« January 2007 | Main | March 2007 »
February 27, 2007
General Evidence-based Information on ADHD
Attention Deficit/Hyperactivity Disorder
Attention Deficit/Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood, estimated to affect between 3% and 5% of school-aged children, as well as 1% to 6% of Adults.
Diagnosis
Accurate diagnosis is difficult (usually requiring multiple tests and more than one visit to a healthcare professional) but essential, as early treatment can substantially affect the course of a child's educational and social development.
A person is considered to have ADHD if he or she demonstrates symptoms of inattention, hyperactivity, and impulsivity for at least 6 months in at least two settings (such as at home and in school). The symptoms must appear before age seven and cause significant functional problems at home, in school, and in various social settings. Although many children with ADHD have symptoms of both inattention and hyperactivity-impulsivity, some demonstrate symptoms from only one of the clusters below.
Symptoms of Inattention
•Fails to pay close attention to details or makes careless mistakes.
•Has difficulty sustaining attention in tasks or play activities.
•Does not seem to listen when spoken to directly.
•Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
•Has difficulty organizing tasks and activities.
•Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
•Loses things necessary for tasks or activities.
•Is easily distracted by extraneous stimuli.
•Is forgetful in daily activities.
Symptoms of Hyperactivity and Impulsivity
•Fidgets with hands or feet or squirms in seat.
•Leaves seat in situations where remaining seated is expected.
•Runs or climbs excessively in inappropriate situations (in adolescents or adults, may be limited to subjective feelings of restlessness).
•Has difficulty playing or engaging in leisure activities quietly.
•Acts as if "driven by a motor".
•Talks excessively.
•Blurts out answers before questions are completed.
•Has difficulty awaiting turn.
•Interrupts or intrudes on others.
Causes
ADHD tends to occur in families, and often overlaps with other brain-based disorders such as Depression, Learning Disorder, Tic Disorder, or Obsessive Compulsive Disorder. Genetic and environmental factors that affect brain development during prenatal and postnatal life are likely involved. Children and adults with ADHD often are found to have altered brain activity in the prefrontal cortex, a region thought to be the brain's command center. Researchers also find that hyperactive behavior in children may result from excessive slow-wave (or theta) activity in certain brain regions, although a number of ADHD subtypes with quite different brain features have been identified, contributing to the complexity of evaluation and treatment.
Treatment
Multiple strategies are most effective to manage ADHD over the long-term. A therapy called Neurofeedback, or EEG Biofeedback, is a non-drug alternative shown in a number of published studies to be beneficial in about 70% of cases. Psychostimulant medications are beneficial in 55% to 60% of cases. Behavioral treatments include individual and family education, behavioral therapy, school remediation, and social skills training. Nutritional management is a frequently explored alternative therapy. Although relatively few studies support various nutritional approaches as effective for ADHD, a growing number of studies do suggest an association between essential fatty acid (EFA) deficiencies and hyperactivity in children. A few studies have shown certain nutritional supplements such as Pycnogenol or DMAE may be similarly effective as Ritalin for ADHD. Preliminary evidence also indicates that homeopathy may significantly improve behavior among children with ADHD.
Research suggests that children who receive sustained comprehensive treatment (such as Neurofeedback, medication, or behavioral therapy) are less likely to have behavioral problems in adolescence. In most cases, ADHD can be effectively managed throughout life, particularly when multiple treatment strategies are combined.
(Adapted from information supplied by the Center for Integrative Medicine, University of Maryland Medical Center, 2004.)
Posted by jeffreywilson1 at 03:13 PM | Comments (0)
February 21, 2007
FDA tells ADHD drugmakers to warn of risks
WASHINGTON, Feb 21 (Reuters) - Companies that make drugs to treat attention deficit hyperactivity disorder must take extra steps to alert patients to possible cardiovascular and psychiatric risks, U.S. health officials said on Wednesday.
The Food and Drug Administration (FDA) said it told the drugmakers to develop patient-friendly guides that explain the risks and to hand them out with the medications, which already carry label warnings about the risks.
"Despite this new warning language ... we continue to view ADHD as an important ailment that benefits from treatment from this class of medications," said Dr. Tom Laughren, head of the FDA's division of psychiatry products. "We consider these drugs quite safe."
Novartis AG
Novartis, Shire and several privately held manufacturers said they would work with the FDA to produce the patient information. Representatives of other drugmakers did not have immediate comment.
