Transcript Slide 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:
Attention Deficit/Hyperactivity Disorder
•Occurs in 3%-7% of school aged children.
• Is characterized by a pattern of inattention,
restlessness, and impulsiveness.
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
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.
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.
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.
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.
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.
Smaller brain volumes associated
with severity of ADHD symptoms.
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.
Rectilinear Activating System
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.
Treatment Options for ADHD
Medications
Currently, 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.
ADHD counseling and therapy
Children 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
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
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
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
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.
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.
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.
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.
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.
The Adult Self-Report Scale
Test
For each of the following 6(ASRS)
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?
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.
Some Famous People Who
Had/Have ADHD
Tommy Hilfiger
Vincent Van Gogh
Magic Johnson
Thomas Edison
Michael Jordan
Orville & Wilber Wright
Terry Bradshaw
Bruce Jenner
Jackie Steward
Benjamin Franklin
Leonardo Da Vinci
Alexander Graham Bell
Jamier Oliver
Ingvar Kamprad
Will Smith
Winston Churchill
Abraham Lincoln
Albert Einstein
Robin Williams
Tom Cruise
Bill Cosby
Jim Carey
Steven Spielberg
Sir Issac Newton
Ansel Adams
Henry Ford
Emily Dickinson
Ralph Waldo Emerson
Walt Disney
Pablo Picasso
Virginia Woolf
Wolfgang Amadeus Mozart
Resources
Mayo Clinic
http://www.mayoclinic.com/health/adhd/DS00275/DSEC
TION=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/ADHDChecklist-ADHD-Assessment.html
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