ATTENTION DEFICIT HYPERACTIVITY DISORDER

Part VII of VII — Sustaining Hope

Mark

Today, at age 14, Mark is doing much better in school. He channels his energy into sports and is a star player on the intramural football team. Although he still gets into fights now and then, a child psychologist is helping him learn to control his tantrums and frustration, and he is able to make and keep friends. His grandparents point to him with pride and say, "We knew he'd turn out just fine!"

Lisa

Lisa is about to graduate from high school. She's better able to focus her attention and concentrate on her work, so that now her grades are quite good. Overcoming her depression and learning to like herself have also given her more confidence to develop friendships and try new things.

Lately, she has been working with the school guidance counselor to identify the right kind of job to look for after graduation. She hopes to find a career that will bypass her attention problems and make the best use of her assets and skills. She is more alert and focused and is considering trying college in a year or two. Her counselor reminds her that she's certainly smart enough.

Henry

These days, Henry is successful and happy in his job as a shoe salesman. The work allows him to move around throughout the day, and the appearance of new customers provides the variety he needs to help him stay focused. He recently completed a course in time management, and now keeps lists, organizes his work, and schedules his day. Now that he has harnessed his energy, his ability to think about several things at once allows him to be creative and productive.

He is proud that he and his wife have developed important parenting skills for working with their son, so that he, too, is doing better at home and at school. Henry is also pleased with his new ability to follow through on projects. In fact, he just finished making his son a beautiful wooden toy chest for his birthday.

Can ADHD Be Outgrown or Cured?

Even though most people don't outgrow ADHD, people do learn to adapt and live fulfilling lives. Mark, Lisa, and Henry are making good lives for themselves—not by being cured, but by developing their personal strengths. With effective combinations of medicine, new skills, and emotional support, people with ADHD can develop ways to control their attention and minimize their disruptive behaviors. Like Henry, they may find that by structuring tasks and controlling their environment, they can achieve personal goals. Like Mark, they may learn to channel their excess energy into sports and other high energy activities. And like Lisa, they can identify career options that build on their strengths and abilities.

As they grow up, with appropriate help from parents and clinicians, children with ADHD become better able to suppress their hyperactivity and to channel it into more socially acceptable behaviors, like physical exercise or fidgeting. And although we know that half of all children with ADHD will still show signs of the problem into adulthood, we also know that the medications and therapy that help children also work for adults.

All people with ADHD have natural talents and abilities that they can draw on to create fine lives and careers for themselves. In fact, many people with ADHD even feel that their patterns of behavior give them unique, often unrecognized, advantages. People with ADHD tend to be outgoing and ready for action. Because of their drive for excitement and stimulation, many become successful in business, sports, construction, and public speaking. Because of their ability to think about many things at once, many have won acclaim as artists and inventors. Many choose work that gives them freedom to move around and release excess energy. But some find ways to be effective in quieter, more sedentary careers. Sally, a computer programmer, found that she thinks best when she wears headphones to reduce distracting noises. Like Henry, some people strive to increase their organizational skills. Others who own their own business find it useful to hire support staff to provide day-to-day management.

What Hope Does Research Offer?

Although no immediate cure is in sight, a new understanding of ADHD may be just over the horizon. Using a variety of research tools and methods, scientists are beginning to uncover new information on the role of the brain in ADHD and effective treatments for the disorder Such research will ultimately result in improving the personal fulfillment and productivity of people with ADHD.

For example, the use of new techniques like brain imaging to observe how the brain actually works is already providing new insights into the causes of ADHD. Other research is seeking to identify conditions of pregnancy and early childhood that may cause or contribute to these differences in the brain. As the body of knowledge grows, scientists may someday learn how to prevent these differences or at least how to treat them.

