In today’s New York Times, commentary on the emergence of Michael Phelps as icon for kids with attention deficit disorder, and how people perceive ADHD and other disorders:

On the one hand:

The notion that a disability can be harnessed in a positive way is not a new concept. Last year, a study found that 35 percent of the small-business entrepreneurs surveyed identified themselves as dyslexic. The researchers concluded that dyslexia made them better communicators and problem solvers, more likely to delegate authority.

…

“We want to tell children, ‘You’ve got a difference, but not a disease,’ ” he said. “Michael Phelps is one of any thousands of examples of mega-successful people, C.E.O.s and brain surgeons and famous writers, inventors and entrepreneurs, who have A.D.H.D.”

On the other:

Other experts, however, say that while such success stories can be inspiring, parents need to know that their children face real risks. Research shows that children with attention deficit have different brain patterns from other children, and that they are more likely to drop out of school, be involved in car accidents and use illicit drugs.

…

Ms. Knochenhauer, who has four children with the disorder, says they too were inspired by the astonishing performance of Mr. Phelps in Beijing. But she added, “I would argue that Michael Phelps is a great swimmer with A.D.H.D., but he’s not a great swimmer because he has A.D.H.D.”

Dr. Koplewicz, of N.Y.U., agreed. “There are lots of children in the world who have chronic illnesses or disorders like diabetes, allergies or dyslexia who accomplish great things in spite of the fact that they have these disorders,” he said. “I worry when we say A.D.H.D. is a gift, that this minimizes how real it is.”

Tara Parker-Pope, A New Face for ADHD.  And a Debate, New York Times, 24 November 2008.

I like Hallowell’s comment that ADHD ought be considered a “trait”, with all the pluses, minuses, and non-relevants that a trait can be.  As for the research into small business, the 35% dyslexic number is shockingly high to me.  I’ve wanted to do a similar survey for small business owners and ADHD.  If anyone would like to fund it, please email me!

In today’s news on adult attention deficit disorder:

This lack of ability to concentrate costs the average adult sufferer 22.1 days of “role performance,” per year, including 8.7 extra days absent, according to researchers led by Dr. Ron de Graaf of the Netherlands Institute of Mental Health and Addiction.

It might be cost-effective for employers to screen workers for ADHD and provide treatment, the researchers suggest.

…The majority of the lost performance was associated with reductions in quantity and quality of work rather than actual absenteeism, the researchers said.

– Randolph Schmid, Associated Press Science Writer, ADHD Can Cost Adults 20 or More Workdays A Year, 26 May 2008.

This article speaks about adult workers as a whole, not focusing on executives or professionals.  If you consider that an executive or professional’s time is highly leveraged across other staff, the cost to business is especially high.  Appropriate ADHD treatment for a line worker might return a few thousand dollars to the company’s bottom line.  Appropriate treatment for a C-level exec or owner could return manyfold more.

This blog occasionally mentions how our ADD nature can be an advantage. But I hadn’t thought about this one:

As Major League Baseball begins to dig out from its steroids scandal, new kinds of performance-enhancing substances are sweeping big-league clubhouses: Ritalin, Adderall and other drugs designed to help with Attention-Deficit Disorder. According to records MLB officials turned over to congressional investigators as part of George Mitchell’s probe into steroid use in baseball, the number of players getting “therapeutic use exemptions” from baseball’s amphetamines ban jumped in one year from 28 to 103—which means that, suddenly, 7.6 percent of the 1,354 players on major-league rosters had been diagnosed with ADD.

One possible reason for this increase: in 2005 baseball banned the use of “greenies,” amphetamines that help players remained focused and energetic through the rigors of a 162-game season. Amphetamines were once as common as deli spreads in big-league clubhouses—in some, greenies were used to spike the coffee. Players are now seeking doctors’ prescriptions for ADD medications, usually Ritalin and Adderall, apparently to replace the now-illegal energy boosting drugs…

– Charles Euchner in Are players using an ADD diagnosis to evade the amphetamine ban?, Newsweek Web Exclusive. Feb 6, 200. Click title for full article at Newsweek.

This full article is worth a read for more than the tidbit, above.  There’s mention of athletic activity as “the best cure for ADD” via its emphasis on both exercise and focus.  There’s also mention of how the player’s working lifestyle (lots of travel, irregular schedules, and other things that match the experience of a business executive) fuel the symptoms of ADD.

As a “brain personality,” attention deficit disorder drives people into executive positions and business ownership via its strengths (e.g., ability to multitask) and its weakenesses (e.g., lack of patience). Research just reported in the New York Times looks into the role of dyslexia as a similar driver, particularly for its role in causing people to develop “compensatory skills”:

Tracing Business Acumen to Dyslexia
By BRENT BOWERS

It has long been known that dyslexics are drawn to running their own businesses, where they can get around their weaknesses in reading and writing and play on their strengths. But a new study of entrepreneurs in the United States suggests that dyslexia is much more common among small-business owners than even the experts had thought.

