Diseases - Attention Deficit And Learning Disability

Attention Deficit Disorder, more recently re-Christened Attention Deficit/Hyperactivity Disorder, is another medical or quasi-medical phenomenon of recent decades. Coupled with Learning Disability, it is said by the U.S. Department of Health and Human Services to affect 2.6 million children. Data distilled from the 1997 and 1998 National Health Interview Survey are presented in the graphic showing the prevalence of this disorder for all children, boys, and girls.

Children with ADD cannot concentrate, listen, pay attention, follow instructions, organize activity, or remember things from one minute to the next. They shy from tasks that require mental effort. This syndrome occurs with hyperactivity — constant fidgeting and squirming, inability to stay seated, to have a "quiet time." Hyperactive children are "driven," in motion, and talk excessively; they can't wait their turn, blurt out answers, and butt into others' games or activities. The learning disabled suffer from psychological disorders that make it difficult or impossible for them to process language and mathematical concepts; the term specifically excludes those who have difficulties because of physical or brain dysfunctions — hearing problems, visual impairment, brain damage, etc. The learning disabled often cannot listen, think, write, read, or spell effectively. Their traits merge, at the edges with ADD.

The disorder seems to have emerged about 30 years ago. The Centers for Disease Control (see source), cites numerous academic and other sources that, taken together, appear to assign the cause to transformations in families, marital instability, inadequate day care (day care itself necessitated by changes in the economy), and poverty. Schools and the medical profession are credited, by the CDC's authors, for recognizing and diagnosing the problem. In another volume in this series (Community and Education), we take a close look at changes in our family structure. Elsewhere in this volume (see Chapter 6, Drugs), we deal with our methods of sedating children who are afflicted with ADHD — and also those who do not have the symptoms. The object in this panel is to trace the characteristics of this socio-behavioral disorder.

Notice, for instance, that the disorder is much more prevalent in older children than in younger, suggesting that more parental care may be available to children earlier in age than as they grow and become more independent. Their exposure to TV, possibly inadequate nutrition, and family stresses grows with time, manifesting in dys- functions.

Attention Deficit Disorder is highest among non-Hispanic whites, least among Hispanics. Learning disabilities are most pronounced among non-Hispanic blacks. One can only speculate about causes for these differences. The disorders have been under study for some time, but considerably more work, with larger populations, will be required to understand differences between racial/ethnic groups.

Finally, family structure also plays a role. Children with ADD are 3.8% of total where the family is headed by the mother alone, 3% in families with mother and father both present. Learning disability is 6.1% in mother-only families, 3.5% in father-mother families. And where both ADD and LD are present, the one-parent home has a 4.6% rate versus a two- parent family with a 2.9% rate. ADD is higher among the better off ($20,000 or more family income) and lower among the poor (less than $20,000). Learning disability shows the reverse pattern.

Source: Pastor, P.N. and C.A. Reuben. Attention deficit disorder and learning disability: United States, 1997-98. National Center for Health Statistics. Vital Health Statistics 10(206). 2002.