WHAT ABOUT A.D.D.?

     Section I of this discussion is a compilation of information taken directly from Web M.D. Medical Encyclopedia and other resources. It has been paraphrased and edited for the sake of order and clarity.

     Section II of this discussion will be commentary on A.D.D. and related behavioral problems from a Biblical perspective.

Section I:

INFORMATION FROM WEB M.D. MEDICAL ENCYCLOPEDIA AND OTHER RESOURCES:

While A.D.D. (Attention Deficit Disorder) is still a very common term to describe certain behavioral problems among younger children, teens and adults, the more common term is A.D.H.D. (Attention Deficit Hyperactivity Disorder). A.D.H.D. is a form of A.D.D. where the primary problem is hyperactivity rather than inattentiveness.

A.D.H.D. is defined as  a behavior disorder with symptoms that begin in early childhood and can continue into adulthood, causing difficulties at home, school, work and within the community. (It is estimated that anywhere from 3-7% of children have A.D.H.D.)

SYMPTOMS OF A.D.H.D.:

Inattention - One who experiences A.D.H.D. may be unable to focus, remember or organize; may be careless and have a hard time starting and completing tasks that are boring, repetitive or challenging.

Impulsiveness - One who experiences A.D.H.D. may act before thinking, not make sound judgments or solve problems well; may have trouble developing and maintaining personal relationships.

Hyperactivity - One who experiences A.D.H.D. may squirm, fidget, climb or run when not appropriate; may have difficulty playing with others; may talk a great deal and not be able to sit still.

CAUSES OF A.D.H.D.

It is not clear what causes A.D.H.D. It is known that chemical balances in the brain affect temperament and behavior.

The risk of suffering from A.D.H.D. is increased when mothers drink, smoke, or use drugs during pregnancy and when the child faces stressful family situations.

PREVENTION OF A.D.H.D.

There is no known way to prevent A.D.H.D., but it might help to avoid alcohol, drugs and smoking during pregnancy.

MINIMIZING THE PROBLEMS OF A.D.H.D.

Though A.D.H.D. is not preventable, the problems can be minimized via:

1.Good medical care and health habits during pregnancy.

2.Learning and applying good parenting skills  including setting consistent behavior limits.

3.Maximizing preschool learning by reading to children and providing new learning experiences.

4.Using nurturing techniques

a. Frequent physical contact (touch and hold your baby as much as possible) especially during the first six months.

b. Limit exposure to the TV.

c. Choose age appropriate toys  especially toys that stimulate the brain  books, blocks, puzzles.

d. Encourage child to play  sometimes alone, sometimes with you.

e. Make sure child gets enough sleep and rest.

f.  Encourage child to eat healthy foods  limit sugar and fat.

TREATMENT FOR A.D.H.D.

There is no cure for A.D.H.D., but the symptoms can be controlled. Treatment includes the use of various medications. Some benefit can come from Socialization Training and Behavior Management.

I. Medications

a. Antidepressants

i.   Pamelor

ii.  Aventyl

iii. Tofranil

iv. Wellbutrin

b. Antihypertensives

i.   Catapres

ii.  Texex

c. Psychostimulants  This is the most common treatment for A.D.H.D. Treatment is based on the theory that there are chemicals in the brain which are produced by nerve cells. These chemicals are called neurotransmitters. The nerve cells send messages back and forth           across the space between the cells. This process is called Synapse. Certain  neurotransmitters (chemicals) are believed to play a role in mental functioning. They  include Serotonin, Norepinephine, Dopamine, and Gamma -Aminobutric Acid (GABA).    When the chemicals are out of balance people can experience headache, depression, or  other health problems. Psychostimulants increase the synaptic activity of the neurotransmitters (chemicals)

i.   Amphetamines such as Dexedrine or Adderall

ii.  Methylphenidate  Brand names include Ritalin, Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin LA, and Ritalin CR.

1.  Methylphenidate is a mild stimulant to the central nervous system (brain and nerves).   The exact way it works is unknown. It may cause drug dependence.

2.  Overdose of Methylphenidate may produce agitation, tremors, seizures, confusion, hallucinations, sweating, headaches, fast or irregular heartbeat.

3.  Serious side effects include allergic reactions of difficulty in breathing and closing of  the throat, fast or irregular heartbeat, very high blood pressure, or liver damage.

