The primary research question was the perceptions and experiences of parents and guardians about the relationship between the experience of the grief and loss in children and the diagnosis of AD/HD in school-aged children of Central Texas taken into account military families where the deployment of one of the parents influence the performance of children in school.
According to Harris, Attention Deficit Hyperactivity Disorder is a persistent pattern of inattention, which may include hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development-Criterion A. Some hyperactive-impulsive or inattentive symptoms that cause impairment must have been present before age 7, although many individuals are diagnosed after the symptoms have been present for a number of years, especially individuals with the predominantly Inattentive Type-Criterion B (Harris, 27).
The results of our findings may be presented in the following table.
There are a lot of types of losses that may influence the children’s behavior and personality. The main types of losses are divorce, separations, deployments, death, incarceration, moves, and adoptions. Such events like the death of the parent or sibling, deployment of one of the parents or their divorce, the removes from one place to another belong to such losses which impressed the life of children and their learning, thinking, retention, and performance at school. According to Walsh-Burke (2006): “Grieving children can become afraid of going to school or have difficulty concentrating, may behave aggressively, become overly concerned about their health, or withdraw from others”. As the result, children may be perceived as having attention deficit disorder during their grieving. “Grief is defined as the physical, psychological, and social reaction to the loss of something or someone important to us. Grief represents the particular reactions that a person experiences while in a state of loss” (Burke-Walsh, 2006, p. 16). The main cause of this grieving is the death of a significant person or a pet. Such grieving is the child’s response to this loss. Sigle-Rushton, Hobcraft, and Kiernan (2005) pointed out that children born after 1950 are more sensitive to the parents’ divorce rather than to the death. Many children experience divorce the same way as the death of one of the parents. Mathew (1999) highlighted that child’s grief is not limited only to the loss from death: “when children deal with death, with divorce, with frequent moves, with a difficult medical diagnosis, with illness, or with giving up something meaningful, the loss is experienced” (p. 96). The state of grieving is very much like AD/HD. According to Vance and Pumariega (2001) grief as well as AD/HD is supported by a number of symptoms namely “persistent sadness, an inability to enjoy favorite activities, increased irritability, frequent complaints of physical illnesses, frequent absences from school or poor performance….poor concentration…etc.” (p. 414). It is quite difficult to define whether it is grief or attention deficit disorder which symptoms are primarily and require intervention. Parents of grieving children notice their children’s distractions and difficulties at school. They should be aware that attention and poor concentration are frequent companions of loss and grief. Wolfelt (1996) said it this way. “Many bereaved children express the pain of grief by acting out. The counselor who isn’t sensitive to the normalcy of this behavior is often tempted to see distractibility, impulsivity, and hyperactivity as reflecting full-blown AD/HD” (p. 77).
The connection between loss and diagnosis of AD/HD in children is unrecognized and sometimes it is very difficult for many parents to define whether their children suffer from AD/HD or not. According to the results of our research, many parents don’t observe the connection between AD/HD and separation and loss. According to the parents’ responses, they find it difficult to define whether their children have AD/HD or not (P185a). There are a lot of stresses and difficulties in our life nevertheless not every child who experienced losses and deployments is diagnosed with AD/HD (P187a). Many children are diagnosed to have AD/HD without having experienced any separation, loss, or death (p008). On the other hand, the deployment of parents may result in speech delay in many children (p026a). The deployment intensifies the stress situation of the child and makes concentration and self-control too difficult (P098a). The death of relatives may cause AD/HD. For example, the death of a younger sister causes indifference to the study of the older one (P121). The death of the grandmother may also result in the deterioration of attention, behavior, and grades (P144b). Grief may cause a wave of anger and maybe one of the main causes of AD/HD (Sp113a). Other parents think AD/HD is hereditary and nothing can cause it (P123c). Some factors only may bring all these hereditary factors to the surface (S072). There are cases when children are diagnosed with AD/HD because one of their parents had also AD/HD in childhood (P204a). Nevertheless, such cases as death, divorce, or deployment are impossible to go through without any reaction. Children are very vulnerable and psychologically weak to experience these cases without any impresses on their behavior. There are semi-depression and emotional states that the children have to go through (P126a). Divorce may be a very stressful situation for every child and it is very important to keep friendly relationships between parents not to traumatize the child (P130c). Many children do not even know who is their father or mother (S007a). It is quite difficult to realize that every child should have parents and you do not have them. Why are you deprived of parental attention? Are you worse than other children? Children who don’t have a mother or a father have weak self-confidence and are inclined to blame themselves for the absence of one of the parents. There are a lot of cases when divorce causes AD/HD (P132). It is still a debatable question whether AD/HD comes naturally or is caused by a wide range of reasons. Many parents consider the diagnose of AD/HD to be senseless or “an easy decision” as far as it is like a label that may spoil the life of children who think that they are not like others. All children are susceptible to problems and feel stressed but it does not mean that their reaction is unhealthy. On the contrary, if they do not feel anything during the divorce, separation, or death, it seems abnormal (S086a). Nevertheless, parents should be aware of the problems of their children in order to help them in time. Children need attention and parents should react to their needs and feelings.
