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Attention Deficit Disorder
I am going to stir the pot here and put out a few poorly developed thoughts. When I was in medical school in the early ’70s there was a fairly new problem described in some children who had trouble fitting in as it pertained to organized classroom activities. These children seemed to be unable to channel their focus or attention in the appropriate way. I don’t think any of the people studying these kids paid enough attention to what these kids were actually focusing on and perhaps because of that, these children were diagnosed as suffering from organic brain syndrome. Yes, that was the best label that the experts could come up with at the time. Organic Brain Syndrome. Robert Heinlein could not have defined it better. He would have adopted that term as satire but this was actually real.
There was certainly good evidence that something structurally different described the behavior and perceptive abilities of some kids. It was most evident in their attempts at artwork. There were kids who could draw a picture that, with a little explanation, could conform to a narrative that made sense, and there were kids who could not draw anything that even they could explain. There were cognitive tests that were developed to identify and quantify these children suffering from their Organic Brain Syndrome. The scientists had a label, they just needed the right hammer to find the nail.
Big Pharma stepped in with the hammer that every pediatrician and educator was ready to swing.
What is attention? Is it what we attend to or is it what we want from others? If I ignore you, you are not getting attention from me. Who is lacking attention here? You or me?
Published in General
As someone who tutored kids in addition to taking care of the elderly, here is an observation:
On the day of the tutoring session, the parent would set their child up with the proper environment. The big desk in the den. The needed books. Proper lighting and the calculator, plus devices. Pens, paper, erasers etc.
My student and I would begin to tackle the day’s assignments. Twenty minutes into the session, mom would arrive to hand her offspring their diet soda and give me my ice water.
We both drank our drinks. Then over the next minutes, the same human who had been engrossed in the reading assignment, the math problems or whatever, suddenly could not focus. They had to nervously twitch their legs and they had to check their phones for emails.
Their eyes would be glassy and the lesson for all intents and purposes was over.
Diet sodas contain aspartame which has a toxic effect on the brain’s designated functions, one of which is to pay attention to the task at hand. It produces an especially serious adverse factor when people under the age of 20 consume it, as their brains are still developing. Dr Martini, who practices in the state of Georgia, has compiled many scientific studies on the harm aspartame does.
Kids who were my students and who were raised in homes where sodas weren’t a thing on a daily basis did not exhibit these behaviors.
MSG is also a problem, although it leads to massive depression and not to hyper behaviors. It is listed on food labels as “modified food starch” “modified tapioca starch” basically modified whatever. The terms “spices” and “natural flavoring” are also code words for the MSG.
I am convinced if this information was widely known, we could get the 6% of all American grammar school kids off the ritalin and back to real health. (Or half of them anyway.) Parents would no longer be dealing with as many suicidal teenagers, who go the route of cutting or anorexia.
But Big Pharma would lose profits, so it probably will not happen. (Sigh.)
I think that there’s a real issue. But I think it is different thinking. I don’t think it’s actually disorder. We have a society that emphasizes a certain way of thinking that does not fit these people’s brains. I know I see it in my practice and I see it in my own daughter.
I pray that she can get into a job that will let her use those talents.
The insulin spike from real sugar might have done the same thing
Yes I agree. Also among possible other suspects would be the food additives that are there to enhance the color of what we eat and drink, and yes, preservatives too.
I recently went Keto and was amazed at how there is no longer this rocketing feeling of being up and down all day long. That feeling occurred not just after consuming sugars but also carbs.
Every doctor I have ever seen has always applauded my lack of diabetic tendencies. But obviously all the carbs I consumed were amping me up and letting me down.
As one of my former co workers once described it “Adderall focuses me.” He was around 30 when he was diagnosed with ADHD.
I believe that ADHD does exist, but it is often over diagnosed due to schooling.
Note: School sucks. I’m not blaming the school system for the over diagnosis. It took me ten years after highschool to be able to get more of a diploma, and that was in tech school.
Edit: changed schooling to the school system.
Me too. (Well, at least lower carbs and higher fats if not strict keto)
Was that shortly after coed schooling became the norm?
What curriculum changes happened just before this trend started?
When did 60s hippies start taking over the schools?
What fads in child psychology were put in place 5 to 10 years before these observations were made?
And those are only some of questions worth asking about the schools! There are so many questions about the kids’ home life that potentially relevant.
