Autism / Asperger’s Quiz

http://psychcentral.com/quizzes/autism.htm

ADHD is Real (from: http://www.adhdawarenessmonth.org/adhd-facts/)

Nearly every mainstream medical, psychological, and educational organization in the United States long ago concluded that Attention-Deficit/Hyperactivity Disorder (ADHD) is a real, brain-based medical disorder. These organizations also concluded that children and adults with ADHD benefit from appropriate treatment. [1,2,3,4,5,6,7]

ADHD is a Common, Non-Discriminatory Disorder

ADHD is a non-discriminatory disorder affecting people of every age, gender, IQ, religious and socio-economic background.

In 2011, the Centers for Disease Control and Prevention reported that the percentage of children in the United States who have ever been diagnosed with ADHD is now 9.5%. [8] Boys are diagnosed two to three times as often as girls.

Among adults, the Harvard/NIMH National Comorbidity Survey Replication found 4.4% percent of adults, ages 18-44 in the United States, experience symptoms and some disability. [9]

ADHD, AD/HD, and ADD all refer to the same disorder. The only difference is that some people have hyperactivity and some people don’t.

Diagnosing ADHD is a Complex Process

In order for a diagnosis of ADHD to be considered, the person must exhibit a large number of symptoms, demonstrate significant problems with daily life in several major life areas (work, school, or friends), and have had the symptoms for a minimum of six months.

To complicate the diagnostic process, many of the symptoms look like extreme forms of normal behavior. Additionally, a number of other conditions resemble ADHD. Therefore, other possible causes of the symptoms must be taken into consideration before reaching a diagnosis of ADHD.

What makes ADHD different from other conditions is that the symptoms are excessive, pervasive, and persistent. That is, behaviors are more extreme, show up in multiple settings, and continue showing up throughout life.

No single test will confirm that a person has ADHD. Instead, diagnosticians rely on a variety of tools, the most important of which is information about the person and his or her behavior and environment. If the person meets all of the criteria for ADHD [10,11], he or she will be diagnosed with the disorder.

Other Mental Health Conditions Often Occur Along With ADHD

Up to 30% of children and 25-40% of adults with ADHD have a co-existing anxiety disorder. [12]
Experts claim that up to 70% of those with ADHD will be treated for depression at some point in their lives. [13]
Sleep disorders affect people with ADHD two to three times as often as those without it. [14]
ADHD is Not Benign

ADHD is not benign.[15] Particularly when the ADHD is undiagnosed and untreated, ADHD contributes to:

Problems succeeding in school and successfully graduating. [16,17]
Problems at work, lost productivity, and reduced earning power. [18,19,20,21]
Problems with relationships. [22,23]
More driving citations and accidents. [24,25,26,27]
Problems with overeating and obesity. [28,29,30,31]
Problems with the law. [32,33]
According to Dr. Joseph Biederman, professor of psychiatry at Harvard Medical School, ADHD may be one of the costliest medical conditions in the United States: “Evaluating, diagnosing and treating this condition may not only improve the quality of life, but may save billions of dollars every year.” [34]

ADHD is Nobody’s FAULT

ADHD is NOT caused by moral failure, poor parenting, family problems, poor teachers or schools, too much TV, food allergies, or excess sugar. Instead, research shows that ADHD is both highly genetic (with the majority of ADHD cases having a genetic component), and a brain-based disorder (with the symptoms of ADHD linked to many specific brain areas). [35]

The factors that appear to increase a child’s likelihood of having the disorder include gender, family history, prenatal risks, environmental toxins, and physical differences in the brain. [36]

ADHD Treatment is Multi-Faceted

Currently, available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, behavioral interventions, education or training, and educational support. Usually a person with ADHD receives a combination of treatments. [37,38]

