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If a child is diagnosed with ADD/ADHD

January 09, 2009|By Dr. YVONNE FOURNIER / Scripps Howard News Service

DEAR DR. FOURNIER: We were summoned to our daughter's school, told she is ADHD and instructed to get her on the meds. My neighbor says ADHD is something that was developed so pharmaceuticals can sell more unnecessary drugs and absolve parents from having to actually parent and teachers from taking responsibility for what our daughter isn't learning. Please tell us the truth.

ASSESSMENT: I have been answering questions about ADD/ADHD (Attention Deficit Disorder with or without hyperactivity) and the surrounding controversy for several years now.

The ADHD diagnosis is often communicated to parents when their children become distracted and do not complete tasks or act impulsively and disrupt the classroom.

ADD/ADHD is not a disease, but a cluster of behaviors, some of which may be acceptable in certain classroom situations and not in others. In some cases, these behaviors may continue through life and be the very strengths that lead to success, such as the "daydreamer" who becomes a heralded movie director or the "talker" who becomes a noted trial lawyer.

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The diagnosis, however, should come from a developmental pediatrician. And yes, true ADD/ADHD behavior is usually treated with medication. It is more important, however, to diagnose and treat your child's underlying learning problem, not its behavioral manifestations.

Critics will say that ADHD medication has dramatically improved millions of children's school performances. While this may be true in some cases, the educational success for an equal number of children is short-lived unless additional learning strategies are put in place. Potential drug addiction (and other ailments) by prescription carries too high a risk without concurrent educational therapy.

No pill can teach a child the difference in reading a textbook for content and reading a novel for a book report or help a child discover his or her working capacity, which leads to personal time-management techniques. And when the child becomes an adult, no pill can teach her short- and long-term time-management skills and how to continue focusing on only one thing even if the world wants her to "multitask." Neither can a pill teach a fifth-grader the phonics he didn't learn in second grade.

And not every child with a learning problem has ADHD. Conversely, many children who display ADD/ADHD behaviors have learning difficulties, which often go untreated because their anxiety is masked by behaviors too easily labeled ADD/ADHD.

Under medication, some children do improve their attention enough to be able to sit still and do as they are told, but this does not ensure steady, long-term overall improvement. New stresses and challenges plus a higher level of expectations may make a child tune out or give up.

WHAT TO DO: If your child has a learning problem, don't rush to judge that he/she has ADD/ADHD. If your child is diagnosed as such, learn to separate the pediatric from the learning problem and get treatment for the former only if absolutely needed.

Take, for example, a child who consistently forgets homework assignments. Forgetting homework assignments is fundamentally a self-management learning-strategy problem. Robotizing medications are not the solution; teaching is.

The idea of doing homework sounds so simple to adults, yet it's a complicated process, particularly for children who have not been taught long enough to actually learn the required strategies.

Use your best parenting instincts, consult the experts when necessary and work together to devise a comprehensive treatment plan for what is, essentially, an educational difficulty. Is this truly ADD/ADHD, or an 8 a.m.-3 p.m. problem? The aim should be to help your child learn to learn long-term without the crutches provided by medicinal drugs.

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