disorder, what the treatments are, and what social effects are associated with ADHD.
It is agreed among the psychological and scientific communities that ADHD is a true biological disorder resulting from both structural and chemical dysfunction in the brain. (Kazdin, 2000) (Warner, 2003) According to the Encyclopedia of Psychology, ADHD is a behavioral condition effecting 3-7% of school-age children that makes focusing on everyday tasks challenging, (Kazdin, 2000) but new medical studies are showing that ADHD is actually more than that. Brain imaging techniques have proved that brains of children with ADHD are actually physically different that those without ADHD. (Chabam & Tannock, 2009) Brain imaging techniques provide a way for medical professionals to look into the brain. There are many different methods of brain imaging: computerized tomography (CT), Magnetic Resonance Imaging (MRI), Functional Magnetic Resonance Imaging (fMRI), Positron Emission tomography (PET), Single Photon Emission tomography (SPECT), and the standard electroencephalograph (EEG), which measures brain electrical activity. Until recently, imaging research was only able to show structural difference using the CT and MRI scans. Structurally, the ADHD brain has shown to have a smaller frontal cortex. The frontal cortex, which is the outer surface of the brain, is part of the cerebral cortex. The cerebral cortex is made up of four lobes: the frontal lobe, temporal lobe, occipital lob, and parietal lobe. The frontal lobe area of the brain is where executive functions like problem solving, attention, reasoning, and planning occur. The lacks of abilities in these areas are the most common symptoms of ADHD. (Warner, 2003)
A picture of the different lobes of the cerebral cortex(http://www.adhd.org.nz/neuro1.html)
More recent technology has begun to allow for imaging the brain while working. These functional imaging techniques, such as SPECT, fMRI, and EEG show a decrease in activity in the already smaller frontal lobe. (Saul, n.d.)
http://dujs.dartmouth.edu/wp-content/uploads/2009/11/adhd_cmyk.jpg (DUJS, 2009)
It has also been discovered that there are chemical imbalances in children with ADHD. There are three primary brain neurotransmitter imbalances that are linked to ADHD: norepinephrine, dopamine, and serotonin. These neurotransmitters play critical roles in performing daily activities. Research has shown that the distractibility that is associated with ADHD is caused by increased levels of norepinephrine. The impulsiveness is caused by decreased levels of dopamine and obsessiveness is caused by too little serotonin. (Hawkins, 2009)
Treatment of ADHD has been a topic of much debate, but what most people don't understand is that treatment is not limited to just prescription stimulant medications such as Ritalin and Aderall. While these treatment options can drastically improve ADHD symptoms, stimulant medications are not the only treatment options available. In some instances, effective treatments can be simple actions taken by parents to manage behavior.
Children with ADHD require a different approach when it comes to guidance and discipline. They do need discipline. ADHD is not an excuse to allow children to misbehave, and ineffective parenting will make the behaviors of the disorder even worse, but normal parenting techniques do not typically work to manage ADHD behavior. Parents of children with ADHD need to provide consistency, structure, and reasonable expectations. All children need structure, but children with ADHD require structure to thrive. When children with ADHD know what to expect every day, they are far more likely to be successful. Routines make activities manageable, and allow for focusing on one thing at a time. Children with ADHD should never be expected or required to multitask. It is just not possible for them. Also, providing these children with very simple, immediate reward systems encourage positive behavior and task completion. They cannot be expected to wait for or work up to large rewards, and consequences for misbehaving need to be spelled out in advance and occur immediately. Most importantly, the consequences need to be consistent. Follow through is very important for behavior management, and keeping a positive attitude, even when difficult, is important. Children with ADHD do not act out intentionally.
Children with ADHD are often socially stigmatized, being labeled as troublemakers and deemed the undesirables in school and social play situations. School can be especially difficult. Teachers expect children to sit, listen, and learn, but for children with ADHD this can be very difficult. Often the disorder is overlooked, and the children are labeled as having behavior problems. This leads to other children often not wanting to associate with the ADHD children. Children with ADHD are emotional, and tend to lack social skills. They get upset easily and tend to take things personal. Most children learn social skills by experience. They watch peers, parents, and other relationships, and over time, learn through the impact of their actions and others. Children with ADHD do not pick up on these lessons so they never really master social interaction. This leads to feelings of rejection, which can then lead to low self-esteem, depression, anxiety, and long-term problems that can carry into adulthood. (Jacobs, n.d.) Children with ADHD need strong emotional support. They will never be accepted the same way by peers as other children are, so parents need to provide extra encouragement. Parenting a child with ADHD can be more than challenging sometimes, but parents need to understand that these children need to know they are loved unconditionally. Love and positive reinforcement are the best treatment a parent can give a child with ADHD.
