ADHD (Attention Deficit Hyperactivity Disorder)

ADHD or Learning Disability?

Vikas is in class III and looks around his classroom when it’s reading time. He needs frequent reminders to get back to work. His teachers and his parents are puzzled why such a seemingly bright boy is having trouble in school. Could it be an attention deficit causing the problem? Could a learning problem cause the inattention? How can they help Vikas succeed?

Learning and attention problems are common and can range from mild to severe. In India a significant percent of school-age children are identified with Learning Disabilities. At the same time many more will display symptoms of Attention Deficits. Many of these children have both. Although the studies vary, 25 to 70 percent of children with ADHD have a learning disability and from 15 to 35 percent of children with LD have ADHD. There are many children who have milder learning or attentional problems but the additive effects can be significant. Even mild dysfunctions in these critical brain functions can create problems as demands increase in secondary school, college and in life.

The important issue is that both are brain related issues - separate but dependent on each other for successful functioning. Learning is the way the brain uses and remembers information like a big production factory taking in raw materials, storing parts and then manufacturing and shipping a finished product. Attention involves brain controls, which regulate what information gets selected as important and gets acted on. The attention/behavior control system acts like the senior employees at the factory distributing the amount of energy required for, setting priorities, deciding what to produce and monitoring quality control. Late shipments or poor quality products could be the result of any number of glitches in either system. Minor problems in one system can be compensated for but when both systems are affected failure looms. Sorting out the breakdown points is critical but can be complicated.

A child may be distractible because weak attention controls are unable to filter out unimportant sights or sounds. However, if reading is too difficult the child may look around because it doesn’t make sense. A child might be “disruptive” because their behavior controls are weak and they impulsively call out or annoy others. Some children with learning problems may act-up out of frustration or embarrassment. They would rather be considered “bad” than dumb. Other difficulties that can occur with either learning or attention problems might be:

⇒ Underachievement despite good potential
⇒ Inconsistent concentration
⇒ Difficulty with time-limited tasks
⇒ Problems with starting and completing work
⇒ Messy writing or disorganized papers
⇒ Low self-esteem
⇒ Problems with peer relations
⇒ Behavior problems
⇒ Secondary emotional problems due to repeated failure and frustration

Testing for learning disabilities includes cognitive and achievement testing with speech and language, motor skill and other evaluations as needed. But the main issue is that the child should be tested.

A lot of parents ask us, is a screening even necessary? Yes of course, when we consider the potential that may or can be wasted for a lifetime, struggling and not knowing what to do or underachieving regularly, it is definitely worth the time and effort to assess and begin a remediation process that can bring out the child’s potential in a positive manner.

So the very question itself is self-defeating.

As learning disabilities reflect the brain's difficulty in processing certain kinds of information, Children with learning disabilities are more likely to show:

History of developmental delays

Family history of learning problems

Normal medical evaluation but can have cognitive issues

Language delays that may include mixing up sounds in words (e.g., aminal for animal)

A lot of knowledge but difficulty in expressing ideas clearly

Slowness with learning academic readiness skills (e.g., letter identification)

Difficulty applying learned skills rapidly and automatically resulting in labored reading and poor reading comprehension

Report cards and tests that show consistent pattern of difficulty in one area

Behavioral issues occur when processing weakness are stressed (e.g., too many instructions given at once when deficits in language processing are present).

Social problems because language processing impacts negotiation skills or visual-spatial problems result in standing too close to others.

Attention and behavior control problems may range from normal temperament variation to severe Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is the most current term for children who experience levels of inattention and/or hyperactivity and impulsivity that are excessive for their age and causes impaired functioning in more than one setting (home, school, friends, play or work). With Attention Deficit Problems your child will show

Hyperactivity, when present, noted in preschool but decreases to restlessness as the child ages

Impulsivity such as calling out, acting without thinking or excessive talking

Difficulty with effortful attention, often more evident once in school

Problems with “budgeting” of attention and may over-focus on favored activities

Need for frequent prompts or reminders to start or complete routine tasks

Problems across multiple situations but with variable severity

Difficulty in-group or independent work but does well one-on-one

Impulsive, “careless” errors and inattention to detail across subjects

Problems with listening comprehension or academic “gaps” due to inattention or “superficial grasp” of material

Written expression problems are most common

Report cards and tests show highly inconsistent grades across subjects

Tendency to “fade” or drift off during sustained tasks such as reading or chores

Low frustration tolerance and lack of persistence unless highly engaged

Better scores in testing than performance in the classroom or on homework

Social problems because of annoying behavior and conflict

Interventions for children with ADHD should include positive behavior management, educational interventions and medication when appropriate. Behavior management at home and school should emphasize increased structure, reinforcement for appropriate behavior and avoid punitive punishments.

Only about 70 percent of children with ADHD respond to the first medication tried. Even if a child shows behavioral improvement, medication will not address an underlying learning disability. When both LD and ADHD are present medication can help support the extra “brain work” needed to compensate for processing problems.

Children with ADHD may often be described as crazy, a bundle of energy, or wound up. Such descriptions seem to imply that ADHD children have too much energy. However, one seldom complains of having too much energy. This could be the reason that ADHD may not feel like a disorder. In reality the problem of this excess energy is not the amount of energy, but rather the channeling of this energy. Due to the simple fact that children generally prefer to be active and activity needs energy, children with ADHD may actually be content with having excess energy. However, they may not have acquired the cognitive skills or social skills needed to channel this excess energy productively. Eventually, the excess energy and/or impulsiveness may begin to disrupt the social atmosphere of the ADHD child. Later, the ADHD child may begin to react maladaptive to the excess energy in the form of bad behavior. Impulsiveness as well as

The key to long-term success for children with Learning Disabilities and/or ADHD is a positive attitude and an emphasis on developing strengths. Parents and teachers should foster a resilient, problem-solving approach to life’s challenges. Children should have opportunities to devise alternative ways of meeting goals, develop their talents and use their skills to help others. A child should not be limited by their learning or attention differences, but inspired to achieve by using their different strengths and passions.

If you feel on an intuitive level that your child may fall in any of the bandwidths above it is crucial for you as a mother or a worried father not to ignore the obvious symptoms.

Parents must as a ‘rule’ have any difference or anomaly assessed and screened. Children do not avoid reading on purpose. They avoid reading if there is a problem that they are facing when they ‘try to read’.

For additional information on how to help your child achieve and identify his core weaknesses and strengths please call us on 88260-22886 to make an appointment or e mail us at info@dyslexiaindia.org.in to initiate a contact with us.