Children who have attention deficit are more vulnerable to be diagnosed with AD/HD. The level of AD/HD is intensified in the USA during the last ten years. As Barkley (2006) stated: “A review of prevalence research suggests that the prevalence of the disorder is approximately 3.8% in the U.S. studies using earlier versions of the DSM and nearly double this (7.4%) in studies using DSM-IV” (p. 111). Barkley (2006) observes the reasons for such increasing and he pointed out that the higher rates were identified in the military families where parent’s deployment is a very usual event.
Kutscher (2005) identified a “syndrome mix” of sensory integration problems, anxiety, depression, and learning difficulties ( p. 17). Kutscher further pointed out that distraction and concentration problems were primary symptoms of AD/HD. Vance and Pumariega (2001) associated inattention and co-morbidities including aggression, depression, anxiety, and social skills challenges with AD/HD. There are vague boundaries between the loss and AD/HD. There is no certain clarity whether all children who experienced loss and grief should be diagnosed with AD/HD. Many researchers draw a comparison between a major loss in the child’s life and the diagnosis of AD/HD. In fact, AD/HD is a neurobiological disorder with genetic components, and grief and loss are not obligatory causatives for this diagnose. Grief and loss may be factors that contribute to the symptoms that result in a diagnosis of AD/HD.
Let us have a closer look at military families living in Central Texas. Texas is the largest military base in the United States where nearly 100,000 military families live. There are a lot of children whose parents are in the military comprise. The study examining the children of military families demonstrates the correlation between loss and AD/HD diagnosis. Children from military families experience frequent removals, parent deployment, parental divorce, and parental loss.
The central Texas town in the study was founded in 1850 and is one of several Central Texas cities whose financial and economic growth are connected to the military base and the military presence there (Armstrong,1988). There are 8900 students in the school district at 12 campuses: 8 elementary schools; 2 middle schools; 1 high school; 1 alternative school. Sixty-one percent of the school district students were white, 28% Hispanic; 8% African American; 2 % Asian American; and 1% Native American. Of the 8900 students in the school district, 45 % (3487) were economically disadvantaged; 42% were at risk; 7% had limited English proficiency, and 11.5% were in special education. In 2009, the district was “academically acceptable” in the State of Texas rankings with 4 ‘exemplary’ elementary schools and 4 ‘recognized’ elementary schools (Harris, 29). Approximately 60% of the students in the school district are connected to the military through one or both parents. The deployment of one of the parents is one of the main reasons for AD/HD:
- K010d ADHD is a very difficult barrier for families especially when a parent is gone due to deployment. I hope your research yields reward to those coping.
- K020a Edward is a very intelligent child. Yet he tends to act out in any way possible, perhaps with hopes that his father will return. This is at every deployment.
