Tuesday, April 20, 2004

ADD and medication

It is a subject of contentious debate whether or not Attention Deficit Disorder should be medicated. Some even dispute its reality as a disorder, claiming that it is just a fancy word for the normal behavior of children (particularly boys) or is the result of parents failing to instill discipline in their children.

I seem to have left my crystal ball at my office, so I can't determine for sure which side is right. But I can share my own experiences, anecdotal as they are.

When I was a child, it was difficult for me to focus in school. My parents, it should be said at this point, are some of the best there are. When I was young there weren't any Game Boys, and I was highly restricted in the amount of TV I was allowed to watch. My mom, an elementary school teacher, always provided us with mentally stimulating games and toys. But I was having problems in school. The teacher noticed that I wasn't able to complete my assignments and wouldn't focus on tasks.

Nowadays, I probably would have been sent for testing or sent to a psychologist or something. But my teacher came up with something really clever. Instead, she taught me how to knit, and allowed me to knit in class.

Knitting did amazing things for me. For once, I was able to focus only part of my mind on the school task, leaving the rest of it to be mesmerized by the repetitive motion of the knitting. I started doing better in school and being able to complete my tasks.

I knitted and crocheted my way through high school and college classes. My later teachers were always suspicious of my knitting in class, and would often surprise me with questions to try to catch me not paying attention. But I always was able to answer their questions right away. I never took notes. The items I made were mnemonic devices, like the knitting of Madam deFarge. They enhanced my memory.

I gradually learned to control my attention without the handwork. My graduate classes were very small, so I thought it would be rude to knit in them (no one can see you knit in a 300-person lecture hall). But whenever I found the material difficult and noticed my focus slipping, I would get out two pencils and make knitting motions with my hands in my lap, under the desk.

I've noticed that Sonshine, who is four, behaves in many of the ways that might get him labeled with ADD or ADHD when he gets to school. However, I've also noticed that his behavior is changing over time as he learns discipline and self-rule. I've found that little things are highly effective in encouraging him to control himself. If I spend five minutes each morning just cuddling him and touching him (rubbing his back, etc.), if I make sure to provide him with a time to run and play and a creative time to do whatever he decides to do, if I provide him with swift correction and clearly communicate that this is the opportunity for him to adjust his attitude before he receives a time-out or Manual Attitude Adjustment (a.k.a. spanking), he behaves much better during the day. The preschool he goes to follows the same principles, with the exception that he doesn't get spankings there. If he's allowed to just run wild, as unfortunately he sometimes is during heavy grading times, it only gets worse over the succeeding days. Even under the best conditions he still jumps off the furniture before I can catch him, and he often walks through parking lots waving his head around like he's mentally retarded (he says he likes the way his head feels when he does this). But people are always commenting on what a well-behaved child he is. So I think parenting may be a valid part of the picture when it comes to these kinds of behaviors.

I won't rule out that there are children who are legitimately helped by drugs like Ritalin. I don't know enough about the brain to rule out as a possibility the idea that children might have actual brain dysfunctions. But I do think there are likely lots of children like Sonshine and myself, where all they really need is a little creativity or a little discipline.