They said I had ADD, or ADHD. At least one of the two. I never saw a professional that I can recall, but we were in Zimbabwe and my parents were doctors. They got me ritalin, probably from South Africa.
Before that they tried giving me coffee. It was horrible. I don’t know why they didn’t try strong tea. I was down with tea, and it doesn’t taste bad like coffee does.
Ritalin seemed to help for a couple of years.
In 9th grade, at Rosslyn Academy in Nairobi, I noticed I was doing better in school on days I forgot to take the pills. So I quit taking them. I guess my parents quit refilling them around that time too. I think [Name Withheld] stole what was left and sold them at school.
Did I have a disorder, or did I just have issues managing my own energy, and should we blame my parents for that, or my own immaturity, or a boring education system?
Carol I am having a different reaction. Less energy. OK since I am losing weight slowly. Would be even more if I could give up the port. Not yet. But getting less carbs is sure good for the gut.
I’ve had that problem my whole life. I agree with @bryangstephens that it’s not so much a disorder as a condition. Most of human history hasn’t required humans to sit in a classroom for hours to be successful.
A thousand years ago, even 200 years ago, inability to concentrate wasn’t an issue.
As for my problem with it, I learn by doing, and not by hours staring at a book, though I do read prodigiously. But when it comes time to actually study, sigh.
Anyway, didactic learning is how I’ve had some economic success.
Attention deficit (or inability to concentrate) and hyperactivity are two different things, right? I also know someone who’s been labeled alternately ADD and ADHD back and forth over his lifetime. One thing’s for sure, he’s not hyperactive in the least.
It seems like, sure, there are structures in the brain that are useful or integral to concentration and attention, but not just one. And if they can’t differentiate between one disorder and the next, it seems like ADD/ADHD is only a little more on point than Organic Brain Syndrome.
I’m going to work this weekend on an article explaining exactly how psychiatric diagnosing works. And I think that will help explain more detail this sort of thing. The reality is that some people move around to stimulate themselves so they have a harder time sitting still and others don’t but their brain still run around.
Indeed I believe There must be an advantage a brains of this type it wouldn’t be so prevalent. As a side note I’ve seen as high as 40% of the population really under the population really does not respond well to traditional classroom learning. Both of my children and myself fall into that category. My valedictorian wife was in the 60%.
I believe that this brain type probably a probably is quite an advantage when it comes to hunting. The reality for most of these people is that in fact they are capable of hyperfocus. That is to say they can focus on one thing to the exclusion of everything else and ways that for people who don’t have that brain type frankly can find pretty amazing. It just has to have their interest. I would much rather be in a foxhole with somebody of this brain type who’s quick to notice everything and respond as opposed to somebody who’s calm and deliverative. If something’s approaching the Fox hole I want the guy in there with me to shoot it not think about whether or not he should be shooting it.
For some people as their brain continues to develop There is a change in their management. One of the things you have to remember our brains are in constant development up until about of age 25. The frontal lobes and preferential cortex are the last to develop and those are most engaged in tamping down and controlling the rest of our brain.
Really if you think about it it’s kind of interesting that part of why it takes so long for human beings to grow up it’s because we have brains designed to control our impulses. For all that we seem to complain or look at how ruled by instinct and impulses we are human beings are actually quite liberated for most of that stuff compared to other mammals and certainly reptiles and other animals.
I think perhaps there is potential for development even life-long, but I have no expertise in these things.
“Did I have a disorder, or did I just have issues managing my own energy, and should we blame my parents for that, or my own immaturity, or a boring education system?”
I wonder how many children who are homeschooled are taking ritalin or the newer equivalent drugs? Maybe a tiny minority. Heck, I would probably need mind altering drugs before I even tried to home school my kids.
My grandmother was an RN, a country nurse, and the only medical professional within 20 miles of a doctor. When children had such issues in the elementary school a baseball field away from her house, she recommended a cup of black coffee every morning before school (and on hand at school if needed.) She claimed it worked wonders. That was over 80 years ago today, before ADHD was a thing. I’ll bet she was right.
The lack of honest-to-goodness hard labor contributes to the problem.
I’m guessing it’s complicated.
I got tested for AD[H]D once, just on a lark. I was told that I’m extraordinarily high-function in this regard, not a hint of anything remotely like AD[H]D: if I wasn’t getting my lists of tasks accomplished, it’s because I didn’t want to.
