Inattentive ADHD, Out in the Cold

I have told you many times about the great school that my children attend. It is a school that above all, KNOWS and genuinely LIKES kids. The teachers work in an environment where they are allowed to control the destiny of their classrooms. This makes teachers happy and happy teachers are more likely to have happy students. This school is pretty 'State of the Art” in many ways. It is, however, not perfect especially with regards to its knowledge of Inattentive ADHD.

It is not really the school's fault; there is precious little knowledge to be had about Inattentive ADHD. The current diagnostic criteria and treatment principals used for spotting and treating Inattentive ADHD are crude and poorly studied. Recently published information regarding this condition (1985 - 2010) tends to lump treatment options for Inattentive ADHD with the treatment options for Hyperactive/Impulsive ADHD. Older information, pre-1985, tends to lump the diagnosis of this condition with the diagnosis of Sluggish Cognitive Tempo.

When my eldest son's second grade teacher, a teacher who adores children and who has taught successfully for over 45 years, gave us this piece of paper with a profile of a kid that she thought was just like our son, a sheet of paper that explained, in kind of vague terms, why he needed ADHD medication, I realized that the 'State of the Art' school, that my kid's attended, knew little about Inattentive ADHD.   They knew that there were some kids that were inattentive, likely to be distracted, spaced out, somewhat impulsive and sluggish who needed to be evaluated for ADHD but that was about it.

I cannot tell you the number of parents of Predominantly Inattentive children, that I know, who have received, at their teacher conference, some ADHD like sheet of paper and have rejected the information in it outright. The information is these particular pieces of paper does not really describe a child with Inattentive ADHD, the materials more accurately describes something else. Sometimes the materials describe a child with Sluggish Cognitive Tempo who is also a bit impulsive. Sometimes the materials will describe a child who is impulsive and inattentive but not sluggish or a child that is hyperactive, inattentive, and impulsive.

The worse schools give no materials at all and do not even notice your inattentive child. These schools are happy to have a spaced out, quiet child sitting in the classroom. If that child manages to test in the average range for reading and math he will coast through his school life totally under the radar and whatever opportunity this child might have had to maybe learn something in school will be lost.

Not all people who are Predominantly Inattentive are also predominantly sluggish. Most people with Inattentive ADHD are neither impulsive nor hyperactive. Many of us are not sluggish at all and some of us are only a bit sluggish and on a sluggish to hyperactive bell curve would fall in the 'normally active' range. Most of us with inattentive ADHD are no more impulsive than would be considered normal. If you happen to have a child, like I have and a child like I was as a kid, that is Predominantly Inattentive and is NOT impulsive or predominantly Sluggish, these generic ADHD descriptive materials will not resonate with you and your child will likely not get any help.

After I got the ADHD materials from my son's teacher, I started thinking about the lack of information available about Inattentive ADHD and I started thinking that I wanted to learn more about the materials available for teachers. There is very little available. Teachers need better material and need to be educated regarding the differences between inattentive ADHD and the other types of ADHD. They need to know that NOT all children with Predominantly Inattentive ADHD are predominantly sluggish.  Teachers are often the first step in the process of getting help for a person with Inattentive ADHD but teachers need better resources than are currently available.

If the American Psychiatric Association (APA) gives Inattentive ADHD a category of their own in the DSM V (The manual that mental health providers use for diagnosing), people with Predominantly Inattentive ADHD may finally travel out of the cold woods and into a warm classroom. Teachers, like my son's second grade teacher, will have better resources to distribute to parents of children with Inattentive ADHD and these same teachers will be better able to guide parents towards community resources where the parent can find the further help that they will need.

I am hoping, for the sake of the many people with Inattentive ADHD who have gone through life thought of as lazy, mentally slow and incompetent that the APA does not bury this condition in with the Hyperactive or Impulsive types of ADHD as it did in the DSM IV. We know, from our current experience that this approach has left most ADHD-PI kids and  their families all alone, out in the cold, searching for answers.

6 comments:

  1. You are absolutely right! Right now your blog is basically my only resource for ADHD-PI that I refer to and look foward to reading. I also think that for teachers who have been teaching for many years have not had to encounter many children with disabilities. Today children with some sort of disabilty even undiagnosed are making up at least 1/4 to 1/2 of the class. Most of these teachers are not trained in any sort of Special Education and for the money they make or complain to make they dont want to be educated to learn or deal with any child with needs. I have been told many times that "I have 27 other children in my classroom, I cannot give your child any special attention". But, they do have their hands full with kids with behavior, unfocused, even children so severe they they scream in class and throw themselves to the ground and the teacher cannot deal with it. I saw a teacher first hand in second grade (I am a monitor myself) talking about anger and telling the kids that sometimes she loses it with her children at home and sometimes yells at them and one of the kids raised his hand and said "Oh, so you do to your children like you do to us!" I almost fell off the chair. The teacher has been teaching 2nd grade for many years and last year 1/2 her class had all kinds of issues and she could and did not know how to handle it.

    Because more and more kids with IEP's are heading for the regular education classes the teachers should have to have mandatory training.

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  2. Tomsmom,

    I think that you are so right. There are so many kids now in the classroom with one issue or another. I think that there are researchers working hard to understand why this is. At first the thought was that we had more awareness of problems like dyslexia, Tourette's, ADHD, Depression, etc but that incidence had not increased. I think that more and more educators are coming to the conclusion that yes, there is more awareness but there are also more kids with learning problems.

    Some researchers are studying epigenes to see if there is something in the environment 'turning on' genes that can lead to some of these problems or that can worsen the severity of these problems.

    The plot thickens every day.

    Thanks for your great comment!!

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  3. Tessermom,

    WOW! Your post really resonated with me. My son, who is now a high school senior, has had ADD inattentive symptoms since at least late elementary school. We had such a hard time figuring out why he struggles so much with detail, organization, follow through, etc. with nary a mention about these issues from teachers at parent teacher conferences. He's really bright, always tests in the highest percentiles on standardized tests (oh joy for the school system) and has never been a behavior problem. So as for us wondering what he's actually learning and how he's learning it -- well, we've gotten some dumbfounded looks from teachers when asking relevant questions. The "under the radar" phenomenon is the story of his educational life, and many other kids also, I'm sure. Teachers really need to be educated about the differences in ADHD.

    Thank you so much for your site and the information you provide.

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  4. I am pleased to announce the launch of the American Academy of Child and Adolescent Psychiatry’s newest online Resource Center: Attention Deficit/Hyperactivity Disorder!

    The ADHD Resource Center includes relevant Facts for Families, video clips, up-to-date research, assessment tools and more. This is the ninth resource center available to parents, families, clinicians, and the general public on our website, www.aacap.org.

    Please visit http://www.aacap.org/cs/ADHD.ResourceCenter to access the ADHD Resource Center.

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  5. The AACAP has some wonderful information on their site. Their resource section is also helpful.

    One of the AACAP main goals is the encouragement of specialty training of psychiatrist in the field of child and adolescent mental health issues. There are currently only about half of the number of Child and Adolescent Psychiatrist needed to serve all the children and adolescents in need of mental health evaluation and treatment.

    It is difficult to find psychiatrist especially trained to address the diagnostic and treatment issues of children with Inattentive ADHD because there are simply not enough trained psychiatrist specializing in this field.

    Thanks so much for this comment!!

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