Attention Defecit Disorder By Jim Jacob Discovery BBS 818-353-0770 In 1902 a doctor named

                   Attention Defecit Disorder



                          By Jim Jacob



                          Discovery BBS



                          818-353-0770





     In 1902 a doctor named Still describe children who had behavioral

problem which he termed "defects in moral control" and he recoginzed

that the condition occurred more commonly in boys.  He described the

childern as having conduct disorders and poor attention.

     The discovery of the "paradxivcal quietening effect" and marked

behavioral and school improvement of hyperactive childern treated with

Benzedrine in 1937.  This find may have influenced the selection of

the term of "Minimal Brain Dysfunction."

     In 1959 Knobloch and Pasamanick, who compared birth history of

500 childern referred for behavior problem with a matched control

groups of 350 children from the same socioeconomic group and found

that the behavoir disordered children had significantly more

complications of pregnancy and that most common behavioral syndrone

was hyperactivity.

          Below is a brief historical highlights:

          1.  The discription of the syndrome is not new in

          the medical literature and appeared as early as

          1902.

          2.  The interaction between organic factors and

          the environment in the perpetuation of the

          behavioral syndrome was recognized in the 1930's.

          3.  The terminology of the syndrome has changed

          over time from MBD to Attention Deficit Disorder.

          (Hyperactive Childern Grown Up, Grabrille Weiss

          and Lily Trokenberg Hechtman).

     Within the past 20 years the condtion has become the most-

researched and best known of the childhood behavior disorders.  It is

the most common single condition referred to child psychiatry clinics. 

The condition is severe enough to be very distressing to teachers and

parents.  In 1960's the use of stimulants drugs began to help

behavior.  In 1970's discovery that hyperactive child syndrome was not

limited to childhood, and that children do not necessarily outgrow

this condition.  The fact of psychiatric and social impairment and

continuing into adolescence and adulthood was established.

     Finally, attention deficit disorder (ADD), has become the

established, current name.

     It can take a long time to diagnose attention-deficit

hyperactivity disorder.  It effects one in five school age childern. 

In the past it was assumed that after puberty it would disappear,

which in today's research is not necessarily true.  Three things are

giving hope to adults with attention-deficit hyperactivity disorder:

          1.  Early intervention

          2.  More of the population becoming aware

          3.  Researchers are beginning to focus on the

          underlying causes of this disorder.

     Identifying the child with attention-deficit hyperactivity

disorder has become easier.  These are inability to sustain attention,

impatient, impulsive, and nonreflective.  There often is a lack of

social skills.  Other disabilities may be present, including conduct

disorder.

          The American Psychiatric Association states the

          essential features of ADD as:

          

          ADD With Hyperactivity

               Inattention

               Does not finish tasks

               Does not seem to listen

               Is distractible

               Has diffculty concentrating on tasks

               Has difficulty sticking to play

               Impulsivity

               Acts before thinking

               Shifts from one activity to another

               Has difficulty organizing work

               Needs much supervision

               Often calls out in class

               Has difficulty awaiting turn

               Is restless during sleep

               Is always "On the go"

               Onset:  Before 7 years of age

                  (Usually by 3 years)

          ADD Without Hyperactivity

               As above, except for the absence of

               hyperactivity.

     There are many approaches to therapy with a child showing ADD. 

It is geared to a a child's particular needs.  Almost always, the

child with ADD is treated through educational management.  The more

individualized education and positve approach is best for the child. 

Having least amount of distraction in class by sitting near the

teacher can be of great help.  Short sessions of work with regular

breaks seems to work well for the child.

     Medical management is often a essential part of ADD treatment. 

It should not be the only treatment.  Treatment with drungs such as

dextroamphitamine, methylphenidate, or pemoline depends on the degree

of ADD in academic and social activities.  The drugs should be given

only after extensive discussion with the child's parents and school.

     Medical history, findings on examination, or the results of

laboratory testing will not show the child's reaction to medication. 

An appoved questionaire for parents and teachers should be used to

determine a child's behavior.  This can assist the health care

professional in determining whether to treat a patient with

medication.  Follow-up reports are important to keep track of the

child's progress.

     Beacause some ADD childern have poor motor control, they can be

helped through physical education.  If a child is gifted in sports,

running most common, it should be encouraged by professionals.  This

is a socially accepted form of self-expression with no limits and

builds good self-esteem.

     Psychotherapy is widely used with medical treatment in children

with ADD.  The child should be shown that medical treatment cannot

correct all problems but to increase personal control of behavior help

along with medication.  In this situation parents need to have

counseling as well.

     There is a strong genetic infulence in attention-deficit

hyperactivity disorder.  In recent years several studies have been

done with family and twins to suggest this disorder is hereditary. 

One of the studies was done by David Comings, M.D., director of the

Department of Medical Genetics at the City of Hope Medical Center.

     New research attached to genetics include theories about children

with attention-deficit hyperactivity disorder will have more genetic

problems.  Research also shows systems play a central role in ADD. 

This research was done by Bennett and Sally Shaywita.

     Reports of reduced concentrations of homovanillic acid (HVA) in

the cerebrospinal fluid of children with ADD suggest adnormalities

in central dopaminergic system.  This new research seems to not

support the other theory call lag theory.  This theory states children

with attention-deficit hyperactivity disorder (ADD) are behind their

peer but not different in any important ways.

     Whatever the causes, today about at 3%  worldwide if the average

amount of children with the desease.

     In the past 15 years more and more interest in ADD has taken

place.  Whatever the location, it is likely this interest will

continue, so research can go forward to find the best ways to treat

this common problem.