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ADHD Newsletter December 1997

  ADHD News and Information Home > ADHD Articles 1997 >December

Dr. Dave's Advice
Help Wanted
Important Names and Organizations to Know

It's Christmas already! Hard to believe that another year has gone by so soon. Is everyone ready for the Holidays?

A while back I subscribed to a mailing list for college and university information and I ran across something I thought might be useful to some.

For those of you with American Indian Heritage, there are special services available to you. While this information talks mostly about grants and scholarships for college and university students, keep in mind that there are programs and services for our children at the elementary school level as well, even special services so you may want to take the time to check out available resources if you are having trouble getting services elsewhere.

1. "Winds of Change Magazine's Annual College Guide for American Indians from the American Indian Science and Engineering Society (AISES) at 5661 Airport Road, Boulder, CO 80301-2339, e-mail Contacts are listed in the book.

2. Dartmouth, Stanford, Harvard, Univ. of Arizona have strong programs and actively seek qualified applications. Dartmouth coordinator is: Jarrit Whitley (603)646-3360; Standord's Nicole Burrell (415) 725-2844; UofA is G. Bruce Meyers (520)621-3835. Fort Lewis College offers free tuition to any student who is an enrolled member of a federally recognized tribe.

3. Student can contact their tribal headquarters for scholarship information.

4. NACAC may have a list titled "Native American Tribal Colleges" which lists 25 colleges by state.

5. Contact the United States Department of the Interior, Bureau of Indian Affairs and they should have a booklet on grants and scholarships.

6. Two books: The Multicultural Student's Guide to Colleges by Robert Mitchell; America's Black and Tribal Colleges by J. Wilson Bowman. Another addition to Sunny's list is the American Indian College Fund, Which provides private support and scholarships for the 29 Indian colleges. They can be reached at (212) 787-6312.

If anyone would like a copy of NACAC's list of Native American Tribal Colleges, please send an e-mail request to Kelli Walbridge at

** Dr. Daves ADDvice **

I'd like to respond this month to a very good question from one of Brandi's readers. Here is the question:

"What are the guidelines that are used to determine which medicines a child should be on for add? And which guidelines are used to let parents and teachers know if the medication is working properly?"

These are really important questions because although there is considerable research evidence that medication is quite helpful for the vast majority of children with ADHD, it is frequently prescribed and monitored in such a way that prevents children from getting the maximum benefit possible.

There is not the space here to provide an extensive overview of medication treatment for ADHD, but you can visit

In regards to the first question raised above, there is simply no way to predict in advance which of several medications will be most helpful for a child with ADHD, nor the optimal dose will be. Physicians generally start with Ritalin, which is certainly reasonable since it is the most extensively researched. A child who does not respond well to Ritalin, however, may do very well on another stimulant (e.g. Adderall, Cylert, Dexedrine). Similarly, a child who does not do well on the initial doses tried may do very well on a different dose. In some cases, side effects that are prominent with one medicine may be absent with another.

The bottom line is that because there is no way to know in advance what will be best for an individual child, the child's response needs to be monitored very carefully. One very useful procedure is to begin a child on medication using a careful trial in which a child is tried on different doses during different weeks, and is also put on a placebo for one or more weeks during the trial. The child's teacher is asked to complete weekly ratings of the child's behavior and academic performance, and side effects forms are completed by both parents and teachers.

Why have a child receive a placebo during the trial? This is important because no matter how good one's intentions are, it is very difficult to be objective about a child's behavior when one know the child is on medication. Thus, one study found that when children with ADHD were given a placebo, the child's teacher reported significant improvement over half the time. This is probably because teachers expect the child to do better which can color what they see. Also, when children believe they are on meds they actually may do a bit better, at least for a period of time.

By using the placebo procedure outline above, the information obtained is less likely to be effected by such potential biases because the teacher does not know when the child is getting medicine and when he or she is not.

By comparing the teacher's ratings for the different medication weeks with the placebo week, one has a more objective basis for deciding if the medicine really helped, whether it helped enough to be worth continuing, what dose produced the greatest benefits, whether there were adverse side effects, and what problems may remain to be addressed even if the medicine was helpful.

