Immaturity May Lead To Misdiagnosis Of ADHD

The Canadian Medical Association Journal published a study last month looking at ADHD diagnoses in children between the ages of 6-12 in BC.  They found that the youngest children in the class - those born in December - were much more likely to be diagnosed with ADHD than those who were born in January. 

Here's a summary of the article from Medical News Today.

The Bridgeway Team


Immaturity May Lead To Misdiagnosis Of ADHD

The youngest children in the classroom are significantly more likely to be diagnosed with attention-deficit/hyperactivity disorder (ADHD) - and prescribed medication - than their peers in the same grade, according to a study just published in CMAJ (Canadian Medical Association Journal).

ADHD, which is often treated with prescription medication, is the most commonly diagnosed behavioural disorder in children. Two recent studies have shown a link between the relative age of children and diagnosis of ADHD and prescription of medication. Younger children in the same grade as children who may be almost a year older may appear to be immature compared with their older peers. This apparent lag in maturity has been called the "relative-age effect" and influences both academic and athletic performance.

Researchers from the University of British Columbia were interested to see whether this relative age effect was present in Canada and looked at a large cohort of 937 943 children in British Columbia, a province where the cut-off for entry into kindergarten or grade one is Dec. 31. The research included children who were between 6 and 12 years at any point during the 11-year study conducted from Dec. 1, 1997 to Nov. 30, 2008.

Researchers found that children were 39% more likely to be diagnosed and 48% more likely to be treated with medication for ADHD if born in December compared to January. Due to the Dec. 31 cut-off birth date for entry into school in British Columbia, children born in December would typically be almost a year younger than their classmates born in January.

"The relative age of children is influencing whether they are diagnosed and treated for ADHD," said lead author Richard Morrow, University of British Columbia. "Our study suggests younger, less mature children are inappropriately being labelled and treated. It is important not to expose children to potential harms from unnecessary diagnosis and use of medications."

There are significant health and social ramifications of inappropriate diagnosis of ADHD. Medication to treat ADHD can have negative health effects in children such as sleep disruption, increased risk of cardiovascular events and slower growth rates. As well, younger children who have been labelled ADHD may be treated differently by teachers and parents, which could lead to negative self-perception and social issues.

"This study raises interesting questions for clinicians, teachers and parents," noted coauthor and psychiatrist Jane Garland, University of British Columbia and BC Children's Hospital. "We need to ask ourselves what needs to change. For example, attention to relative age of children for their grade and more emphasis on behaviour outside the school setting might be needed in the process of assessment."

Although the prevalence of ADHD diagnosis and treatment is about three times higher in boys than girls, the effect of relative age applied to both. In fact, girls born in December and typically younger within their grade were 70% more likely to be diagnosed with ADHD than girls born in January.

"The potential harms of overdiagnosis and overprescribing and the lack of an objective test for ADHD strongly suggest caution be taken in assessing children for this disorder and providing treatment," conclude the authors.

The ADHD medications included in the study were methylphenidate, dextroamphetamine, mixed amphetamine salts and atomoxetine.

Raising Compassionate Kids with ADHD and LD

We're going to stick with the theme of compassion and empathy for one more day, and share an article we found on www.additudemag.com about compassion and ADHD and the benefits that fostering compassion and empathy can help with self-esteem.  (Lessons that apply equally to kids with LDs!)

Enjoy!

Rhonda & the Bridgeway team

Raising Compassionate Kids with ADHD

by Carol Brady, Ph.D.

Children with attention deficit disorder can be just as caring as other kids. But because of their poor impulse control and short ADHD attention spans, they sometimes come across as aloof or self-centered.

That was the case with 10-year-old Rachel (not her real name). Rachel's parents brought her to see me because they were concerned about their daughter's apparent lack of empathy. "Rachel doesn't care about anyone," they told me. "She's selfish and rude, even though we've done everything we can to help her change."

It was clear from the first few visits that Rachel was feeling hopeless about herself. She was so used to receiving help that it never occurred to her that she might be capable of caring about (or doing things for) other people. Once I helped convince her that she was capable of helping others, her outlook turned around. She became much happier.

Parents As Models

It goes without saying that children learn from what they see and experience at home. If you'd like to raise a caring, helpful child, be sure to express gratitude for jobs well done by every member of the family. "Thanks for setting the table," you might say. "You really helped me out by giving me some time to rest today," or "That kitten really purred when you petted her so gently."

Some parents worry that making a big deal about thanking a non-ADD sibling might alienate the child who has ADD. Not so. As long as you express thanks to everyone in the family, you have nothing to worry about.

Another way to teach compassion is to change the way you correct problem behavior. For example, instead of "I told you to stop - now look what happened," you might say, "You made a mistake. What can you learn from it? Together, I'm sure we can come up with a plan."

The key is to use a firm yet caring tone of voice and choice of words, rather than yelling or issuing threats or insults. Often, I urge parents to couch their disapproval in terms of puzzlement or curiosity: "Oh no, not again. I'm confused by your behavior because this is not how I see you" or "What do you imagine caused this situation?"

Make sure your child gets a chance to see you helping other people. Remember, actions speak louder than words. Saying, "I'm going to help grandma fix her garden," or "Your uncle needs my help in moving some boxes today," and then bringing your child along will teach generosity and responsibility better than any lecture can. If you're donating outgrown clothes and toys to less fortunate families, let your child help pack the boxes.

Fostering Self-Esteem

Like Rachel, many of the children who come to my office have low self-esteem and are convinced that they have little to offer to the world. On the contrary! With a little help, kids with ADHD often turn out to be more compassionate than other kids.

