| Let's look at five behavioral issues which are not | | | | thinking skills much better than other antidepressants. |
| ADHD (Attention Deficit Hyperactive Disorder). While | | | | Please consult your doctor about possible advantages |
| these difficulties may be found along with ADHD, it | | | | of dual-action antidepressants for children with both a |
| doesn't mean that they are symptoms of ADHD. | | | | low mood and executive dysfunction). |
| The five problems we'll discuss are Anxiety, | | | | 3. Disruptive Behavior is an especially prevalent |
| Depression, Disruptive Behavior, Learning Disabilities, | | | | problem in school. Some kids just won't settle down |
| and Sensory Integration Disorder. Please believe me - | | | | and are a significant learning liability for other |
| I don't want to make your life more complicated! Yet | | | | students. Sometimes, disruptive behavior is mistaken |
| if we wish to approach treatment and outcomes | | | | for hyperactivity. Indeed, hyperactivity may lead to |
| with a degree of scientific objectivity, an accurate | | | | disruptive behavior, but they are not the same thing. |
| understanding of a child's behavior is essential. | | | | All kinds of kids can be disruptive, sometimes |
| Unfortunately, we live in a time when all kinds of | | | | intentionally. A hyperactive child has trouble slowing |
| behavioral problems are herded under the umbrella of | | | | down, even though he may wish to. An intentionally |
| ADHD. But what if some attention problems have a | | | | disruptive child may be feeling frustrated by |
| different foundation, and what if psychostimulant | | | | classroom expectations, rebelling against authority, |
| medication isn't always the best response to | | | | developing self-control at a slower rate than peers, |
| behavioral problems - even those that appear to | | | | or seeking attention. If a child is invested in gaining |
| involve hyperactivity? | | | | attention through mischief, loudness, or intrusion, a |
| 1. Anxiety is a problem that may easily affect | | | | medicine such as Ritalin (TM) is not likely the best |
| attention because a child can be preoccupied with | | | | course of treatment. |
| internal thoughts or worries. As a consequence, he or | | | | 4. Learning Disabilities may affect one or more |
| she may appear to be zoning out. An important | | | | subject areas, as well as social interaction. It stands |
| question to consider is whether your child is equally | | | | to reason that if a child has a learning problem, in |
| distracted when he or she is relaxed. If not, | | | | reading for example, he or she will be less attentive |
| situational factors may be triggering anxiety and | | | | to that aspect of instruction. A learning disability can |
| inattention. Sometimes children who do not know | | | | certainly be exacerbated by ADHD, but ADHD itself |
| how to handle a worrisome situation, or who have | | | | is better understood more as a learning liability than |
| difficulty expressing their feelings, "clam up." Don't | | | | something like dyslexia - a specific learning disability. |
| you have a harder time concentrating on work if | | | | 5. Sensory Integration Disorder (SID) is a problem |
| you're nervous or worried about a personal situation? | | | | with either being oversensitive or undersensitive to |
| It can be much more difficult for a child to articulate | | | | sensory stimuli. These problems can make a child |
| his or her worries. A concern that seems trivial to | | | | appear either hyperactive or inattentive. This disorder |
| adults can also cause great anxiety for a child, as | | | | is often confused with ADHD, especially in preschool |
| well. For example, a preschool boy was very worried | | | | children whose sensory integration difficulties |
| in school until it was discovered that he was having | | | | undermine "self-control." A child with a sensory |
| trouble handling his buckles and snaps at the | | | | integration disorder may be distressed by loud noises, |
| bathroom break but was afraid to ask for help; a 7th | | | | bright lights, rough textures, or smells; or conversely, |
| grade girl couldn't focus in her Language Arts class | | | | may need to handle things, hang upside-down, or |
| because she was seated next to a girl who had | | | | shout boisterously. For an excellent discussion of |
| mocked her in gym. | | | | Sensory Integration Disorder, read Carol Stock |
| Depression is a mood disorder which can impair | | | | Kranowitz's book, The Out-of Sync Child. |
| executive thinking skills like working memory, | | | | Each of the disorders described above could |
| cognitive flexibility, planning, and attention. | | | | potentially be found along with ADHD, in which case |
| 2. Depression turns our mind's idle down, and as a | | | | both disorders need to be treated. Without question, |
| result we can appear "out of it" - but the cause is | | | | ADHD is major health epidemic facing children. The |
| not ADHD. Irritability, lack of initiation or interest, and | | | | Center for Disease Control and the World Health |
| inattention may be symptoms of depression or | | | | Organization have both affirmed this fact. In the |
| ADHD. Of course, most children can't describe | | | | midst of managing this crisis, we've got to work hard |
| exactly what they feel, or whether a mood problem | | | | to resist "one size fits all" thinking. Let's make sure |
| or poor focus came first. In such cases, it is critical to | | | | children's behavior is carefully evaluated and |
| evaluate a child's behavior in multiple contexts, and to | | | | understood within a social and emotional context. If |
| determine if an improvement in mood helps focus. | | | | we were the person being treated, we wouldn't |
| (Some dual-action antidepressants such as Effexor | | | | expect or accept anything less! |
| (TM), which effect norepinephrine, enhance executive | | | | |