Compare this type of careful trial with what is often done: the doctor prescribes medication and asks the parent to let him know what happened. Parents ask the teacher for feedback about how their child did on medication, and passes this along to the physician who then decides whether to continue, try a different dose, or try a different medication. Here are possibilities that are much more likely to occur with this procedure:

1. Because of the "placebo" effect, medication may be reported to have been helpful even though no real benefit was produced. The child then continues to take medicine even though he or she is not really benefiting.

2. Because a systematic comparison of different doses is not made, the child is maintained on a non-optimal dose, and thus fails to get al the benefits that are possible.

3. Medication is discontinued because of "side effects" that actually had nothing to do with the medication (see below).

4. Because a careful assessment was not made of how the child did on medicine, problems that may have remained even though the medicine was helpful are not targeted for adjunctive forms of treatment.

Let me say something about side effects. I do these type of trials all the time and often find that what would otherwise be assumed to be side effects of medication actually occur during the placebo week! Several carefully controlled studies have reported similar findings, as well as the fact that problems presumed to be side effects of medicine are often present prior to starting medication.

Suppose a good trial has been done and the proper dose selected - now what?

After this has been done, it is VERY important to monitor how the child is doing on a regular basis. In fact, guidelines recently published by the American Academy of Child and Adolescent Psychiatry, recommend that at least weekly ratings from teachers be obtained. This is because a childs response to medication can change over time, so what starts out as being very helpful may become less helpful over time. Some of you may have already had the unfortunate experience of believing that things were going along pretty well, and then finding out at report card time that this was not the case. With regular, systematic feedback from teachers about how well a child's ADHD symptoms are being managed, the quality of work being completed, peer relations, etc., this type of unpleasant surprise does not need to occur. This is not difficult to do, but in my experience, is rarely done.

low me to put in a plug for procedures I have developed and use regularly to help parents with these important issues. If you visit my site you'll find overviews of a medication trial program to assist with initial medication trials and a monitoring system to carefully follow how a child is doing. I use these programs all the time and know how useful they are. Please consider giving them a try if you are considering the use of medication for your child or have a child who is already on medication.

at's all for this month. I'm going to be away for the holidays so I may not be able to respond promptly to any follow up questions you have this month's column. Best wishes for a safe and happy holiday.

David Rabiner Ph.D

S. I also publish an electronic newsletter called ADHD RESEARCH UPDATE that is devoted to keeping parents informed about new research on ADHD. I'd be delighted to send you 3 sample issues to review to see whether you would like to subscribe. To receive these free samples email me at addhelp@mindspring.comand put "free trial" in the subject line.

**Help Wanted**

I am a graduate student in the Athabasca University's Master of Distance Education Program in Canada. I am working on a thesis aimed at learning more about Attention Deficit Disorder in the Adult Population and Distance Education.

If you are an adult who has ADD (Attention Deficit Disorder) and either are taking courses or have recently taken courses by distance education ( using the internet, teleconferencing, correspondence, videoconferencing, computer-assisted learning, etc.), I need your help as a volunteer in my research study.

All information provided to me on this project will be kept in strict confidence. You will be asked to complete a questionnaire and you may be selected for a followup interview (all kept in strict confidence).

Participants selected for the project may decide whether they wish to continue with the study at any point.

To volunteer please e-mail at:

**Humor From the ADDult Message Board**
------------------------------------------------------ Microsoft TV Dinner Instructions

You must first remove the plastic cover. By doing so you agree to accept and honor Microsoft rights to all TV dinners. You may not give anyone else a bite of your dinner (which would constitute an infringement of Microsoft's rights). You may, however, let others smell and look at Your dinner and are encouraged to tell them how good it is.

If you have a PC microwave oven, insert the dinner into the oven. Set the oven using these keystrokes: <\mstv.dinn.//08.5min@50%heat// Then enter:

If you have a Mac oven, insert the dinner and press start. The oven will set itself and cook the dinner.