Some of the children I've worked with - including Rachel - have proved to be extraordinarily compassionate toward younger children. Others are good at taking care of and being loving to animals. Each time you notice and praise acts of kindness by your child, you help boost her self-esteem - and that encourages her to be even more interested in others. It becomes a self-fulfilling prophecy.

So get in the habit of "catching" your child "giving back" to others. Be sure to let him hear you tell grandpa that you noticed some pretty amazing behavior that day. (Even the smallest act is worthy of praise - for example, letting someone else sit in the "best" seat in the car.)

I recall how one patient of mine began our session by informing me, "Today is Dr. Brady Day, and you get to pick the game." Being able to honor me made this girl feel good about herself. She helped me to realize that giving back to others helps all of us feel good about ourselves.

Opportunities to Help Others

As you demonstrate how you give back to the community, help your child find opportunities to do likewise.

If you're worried that your child might have trouble behaving appropriately in a conventional volunteer situation (a hospital or community center, for example), look for special situations: One nine-year-old I know became her big sister's "special assistant" in caring for a pig to be entered in a livestock show.

In another case, a preteen who had difficulty behaving in big crowds helped set up tables for an event before the guests arrived. He was ecstatic when he saw his name listed in the program under the heading "Volunteers who made tonight's event possible."

Volunteer opportunities are plentiful in most communities. Some teens I know have enjoyed working for Habitat for Humanity or for hospitals that have well-structured volunteer programs. These youngsters have told me that they really enjoy helping others and that the rewards they reap cannot be counted in dollars and cents.

At this point, you may be thinking, "But Dr. Brady, you don't know my child. He can't even get to school on time, much less become an example of altruism." Well, here's a chance to prove me wrong. My experience has convinced me that almost any child can become a sensitive, caring individual.
The key is to live your values rather than to lecture about them - and to value your child for who he is.

8 gifts for ADHD (and LD) kids

I recently came across a blog by Zoe Kessler, adult ADHD'er who was diagnosed when she was 47.  She blogs for PsychCentral.com on life with ADHD, and has graciously agreed to share one of her recent postings with us - 8 gifts for ADHD Kids.  I think this advice would also suit LD kids just fine as well.

Thanks Zoe!

Rhonda

8 Gifts for ADHD Kids

By Zoë Kessler, BA, B.Ed.

I’ve been feeling pretty nostalgic this Christmas. In particular, I’m remembering what it was like being a hyperactive little girl with undiagnosed ADHD.

Based on on my research and my experience as an adult with ADHD, I’d like to suggest the following gifts that parents can give to their ADHD kids, both during the holidays and throughout the year.

I know these gifts aren’t “one size fits all,” but I’m pretty sure most of them would have been great for me. Maybe some (or all) of them would be good for your son or daughter, too.

1 ) your time
More than anything else, kids with ADHD want to feel connected. Spending quality time with your child is worth more than anything you can wrap up and put under the tree. Spend time sharing activities that your child enjoys; your support and encouragement will go a long way in helping your son or daughter build self-confidence and trust in their own talents and abilities.

2 ) understanding

Help your child manage their ADHD symptoms over the holiday; a gift for the whole family!

Holidays are a time when routines go out the window; that can stress out a kid with ADHD. Try to keep your child in the loop by letting them know what’s going on, what’s going to happen, and that it’s ok for them to take time out if they’re overwhelmed.

Throughout my childhood, I frequently removed myself from family gatherings. The din of music, a million conversations going on at once, kitchen sounds, animals and other kids running around, drove me crazy. I’d lock myself in an upstairs bathroom; sit in an empty bedroom; or go for a walk down the road (while freezing in the cold Canadian winters) to get away and re-group.

I think it’s great that I took care of myself. I don’t think it’s great that I felt so alone. It would have been great had my folks known about my ADHD and hypersensitivity and been able to give their support, understanding, and encouragement.

You have the chance to give your sensitive ADHD child the gift of understanding at Christmas. Try to be aware of what they’re feeling; support them during new or out-of-the-ordinary experiences, such as parties and social events; encourage them to do what they need to do.

3 ) control
During the holidays, your child with ADHD may feel even less in control of their life (and symptoms). Give them a role to play, perhaps by helping in the kitchen or setting the table. Let them decide what’s for dessert; let them pick what holiday movie they want to share as a family; this will give them back some control over what’s happening.

4 ) transition time
People with ADHD need more time to switch from one activity to another. If you’re frantically getting ready to go to a family gathering, or trying to get a meal on the table for company, don’t leave notifying your child until the last minute. Make it a priority to give your son or daughter enough time to finish what they’re doing, to mentally prepare for what’s coming next, and to join you in the next activity. And remember that this might take longer than it would for others (1/2 hour’s notice; then a 15-minute heads-up; then a last 5-minute warning, for example). This will help make transitions easier for you and your child over the holidays, and lessen the chances that Johnny’s still playing a video game in his pajamas while the car’s idling in the driveway with the rest of the family waiting.

5 ) role modeling
This is a gift to give all year long. You may not think your hyperactive little angel is paying attention; trust me, they are. They’re not only watching, they’re absorbing everything you do. My parents smoked and drank; my mom loved being outdoors and being creative; my dad never hesitated to help anyone in need. All of these things and more showed up in my adult life. I wasn’t as distracted as they thought, after all.

6 ) meditation
Meditation can be an effective non-drug treatment for kids (and adults) with ADHD. Make this a family activity, and you’ll not only be a good role model; you’ll be giving your child gift #1 – your time. And – bonus – meditation will be good for you too, especially if you’ve already given your child the gift of ADHD through your genes!

