ADHD Is Not A Death Sentence! Your Child Can Achieve Success Despite Having This Disorder

by Robert Kirwan

CASE
STUDY

A young mother who we will call Samantha (not her real name) came to my office the other day and started the conversation with the following: “I just spoke to my 8 year old son’s teacher. She told me that she thinks he should be tested for ADHD because of the difficulty he is having concentrating in class. I don’t want him to be labeled at such a young age, but I don’t want him to fail his year either. Can you help me?”

ANALYSIS OF THE SITUATION

   I would like to share my response to Samantha with other parents who may be facing similar concerns with their own sons or daughters.  
  

   First of all, Samantha, let me reassure you that you should not panic just because your child may have ADHD or ADD. In fact, researchers in the
United States have recently discovered that that certain parts of the brain in children with attention deficit hyperactivity disorder develop more slowly than other children’s brains, and that anywhere from 14 to 35% of children with ADD/ADHD will fully overcome the symptoms by age 27.
  
   Dr. Philip Shaw of the National Institute of Mental Health lead a team of researchers who found that these regions of the brain developed more slowly in children with ADHD.
  

   In what has been called the most detailed report of its kind, Dr. Shaw’s research team used MRI scans to measure the cortex thickness at 40,000 points in the brains of over 200 children with ADHD and over 200 children who were developing normally. The scans were repeated up to four times over a 15 year period.

   In particular, the scientists measured the thickness of the cortex, which is the brain’s outer layer of gray matter, in different parts of the brain at different points in time as the children grew up. The cortex thickens as the brain develops, but after reaching its peak thickness it thins as the brain matures.

   What the researchers found was that in the brains of children and adolescents with the disorder, more than half of the cortex did not reach peak thickness until around the age of 10 and a half, nearly three years later than was the case in normally developing children.

   The lag was most pronounced in the prefrontal areas of the brain which control many cognitive functions that are implicated in ADHD. These include areas of the brain that are responsible for: impulse control; organizational and attention skills; working memory, which is the ability to hold information and manipulate it at the same time; and some higher order motor functions.
  
   Development of the higher-order functions and areas that coordinate those functions with the motor areas was especially delayed in ADHD children while the only part of the brain that matured faster in these children was the motor cortex which might account for the restlessness and fidgety symptoms common among children who are diagnosed with ADHD.
  
   The most promising discovery made by the scientists is that brain development in the ADHD children followed the same basic sequence as in the more typical children. While it is true that as many as two thirds of all children with ADHD will still have a lot of symptoms as adults, researchers are hoping to study those who do outgrow the disorder to determine what the brain did to correct the problem. It is possible that at some point in the future they will find a way of boosting the recovery process through some sort of intervention.

RECOMMENDATION

   The first thing you should do, Samantha, is go to your doctor and see if he can confirm that your son has ADHD. If you feel that his restlessness is affecting his performance at school, then your doctor may recommend some medication to control his behaviour while in class. We want to make sure that your son achieves the maximum level of success in school so that he feels good about his academic accomplishments.

   While the behaviour is being controlled through medication at school, I would advise that you allow the medication to wear off by the time his personal tutor arrives in the evening. I want the tutor to help your son with areas of his actual school work in which he is having difficulty, but moreover, I want the tutor to develop skills in your child that will stimulate those areas of the brain that are slow in developing. For example, your tutor will do some activities that help your son develop the ability to focus his attention on certain tasks for short periods of time. We will show him how to take notes or how to do things that will prevent him from getting distracted so easily. The tutor can talk to you about setting up some kind of reward system so that your son begins to look forward to working at home and with his tutor.
  
   Our overall objective is to allow your son to identify those areas and topics in which he is extremely interested and then have the tutor develop the desired skills while your son is in his “own element”.  We will actually use his hyperactivity as a strategy to develop skills.
  
   While the tutor is working with your son once or twice a week to “exercise” those parts of the brain that are developmentally delayed, the medication will help your son “perform” well for his teachers in school, thus ensuring that he will get good grades as he progresses through the school system.
  
   Hopefully, your son will be one of those children who “grow out” of ADHD and by the time he is a teenager or young adult it will no longer be necessary for him to remain on medication. The skills he has been working on with his “personal learning coach” will then take over and he should be able to pursue his education and career goals.

 

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