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Mental Health: A Report of the Surgeon General, Chapter 3, Section 4: Attention-Deficit/Hyperactivity Disorder. www.surgeongeneral.gov/library/mentalhealth/chapter3/sec4.html
National Institute of Mental Health: Attention Deficit Hyperactivity Disorder. www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/
Center for Disease Control and Prevention: Attention-Deficit/Hyperactivity Disorder. www.cdc.gov/ncbddd/adhd/
U.S Department of Education Research: Attention Deficit Hyperactivity Disorder. www2.ed.gov/rschstat/research/pubs/adhd/
American Academy of Pediatrics Children’s Health Topics: ADHD. www.aap.org/healthtopics/adhd.cfm
Phelan, K. (2002). World of Distraction: Adult Attention-Deficit/Hyperactivity Disorder. www.ama-assn.org/amednews/2002/03/18/hlsa0318.htm
American Academy of Child & Adolescent Psychiatry: ADHD Resource Center. www.aacap.org/cs/ADHD.ResourceCenter
Back to Fact 1
Akinbami, L.J., Liu, X., Pastor, P.N., Reuben, C.A. (2011). Attention Deficit Hyperactivity Disorder Among Children Aged 5–17 Years in the United States, 1998–2009. www.cdc.gov/nchs/data/databriefs/db70.htm
National Institute of Mental Health. (2006). Harvard Study Suggests Significant Prevalence of ADHD Symptoms Among Adults. www.nimh.nih.gov/science-news/2006/harvard-study-suggests-significant-prevalence-of-adhd-symptoms-among-adults.shtml
Back Fact 2
Center for Disease Control and Prevention: Attention-Deficit/Hyperactivity Disorder Symptoms and Diagnosis. www.cdc.gov/ncbddd/adhd/diagnosis.html
Searight, H.R., Burke, J.M., Rottnek, F. (2000). Adult ADHD: Evaluation and Treatment in Family Medicine. www.aafp.org/afp/20001101/2077.html
Back to Fact 3
National Resource Center on ADHD. (2008). What We Know: AD/HD and Coexisting Conditions. www.help4adhd.org/documents/WWK5.pdf
National Resource Center on ADHD. (2008). What We Know: AD/HD and Coexisting Conditions: Depression. www.help4adhd.org/documents/WWK5c.pdf
National Resource Center on ADHD. (2008). What We Know: AD/HD, Sleep, and Sleep Disorders. www.help4adhd.org/documents/WWK5d.pdf
Back to Fact 4
Barkley, R.A., et al. (2002). International Consensus Statement on ADHD. www.russellbarkley.org/images/Consensus 2002.pdf
Adler, L.A and Cohen, J. (2002). ADHD: Recent Advances in Diagnosis and Treatment. www.medscape.org/viewarticle/443113
Biederman, J., Faraone, S.V. (2006). The Effects of Attention-Deficit/Hyperactivity Disorder on Employment and Household Income. www.medscape.com/viewarticle/536264
Adler, L.A and Cohen, J. (2002). ADHD: Recent Advances in Diagnosis and Treatment. www.medscape.org/viewarticle/443113
Kessler, R. C., Lane, M., Stang, P. E., Van Brunt, D. L. (2009). The Prevalence and Workplace Costs of Adult Attention Deficit Hyperactivity Disorder in a Large Manufacturing Firm. www.ncbi.nlm.nih.gov/pubmed/18423074
Back to Fact 5
Gjervan, B., Torgersen, T., Nordahl, J M., Rasmussen, K. (2011). Functional Impairment and Occupational Outcome in Adults with ADHD. jad.sagepub.com/content/early/2011/06/29/1087054711413074.abstract
Biederman, J., Faraone, S.V. (2006). The Effects of Attention-Deficit/Hyperactivity Disorder on Employment and Household Income. www.medscape.com/viewarticle/536264
Barkley, R.A., Murphy, K., and Fischer, M. (2007). ADHD in Adults, What the Science Says. New York, NY: Gilford Press.
Biederman, J., et al (2006). Functional Impairments in Adults with Self-reports of Diagnosed ADHD: A Controlled Study of 1001 Adults in the Community. www.ncbi.nlm.nih.gov/pubmed/16669717
Back to Fact 5
Barkley, R.A., Guevremont, D.C., Anastopoulos, A.D., DuPaul, G.J. & Shelton, T.L. (1993). Driving—Related Risks and Outcomes of Attention Deficit Hyperactivity Disorder in Adolescents and Young Adults: A 3- to 5-Year Follow-up Survey. pediatrics.aappublications.org/content/92/2/212.abstract
Barkley, R.A., Murphy, K.R., Kwasnik, D. (1996). Motor Vehicle Driving Competencies and Risks in Teens and Young Adults with Attention Deficit Hyperactivity Disorder. pediatrics.aappublications.org/content/98/6/1089.abstract
Snyder, J. (2001). ADHD & Driving: A Guide For Parents of Teens with AD/HD. Whitefish, MO: Whitefish Consultants.
Murphy, K. (2006). Driving Risks in Adolescents and Young Adults with ADHD. preview.tinyurl.com/3nkpn7u
Dukarm, C.P. (2006). Pieces of a Puzzle: The Link Between Eating Disorders and ADD. Washington, DC: Advantage Books.
Waring, M.E., and LaPane, K.L. (2008). Overweight in Children and Adolescents in Relation to Attention-Deficit/Hyperactivity Disorder: Results From a National Sample. pediatrics.aappublications.org/content/122/1/e1.full.pdf
Back to Fact 5
Pagoto, S.L. et al. (2009). Association Between Adult Attention Deficit/Hyperactivity Disorder and Obesity in the US Population. www.nature.com/oby/journal/v17/n3/full/oby2008587a.html
Dempsey, A., Dyhouse, J. and Schafer, J. (2011). The relationship between executive function, AD/HD, overeating, and obesity. wjn.sagepub.com/content/33/5/609.abstract
Quily, P. (2011). Up To 45% 0f Prisoners Have ADHD Studies Show. Crime & Jail Are Costly, Treatment Is Cheap. adultaddstrengths.com/2011/01/12/adhd-and-crime-ignore-now-jail-later-15-clinical-studies/
Biederman, J., et al (2006). Functional Impairments in Adults with Self-reports of Diagnosed ADHD: A Controlled Study of 1001 Adults in the Community. www.ncbi.nlm.nih.gov/pubmed/16669717
Medical News Today. (2005). $77 billion in lost income is attributed to ADHD annually in USA. www.medicalnewstoday.com/releases/24988.php
Back to Fact 5
Barkley, R.A., et al. (2002). International Consensus Statement on ADHD. www.russellbarkley.org/images/Consensus 2002.pdf
American Academy of Child & Adolescent Psychiatry: ADHD Resource Center. www.aacap.org/cs/ADHD.ResourceCenter/adhd_faqs
Back to Fact 6
National Institute of Mental Health: Attention Deficit Hyperactivity Disorder. www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/how-is-adhd-treated.shtml
Center for Disease Control and Prevention: Attention-Deficit/Hyperactivity Disorder. www.cdc.gov/ncbddd/adhd/treatment.html

By MARGARITA TARTAKOVSKY, M.S.

No Boundaries Juniors Pull On Maxi Tulip SkirtMany women with ADHD live with a painful secret: “Shame, unfortunately, seems to be the name of the game, for many women I have worked with who have ADHD,” said Terry Matlen, MSW, ACSW, a psychotherapist and ADHD coach.

Even women with advanced degrees in demanding, high-powered positions feel incredibly overwhelmed once they get home, stressed out by all the household details, she said. “They feel like they are living a lie — that their accomplishments are simply due to good luck.”

Even for women who understand how ADHD makes daily life difficult, one minor mistake or overlooked task can send them reeling from humiliation — “like simply forgetting to sign their child’s school-related paper in time.”

This triggers a barrage of negative, cruel thoughts: “Oh no! I’ve done it again. What is wrong with me? I’m such an idiot!”

In childhood, girls are taught that we must keep a tidy home, cook dinner every night, do laundry, entertain, take care of the chores, raise well-behaved children and work full time, said Matlen, author of the forthcoming book The Queen of Distraction: How Women with ADHD Can Conquer Chaos, Find Focus, and Get More Done.

For women with ADHD these expectations — however unrealistic and unfair — can amplify their shame and sink self-esteem. This happens particularly when women become parents because there are so many additional responsibilities, she said.

When they can’t keep up, they start feeling guilty. They berate themselves for not being what they perceive as good enough mothers. They worry their kids won’t learn certain skills, such as time management. They regularly compare themselves to other moms, for whom parenting and other motherhood-related responsibilities seem to come easily, she said.

“Women are taught to be a stabilizing force in the family. If she falls apart, then what? So she continues to live with her painful secrets of feeling inadequate, unintelligent, incapable.”

Many women with ADHD also have been told that ADHD isn’t a “real” condition, said Matlen, who also has ADHD. They’re told they just need to work harder, but “Telling a woman to try harder is like asking someone with a hearing impairment to listen better.”

Letting go of shame and feelings of inadequacy is a process that takes time. Matlen’s seven tips can help you get started.

1. Connect with other women who have ADHD.

According to Matlen, “Women with ADHD have much in common and feel much better when they see how it affects others and how they manage.” She suggested joining online groups and support groups in your area.

Matlen has created a range of websites for women with ADHD:

www.WomenADHD.com: a community where women with ADHD can connect.
www.QueensOfDistraction.com: an online group coaching for women with ADHD.
www.Facebook.com/ADDconsults: features resources for women.
https://www.facebook.com/groups/womenWithADD/: a Facebook page for women to connect and share information and resources.
www.MomsWithADD.com: a community for moms with ADHD.
She suggested these other great websites:

www.SariSolden.com: Solden penned a groundbreaking book on women with ADHD. Her website is for both men and women, but lots of women are drawn to her site.
http://www.addiva.net: a site for women, especially who are middle aged and up.
http://www.addvance.com: offers resources for women.
To find other groups, Matlen also suggested trying Facebook and typing in the search box: “women with ADHD.”

2. Attend ADHD conferences.

“A lot of the issues surrounding shame and inadequacy are due to feeling like you’re the only one who has difficulties with organizing, time management, etc.” But you’re not the only one. Conferences help you connect with other women with ADHD, and learn important insights into how ADHD affects you, she said. Matlen recommended the ADDA conference and CHADD conference.

