There have always been children who are difficult at home and in the classroom. They are not brain-damaged in any way, nevertheless they are children with a learning disability, children who have difficult in learning the normal way. These are often the brightest in the class, yet their reports regularly have comments like "could do better," "has not achieved his full potential," "is inclined to be disruptive and disturb the class," "a chronic dreamer." Most of us have met little boys who bang into things, climb on the furniture or to the top of trees and lamp posts, beat up siblings and answer back.
Although they may have an above-average IQ, these children have become failures by the time they leave school. They have trouble attending to one subject for very long; they are fidgety and find it hard to sit still and are terribly distractible. They are often impulsive and act without considering the consequences. Some, particularly girls, can sit still, but spend all their time day- dreaming. Teachers reprimand them constantly and parents try to encourage, or alternately scold them, to no avail. They determine to improve, but the determination lasts less than a day. It seems they cannot help themselves.
About a hundred years ago, a British pediatrician, G. F. Still, gave a series of lectures to the Royal College of Physicians. He described some children in his practice who were obstreperous, dishonest and willful. They were difficult to control and showed signs of lawlessness. He argued that these children were not the result of bad parenting, but their condition was due to an injury at birth or biologically inherited.
When I was a very small child, we had a book called Struvelpeter which had horrific cautionary tales in rhyme. They perfectly describe this type of behavior, as is evident in this example:
The Story of Fidgety Phil
"Let me see if Philip can
Be a little gentleman.
Let me see if he is able,
To sit still for once at the table."
Thus, Papa bade Phil behave,
And Mama looked very grave,
But fidgety Phil -- he won't sit still,
He wriggles, and giggles,
And then, I declare,
Swings backwards and forwards
And tilts up his chair,
Just like any rocking horse.
"Philip, I am getting cross!"
See the naughty, restless child,
Growing still more rude and wild,
'Til his chair falls over quite,
Philip screams with all his might,
Catches at the cloth, but then,
That makes matters worse again.
Down upon the ground they fall,
Glasses, plates, knives, forks and all.
How Mama did fret and frown,
When she saw them tumbling down!
And Papa made such a face,
Philip is in sad disgrace.
Until about forty years ago, when the hyperactive child syndrome was first separated from any notion of brain damage, researchers continued to see the symptoms as part of a physiologic hyperactivity, whose causes were rooted in biology, rather than in the environment. Then, about ten years later, while research into the disorder increased, a new label was coined for these children: Attention Deficit Disorder, commonly known as ADD. Some researchers gave it a longer name: Attention Deficit Hyperactivity Disorder, or ADHD.
Needless to say, parents of difficult children clutched at the diagnosis with great relief. At least now it had a name. And there are millions out there, just like him. The intelligent toddler who could never sit still for long. He started school and although he never seemed to listen, his innate intelligence helped him along. He went to yeshiva ketana and although the first week or two seemed to be fine, he never listened, lost his chavrusos and was a failure. He was always late, or didn't turn up at all because he forgot. He was often angry or depressed. He was always looking for new happenings or exciting stimuli, and drove his parents to distraction.
A brain damaged child, and also one with ADD, does not have many friends. To make friends, you have to pay attention, to listen to others. To get on well in a group, you have to be able to follow what is being said in the group. Social cues are often subtle: the raising of eyebrows, a slight change of tone of voice, narrowing of the eyes, in fact, any sort of body language, which a person with ADD often misses. His distractibility or impulsive behavior may lead to a lapse in social behavior or real social gaffes. Peers will deal with him mercilessly, and he will not be accepted by the group, nor obtain understanding from a friend.
Most children are distractible, restless and impulsive at some time. ADD has become a fad with some physchologists who see it everywhere. But if a child really does have ADD, it is of great importance that the diagnosis is made as early as possible. These children are misunderstood and labeled lazy, defiant, odd or `terrors.' Once ADD is diagnosed, the clashes with parents, accusations and recriminations will cease. Parents recognize it as a learning disorder and are more supportive and less critical. This is already half the treatment and cure of ADD.
One third of these children seem to outgrow their difficulties. But two thirds of adults who showed the symptoms as children still have to live with ADD. Most of them do not even know they have it. They are extremely exasperating to those around them, live lives of underachievement, unfinished tasks, never achieving what they set out to do. In fact, they feel, and often are, failures. In former days, before the term was invented, the `wild' or `naughty' child either turned into a wonderful adult, or a feckless one.
According to psychologists, millions of adults have ADD. They are chronically disorganized, anxious or depressed; they procrastinate and have trouble with close relationships. They have many symptoms which most of us suffer from at some time or other, but theirs are chronic. ADD, according to British psychologists, is far more common in the United States than in England. There is no definite test for ADD; no blood test, CAT scan, PET scan or X ray. There is not even a psychological testing score.
So how do they diagnose ADD and come to the correct conclusion? And how do they treat it? This will be discussed at some future date. There are dozens of books on the market for the interested reader, and for one who feels s/he might be suffering from ADD.