A hundred academic textbooks and a thousand medical journal articles on ADHD
(attention deficit hyperactivity disorder) can provide the details on this
children’s condition. But nothing is as useful for families as a personal
account written by the parent of a child struggling with the condition, which
affects one in 10. Hanna Stern, whose son Assaf, or Assi for short – who
recently completed military service – was diagnosed with ADHD, tells their story
and offers advice in a new Hebrewlanguage, soft-cover volume called Ulai
Takshivu?! Mabat Ishi al ADHD (Will You Listen?! ADHD from a Personal
The NIS 84, 254-page book, issued by Focus Publishing
Company , was written by a mother who is also a journalist.
to sharing the ordeal of her son and family, Stern also interviewed a wide
variety of professionals in the field, as well as other parents. She puts the
disorder in an Israeli perspective, describing where and how help is available
from government ministries, health funds, voluntary organizations and private
experts. The result is a compelling, optimistic and positive story about
children who have many gifts despite their difficulties.
Assi was born
following a long series of painful fertility treatments in November 1987 to
Hanna and Itzik. The couple already had a daughter, Shirli. Assi was diagnosed
with ADHD while his mother was under close supervision by obstetricians when she
was pregnant with his brother Matan. Assi’s delivery was normal, but due to the
persistent efforts by Assaf Harofeh Medical Center’s fertility specialists, he
was named for the hospital. The pregnancy with Assi, writes Stern, was normal
and nurtured great expectations, and the delivery was quick. He was a good baby,
with a good appetite. He began to walk and speak at an early age and was all
But when he turned five, Assi turned into a problem child. His
kindergarten teacher complained that he was “violent, does not participate and
disturbs the other children.”
After his brother was born, things got
worse. The parents learned that Assi spent most of his time in kindergarten
“under punishment” and was regarded as different than the other youngsters.
Feeling rejected, he bit his nails until his fingers bled and spent most of his
time sitting on the steps near the entrance.
With a new baby, Stern felt
helpless and unable to connect with the teacher, who preferred well-behaved
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But even though Assi was wild, no one suggested he remain in
kindergarten for another year because he was unripe for school.
know where to turn. A friend suggested I go for a hospital consultation. The
doctor looked at him for a few seconds and said: ‘He has ADHD. You have to give
him Ritalin.’ I felt as if a 5-kg hammer had landed on my head. I felt weak and
“How do you know?” I asked him. “You haven’t even examined
him!” “I have experience and I’ve seen many children like this,” he
Stern recalls that she hadn’t a clue what ADHD was about or where
it came from.
“I don’t recall even how I got to my car in the lot. I do
remember feeling scared and uncertain about the new situation. We didn’t give
him Ritalin because I didn’t believe the diagnosis. I wanted to hear a second
opinion and more explanations.”
ADHD, diagnosed in boys much more
frequently than girls, involves overactivity, lack of attention, impulsive
behavior or a combination of these. It is one of the most common behavioral
disorders of childhood and can continue through adolescence and adulthood. ADHD
is categorized according to several subtypes. Most ADHD children suffer from
hyperactivity, impulsivity and inattention.
It is incurable, but various
treatments can relieve many of the symptoms and children with the condition can
grow up to be successful in school and have productive lives.
can be forgetful sometimes, or have difficulty focusing on one thing or
listening to others, quickly becoming bored, daydreaming and refusing to follow
instructions. But to be diagnosed with ADHD, the child must suffer from symptoms
for at least six months and to a degree more significant than in other children
of the same age.
AS THE condition appears to run in families, a number of
genes are thought to be involved, although researchers have not yet pinpointed
the exact cause. After diagnosis of a child, many parents recall behaviors of
their own that suddenly seem to them to have been connected to ADHD. Chronic
exposure to tobacco smoke and alcohol use during pregnancy is thought by some
researchers to be involved, along with certain food additives. No single test
can determine diagnosis, but TOVA (Test of Variables of Attention) can give an
indication, and close observation by a specialist can confirm it.
most common treatments for ADHD are stimulants such as amphetamines that,
ironically, have a calming effect on such children. There are short-acting,
long-acting and slow-release drugs in various forms and dosages that are
prescribed by doctors and other qualified professionals, but one type does not
This was the case with Assi, who took Ritalin for a short period
but had to give it up because of significant side effects including headaches,
sleeplessness and nightmares when he did fall asleep. Other children have
reacted to ADHD drugs with lack of appetite, anxiety, irritability and – less
commonly – sudden, repetitive movements or sounds called tics. Dosage may be
reduced to improve reactions, but some children may not be able to manage with
the medications at all. Assi was prescribed another drug named Nitan, and with
various dosage modifications and other therapies, his symptoms were
There has been strong opposition among some
parents to giving medications, for ideological reasons. The author, with help
from the experts she consulted, explodes myths about ADHD, such as the belief
that the disorder passes in adolescence, results from brain damage, does not
have to be treated, or can be “borderline,” and that medication causes
depression in children or turns them into “zombies.” All not true, says Stern
after much investigation.