Be forewarned that Microsoft dinners may crash, in which case your oven must be restarted. This is a simple procedure. Remove the dinner from the oven and enter

Many users have reported that the dinner tray is far too big, larger than the dinner itself, having many useless compartments, most of which are empty. These are for future menu items. If the tray is too large to fit in your oven you will need to upgrade your equipment.

Dinners are only available from registered outlets, and only the chicken variety is currently produced. If you want another variety, call Microsoft Help and they will explain that Microsoft Chicken is all you really need.

Microsoft has disclosed plans to discontinue all smaller versions of their chicken dinners. Future releases will only be in the larger family size. Excess chicken may be stored for future use, but must be saved only in Microsoft approved packaging or the warranty is invalidated.

Microsoft promises a dessert with every dinner after '98. However, that version has yet to be released


Microsoft dinners may be incompatible with other dinners in the freezer, causing your freezer to self-defrost. This is a feature, not a bug, as your freezer should be defrosted periodically.


For several years now, my voice of sanity and reason in times when I had lost mine, has been my friend Cara. We both hit the internet about 2 1/2 years ago with a passion, hers poetry, and mine, ADD/ADHD. We've learned a lot about the internet over the years, and having already raised a child with ADD, it has helped to be able to tap into her knowledge and wisdom. Cara has a massive poetry site with over 300 pages. If you like poetry, you'll love her site and appreciate the work she has put into it. I hope you enjoy this Christmas poem that she wrote.

I wish you happy holidays
may love fill your heart,
and may you come together
with those who've been apart,

may you seize the moments
so rare, precious and true,
the ones filled with memories
so very special to you,

may everyone you love
fill your presence there
and may you be shown true
just how much they care,

yes, have a happy holiday,
be of light heart and cheer,
and may the goodess follow you
straight into the next year!
Cara's Poetry Cove

**Important Organizations and Numbers to know**

I took this information from the LDA Resource Page. You will find them on the internet at

Help for Adults with Learning Disabilities

American Association for Vocational and Instructional Materials 1-800-228-4689 American Association for Vocational Instructional Materials has an operator, available from 8:00am-5:00pm Eastern Time (ET) Monday-Friday, who provides information on educational materials (software, videos, manuals), including a listing of Category L Modules that deal with teaching students with special needs. Products are available for purchase.

Equal Employment Opportunity Commission 1-800-669-3362 Equal Employment Opportunity Commisssion (EEOC) voice mail directs calls From 7am-5:30pm ET (Monday-Friday). Operators accept orders for publications, fact sheets, posters, and a resource directory for people with disabilities, including learning disabilities. They do not answer questions relating to employment but can give referrals to local EEOC offices.

ERIC Clearinghouse on Adult, Career, and Vocational Education at the Center for Employment, Education & Training at Ohio State University 1-800-848-4815 ERIC Clearinghouse on Adult, Career, and Vocational Education has a 24-hour voice mail service that provides information on ERIC Digests, annotated bibliographies, and assorted publications, some with information on learning disabilities. ERIC does not answer specific questions on disabilities, local programs, or jobs.

Federal Student Aid Information Center 1-800-433-3243 Federal Financial Aid Hot Line accepts calls from 9am-8pm ET (Monday-Friday) and provides information on eligibility, benefits, applications and other questions about Student Aid. Voice mail directs calls during business hours.

GED Hotline 1-800-629-9433. General Education Development (GED) Hotline has a 24-hour operator service that provides information on local GED classes and testing services. They have an accomodations guide for people taking the GED who have a learning disability.

HEATH Resource Center 1-800-544-3284. National Clearinghouse on Postsecondary Eduction for Individuals with Disabilities (HEATH Resource Center) has information specialists available from 9am-5pm ET(Monday-Friday) who provide resource papers, directories, information on national organizations, and a resource directory for people with learning disabilities.

