The statistics are mind-boggling. In 1990, 750,000 children were diagnosed with Attention Deficit Hyperactive Disorder. Today, over four million. Ciba-Geigy, the company that manufactures Ritalin, attributes the surge in ADD/ADHD to heightened public awareness. Yet some critics compare the increase to an epidemic and claim that parents, teachers, and doctors are overdiagnosing, misdiagnosing and therefore drugging spirited and creative young children.

ADD/ADHD is indeed the hot topic of the 90's. Debated, criticized and misunderstood - just the mention of the word hyperactivity can start a battle that leaves outsiders outraged, teachers exhausted, parents isolated and children feeling confused and striving to gain control over their mind as well as their body.

I know this controversy all too well. My family and I live with ADHD daily - his name is Jake and he will soon be five. The youngest of three children, Jake is by far the most difficult child that I've ever dealt with - but he is also the most creative, intelligent, funny, lovable and gifted. Our family is constantly bombarded with questions about Jake, his medicine, our discipline techniques and his diet. Due to the lack of public knowledge, I now publish the newsletter, Mama's Little Helper, and I have compiled the top 10 questions that we are asked about ADD/ADHD in hopes that you will be enlightened.

1. What is ADD/ADHD? Actually, the term includes a broad category of emotional, mental and behavioral disorder. It is defined as developmentally inappropriate impulsively and inattention with or without hyperactivity. It is a chronic disorder which begins at infancy and extends to adulthood. 10 boys will have it for every 1 girl and most ADHD patients will outgrow the hyperactivity in their teens, but will forever have to deal with their attention difficulties.

2. What Causes it? While no single cause can be pin-pointed, it is believed that it is generated by a biochemical imbalance in the brain. There appears to be a deficiency in the brain's ability to produce certain chemicals that results in the persons brain being UNDERSTIMULATED and therefore deficient in regulating its own activities (such as impulse control, temper, attention). Other theories say that there may be a thyroid dysfunction, the brain may not metabolize glucose properly (at a rate less than normal), toxins may have affected the fetus, trauma after birth to the brain or infections, or, as the Feingold Institution claims, there is an allergic reaction to foods, chemicals and pollutants.

3. What are the symptoms? Most symptoms can be seen early in life, such as: irritability, sleep disorders, does not want to be held, squirms, walks and talks early, sensitive to light and sounds, whiny, clumsy, and may have talked early. Later on, symptoms that are common, but not all need to be present, are:

* head-knocking, self-destructive, abusive, temper tantrums, destroys property

* lack of concentration, inability to finish tasks, learning disabilities

* low tolerance to stress, daily or hourly mood swings, impatience

* sleep disturbances, difficulty with time management, eating problems

* inability to finish tasks, forgetfulness, difficulty playing quietly, fidgeting

* constant movement, migraines, memory disorders, phobias, social failure

* diminished self esteem, bossy, whinny, overdramatic, the class clown

* Good points: highly intelligent, big dreamers, immense imaginations, highly creative, optimistic, mechanical, computer-oriented, determined, insightful, deeply compassionate, artistic - and Einstein, JFK, Dustin Hoffman, Abraham Lincoln, Edgar Allen Poe, Mozart, Alexander Graham Bell, Galileo, Wright Brothers and Louis Pasteur are all said to be ADD or ADHD.

4. How is it diagnosed and treated? There is an evaluation, review of past and present history, prenatal record, birth information, allergy testing (for some), school teacher evaluations and class history, test for learning disabilities, family history, physical and in most cases - blood work.

Ritalin, Cylert, Dexedrine are stimulants that are thought to stimulate the understimulated brain chemicals, or neurotransmitters which allows the individual to focus, learn, sit still and concentrate. When the medication is used effectively and the diagnose is correct, these medications will work 80% of the time, and not all children will need to take the medication for life. It is often times outgrown.

Stimulants have been used since the 1930's with no evidence of long-term damages.