Which is true.
But I know people who really do focus better on AD[H]D meds. I can tell, talking to them, whether or not they’ve taken theirs. While I don’t doubt for a moment that psychopharmaceuticals are over-prescribed, I also don’t doubt that they’re a boon for a lot of people struggling with the vagaries and imperfections of our complex brains.
I’ve got a young cousin about to enter seventh grade. Until about three years ago he was a scholastic rock star, an effortless straight A student who managed his (admittedly pretty simple) academic tasks promptly and effectively. Then he took a dive into a swimming pool, slipped on the cement, and didn’t quite reach the water. He spent the next year out of school while I tutored him in his home, another choppy COVID year while he and I did remote learning together, then re-entered school at the appropriate grade — and struggles to pull a C in math and science, despite our frequent tutoring.
What’s strange is that I can sit with him while he knocks out an assignment just like he used to do. Or not, and I don’t know why some days he’s perfectly focused and other days it’s all I can do to get him to sit down. We’ve tried controlling for all sorts of things, but neither I nor his parents nor his teachers can find a pattern to it.
On the other hand, he loves history and sports and is a busy, happy, energetic, articulate, and entirely enthusiastic young man, and a lot of fun to be around. He doesn’t want to be a scientist or engineer, has absolutely no interest in either. So there’s no crisis here, just a mystery and a small challenge.
Then, of course, there’s the boy/girl thing. We home-schooled five sons with frequent breaks to chase cows and go fishing, while our daughter wouldn’t put down a book until I took away her flashlight an hour after bedtime. The classroom setting seems to suit girls, and boys who happen to be bookworms as I was growing up.
I have ADHD, or as I prefer to call it, “Variable Attention Syndrome.”
The problem with the name “Attention Deficit Disorder” is two fold. I don’t have a “Deficit” and I don’t have a “Disorder.”
As I go through the day, I am not focused. It is what it is.
But put me in a Courtroom during an evidentiary hearing, and I am a killer. I pick up nuances and subtle signals from the Judge. It is exhausting and exhilarating. I am hyper focused like a boxer who will be knocked out if their attention wanders.
As a Special Education teacher with 45 years of classroom experience I can attest to the actual existence of ADHD. Whether is can be defined or should be defined as a disability is questionable. It is common enough in both sexes, not just little boys as some would like to believe that, in my opinion, it must have some evolutionary benefit, or, at least, not have been disadvantageous to earlier generations. There is no question that many kids who these days populate special education classes would have likely simply dropped out and not have constituted a problem in what we now call general education classes.
The kids who were diagnosed as ADHD in my classes were subjected to pretty extensive evaluations by psychologist and physicians, as well as, accumulated surveys from parents, teachers, and other adults who had regular contact with them. There is nothing imaginary about the syndrome. Spend five hours a day with such a child and you see clearly that that child is unable to control impulses and acts out erratically, often violently, and can be a very disruptive influence in a classroom with the normal load of 25 to 30 children.
I am not a great believer in medicating kids, but for many I worked with the use of medications judiciously with weekly evaluations was very helpful. Properly dosed it could allow a child to begin to control many of the behaviors which were causing him/her to be disciplined or removed from class. However, for many learned compensatory behaviors continued even with medications. It was very important to differentiate between which behaviors were residual and could be dealt with through behavior modification and which required medication.
The biggest problem is not that kids are being medicated. It is that qualified, trained people are not necessarily available to fill all of the special education classrooms that are supposed to serve these children. Also, children with behavioral difficulties, no matter the etiology, are dumped together in special education classrooms. This makes it quite difficult to diagnose the actual nature of the problem.
I worked for four years in a wonderful program at Seattle Children’s Home. The classes were limited to no more than ten students which is actually normal for Special Ed classrooms. However, a major difference was that students allowed into the program were specifically limited to kids of normal intelligence and not Conduct Disorder which is also referred to as sociopathic. Each classroom had a social worker and occupational therapist assigned to it, as well as a qualified teacher and classroom aide. A child psychiatrist was a part of the administrative staff. Staffing conferences were held on a regular basis for all students that included the classroom staff as well as the administrative staff. Medications were a part of the program and were very carefully monitored and assessed.
When the program was forced to close I returned to the schools where I attempted as much as possible to maintain the same level of professionalism.