NIMH and the U.S. Department of Education are cosponsoring a large national study—the first of its kind—to see which combinations of ADHD treatment work best for different types of children. During this 5-year study, scientists at research clinics across the country will work together in gathering data to answer such questions as: Is combining stimulant medication with behavior modification more effective than either alone? Do boys and girls respond differently to treatment? How do family stresses, income, and environment affect the severity of ADHD and long-term outcomes? How does needing medicine affect children's sense of competence, self-control, and self-esteem? As a result of such research, doctors and mental health specialists may someday know who benefits most from different types of treatment and be able to intervene more effectively.

NIMH grantees are also trying to determine if there are different varieties of attention deficit. With further study, researchers may find that ADHD actually covers a number of different disorders, each with its own cluster of symptoms and treatment requirements. For example, scientists are exploring whether there are any critical differences between children with ADHD who also have anxiety, depression, or conduct disorders and those who do not. Other researchers are studying slight physical differences that might distinguish one type of ADHD from another. If clusters of differences can be found, scientists can begin to distinguish the treatment each type needs.

Other NIMH-sponsored research is examining the long-term outcome of ADHD. How do children with ADHD turn out, compared to brothers and sisters without the disorder? As adults, how do they handle their own children? Still other studies seek to better understand ADHD in adults. Such studies give insights into what types of treatment or services make a difference in helping an ADHD child grow into a caring parent and a well-functioning adult.

Animal studies are also adding to our knowledge of ADHD in humans. Animal subjects make it possible to study some of the possible causes of ADHD in ways that can't be studied in people. In addition, animal research allows the safety and effectiveness of experimental new drugs to be tested long before they can be given to humans. One NIH-sponsored team of scientists is studying dogs to learn how new stimulant drugs that are similar to Ritalin act on the brain.

Piece by piece, through studies of humans and animals, scientists are beginning to understand the biological nature of attention disorders. New research is allowing us to better understand the inner workings of the brain as we continue to develop new medications and assess new forms of treatment.

As we learn more about what actually happens inside the brain, we approach a future where we can prevent certain brain and mental disorders, make valid diagnoses, and treat each effectively. This is the hope, mission, and vision of the National Institute of Mental Health.

What Are Sources of Information and Support?

Several publications, organizations, and support groups exist to help individuals, teachers, and families to understand and cope with attention disorders. The following resources provide a good starting point for gaining insight, practical solutions, and support. Other resources are outpatient clinics of children’s hospitals, university medical centers, and community mental health centers. Additional printed information can be found at libraries and book stores.

Books for Children and Teens:

Galvin, M. Otto Learns about his Medication. New York: Magination Press, 1988. (for young children)

Gehret, J. Learning Disabilities and the Don't Give Up Kid. Fairport, New York: Verbal Images Press, 1990. (for classmates and children with learning disabilities and attention difficulties, ages 7-12)

Gordon, M. Jumpin' Johnny, Get Back to Work! A Child's Guide to ADHD/Hyperactivity. DeWitt, New York: GSI Publications, 1991. (for ages 7-12)

Meyer, D.; Vadasy, P.; and Fewell, R. Living with a Brother or Sister with Special Needs: A Book for Sibs. Seattle: University of Washington Press, 1985.

Moss, D. Shelly the Hyperactive Turtle. Rockville, MD: Woodbine House, 1989. (for young children)

Nadeau, K., and Dixon, E. Learning to Slow Down and Pay Attention. Annandale, VA: Chesapeake Psychological Publications, 1993.

Parker, R. Making the Grade: An Adolescent's Struggle with ADD. Plantation, FL: Impact Publications, 1992.

Quinn, P., and Stern, J. Putting on the Brakes: Young People's Guide to Understanding Attention Deficit Hyperactivity Disorder. New York: Magination Press, 1991. (for ages 8-12)

Thompson, M. My Brother Matthew. Rockville, MD: Woodbine House, 1992.

Books for Adults With Attention Disorders:

Adelman, P., and Wren, C. Learning Disabilities, Graduate School, and Careers: The Student's Perspective. Lake Forest, IL: Learning Opportunities Program, Barat College, 1990.