ADHD can make it difficult for patients to pay attention and can cause hyperactivity and impulsiveness. The FDA said people with ADHD may have low self-esteem, difficulty in school, and trouble relating to family and peers.
The risk of heart and psychiatric trouble in patients taking ADHD medications is not new.
FDA officials held two public meetings in early 2006 about concerns over the risks associated with the drugs after reports of sudden death, heart attack and stroke in patients with underlying heart problems who took them.
Another FDA review found that about one in 1,000 patients experienced drug-related psychiatric issues, such as hearing voices, becoming suspicious for no reason, or becoming manic.
The FDA was criticized last summer when, without a public announcement, it asked manufacturers to include the warning on their labels.
Some critics have challenged the agency for taking too long to notify the public about the risks, while others have said the warnings could lead some patients who might benefit from the drugs to stop taking them.
While doctors should already be aware of the risks, FDA's Laughren said the agency wanted patients to have easier to understand information that would help them provide details about past heart or mental concerns before taking the drugs. The guidelines would also encourage them to report side effects.
Companies have 30 days to comply with the FDA's request. A draft of the guide is posted on the FDA's Web site at http://www.fda.gov/cder/drug/infopage/ADHD/default.htm
Additional reporting by Lisa Richwine)
Posted by margo at 04:11 PM | Comments (0)
February 13, 2007
City Children Get More Medications
Children that live in larger cities are five times more likely to be prescribed ADHD stimulants than children living in rural areas.
New studies prove analyzing prescription rates for ADHD medications in large cities have found a huge geographical discrepancy.
The state has historically much higher rates of prescribing psycho-stimulants like Ritalin than the rural areas.
City dwellers about five times more likely to be prescribed Ritalin or another stimulant treatment, dexamphetamine.
This was probably because diagnosis of ADHD in adults remains controversial and possible mainly through private, city-based clinics, the researchers say.
Boys and girls in cities or regional areas were about 2.5 times more likely to be prescribed the drugs, which work by stimulating the brain-messenger chemical dopamine.
The medication has come under fire from several groups who claim many children are being over medicated, putting them in a zombie-like state.
By: Margo Richter
Posted by margo at 07:58 PM | Comments (0)
February 09, 2007
New Product to Help Your Child With ADHD
Behavioral Therapeutics, Ltd. has launched a new product called Good Vibrations. It is an interactive device designed to teach children with attention issues to self-regulate through the transmission of gentle vibrations. Utilizing the principles of learning theory, Good Vibrations teaches self-regulation by raising self-awareness and by harnessing the power of positive reinforcement.
Good Vibrations will help a child at home and in the classroom. A discrete, watch-like device is worn that will silently vibrate. When the child is on-task, a reward vibration will be sent by the teacher or parent with a transmitting unit. When the child is off-task, a reminder vibration will be sent. Every vibration sent is time-stamped so that at the end of the day, all the information can be analyzed and trends can be spotted at specific times. This information will keep the child, parents, and teachers informed so the ultimate goal of self-regulation can be achieved!
For more information, go to www.behavioraltherapeutics.org
Posted by tim at 12:24 PM | Comments (0)
February 03, 2007
Getting College Services for ADHD Students
For young adults with ADHD and other learning disabilities college seems like a huge challenge. Getting extra help might seem out of reach. But, that is not truth any more. Now, when you or your child is looking to apply at different colleges, look into each college’s support services. That might help make your mind up on where to attend your formal education. It will be listed and described in college catalogues. You would assume that support services are much the same from one school to the next, but this is far from true. Although several guides that have been developed to assist parents and students in selecting colleges with good learning disability support services, no such guide has yet been developed for ADHD support services. Having the right questions to ask is vital. Here is a list of questions to get you started.
Questions to ask:
1. How many students with ADHD or other learning disabilities are registered with the DSS office? The more the better! A large number of registered students suggest better funding and staffing for support services.
2. Is the director of the Office of Disabled Student Services a clinical specialist in ADHD and/or other learning disabilities? If their answer is "no", the college is less likely to offer good support services.
3. How many ADHD and/or other learning disabilities specialists are employed full-time by disability services? Beware of large universities that employ only few specialists.
4. How long has the current director held the position? The longer the better. The program director is typically the individual who is the heart and soul of disabilities support program.
5. How long has the support program for students with ADHD and other learning disabilities existed on campus? The longer the better. Good support programs take time to build and be reliable.
6. Is there a formal learning disabilities program available for students on campus and do they a separate application? Are there additional costs associated with this program? Many students with ADHD also have learning disabilities and may need support services for learning disabilities as well.
