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Understanding and Managing Attention Deficit Disorder

There is a lot of misinformation and misunderstanding surrounding the term Attention Deficit Hyperactive Disorder (ADHD) and Attention Deficit Disorder (ADD). Despite the emphasis on attention disorder, attentional problems are only part of the issue. I prefer to view this as a regulation disorder. These youngsters are generally diagnosed between 4 to 17 years old. Boys tend to be identified most frequently with ADHD(13%), and girls with only 5.5% and mostly with ADD. The regulation disorder certainly includes inattentiveness, distractibility, or difficulty focusing on the task at hand. However, parents and teachers also understand many other symptoms are present. These include: a struggle to organize their efforts, difficulty sustaining their effort or motivation, taking short cuts/not completing a task, rushing through a task, acting or reacting impulsively with little regard for the consequences, and an inconsistent ability to profit from experience (poor understanding of cause and effect relationships).

Unfortunately, these children are sometimes viewed as lazy, or lacking will power or self discipline. So why can they spend hours on a video game, but forget homework, resist chores or can never find anything? The short answer is that electronic activities are highly stimulating and motivating due to its entertainment value. The general world is not so entertaining. Doing homework or chores is not usually a high value target! Therefore, the inability to regulate focus, to sustain motivation, and to organize behavior is not fully developed with these children. Some research suggest a developmental lag of up to 30%.

Researchers do know that ADHD is a brain chemistry and genetic disorder. The full understanding is still lacking. So it is clear the child with ADHD cannot simply will or self determine him or herself to constantly focus anymore than a child with Type 2 Diabetes can will their pancreas to regulate insulin production. Despite the chatter about this being sugar/ diet determined, no significant research supports this as causative. Healthy eating is a good idea, but not a cure for ADHD.

The formal diagnosing for ADHD must include a medical review, psycho-educational evaluation, and observational input from parents and teachers. Once this information is gathered, a determination can be made for a proper diagnosis. Sometimes ADHD can be a singular issue or it can be part of a more complex circumstance. These children may also be struggling with anxiety, depression, or a deeper conduct disorder.

The treatment package for ADHD typically includes medication, teacher/school accommodations, and parent education. It is important that ADHD children are provided with daily structure. Such an approach includes: clear expectations and consequences, checklists, frequent feedback, consistent follow up and enforcement of the task, and daily support for the effort to struggle and achieve the goals established.

Dr. McGee is the director of Family Guidance Centers and has been in private practice for over 35 years. For a more complete view of his practice, please visit

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