ADHD

1. ADHD To start out, we just wanted to give you a picture of what we, as Educators, are dealing with when we talk about ADHD:

2. Attention Deficit/Hyperactivity Disorder Occurs in 3%-7% of school aged children. Is characterized by a pattern of inattention, restlessness, and impulsiveness.

3. What doesn’t cause ADHD? ADHD is not caused by ……… Bad Parenting Family Problems Poor Teachers Bad Schools Food Allergies Too Much TV Excess Sugar

4. ADHD is diagnosed for the following reasons: 1.) Symptoms of inattention, restlessness, and impulsiveness need to occur often. 2.) Have persisted for the past 6 months. 3.) Be out of place for the child’s developmental stage. 4.) Some of the behaviors were present before the age of 7 and occurred in more than one setting.

6. Students with ADHD often have problems in the following areas: 1.) Problem Solving 2.) Organizational skills 3.) Memory 4.) Motor coordination such as poor hand writing and clumsiness has also been observed.

8. Genetic factors have been linked to ADHA: Twin, family, and adoption studies have supported genetic heritability of ADHD to range from 60%-90%. One study showed children with ADHD to have greater variation in the gene associated with dopamine receptors in the brain.

10. Environmental basis of ADHD: Prenatal exposure to alcohol can cause hyperactivity, disruptive, and impulsive behavior in children. Maternal smoking also produces an increased risk of ADHA. Other toxins in the environment such as lead and PCBs have been linked to ADHD.

12. Brain Imaging: Reduced volumes in the frontal cortex, the basil ganglia, the corpus callosum and the cerebellum have been observed in ADHD patients. ADHD children showed slow brainwave activity compared to normal children. Slow brainwave activity indicates a lack of control in the frontal cortex of the brain.

13. Smaller brain volumes associated with severity of ADHD symptoms.

14. The Reticular Activating System is a complex collection of neurons that take in external stimuli from the base of the brain and delivers it up to the mid brain.

15. Rectilinear Activating System

16. ADHD Affects Neurotransmitters: Current research suggests that ADHD is caused in part by a deficiency of dopamine, and norepinephrine in the reticular activating system. Drugs such as Ritalin increase the levels of norepinephrine and dopamine in the frontal lobes.

18. Treatment Options for ADHD MedicationsCurrently, stimulant drugs (psychostimulants) and the nonstimulant medication atomoxetine (Strattera) are the most commonly prescribed medications for treating ADHD. Stimulant medications for ADHD include: - Methylphenidate (Ritalin, Concerta, Daytrana) - Dextroamphetamine-amphetamine (Adderall) - Dextroamphetamine (Dexedrine, Dextrostat) Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters. These ADHD medications help improve the core signs and symptoms of inattention, impulsivity and hyperactivity — sometimes dramatically. Additionally, the right dose varies from child to child, so it may take some time in the beginning to find the correct dose.

19. ADHD counseling and therapyChildren with ADHD often benefit from behavior therapy or counseling, which may be provided by a psychiatrist, psychologist, social worker or other mental health care professional. Some children with ADHD may also have other conditions such as anxiety disorder or depression. In these cases, counseling may help both ADHD and the coexisting problem. Counseling types include: Behavior therapy. Teachers and parents can learn behavior-changing strategies for dealing with difficult situations. These strategies may include token reward systems and timeouts. Psychotherapy. This allows older children with ADHD to talk about issues that bother them, explore negative behavioral patterns and learn ways to deal with their symptoms.

20. Parenting skills training. This can help parents develop ways to understand and guide their child's behavior. Family therapy. Family therapy can help parents and siblings deal with the stress of living with someone who has ADHD. Social skills training. This can help children learn appropriate social behaviors. Support groups. Support groups can offer children with ADHD and their parents a network of social support, information and education. The best results usually occur when a team approach is used, with teachers, parents, and therapists or physicians working together. Symptoms often lessen with age. However, most people never completely outgrow their ADHD symptoms.

21. Alternative medicine There's little research that indicates that alternative medicine treatments can significantly reduce ADHD symptoms. Some alternative medicine treatments that have been tried include: Yoga and meditation. While it might seem to make sense that two calming activities, such as yoga and meditation, would help reduce symptoms of ADHD, there's no conclusive evidence that either therapy does so. Special diets. Most diets for ADHD involve eliminating foods thought to increase hyperactivity, such as sugar and caffeine, and common allergens such as wheat, milk and eggs. Some diets recommend eliminating artificial food colorings and additives. So far, studies haven't found a consistent link between diet and improved symptoms of ADHD. Vitamin or mineral supplements. While certain vitamins and minerals are necessary for good health, there's no evidence that supplemental vitamins or minerals can reduce symptoms of ADHD.