“I worked for four years in a wonderful program at Seattle Children’s Home. The classes were limited to no more than ten students which is actually normal for Special Ed classrooms. However, a major difference was that students allowed into the program were specifically limited to kids of normal intelligence and not Conduct Disorder which is also referred to as sociopathic……When the program was forced to close I returned to the schools where I attempted as much as possible to maintain the same level of professionalism.”
This sounds almost like the level of attention that homeschooled kids get.
Is the attention deficit with the students or is it with us?
I just googled: homeschooling ADHD students and got 1.5 Billion results.
The top six or seven I noticed seemed very promising.
I actually was homeschooled till Rosslyn except for a short stint in first grade. Still managed to find it boring sometimes. I expect public school would have been worse.
I hope I didn’t misdirect anyone about ADD vs. ADHA. As it turns out, ADD has been nixed as a diagnosis for quite a while and has been replaced with ADHD with at least three “presentations”, at least one of which does not include energetic or hyper activity.
As an aside, I was “diagnosed” with “hyperactivity” in 1967 (before the first DSM came out, I think). I was instructed to go to the doctor for a cardiac work-up because I had brief costo-sternal joint chest pain while waiting standing in line to be let out of school. The teachers’ husband had just died of a heart attack and she made my parents pick me up from school and go to the doctor. When I got there someone who looked like Eugene Levy in a lab coat stared at my face and listened to my chest for five minutes and took my parents out of the room for a long time.
And when he came back he gave me a yellow ritalin pill to take and a prescription for more. I took it. When we got home, my father told me that the doctor said I looked hyperactive and prescribed ritalin for me, but that my father doubted it. I certainly doubted it. I was never hyperactive or lacking attention, ever. Though I did get pretty bored in school. (First grade was all review work to me.) And I never took another pill, and never had any hyperactive problems.
This is one reason why I say that doctors prescribe in fad fashion, and shouldn’t be taken too seriously, especially regarding psychotropics.
All of us with more than one kid know how incredibly varied they are and how their attention varies. Moreover, we can remember our own relationships with school, peers and siblings. The notion that we’re going to subject all to the same educational and growing up process and set them in direction early on is insane. Not a little insane but totally. We have to abolish our public school superstructure, administrative overhead and means of finance. Let parents pick any school and pay for it. Let teacher run schools compete for students, i.e. bottom up free market with tuition coming form parents and the subsidy as now based on income . Schools will vary. Some kids start off with sprints, others wander around. intellectually and just want to compete in sports or art, whatever, but they sort it out, and some teachers are lousy and should pick a different profession and will have to because they’ll cost schools students which is where school income comes from.
Any student actually diagnosed with ADD or ADHD unquestionably has symptoms which are wholly theirs. The environment certainly can exacerbate the symptoms and behavioral deficits. Much of what we see in those kids is learned, adaptive or, better said, maladaptive behaviors developed prior to treatment. Those behaviors frequently last well beyond the effective treatment.
One thing I saw rather startlingly was in a student with extreme ADHD I worked with at SCH. He could not write a simple sentence, much less coherent paragraph in eighth grade. However, if I put him in front of a computer with word processing software he would sit and write lengthy essays and stories. Something about the computer screen worked on his brain and kept him focused. It doesn’t work with all affected kids, but it did with him. Individualizing instruction for each child is extremely important. You can’t make assumptions. This is probably why homeschooling can be more effective, as in that situation it is far more likely that an appropriate technique will be found for the individual student.
I was probably a little ADD as a kid. My parents sent me to a private school near home, the same one that Donald Trump attended, Kew Forest School. I didn’t do all that well in class, but one of the teachers there tutored me at home a few evenings a week, and I progressed far better with her than in my normal classes. It is very easy for a kid to develop a reputation in a school and be treated with lowered expectation by teachers as he or she moves through the system. My greatest gains were made when my parents sent me to a new school where I was an unknown commodity. My first semester there I did the best I had ever done. That became the expectation rather than the previous case. I graduated four years later pretty close to the top of my class, a real difference from where I had been at Kew Forest.
One point I would make about medications. A few times in college I used uppers to prep for exams. I definitely noted an increase in my ability to stay focused with their use. I have no doubt that they can be helpful for ADD/ADHD kids.
Some years ago I read an article I just don’t recall (been too long) but the crux was that most diagnoses of ADD could be handled without recourse to drugs.
Needless to say it did receive a deficit of attention.