5. Why is there an ADHD/Ritalin controversy? Dr. Thomas Phelan MD, author of 1-2-3 Magic and All About Attention Deficit Disorder answers: #1- it is an emotionally jarring decision, for a parent to consider medicating children to help behavior in their children. Parents don't understand it and that makes it harder on them. #2 - the media likes conflict - claiming to present both sides. Media can't do pro/con stories because there's little con's to Ritalin. It works! Also, it is being both over and under prescribed. I think that it's the under-prescribed that's the biggest crime.

6. Why has the number of ADD/ADHD diagnosis increased over the last 10 years? This question is debated. Some skeptics claim it is due to both parents working outside the home and ignoring the children, or that the parents are not properly disciplining the children The experts, such as Dr. Phelan, has a different explanation. The increase is primarily due to public awareness. There's no more ADHD than there used to be, he said, the ADHD number hasn't increased. It's always been there. It's just more public awareness.

Jane Hersey, National Director of the Feingold Institute, claims that 60-70% of the people diagnosed with ADD/ADHD actually have food or environmental allergies and the reason for the increase is due to the increase in pollution, food preservatives, chemicals and dyes. ADD symptoms match the many different symptoms of a reaction to synthetic chemical additives. Hersey claims. That explains why there is so much ADD in the U.S. but not as much with other countries where food additive guidelines are much stricter.

7. How long has ADD/ADHD been around? In 1902 George Frederic Still described children in his clinical practice who were often aggressive, defiant, resistant to discipline, excessively emotional and displayed dishonesty. He thought they shared basic defect in moral control. 1930 saw the first use of psychoactive drugs to control hyperactivity. 1940's - term brain-injured child was coined to describe energetic, temperamental, aggressive, and misunderstood children. 1950's - minimal brain dysfunction.1960's - Hyperkinetic Reaction to Childhood was the term used. 1970's - it was found that the cause has attention problems, not brain disorders. 1980's - it was sanctioned as Attention Deficit Disorder. Mid 1990's - the word Hyperactivity was added.

8. What treatment, other than Ritalin, is recommended? Most doctors will include a behavioral modification program to follow. This includes counseling, structure of time and school, positive feedback, family negotiations, internal structure, to ease child into transitions, to assist the child in dealing with peers and peer conflicts, temper control and building self-esteem. This is the longest and most difficult part of the treatment.

9. What are the consequences for a child who does not receive treatment? Half of them will have a conduct disorder. 1/4 will be anti-social as adults. According to Dr. Phelan, 40% of people in prison grew up with undiagnosed ADD/ADHD disorder. It could leave individuals having difficulty getting organized, easily distracted, difficulties with relationships, and a lack of self-confidence. The may suffer from chronic proscrationation, be impatient, considered and outcast or have a tendency towards dangerous activities. Studies show that 1 in 3 will drop out of school, and that untreated ADHD people are more likely to become alcoholics, smokers and drug abusers than the regular public.

10. What are some tips for parents of ADHD/ADD or hyperactive children?

A. Try martial arts. It can help with self-control, concentration and respect for others.

B. Play calming background music such as classical, Beetles or Elvis. The steady beat has helped to calm hyper children.

C. Enhance child's self-esteem daily.

D. Teach child physical relaxation techniques such as yoga or stretching.

E. Use touch to soothe and calm. Massage, back rubs, hugging all help.

F. Reduce stimulation. Turn off the TV more, play games. =

G. Eat protein in the morning. Researchers speculate that ADD/ADHD kids may be more sensitive to seratonin, causing them to feel irritable. Protein helps block the seratonin and feel less moody and restless.

H. Get organized. Have a place for everything. The child's bedroom should consist of everything in its own plastic or wooden organizers. If everything is in a toybox, it looks like an exploring expedition to them.

I. Read discipline books. I recommend 1-2-3 Magic.

J. Go to water whenever possible. Water works wonders with many hyperactive children. You may want to invest in a pool pass, a small pool at home or more bath toys.

Copyright 1997 Terri Andrews All Rights Reserved