by Susan Ince
As she emptied her son’s preschool cubby, Mary Robertson wept. She felt that she must be a terrible mother — why else would 5-year-old Anthony have been kicked out of school for throwing blocks while the other students raptly enjoyed story time? After his expulsion, learning experts diagnosed Anthony with attention deficit hyperactivity disorder (ADHD), a condition thought to affect at least one kid in every classroom. His mother, meanwhile, worked out an individualized educational plan for him so he could continue in a regular classroom and became an active member of Children With Attention-Deficit/ Hyperactivity Disorder (CHADD), a national support organization.
Knowing that these kinds of problems tend to run in families, the Lexington, KY, mother feared a similar ordeal when her second child was born. Instead, daughter Samantha was so laid-back that she never even received a time-out.
Surprisingly, Samantha’s transition to school was also tough. Although she sat quietly, Samantha couldn’t focus well enough to learn or even to play with the other kids. “There I was, on the national board of CHADD, and I completely missed that my daughter also had attention issues!” exclaims Robertson.
If even this savvy mom was caught off guard, how can less informed parents know when their youngster needs help? Indeed, more and more experts are saying that the way kids with attention troubles have been identified has done American families a disservice. They’re adamant that half of all kids with these difficulties are not being diagnosed, and those like Samantha — who lack focus but don’t exhibit other behavior that attracts notice — are the most likely to slip through the cracks. (Often confusing is the clinical diagnosis for Samantha’s problem: ADHD, predominantly inattentive type. In other words, she has a hyperactivity disorder without the hyperactivity.)
The latest thinking is that lumping the two kinds of kids — the fidgety ones and the unfocused ones — together under the same diagnosis is actually preventing children like Samantha from getting the help they need.
“The problem is that the disorders sound like cousins, but the research indicates they are completely distinct and unrelated problems,” says Richard Milich, Ph.D., professor of psychology at the University of Kentucky, Lexington, and a prominent researcher on ADHD. “(An inattention issue) may not be a behavioral but a learning or developmental disorder. We don’t know where it fits — but it’s not, as previously believed, with ADHD.”
It’s a theory that’s grabbing attention. Russell A. Barkley, Ph.D., an ADHD specialist at the University of Massachusetts Medical School at Worcester, has even proposed a new name: focused attention disorder.
Still, even as researchers dig deeper, parents and teachers often fail to recognize the condition. Here’s what you need to know.
Spotting The Struggle
Richie Whitman’s difficulties began in the third grade. When reading, he couldn’t focus on long passages. He was easily distracted, his backpack looked like a trash can, and he often forgot to hand in his homework.
“Inattentive kids are in their seats, but they’re in another world. They have to go over material three, four, five times to answer questions,” says Clare B. Jones, Ph.D., a diagnostic specialist. According to Jones, these youngsters are extremely forgetful — to the point that they can’t seem to remember to feed the dog even though it’s a daily chore or will raise their hands but forget the answer when the teacher calls on them. And, significantly, they look like daydreamers. (For more, see “Pinpointing Attention Problems.”)
Other kids may call them couch potatoes or airheads. “Some common symptoms in these children — being sluggish, lethargic, or spacey — aren’t even listed in the official diagnostic manual,” says Caryn L. Carlson, Ph.D., associate professor of psychology at the University of Texas at Austin. In the past, inattentive kids were often targeted as lazy and unmotivated. But most need a cure, not criticism.
“It’s essential that these children’s problem be diagnosed as a true impairment — not a lack of motivation — so they can be helped,” says Rosemary Tannock, Ph.D., senior scientist with the Research Institute of the Hospital for Sick Children in Toronto. That’s one reason these kids have been going unnoticed: Even caring teachers often fail to see that it’s a matter of “I can’t” rather than “I won’t.” And attention troubles are even less likely to be perceived in girls, in part because such problems are assumed to be a guy thing. “What gets a boy tested often gets a girl corrected: ‘Sit up, try harder,’” says Jones.
Growing up on Long Island, Rose Nicolosi’s* daughter Marielle* was a sweet, albeit shy, girl. But when Marielle stopped at her locker between classes, she’d lose track of time and end up needing a late pass; her grades were disappointing despite painful amounts of effort. As often happens, her attention deficit wasn’t discovered until later, when Marielle was in middle school.
“My daughter has tremendous self-esteem problems because of this disorder,” says Nicolosi. “Just having a diagnosis has been a help.”
Being blamed for behavior like Marielle’s — and riding a downward spiral of negative self-worth — is one of the most devastating effects of undiagnosed attention issues. Tammy Amoroso, a mother in Phoenix, learned that she had the disorder at the same time as her 8-year-old daughter, Ashley. Amoroso looks back on her school years with regret. “The other kids laughed at my mistakes,” she says. Her insecurities were so overwhelming that, when she finished high school, she turned down an acceptance to design school. Today, she’s getting treatment alongside her child.
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