What's the hardest part of having attention deficit disorder (ADD ADHD)?
Recent surveys suggest that, for many people, it's the inability to focus - to concentrate unwaveringly on a task or situation. For adults, a lack of focus can be especially vexing in meetings, lectures, and other situations when it's important to understand or contribute to formal conversations involving complex information.
Business meetings were a nightmare for Carol Henderson, a film producer in Los Angeles. "I just get hyper when there is no action being taken," she says, noting that medication "only takes you so far. When it's repetitive, and the meeting goes on and on, I feel the need to move, to do something."
For kids, the equivalent of the nervous-making meeting may be a school assembly, a math class, or a lecture on whatever subject they find least interesting. "Such a situation is asking kids to do something they may find very hard - to sit there and say nothing," says Jack Naftel, M.D., professor and director of the division of child and adolescent psychiatry at the University of North Carolina at Chapel Hill. "Often, there is an impulse to ask a question or jump in."
Both kids and adults often see "jumping in" as the only way to stay focused in challenging situations. But jumping in is often inappropriate, and it can prolong the hardship. "I say only the briefest thing possible [in meetings] because my contribution could make it go even longer, which would be far worse," says Henderson.
Adults and children boost their focus in such situations by a variety of strategies, from sitting on their hands to rhythmically locking and unlocking their fingers. Henderson says she can enhance her concentration simply by scrutinizing the clothing and jewelry worn by others in the room. "It's like a game I play, to see how I would match up different styles and colors."
Two things at once
Why does AD/HD make it hard to focus? And why do many people with AD/HD find it easier to stay focused and to assimilate new information by doing two things at once - which would pose an enormous distraction to people without AD/HD?
Doing two things at once may facilitate "buffering." According to the Evidence-Based Practice Manual, a text of recent research, buffering is "an intervention that mediates another effect." In other words, when stress surfaces, a relaxing counter-measure may help. People often doodle, fidget or - when the situation permits - do some form of exercise.
Many people find that listening to music is the best way to boost their focus. Earlene E. Strayhorn, M.D., a child psychiatrist at Rush University Medical Center in Chicago, often recommends music to patients who say they are unable to get in the learning groove. Music brings a powerful "self-soothing effect" that makes it easier to read and do homework, she says.
Buffers of all kinds
To get an idea of the range of buffers used successfully by people with AD/HD, one need look no further than the household of Mary Ann Moon, of suburban Washington, D.C. Moon's son and daughter have AD/HD, as does her husband.
Moon's teenage son has trouble absorbing information from a printed page. But he finds it easy to learn if he listens to books on audiotape - while throwing a ball against his bedroom wall. He has found that he can take in information better if he's doing something else at the same time.
"It's hard to do this if you're physically reading the book," says Moon. "But if you're lying in bed listening to the book, you can throw a ball against the wall or draw a picture at the same time."
Mary Ann's college-aged daughter needs noise, too - but at a lower decibel level. She listens to the radio while she reads, letting the music and the banter of DJ's buffer her study.