7 ) nature
Being out in nature is great for people with ADHD. It’s good for anyone, but a lot of us ADHDers feel so much better in the woods, walking along the shoreline, hiking in the mountains, it’s worth a shot to get out there with your kids at least once a week to see if this helps keep them on an even keel.

8 ) exercise
Exercise is one of the all-time best treatments for ADHD, and it’ll give your child better overall health and well-being, including helping them to sleep better (a problem for a lot of kids with ADHD) and the ability to focus better. As with the other gifts, this one can be shared by the whole family.



A gift for the whole family!
Finally, remember that every one of these gifts is a gift to the whole family. Helping your child with ADHD to not only manage their symptoms, but most importantly, to accept their symptoms and themselves no matter what, is the best gift you can give – and – bonus – none of these gifts have to be wrapped!

Kessler, Z. (2011). 8 Gifts for ADHD Kids. Psych Central. Retrieved on December 16, 2011, from http://blogs.psychcentral.com/adhd-zoe/2011/12/8-gifts-for-adhd-kids/

ADHD and the genetic connection

There is more research out this week on the brain and ADHD, this time from the Children's Hospital of Philadelphia.  They're looking at the influence of genetics and how genes impact pathways in the brain.  The research was published in the journal Nature Genetics, but here's an exerpt from a media release sent out earlier this week.

I also discovered an interesting blog posting on boys and ADHD from Dr. Stan Kutcher, an internationally-renowned expert in mental health from right here in Halifax!  I`m going to share more about Dr. Kutcher and his work in mental health next week.  Stay tuned!

Rhonda

New Gene Study of ADHD Points to Defects in Brain Signaling Pathways

PHILADELPHIA, Dec. 4, 2011 /PRNewswire via COMTEX/ -- Children's Hospital of Philadelphia Research Suggests that Interventions at the Glutamate Transmission Level Might Treat Disorder--

Pediatric researchers analyzing genetic influences in attention-deficit hyperactivity disorder (ADHD) have found alterations in specific genes involved in important brain signaling pathways. The study raises the possibility that drugs acting on those pathways might offer a new treatment option for patients with ADHD who have those gene variants--potentially, half a million U.S. children.

"At least 10 percent of the ADHD patients in our sample have these particular genetic variants," said study leader Hakon Hakonarson, M.D., Ph.D., director of the Center for Applied Genomics at The Children's Hospital of Philadelphia. "The genes involved affect neurotransmitter systems in the brain that have been implicated in ADHD, and we now have a genetic explanation for this link that applies to a subset of children with the disorder."

Read the rest of the media release here: http://www.marketwatch.com/story/new-gene-study-of-adhd-points-to-defects-in-brain-signaling-pathways-2011-12-04

A look inside the ADHD brain

As a parent of a child with ADHD, I often tell other people that my child's brain, "works differently".  Now, I have the proof.  Another great article from PsychCentral.

Brain Images Show Abnormal Areas in ADHD Kids

By Rick Nauert PhDSenior News EditorReviewed by John M. Grohol, Psy.D. on November 30, 2011

In a small study, functional magnetic resonance imaging (fMRI) has identified abnormalities in the brains of children with attention deficit/hyperactivity disorder (ADHD). Researchers believe the brain abnormalities may serve as a biomarker for the disorder.

“Diagnosing ADHD is very difficult because of its wide variety of behavioral symptoms,” said lead researcher Xiaobo Li, Ph.D. “Establishing a reliable imaging biomarker of ADHD would be a major contribution to the field.”

Experts report that ADHD affects an estimated five to eight percent of school-aged children and is one of the most common childhood disorders. Behavioral inattention, hyperactivity and impulsivity behaviors that are out of the normal range for a child’s age and development are criteria to diagnose ADHD.

However, there is no single test capable of diagnosing a child with the disorder. As a result, difficult children are often incorrectly labeled with ADHD while other children with the disorder remain undiagnosed.

For the study, Li and colleagues performed fMRI on 18 typically developing children and 18 children diagnosed with ADHD (age range 9 to 15 years).

Investigators engaged the children in a test that occupied their attention while they were undergoing fMRI. The children were shown a set of three numbers and then asked whether subsequent groups of numbers matched the original set.

For each participant, fMRI produced a brain activation map that revealed which regions of the brain became activated while the child performed the task. The researchers then compared the brain activation maps of the two groups.

Compared to the normal control group, the children with ADHD showed abnormal functional activity in several regions of the brain involved in the processing of visual attention information. The researchers also found that communication among the brain regions within this visual attention-processing pathway was disrupted in the children with ADHD.

“What this tells us is that children with ADHD are using partially different functional brain pathways to process this information, which may be caused by impaired white matter pathways involved in visual attention information processing,” Li said.

Li said much of the research conducted on ADHD has focused on the impulsivity component of the disorder.

“Inattention is an equally important component of this disorder,” she said, “and our findings contribute to understanding the pathology of inattentiveness in ADHD.”

Source: Radiological Society of North America

Meditation to focus your brain

I was poking around on the internet the other day and came across two articles that suggested meditation has positive effects on the symptoms of ADHD.  I'm not sure it would work for everyone, but it might work for some, so I thought I'd share the stories here.  Let me know if you have tried meditation and how it has worked for you!

Rhonda

Meditation may help brain tune out distractions
From CBS News Healthwatch

(WebMD)
People who meditate may be able to use their brain in ways others can't to tune out distractions and focus on the task at hand.

A new study shows that experienced meditators may have less activity in parts of the brain associated with daydreaming and distraction while meditating and in their day-to-day lives.

Researchers say this brain network, known as the "default mode network," has also been linked to anxiety, attention deficit hyperactivity disorder (ADHD), and Alzheimer's disease.