4.  Less serious side effects include insomnia, nervousness, drowsiness, dizziness, headache, blurred vision, tics, abdominal pain, nausea, vomiting, decreased appetite, weight loss, and slowed growth.

II.  Socialization Training and Behavior Management

a.  Behavior Therapy

i.  Establish routine for children.

ii.  Establish rules for behavior.

iii. Give rewards or consequences depending on compliance.

iv. Train in social skills.

1.  Teach child to listen and engage in conversation.

2.  Teach child how to enter into new group situations.

3.  Teach child how to give and receive praise and criticism.

4.  Teach child how to cope with frustration.

b.  Behavior Management.

i.   Encourage good behavior through praise and rewards.

ii.  Allow natural and logical consequences for bad behavior.

1.  Natural consequence - Going out in cold weather without a coat naturally leads to feeling cold.

2.  Logical consequences - Logical consequences are the consequences we set up to logically follow when a person breaks the rules, values or acceptable behavior.   For example, a child who throws a toy may be required to take a time out, calm down and think about his behavior.

c.  Specific Help for Children Age 5 and Younger.

i.   Beware of the need for routine and structure.

ii.  Tell the child what you expect.

iii.  Use a system of reward.

iv.  Participate with your child in activities  making puzzles, etc.

d.  Specific Help for Children Age 6-12.

i.    Give clear instructions.

ii.   Break tasks down into simple steps.

iii.  Increase reward for good behavior.

iv.  Anticipate times and situations where child might misbehave.

v.   Explain consequences for misbehavior.

vi.  Follow through as soon as possible.

vii. Model good behavior - Be patient, understanding and calm. Avoid angry outbursts.

A.D.H.D. MAY BE ACCOMPANIED BY O.D.D. OR ANXIETY.

One-third to one-half of those who have A.D.H.D. also have O.D.D. or anxiety.

I.  Anxiet-  Anxiety is an uncomfortable feeling of fear, uneasiness or concern about the future. The emotional symptoms of anxiety are:

a.  Being keyed up, on edge and easily startled.

b.  Excessive worry.

c.  Constant sadness.

d.  Reduced ability to concentrate.

e.  Increased irritability or agitation.

II. O.D.D.  Oppositional Defiant Disorder. The symptoms are:

a.  Being hostile toward parents or other authority figures.

b.  Arguing about and possibly breaking rules.

c.  Loss of temper.

d.  Annoying others on purpose.

e.  Blaming others for mistakes or misbehavior.

f.   Being overly sensitive.

g.  Being angry.

h.  Being resentful.

i.   Being vengeful.

*Symptoms must persist over six months and cause significant family problems before diagnosis can be made.

CONDUCT DISORDER

O.D.D. can get worse and lead to Conduct Disorder. Children with Conduct Disorder may have a pattern of lying, stealing, cheating, skipping school, running away from home, harming animals, property or other people.

Section II:

           RESPONDING BIBLICALLY TO THE PROBLEM OF A.D.D. AND RELATED DISORDERS.

While the Medical Community states that 3-7% of children have A.D.H.D., I have been in churches where I have been told that  7 of the 12 kids in this class are on Ritalin and  Most of the kids in our youth group are on Ritalin. In other words, the official message is that a maximum of 7 out of every 100 children may have this problem, but overreacting medical professionals are putting large percentages of our youth population on medication, because they see many children who misbehave. The diagnosis of this problem on local levels makes this a problem of epidemic proportions. It is not unusual for a child to be more active than his peers or for one to be of a quiet nature. Such children should not be marked as having a  disorder. A large variation among children s actions and personalities fall within the range of normal. They should not be quickly labeled as suffering from a chemical imbalance.

It is significant that the symptoms of A.D.D., A.D.H.D., O.D.D. and Conduct Disorder abound in our society. It is equally significant that they are the same symptoms reflective of poor training, poor discipline and lax parenting. These symptoms have multiplied in our society as the family unit has been weakened through broken marriages, single parenting, step family relationships and working moms. These difficult family settings have affected the discipline and training of children. We should not be surprised by growing behavioral problems among our youth.

The medical community claims that it is not clear what causes these problems. They do state rather emphatically that the problems cannot be prevented and they cannot be cured. The Christian recognizes that while certain people may have chemical imbalances, the symptoms of all these disorders are readily produced by what the Bible describes as the sinful human nature. The whole approach of the medical professionals bypasses individual responsibility if we do not know the cause of these disorders and since they cannot be prevented or cured, we cannot hold the child responsible or accountable for his actions.