7. Is there an ADHD specialist or ADHD special service for students? Most often the answer is "no." A positive answer, however, is an excellent sign.
8. Is there an ADHD student support group on campus? Finding other students with ADHD and having an organized meeting is a big plus.
9. Is there a faculty education program to familiarize the faculty with the needs of students with ADHD or other learning disabilities? Faculty education about ADHD is very important. Today, many faculty members have little knowledge and even less training about ADHD and may even have a negative, skeptical attitude toward students who ask for accommodations.
10. What kinds of accommodations does the school offer students with special needs? At the bare minimum, a college should provide the possibility of a note-taker in each class, the possibility of extended time on exams, and the possibility of taking exams in a quiet, non-distracting environment.
11. Is specialized tutoring available for students with ADHD or other learning disabilities? Almost all campuses provide peer tutoring, however students with ADHD and other learning disabilities typically need more specialized tutoring from a trained tutor.
12. Does the DSS office facilitate the communication of the student's disability needs to each professor? Disability services should provide official documentation of the student's disability and the accommodations for which he is eligible.
13. How complicated is the procedure a student must follow to obtain alternative testing (extended time or on a computer)? Some schools require such a complex set of steps each time a student with ADHD receives alternative testing that it is difficult.
14. Is there a specialist on campus who teaches planning, organizational and study skills? If "yes", that is positive sign. If "no," ask if they have a list of private professionals in the community that can provide these services.
15. What types of writing supports are? Writing papers is one of the greatest challenges for college students with ADHD. Because they have a particular set of challenges, it is most helpful if writing tutors are available that trained and experienced in working with students with ADHD.
16. Is ADHD coaching available through the student disability office? Some cutting-edge support service offices are beginning to train their staff in ADHD coaching techniques.
17. Does the student disability office have a list of local professionals that provide ongoing treatment such as medication and psychotherapy for ADHD? This list should be made open in all disability offices.
18. Do students with ADHD and other learning disabilities have early registration privileges to allow them to select the courses and professors they need? A very critical accommodation, allowing a student with special needs to hand-pick professors and to customize his or her schedule. It is not a good sign if a college does not provide this accommodation.
19. Does the school offer specialize academic advising through the DSS office for students with ADHD and other learning disabilities? A very strong need! If students with ADHD and other learning disabilities are sent, along with all other students, for academic advising by someone with little or no training in ADHD, the advising is unlikely to be helpful.
20. Is there a way in which a student can identify faculty members who are knowledgeable about and sympathetic toward the needs of students with ADHD and other learning disabilities? Few disability offices will provide an "ADD-friendliness" rating of faculty members, however many office will allow students to make such ratings and will keep a book of such ratings available for other students to peruse.
21. Does the DSS office help to mediate disputes between student and professor regarding rights and accommodations? Many college professors are still not aware of the legal rights of students with a documented disability such as ADHD and some are even hostile to the idea of providing accommodations to these students. Students with ADHD should strongly pursue the choice of a college which has an active ADHD faculty education program and which provides mediation when students encounter resistance from a professor who is asked to provide reasonable accommodations.
22. What is the school's policy toward course substitution when a student's disability prevents him from fulfilling a particular requirement toward graduation such as a math or foreign language course? Are requirements ever waived? Under what circumstances? If a student with ADHD has a particular difficulty with math or foreign language, it is critical that the flexibility of such requirements be carefully considered before applying to a particular college.
23. Are counselors available on an ongoing basis for ADHD? ADHD student guidance, more so than others, counseling from trained staff can make the difference between success and failure during the first year or two of college.
24. Is it necessary for students in the DSS to fail math or foreign language before they qualify for a waiver, and does the failing grade become part of the student's GPA? This is the most important question! Some schools that provide requirement waivers or course substitutions first require a student to take and fail the required course. If this failing grade becomes a permanent part of the undergraduate record it can and will have a permanent negative effect upon your GPA.
At some colleges, in order to be eligible for services and particular accommodation, you might have to produce either an IEP (Individualized Educational Program) or a letter from your physician stating that you do have ADHD; and as a result of having ADHD, you require specific accommodations.
Take the time to carefully research each college you are considering attending. Often many high school children think they will not need these services. So they give little or no consideration of the services available for students. It’s better to have them available than to not know what you could be missing out on to make your college academic career easier. Call the colleges, do your research and be prepared, that is part of being a responsible adult.
By: M.Richter
Posted by margo at 12:06 PM | Comments (0)