Chicago Community Kollel Interactive Parenting Column #5

Shmuel:

As we noted in last week’s column, A.D.D./A.D.H.D. (Attention Deficit Disorder), in the broadest sense, is the difficulty or inability of an individual to sustain the level of concentration necessary to function properly – in school, at work, or in other arenas of social interaction.

As you explore the possibility that you son may have ADD, it is important for you and your wife to collect as much information as possible. To begin with, spend some time objectively observing your son and see if he is exhibiting the standard symptoms of A.D.D. during his time spent out of school.

In particular, try to answer the following questions:

• Is he fidgeting or squirming often?

• Is he interrupting others regularly during conversation?

• Is he very easily distracted?

• Does he have difficulty finishing tasks or chores?

• Does he speak very rapidly?

If the answer to some or all of these questions were a resounding yes – it would be a prudent move to follow up on the rebbi’s recommendation and get your son evaluated for ADD. Should you wish to engage in additional due diligence before moving forward with testing your son, you may wish to use one of the [more precise] assessment tools that are readily available. For example, the Washington D.C.-based American Psychiatric Association lists 14 attributes of ADD/ADHD, of which at least eight symptoms must be present for a child to be officially classified as ADD or ADHD. Simply review them and check them off as you go:

1. ___ Often fidgets with his/her hands or feet, or squirms while seated.
2. ___ Has difficulty remaining seated.
3. ___ Is easily distracted by extraneous stimuli.
4. ___ Has difficulty awaiting turn in games or group activities.
5. ___ Often blurts out answers before questions are completed.
6. ___ Has difficulty following instructions.
7. ___ Has difficulty sustaining attention in tasks or play activities.
8. ___ Often shifts from one uncompleted task to another.
9. ___ Has difficulty playing quietly.
10. ___ Often talks excessively.
11. ___ Often interrupts or intrudes on others.
12. ___ Often does not listen to what is being said.
13. ___Often forgets things necessary for his/her tasks or activities.
14. ___Often engages in physically dangerous activities without considering possible consequences.

Please note that although some of these attributes may seem similar, they are not exactly the same. It is also important to note that ADD/ADHD diagnoses are further broken into three (there are actually several additional sub-types, but that is beyond the scope of this article) specific categories, each with its specific clinical presentation that better describes a child’s behavior:

1) Hyperactive/Impulsive Type (classic Attention Deficit Hyperactive Disorder),

2) Inattentive Type (classic Attention Deficit Disorder), and

3) Combined Type (a combination of inattentive and hyperactive).

The most common type of ADD/ADHD is "Classic ADHD." This "bouncy" type is also the easiest to diagnose. People with Classic ADHD fidget, squirm, and talk often and loudly. They can’t sit still, are impulsive and they have more than enough energy to spare. The Inattentive Type, on the other hand, is the second most common, but is the sort that most often slips through the cracks. These are generally pleasant people to be around but are forgetful and seem to be ‘daydreamers.’

Getting Assessed

While educators are often the ones who recommend children for ADD/ADHD testing, it is very important to bear in mind that only competent, credentialed professionals are qualified to actually make the actual diagnosis and suggest medication (when appropriate).

There are generally two routes to take in order to evaluate your child for ADD/ADHD. One would be to get an ‘evaluation’ from your local school district. Most school districts in the United States offer free educational/psychological assessments of students – including those who attend non-public schools. Your child’s principal or the director of special services can, in all likelihood, direct you to the appropriate office to arrange for an evaluation to be done. If you are finding it difficult to access district services, consider contacting Mrs. Leah Steinberg, Director of Agudath Israel’s Project LEARN (Limud Education Advocacy and Referral Network). LEARN helps parents navigate the path from determining that their child has special education needs to obtaining the services that they are entitled to by law. Mrs Steinberg can be contacted at (212) 797-9000, ext. 325, or via email at lsteinberg@thejnet.com.

Another route to take would be the medical one. Speak to your pediatrician and ask for a recommendation to a pediatric neurologist or a physician who specializes in attention deficit.

© 2006 Rabbi Yakov Horowitz, all rights reserved