1. What is the difference between ADD and ADHD?
ADD and ADHD are the same disorder - ADD is just an outdated term. Attention Deficit Disorder with or without hyperactivity (ADD) was so named in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is written by the American Psychiatric Association and is used in the United States as a system to classify, describe and diagnosis mental disorders. When the DSM was updated to the fourth and current version, DSM-IV, in 1987, the term ADD was changed to Attention Deficit Hyperactivity Disorder (ADHD). It was then broken down into three subtypes:
1. Predominantly Inattentive Type
This is the subtype commonly thought of as ADD. This is characterized by the child who has an inability to sustain attention for repetitive, structured, and less enjoyable tasks; shows problems with concentration, is easily distracted, disorganized and forgetful; loses personal items and often appears as if they are not listening.
2. Predominantly Hyperactive-Impulsive Type
This is characterized by the child who shows hyperactive behaviors including fidgetiness, difficulty staying seated, running, jumping, excessive talking and appearing as if “driven by a motor.” Additionally, they also display impulsive behaviors including difficulty waiting for their turn or stopping on-going behavior, interrupting others, and an inability to resist immediate gratification.
3. Combined Type
This child will display behaviors characteristic of both inattentive and hyperactivity-impulsivity subtypes.
2. My child can sit and watch TV for hours - he doesn't have ADHD!
This is one of the most common misunderstood features of ADHD. Parents believe that since their children can maintain attention and focus to watch TV, play on the computer or play video games for an extended period of time, that they do not have ADHD. This is incorrect. The inability to focus in children with ADHD is for boring, uninteresting or mundane tasks. So someone with ADHD may have difficulty sitting through a math or history class, but has no problem playing XBox.
3. I don't want to medicate my child because we don't know the long-term effects of ADHD medication.
Stimulants, the common drug-class used to treat ADHD symptoms have been around since 1937, making them older than almost every other class of medications currently available. Ritalin, a more common medication, is one of the longest- prescribed and well-studied medications available. Some medical professionals argue that it is safer than aspirin, and others claim that we know more about the short and long-term effects of stimulant drugs than we do anti-depressants. While there are risks associated with any medication, both stimulant and non-stimulant ADHD medications are safe and effective to take for many years.
In fact, some research shows that children not on ADHD medication are more likely than their medicated peers to develop alcohol and substance abuse, most likely due to their impulsivity and self-destructive behaviors as well as a means for coping with their symptoms. Additionally, a significant percentage of children with ADHD also have coexisting anxiety and / or depression; non-medicated children are also more likely to abuse alcohol and illicit drugs as a way of self-medicating and managing their symptoms.
Finally, children show the best prognosis when medication is used in conjunction with psychotherapy and family education.
4. Medication is viewed as a “magic pill” and kids are overmedicated these days.
While there certainly has been a significant increase in medication use over the past several years, it is important to note that medication is only one component of a complete interdisciplinary approach to ADHD. Both children and their family benefit from comprehensive treatment, such as psychoeducation related to ADHD, it’s prognosis and symptom management. Children with ADHD also benefit from behavioral therapy approaches that will help them learn how to manage symptoms that interfere with learning, how to stay organized and strategies to combat forgetfulness. Through behavior therapy, parents learn how to use reinforcement and rewards to help their children acquire and retain more appropriate behaviors. Cognitive-behavioral therapy can teach children coping strategies for the anxiety or depression that often accompanies ADHD. Parent Management Training and group therapy can help parents learn how to reduce parent-child conflict, and cope with the difficulties of raising a child with ADHD. Additionally, a nutritionist can help families ensure that children are maintaining a proper, nutritional diet.
5. Kids with ADHD are disabled / are disadvantaged / won't amount to anything / have no future.
Dr Ned Hallowell, a renowned ADHD expert, explains ADHD best. He does not view ADHD as a disability; instead, he found a unique way to explain ADHD as a strength to his young patients:
I go to great lengths not only to present the medical facts but also to create a framework of understanding that describes ADHD in strength-based terms. I tell the child that he is lucky in that he has a racecar for a brain, a Ferrari engine. I tell him he has the potential to grow into a champion. I tell him (assuming it is a he, but he could just as easily be a she) that with effort he can achieve greatness in his life, and then I tell him about the billionaires, CEO’s, Pulitzer Prize winners and professional athletes with ADHD I’ve treated over the years. But I also tell him he does face one major problem. While he has a racecar for a brain, he has bicycle brakes. I tell him I am a brake specialist…
Additionally, there is a long list of famous artists, scientists, and politicians had ADHD as children. Here's a list of some well-known celebrities with ADHD:
Ralph Waldo Emerson
Zsa Zsa Gabor
John F. Kennedy
George Bernard Shaw
Vincent Van Gogh
Statistics provided the Center for Disease Control and Prevention www.cdc.gov
Ashley, S. (2005). The ADD & ADHD Answer Book: Professional Answers to 275 of the Top Questions Parents Ask. Sourcebooks.
Wender, P. H. (1995). Attention-deficit hyperactivity disorder in adults. New York: Oxford University Press.