3. Revise negative thoughts.

Matlen stressed the importance of doing the internal work of dealing with negative thoughts and replacing them with positive thoughts. She shared this example: “I may not be great at remembering people’s names, but I know how to draw, paint, comfort people who are hurting, etc.”

4. Focus on your strengths.

“I’ve seen so many women’s self-esteem take a huge pounding as they forget or dismiss their strengths,” Matlen said. Remember to celebrate your abilities and the things you’re good at.

5. Channel your ADHD into positive pursuits.

If you’re impulsive, channel that into being playful and pursuing creative outlets, such as painting and dancing. If you’re a dreamer, Matlen said, start a journal to capture your ideas. Instead of fighting your ADHD, accept that it’s part of your neurobiology — not a character flaw — and reroute it into healthy, enjoyable activities.

6. Be picky about the people in your life.

“Reach out to people who celebrate your strengths and stay away from negative people,” Matlen said. If you’ve been too ashamed to tell anyone you have ADHD, consider sharing it with people you trust who aren’t judgmental, she said.

7. See a therapist.

It’s crucial to work with a therapist who has a solid, compassionate understanding of how ADHD affects women, Matlen said. “There may be years of struggling with low self-esteem, low self-worth, depression [and] anxiety that need to be teased out in the context of ADHD.”

Therapy also can help you realize that you’re a “perfectly capable woman who happens to have an ADHD brain,” Matlen said. Because you are.

Attention Deficit Hyperactivity Disorder is one of the most common neurodevelopmental disorders of childhood, often lasting into adulthood. Though it is commonly treated with a “stimulant” medication, there have been concerns that such drugs could stunt a child’s growth. Now, a new study suggests this type of medication does not affect children’s final height in adulthood.
Girl’s growth
The latest study reveals that stimulant medication taken by children treated for ADHD does not affect their final height in adulthood.
The longitudinal study is published in the American Academy of Pediatrics’ (AAP) journal Pediatrics.

According to the American Psychiatric Association, 5% of children have Attention Deficit Hyperactivity Disorder (ADHD). But studies in the US indicate that this rate is higher. Recent surveys of parents have found that around 11% of children aged 4-17 have been diagnosed with ADHD as of 2011, totaling 6.4 million.

Children with the disorder usually have difficulty paying attention, controlling impulsive behavior or are overly active. Though the underlying causes and risk factors for ADHD are not known, the Centers for Disease Control and Prevention (CDC) note that genetics may play a role.

Additionally, researchers are currently investigating other potential causes and risk factors, including brain injury, environmental exposures, alcohol and tobacco use in pregnancy, premature delivery and low birth rate.

Though it may seem counterproductive to give an overactive child a stimulant, the most commonly used medication for treating ADHD is a type of stimulant medication, which has a calming effect on children with the condition.

According to the CDC, between 70-80% of children with ADHD respond positively to such medications.

‘Neither ADHD nor stimulants linked with final adult height’
To investigate whether stimulant medications are associated with final adult height, the researchers examined 340 children with ADHD who were born between 1976-1982 and compared their final height in adulthood with a control group of 680 children who did not have the disorder.

Fast facts about ADHD in the US
The percentage of children diagnosed with ADHD increased from 7.8% in 2003 to 11% in 2011
Boys are more likely than girls to be diagnosed with ADHD
The annual societal cost of illness for ADHD is estimated to be between $36-52 billion, in 2005 dollars.
After studying height and stimulant treatment information from medical records and an adult follow-up study, the team found that neither ADHD nor stimulant treatment was associated with final height in adulthood.

Additionally, they observed that boys with ADHD who were treated with stimulants for more than 3 months had a growth spurt later than those not treated with stimulants. However, there was no difference in the size of the growth spurt.

There was also no link between a longer period of treatment with stimulants and final adult height, say the researchers, who conclude:

“Our findings suggest that ADHD treatment with stimulant medication is not associated with differences in adult height or significant changes in growth.”

Medical News Today recently reported on a study that suggested treating people who have ADHD with stimulant medication could reduce their likelihood of taking up smoking.

Meanwhile, guidance published in Pediatrics in June suggested ways of preventing substance abuse in people with ADHD, given that children with this disorder are at greater risk of abusing alcohol, tobacco and other illicit substances.

Written by Marie Ellis

IDEA, IEPs, and Section 504 Plans: ADHD School Accommodations
Both laws apply to ADHD — so which fits your child?
by ADDitude Editors
The Individuals with Disabilities Education Act (IDEA) covers students who qualify for special education. Under IDEA, a student is eligible to receive special education and/or related services if it can be determined that the student has a disability under one of the qualifying conditions.

Each public school child who receives special education and related services must have an Individualized Education Program (IEP), according to the Department of Education. The basic requirements for IEPs are that they must be designed for one student and must be individualized documents.

Students who do not meet the criteria spelled out by IDEA may still qualify for help under SECTION 504 of the Rehabilitation Act of 1973, also known simply as “Section 504” or “a 504 Plan.”

What’s the difference between IEPs and 504 Plans?
While the procedures are different, the goal is the same: to ensure that students with disabilities have access to a free and appropriate public education that is comparable to the education available to their non-disabled peers.

IEPs under IDEA cover students who qualify for Special Education. Section 504 covers students who don’t meet the criteria for special education but who still require some accommodations. Section 504 is actually a civil rights law, designed to protect the rights of individuals with disabilities in programs and activities that receive federal assistance from the Department of Education. A student is eligible as long he/she currently has or has had a physical or mental impairment which substantially limits a major life activity. Students who have ADHD may qualify if their ADHD “substantially limits” their ability to learn.

Instead of having an IEP, students who qualify under Section 504 are required to have a plan that specifies any accommodations that will be made in the classroom. Accommodations for the ADHD student may include allowing extra time to complete assigned work or breaking long assignments into smaller parts.

By MARGARITA TARTAKOVSKY, M.S.

When ADHD and Anxiety Occur TogetherIt’s not uncommon for individuals with attention deficit hyperactivity disorder (ADHD) to struggle with anxiety, whether it’s several symptoms or a full-blown disorder.

In fact, about 30 to 40 percent of people with ADHD have an anxiety disorder, which includes “obsessive-compulsive disorder, generalized anxiety disorder, phobias, social anxiety and panic disorder,” according to Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor at Harvard Medical School. The Anxiety Disorders Association of America even estimates the figure to be almost 50 percent.

Here’s why ADHD and anxiety co-occur (occur together), how this affects treatment and several strategies for coping with anxiety.

Why ADHD & Anxiety Co-occur
ADHD symptoms can be very intrusive and make life a lot more stressful. For instance, you might miss a critical deadline at work and get fired, forget about your math final and fail the exam or act impulsively and put yourself in danger. Even the fear that you might forget something can keep people continuously worried and anxious.

In other words, “People with ADHD, especially when untreated, are more likely to feel overwhelmed and to have more things fall through the cracks which evokes more frequent negative situations—others are angry with them, they feel disappointed in themselves,” said Ari Tuckman, PsyD, a clinical psychologist and author of More Attention, Less Deficit: Successful Strategies for Adults with ADHD.

People with ADHD tend to be sensitive, which can leave them especially “vulnerable to feeling things more deeply and being more affected by situations and emotions,” Olivardia said.

