Attention deficit disorder is usually explained as the result of bad genes by those who "believe" in it, and as the product of bad parenting by those who don’t. The aura of confusion, moral judgement and even acrimony that surrounds public debate about the condition discourages a reasoned discussion of how environment and heredity might mutually affect the personalities and neurophysiology of children growing up in stressed families, in a fragmented and highly pressured society, and in a culture that seems more and more frenzied as we approach the turn of the millenium.

I have attention deficit disorder myself, and my three children have also been diagnosed with mild ADD. I do not think it is a matter of bad genes or bad parenting, but I do believe it is a matter of genes and parenting. Modern neuroscience has established that the human brain is not programmed by biological heredity alone, that its circuits are shaped by what happens after the infant enters the world, and even while it is in the uterus. The emotional states of the parents and how their live their lives have a major impact on the formation of their children’s brains. The good news is that major changes in the circuits of the brain can occur in the child and even in the adult if the conditions necessary for positive development are created.

Quick to arise whenever the environment is mentioned is the question of blame. "You mean it’s the parents’ fault," people immediately ask. It is a simplistic notion that if something is wrong, someone has to be at fault. It would not help parents of children with ADD, besieged on all sides by the non-comprehending judgements and criticality of friends, family, neighbours, teachers, and even strangers in the street, to have yet one more finger pointed at them.

A doctor in Toronto gave the father of a nine-year old girl with attention deficit disorder a dramatically apt analogy. Imagine, he said, you’re standing in the middle of a really crowded room. Everyone around you is talking. Suddenly someone asks you: "What did so-and-so just say?" That’s what it’s like inside the ADD brain, that’s how it is for your child. A parallel analogy comes to mind regarding the situation the parents of ADD children find themelves in: one is stuck in the middle of heavy traffic at an intersection; the engine is stalling, you are trying your best. Everyone is yelling and honking angrily at you, but no one offers to help. Perhaps no one knows how to.

As parents we do not need to feel more guilt than we already do. What we do need to have is less guilt and more awareness of how the quality of the parent-child relationship can be used to promote our children’s emotional and cognitive development. Scattered Minds is written to promote such awareness.

The book is written also with two other sets of readers in mind. First, it is my hope that adults with attention deficit disorder will find insights here that will help them gain a deeper understanding of themselves and of the path they could take towards their own healing. It is meant also to give health professionals with ADD clients and teachers working with ADD students a comprehensive view of a much misunderstood condition.

The analysis of ADD given in this book attempts to synthesize the findings of modern neuroscientific research, developmental psychology, genetics, and medical science.These are combined with an interpetation of social and cultural trends, as well with my own personal experience as an adult with ADD, as a parent, and as a physician. To avoid giving the book an academic slant, chapter references are given in the Notes at the end, in some cases along with further comments intended for the professional reader and for lay readers seeking source information.

Case histories and quotes are all from my files. In most cases the names have been changed.

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