In this story told by Dana Olney-Bell, a sixth-grader at a private middle school in California, it clearly explains what life is like for a child with ADHD. Dana writes:
"I'm 12 years old and for as long as I can remember, I've had opposite sides to myself. I'm told that I'm gifted, very smart and creative. But I also have to work really, really hard at things that seem much easier for other kids, like memorizing and paying attention. Sometimes I have complicated ideas that I can't explain to others. That really frustrates me, and I get upset with the person for not getting it! I guess you could say I cry pretty easily. This really bugs my mom. Sometimes I have the same sort of problem when I need to ask a question. I get stuck on a question because I can't formulate it. And I have the same problems when I'm trying to write down my ideas for a paper. When I'm doing something that's hard for me, like writing, I drift off easily and end up doing a quick job so I can do something else that I'm better at. But then I don't get a very good grade on my essay, and I feel bad. The problem is, there are so many interesting things to do in my house; things that I think are just as educational as writing. I'd rather do chemistry and cooking experiments in the kitchen, or try out new kinds of seeds or soil mixtures in my garden, or watch the History Channel orÂ Popular Mechanics for Kids, or solve logic puzzles and games. I'd rather study bird behavior (with my birds, of course!), work on my Web site with my dad, and engineer new contraptions with wood or whatever else is lying around. I love my school, but I hate it that homework takes away time from doing these things. That's what it's like to be gifted and have Attention-Deficit/Hyperactivity Disorder. Sometimes it makes me want to give up when I realize how much harder I have to work at things that are not that hard for other kids. I like taking a long, long time on something and making it exact. But slowness is another problem I have that frustrates other people. In third grade I went to a special school for kids with learning disabilities. When I returned to my public school, kids asked me, "Dana, did you go to a special-ed school in third grade?" Special education is not a popular thing. You have to be normal to be cool.
What's the best way to help kids like me? We need lots of parent support and not to be yelled at for getting bad grades. The best thing parents can do is help their kids overcome their difficulties. It's helped me when my mom shows me new ways to study for a test. It's helped me to find friends who are honest and don't talk behind my back. It's helped to find a school where the teachers see that I have things I'm very good at. I hope other kids who are gifted and have ADHD know they're not alone. I hope this helps kids to talk to their parents and teachers about things that bother them and makes them feel less weird and alone. Talking with them about what things you're good at and what things are hard for you - and why they're hard for you - can help kids figure out how to make school a little easier. Most of all, talking about things can also help kids feel better about themselves." (Olney-Bell, 2004)
ADHD is a real disorder that affects thousands of children, but not all children that misbehave have ADHD. There are many factors that might make children misbehave. Problems at home, divorce, death of a loved one, moving, neglect, abuse, and inconsistent parenting can all lead to discipline problems that have nothing to do with ADHD. Only children with ADHD need ADHD treatment. It is important that a licensed health care profession conduct the lengthy process of diagnosis before assuming a child has ADHD. A good ADHD specialist can reveal if a child truly has ADHD or if the child is suffering from other problems. Accurate diagnosis is what leads to effective treatment.
It is also important for both the ADHD child and the respective parent to understand that ADHD is not an excuse for misbehavior. Life does not yield to the diagnosis of ADHD.Â When ADHD disrupts the flow of daily life, it is important that the child with ADHD not hide behind the condition. This is one of the problems that children with ADHD face on a daily basis. The truth is there is no excuse for inappropriate behavior. There are many options and resources available to help cope with the challenges of ADHD. Medications and behavioral therapy can help reduce the symptoms of ADHD, but treatment is never a substitute for responsible parenting. Parents need to be their children's best advocate. After all, the decisions parents make can affect the child for the rest of the child's life. Parenting a child with ADHD can be rewarding and wonderful, and it can also be very difficult, stressful, and emotionally draining. ADHD children require a lot of attention, supervision, and patience, but with appropriate support, they can be greatly successful in all aspects of life.