HOW TO COPE WHEN YOU CAN'T FOCUS; CAPE WILL BECOME RESEARCH SITE FOR A DISORDER THAT AFFECTS ADULTS

A statewide study aims to improve treatment of Attention Deficit Hyperactivity Disorder in adults and ultimately devise strategies to help them improve job performance.

Cape Girardeau will serve as an evaluation site in the study, which was commissioned by the Missouri Division of Vocational Rehabilitation through the University of Missouri-Columbia.

Eight evaluation sites have been set up around the state to identify patients for the three-year, $300,000 study.

In addition Dr. Steve Jordan, a neuropsychologist at St. Francis Medical Center in Cape Girardeau, professionals in St. Louis, Kansas City, Florissant, Carl Junction, Springfield, Columbia and Kirksville will participate in the study.

ADHD and Attention Deficit Disorder are usually diagnosed in children and teen-agers.

Dr. James Koller, a professor of educational and counseling psychology at MU and project leader, said many people mistakenly assume that ADD/ADHD goes away when the person reaches adulthood.

But as many as 65 percent of children diagnosed with ADD/ADHD will still have some symptoms as adults.

And the symptoms that may have interrupted the learning process when they were children in a classroom can keep them from performing well in the workplace as adults, Koller said.

"Some of it may go away," he said, adding few adults suffer from hyperactivity.

But little research has been done on ADD/ADHD in adults, Koller said.

"There is enough evidence in the research literature to show that adults do have a number of behavioral concerns, such as depression, aggressiveness or acting out," he said.

Staff at the eight evaluation sites will screen adults for ADD/ADHD.

MU put together a battery of tests to be used to identify adults with ADD/ADHD.

"For the first time, we've designed a test that will look at adults with ADD/ADHD and be able to sort those folks from folks who have different types of problems that may lead to the same symptoms," Jordan said.

People with ADD/ADHD have problems getting started on tasks, and once started, with finishing them.

They are easily distracted and have problems focusing on a single task.

They may speak out inappropriately and have difficulty dealing with criticism and anger.

"The term I use is cruising," Jordan said, comparing it to a person, who, while cleaning the living room, finds an item that needs to be taken into the kitchen. Once in the kitchen, he starts cleaning there until he's distracted by another task.

"You just move from room to room and never get any of the rooms cleaned," Jordan said. "These are things all of us may experience. But with these folks, they tend to occur more frequently and are more of a problem from day to day."

As many as 400 adults from around the state will be referred to the University of Missouri Assessment and Consultation Clinic in Columbia.

There, clinic staff will help ADD/ADHD clients learn a variety of coping skills to help them perform better on the job and at home.

In addition, staff will "shadow" clients in work settings and offer suggestions on how to handle stressful situations.

Counseling may include teaching clients to draw up checklists to help make sure a project is completed, or a step-by-step outline of what actions have to be taken to complete a project.

Adults with ADD/ADHD may also need medication, including depressants and other drugs.

Clients also will work with counselors from the Division of Vocational Rehabilitation for further education and counseling.

The information gathered during the project will be used to help formulate concrete treatment strategies to be used by vocational counselors and others who work with ADD/ADHD adults.

Koller hopes the project will become a model in identifying and exploring treatment options for adults with ADD/ADHD.

ADD/ADHD RESEARCH

What are Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD)?ADD/ADHD is a syndrome affecting children and adults, which includes poor attention span, weak impulse control and, in some cases, hyperactivity. ADHD is a subtype of ADD that is treatable, but not curable. Children and adults suffer the typical ADD symptoms plus marked hyperactivity.What are symptoms of ADD/ADHD?Symptoms include fidgeting or squirming, difficulty remaining seated, being easily distracted, difficulty awaiting one's turn, blurting out answers, difficulty following instructions, difficulty sustaining attention, shifting from one activity to another, difficulty playing or working quietly, talking excessively, interrupting other speakers, not listening to spoken instructions, losing things, and engaging in dangerous activities.How widespread is ADD/ADHD?Depending on how the disorder is defined and diagnosed, estimates range from 1 to 20 percent of the U.S. population. Most experts put the figure at 3 to 5 percent of the population. ADD/ADHD is usually diagnosed in children and teen-agers, but up to 65 percent of children diagnosed with ADD/ADHD will have significant symptoms as adults. Only 2 percent of adults with ADD/ADHD get jobs requiring a college education.What causes ADD/ADHD?There are a variety of factors including genetic/ hereditary causes; brain damage by head trauma before, during or after birth; brain damage by toxins -- fetal alcohol syndrome or neonatal exposure to drugs, viruses, bacteria or other toxins, such as lead or mercury; food allergies; and neurobiological brain differences.How is ADD/ADHD treated?Ritalin is a drug used to control hyperactivity in children by regulating dopamine levels in the body. Anti-depressants, tranquilizers and mood stabilizers are used to treat adults with ADD/ADHD, as is behavioral education.