"The default mode is when you ruminate, think about yourself, or daydream," says study researcher Judson Brewer, MD, PhD, medical director of the Yale Therapeutic Neuroscience Clinic. "Everybody has it, but experienced meditators have a different type."

Brewer found that people who meditate are able to link up other parts of their brains to monitor activity in the default mode network that tell them to get back on task when distractions arise and be present in the moment.

The study is published in the Proceedings of the National Academy of Sciences.

Read the rest of the article here.


Mindfully Managing ADHD    
By Ronald Alexander, Ph.D.

From The Huffington Post

Even though it was only diagnosed about 50 years ago it seems that most people today have either dealt with or at least heard about ADHD (Attention Deficit Hyperactivity Disorder). Now there are variations of this disorder, including AD/HD and ADD, but basically the key behavioral signs in children are inattention, hyperactivity and impulsivity. Adults with ADHD often exhibit signs of depression, mood swings, anger and relationship issues, poor time-management skills and procrastination. The severity of these symptoms can vary, and there are many adults who aren't aware that they are mildly-afflicted with this disorder. Research indicates that it is caused by a genetic chemical imbalance in the brain and therefore can be inherited, although there are some who believe that factors like food additives contribute to the disorder. Most do agree though that triggers such as stress, anxiety and diet can intensify the symptoms.

As a therapist in Los Angeles I've worked with many patients with ADHD, especially in the entertainment industry. When I recommend they consider starting a mindfulness meditation practice, usually the first objection I hear is, "Oh, I could never mediate -- I'm too restless to be able to sit still long enough. Besides, it could stifle my creativity and dull my mind." I assure them that on the contrary, mindfulness meditation has proven to be a very effective tool in dealing with this disorder and takes less time than they think.

Mindfulness helps create the capacity to not only calm and sooth but increases the ability to focus. It offers two important benefits that help reduce restlessness. One is heightened concentration, allowing you to be more productive. Another is physiological changes, namely, a decrease in skin temperature and increase in oxygenation of the brain, a decrease in lactic acid (which causes fatigue) and cortisol (a stress hormone). With less fatigue and stress, you become less distracted and more efficient in using and managing your time. Through mindfulness you feel less anxiety and stress, and instead experience more "one-pointedness of mind." In Zen this means being in a state of complete focus or heightened concentration and totally aware of the present moment. The more frequent someone practices mindfulness the more they enter the zone of single-minded focus and become less plagued by the monkey mind.

For more on meditation, including a how-to guide by Ronald Alexander, please check out the Huffington Post article by clicking here.

Parents Promoting Self-Esteem

When you have average to above-average intelligence, but you're struggling with a skill that comes to your peers without much effort, you start to question your ability.  That's exactly what happens to a child with a learning disability.  And as they continue to struggle, their self-esteem begins to slide.  It's one of the biggest concerns parents bring to us at Bridgeway.  But don't loose hope, those self-esteem issues will turn around as children begin to learn in a way that works for them.  In the meantime, there are things we can do as parents to help.  This article from the website, Smart Kids with LDs, offers some advice.

Rhonda

Parents’ Tips for Promoting Self-Esteem

Parents of children with LD and ADHD offer the following tips for building self-esteem and encouraging competence:

Praise…
Give praise for a specific job well done—completing a chore, finishing a homework assignment, participating in a Boy Scout fundraiser.

…But not too much
Kids are aware if you’re making too much fuss, or if what you say doesn’t relate to something worth noting. Hollow praise diminishes the real thing.

Encourage decision-making
Giving a child the power to choose offers a taste of what is involved in making responsible decisions, including living with the consequences. When young, it may be choosing an activity or what to wear; later on, it may involve what courses to take or summer program to attend. Remember that you get to define the options, and few decisions are irreversible.

The process of making her own decision offers
your child a much-needed sense of having some
control over her life.

Offer a chance to shine
Whether it’s skating or drawing, a consuming interest in frogs or singing in the school play, make sure your child has opportunities to show off his strengths. Involvement is the key. As long as he’s interacting with a group that shares his interests, it’s okay to be the team manager or the guy that brings down the curtain at the end of the show.

Be the first
Kids gain status with their peers from being the first to see a new movie, go to a special event, show up with the latest fashion accessory or get a hot new gadget. Encourage the willingness to lead rather than follow.

To medicate or not to medicate

Someone shared this cartoon with me the other day, and it really made me sad.  The suggestion, of course, that the active, imaginative boy Calvin is changed by his "pills".  Although he's getting down to tasks, he's being robbed of the colour (or imagination) in his life.  Without it, his pal Hobbes is no more than a stuffed toy. 

We've heard plenty of horror stories in the past about medications used to treat ADHD and the negative impacts they can have on children.  But I have also heard several stories about how it has made a very positive difference in the life of a child, with the kids themselves asking not to be taken off the medication because of how clearly they're able to think.  The ultimate choice is up to you, your family and your doctor, but here's a bit of advice I thought I'd share from ADDitude Magazine for those who are debating the pros and cons.

Rhonda


ADHD Medication or Alternative Treatments?

After a child is diagnosed with attention deficit disorder (ADD ADHD), one of the most difficult decisions for a parent to make is whether to start him or her on medication. I've been there myself.

Two of my three children have ADHD, and, although my wife and I eventually decided to try medication — which, by the way, has helped both of them immensely without any side effects — arriving at that decision took careful reflection.

When it was suggested that my kids try medication, I had my concerns. I know that ADHD drugs are safe and effective, but I worried that perhaps, for some unknown reason, they might harm my children's health. Although stimulant medications have been with us for more than 60 years, I wondered if some new side effect might emerge.

