Understanding ADHD

ADHD is an acronym that stands for Attention Deficit Hyperactivity (or Hyperactive) Disorder. Many people see that word "hyperactivity" and automatically assume that an ADHD child is simply a hyper child who can't sit still, and most do not truly understand the ramification of the attention deficit part of this disorder.

Brains of people who have ADHD function differently on brain scans than those who do not suffer from ADHD. Brain scan testing can confirm this different type of brain function, and thus make a definitive diagnosis of ADHD. However, because the only clinical testing available to diagnose ADHD is too expensive for most to afford, and too cost prohibitive for insurance companies to pay for, this particular disorder remains among one of the most misunderstood and over diagnosed conditions, particularly among children, and especially young boys. The diagnostic criteria for determining if a patient has ADHD is usually left to observation and a survey performed by the parent. So what is AHDH really?

First, it is true that an ADHD child can often appear hyper, wound up, and unable to sit still. However, all children and even adults have moments of hyperactivity. With an ADHD child though, it goes much beyond just being a hyper or active child. The ADHD child cannot contain or control the body movement and the hyperactivity, and coupled with the impulsive behavior that is also a problem for ADHD children, that hyperactivity becomes problematic.

What differentiates an ADHD child from a typical hyper child is that problematic behavior. A typically hyper child will have periods, especially when engaged in activities that are pleasurable to them, where they can sit still for long periods of time. An ADHD child is unable to do that, even when they would want to do it. Additionally, the attention span and hyper behavior of an ADHD child is often inappropriate for their age.

Research shows that a child who suffers from ADHD is typically 30-45% delayed in their social and emotional maturity and growth, as well as their cognitive reasoning. However, ADHD children are usually intellectually superior to their same aged non-ADHD counterparts. This is often a dangerous combination when a child has the intellectual capacity to grasp adult situations but not the emotional maturity or social graces to relate when in adult situations. If the ADHD child also shows high impulsivity, in addition to the other problems, you have a child who is smart enough to know what's going on, but too impulsive and immature to keep from saying or doing something inappropriate.

Most ADHD children will be defined by their parents as being 'risk takers'. In actuality, it is not so much that an ADHD child takes risks as it is that the ADHD child is unable to truly form a cognitive connection to cause and effect. In other words, you can explain to the ADHD child how if they touch the stove it is hot and it will burn them, and they will repeat that to you as though they understand, but two seconds later, their hand will reach out and touch the stove anyway.

When asked, "Why did you do that? Didn't you know that the stove would burn you? Didn't I tell you not to touch it?" The ADHD child will respond, "I don't know why I did that. Yes, I knew it would burn me, but I don't know why I had to touch it."

And that is the crux of the problem. The impulsive behavior and lack of true understanding of the causal relationship of actions versus consequences causes the ADHD child to do things that appear risky, when in fact, the ADHD child simply did not truly comprehend the risk on a cognitive level. This behavior extends from childhood well into teen and adult years, and ADHD sufferers may find themselves engaging in drugs, alcohol, casual sex, fast and dangerous driving, physically confronting and aggravating people who are larger than them, defying authority, and other such risky behaviors, without truly realizing the potential consequences of their actions until it is too late.

With most children, cognitive reasoning begins somewhere around 9-12 years of age. Understanding cause and effect, making connections in the mind of "if I do X, then Y will happen" on a larger level doesn't really even sink in until around that time. Through behavior modification and repetition, we can teach a younger child certain dangers, but a child's ability to put 2&2 together on their own doesn't begin until pre-adolescence.

If an ADHD child progresses at 30-45% slower on the cognitive reasoning and emotional maturity scale, then cognitive reasoning of this nature will not even begin to kick in until around a minimum of 14 years of age or so, quite possible up to 19-25 years of age on the upper end. Now, one might think that from that point forward, development would be the same, only delayed, but that is not the case.

You see, cognitive reasoning kicks in for a child in pre-adolescence while that child is in junior high or middle school, and learning at the same time as the other children. The circumstances that surround the child, living at home with parents, in classes at school, etc, are all geared toward teaching children who are developing cognitive reasoning and therefore, these children receive a good foundation while they learn.

An ADHD child is receiving the same information, but they are receiving it at a time when their brains are not able to process it yet. By the time an ADHD person's brain catches up with the cognitive reasoning parts of emotional development, the person's life circumstances already expect them to this vital life skill, and they don't. Because of this, high school and college classes are not geared toward teaching to an ADHD brain, life circumstances are not geared toward teaching the child good behavioral habits, and thus, the ADHD patient suffers in grades, job performance, social relationships, finances, and many other normal life skills areas.

It would do no good to work with an ADHD child at age 9-12 and try to teach them these cognitive reasoning skills, because the pathways of their brain will not yet be able to process this information. Proper diagnosis and understanding of this limitation is essential in order for an ADHD child to succeed, and modified behavior plans and educational plans at the junior high and high school level, as well as parental behavior modification plans are essential in order to target this type of education and development in an ADHD child at the time that their brains are able to start making these connections, instead of at the usual age for most children.

If these cognitive reasoning skills are not taught at the appropriate time for an ADHD child, and the child goes through the mainstreamed school system without this modification, the child will grow up to be an adult with a cognitive reasoning deficiency, but with an intellect that is still higher than most. This can be very confusing and frustrating to coworkers, teachers and professors, and the ADHD person as well.

An ADHD patient will appear 'normal' in most ways. They have no physical limiting handicaps, and are usually quite loving and intelligent people. Therefore, when most will view them as perfectly capable, the ADHD patient often is accused of being lazy, unproductive, or worse, unwilling or uncaring about their life circumstances. This is rarely the case, and without understanding how ADHD affects cognitive reasoning like this, and without a good plan to try to train the ADHD brain to function within expected societal guidelines, the ADHD patient will often suffer from secondary mental health problems, such as low level depression, anxiety, obsessive compulsive tendencies, and many turn to alcohol and drug use and abuse in an attempt to self-medicate.

As with any brain development condition of this nature, there are varying degrees of severity of symptoms. Some ADHD children will exhibit high impulsivity, while some my by hyperactive, but show no impulsivity. Some will be able to hyper focus at times, while others cannot maintain attention spans for any appreciable amount of time. Each patient will be different, and treatment itself will also be different.

Behavior modification and organization training can help, along with some occupational therapy, and for some with mild to moderate ADHD, as long as it is received consistently, this may be enough. For more severe cases of ADHD, medication and counseling, along with the above specified behavior modification is required.

In order to determine what will be most beneficial for your child, consult your family physician and/or licensed mental health professional. They are best qualified to test, diagnose and treat ADHD.