Take This Quiz….Read the Article….Learn Your Score
By Cynthia Hammer, MSW, Executive Director, Inattentive ADHD Coalition, www.iadhd.org
Medication for ADHD should be taken only as a last resort. True False
Boys always have the hyperactive type of ADHD True False
We all have a bit of ADHD, so it is not a severe problem. True False
Too many children are unnecessarily diagnosed with ADHD True False
ADHD results from poor parenting True False
Children with ADHD are rarely outstanding students True False
Most children outgrow their ADHD symptoms by 18. True False
Identifying students with learning challenges and providing appropriate accommodations is not a school's responsibility. True False
Often people form opinions not based on facts. This article includes only facts and information based on research, which might challenge your beliefs about ADHD, its causes, manifestations, and treatments.
Please reconsider your beliefs if you read something that differs from what you believe.
ADHD is a chronic neurodevelopmental condition that is mainly genetic. Although each child's brain is as unique as their fingerprints, children with ADHD have minor brain chemistry and structure variations that differ from neuro-typical children. Most children are born with ADHD and continue to have it throughout their lives. It does not result from poor parenting, although environmental factors can lessen or exacerbate its symptoms.
There are two common types of ADHD—Combined and Inattentive. With the Combined Type, a child is hyperactive, impulsive, and distractible. Children with the Combined Type are typically diagnosed by age seven as disruptive children are noticed and get help.
Children with the Inattentive Type are usually introverted, shy, and dreamy, not paying attention in class but not causing a disturbance. If the child is committed to being a good student, they may never come to your attention.
If the child is quiet and gets good grades, is his inattentive ADHD still a problem? Why be concerned if children with inattentive ADHD have been underdiagnosed and continue to be?
The answers to these questions come from adults who discover at age 25, 45, 65, or even 85, when finally diagnosed with inattentive ADHD, that they lived unnecessarily greatly diminished lives. They were hampered from using their full range of abilities and experienced more failure than their peers. Fewer of them graduate from college, which often takes additional years if they do. They have less successful professional lives and earn significantly less income. More of them have failed relationships. Low self-esteem leads them to pair with anyone willing to be with them, or their procrastination, forgetfulness, and tardiness drive their partners and friends away.
Studies show that an ADHD diagnosis is associated with poor health outcomes, including obesity, accidental injuries of all types, substance use, and comorbid psychiatric disorders. The diagnosis increases the risk of exposure to traumatic events, victimization, suicide attempts, and completions. Their lifespan, on average, is twelve years less than those without ADHD. Early diagnosis and treatment of ADHD mitigate these dire outcomes. CHADD-Health-Outcomes-White-Paper_8-5-21-FINAL.pdf
Someone with inattentive ADHD tends to be:
• Easily pulled off course, forgetful, and inattentive.
• Disorganized mentally and physically, making careless mistakes, and not paying close attention to detail.
• Forgetful of one or more items when an assignment requires multiple items.
• Resistant to undertaking tasks that are boring or require significant mental energy.
They have:
• Difficulty organizing their work, setting priorities, planning a strategy, and remembering to complete all required tasks.
• Difficulty organizing their things and are often sloppy.
• Trouble keeping track of their belongings and forgetting where they put them, partly because they rarely put things away.
• Trouble holding multiple things in mind can make arithmetic calculations, reading, or abstract problem-solving difficult. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1474811/?fbclid=
Think how a child's or adult's life is impacted by these behaviors, which occur all day, every day. Ponder how these behaviors reduce their opportunities for success.
Children with undiagnosed inattentive ADHD grow up with frequent criticism from parents and others who don't understand the child's behaviors and get frustrated or angry. Here are some examples:
"I've told you "X" times already. How do you not remember? It's like you don't care."
"You're just being lazy. You need to do better. You aren't trying!"
"You never listen to me. You should have planned this out better."
"You lost XYZ again? Why can't you remember where you put it?"
"Anything that starts with "You should've..." or "If you had..." or "Why don't you….."
Dr. William Dodson, a psychiatrist who has treated adults with ADHD for over 30 years, says, "It's common for those of us with ADHD, from childhood to adulthood, to feel like failures for not meeting the expectations of our parents, friends, teachers, and others. When children hear and sense these negative comments, they internalize them. They begin to view themselves and the world through these hurtful and harmful comments."
Professor Philip Asherson of the Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, states, "With younger children, it is essential to think about their self-esteem. Difficult children often get difficult reactions from parents and teachers. They're being criticized all the time. This can instill a negative self-view of life. Then, when older, for example, they're much more likely to become anxious or a depressed adult. Being positive and supporting somebody is important to instill a positive, long-term outcome for [children with ADHD]."
