Attention Deficit Disorder (ADD or ADHD)
frequently asked questions (FAQs)
An attention deficit disorder is a medical condition which affects a person's ability to concentrate and maintain attention to tasks.
Passive inattention (drifting off, daydreaming, etc.) is generally referred to as ADD (attention deficit disorder). When inattention is combined with significantly heightened activity level and impulsiveness, ADHD (attention deficit hyperactivity disorder) may be a more appropriate term. Often the two terms are used interchangeably and the combination term 'ADHD' is frequently used.
As previously mentioned, ADHD is a medical condition which requires a medical diagnosis. Although it is a medical condition, ADHD cannot be diagnosed by any type of neurological or laboratory test. The diagnosis is based upon a set of behavioral characteristics, and as such, can be a rather subjective process. Often a pediatrician, psychologist, or psychiatrist makes the diagnosis based upon observation of the child and interview of the parent about behavioral characteristics which are observed at home or at school. Frequently the school will also be involved in the process either as part of an evaluation for possible special education services or simply through behavior ratings which are completed by teachers. There are also various types of computerized performance 'tests' which are designed to directly measure a student's ability to maintain attention to a computer task. However, this type of assessment is most useful and appropriate in a medical setting which can often provide a more controlled evaluation and allows the option of trial medication. This can be especially beneficial to help determine the potential effectiveness of medication if a diagnosis is made. It is very important to remember that ADHD is not diagnosed by the school, but the school can take a very active role in the diagnosis.
Depending on the source, it is estimated that somewhere between 2% and 10% of the population is experiencing some form of attention deficit disorder (ADHD). But since the condition involves behavioral characteristics which can range from very mild to extremely severe, many undiagnosed students may exhibit behaviors very similar to those of students who are diagnosed with ADD or ADHD. And since the diagnosis itself is very subjective, it is not possible to accurately determine the actual size of the ADHD population.
Technically, an attention deficit disorder, by itself, is not considered a specific learning disability or other special education handicap as defined by Federal Special Education regulations. However, since ADHD students experience many, if not all of the same processing difficulties that are experienced by LD students, they often are found eligible for special education services under the SLD (specific learning disability) classification. In other words, it really depends on how well the student is able to cope with his or her attention deficit disorder. If the ADHD 'severely' impacts the student's academic skills and classroom achievement, then an SLD diagnosis may be appropriate. If the ADHD has not severely impacted the student's skills (i.e. he/she scores well on standardized achievement tests) but does interfere significantly with their ability to cope with daily classroom expectations (staying focused, understanding assignments, completing homework, etc.) then another category of special education called OHI (other health impaired) may be considered. OHI is an appropriate diagnosis when a student has any type of health/medical condition which severely interferes with his or her ability to cope with daily classroom expectations. For any type of special education services, the school must determine if the student's needs are severe enough to meet State and/or Federal requirements.
First of all, the vast majority of mainstream teachers are very sensitive to the special needs of individual students and will frequently provide modifications and accommodations when a legitimate need is presented. Unfortunately, many ADHD students may appear lazy, disinterested, unmotivated, or are even disruptive within the classroom. Teachers are sometimes reluctant to provide help to someone who either doesn't seem to care or creates a difficult teaching environment. In these cases it is especially important for the student (with parental support) to realize and admit to his or her difficulties and try to work with the teacher to come up with an appropriate plan of intervention. There also may be tutorial services available within the school which could help strengthen lagging skills. But again, the student must be willing to admit the need for help. If a student is actually 'diagnosed' with a disability or 'handicap' of some form (including ADHD) but is not eligible for special education services he or she may be eligible for a mainstream alternative called a 'Section 504' plan. Section 504 of the Rehabilitation Act of 1973 guarantees the right to an appropriate education (including necessary accommodations) for any student with a disability. School personnel can help to determine if a student meets the requirements of Section 504. This can be especially helpful for ADHD students who may need a quiet space for testing or other classroom supports to help maintain attention and reduce disruption.
When a child is diagnosed with an attention deficit disorder, often one of the most difficult decisions is whether or not to treat the condition with medication. Typically, the medication prescribed is some form of 'stimulant' - most commonly ritalin. Although this type of medication is quite safe and usually highly effective, parents are wise to at least consider the potential side effects which can include loss of appetitive, sleep disturbance, and very rarely 'tics'. There have been some (extremely few) cases in which children developed 'tics' after initiating medication and later were diagnosed with Tourette's Disorder. Although that may suggest a cause and effect relationship, it has not been established that the medication actually caused the Tourette Disorder. It is quite possible that the behavioral characteristics which were first diagnosed as ADHD in these children were actually the early symptoms of Tourette's, and the medication simply helped to progress the disorder to the next inevitable stage. Again, these potential negative reactions to medication have been extremely rare. On the positive side, stimulant medication, when introduced at an early age and combined with positive behavioral interventions, has proven to be highly effective for treating both ADD and ADHD. When introduced at later ages, medication has been somewhat less effective primarily because negative behavioral patterns have often already been firmly established by this time. While the medication may 'allow' a student to make better behavioral choices, the choices are still his or hers to make. And as we all know, negative habits are especially hard to break.
Studies have suggested that approximately 50% of students who required medication in elementary grades are able to cope without medication by high school. This may be due to a combination of neurological development and learned behavioral changes. The other 50% of these students may benefit significantly from the medication for most of their adult lives.
Although some professionals may make such a claim, studies have shown that virtually all children react favorably to stimulant medications such as ritalin. In other words, almost all students in such studies were better able to maintain attention to tasks and control impulsive tendencies when taking the medication. So, simply because a child responds favorably to medication, this does not definitely prove that the child has ADHD.
Return to the LDinfo Web Site to find out about any of the following topics (and more):
Learning disabilities - what is a learning disability (LD or SLD)?
Dyslexia: Dyslexia is a reading disability or reading disorder
Dysgraphia Dysgraphia is a writing disability or disorder
Dyscalculia Dyscalculia is a math disability or disorder
What is an attention deficit disorder (ADD, ADHD, AD/HD)?
Gifted LD: Can a student be gifted and LD?
Emotional/Behavioral issues and LD: Do LD students experience behavior problems or depression?
Section 504: What is a Section 504 plan?
What is special education?
What is processing?
What is a severe discrepancy?
What is a nonverbal learning disability (nonverbal LD or NLD)?
What is a central auditory processing disorder (CAPD)?
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