Up Close With Dr. E

Diagnosing AD’s


Attention Disorders occur in about 7% of school-aged children, and boys are diagnosed 10 times more often than girls. Two-thirds of all children diagnosed with an AD will retain core symptoms throughout their life.

AD’s are caused by genetic, or inherited factors, so, it is not uncommon to find families where a parent has an AD, as well as one, or two of their children. The term Attention Disorder is used as the broader name for Attention Deficit Disorder without Hyperactivity and Attention Disorder with Hyperactivity. The identification of AD’s is the focus of today’s article. The hope is that by educating you, you can, in turn, help your own children or adult family members who might be struggling with an undiagnosed AD. It is critical that you understand that undetected, and untreated, AD’s destroy lives. Having an untreated AD places one at risk for the following: school failure, substance abuse, divorce, depression, jail and a life of underachievement and unfulfilled hopes and dreams. How, you ask?

We, those who do not have AD’s, take for granted our ability to listen, focus our attention, remember what we have studied on test day, and make and achieve goals. For people born with an AD, basic cognitive (thinking) tasks are impossible. AD people who are undiagnosed and untreated cannot set a goal, motivate themselves to finish a goal, or “keep their eye on the ball.” Another more serious problem for them is their inability to restrain impulses. Impulse control is the “master skill” needed for the regulation of all emotions and behaviors. Imagine being 6 years old, sitting in a classroom, with your impulses telling you to stand up and start stretching your muscles, walk around, talk to your friend, make a paper airplane and send it flying, and, to your own amazement, you do all of these.

Two problems plague AD sufferers. The first is the havoc caused by the core symptoms of their condition. The second is more subtle. Every person, regardless of age, sex, ethnic origin or nationality, has a private and deeply personal relationship with themselves. This relationship makes daily evaluations, such as, “Am I a good person, Am I capable, Do I like myself?” So, imagine, since the age of 4, you have been constantly in trouble, confused, or having to re-do homework, or losing assignments, or unable to control your emotions. How do you explain all of these shortcomings to yourself? Here is how: “I’m not like others, I’m not capable, I’m worthless.”

Defining and explaining one’s life around an undetected AD is a nightmare. However, re-defining one’s life, after an accurate diagnosis of AD, is an inspiring dream. Let us learn how to identify AD’s by listing their core symptoms:

1. Hyperactivity (H). Driven as if by a motor, squirmy and restless.

2. Impulse Control (IC) problems. Unable to stop, think, and restrain emotions and behaviors.

3. Poor concentration and disorganization (PC). The inability to focus attention and organize.

4. Motivation (M) problems. Unable to finish a task.

Using these core symptoms, let’s get to know Joe, 28, a mechanic who has an undiagnosed AD. I will put in parentheses which core symptom he has.

Joe is an expert at fixing car engines. He works at a large dealership and is respected for his skills. But, whenever his boss talks to him, Joe ends up yelling (IC), and is unable to control his temper (IC). If he has too many cars to fix, he becomes overwhelmed and mentally scattered (PC), and cannot prioritize his work (PC). This leads to arguments with co-workers (IC). On a good day, Joe, because of his workaholic pace (H), can fix more cars than any other mechanic. Customers ask for him when they schedule maintenance. Unfortunately, his work is erratic (M), and his mood shifts (IC) make him unpredictable (IC). At home, he interrupts his children, walks away from his wife while she is talking, and is rude, angry, and makes his family walk on eggshells (IC). At night, he is unable to turn his mind off (IC), so his sleep is disrupted. He is unable to balance his checkbook and is late for appointments (PC). He has begun to feel discouraged and sad but can’t link his sadness to any cause (PC). He has been drinking more, and his wife is worried he will become addicted.

If Joe does not receive quality treatment, his AD will destroy his marriage, his relationship with his children, his job, and his belief in himself. What would Joe look like with effective treatment of his AD?

Now 35, Joe just had his first bank loan approved, so his family can move outside the city into their new home. He is deeply involved with his children. He sleeps well and rarely drinks alcohol. He was promoted at work, and recently completed training in new methods of foreign car repair. In his garage are two old clunkers; cars he will use to teach his two children how to repair and drive.

The content of this article is for educational purposes only, not treatment. The characters in this story are not real. Names and details have been changed to protect confidentiality.


Dr. Richard Elghammer contributes his column each week to the Journal Review.


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