I countered those concerns by worrying about the potential "side effects" of not taking the medication: namely, my children struggling to stay focused and getting frustrated when they couldn't. After envisioning that scenario, the decision became far less difficult.

Take your time

Each parent — and child — comes to the question of medication with different assumptions. My strong advice is to take your time, honor your feelings, and find a doctor who will remain patient, a professional who will provide information — not hurried commands — as you wrestle with your decision.

From a medical standpoint, the decision is obvious. Medication is by far the most proven, safe, and effective treatment for ADHD. Careful, controlled studies have established that a trial of medication makes sense once the diagnosis is made. Remember that a trial of medication is just that — a trial. Unlike surgery, it can be undone. If the medication doesn't work or if it produces side effects, the physician can reduce the dosage or discontinue it. No harm done. But unless your child tries the medication, you will never know if it can benefit him or her as it has other children and adults.

Do some fact-finding

From a personal, parental standpoint, though, the decision is anything but easy. It takes time and requires talking with your doctor and other experts. You might want to research the medication online and find out what the latest studies conclude about it. Get all the facts, and make a scientific, rather than a superstitious, decision. But I urge you never to start your child on medication until you're comfortable doing so. Don't feel that you're trying your doctor's patience or that your questions are foolish. Nothing done out of love for your child is foolish.

However, I also urge you not to reject medication out of hand. Many parents have heard so many bad things about ADHD drugs that they're willing to travel to Tibet to find an alternative treatment before giving medication a try. It's very important to do your homework and separate the facts from the myths before dismissing the treatment.

Honor your feelings

When I give lectures, people often ask me if I "believe in" medication for children and adults with ADHD. My reply is that medication isn't a religious principle; it's a medical treatment. My feelings about ADHD medications are similar to those about medications in general: They're great when they're used properly, and they're dangerous when they're not.

Sometimes it takes months or even years before parents decide to put their child on medication. Every parent has his or her own timetable. Stick with yours.

Another expert opinion on ADHD

There are a lot of experts out there on ADHD.  I don't think any one person has all of the answers, so I like to read lots of different options and opinions. 

Dr. Sam Goldstein is an expert on ADHD from the University of Utah School of Medicine.  He'll be speaking tonight in Calgary.  Unfortunately, I can't drop everything and fly half way across the country, so I'll have to settle for a little light reading - again.  I did find this article which features an interview with Dr. Goldstein in The Calgary Herald, and I thought I'd share it with here.  Enjoy!

Rhonda

An Interview with Dr. Sam Goldstein

Dr. Goldstein is a doctoral psychologist with areas of specialization in school psychology, child development and neuropsychology and sees about 300 patients a year. He’s also editor in chief of the Journal of Attention Disorders, a filmmaker and the author of many books including Raising a Self-Disciplined Child.

The Herald grabbed a few minutes with Goldstein prior to his visit.

Q: What, exactly, is attention deficit hyperactivity disorder?

A: Simply put, it’s a delay in a child’s ability to keep pace with their developing self-discipline relative to their peers.

They tend to have trouble regulating their emotions and their behaviours, which interferes with performance situations like school, social situations like on the playground or in family situations like at the dinner table.

It’s been portrayed as a psychiatric condition, but it really is a developmental difference or delay. The brain’s executive function is slower to develop.

Q: It seems to be everywhere, but how widespread is it really?

A: The problem is they’ve so liberalized the definition of it that now every other child is described as having ADD, which is unfortunate because if you look at the outcome of the two or three or four per cent of children who are at the bottom of the bell curve at the rate at which they mature in this area, they struggle.

They struggle in school, with substances, with interpersonal relationships. They struggle to transition into functional adult life. They are also more likely to kill themselves in a car, more likely to contract a sexually transmitted disease.

Q: Is ADHD something kids can outgrow as the executive part of their brain matures?

A: Do you outgrow ADHD? No. Can you reach a point in your life where you compensate sufficiently or where your brain has matured to where you don’t meet the diagnostic definition because you do not have significant impairment? Absolutely, yes.

What we see is that if you take a group of children with ADHD and follow them into adulthood, about one-third have very poor outcomes. One-third are in the middle and one-third do pretty well. What percentage still meet the diagnosis? Probably 80 per cent.

Q: Can you predict who will be OK and who won’t?

A: We began looking at children with conditions like ADD who transitioned to adulthood and managed to find some normalcy in their lives, who managed to get through school and have a family and jobs and not be burdened by substance abuse and other adversities.

We discovered that there’s this “ordinary magic”: universal qualities that insulate children over time. Treatment — medication, counselling, educational support, parent support — has only a very small prediction in outcome.

The larger prediction of who will thrive is predicted by universal factors . . . things like developing self-discipline, resiliency and learning to deal with mistakes. Being connected to people. Developing empathy. Learning how to problem-solve. Developing an island of competence — something that gives you a sense of identity and purpose, even in the face of other challenges and adversities. Having a charismatic person in your life [an adult from whom you gather strength], who loves and cares for you, even when they’re angry at you.

These seem like fairly ordinary phenomena, but when you study the outcomes of children broadly — not just those with disabilities — you find they’re very powerful predictors over time of life satisfaction, of normalcy in adult years.

Q: Do people with ADHD have any unique strengths?

A: They have the same strengths as anybody in the general population. I don’t think the condition comes with any assets or benefits. Out of the thousands of studies that have been done, there’s not a single one to demonstrate that people with ADHD perform better.