Hallowell, E., and Ratey, J. Driven to Distraction. New York: Pantheon Books, 1994.

Hartmann, T. Attention Deficit Disorder: A New Perception. Lancaster, PA: Underwood-Miller, 1993.

Kelly, K., and Ramundo, P. You Mean I'm Not Lazy, Stupid, or Crazy?! Cincinnati, OH: Tyrell and Jeremy Press, 1993.

Weiss, G., and Hechtman, L. (eds). Hyperactive Children Grown Up. 2d ed. New York: Guilford Press, 1992.

Weiss, L. Attention Deficit Disorder in Adults. Dallas, TX: Taylor Pub. Co., 1992.

Wender, P. The Hyperactive Child, Adolescence, and Adult: Attention Deficit Disorder Through the Lifespan. New York: Oxford University Press, 1987.

Books for Parents:

Anderson, W.; Chitwood, S.; and Hayden, D. Negotiating the Special Education Maze: A Guide for Parents and Teachers. 2d ed. Rockville, MD: Woodbine House, 1990.

Bain, L. A Parent's Guide to Attention Deficit Disorders. New York: Dell Publishing, 1991.

Barkley, R. Defiant Children. New York: Guilford Press, 1987.

Child Psychopharmacy Center, University of Wisconsin. Stimulants and Hyperactive Children. Madison: 1990. (Order by calling (608) 263-6171.)

Copeland, E., and Love, V. Attention, Please!: A Comprehensive Guide for Successfully Parenting Children with Attention Disorders and Hyperactivity. Atlanta, GA: SPI Press, 1991.

Fowler, M. Maybe You Know My Kid: A Parent's Guide to Identifying, Understanding, and Helping your Child with ADHD. New York: Birch Lane Press, 1990.

Goldstein, S., and Goldstein, M. Hyperactivity: Why Won't My Child Pay Attention? New York: J. Wiley, 1992.

Greenberg, G.; Horn, S.; and Wade F. Attention Deficit Hyperactivity Disorder: Questions & Answers for Parents. Champaign, IL: Research Press, 1991.

Ingersoll, B., and Goldstein, S. Attention Deficit Disorder and Learning Disabilities: Realities, Myths, and Controversial Treatments. New York: Doubleday, 1993.

Kennedy, P.; Terdal, L.; and Fusetti, L. The Hyperactive Child Book. New York: St. Martrin's Press, 1993.

Moss, R., and Dunlap, H. Why Johnny Can't Concentrate: Coping with Attention Deficit Problems. New York: Bantam Books, 1990.

Silver, L. Dr. Silver's Advice to Parents on Attention-Deficit Hyperactivity Disorder. Washington, DC: American Psychiatric Press, 1993.

Vail, P. Smart Kids with School Problems. New York: EP Dutton, 1987.

Wilson, N. Optimizing Special Education: How Parents Can Make a Difference. New York: Insight Books, 1992.

Windell, J. Discipline: A Sourcebook of 50 Failsafe Techniques for Parents. New York: Collier Books, 1991.

Other Resources:

For individuals with a computer and modem, there are on-line bulletin boards where parents, adults with ADHD, and medical professionals share experiences, offer emotional support, and ask and respond to questions.

Two such on-line services include CompuServe [(800) 848-8990] and America Online [(800) 827-6364]. You may also wish to check with other national and local on-line communications companies to see if they offer similar services.

Resources for Teachers and Specialists:

Barkley, R. Attention Deficit Hyperactivity Disorder (four 40-minute videocassettes in VHS format). New York: Guilford Publications, 1990.

Copeland, E., and Love, V. Attention Without Tension: A Teacher's Handbook on Attention Disorders. Atlanta, GA: 3 C's of Childhood, 1992.

Harris, K., and Graham, S. Helping Young Writers Master the Craft. Cambridge, MA: Brookline Books, 1992.