Genetics also may explain why ADHD and anxiety co-occur. According to Olivardia, there’s good evidence to show that ADHD and OCD have genetic underpinnings. (Here’s one study.) Studies from Massachusetts General Hospital suggest that 30 percent of people with OCD have ADHD.

How Anxiety Affects Treatment
“Anxiety adds another element to ADHD treatment, because you are both developing strategies for the ADHD symptoms and working with the resulting anxiety simultaneously,” Olivardia said.

It also potentially complicates treatment because anxiety can paralyze and leave people stuck in their old ways. As Tuckman said, “People who are anxious are less likely to try new things for fear of them not working out—this includes new strategies to help them get on top of their ADHD.”

Anxiety has another side effect. “We don’t think as clearly when we feel anxious or preoccupied which can add to the ADHD-based distractibility and forgetfulness,” Tuckman said. This can happen particularly with more complex problems, he added.

Anxiety & Stimulants
Stimulant medications are highly effective in treating ADHD. But stimulants “can sometimes exacerbate anxiety symptoms,” Olivardia said. Still, symptoms should subside after several days or weeks, Tuckman said.

Also, these symptoms actually might be responses to the medication. According to Tuckman, “the physical sensations of faster heartbeat, dry mouth, etc. are just normal reactions to the medication, just as we would expect that our heart rate would increase after running up a flight of stairs.”

If people can’t tolerate stimulants, psychiatrists may prescribe a non-stimulant along with a selective serotonin reuptake inhibitor (SSRI), which has anxiety-reducing effects. (Tuckman noted that non-stimulants may be less effective than stimulants.)

However, if a person doesn’t want to take several medications, they might decide to medicate one of the disorders and cope with the other behaviorally, Olivardia said.

Also, therapy is very effective for anxiety, said Tuckman, who typically “prefer[s] to address the ADHD first and then see how much of the anxiety shakes out on its own…”

Anxiety-Alleviating Strategies
Understand how your anxiety and ADHD work. Determining how your anxiety functions will help to “inform your treatment,” Olivardia said. “For example, if you found that most of your anxiety was coming from consequences of your ADHD, then the focus of treatment should be the ADHD. If you find they are independent of each other, although are affecting each other, then you want to make sure you are adequately giving each the clinical attention it deserves,” he said.
Minimize worry. Anxious people worry excessively, and these negative thoughts can run your life if you let them. Instead, “Try to come up with alternate explanations or predictions,” Tuckman said. Let’s say your boss was short with you. Instead of thinking that you did something wrong, consider that she’s stressed because of personal reasons, he said. Unless you have a specific reason or actual proof, worrying is needless (and only makes things worse).
Don’t believe everything you think. Again, worry thoughts energize anxiety. But you don’t have to listen to them. “Notice your anxious thoughts without believing everything your imagination comes up with nor feeling compelled to act on it,” Tuckman said.
He explained that anxiety acts as an alarm that “warns us of danger.” For some people, this alarm is super sensitive. He compared it to a “fire alarm that goes off every time someone burns the toast. It’s bothersome to listen to that alarm go off, but we don’t go running from the building. We check out the situation, see there is nothing to worry about, then go about our business.”

Engage in healthy habits and good self-care. Poor nutrition, lack of sleep and little exercise also fuel anxiety, and ensure you have a shorter fuse when it comes to stress. It’s tremendously helpful to eat nutritious foods, participate in enjoyable physical activities and get enough sleep.
Minimize stress. Olivardia suggested that readers “lower [the] stress in their lives and introduc[e] activities that they enjoy and feel soothed by.”
Surround yourself with supportive people. Negative people only add to your stress. Instead, fill your life with “positive, affirming people,” Olivardia said.
Practice relaxation techniques. “Engaging in relaxation training and deep breathing can help [alleviate anxiety],” according to Olivardia. Learn more about relaxation and meditation methods and deep breathing.
Both anxiety and ADHD are very treatable with medication and psychotherapy, and there are many effective strategies to manage symptoms and lead a more enjoyable life.

I recently diagnosed eight-year-old Aidan with attention deficit disorder (ADD ADHD). When I met with his parents to explain the disorder, each time I described a symptom, his mother exclaimed, “That’s me!” or “I’ve been like that all my life, too.” At the end of the appointment, she asked me if she should be evaluated, as well.

As an adult, Aidan’s mother had jumped from job to job, and had difficulty meeting household demands. As a child, she had struggled through school, often getting into trouble and getting poor grades. After a thorough evaluation of her chronic and pervasive history of hyperactivity, distractibility, and other symptoms of ADHD, she was diagnosed by a psychiatrist who works with adults.

Aidan and his mother both started on ADHD medication. Aidan’s grades and behavior improved. His mom reported being more relaxed and efficient at work and at home. On a follow-up visit, she remarked, “If only I had been on medication as a child. I could have finished college, I could….” Then she paused: “Oh, my gosh, does this mean that Aidan will take medication for the rest of his life?”

Good question. The best answer I could give was, “Possibly.” Why can’t I be more specific? Didn’t she deserve a clearer answer? Until the early 1990s, the medical community considered ADHD a “childhood disorder.” Believing that children “outgrew” the condition, physicians routinely took them off medication before high school. In many cases, however, the teens struggled socially and academically, making it clear that ADHD symptoms had not gone away. And, as greater efforts were made to educate parents about ADHD, more and more of them, like Aidan’s mother, began to recognize their own ADHD symptoms.

Clinically, we have seen that some individuals do show enough improvement after puberty that they no longer need medication. But the American Academy of Family Physicians reports that two-thirds of children with ADHD continue to grapple with the condition throughout adulthood.

How do I determine whether a particular child still needs medication? I advise taking children and adolescents off medication once a year. If the symptoms of hyperactivity, inattention, and/or impulsivity are no longer noticeable, they stay off. Should these behaviors return, medication should be restarted. This process teaches adolescents about the challenges ADHD presents in their lives, and how to determine themselves whether medication is needed in school, at home, with friends, and so on. Medication should be used whenever symptoms interfere with the demands and expectations of a specific task or activity. It is not necessarily needed all day, every day.

For example, a college student may learn that she benefits from an eight-hour capsule to cover morning and afternoon classes, but can be off medication while she relaxes, exercises, or socializes later in the day. On evenings when she needs to study, she can take a four-hour tablet at about 6 p.m. An adult may find that he needs medication at work but not at home, or for some social functions, but not others.

Will your child need medication for the rest of his life? Possibly. You can find out one year at a time. And, if medication is needed, you can teach him to use it for specific times and situations. In the future, I hope that fewer adults will tell me, “If only I had been on medication as a child….”

A woman gave birth to me, and another woman saved me from a life of misery by being there for me during my darkest hour as a young man. Later on, a woman known as my wife was there to see me survive a suicide attempt, and she stood by me through my psych-ward stay, helping me get to where I am now — a freight train of determination to raise adult ADHD awareness worldwide. Women have played vital roles throughout my life, so it’s frustrating when they are overlooked. It’s particularly unfortunate that they are largely ignored when it comes to ADHD diagnoses.

