John M. Jaquith, M.Ed.
What is ADD and ADHD? Essentially, both of these are labels that describe symptoms. In fact, a list of symptoms is used to identify such children. A child receives a label based on prolonged occurrences of eight or more, out of a possible fourteen, symptoms before the age of seven. These symptoms have been identified as:
- Often fidgets with hands or feet or squirms in seat.
- Has difficulty remaining in seat when required to do so.
- Is easily distracted by extraneous stimuli.
- Has difficulty awaiting turn in games or group situations.
- Often blurts out answers to questions before they have been completed.
- Has difficulty following through on instructions from others.
- Has difficulty sustaining attention in tasks or play activity.
- Often shifts from one uncompleted activity to another.
- Has difficulty playing quietly.
- Often talks excessively.
- Often interrupts or intrudes on others.
- Often doesn’t listen to what is being said.
- Often loses things necessary for tasks or activities at school or at home.
- Often engages in physically dangerous activities without considering the possible consequences.
The label ADD refers to those children who are experiencing attention problems, but who are not hyperactive or impulsive. Such children display a variety of symptoms that can be related to inefficiencies in different areas of their development. Fortunately, developmental problems can be identified, addressed, and often eliminated.
In the development of tactility, there are two common areas where problems can occur. The first one involves the ability of an individual to appropriately process sensations of light touch, pressure and pain, the other involves proprioception. Proprioception refers to one’s knowledge of where his body is in space. If an individual has not completed developing his proprioception, his brain is not likely to know specifically where his body is. Symptoms include: bumping into things, fidgeting or squirming around, and to a degree, engaging in physically dangerous activities without considering the consequences.
To determine if your child has a problem with tactility, ask yourself these questions. Does my child exhibit the above mentioned symptoms? Does she have a high threshold for pain (i.e., not knowing where she got bruises on her arms and legs after playing outside)? Is she inappropriately ticklish (not ticklish at all or so ticklish that she can’t stand to be touched)? If you answered yes to any of these questions, your child may not have completed all of the developmental levels dealing with tactility. These problems can be corrected by providing specific tactile stimulation in order to complete all of the levels of tactile development.
Processing (both auditory and visual) is another area that is often found to be underdeveloped. An individual’s auditory and visual processing affects their short-term memory. If a child has low processing, it may appear that he is not listening to what is being said. The reality is that he is unable to process the information completely. Other symptoms that occur related to short-term memory/low processing include the following: difficulty following through on instructions from others, inability to remain in one’s seat, easily distracted, difficulty waiting for ones’ turn in game situations, problems with sustaining attention or shifting attention from task to task, difficulty playing quietly, and losing things necessary for task completion. Children with low processing can be identified by using a simple technique.
To check your child’s auditory and visual processing levels, you will need to administer a digit span test. To do this auditorily, dictate a sequence of numbers to your child. Say them slowly and in a monotone B about one second apart. For example, say: “6-4-3-7.” Then have your child repeat the numbers back to you in the same order. If she can correctly repeat four numbers in a row, try a sequence of five, then six, and so on. Take note of the sequence length she is able to complete without making a mistake. To test your child’s visual processing, show her sequences of numbers on flashcards. They should be on 3×5 cards, written in dark solid ink, and shown to your child for approximately three seconds. After three seconds, put the card down and have the child repeat the numbers she saw on the card in the same order. Begin with a sequence of three or four numbers and increase the sequence size using new numbers and cards. Take note of how long of a sequence she can do correctly. A three-year old should be able to complete sequences of three numbers (both auditorily and visually), a four-year old should be able to complete a sequence of four, a five-year old five, a six-year old six, a seven-year old seven, and adults should be able to complete a sequence of seven or more. If your child has low processing skills, you can help increase her skills by practicing the digit spans daily, thus increasing the brain’s ability to process information.
Long-term memory problems may also be an issue with children who have received a label such as ADD or ADHD. This is related to a concept known as dominance. Almost everyone is either right-handed or left-handed. In order for the brain to take in information as efficiently as possible, it is helpful to consider if a child is right or left eared, eyed, and footed.
How can you know which is your child’s dominant eye, ear, or foot? This process involves gathering a great deal of information. We’ll start with the hand. Which hand does your child write with? Does he write with this hand all of the time? Which hand does he use to perform other functions with? Which hand does your child use to eat, throw a ball, or brush his teeth with? Is he doing all of these activities with the same hand? If so, which one? If your child does all or most activities with a single hand, it is probable that he has established a dominant hand.
It is fairly easy to observe the foot because it is similar to the hand. Watch your child to see which foot she uses to kick a ball. Observe your child hopping on one foot. Which foot did she use? The foot used most often should be recorded. Also, note if the foot she uses changes consistently. Once you have gathered information about the child’s hand and foot, the eye and ear can be assessed.
We all engage in two types of visual activities. They are referred to as near-point and far-point activities. When visual activities occur close to us (i.e. reading and writing), they are called near-point activities. When visual activities occur at a distance (i.e. watching t. v. or riding in a car), they are called far-point activities. There are several different ways to assess which eye your child is using to take in information.