22. Herbal supplements. There is no evidence to suggest that herbal remedies, such as St. John's wort, help with ADHD. Essential fatty acids. These fats, which include omega-3 oils, are necessary for the brain to function properly. Researchers are still investigating whether these may improve ADHD symptoms. Neurofeedback training. Also called electroencephalographic biofeedback, this treatment involves regular sessions in which a child focuses on certain tasks while using a machine that shows brain wave patterns. Theoretically, a child can learn to keep brain wave patterns active in the front of the brain — improving symptoms of ADHD. While this treatment looks promising, more research is needed to see whether this treatment works.

23. Behavioral Therapy This type of therapy helps and individual with ADHD reduce problems at school and with relationships. Following are examples that might help with your child’s behavioral therapy: Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime. Get Organized. Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them. Avoid distractions. Turn off the TV, radio, and computer, especially when your child is doing homework.

24. Limit choices. Offer a choice between two things (this outfit, meal, toy, etc., or that one) so that your child isn't overwhelmed and overstimulated. Change your interactions with your child. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of responsibilities. Use goals and rewards. Use a chart to list goals and track positive behaviors, then reward your child's efforts. Be sure the goals are realistic—baby steps are important!  Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior. Help your child discover a talent. All kids need to experience success to feel good about themselves. Finding out what your child does well — whether it's sports, art, or music — can boost social skills and self-esteem.

25. ADHD Facts  Approximately 9.5% or 5.4 million children 4-17 years of age have ever been diagnosed with ADHD, as of 2007. Rates of ADHD diagnosis increased an average of 5.5% per year from 2003 to 2007. Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD.

26. Parents of children with a history of ADHD report almost 3 times as many peer problems as those without a history of ADHD (21.1% vs. 7.3%). Using a prevalence rate of 5%, the annual societal ‘‘cost of illness’’ for ADHD is estimated to be between $36 and $52 billion.  It is estimated to be between $12,005 and $17,458 annually per individual. About 70 per cent to 80 per cent of children with this disorder continue to have symptoms during their teen years, and about 50 per cent have symptoms into adulthood.

27. There are three different types of ADHD, depending on which symptoms are strongest in the individual: Predominantly Inattentive Type: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines. Predominantly Hyperactive-Impulsive Type: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others. Combined Type: Symptoms of the above two types are equally present in the person.

28. The Adult Self-Report Scale (ASRS) Test For each of the following 6 questions, pick the answer that best suits you. Your choices are never, rarely, sometimes, often and very often. 1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?  2. How often do you have difficulty getting things in order when you have to do a task that requires organization? 3. How often do you have problems remembering appointments or obligations?  4. When you have a task that requires a lot of thought, how often do you avoid or  delay getting started?  5. How often do you fidget or squirm with your hands and feet when you have to sit down for a long time?  6. How often do you feel overly active and compelled to do things, as if you were driven by a motor? 

29. Scoring Your Self Assessment 1. For questions 1, 2 and 3, if you have answered "Sometimes", "Often" or "Very Often", give yourself one point for each. This means, if you score, say "sometimes" for question 1, and "often" for question 2 and 3, you now have 3 points. What if you answered "Never" or "Rarely" for questions 1-3? No points! 2. For questions 4,5, and 6, if you answered "Often" or "Very Often", give yourself one point each. No points are awarded if you had answered "Never", "Rarely" or "Sometimes" in this case. 3. Now total up all the points. 4. If your total is 4 and above, you are said to have a Positive Score. If the total is 3 and below, it is considered a Negative Score.If you have a positive score and are ready to undergo a full diagnosis, do go and see a doctor who is very experienced with ADHD. It should be noted that 80% of adults who garnered a positive score turned out to be ADHD positive when they underwent a full-scale diagnosis.

30. Some Famous People Who Had/Have ADHD

31. Resources Mayo Clinic http://www.mayoclinic.com/health/adhd/DS00275/DSECTION=treatments-and-drugs National Institute of Mental Health Attention Deficit Disorder Association http://www.add.org/ The Centers for Disease Control and Prevention http://www.cdc.gov/ncbddd/adhd/data.html http://www.adhdquestionsandanswers.com/ADHD-Checklist-ADHD-Assessment.html

32. Resources From reinforcement learning models to psychiatric and neurological disorders. Maia TV, Frank MJ. Nat Neurosci. 2011 Feb;14(2):154-62. Review. The neurological basis of ADHD. Curatolo P, D’Agati E, Moavero R. Ital J Pediatr.2010 Dec 22;36(1):79.Review. PMID:21176172 Dr. Gerald August, Psychology Department University of Minnesota