I recently finished ”100 Questions & Answers about Attention Deficit Hyperactivity Disorder (ADHD) in Women and Girls” by Dr. Patricia Quinn. It’s a moving book, full of stories, research stats, and insights on how differently women manifest ADHD symptoms and struggle as a result. Yes, I’m a man, so I can only understand the female battle with ADHD up to a point. But I hear stories from women who reach out to me online through my Twitter account, blogs, YouTube, and elsewhere. I regularly hear stories of tragedy, misdiagnoses, depression resulting from delayed diagnoses, and so on.

But why? Why do women tend to be more isolated when it comes to their ADHD symptoms and diagnoses? While research does suggest that ADHD affects more men and boys than women and girls, that doesn’t mean there isn’t a large group of females out there suffering from severe ADHD symptoms — often with very little (if any) support from others.

Gender roles play a huge role in girls and women going undiagnosed or misdiagnosed. In our society, women are under immense pressure to be quiet, gentle, pretty, and a whole host of other stereotypical, media-induced gender norms. It’s no wonder girls and women with ADHD often “cover up” their symptoms, trying to fit in. Talking excessively and being easily distracted are potential red flags for ADHD, but they also aren’t “ladylike,” so they are hidden. Other signs, such as obsessive studying to get great grades, secret battles with anxiety, depression and/or eating disorders, go unnoticed or are chalked up to other conditions. Those cues mesh with how women have been expected to behave for a very long time. So testing for ADHD is skewed to recognize behaviors more natural to boys.

“For women with ADHD, issues relating to depression, anxiety, low self-esteem, social rejection and/or isolation, and struggles as a wife and mother to live up to society’s expectations, not to mention the impossible demands of single motherhood, may need to be addressed in individual psychotherapy or cognitive behavioral therapy (CBT),” writes Dr. Quinn.

There are three co-existing conditions that seem to disproportionately affect women with ADHD. All of us — women themselves as well as we men who couldn’t live without them — should be aware and willing to receive and/or give support when these problems are presented:

Eating Disorders and ADHD: Searching for Control
Eating disorders in girls and women with ADHD appear to be quite common, due to internalizing their symptoms instead of asking for help. “Some girls with ADHD and anxiety stop eating as a means of controlling a world that they see as being out of their control,” writes Dr. Quinn. They try to regain control by becoming obsessive with their eating patterns, and this can easily result in a number of disorders. Some women eat to feel better emotionally; others forget to eat because they are distracted, then overeat once they remember the meals they’ve missed.

Anxiety and ADHD: A Vicious Circle
I recently wrote a post about how fifty percent of adults with ADHD also have an anxiety disorder, so I wasn’t surprised to read that Dr. Quinn also observes a major connection between the two disorders. After all, our minds tend to be hyper, distracted, passionate, and busy! That certainly isn’t rocket science, but research offers much-needed credibility to these truths. The sheer stress of having a mind like ours leads to anxiety. What’s worse is that for women, anxiety is often written off due to a busy schedule or raising multiple children. They may not crumble as easily as men do under the pressure of anxiety, so a diagnosis is harder to find.

Depression and ADHD: One Can Hide the Other
When a doctor treats a woman for depression instead of ADHD, nothing improves. The underlying symptoms aren’t all being dealt with, so the woman will likely still have a very hard time in other areas of life, which no pill for depression will fix. She may develop coping skills to help carve out her niche in life to get by, but for many the band-aid depression diagnosis can be destructive, if not deadly. The woman is led to believe she’s “cured” of the depression only to have other ADHD symptoms creep up and sabotage everything she worked so hard to fix.

The fairer sex deserves so much more from society! They go on to be the mothers, the leaders, the healers, and the “rocks” of their families. But who’s there to be their rocks?

We have to keep this awareness building. Millions of lives literally depend on it. Girls and women are suffering in silence, and that just won’t do. ADHD affects all of us, and this is an all-for-one, one-for-all kind of battle. It’s time to say “We’re with you, ladies.”

As many as 85 percent of American adults who have ADHD don’t know it yet, which means millions of adults are living with unexplained ADHD symptoms and think it’s normal. American journalist Lisa Ling was recently diagnosed with adult ADD (a form of ADHD that doesn’t include the hyperactive aspect) while she was filming a show on the subject. Then and there, she had Dr. Craig Liden test her to see if her suspicions were true, and she was right: At the age of 40, she found out she has been living with undiagnosed ADD likely since her childhood.

I was diagnosed with ADHD at 35 after a suicide attempt rushed me to the E.R. The diagnosis changed my life forever. But as relieving as an adult ADHD diagnosis can be, it can also bring forth a number of concerns. While I can’t read Lisa Ling’s mind, I bet some of these common questions popped up when she got her ADD diagnosis, just as they did for me:

1. Will I need to be medicated for the rest of my life?
Not unless you want to be. Medication can change lives, but depending on your symptoms and any other conditions you may have, it can also do more harm than good both physically and mentally. From personal experience, I can tell you that the key to answering this question for yourself is to invest time into learning about your symptoms, the types of ADHD medications currently available, and the possible side effects.

Keep an open mind. Medication is not the only solution – in fact, it’s only one part of it! People seem to want the quick fix these days, but there isn’t one when it comes to adult ADHD. You will have it for the rest of your life, unless a cure of some sort is found. Once I learned to settle in and learn the best tools and techniques for minimizing my symptoms, I felt a weight had been lifted. Tools like mindfulness and regular exercise have literally changed my life!

2. Do I have to tell my family/friends/employer?
I’m biased when it comes to this question, because frankly, I’m proud to have ADHD. But if you feel that people knowing about your ADHD could hurt your career or relationships, then you don’t have to tell people. You should still do your own research and learn how to live your best life with this condition, but this is ultimately all about you, not anyone else.

With one exception: Be honest with your partner/spouse. That is the most important advice I can give. If you hide it from them, not only do you rob them of being able to understand you better, you’re also short-changing yourself. Your partner can only help you when they know what you’re going through. If you hide your true self from the world, you suffer in silence. I’m working hard to raise adult ADHD awareness so that people won’t have to do that. Enough is enough. ADHD can be a blessing, so don’t treat it like a curse.

3. Can I still be successful, or am I destined to fail?
Here’s the amazing news: Once you have a diagnosis, you have the clarity to begin taking charge of your life like never before. This can result in success in every area – as long as you’re committed to reaching for it! I am a living, breathing example of how you can go from depression and despair to success with time, therapy, and being 150 percent honest with yourself. (Support from family, friends, websites like Everyday Health, and medical professionals doesn’t hurt, either.)

4. Could my diagnosis be wrong?
Great question! There are a lot of misdiagnoses out there for several reasons, such as a rushed diagnosis by a physician who doesn’t spend enough time with the patient. Conditions such as bipolar disorder, depression and anxiety disorders can also be misdiagnosed as ADHD and vice versa, so make sure to get a second (and third) opinion if you aren’t sure. There’s nothing wrong with that. I was fortunate enough to be assessed by a team of specialists at the same time.