There’s a movement to glorify people with ADHD, to describe them as “hunters in a farmers’ world,” [a reference to author Thom Hartmann’s books about ADD]. Really, people with ADHD learn to live with it, to adapt and make it part of their successes. There’s never been any empirical support for the folklore that having ADHD will make a person a better jet fighter or stockbroker.

Q: Are there learning environments that children with ADHD function better in?

A: Yes, when they can talk, move and question. When the material is not boring and repetitive and effortful and the payoff is something they value. It isn’t that they can’t pay attention, it’s that they don’t regulate attention unless the stakes are higher. They need a higher level of stimulation and motivation to bring that kind of self-discipline to the table.

It’s not that they can’t do it, it’s that they don’t do it in a consistent, predictable, independent way. That’s what parents have to understand: It’s not “I have to teach you how to do it”; it’s more like “I have to help you develop the self-discipline to do what you already know.”

Q: What other advice do you have for parents?

A: [Raising a child with ADHD] is a challenge. Treatments like medication take you just so far. Emerging literature shows that communicating and interacting with your child every day, giving them opportunities to become stress-hearty and really appreciating their assets along with their liabilities sets a foundation for a parent to make a difference.

How you shape their lives will determine what happens to them over time, help them be more consistent, predictable and independent in what they already know how to do. Be proud, patient and persistent. It’s like teaching a poorly coordinated child to ride a bicycle. You need to be patient, understanding and appreciate that the child’s disability makes it harder for them to accomplish the task, but if they stick with it, they get it.

Read more: http://www.calgaryherald.com/health/Understanding+ADHD/5728716/story.html#ixzz1e53OmdjP

Taming the homework monster - part 1

Now that I have found the website for Smart Kids with Learning Disabilities, I'm finding a ton of articles that would be of interest to our followers.  I'll try not to share too much, but thought I'd share this piece of advice that I'll be taking home to my family!

Tomorrow - advice for collaborating with your school on homework.

Rhonda

Taming the Homework Monster for Kids with LD & ADHD

By Peg Dawson, Ed.D.

Remember when you couldn’t wait to graduate from school because that meant no more homework and studying? Or so you thought. As anyone with children can attest, homework never ends! While many students consider it the toughest part of the school day, homework also can be a painful aspect of parenting—especially for those whose children have LD including Dyslexia, NLD, Executive Function issues or attention problems. However, that need not be the case. When homework is a collaborative effort between home and school, with parents and teachers both playing helping roles, it is likely to make the process go more smoothly. Here are some pointers for all involved.

What Parents Can Do

• Check in with your child every day
  Ask what the homework assignment is and if there’s any doubt about the answer, check his assignment book. This lets him know that parents see homework as important.

• Make a daily homework plan. At a minimum, it should include a list of what needs to be done and when she plans on doing each assignment. To help her develop time-management skills, have her estimate how much time it will take to complete each assignment (and track this to help her improve the skill). When making a plan, ask about long-term assignments and upcoming tests, so those can be built into the plan.

• Provide a clean and quiet workspace.
  It’s also helpful to keep on hand extra supplies such as pencils, markers, scissors, rulers, calculators, etc.

• Reward rather than punish.
  Giving him something he can look forward to when homework is finished may be the incentive he needs to get through it. Saying, “Guess what? You get to do X as soon as you finish your spelling workbook,” is more motivating than saying, “If you don’t do your homework, X is off-limits.”

• Supervise, but don’t micromanage.
  The goal is for your child to complete homework independently, but that often depends on maturity, which varies tremendously from child to child. In the early stages, parents often need to sit with children while they work. As they get older, parents can check in frequently, be there for the hard stuff, or just get them started and then leave.

• Distinguish between your role and the teacher’s role.
  It’s your job to make sure that your child does his homework and puts it in his backpack when complete. It is the teacher’s job to make sure it’s done right. In most cases it’s best to let teachers judge neatness as well (although at times it’s effective to let your child know that if you can’t read his handwriting, he’ll have to redo it).

• Reach out for support.
  If homework battles threaten family functioning, make an appointment with the school. Homework wars should not jeopardize parent-child relationships. If they threaten to do this, then parents and teachers need to put their heads together to come up with alternatives.

Succeeding with ADHD - Tips from Michael Phelps' Mom

Ever watched Extreme Makeover: Home Edition on TV?  Remember watching the 2004 Summer Olympics in amazement as Michael Phelps won eight medals - six of them gold?  You were watching two ADHDers lead successful lives.  Ever wonder how they did it - and what their parents went through?  Read this fantastic article with interviews with three mothers whose children have gone on to some huge achievements.

Enjoy!

ADHD Parenting Advice from Michael Phelps' Mom


What does it take to succeed despite attention deficit disorder (ADD ADHD)?

It takes hard work, for starters — a willingness to meet challenges head-on. It takes support from family members, teachers, therapists, and coaches. And, of course, it’s hard to overstate the benefits of ADHD medication.

But, of all the ingredients needed to make a happy, successful life, nothing is more important than good parenting. Behind almost every ADHD success story is a devoted parent (or two). In honor of mothers, let’s give credit where credit is due — and heed their ADHD parenting advice.

The three mothers profiled here helped their sons and daughters achieve great things — more than they could have imagined. Steadfast and resourceful, they saw strength where others saw weakness, and kept looking for ways to help their children after others were ready to give up. Let their stories inspire you!

Read more on the ADDitute Magazine website.

Adults and ADHD

If you have a child who has ADHD, there's a pretty good chance that one or more of the adults in the family tree do too.  It can lead to conflict (trust me, I know!) but it can also be a gift.  Why is that?  Well, it helps you understand what your ADHD child might be going through.

