Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

8 Kislev 5763 - November 13, 2002 | Mordecai Plaut, director Published Weekly









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Opinion & Comment
Attention Deficiency and Hyperactivity Disorder

by Chaim Walder

A few weeks ago I was at a particularly loud wedding. You find an open seat right next to one of the orchestra's speakers and you know the night is bound to end with a splitting headache if this keeps up.

People want to talk to you. Not outside. Here and now, alongside the orchestra just as the electric guitarist begins a solo. They have a lot to say, so you cup your hand to your ear, scrunch up your face until your eyebrows nearly touch your chin, tilt your head to the southeast and shout, "What? What's that?"

You cannot make out a single word. At best you may be able to discern the topic of discussion, but that would be the case even if the talker hadn't breathed a word. For the most part you keep nodding your head and making a spiral gesture with your fingers, meaning "Let's talk it over later." At the conclusion of the conversation you say, "We'll talk some more." If the matter is particularly pressing you can say something like, "No doubt about it" or, "You're absolutely right."

Then someone comes over to you and says, "I want to pay you a compliment." Suddenly there is no orchestra, no electric guitar, no drums pounding in your ears. Actually the band plays on, but as far as you're concerned it's miles away. You hear every single word, even if said in a whisper.


I use this description to relate what a child with Attention Deficiency and Hyperactivity Disorder (ADHD) experiences. When we sit in a classroom and listen, various events are taking place besides the class itself. Chairs move, people cough, a cement truck passes by outside, an airplane flies overhead, a fly flits across the room, someone takes out a pen, someone else is folding a piece of paper, a third person is talking to a friend, the table behind you is too close. The one in front, too. Someone passes you a note. One of the fluorescent lights is flickering slightly. There's a strange- looking box on the ceiling. What is it? Part of the electrical system? A hidden camera? The air conditioner is on too high . . .

The vast majority of people neither see nor hear all these events taking place. For them, there is a class being taught. They listen attentively and all else vanishes. The greater their powers of concentration, the less importance the surroundings hold for them.

For a child with ADHD, the surroundings are very important. Not only are they important, but they are also disruptive. Just like an orchestra playing at full volume. They have trouble concentrating on one thing and their attention is scattered, drawn to a myriad of other sights and sounds. To the observer the child seems to have little desire to learn and ignores the teacher.

A child with ADHD has to devote much more energy than a normal child in order to focus on the speaker and to comprehend what he is saying. "Could it be," you may wonder, "that this is entirely beyond his ability?"


The answer is also found in the parable at the beginning of this article. The compliment. Isn't it true that we can hear one even two feet away from the trombone player? Doesn't it sound louder than the electric guitar? For suddenly, we really want to hear. We are able to summon our powers of hearing despite all of the disturbances.

The same applies to the child with an impaired ability to listen and focus. The compliment, in this case, is much more general. I prefer to call it "atmosphere."

The moment the child is surrounded by a "complimentary atmosphere," a loving place, the image of a caring person who demands things of him and understands him, he will find within himself the power to listen, just as we find the power to listen while under attack by an orchestral onslaught.

This is why a child may be diligent and industrious under one teacher, but idle and lazy under another. The power of human will.

By the way, eventually these children develop unusual abilities in task execution due to a lack of faith in their ability to sharpen their powers of concentration. To the rest of us it comes naturally. For them it does not. Some of them succeed in various, sometimes totally unrelated, fields because of their acquired ability to concentrate on both the lesson and the strange-looking box on the ceiling, not to speak of the cement truck outside. Who among us can do four things at the same time? Someone "blessed" with a listening disorder.

I am describing it in endearing terms in order to demonstrate to parents and teachers that the child is not to blame, and to help ensure his ability to function in the future if the situation is handled properly. For the child it is not easy to cope and we cannot make light of the obstacles he faces.

When I encounter a child who begins to take a keen interest in the computer, the printer, the cellphone, the pictures on the wall, who keeps standing up and sitting down, answers questions with long replies adding in questions of his own on other topics that apparently interest him at that moment, who may pick up objects from my desk and ask questions about them, who is curious, squirmy and unsettled -- I advise the parents to look into the possibility that the child has a listening and attention disorder, which in most cases is accompanied by hyperactivity.

A few words on hyperactivity: The initial impression a hyperactive child makes is of an internal impulse that leaves him unsettled. Sometimes this can manifest itself in infancy. And this is further proof that there are side benefits to it as well.

The child gets high marks in motor skills. He starts walking at a young age, he doesn't like to be stuck in a daybed and climbs out on his own. He climbs all over everything to the point of endangering himself. He is not the type who sits in his seat throughout Shabbos meals. In social interactions he tends to touch others unintentionally, often resulting in squabbles. These conflicts take place both at home and at school, at simchas and out in the streets.

Some families are at a loss over how to cope with such a child, and may heap him with anger and accusations. They are sure he is acting this way intentionally. He is not.

In some cases the child is impulsive. He answers questions before they are fully formed, endangers himself through risky leaps and inadvertently running into the street, bumps into things while walking and knocks over objects with quick, reckless movements.


Neurologist Prof. Avinoam Shofar, who published a booklet called "Hayeled im Lakut Hekshev," describes these three problems -- listening disorder, hyperactivity and impulsiveness -- as a cake from which every child receives unequal portions from the Creator.

Some get a large hunk of hyperactivity and just a small slice of listening disorder, which produces a rambunctious child with a quick grasp of new concepts. Or the opposite, a calm, quiet child who has trouble listening and focusing and drifts in a world of his own most of the time. Still others get all three: they are highly active, a bit impulsive and have trouble concentrating.

Hyperactivity and impulsivity disappear as the child matures, but listening defects remain. Hyperactivity tends to worry parents more although it is a temporary problem and only affects the child in terms of technical functioning. The reason for their concern is simple: although listening disorder is a more acute problem it, causes no outward disruption, while hyperactivity is a real nuisance to people in the child's immediate environment. And the immediate environment watches out for itself.

On the other hand often expectations of social tolerance prevent the child from receiving help. Sometimes the child is the one who suffers the most-- even in cases where society shows tolerance towards him. He is struggling to overcome difficulties and nobody does anything to help. Parents should definitely remain open to the option of focused treatment-- including drug treatment--which does no harm and does not cause side effects.

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