- p026a Daughter did not talk until after starting pK. Stayed with grandma and sister during the 2003 deployment of mom and dad. The daughter is not an early reader. Still struggles with reading.
- K008b Jared started having difficulties after my first deployment. Speech delays and attention. Then I deployed again and it got worse. His father and I divorced and that didn’t make it any easier for him.
Children from military families are more susceptible to being diagnosed with AD/HD. They experience separation from their parents who have to fulfill war debts. These children are deprived of parental attention. The responses of many parents testify to the fact that children from military families need special attention. As one woman whose husband is a military says that their son has AD/HD as far as he needs more father’s attention and he is acting out for the attention the father cannot give him (Sp148b). Another case demonstrates that although there are no losses in the family, a child has some problems when her father is in Afghanistan as a defense commander. She lives like in her little world nevertheless her mother considers her healthy (SP062a).
There were 181 responses in our research, 45 of them connected with military families. 140 cases were diagnosed AD/HD, 41 didn’t have AD/HD, or parents didn’t observe any reason to worry. Analyzing the results of our research we notice that the most widespread reasons of AD/HD among children are death/loss (20 cases) and separation/divorce (30 cases):
- L046a After the death of his step-father, Hunter became more whiney and used the “ADHD” to help him get away with any trouble or dropping grades he had.
- P126a I think separation, loss, and death play a significant part in behavior and academics. There are lots of questions when one of the three occur. The child tends to dwell more and not necessarily understand why, how, etc. There there’s the angry side, the temper that you have to deal with because of one of the three events. There’s also the semi-depression and emotional state that the child goes through. Not wanting to talk or deal with it. I watch my child/children very closely. You have to. He has also seen a counselor for a few weeks now and I really think this is helping. I make sure to stay on top of the school work, friends, sports, etc. Children with ADHD are just as capable as children who do not have ADHD.
- SP052 I think the child (who is gifted & talented as well as ADD) was already ADD long before diagnosis & the separation from her brother made it worse. She was not identified at school as gifted/talented (although our parents strongly suspected she was) until after her ADD diagnosis and starting her therapy.
- P144b This may be the case. She lost her grandma in 2nd grade. This was her first loss. She continues to struggle with it. Her attention, behavior, and grades began to drop after this event. We also had a miscarriage that same year shortly after which she was aware of and was actually with me when it was found. Took this extremely hard.
- K018 a and b Zachary-unsure if there is any connection. He was very young at the time his dad died. He has very few memories. Victoria was only diagnosed with ADD. She has had a very difficult time dealing with loss. I feel this loss contributes significantly to her ADD.
Many parents explain this diagnose by hereditary factors as far as children of the parents who had AD/HD in childhood are disposed to have it too. 10 cases were explained by hereditary factors. Many cases are diagnosed AD/HD without any typical reasons such as loss or divorce. Parents could not explain such behavior of their children. They didn’t know whether it was AD/HD or just typical characteristics of the awkward age. Children who were treated with the help of medicines felt much better nevertheless parents expressed their concern about the addiction of their children to these pills:
- S001a The doctor is still trying to get the correct medicine for Aaron. When he does his homework and the pills wear off or if he didn’t take his medicine, he is like a jumping bean. He moves so much I don’t know how he sees the words on the pages. Homework is not much fun.
- S086a I am Jesse’s dad and I’m very sorry that I cannot complete the form I just wanted to tell you why I am a 26-year-old male and when I was Jesse age I was diagnosed AD/HD I was put on the riddle and while after that I was told I had an anger disorder and when I took pills for that well to make a long story short I was made to believe that I wasn’t right in the head and I needed to take all the pills well now I’m a grown man and I’m taking 4 pills a day because I have scenes sorry I’m not too good at spelling it (Scisto) so in conclusion, all of that intrude my life and I never had a chance but it if helps your study yes I had a lot of loss in my younger life! I am so sorry but I am a firm believer that kids do not need a label like AD/HD they are kids learning a whole new world every day they get hyper and excited so I’m very sorry it is something I feel very strongly about. So my son Jesse H. will not be tested for AD/HD. Thank you so much and I’m very sorry if you would like you can call me and I can explain a little better. Many parents considered this diagnose to be senseless and they thought that all these psychological problems are typical for those families where children are paid less attention. Nevertheless, there were cases when children were diagnosed with AD/HD even when they lived in good families and are paid a lot of attention. It should be noted that these cases are very rare compared to those which were caused by death, losses, separations, divorces, and deployments.