How do you know if you might have ADHD?  It's a diagnosis that only a physician or mental health practitioner can diagnose, but there are lots of screening tools out there to help you decide if you should consider speaking to a professional.  Here's a link to one of those tools:

Self-test for Adult ADHD

ADHD often looks different in women, and there are different checklists that describe those symptoms:

ADHD Symptoms Checklist for Women 

There are also lots of websites out there for adults with ADHD.  One of my favourites is www.totallyadd.com by Canadian writer/director/actor Rick Green.  Here's a link to a video from the site in which Rick and Patrick McKenna discuss symptoms of adult ADHD.  It's very funny - and worth watching!

http://totallyadd.com/the-adult-symptoms/

Handling ADHD behaviour

If you have ever parented a child with ADHD, you know that discipline can be a challenge.  Here are some great tips on dealing with behaviour at home.

Rhonda


Does your struggle with ADHD behavior look something like this?

You’ve told your child with attention deficit disorder (ADD ADHD) to pick up his dirty clothes from the bedroom floor. Not a single sock has been deposited in the hamper. Did he not hear you — or did he ignore your discipline?

Annoyed, you shout and, worse, feel yourself getting angry and nearing a power struggle. Then come the threats -- no TV for a week, no friends visiting for a month, and whatever else you can think of in your fury. The incident costs everyone dearly: Your child feels angry and demoralized, and you feel like anything but a loving parent. And for what? A pile of clothes in need of a washing machine.

Later that evening, during a quiet moment at the kitchen table, you think back to what happened -- and what has been happening for months now. You wish you had used more effective communication and question whether you love your child any more, whether you’re a fit parent. Don’t worry: You do and you are.

You’re feeling the emotional turmoil and stinging regret every parent experiences when trying to love and discipline your child. Here are some strategies that will help you feel less like an ogre and more like a mom the next time your child needs some “enlightenment”:

Read more on the ADDitude Magazine site - http://www.additudemag.com/adhd/article/2519.html

ADHD and Executive Function

A lot of kids with ADHD struggle with Executive Function.  When I first heard about it, it was a mystery.  But it was the skill set my son struggled with the most, so I learned as much as I could.  Here's a great introductory article

 

What is Executive Function?

 

Executive function is a set of mental processes that helps connect past experience with present action. People use it to perform activities such as planning, organizing, strategizing, paying attention to and remembering details, and managing time and space.

If you have trouble with executive function, these things are more difficult to do. You may also show a weakness with working memory, which is like "seeing in your mind's eye." This is an important tool in guiding your actions.

As with other learning disabilities, problems with executive function can run in families. It can be seen at any age, but it tends to become more apparent as children move through the early elementary grades. This is when the demands of completing schoolwork independently can trigger signs of a problem with executive function.

The brain continues to mature and develop connections well into adulthood. A person's executive function abilities are shaped by both physical changes in the brain and by life experiences, in the classroom and in the world at large. Early attention to developing efficient skills in this area can be very helpful. As a rule, it helps to give direct instruction, frequent reassurance, and explicit feedback.

 

Find out more about how Executive Function impacts learning, how it's identified and ways to cope, click here to read the rest of the article on the National Center for Learning Disabilities website.

Teaching kids with ADHD

There are a lot of ways to support kids with ADHD in the classroom, but the resources aren't always easy to find.  I have just found another terrific site with lots of information for teachers and parents.  In fact, I have spent close to an hour exploring the site!  There are lots of well-researched facts about ADHD and their impacts in the classroom.  I'll be sharing this with my son's teacher. 

http://research.aboutkidshealth.ca/teachadhd

Here's a little preview from the page titled "Rethinking ADHD in the Classroom".

ADHD impedes academic achievement

One of the most critical findings from recent cross-sectional and longitudinal research is that children with ADHD are at high risk for academic failure, grade repetition, placement in special education, and high-school drop-out (see Table 4-1, below).^1-4

Additional research suggests that the association between ADHD and poor academic achievement starts early in a child's school career (that is, kindergarten for many students).^5-9

Table 4-1: Educational Attainment in ADHD

Educational Outcome	ADHD vs. Non-ADHD Peer Group
Low achievement at school:1-3 Grade repetition Low academic grades (Cs and Ds) Achievement scores (reading, math) Placement in special education	two-fold risk two- to four-fold risk 8% to 10% lower two- to four-fold risk
Early school leaving:2-3 Highest level completed High school dropout	one to two years lower three-fold risk
Tertiary level attainment (college):4 College grade point average (GPA)	0.7 lower GPA

7 Myths about ADHD - Debunked!

Ever wondered if ADHD is a real medical disorder, if your kids might outgrow the condition or if your child might have avoided ADHD all together if you had only parented him/her differently?  Here are some of the top ADHD myths - and reasons why they're not true.  Another great article from ADDitude Magazine.

Rhonda

7 Myths About ADHD... Debunked!

 

Few psychological conditions have generated more discussion in recent years than attention deficit disorder (ADD ADHD). Yet, people continue to harbor many mistaken beliefs about ADHD. Read on to learn the truth.

Myth #1: ADHD isn't a real medical disorder

ADHD has been recognized as a legitimate diagnosis by major medical, psychological, and educational organizations, including the National Institutes of Health and the U.S. Department of Education. The American Psychiatric Society recognizes ADHD as a medical disorder in its Diagnostic and Statistical Manual of Mental Disorders - the official mental health "bible" used by psychologists and psychiatrists.
Attention-deficit hyperactivity disorder (also known as attention-deficit disorder) is biologically based. Research shows that it's a result of an imbalance of chemical messengers, or neurotransmitters, within the brain. Its primary symptoms are inattention, impulsiveness, and, sometimes, hyperactivity.
People with ADHD typically have a great deal of difficulty with aspects of daily life, including time management and organizational skills.