5. What now?
Welcome to the club! Our numbers are ever-growing, and there is plenty of support both on and off the Internet. I created The Adult ADHD Blog to share my story and allow others to comment on their own experiences. Everyday Health also has a ton of articles about all aspects of ADHD – from romance with ADHD to good food for ADHD brains. A quick Google search will reveal Facebook groups, Twitter handles, magazines, forums and more. Many cities have ADHD support groups that meet on a regular basis. You can also check out ADDitude’s directory for specialists, support groups, events, and so on.

Trust me on this: Change your life by confirming your diagnosis, accepting yourself, and remembering that many successful people have ADHD! You’re in good company.

Posted in: ADHD

By RICK NAUERT PHD Senior News Editor

Imaging Suggests Evidence of Biological Basis for Adult ADHDEmerging research discovers adults who have recovered from attention-deficit hyperactivity disorder (ADHD) have different levels of brain activity than adults who still suffer from ADHD.

In a new study, MIT neuroscientists discovered key differences in a brain communication network that is active when the brain is at wakeful rest and not focused on a particular task.

The findings offer evidence of a biological basis for adult ADHD and should help to validate the criteria used to diagnose the disorder.

Experts believe about 11 percent of school-age children in the United States will be diagnosed with attention deficit hyperactivity disorder (ADHD).

While many of these children eventually “outgrow” the disorder, some carry their difficulties into adulthood, authorities estimate that 10 million American adults are currently diagnosed with ADHD.

In the first study to compare patterns of brain activity in adults who recovered from childhood ADHD and those who did not, Massachusetts Institute of Technology (MIT) neuroscientists have discovered key differences in a brain communication network that is active when the brain is at wakeful rest and not focused on a particular task.

The findings offer evidence of a biological basis for adult ADHD and should help to validate the criteria used to diagnose the disorder, according to the researchers.

Diagnoses of adult ADHD have risen dramatically in the past several years, with symptoms similar to those of childhood ADHD: a general inability to focus, reflected in difficulty completing tasks, listening to instructions, or remembering details.

“The psychiatric guidelines for whether a person’s ADHD is persistent or remitted are based on lots of clinical studies and impressions. This new study suggests that there is a real biological boundary between those two sets of patients,” said MIT’s Dr. John Gabrieli, an author of the study which appears in the journal Brain.

Researchers focused on 35 adults who were diagnosed with ADHD as children; 13 of them still have the disorder, while the rest have recovered.

“This sample really gave us a unique opportunity to ask questions about whether or not the brain basis of ADHD is similar in the remitted-ADHD and persistent-ADHD cohorts,” said Aaron Mattfeld, Ph.D., the paper’s lead author.

The researchers used a technique called resting-state functional magnetic resonance imaging (fMRI) to study what the brain is doing when a person is not engaged in any particular activity.

These patterns reveal which parts of the brain communicate with each other during this type of wakeful rest.

“It’s a different way of using functional brain imaging to investigate brain networks,” said Susan Whitfield-Gabrieli, Ph.D., a research scientist at the McGovern Institute and the senior author of the paper.

“Here we have subjects just lying in the scanner. This method reveals the intrinsic functional architecture of the human brain without invoking any specific task.”

In people without ADHD, when the mind is unfocused, there is a distinctive synchrony of activity in brain regions known as the default mode network.

Previous studies have shown that in children and adults with ADHD, two major hubs of this network — the posterior cingulate cortex and the medial prefrontal cortex — no longer synchronize.

In the new study, the MIT team showed for the first time that in adults who had been diagnosed with ADHD as children but no longer have it, this normal synchrony pattern is restored.

“Their brains now look like those of people who never had ADHD,” Mattfeld says.

“This finding is quite intriguing,” said Francisco Xavier Castellanos, M.D., a professor of child and adolescent psychiatry at New York University who was not involved in the research.

“If it can be confirmed, this pattern could become a target for potential modification to help patients learn to compensate for the disorder without changing their genetic makeup.”

However, in another measure of brain synchrony, the researchers found much more similarity between both groups of ADHD patients.

In people without ADHD, when the default mode network is active, another network, called the task positive network, is suppressed.

When the brain is performing tasks that require focus, the task positive network takes over and suppresses the default mode network. If this reciprocal relationship degrades, the ability to focus declines.

Both groups of adult ADHD patients, including those who had recovered, showed patterns of simultaneous activation of both networks.

This is thought to be a sign of impairment in executive function — the management of cognitive tasks — that is separate from ADHD, but occurs in about half of ADHD patients. All of the ADHD patients in this study performed poorly on tests of executive function.

“Once you have executive function problems, they seem to hang in there,” said Gabrieli.

The researchers now plan to investigate how ADHD medications influence the brain’s default mode network, in hopes that this might allow them to predict which drugs will work best for individual patients. Currently, about 60 percent of patients respond well to the first drug they receive.

“It’s unknown what’s different about the other 40 percent or so who don’t respond very much,” Gabrieli said.

“We’re pretty excited about the possibility that some brain measurement would tell us which child or adult is most likely to benefit from a treatment.”

Source: MIT

Help your attention deficit hyperactivity disorder child finish her school assignments — and learn how to work independently — by following these readers’ best tips.

ADDitude asked: How do you make sure your attention deficit hyperactivity disorder (ADD/ADHD) student does her homework? And you delivered these five guidelines.

Devise ADD-Friendly Homework Rituals
“Learn your child’s rhythms — when he needs to relax, when he needs to work. We have a structured homework time, and work for short periods. Always check your child’s work — he is more interested in getting it done than getting it right.” -Kathy Zimovan, South Carolina

“I let my son sit on an exercise ball. Being able to move about while doing homework helps kids with ADHD concentrate better. I don’t have to nag him to do his homework, and he does not complain about needing to get up and move around.” -Diane Spriggs, Virginia

“I offer my daughter a piece of carrot or cucumber every 10 minutes or so. She loves the treats, and they motivate her to keep working.” -Eve, New York

“I issue lots of warnings. An hour before my son is supposed to start his homework, I say, ‘Time to adjust your brain for homework!’ I issue the same warning a half-hour before. I found that it really helps smooth the transition.” -Kimberly Forness Wilson, North Dakota

Know your child’s learning style? Help your ADD/ADHD student achieve school success by focusing on study methods that play to his visual, auditory, or tactile ways of learning.

Learn When to Stop Doing it for Them
“I made my son responsible for his grades. He has to face the consequences of bad grades, and he gets rewards for good ones. If he wants me to help him with homework, he has to ask.” -May Beth Thomas, Michigan

“Once your child is in middle school, let her be accountable for getting homework done. When I was young, getting me to do my schoolwork was a battle. Mom finally said, ‘Fine. If you don’t do your homework, I won’t write you an excuse.’ Translation: I would be in trouble with the teacher — and when I got home, I would be in even more trouble with my dad. I learned the hard way, once!” -Ed, Arizona

hare the Responsibilities With Your Partner…Before You Burn Out
“My husband and I have resorted to tag-teaming our child in order to get homework done. LOL.” -An ADDitude Reader

Get Help From the School
“Shorten homework assignments. I asked my son’s teachers to assign one page of grammar homework instead of two, 20 math problems instead of 40. He feels less overwhelmed.” -Lisa, Florida

“Joining a homework club is a godsend. My son gets help right after school, while his meds are still working. He can then come home and relax, and I don’t have to be the screaming mom!” -Sheri, California

Remove All Distractions
“No television, and a clear, clean workspace. The smallest thing, an extra pencil or a piece of paper, can distract my son.” -An ADDitude Reader

“Do it right after school, in the quietest place possible. Try to be patient with your child, even though it’s hard!” -Amy, Florida

“Turning off my children’s text messaging.” -Kay, Colorado

By MARGARITA TARTAKOVSKY, M.S.