To assess far point activities, have your child stand across the room from yourself. Point at your child using your index finger with your arm extended. Instruct your child to point back at you in the same way, so that it looks like his finger is touching yours. Observe which eye the child is using to line up his finger with. Have the child switch hands and repeat the exercise. Which eye is the child using to line up his finger with? Does your child switch between eyes? Record this information along with your previously gathered information on the child’s hand, foot, and near-point visual activities.
Gathering information about your child’s auditory dominance is also a matter of observation. Have your child stand directly in front of a door in your home. Next, have someone on the other side of the door say something softly “through” the door. Encourage your child to “lean in and listen carefully” to what is being said. Observe which ear the child is using to listen at the door. Try this a number of times and record what you see.
Once you have gathered this information it is time to examine it all. Notice which side of the body is used for each activity. Does your child use the left hand, left eye (for near and far point), left ear, and left foot? Or does your child use everything on her right side? Is there a mixture (for example, right hand and foot, but left ear and mixed visually)? To use our brains efficiently, we must have an established dominant side. If there is a mixture of some kind, then the brain does not receive, process, store, and utilize information in the most efficient way possible.
Impulsive behavior is another symptom that is commonly seen in children with the ADD or ADHD label. Traditionally, it has been treated with drugs. Two commonly prescribed drugs are Ritalin and Dexedrine. These drugs are prescribed to affect the chemical make up of the brain (more specifically, they raise dopamine levels). The objective is to reduce the impulsivity of the children. An alternative to medication is to take a look at what is causing the impulsivity, and then eliminate it. Many times food sensitivities are found to be an issue.
Food sensitivities are generally not as obvious as allergies, so they are often referred to as hidden problems. Symptoms of food sensitivities can include, but are not limited to: congestion of the nose and throat (which can be accompanied by headaches and postnasal drip), impulsivity, distractibility, hyperactivity, and a short attention span. Trying an elimination diet may be an avenue for families who suspect food sensitivities in their children. Speaking to someone familiar with food sensitivities is a good place to start. There are some other sources listed at the end of this article that may help.
Addressing problem behavior is often another major area of concern for children who have been given labels such as ADD or ADHD. Establishing a positive environment, implementing a solid daily structure, and providing appropriate feedback are all very important components of a successful behavior plan. Depending on the child, it is sometimes necessary to eliminate certain negative behaviors before it is possible to establish a positive environment.
The key to eliminating behaviors is to establish a consistent plan of action. A consequence to the behavior you are trying to eliminate should be thoughtfully chosen and consistently administered. The consequence should be one that a parent feels will work best for their particular child. Prolonged time out is one method that has worked well when implemented consistently. Negative token economy systems (where a token is lost every time the behavior occurs) have also worked well. In this system, once all of the tokens are gone the child’s day is over. Another alternative is to positively reinforce a behavior that is opposite and incompatible to the one you are trying to eliminate. For example, a child can not be doing his chores and be on the floor throwing a temper tantrum at the same time.
Once the negative behaviors have been eliminated, a positive environment needs to be established. A positive environment is one in which four positive statements are given for every one negative. It is interesting for parents to test this out on themselves. For a period of time everyday, keep track on a piece of paper how many negative statements you make compared to how many positive statements you make. Most of us fall short of the optimum positive environment, but you can use this test as a starting point. Continue improving your positive to negative ratio until you have succeeded in creating a positive environment in your home.
Implementing a daily structure is also important for any expert schooling their child. First, establish a routine that you will follow each day or week. Next, go over this schedule with your child so that he can expect what the day will hold for him. Your child can be involved in the process of developing the schedule, provided that the overall control of a child’s schedule stays firmly with the parent.
It is important to remember that while the identification of labels such as ADD or ADHD is accomplished by looking at a list of symptoms, these symptoms are not the actual problem. It is essential to look at what is really causing these symptoms. Once the root causes are identified, they can be addressed, and hopefully eliminated. The way to address and eliminate the causes is through specific stimulation.
The NACD Foundation (NACD) is an international organization that exists to gather, evaluate, and disseminate information and procedures relative to human development. NACD has conducted over 50,000 individual evaluations and designed 50,000 homeschool programs over the past sixteen years. It empowers parents with the knowledge, techniques, and expertise that enables them to assume primary responsibility for their children’s maximum growth and development. NACD provides families with individualized home programs that serve as homeschool programs for children with labels like ADD, ADHD, Learning Disabled, Autistic, Mentally Retarded, Down Syndrome, Gifted. NACD also serves other families who are committed to serving their children in whatever ways they feel are best.
Doman, Child Management
Journal of the National Association for Child Development (1983) Vol.3, No.1
Doman, Food Sensitivities
Journal of the National Association for Child Development (1984) Vol.4, No. 2
“Guide to Child Development and Education: Miracles of Child Development” by Robert J. Doman Jr., NACD (1986)
“Guide to Child Management” by Robert J. Doman Jr., NACD (1986)
“Guide to the Parent Teacher” by Robert J. Doman Jr., NACD (1986)
Is This Your Child?: Allergies and Your Family
Dr. Doris Rapp
2757 Elmwood, Kenmore, NY, 14217
Why Your Child Is Hyperactive
Dr. Benjamin Feingold
The Feingold Association of the United States
P.O. Box 655, Alexandria, VA, 22306
Reprinted from the Journal of The NACD Foundation (formerly The National Academy for Child Development)