Stern praises a number of professionals she and
Itzik encountered on the family journey through ADHD. One was Moshe Hamiel, an
educational psychologist at the Ma’agalim Institute she describes as “our
angel,” who taught them how to be nonjudgemental and not to conduct
“investigations” when dealing with Assi.
“It was exhausting, and
sometimes we felt like giving up because we didn’t see immediate results,” she
Eventually, however, the Sterns got to a point where they could
“live together without going crazy, to see the good things while not ignoring
the bad things. He brought us to love Assi without conditions such as being a
good boy or not causing problems.”
Stern stresses that today, awareness
and understanding of ADHD in the educational and medical systems are much better
than when Assi was small. Kindergarten teachers working for municipalities are
well trained to recognize problems. In her recent interviews with kindergarten
teachers, she heard of numerous cases of ADHD that were much more difficult than
Assi’s. Alon, a good-looking blond boy, used to bang other kids’ heads on the
floor, touch electricity wires, climb fences and trees and refuse to observe the
“I couldn’t cope with him,” the kindergarten teacher conceded. “We
called in the parents and saw there was no father involved, only a mother who
was in denial.
She said he was a wonderful boy and that it was the
teacher who had the problem. But the man she was living with, who brought him to
kindergarten, admitted that he was a difficult child who spent most weekends
alone. Alon hit the kindergarten staff and other children and was
Today’s teachers can turn to regional support centers staffed
by professional ADHD advisers. There are computer programs today that help
teachers diagnose ADHD. Children’s behavior and improvement with treatment are
monitored using special forms. There are even integrated kindergartens that
combine ADHD kids with “normal” ones whose parents are usually not reluctant to
send them because they know the facilities are high-quality.
many examples of ADHD children who “miraculously” changed thanks to medication.
A charming, intelligent eight-year-old boy named Liel was very disruptive until
he was given medication, after which he was able to read and write competently
for the first time.
He lost his fear of crowds, and at a relative’s bat
mitzva he congratulated her in public as a representative of the cousins. He was
suddenly able to pay attention to the teacher; previously, he hadn’t been able
even to copy anything from the board.
Stern cites Nitzan, the voluntary
organization for ADHD families. Headed by Mali Danino, Nitzan has 36 branches
around the country. Aside from helping with diagnosis, Nitzan offers support
groups and workshops to help parents. A variety of complementary therapies
proved to be very helpful to Assi. These include horseback- riding, psychodrama
and martial arts.
The author notes that as Assi grew older, he found
frameworks suited to his age, including Jerusalem’s Yeshivat Bnei Hayil,
established many years ago by Dr.
Stuart Chesner, a clinical psychologist
who has specialized in accommodating ADHD children. He was admitted from seventh
grade and was bused to the capital even during the hair-raising years of
The institution uses special techniques to improve the
boys’ self esteem and pride. Assi did well enough in his studies to be ready to
complete his matriculation in the future with just a little more
Although his parents thought he would never be able to cope with
his assignment in the Israel Defense Forces – to be in charge of a medication
storehouse – because of the difficulty ADHD youths have with organization, he
proved to be responsible and capable and did well.
His military profile
had been set at 64, Stern reveals, not because of his ADHD but due to an
accidental eye injury he suffered as a boy. Although youths with ADHD are not
exempt from military service, they are assessed and prepared by a special IDF
Although symptoms usually lessen in adulthood, they don’t
disappear altogether. In numerous cases, the condition is diagnosed only when
people are in their 20s or even older. Psychologist Orly Tzadok, whom Stern
interviewed, was surprised to hear that she – who specializes in adult ADHD –
had the disorder herself.
“I wouldn’t switch my ADHD for something else,”
Tzadok enthused. “I have vivacity, creativity – although there is some lack of
control – but I also have the ability to get many things done. You are alive!
This characteristic of ADHD has benefits and shortcomings, but after school
ended, I haven’t sat in one place for a moment.”
schedule is thus packed, and to give counseling, she doesn’t hesitate to travel
even to Eilat. Coaching programs for adults with ADHD have become quite
Stern concludes: “For us, this [book] is only an intermediate
summary. Our story has not concluded; it continues within our family, with our
children and with grandchildren to come. Coping is easier today, as we know the
process, the problem and the obstacles we must overcome. But if we forget for a
moment how to behave, it reappears. Our language with Assi is different,
considerate, with low tones of voice.... This doesn’t happen with our other
children, and maybe this is unfortunate. Maybe these rules should be adopted for
all children and not only those with a problem. It would make child-raising
Now having completed his active IDF service, Assi faces the
usual dilemmas of young adults.
“I am pleased with our child, his looks,
behavior, the way he speaks and deals with people,” Stern writes. “I am happy
for him ... he has succeeded in reaching his target, [and] volunteers with the
Israel Police as he wanted.”
She concludes that he has talents that will
ensure his successful integration into society. He can learn a profession using
“I wonder if he will find a woman suited for him, have a
family, what kind of father will he be, how will he take care of his children. I
hope he will know how to do things in the proper order. What is certain that in
any decision, we will be happy to be partners and give him backing, as we have
not forgotten what we were told when he was born: ‘You are responsible for
bringing him into this world.’”
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