Common Mistakes Adults with ADHD Make in Managing the DisorderWhen you’re managing any disorder, you’re bound to make mistakes. (Life is filled with them.)

For instance, making mistakes when managing ADHD symptoms is normal, said Roberto Olivardia, Ph.D, a clinical psychologist and clinical instructor in the department of psychiatry at Harvard Medical School.

It’s “part of the journey.”

Also, part of that journey is learning from your errors. Below, ADHD experts share the most common mistakes people with ADHD make when managing their disorder and how to prevent or fix them.

Not accepting the diagnosis.

“The biggest mistake someone with ADHD can make is not accepting the diagnosis in the first place,” Olivardia said. “Denial only makes everything worse since you are still suffering from symptoms, without any strategy or plan to combat them.”

The best way to accept the diagnosis is to educate yourself about what ADHD is and what it isn’t, he said. Also, learn about other people who have ADHD, including successful entrepreneurs and musicians, he said.

Plus, if you’re a parent, there’s a great chance that one of your kids has ADHD. “Accepting the diagnosis at that point is beneficial not only to you, but it enables you to set a healthy, accepting frame for your child.”

Relying solely on medication.

It’s also common to assume medication is the only treatment for ADHD, Olivardia said. “Medication can be an important part of treatment … but only as a complement to behavioral work and management one must make in many areas of life.”

For instance, that includes getting enough sleep and learning to manage your time. For specific tips, here’s more on sleep, organization, helpful programs and apps and other healthy habits to incorporate into your days.

Not planning.

“ADHD individuals enjoy the spirit of spontaneity and dread the thought of planning and structure,” said Rudy Rodriguez, LCSW, a coach who specializes in ADHD and founder of the ADHD Center for Success based in Asheville, N.C.

As such, many make the mistake of not planning out their days, which can lead to little productivity. Rodriguez cited Benjamin Franklin’s quote: “If you fail to plan, you are planning to fail.”

Rodriguez suggested writing down a plan for your day. He tells his clients, “if it’s not in writing, it doesn’t exist.” That’s because people with ADHD have an impaired working memory, which can lead to forgetfulness, he said.

He also suggested creating your to-do list the night before. Doing so means “you’ll wake in the morning with a clear idea of what you need to do and what you need to do first.” This prevents you from “meandering mindlessly.”

Underestimating time.

People with ADHD have a distorted sense of time, and they underestimate how long tasks take. “We say, ‘I’ll be ready in 10 minutes’ but the truth is we don’t have an accurate internal clock that alerts us to the passage of time,” Rodriguez said.

He suggested what he calls “mindfulness bells.” This can be anything from an alarm on your cell phone to a kitchen timer. For instance, if you’re giving yourself 30 minutes to work on your computer, so you can get to bed on time, set one alarm to go off at 20 minutes and the second alarm at 30 minutes, he said.

The first alarm is your “’get-ready-to-get-ready-to go’ notification.” This gives you 10 minutes to save and close documents and shut down your computer, he said. When the second alarm dings, you’re all set to get up and go to bed.

Assuming perfect solutions.

ADHD coach Mindy Schwartz Katz, MS, ACC, often hears her clients say things like “if I was just more organized, everything would be fine” or “if I could just get out of bed at 6 a.m., everything would be perfect.”

For instance, one client bought a pricey planner. She believed that once she started using it, it’d become the perfect solution to her problems. But she wasn’t using it, because it simply didn’t work for her.

Managing your ADHD is really about figuring out what works best for you and experimenting with it until it becomes part of your life, Katz said. For instance, the goal isn’t to be organized, it’s “to be functional, to feel good about yourself and to live a good life.”

Listening to ignorant people.

People with ADHD also can make the mistake of listening to individuals who don’t know anything about ADHD, Olivardia said. They might say things like “ADHD doesn’t exist” or “Everyone is a little ADD,” he said. “These statements are not true and only minimize the true experience of those living with ADHD.”

“Make sure to get support from people who are at least aware of ADHD and not critical of the diagnosis,” Olivardia said. And when people are dismissive of your disorder, try these tips.

Focusing on what went wrong.

When she first started seeing clients, Katz noticed that they’d mostly talk about all the things that didn’t go well that week. But the things that go wrong only make up a portion of your day.

Today, she starts every session by asking clients to discuss what went well. Collecting the positives actually sets a different tone. Because when you focus on the positive you experience more positivity, Katz said.

She used one of her favorite quotes as an example: “The grass is always greener where you water it.”

Remember that making mistakes is a natural part of learning. Nothing in this world was ever invented without mistakes, Katz said.

Think of babies first learning to walk, she said. The first time they step on their own, they fall down. They get up. Then they fall down, again. They get up, and they fall down some more. They go through this process, over and over.

“We sometimes expect ourselves to be perfect right out of the gate. We all fall before we walk.”

The key is to turn mistakes into learning experiences, which shifts how they affect you. When things don’t work out, Katz always asks her clients: “What’s your takeaway? How are you going to do things differently? How can you do it better next time?”

Also, avoid being critical when you make a mistake. “Calling yourself an ‘idiot’ will not make you remember something better or motivate you the next time around,” Olivardia said. Rather, “the more you devalue yourself for your ADHD symptoms, the more your self-esteem plummets.”

You’re not stupid or less than for making mistakes. Try to shift your focus away from supposed inadequacies and onto the lesson you can learn and the improvements you can make.

By RICK NAUERT PHD Senior News Editor

Use of ADHD Meds as Study Aid — Cheating? New research finds that nearly 1 in 5 students at an Ivy League college report misusing a prescription stimulant while studying, with one-third of students believing the misuse did not constitute cheating.

The study results will be presented at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Stimulants are used to treat attention-deficit/hyperactivity disorder (ADHD). Recent studies have shown that students without ADHD are misusing these medications in hopes of gaining an academic edge.

This study looked at the prevalence of medication misuse at a highly selective college and whether students believe misuse of ADHD medications is a form of cheating.

Researchers analyzed responses from 616 sophomores, juniors, and seniors without ADHD who completed an anonymous online questionnaire in December 2012.

Results showed:

18 percent reported misusing a prescription stimulant for an academic purpose at least once while in college, and 24 percent of these students said they had done so on eight or more occasions;
Juniors reported the highest rate of stimulant misuse (24 percent);
69 percent of those who misused stimulants did so to write an essay, 66 percent to study for an exam, and 27 percent to take a test;
More students who played a varsity sport and were affiliated with a Greek house reported stimulant misuse compared to students affiliated with only one or neither; and
33 percent of students did not think stimulant misuse for academic purposes was a form of cheating, while 41 percent thought it was cheating and 25 percent were unsure.
“While many colleges address alcohol and illicit drug abuse in their health and wellness campaigns, most have not addressed prescription stimulant misuse for academic purposes,” said senior investigator Andrew Adesman, M.D., F.A.A.P.