The report, compiled by Julie Logan, a professor of entrepreneurship at the Cass Business School in London, found that more than a third of the entrepreneurs she had surveyed — 35 percent — identified themselves as dyslexic. The study also concluded that dyslexics were more likely than nondyslexics to delegate authority, to excel in oral communication and problem solving and were twice as likely to own two or more businesses.

The article also quote the well-known Kinko’s founder Paul Orfalea:

Mr. Orfalea, 60, who left Kinko’s — now FedEx Kinko’s — seven years ago, and who now dabbles in a hodgepodge of business undertakings, is almost proud of having dyslexia and attention deficit hyperactivity disorder.

“I get bored easily, and that is a great motivator,” he said. “I think everybody should have dyslexia and A.D.D.”

Full article here: Brent Bowers, Tracing Business Acumen to Dyslexia. New York Times. December 7, 2007.

For a preliminary copy of the 2004 research report from Julie Logan, click here for a .pdf on dyslexia and entrepreneurship (at her research institute, Simfonec at the Cass Business School in London).  Click here for Julie Logan bio.

Some naysayers argue that attention deficit disorder isn’t a real problem, or that it’s only a problem for people who fail to take personal responsibility for their brains and behaviors.

Admittedly, many past ADD-management have relied too broadly on medication with little focus on self-management. Things are better today with greater use of additional techniques such as cognitive-behavioral therapy. But what about good old fashioned “willpower”? It looks like it’s on the comeback to an active role in personal health management. This from the New York Times:

Every day, we are tested. Whether it’s a cookie tempting us from our diets or a warm bed coaxing us to sleep late, we are forced to decide between what we want to do and what we ought to do.

The ability to resist our impulses is commonly described as self-control or willpower. The elusive forces behind a person’s willpower have been the subject of increasing scrutiny by the scientific community trying to understand why some people overeat or abuse drugs and alcohol. What researchers are finding is that willpower is essentially a mental muscle, and certain physical and mental forces can weaken or strengthen our self-control.

Studies now show that self-control is a limited resource that may be strengthened by the foods we eat. Laughter and conjuring up powerful memories may also help boost a person’s self-control. And, some research suggests, we can improve self-control through practice, testing ourselves on small tasks in order to strengthen our willpower for bigger challenges.

– Tara Parker-Pope on Health, How to Boost Your Willpower, New York Times.  December 6, 2007.  <– Click title for full article.  Registration may be required.

For people with attention deficit disorder, is compulsive internet surfing an example of no focus or an example of hyperfocus?  On the one hand, the addicted surfer is constantly moving from one website to another.  On the other hand, the addicted surfer is clearly focused on one thing: “the internet” and the computer he’s using to access it.

In any case, South Korea is doing something about it.  From the New York Times:

Compulsive Internet use has been identified as a mental health issue in other countries, including the United States. However, it may be a particularly acute problem in South Korea because of the country’s nearly universal Internet access.

It has become a national issue here in recent years, as users started dropping dead from exhaustion after playing online games for days on end. A growing number of students have skipped school to stay online, shockingly self-destructive behavior in this intensely competitive society.

They spend at least two hours a day online, usually playing games or chatting. Of those, up to a quarter million probably show signs of actual addiction, like an inability to stop themselves from using computers, rising levels of tolerance that drive them to seek ever longer sessions online, and withdrawal symptoms like anger and craving when prevented from logging on.

…To address the problem, the government has built a network of 140 Internet-addiction counseling centers, in addition to treatment programs at almost 100 hospitals and, most recently, the Internet Rescue camp, which started this summer. Researchers have developed a checklist for diagnosing the addiction and determining its severity, the K-Scale. (The K is for Korea.)

In September, South Korea held the first international symposium on Internet addiction.

“Korea has been most aggressive in embracing the Internet,” said Koh Young-sam, head of the government-run Internet Addiction Counseling Center. “Now we have to lead in dealing with its consequences.”

– Martin Fackler, “In Korea, a Boot Camp Cure for Web Obsession”, New York Times, 17 November 2007.

I learned that quality requires minute attention to every detail, that everyone in an organization wants to do a good job, that written instructions are seldom adequate, and that personal involvement needs to be frequent, friendly, unfocused, and unscheduled—but far from pointless. And since its principal aim is to seek out people’s thoughts and opinions, it requires good listening.

–Hewlett-Packard co-founder David Packard, in The HP Way.

For an ADDexec, “MBWA” may have as much benefit for managing their ADD/ADHD as it does for managing their staff. Executives with the “H” in attention deficit hyperactivity disorder need the movement.

