Special Education: Attention Deficit Disorder: Part II
By Mimi Rothschild
In an interview with Dr. Robert Mascia of Brookfield Family Medicine, he commented "a lot of times people come in here thinking they have ADD. and in fact they don't have the true diagnosis." He believes that there are many factors to take into consideration. You must consider whether the behavior of the child at home coincides with the behavior of the child at school. "Sometimes," Mascia says, "parents are looking for simple answers and are hopeful that a simple pill is going to answer some of their other problems, but it just doesn't happen."
There is no way to be absolutely 100 percent sure that ADD. is correctly diagnosed--no blood test to give positive fool-proof results. There are several psychological tests that are administered by psychologists in attempts to detect Attention Deficit Disorder; however, these tests are given under conditions which are exactly suited to get the best results from the person with ADD. They are given in a structured setting, with one-on-one motivation and novelty of subject matter. The results of these "ideal" test situations will often indicate that a person who actually has the disorder does not, thus masking a true diagnosis of ADD. Some of these tests include the Wechsler Intelligence Scale for Children (WISC), the Continuous Performance Test (CPT), and the Test of Variability of Attention (TOVA) (Hallowell).
How is Attention Deficit Disorder Treated?
There are five steps to the treatment of ADD., as outlined below.
- Diagnosis. This is the primary starting point. Once the diagnosis has been made, the individual can begin to deal with the problem.
- Education. The more information an individual can learn about ADD., the more they will be able see how it affects them personally in their daily life. Once they understand what effects ADD. has, they will be able to see options and opportunities to deal with the problems.
- Structuring. Structuring is a vital part of the ADD. treatment. People with Attention Deficit Disorder need controls and reminders, such as lists, appointment books, daily planners, goals and most importantly "yellow sticky notes." All of these help to keep the mental chaos to a minimum.
- Coaching. People with ADD. greatly benefit from having a coach to help keep them on task. The coach can be anyone except a close family member. It should not be a close family member because then it becomes nagging and it simply does not work out to well. It could be the school janitor, a neighbor, a friend. Someone who keeps them focused on tasks at hand on a daily basis (i.e., "What are the goals for today?" they might ask each morning).
- Medication. Many different medications are available to help correct Attention Deficit Disorder symptoms. The medications help the individual to focus. The medication also reduces the anxiety and inner turmoil common to people with ADD. It works to correct a chemical imbalance of the neurotransmitters in parts of the brain which regulate attention, impulse control and mood (Hallowell and Ratey, Answers). Medication is not the only answer, but when used properly it is effective and safe. As Jan Menzie, a 46 year-old Toledo, Ohio, schoolteacher, who herself has ADD., says, "Medication doesn't solve one's problems, but it does create a sane starting point (Lane)."
There are two main classes of medication used in treating Attention Deficit Disorder: stimulants and antidepressants. Medication is effective in approximately 80% of ADD. cases (Hallowell and Ratey, Driven). Finding the right medication and correct dosage for each individual may take several months as it is a trial and error process. Each person responds to the medications differently. According to Dr. Mascia, a rule of thumb is to start children with 1 milligram of medication for each kilogram of weight and adjust according to the results.
Some of the most common stimulants used to treat ADD. are: Ritalin, Cylert, and Dexedrine. As their name implies, the stimulants act on neurotransmitters to activate or stimulate the central nervous system. In ADD. this helps the individual to focus more fully. They also have a mood-leveling effect. These drugs do not cloud the sensory system, and they are not addictive in the prescribed amounts (CVS Monogram). Among the anti-depressants used to treat ADD. are: Norpramin, Pamelor and Toranil. These drugs have a similar effect on ADD. symptoms as the stimulants, although they are completely different chemically. When stimulants are not effective, doctors will turn to the antidepressants as an alternative.
As with any medication, some people do experience some side effects with both the stimulants and antidepressants used to treat Attention Deficit Disorder, including: loss of appetite, weight loss, blurred vision, dizziness, nausea, headache, rapid heart beat and sleeplessness. For the great majority of people the side effects are slight and the medication is very safe (CVS Monograph).
