BACK TO PARENT TRAINING SECTION

Q: What causes Attention Deficit Hyperactivity Disorder?
     A: The theories about this abound and every few years someone else comes up with a new idea. For instance in the early 1970s, Dr. Ben Feingold wrote a book about the additives and preservatives in food causing hyperactivity. At other times, there were people who suggested ADHD was caused by flourescent lighting, allergies, sugar, inner ear disorders, and brain damage during the birth process.
     None of these theories have proven of much value for significant numbers of people with ADHD. So the causes of the disorder that some experts say affects nearly 12 million people in this country remains unknown. The best theories lately have centered around genetics and a predisposition to ADHD from
inheritance.
     But, there's a different theory that has gotten a certain amount of support from research conducted over the past nearly thirty years. This is that smoking by mothers during pregnancy might be linked to ADHD.
     ADHD, a disorder that results in the symptoms of inattention, hyperactivity, and impulsivity, has been studied extensively. It usually hampers children in their performance of their school work.
     Yet, one of the interesting facts about ADHD is that it wasn't mentioned much prior to the 1960s in psychology or psychiatry testbooks. This may be because since ADHD affects boys more than girls that it was just taken for granted that boys were more restless, more impulsive, and less likely to be interested
in school work. However, the other explanation could be that the prevalence of ADHD has grown over the past thirty to forty years.
     This begs the question of why it would have grown in the last half of the twentieth century.
     One way of trying to answer this question is to look at what we know about smoking by women of childbearing ages and the effects of maternal smoking on children.
     In general, although the percentage of smoking in our population is declining, the rate of decline is slowest among women of childbearing age. One national survey found that nearly one-third of women of reproductive age smoke. In five separate surveys, twenty-two to thirty percent of pregnant women smoke. An additional important statistic is that nearly half of all non- smoking pregnant women are exposed to secondhand smoke.
     As early as 1975, a study of mothers of ADHD children found that they smoke an average of 14 cigarettes a day as compared to only 6 per day for mothers of non-ADHD children. Since this study, several others in the succeeding two decades have shown that smoking during pregnancy is linked not only to ADHD but to learning problems and behavior disorders in children.
     What maternal smoking tends to do, the research says, is to affect the areas of a child's brain related to the processing of auditory information. This means that a child's ability to listen to what a teacher is saying, to follow directions, or to remember what a teacher says is likely to be seriously compromised if
there was smoking during pregnancy.
     Toxicology research indicates that smoking during pregnancy leads to increased motor activity, learning and memory deficits. And that the greater the amount of exposure to nicotine during pregnancy, the greater the deficits.
     Of course, this theory cannot account for ADHD in children whose mothers did not smoke during pregnancy. Yet the research still makes this a compelling theory.


Q: What is your professional opinion about the use of Catapres patches on high anxiety children? Do you have any updated information about this drug and how it's best used with children? - A.G., Flint

   A: Catapress is the trade name of a medication known as clonidine which is usually used by physicians to deal with hypertension. Because hypertension results in elevated blood pressure, clonidine tends to reduce the heart rate and blood pressure.
Hypertension is the medical term for abnormally high blood pressure. It does not mean nervous tension, anxiety, or over activity. High blood pressure results from either an increased output of blood from the heart or greater resistance to the flow of blood through tiny branches of the arteries. Of course, blood pressure fluctuates considerably in all of us. Hypertension indicates that blood pressure exceeds upper limits most of the time and it occurs most commonly in older people rather than in children or middle-aged adults.
Treatment of hypertension usually consists of dietary measures and relaxation techniques. In more severe cases, usually one or more drugs are also required.
Psychiatrists and doctors I've talked to indicate that Catapres is sometimes used with children although safety and effectiveness in children below the age of 12 has not been established. One of its uses with children concerns youngsters who present serious behavior problems, often with aggressiveness. It has been found to be effective with some children who have symptoms of both attention deficit hyperactivity disorder and aggressiveness.