International Dyslexia Association 1-800-222-3123. International Dyslexia Association (IDA) has a 24-hour voice mail service that receives information requests. From 8:30am-4:30pm ET (Monday-Friday) at (410)296-0232, IDA staff direct people to appropriate materials about issues of dyslexia. Information is given on publications about dyslexia, referrals for testing and tutors, branches of IDA, and workshops and conferences.

Job Accommodation Network 1-800-526-7324. Job Accommodation Network (JAN) has a free consulting service from 8am-8pm ET(Monday-Thursday) and 8am-5pm ET(Friday) that provides information on: equipment, methods and modifications for persons with disabilities to improve their work environment. All information is specific to the disability, including learning disabilities.

Learning Resources Network 1-800-678-5376. Learning Resources Network (LERN) has an operator service from 8am-5pm ET(Monday-Friday) that provides informaton to practitioners of adult continuing education. The also give consulting information, take orders for publications, and provide phone numbers of assocations and organizations that deal with learning disabilities.

National Center for Research in Vocational Education 1-800-762-4093 National Center for Research in Vocational Education has an operator available from 8am-5pm Pacific Time(PT)(Monday-Friday) who provides information on products, electronic services, and vocational education. A catalog and newsletter are also available. The Office of Student Services produces materials on learning disabilites and a sub-catalog for special populations.

National Library Services for the Blind and Physically Handicapped 1-800-424-8567 National Library Services for the Blind and Physically Handicapped has a voice mail system that directs calls from 8am-4:30pm ET (Monday-Friday). Operators provide information on audiocasette, large print, and Braille books and magazines for recreational reading. Callers with learning disabilities must meet certain guidelines to use these services.

National Literacy Hotline 1-800-228-8813. Literacy Hotline has a 24-hour bilingual (Spanish/English) operator service that provides information on: literacy/education classes, GED testing services, volunteer organizations, and a learning disabilities brochure.

Recording for the Blind and Dyslexic, Inc. 1-800-221-4792. Recording for the Blind and Dyslexic, Inc. has operators available from 8:30am-7:pm (Monday-Friday) who provide information on over 80,000 recorded textbooks (in 4-track cassette or computer disk) and other classroom materials, from 4th grade through post-graduate levels, available on loan; the application process and one time fee ($37.50); and the certification process. Callers with learning disabilities are eligible to participate but must complete the certification requirements.

Social Security Administration 1-800-772-1313, 1-800-325-0778(TT) Representatives answer calls from 7am-7pm ET (Monday-Friday) and provide information on a wide range of Social Security and Supplemental Security Income matters. A limited number of automated services are available 24 hours a day. Bilingual (Spanish/English) services are also available.

National Library of Education at the US Office of Educational Research and Improvement 1-800-424-1616. US Office of Educational Research and Imrprovement has an operator available from 9am-4pm ET (Monday-Friday) and provides information on statistics on education and schools, publications, references to other agencies, and references to a specialist on learning disabilities.

ADDTALK is our newest feature to the website. It is a mailing list that allows discussion and support through email. I am very excited about this feature and I think it will become a very useful tool for many of us. I receive a lot of mail from readers that have problems getting into many chat rooms either because their browser doesn't support the program, or servers such as aol have problems connecting to them and some are too "techno" for some of the users. This along with the problems of getting days and times that work for everyone as well as people to host chats etc made the creation of this mailing list the next step to put readers in touch with one another. This mailing list generates a lot of email and is not for those that do not like lots of email. We are still working on the finer points of protocol and use of this list but it has a solid base of users and that alone is worth any amount of effort it will take to get things running smoothly.

To subscribe to ADDtalk, simply send an email message to and place the text "subscribe" minus the quotation marks in the body of the message.

If you have questions or problems email me at

As always, if you wish to be removed from this list, send a remove message to and I will get you removed.

My deepest thanks and gratitude to those who help make this page possible through their support:

May all of you have a Happy and Joyous Holiday Season.
Brandi Valentine

** This newsletter is protected by copyright and any reproduction of this newsletter is prohibted without the express permission of Brandi Valentine**

**P.O. Box 473**
**Browns Valley, Calif 95918**
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