Myth #2: Children who are given special accommodations because of their ADHD are getting an unfair advantage

The federal Individuals with Disabilities Education Act (IDEA) requires that public schools address the special needs of all children with disabilities, including children with ADHD. Special accommodations, such as extra time on tests, simply level the playing field so that kids with ADHD can learn as successfully as their non-ADHD classmates.

Myth #3: Children with ADHD eventually outgrow their condition

More than 70 percent of the individuals who have ADHD in childhood continue to have it in adolescence. Up to 50 percent will continue to have it in adulthood.
Although it's been estimated that 6 percent of the adult population has ADHD, the majority of those adults remain undiagnosed, and only one in four of them seek treatment. Yet, without help, adults with ADHD are highly vulnerable to depression, anxiety, and substance abuse. They often experience career difficulties, legal and financial problems, and troubled personal relationships.

Myth #4: ADHD affects only boys

Girls are just as likely to have ADHD as are boys, and gender makes no difference in the symptoms caused by the disorder. But because this myth persists, boys are more likely to be diagnosed than girls.

Myth #5: ADHD is the result of bad parenting

When a child with ADHD blurts things out or gets out of his seat in class, it's not because he hasn't been taught that these behaviors are wrong. It's because he cannot control his impulses. The problem is rooted in brain chemistry, not discipline. In fact, overly strict parenting - which may involve punishing a child for things he can't control - can actually make ADHD symptoms worse. Professional interventions, such as drug therapy, psychotherapy, and behavior modification therapy, are usually required.

MYTH #6: Children who take ADHD medication are more likely to abuse drugs when they become teenagers.

Actually, it's just the opposite. Having untreated ADHD increases the risk that an individual will abuse drugs or alcohol. Appropriate treatment reduces this risk.
The medications used to treat ADHD have been proven safe and effective over more than 50 years of use. These drugs don't cure ADHD, but they are highly effective at easing symptoms of the disorder. The drugs do not turn kids into addicts or "zombies."

Myth #7: People who have ADHD are stupid or lazy - they never amount to anything

People with ADHD are of above-average intelligence, recent studies show. They certainly aren't lazy. In fact, many well-known, high-achieving individuals from the past are thought to have had ADHD, including Mozart, Benjamin Franklin, Abraham Lincoln, George Bernard Shaw, and Salvador Dali. The list of high-achieving ADDers in business today includes top executives, such as David Neeleman, founder of JetBlue Airways, and Paul Orfalea, founder of Kinko's.

The meaning of ADHD

In our continuing celebration of ADHD Awareness week, we thought we'd share some wisdom about helping your children understand ADHD.  If we help them become aware of how ADHD impacts them, then they can more effectively advocate for themselves.

Here is an exerpt from an article on the ADDitdue Magazine website.  Click on the link below for the full article.

Enjoy!

Rhonda

Your son or daughter has been diagnosed with attention deficit hyperactivity disorder (ADD/ADHD). You’ve done your due diligence, learning about the condition and how the symptoms affect him, academically and socially. Great. But have you shared what ADD/ADHD means with your child? Does she understand why she does things that upset others? Does he know why he is taking medication and how it works? Saying, “You are so hyper all of the time” makes your child feel he is doing something wrong. Saying, “Sometimes your brakes don’t work so well, so you say and do things that might upset your friends” is better.

The Meaning of ADD/ADHD

ADHD Awareness Week: ADD Statistics About Anxiety, Sleep, Work | ADDitude

I just found out that Sunday marks the first week of ADHD Awarness week!  It's quite common for individuals who are dealing with learning disabilities to be dealing with ADHD as well.  The ADHD Awareness Coalition did the survey that looks at the impact of having ADHD on children and adults.  You can read about the report by clicking on the link below.


I'll post more information on living and working with ADHD over the next week.  Enjoy!


Rhonda


ADHD Awareness Week: ADD Statistics About Anxiety, Sleep, Work | ADDitude

ADHD as a superpower?

ADHD can certainly get in the way of learning, but it also fuels brilliant minds that achieve some really big things.  I recently found this great article that shows us how ADHD'ers put their energy to work in business.

Rhonda

Why Some Entrepreneurs Call ADHD a Superpower

Some small-business owners say they've been able to harness the strengths that come with their learning disability.

By DYAN MACHAN
From Smart Money

 People who have it sometimes like to call it their superpower, but in reality, attention-deficit/hyperactivity disorder, or ADHD, is a learning disability. Still, it's surprisingly common among high-achieving business founders, and entrepreneurs afflicted with it are in good company, with Kinko's founder Paul Orfalea and JetBlue founder David Neeleman among the many who talk openly about their having attention-deficit issues. It stands to reason that ADHD would thrive among those calling the shots. While they are often labeled as misfits inside big organizations, their restless creativity dovetails with the high-drama problem-solving associated with running a start-up.
In cases of ADHD, the brain chemicals that regulate attention and brain activity function differently than in the "normal" brain. For those with the disorder, it's harder to buckle down and concentrate and to anticipate the outcomes of their actions. Still, many entrepreneurs have learned to cope when their brains are flooding them with information, and their strategies can be helpful for anyone facing information overload. For people with ADHD, biology is probably to blame. For the rest of us, it's living in 2011.

On the plus side, people with ADHD often have an immense amount of energy, and they think outside the box -- because their ideas could never fit inside one box. On the minus side, they have an inability to focus on what bores them, can make sloppy errors when rushing (which is almost always) and have a stronger-than-average tendency to put a foot in their mouth.

Read more here.