More about Boys and ADD/ADHD

To piggyback on a blog we wrote on Feb 7, here is some more info on Boys and ADD/ADHD. For more information on boys, check out our book WIld Things: The Art of Nurturing Boys.

If a boy is having a hard time at home and school, often parents will worry if he has attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). And while he may, he could also be struggling with a learning disability or maybe even depression, anxiety, or another psychological issue, or some family or school tension. Despite how widely known they are, Attention Deficit Disorder (ADD) and Attention Deficit Disorder with Hyperactivity (ADHD) are extremely uncommon disorders affecting only four percent of all kids (although estimates vary widely from three to eleven percent more. And because over-diagnosing and overmedicating are common, there are a number of families that have significant concerns when attention deficit shows up on the radar.
How do you know if a boys has ADD or ADHD? A boy may have ADD/ADHD if he has a majority of these symptoms.
• He shows trouble paying attention and becomes easily distracted
• You notice that he makes careless mistakes.
• When he is spoken to directly, he doesn’t seem to hear.
• He struggles with following instructions.
• It is clear that he has trouble planning, organizing, following through on assignments or activities.
• He avoids certain tasks or chores (or does them begrudgingly)—especially the ones requiring sustained mental focus.
• He is forgetful or he frequently misplaces the things he needs for tasks or activities, things like homework assignments, books, etc.
• When he is in a place where he has to sit still (such as in restaurants, while at church, or during class) he squirms in his chair or fidgets, gets up, runs around, or climbs,
• He acts like he is the energizer bunny and cant stop moving
• If he seems to talk incessantly and to blurt out answers before questions have been completed (or he interrupts, intrudes, on others’ conversations and can’t wait his turn).
A boy with a majority of these symptoms may have ADD/ADHD—he may—or he just may be a boy. Many, many, many boys are diagnosed with this disorder that don’t have it. But ADD and ADHD are real, and sadly there are many boys who would be gratefully helped in their ability to manage daily life if they were treated for this significant brain malady.
Making an accurate diagnosis, deciding how to treatment, and when to begin treatment kids are some of the greatest challenges in treating children. In considering if a boy has ADD or ADHD, a boy’s parents and his doctor must consider things such as,
• A boy’s normal age-related development. (For instance, it’s normal for a five-year-old boy to not sit still in church or in a restaurant).
• Keeping realistic expectation of a boy’s ability to pay attention, control his restlessness, and manage his impulses.
• Are the symptoms severe enough to impair the boys normal life (not just make a parent’s life or teachers job difficult).
• Are the symptoms frequent enough that they show up significantly in all areas, such as home, school, scouts, sports, etc. (A boy can’t be ADD at school and not at soccer practice or with his grandpa.)

So what is ADD or ADHD?
We have to answer that question on two levels. The first level is diagnostically. The diagnosis of ADD and ADHD is a cluster of specific unwanted behavioral symptoms that co-occur in enough frequency and intensity that psychiatrist can draw a ring around them and call them an “It.” In this way ADD and ADHD diagnosis are largely subjective and can only be made by a trained and licensed mental health care provider—preferably a pediatric psychiatrist or child psychologist. (And be cautious of anyone that tries to diagnosis a boy with ADD or ADHD who is not yet through kindergarten, because there is limited information supporting the validity of the diagnosis among preschool children.)
The second way to understand ADD and ADHD is as a medical brain dysfunction. As science teaches us more and more about the brain, we are learning that ADD and ADHD are actually medical brain disorders that have to do with the brain’s neurotransmitters (the things that transfers the all of the information along the pathways of the brain and tells the body to do what the body does). What researches are beginning to see is that ADD and ADHD are likely a problem with how the brain process and holds on to information. The good news is that we are very close to being able to diagnose ADD and ADHD at the source with brain imaging technology instead of symptomology. (In fact more and more physicians won’t diagnose ADD or ADHD without ordering brain scans.)
The long and the short of it is that if a boy you love has most of the symptoms listed above much of the time, he needs to have a visit to a psychiatrist or psychologist.