We are told these disorders can continue into adulthood. It would appear that it would be an injustice to hold these adult victims responsible for their actions. I want to ask who they think they are kidding, but unfortunately our society is swallowing this message hook, line and sinker.

At the root of this issue is our whole view of humanity. If we are highly evolved animals, we can surrender to this whole idea that for some reason this generation, as no other, has developed mysterious chemical imbalances producing abnormal behavior and we must try to develop medications to help the victims. On the other hand, God in Heaven told us that we have been made in His image and likeness. He has also told us that we are both responsible and accountable for our actions. He has told us that we have sinful natures which will produce all the symptoms attributed to the behavioral problems we are discussing. He has told us that people need to be saved and children need to be trained and disciplined. Therein is the pathway to victory over behavioral problems.

In my years of ministry, I have met a few people with genuine chemical imbalances. What is happening today does not match these problems as they have been historically manifested. It would seem that today s theorists have taken us to new levels of humanistic philosophy to justify the collapse of respect for authority among the current generation of young people. And we better be alert, because when they reach adulthood it may only get worse.

The medical community s primary and preferred treatment for these disorders is the use of drugs. At the time of this writing, the preferred drug seems to be Methylphenidate. It is known that Methylphenidate can cause drug dependency and can produce very serious side effects. We wonder why the preferred treatment would not be training in proper behavior. The reason, of course, is that the accepted approach to these disorders treats them as  medical problems and  mental problems. Chemical imbalance is viewed to be the source of the problem and the introduction of drugs, as brain stimulants, is viewed as the answer to the problem. It is said that 70% of those who receive drug therapy improve. We must wonder what the long term effect of drug-induced brain stimulus will be.

What the medical community calls Socialization Training and Behavior Management is a secondary approach to treating these behavior disorders. The recommended procedures offer many good ideas which could benefit many families. Unfortunately, recommended procedures fail to include the necessity of restraint and control of children, which is foundational in Biblical teaching. For some reason the word  NO is left out and there is no conception of appropriate corporal punishment. This is no surprise because once the term  sinful is replaced by the word  sick, the child is no longer viewed as a young person who must accept responsibility for how he acts and treats others. He is now a  patient who needs medical treatment.

A.D.D. and other related disorders are relatively new terms. They are often used to disguise the sinful misbehavior of young people as a sickness. Since the misbehavior is sickness rather than sin, no responsibility can be assigned nor accountability required. There is only examination of the brain and possible chemical imbalance, but no consideration of the heart where foolishness and sin reside. Since the problem is viewed as sickness of the individual, little consideration exists of the impact on the child by the family that may be in turmoil or the lack of training and discipline that God requires. Since the Bible holds people accountable for their actions, we hold serious reservations regarding a diagnosis that blames sin on chemical imbalance and wonder if chemical imbalance may rather be the result of sinful behavior.

Parents are running scared. Worldly philosophy has found its way into the church, and the first thought that comes to mind when we see a willful or overactive child is A.D.D. STOP! I have found few if any situations where A.D.D. and its related disorders have shown up in a family where sound Biblical parenting has been practiced. Don t panic if your child or grandchild seems to be more aggressive than the  average child. Don t call your pediatric psychologist because your child refuses to eat or tried to hit you when you rebuked him for doing wrong. Parents should not accept these actions, but they are sinfulness not sickness.

Get serious about parenting. The first and primary obligation of parents is to find out what the Bible says and follow it carefully in dealing with children. Believe what the Bible says. Proverbs 22:6 states,  Train up a child in the way he should go; and when he is old, he will not depart from it. This verse is for you and your child. Some parents want to believe their case is unique. They believe what the Bible says is generally true, but their child is an exception. It is as if the Lord knew about every other child, but missed the fact that this little guy was going to be born. What He wrote in the Bible is sufficient for all others, but not this one. NO, NO, NO!. The Bible, the very Word of God, will work for you. Not all children are the same and, certainly, not all children are easy, but the end goal for every child is the same. He must be Biblically-trained to get foolishness out of his heart and to get godly wisdom into his heart.

Let others believe what they will. Look at your children as gifts from God and take the charge to train them as a special assignment from the Lord. Do it His way and reap the benefits as stated in Proverbs 29:17  Correct thy son, and he shall give thee rest; yea he shall give delight unto thy soul.