AIC professor dispels myths of ADHD

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Paul Quinlan

SPRINGFIELD, MA (06/21/2012)(readMedia)-- There are more than three million children in the United States who are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and approximately four times that number of adults with the problem. But, according to a psychologist at American International College (AIC) in Springfield, Mass., despite the increased frequency of diagnosis, there are a number of myths and misconceptions about the causes and cures for ADHD.

Paul Quinlan, Ph.D., director of the Curtis Blake Center for Learning Disabilities at AIC, said much of the recent increase in this diagnosis is the result of our better understanding of this complex syndrome. And yet, many of those research findings defy conventional wisdom.

For instance, he said, individuals with ADHD do not have trouble paying attention. "They are always paying attention to something. The problem is maintaining their attention and regulating their focus," Quinlan said.

Because of their difficulties in regulation, their interest shifts too easily to whatever else in the environment may be attractive. "This may be particularly true when the teacher wants them to pay attention, especially when it may not be something particularly riveting-like sounding out word." he said.

Yet, Quinlan said, the same child whose attention wanders quickly in the classroom may play video games for hours without losing concentration. "Why? Because the game offers rapid, stimulating and exciting changes which ideally feeds their need for stimulation," according to Quinlan.

According to experts in the field, the primary problem faced by individuals with ADHD is termed "disinhibition." Quinlan said disinhibition makes it difficult (sometimes impossible) to inhibit the urge to change focus or to act impulsively. "When those with ADHD cannot inhibit the tendency to shift their attention, we call it attention deficit; when they cannot inhibit their tendency to act impulsively, we call it hyperactivity. In both cases, disinhibition is the culprit and the results can range from annoying to dangerous," he said.

Another myth, according to Quinlan is that ADHD is the result of too much stimulation. "It's easy to understand why we might think of someone whose 'engine' is always running at high speed as overstimulated. But ADHD individuals are actually under aroused rather than over aroused. We used to recommend treating ADHD children by using bland, distraction-free environments: quiet cubicles with nothing on the walls. We now know these children are actually understimulated, and that high speed engine is an attempt to seek stimulation. What works best for these individuals is rapid changes in stimuli with quick rewards. ADHD is not an input disorder, it's an output disorder," he said.

Assuming children and adults with ADHD need instruction in manners or how to behave is usually a mistake according to Quinlan. "ADHD children and adults do not have problems knowing how they're supposed to act. The problem is not a lack of knowledge, but an inability to apply what they know because it would require that pause button they lack. It's like having an orchestra without a conductor. The musicians may have all the skills in the world, but without a leader they cannot make music. The frontal lobes of the brain (just behind the forehead) appear to be the main repository of these controls and there is compelling research to indicate that ADHD individuals have neurological problems in precisely these areas," he said.

While school work can be adversely affected by ADHD, Quinlan said it's the emotional damage which can have far greater impact on those who suffer from ADHD. "It's on the playground, at lunch, during recess and after school where these children will suffer the most. Because their behavior is seen as bossy, disruptive, silly or intrusive, they may be shunned by peers and ostracized from the social aspects of a school environment. Peer relationships during the school years is one of the most accurate predictors of long range emotional well-being. And problems with these relationships early on will often have consequences that carry into adult life," Quinlan said.

What is the best way to treat ADHD? Quinlan said the research is clear that the use of medications is, by far, the most effective treatment for ADHD. "These drugs, usually psychostimulants, can have a dramatic effect in reducing symptoms and improving the individual's functioning in the classroom or on the job. The result is often a happier child with a much improved self-image and much improved peer relationships; or an adult who is better organized, more focused and more productive," he said.

Although these drugs are also the most widely researched and among the safest in the entire pharmaceutical formulary, Quinlan said they should not be used without the help of behavioral interventions and they are the step to take only if other forms of intervention are not sufficient. "The data on addiction potential suggests little, if any, impact and while not risk-free, these drugs can have an important positive impact on the functioning of the ADHD individual," he said.

The Curtis Blake Center was founded in 1969 with the mission of developing and administering programs to enrich the field of learning disabilities. Today, the Curtis Blake Center employs over 75 full and part-time staff members working in three different locations and responsible for five major service programs, offering Diagnostic Evaluations, Tutorial Services, a Summer Instructional Program, the Curtis Blake Day School and the Supportive Learning Services program at AIC to meet the needs of individuals with language learning disabilities.