So how do we get more movement into our days? Fidgeting is one obvious outlet, but do we have others? Management By Walking Around sounds like a good one, as long as it isn’t aimless or hyperactive motion. Pre-work or mid-day exercise may be another, for the deskbound among us.

But picking a walking-oriented career may be even better. A recent CareerBuilder.com listed ten fields “considered to have the best physically active job opportunities, based on information from the U.S. Department of Labor and the U.S. Census Bureau”:

1. Registered nurse
2. Physical therapists
3. Physician assistants
4. Elementary school teachers
5. Radiologic technologists and technicians
6. Kindergarten teachers
7. Occupational therapists
8. Secondary school teachers
9. Police and sheriff’s patrol officers
10. Veterinarians.

Granted, most of those jobs aren’t considered “executive” positions. But you might find more in Laurence Shatkin’s 175 Best Jobs Not Behind a Desk. In the CareerBuilder article, Shatkin says,

“The shift to an information-based economy has meant a constant increase in the proportion of workers who manipulate data for a living, and who therefore spend most of the workday behind a a desk…. Fortunately… there are still plenty of high-activity jobs for people who prefer them… active jobs that have good earnings and are expected to have good job opportunities. They allow you to use your brains as well as muscles and involve the kinds of people and problems that can keep you interested in your work.”

– from “Out in Front”, in the News & Observer careerbuilder.com section, 4 November 2007

——

Amusing related quote: “MBWA is a hyperactive, out-of-the office, interventionist top management practice.” –Vadim Kotelnikov

Do you use caffeine to treat your attention deficit disorder? Or do you avoid caffeine at night to protect your mission-critical sleep? In either case, you probably ought know how much you’re taking and when. Problem is, if you’re drinking decaf coffee, you can’t always be sure.

Excerpt from A Wake-Up Call for Coffee Drinkers, New York Times, October 25, 2007:

Coffee sleuths from Consumer Reports recently tested cups of decaf ordered at Dunkin’ Donuts, Starbucks, Seattle’s Best Coffee, 7-Eleven, McDonald’s and Burger King. They visited six locations of each chain, evaluating 36 cups of decaf in all.

A regular cup of coffee has from 85 to 100 milligrams of caffeine. Most of the 10- to 12-ounce decafs tested had less than five milligrams, the magazine reports in its November issue. But one decaf from Dunkin’ Donuts contained 32 milligrams of caffeine — about the same amount in 12 ounces of Coca-Cola Classic. A cup of Seattle’s Best was found to contain 29 milligrams of caffeine, while a tall Starbucks decaf packed 21 milligrams. Results varied at each chain, but the magazine found that the decaf at McDonald’s consistently had the lowest levels of caffeine.

Coffee beans image courtesy of iband clip art for all.

When you feel your company is struggling to stay focused, take heart in knowing that even the biggest companies — with their monster budgets for hiring smart people — often have the same problem.

Here’s an excerpt of the Washington Post’s coverage of focus problems at Sprint Nextel

Interim Sprint CEO Sets Out To Restore Company’s Focus

[Interim CEO Paul] Saleh said the company has tried to tackle too many big changes in the past year.

Saleh’s solution: Improve customer service and simplify the business.

“We had too many things on our plate before. . . . We were doing too many things to reach too many customers too quickly,” he said. “We have to do fewer things, but do them very well.”

– Kim Hart, in Interim Sprint CEO Sets Out To Restore Company’s Focus, Washington Post, 19 October 2007. (Emphasis added.)

Photo Credit : Sprint Nextel. In case you were wondering, their 2006 revenue was $41 billion dollars. Tons of money do not guarantee smart decisions.

Modafinil (marketed as Provigil): Serious Skin ReactionsFDA has been monitoring cases of serious skin reactions, including erythema multiforme (EM), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), in its postmarketing reviews of adverse event reports associated with the use of modafinil. The product labeling for modafinil has been recently updated to include a bolded warning for serious rash, including SJS. Based on postmarketing data for modafinil, a recently approved drug with a similar chemical structure, armodafinil, includes a similar bolded warning in the product labeling. Healthcare professionals and patients should be watchful for skin reactions associated with the use of modafinil and armodafinil and report cases to FDA’s MedWatch.

From FDA Drug Safety Newsletter, Fall 2007.

Modafinil (sold as Provigil, which is targeted for prevention of certain sleep disorders) is often provided as an off-label prescription for the treatment of attention deficit disorder. In 2006, the FDA denied the Cephalon company’s request to approve modfinil (to be sold under the brand name Sparlon) as an ADHD treatment for children and adolescents. In denying the request, the FDA cited particular concern for the potential of SJS. Full article on Sparlon here at Marketwatch.