(This is Part II in a several-part series on ADHD and Prematurity; read Part 1 here.)
When I was young, no one would have claimed that I, the older sister, was the one with attention issues, even though I’d been born very premature and my brother was only a week away from being considered full-term. My brother was the one who couldn’t stay in his chair at dinner or seemed to always loose his sweatshirt/mittens/etc. at school. He doesn’t have ADHD at all, but on the surface of it, we’d look to him first, a boy.
For my part, I remembered my homework, and was apparently really good at staying in my high chair, playing with my Little People characters. Later on, I liked homework, if it had to do with words. Maybe not so much if it was math. I liked workbooks, and books, and writing things. My parents rarely had to worry about stray mittens or hats being lost or left behind.
And yet — I was the girl on the soccer field chewing her hair, with no clear idea of how to get myself into the game. I was the third-grader proud of her new slip-on shoes, twirling them endlessly under the table, until my mom (or was it my teacher) suggested I not wear slip-on shoes. I was the daydreamer, endlessly creating worlds of significance inside my own head, worlds revolving around the stories I read, or the mysterious, dark pine trees in the back of the playing field at school, or the red “Mars rocks” in someone’s yard on the opposite way home from school (opposite from the way we usually walked), which got me thinking about journeys to Mars rather than the cars in the neighborhood. No wonder my mom was forever reminding me to pay attention, to look both ways, to watch for the cars.
Imagine my surprise when I read, some thirty-odd years later (long after the shoe-twirling and the Mars-rock-daydreaming), about inattentive ADHD, particularly in women. A friend had posted some articles about ADHD as related to her own adult diagnosis, and some of it sounded way more familiar than I’d expected, while some of it sounded entirely foreign.
Among the not-at-all-familiar included anything hyperactive or impulsive, anything ditzy, anything chatty-Cathy, anything space-cadet, anything lazy.
Among the familiar included, well, daydreaming and fidgeting, being introverted, starting projects that never get finished (like the dozen-odd knitting projects stuffed in bins, or, that attempt at making a game out of the Baby Sitters Club when I was 10, which was, guess what, never finished). Difficulty paying attention in lectures sounded all-too-familiar (thank goodness I majored in a humanities subject and mostly had research papers for finals, which didn’t rely on my attempts to take notes on discussion-based classes. True confession of a woman with a PhD).
Things I’d never considered, but which made sense, included: that a lack of talent for small talk could be related to issues with attention, or lack thereof, to social cues and graces, that maybe not paying attention to the latest trends in fashion, music, or popular entertainment was just that, a lack of attention, or rather, a strong preference to send it in certain directions,, like to Middle-Earth rather than Madonna.
So, is it ADHD? I don’t know. And, I’m not sure it matters. In the end, diagnostic labels are conveniences, especially if someone needs services or insurance coverage for treatment, but diagnostic labels rarely tell the whole story.
I’m still a fidgeter. Once I’d somehow stopped twirling my shoe or chewing my hair, I found other fidgets. Some have stuck with me, much to the frustration of those who love me, and wish I didn’t do things like twirl my hair, or pick at my hair or fingernails. I’ve since bought a couple of the various fidget devices that became wildly popular in the last few months, and I use them (if I can find them, or if I can remember to pick one up).
And I still get lost in worlds of my own significance. If my parents knew that “one more chapter” of reading after they stopped by my room to say, “Lights out,” meant that I’d blow right past the end of the chapter as if it were just another paragraph break, well, my husband knows, too, that if I’m reading… it may be a long time before I come upstairs to bed. (Sorry, dear.) And having kids and a full-time job has done quite a number on my once-treasured ability to remember all the things that need remembering. Thank goodness I have a supportive, and most definitely organized, spouse, who helps RSVP to birthday parties, sign the kids up for activities, and get those pesky field-trip forms turned in on time.
If you recall from my previous post in this series, the earlier a preemie is born, the more likely he or she is to develop attention-related difficulties or traits. I’d be stunned, in other words, if the experiences I’ve described here weren’t related, in some way, to the types of brain differences prematurity can cause.
In addition, attention-related issues that may look like ADHD or inattentiveness are often the flip-side of giftedness and intellectual ability. Daydreaming, not paying attention to that which don’t interest one, focusing intensely on a subject of interest, and being emotionally intense can look like ADHD in a cursory examination, but are instead the result of a gifted and creative mind. Giftedness can co-exist with actual ADHD, just as giftedness can co-exist with other diagnoses, such as a learning or neurodevelopmental disability (this is often referred to as “2e,” or twice-exceptional). As a part of the “gifted and talented” program at my school, this flip-side may be as much or more the case as ADHD.
Finally, a former preemie’s more neurodiverse traits are often subclinical, meaning present, possibly causing mental health difficulties, but not overwhelming enough to be diagnosed as a particular disorder. My husband points out, for example, that my fidgets are the ordinary fidgets of someone who plays with a pen cap during a meeting, not the fidgets and distractibility that disrupts an entire classroom or meeting. I’ve never lost a job or had a serious consequence happen due to anything attention-related, for example, which again raises the question: what’s the significance? it enough to feel some similarity, but not the whole shebang?
What I do know for certain is that while figuring out that I should be entertained by Madonna and pointy boobs may have helped with not seeming totally out of it during college, it was Middle-Earth — and other related passions and interests to which I’d devoted much more significant attention — that’s always led me to my friends and loves. At the end of the day, that’s the kind of attention that matters most.
Like what you’re reading? This is Part II in a series…
This is Part 1 in a several-part series about prematurity and ADHD for October, ADHD Awareness Month.
Part 1 of the series laid out the basics of how prematurity and ADHD/attention-deficit hyperactivity disorder can be related.
Part 2 was going to take a closer look at the brain, but that’ll now be Part 3, asking: “What regions of the brain are neurodivergent/neuroatypical in prematurity and in ADHD? Why is ADHD so much more common in former preterm children or adults than in the full-term population?”