ATTENTION DEFICIT DISORDER (ADD) WITHOUT HYPERACTIVITY
This is now regarded as one of the three sub-types of ADHD. Children find it very hard to concentrate, are easily distractible, abnormally tired and may indulge in a lot of daydreaming. They do not have the hyperactivity, behavioural difficulties and impulsivity typical of children with ADHD, but they find it very hard to perform at an acceptable level in the classroom and homework is usually a struggle. Diagnosis is often made if the child has difficulty with at least six of the following symptoms of inattention:
Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
Often has difficulty sustaining attention in tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork or other tasks (not due to oppositional behaviour or failure to understand instructions).
Often has difficulty organising tasks and activities
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
Often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books, or tools)
Is often easily distracted by extraneous stimuli
Is often forgetful in daily activities
These symptoms must have been present for a least six months, and have been evident before the age of seven both at school and at home.
Children with ADD share most of the underlying factors of Attention Deficit Hyperactivity Disorder (ADHD), but because they are not challenging and disruptive they do not have as many difficulties in school. Oxygenation is often a problem, so they can often be seen yawning; blood sugar levels may fluctuate, so a diet that induces slow release of sugars is beneficial and they can react to artificial additives, preservatives and certain foods. There are always a number of sensory integration issues which affect central auditory processing, visual processing and brain integration. The combination of difficulties results in them not having enough energy to bring to a learning task and they are very easily overloaded. The consequences of their disorganisation and forgetfulness add to their difficulties.
Suggested action
It is important to come to a full understanding of the causes of a child’s attention problems. We find that there are always significant sensory integration issues holding the children back but because the child often has no difficulty with the mechanics of reading and spelling it is assumed the child is just lazy. There are often metabolic issues, but these never exist by themselves. Use all the information in the website to get a full picture.
Case Histories
AIDAN
Presenting problems
Aidan was nine years old and could not concentrate. He had an average IQ, with appropriate ability in maths and literacy skills and no obvious memory problems. He found reading very tiring however, and there were also a number of maths related difficulties despite reasonable scores in testing. He found it hard to focus his attention in all his lessons, but particularly maths and geography, and showed little desire to participate in any aspects of school life. He was tense and anxious, argumentative, socially immature, and despite being a friendly boy he did not have any close friends. He was emotionally oversensitive but also over-reacted to some sounds and tactile sensations. His continuing problems with asthma and hay fever suggested an oversensitivity to inhaled stimuli too.
Assessment
When he was assessed it was apparent that Aidan was having great difficulty with oxygenating the cells he needed for the tasks he was presented with. He immediately started yawning, looked tired and was asking if he could stop before the end of nearly all the tasks. He had a particular problem with anything involving listening skills. He had a very slow speed of processing, poor ability to locate the source of a sound, very poor short-term memory skills and great difficulty with sound discrimination if there was any background noise. He also found writing and drawing very difficult. His handwriting speed was very slow, he had little idea of punctuation and he adopted an immature claw-like grip which would make things very difficult. His visual motor skills were very poor - he said the test (copying geometric shapes) made his tummy hurt - and his drawings of people (a measure of his awareness of 'body in space') were like those of a much younger child. He had no established eye dominance and poor eye teaming ability, so his visual processing was also immature.
Progress
Aidan's self-confidence had been destroyed by a previous school, so his progress was initially quite slow. Six months after the start of the programme there was little change in his concentration, at school although his maths was getting better. We were measuring definite improvements in his speed of auditory processing, but he was very inconsistent in other tests. As time went on he was not as tired, but his asthma and hay fever were causing a lot of problems and his concentration was no better.
It was well over a year after the programme started that Aidan really began to improve. His eye dominance had established properly in his right eye some months before, which would have made it much easier for his visual system to mature. His concentration was much better, he was trying very hard and the school were seeing remarkable improvements. His grades had all gone up, he was much better at doing his homework. He was doing very well at football and his asthma was so much better that he no longer needed medication. He was at last beginning to shine in some areas of the curriculum.