When a child with undiagnosed inattentive ADHD becomes an adult, she brings her challenging behaviors to the workplace. How valued an employee will she be when she is frequently late for work or submits her work late and with numerous errors, or she doesn't understand the assignment and spends time on irrelevant activities or doesn't listen when spoken to?
Meanwhile, the belittling comments or the rolled eyes of coworkers, friends, and family continue. The child or adult feels different without understanding why or how. Her low self-esteem and self-confidence continue to suffer and often metastasize into the comorbid conditions of depression and anxiety.
Whatever dreams she had for her life slowly erode as, time after time, she underperforms.
Some, however, go in the other direction and accept nothing less than perfection. They expend significant energy masking their deficits. They believe being perfect is the only way others will accept them. They exhaust themselves, struggling to keep their challenges and failures hidden from the world.
They make a good impression but lose touch with themselves and feel like a fraud. No one can see or know who they are. Successful undiagnosed adults struggle, spending twice the effort to obtain a similar result. Their low self-esteem makes them believe they are worth less than others.
"I have a very high IQ that was tested when I was in school, and I can compensate, but, as a consequence, I am burnt out, exhausted, tense and snappish.
It's like being a sprinter with a piano tied to my back who still competes in the race. Sure, I can do it, but I'm wrecked after I get to the finish line in a way that the other participants aren't."
"I sometimes wonder how much faster I would be without the weights holding me down. I try not to think that way, but it is difficult not to wonder sometimes."
"I am at the point where I am trying not to be angry at how unfair it is that I have to have the metaphorical piano tied to me. It's hard. My peers don't see how hard I have to work to compensate and I often hear everything "comes so easily" to me. Oh, Buddy! If you only knew."
Believing they have abilities, they aren't using without understanding why is the tragedy of undiagnosed inattentive ADHD. Getting diagnosed is a relief--"Now I understand and can work to improve my life"—and a sorrow-- "Now I understand and am sad my life has been less than it could have been." Many say that having ADHD isn't the problem. Not knowing they had ADHD was the problem. Like any medical condition, you flounder until you understand what you are dealing with. Once your condition is known and understood, you can set a course correction.
Following a diagnosis of inattentive ADHD, the course correction for adults includes medication and developing new habits and behaviors. The American Academy of Pediatrics recommends FDA–approved medications, parent training, and behavioral classroom interventions for elementary and middle school-aged children.
A large-scale treatment study by the National Institute of Mental Health (NIMH) study assessed the safety and effectiveness of ADHD medications. It provides evidence that stimulant medication reduces hyperactivity and impulsivity, improves attention, and increases the ability to get along with others. For this reason, stimulant medications remain the first choice for treating individuals with ADHD.
Professor Philip Asherson says, "When you get the medication correct--the right medication and the right dose-- what it's doing is boosting the function of the brain. That's why the medications are called stimulants. They enhance brain function. It seems parts of the brain are not functioning as efficiently as they should, and the medications enhance the brain's efficiency. Medications enable those with ADHD to perform better, giving the child or adult more control and regulation."
According to Dr. Russell Barkley, numerous studies indicate that stimulant medications are safe for children and beneficial (neuro-protective) if started early. Evidence-based on 30+ studies supports the notion that stimulant medications promote brain development and that the ADHD brain may proximate that of neuro-typical children with early and continued intake of stimulant medication. https://www.youtube.com/watch?v=HYq571cycqg
---------------------------------------------
There are likely one or more children in a typical classroom with probable inattentive ADHD. Their lives will change if they are identified and help is initiated.
The Child Find mandate of the national Individuals with Disabilities Education Act "requires all school districts to identify, locate and evaluate all children with suspected disabilities, regardless of their severity. This includes children who earn passing grades." https://www.wrightslaw.com/info/child.find.mandate.htm
Anyone, parent or teacher or school counselor, can set the wheels in motion to have a child evaluated.
Perhaps your local school has used Connor's Rating scale and believes it is an adequate tool for identifying these children, but for too many years, these children have not been diagnosed. The hyperactive type of ADHD may be over-diagnosed; but the inattentive type is underdiagnosed. Until school personnel and parents learn what to look for, they won't "see" the children with inattentive ADHD. By distributing the Child Questionnaire and explaining its importance to the teachers in your school, you will help them "see" these children and get them the help they need.
That is why we created the free Child Questionnaire which provides more guidance on what behaviors to watch for. The Questionnaire is available in English and Spanish.
Now, back to the seven statements that began this article and find out how well you scored. The correct answer to each item is False.
*This article may be freely copied and distributed.