Johnson, D. I Can't Sit Still-Educating and Affirming Inattentive and Hyperactive Children: Suggestions for Parents, Teachers, and Other Care Providers of Children to Age 10. Santa Cruz, CA: ETR Associates, 1992.

Parker, H. The ADD Hyperactivity Handbook for Schools. Plantation, FL: Impact Publications, 1992.

Related Materials Available from NIH:

Attention Deficit Disorder Information Packet and "Know Your Brain Fact Sheet." Both are available from NIH Neurological Institute, P.O. Box 5801; Bethesda, MD 20824 (800) 352-9424.

Learning Disabilities (NIH Pub. No. 93-3611) and "Plain Talk about Depression' (NIH Pub. No. 93-3561). These are available by contacting: NIMH, Room 7C-02, 5600 Fishers Lane, Rockville, MD 20857.

Support Groups and Organizations

Attention Deficit Information Network (Ad-IN)
475 Hillside Avenue
Needham, MA 02194
(617) 455-9895

Provides up-to-date information on current research, regional meetings. Offers aid in finding solutions to practical problems faced by adults and children with an attention disorder.

ADD Warehouse
300 NW 70th Avenue
Plantation, FL 33317
(800) 233-9273

Distributes books, tapes, videos, assessment on attention deficit hyperactivity disorders. A central location for ordering many of the books listed above. Call for catalog.

Center for Mental Health Services
Office of Consumer, Family, and Public Information
5600 Fishers Lane, Room 15-105
Rockville, MD 20857
(301) 443-2792

This national center, a component of the U.S. Public Health Service, provides a range of information on mental health, treatment, and support services.

Children and Adults with Attention Deficit Disorders (CH.A.D.D.)
499 NW 70th Avenue, Suite 109
Plantation, FL 33317
(305) 587-3700

A major advocate and key information source for people dealing with attention disorders. Sponsors support groups and publishes two newsletters concerning attention disorders for parents and professionals.

Council for Exceptional Children
11920 Association Drive
Reston, VA 22091
(703) 620-3660

Provides publications for educators. Can also provide referral to ERIC (Educational Resource Information Center) Clearinghouse for Handicapped and Gifted Children.

Federation of Families for Children's Mental Health
1021 Prince Street
Alexandria, VA 22314
(703) 684-7710

Provides information, support, and referrals through federation chapters throughout the country. This national parent-run organization focuses on the needs of children with broad mental health problems.

HEATH Resource Center
American Council on Education
1 Dupont Circle, Suite 800
Washington, DC 20036
(800) 544-3284

A national clearinghouse on post-high school education for people with disabilities.

Learning Disabilities Association of America
4156 Library Road
Pittsburgh, PA 15234
(412) 341-8077

Provides information and referral to state chapters, parent resources, and local support groups. Publishes news briefs and a professional journal.

National Association of Private Schools for Exceptional Children
1522 K Street, NW, Suite 1032
Washington, DC 20005
(202) 408-3338

Provides referrals to private special education programs.

National Center for Learning Disabilities
99 Park Avenue, 6th Floor
New York, NY 10016
(212) 687-7211

Provides referrals and resources. Publishes Their World magazine describing true stories on ways children and adults cope with LD.

National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847
(800) 729-6686

Provides information on the risks of alcohol during pregnancy, and fetal alcohol syndrome.

National Information Center for Children and Youth with Disabilities (NICHCY)
P.O. Box 1492
Washington, DC 20013
(800) 695-0285

Publishes free, fact-filled newsletters. Arranges workshops. Advises parents on the laws entitling children with disabilities to special education and other services.

Sibling Information Network
A.J. Pappanikou Center
1776 Ellington Road
South Windsor, CT 06074
(203) 648-1205

Publishes a newsletter for and about siblings of children with special needs.

Tourette Syndrome Association
42-40 Bell Boulevard
Bayside, NY 11361
(718) 224-2999

State and local chapters provide national information, advocacy, research, and support.

Source:

NIH Publication No. 94-3572
Printed 1994