Trouble with impulsivity and inadequate ability to pay attention characterizes most of the human race. It is particularly characteristic of childhood; while developing, all children are hyperactive and inattentive, compared with an adult standard.

Children and adults inflicted with extremes of these two neurodevelopmental problems have a particular difficulty in our complex, organized, and demanding society, and consequently“ excessive“ hyperactivity and inattention are presently considered a disease, with specific diagnostic criteria, and medicinal, psychiatric, and sometimes instrumental treatments.

ADHD is divided into predominantly inattentive, predominantly hyperactive/impulsive, and combined. I will concentrate on certain features of the attentive aspect.

I encourage you to read the excellent Mayo clinic article which covers most bases, including advice for parents and relatives who have to deal with these sometimes difficult individuals.

ADHD most commonly involves children. It leads to difficulty at school, and often suboptimal interpersonal relations. Drugs such as amphetamines and Ritalin are most commonly given, and seem to work; it is always amazing to see a stimulant quieting down an overactive child. Struggling college students often consume these same medications, since they seem to give a short term boost In concentration, ability to learn, and performance in tests.

Caffeine is the poor man’s drug and also sometimes helps. 60 years ago I worked in the UCLA clinic where we checked problem children for “split dominance”, where the children may throw with the right hand and kick with the left foot. There is no mention of this in the literature now, and indeed FADS have characterized the whole area.

My middle son had difficulty in school and was hard to get along with. I tried him on some amphetamine, but he wisely spit it out. He turned out to have dyslexia (poor reading ability), studied engineering in college,  and is running his own company; Entrepreneurs are often dyslexic.

Be very careful before labeling a child with the stigma of ADHD. Try loving and working with her more. If the situation is clear cut, make sure the least five of the nine criteria are present before agreeing to try drugs.

One of my grandchildren was very slow in learning, and was distracted easily. His mother persisted in sending him to a Montessori preschool, and when he went into his growth spurt (I like to think he myelinated his neural pathways), a miraculous change took place; He now seems very interested in many things and does excellent work at school.

You cannot lavish too much attention on developing children. ADHD thought present in somewhat less than 10% of children, particularly boys. It is also being increasingly recognized in adults, where it interferes with their personal, home, and occupational lives. Anxiety, depression, and other psychiatric problems may follow.

I wonder if inattention also afflicts some of my elderly friends; if they don’t pay attention to what they’re doing, they may well FALL, and curtail their lives. We could all pay better attention to what we are doing.

TOO MUCH ability to pay attention, however, could grade into obsessive compulsive disorder. In more extreme forms, ADHD is certainly real, and failure to intervene can result in distressing secondary problems. However, it is almost too convenient a category for assigning children. Haste in categorization may result in missing other problems.

When normal, our brains are amazingly fine tuned instruments. The best thing to do is keep them exercised, stimulated, and well nourished.

—Dr. C.

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