Understanding ADHD Part 1: Without a reliable test for diagnosis, the disorder remains misunderstood
by Brett Buckner
Special to the Star
Aug 18, 2013 | 4941 views |  0 comments | 30 30 recommendations | email to a friend | print
Illustration by AnnaMaria Jacob/The Anniston Star
Illustration by AnnaMaria Jacob/The Anniston Star
Kameron Butler is used to being the “weird girl,” a name classmates at Oxford High School have been known to hurl, both to her face and behind her back.

But she doesn’t care what those people say — they’re not her real friends anyway. Kameron knows her life would be much worse if it weren’t for the medication she’s been taking since she was 5 years old. That’s when she was diagnosed with Attention Deficit Hyperactive Disorder — better known as ADHD.

“It’s like having a split personality,” says Kameron, now 15. “You have the medicated side and the unmedicated side. I’ve got friends that I’ve known for a really long time that wouldn’t know I have ADHD unless I told them. But then I have the days, when if I don’t take my medicine people keep asking if I’m high or something … my emotions go haywire.

“Without the medication, I’d be the girl that nobody wanted to be around because I’m so annoying.”

The Center for Disease Control and Prevention estimates that 6.4 million children between the ages of 4-17 at some point in their lives have been diagnosed with ADHD. According to the CDC, prevalence of parent-reported ADHD diagnosis varies substantially by state. Alabama has the second highest rate at 14.3 percent, just behind North Carolina with 15.6 percent — compared to Nevada, the lowest at 5.6 percent.

The hallmarks of ADHD include inattention, hyperactivity and lack of impulse control. ADHD is a brain disorder that presents itself in children ages 5-7, following them through adolescence and into adulthood. Brain imaging studies reveal that in youths with ADHD, the brain matures in a normal pattern but is delayed an average of about three years. The delay is most pronounced in the region of the brain responsible for thinking, paying attention and planning.

“It was an absolute nightmare,” says Shelly Matthews, whose 7-year-old daughter was recently diagnosed with ADHD. “The constant demands, meltdowns, anger and frustrations … it was just awful. The week was hard because I pretty much waited for the school to call. She was always in trouble for disrupting the class.”

Like most children with ADHD, Matthews’ daughter, whom she does not want identified, required constant interaction.

“The weekends were worse,” she said. “I knew from the minute she woke up, it was going to be a fight to keep her entertained. She was relentless, and I was exhausted.”

Matthews remembers one of many breaking points. Her daughter had a school project that could’ve been done in 20 minutes, but no matter how she asked, then pleaded, then threatened, her daughter simply wouldn’t focus long enough to complete the assignment.

“I was crying, and she was crying trying to make me understand, but I just didn’t get it,” she said. “At that moment I felt like the worst mother in the world.”

Matthews eventually took her daughter to her pediatrician. After a series of conversations and evaluations, they spoke with a psychiatrist in Birmingham. It took only two sessions before her daughter was diagnosed with ADHD and placed on Adderall in an effort to stabilize her behavior.

“It was like night and day,” Matthews said. “It wasn’t overnight, and we tried several different dosages and medications, but now … she’s a different child.”

Cruel labels

ADHD is a “pervasive” disorder, according to the American Psychological Association, meaning it appears in multiple settings beyond the classroom. There are three types of ADHD — hyperactive, inattentive and combined.

Kameron, who admits to “talking people’s heads off about absolutely nothing,” falls into the first category. Even on her medication, focusing — especially in math class — can be a challenge. She fidgets constantly, and has at least one leg bouncing off the floor at all times. But were it not for the medication turning down the level of her hyperactivity, “I’d be bouncing off the walls and pretty much out of control.”

The same could be said of Matthews’ daughter, who was the “typical class clown.”

There is no single test to determine ADHD. However, the Food and Drug Administration recently approved the first brain-wave test to aid in diagnosis. Based on EEG-technology, the noninvasive test, called the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System, computes the ratio of theta and beta brain waves in 15 to 20 minutes. Children with ADHD have a higher theta-beta ratio than those who do not have the disorder.

To be diagnosed with ADHD, the child’s symptoms must be consistent for at least six months and be disruptive to the point that they have trouble functioning in school or other social settings. Medical professionals will eliminate other potential causes including clinical anxiety and depression, lead poisoning, undetected seizures, emotional traumas and sudden life changes such as a death in the family.

For the most part, the hyperactive, “noisy” child demands more attention. But it’s the second group — the inattentive — that can slip through the cracks, explains Jennifer Benefield, a therapist for the Children’s Day treatment program in Jacksonville. Operating under the umbrella of The Calhoun-Cleburne Mental Health Board, the center is an “intensive” program for preschool children with a variety of emotional and behavioral issues.

“It’s the inattentive children that can be overlooked,” Benefield said. “Because they aren’t bouncing off the walls, they don’t always get noticed. They have problems, especially in school because it looks like they’re paying attention when they’re really a million miles away, staring off into space, and haven’t heard anything that’s being said.”

At Children’s Day, the objective is teaching children how to deal with the disorder by teaching social skills — making friends, reading social cues, following directions, respecting authority and improving peer-interaction skills. Children in the program are referred by their preschools or daycares, pediatricians, therapists or brought in by their parents.

As part of the intake, counselors like Benefield gather family and medical history, symptoms and interviews with someone outside of the home environment — normally a teacher. Potential students are then given an assessment — like the Vanderbilt ADHD Diagnostic Parent Rating Scale or the Conners 3 ADHD index, both of which use rating scales to measure a child’s level of hyperactivity or inattentiveness.

With the proper diagnosis, medication — if necessary — and counseling, children with ADHD can accomplish anything and lead normal lives. Kameron Butler has come to terms with her ADHD and wouldn’t change a thing, even if she could.

“I’ve learned to live with it,” she said. “It’s part of who I am. I know to some people, I’m the weird kid at school, and I’m fine with that.”

Next week Brett Buckner explores the controversy of over diagnosing ADHD.

He can be contacted at brettbuckner@ymail.com.
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