- S014a ADHD is overrated and overdiagnosed. I don’t believe my child has ADHD, I think it’s the doctor’s “easy way” out of kind the real answer. The primary question of our research is whether AD/HD is connected with children’s grief. As we can see from the results of our research, in most cases children who have experienced some psychological scars caused by the death of one of the parents, divorce, separation, deployment, adoption, or jailing of one of the parents are more likely to be diagnosed AD/HD. According to Harris’s research, the average age of children at the time of diagnosis is 6,93 years of age (116). Children of this age need more parental attention, they are more susceptible to psychological scars as far as they are not independent and their life is directly connected to their parents. The average number of losses per child is 1,84. Generally speaking, children who have experienced loss have AD/HD and those who don’t have such experience do not have this illness. The results of our research testify to the fact that there is an association between grief and loss and AD/HD. Although many respondents explained AD/HD by a wide range of reasons where death and loss were the most popular, many of them said that this psychological illness is hereditary:
- P123c-d None, in our case. It seems to be hereditary. My whole household growing was severe ADHD.
- Sp095 b and c The main point for my boys has been that these medical differences are hereditary. The loss was the catalyst to bring the symptoms to the surface. Note two sons diagnosed with ADHD, each in a year father was deployed, one in 2005; one in 2009.Sp142c none probably inherited from loony, druggy mother
- P204a Our daughter comes by ADHD naturally, father had the same ADHD behavior as a child. Mother incarcerated year before diagnosis.
- M051a ADHD and other illnesses of mental problems related to also stress and a lot of other disorders run in my child’s family on both mothers’ and fathers’ sides.
- To59d I don’t really find a significant correlation. My oldest son is 19 and he also has a DX of ADHD. I think my sons are genetically predisposed to ADHD.
As we can see from our research, the main problem of modern families is that parents do not pay enough attention to their children which may cause AD/HD. There are a lot of other reasons which result in AD/HD namely loss, death, deployment, divorce, separation, jailing, adoption, and other stressful situation in children’s life which traumatize their weak psychic. More than that, there were cases where AD/HD was caused by inherited factors and other medical explanations. In some cases, parents did not accept their children to have AD/HD. They explained the problems with their behavior and study performance with their age. Nevertheless, in many cases children who were diagnosed with AD/HD had experienced loss and grief. This research allows us to conclude that there is a correlation between loss and grief and AD/HD.
Reference List
Armstrong, L. (1988). The story of Bell County. Belton, TX: The Bell County Historical Commission.
Barkley, R. (2006). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York, N.Y.: The Guilford Press.
Harris, H.W. (2011). Attention deficit/hyperactivity disorder or grief: A study exploring the association between childhood loss and grief and a diagnosis of AD/HD in elementary aged children in Central Texas. Dissertation, University of Mary Hardin-Baylor, College of Education, Belton, Texas.
Kutscher, M. L. (2005). Kids in the syndrome mix of AD/HD, LD. Asperger’s, Tourette’s, Bipolar, and more. London, England: Jessica Kingsley Publishers.
Sigle-Rushton, W., Hobcraft, J., & Kiernan, K. (2005). Parental divorce and subsequent disadvantage: A cross-cohort comparison. Demography, 42(3), 427-446.
Walsh-Burke, K. (2006). Grief and loss: Theories and skills for helping professionals.
Boston, MA: Allyn & Bacon. Wolfelt, A. D. (1996). Healing the bereaved child: Grief gardening, growth throughgrief and other touchstones for caregivers. Ft. Collins, CO: Companion Press.