“Because many students are misusing prescription stimulants for academic, not recreational purposes, colleges must develop specific programs to address this issue.”

Survey results also showed that students who misused stimulants were more likely to view this as a common occurrence on their campus compared to students who had never misused an ADHD medication.

Specifically, 37 percent of those who had misused an ADHD prescription thought that more than 30 percent of students had done the same compared to only 14 percent of students who had never misused a stimulant.

“The findings from this and similar studies pose a challenge to pediatricians,” Adesman said.

“To the extent that some high school and college students have reported feigning ADHD symptoms to obtain stimulant medication, should physicians become more cautious or conservative when newly diagnosing ADHD in teens?,” he said.

“Additionally, should pediatricians do more to educate their ADHD patients about the health consequences of misuse and the legal consequences that could arise if they sell or give away their stimulant medication?”

“It also is important to consider the ethical implications of prescription stimulant misuse in higher education,” said principal investigator Natalie Colaneri, a research assistant at Cohen Children’s Medical Center.

“It is our hope that this study will increase greater awareness and prompt broader discussion about misuse of medications like Ritalin or Adderall for academic purposes,” she said.

“It is important that this issue be approached from an interdisciplinary perspective: as an issue relevant to the practice of medicine, to higher education and to ethics in modern-day society.”

Source: American Academy of Pediatrics

By TRACI PEDERSEN Associate News Editor

Dog Ownership Can Benefit Children with AutismMost children with autism tend to bond strongly with dogs, according to new research at the University of Missouri.

“Children with autism spectrum disorders often struggle with interacting with others, which can make it difficult for them to form friendships,” said Gretchen Carlisle, Ph.D., a research fellow at the Research Center for Human-Animal Interaction (ReCHAI) in the University of Missouri College of Veterinary Medicine.

“Children with autism may especially benefit from interacting with dogs, which can provide unconditional, nonjudgmental love and companionship to the children.”

For the study, 70 parents of children with autism were interviewed. Nearly two-thirds of the families owned dogs, and of those, 94 percent of the parents reported their children with autism had a bond with their dogs.

“Even in families without dogs, 70 percent of parents said their autistic children liked dogs. Many families with dogs reported that they made the decision to get a dog because of the perceived benefits to their children with autism,” Carlisle said.

“Dogs can help children with autism by acting as a social lubricant,” Carlisle said. “For example, children with autism may find it difficult to interact with other neighborhood children. If the children with autism invite their peers to play with their dogs, then the dogs can serve as bridges that help the children with autism communicate with their peers.”

“Families with an autistic child need to consider their child’s sensitivities carefully when choosing a dog in order to ensure a good match between pet and child,” Carlisle said.

“Bringing a dog into any family is a big step, but for families of children with autism, getting a dog should be a decision that’s taken very seriously,” Carlisle said.

“If a child with autism is sensitive to loud noises, choosing a dog that is likely to bark will not provide the best match for the child and the family. If the child has touch sensitivities, perhaps a dog with a softer coat, such as a poodle, would be better than a dog with a wiry or rough coat, such as a terrier.”

Carlisle believes that parents should involve their children with autism in the dog-buying process.

“Many children with autism know the qualities they want in a dog,” Carlisle said. “If parents could involve their kids in choosing dogs for their families, it may be more likely the children will have positive experiences with the animals when they are brought home.”

The study only looked at dog ownership among families affected by autism, but Carlisle said that other types of pets could be a good option as well.

“If you know one child with autism, you know one child with autism,” Carlisle said. “Dogs may be best for some families, although other pets such as cats, horses or rabbits might be better suited to other children with autism and their particular sensitivities and interests.”

The study was recently published in the Journal of Pediatric Nursing.

Source: University of Missouri, Columbia

Are ADHD Drugs Right for You or Your Child?

Medications for Treating ADHD: Risks, Benefits and Regimens
Medication can help reduce symptoms of hyperactivity, inattentiveness, and impulsivity in children and adults with ADD/ADHD. However, medications come with side effects and risks—and are not the only treatment option. Whether you’re the parent or the patient, it’s important to learn the facts about ADD/ADHD medication so you can make an informed decision about what’s best for you or your child.
IN THIS ARTICLE:
Medications for ADD / ADHD
Stimulant medications
Stimulant safety concerns
Non-stimulant medications
ADD/ADHD meds & children
Medication alone is not enough
Taking medication
Dealing with side effects
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Medication for ADD & ADHD: What you need to know
Making ADD/ADHD medication decisions can be difficult, but doing your homework helps. The first thing to understand is exactly what the medications for ADD and ADHD can and can’t do. ADHD medication may help improve the ability to concentrate, control impulses, plan ahead, and follow through with tasks. However, it isn’t a magic pill that will fix all of your or your child’s problems. Even when the medication is working, a child with ADD/ADHD might still struggle with forgetfulness, emotional problems, and social awkwardness, or an adult with disorganization, distractibility, and relationship difficulties. That’s why it’s so important to also make lifestyle changes that include regular exercise, a healthy diet, and sufficient sleep.

Medication doesn’t cure ADD/ADHD. It can relieve symptoms while it’s being taken, but once medication stops, those symptoms come back. Also, ADD/ADHD medication works better for some than for others. Some people experience dramatic improvement while others experience only modest gains. Because each person responds differently and unpredictably to medication for ADHD, its use should always be personalized to the individual and closely monitored by a doctor. When medication for ADD/ADHD is not carefully monitored, it is less effective and more risky.

Generic vs. Brand-Name Drugs
Generic drugs have the same use, dosage, side effects, risks, safety profile, and potency as the original brand-name drug. The main reason why generic drugs are cheaper than brand-name drugs is that the generic drug manufacturer does not need to recoup huge expenses for developing and marketing a drug. Once the patent for the original drug has expired, other manufacturers can produce the same drug with the same ingredients at a markedly lower cost.
Occasionally, brand-name drugs have different coatings or color dyes to change their appearance. In rare cases, these extra ingredients will make the generic form of the drug less tolerable, so if your condition worsens after switching from a brand-name to a generic drug, consult your doctor. In most cases, however, generic drugs are just as safe and effective as brand-name drugs.
Stimulant medications for ADD & ADHD
Stimulants are the most common type of medication prescribed for attention deficit disorder. They have the longest track record for treating ADD/ADHD and the most research to back up their effectiveness. The stimulant class of medication includes widely used drugs such as Ritalin, Adderall, and Dexedrine.

Stimulants are believed to work by increasing dopamine levels in the brain. Dopamine is a neurotransmitter associated with motivation, pleasure, attention, and movement. For many people with ADD or ADHD, stimulant medications boost concentration and focus while reducing hyperactive and impulsive behaviors.

Short-acting vs. long-acting stimulants for ADD / ADHD
Stimulants for ADD/ADHD come in both short- and long-acting dosages. Short-acting stimulants peak after several hours, and must be taken 2-3 times a day. Long-acting or extended-release stimulants last 8-12 hours, and are usually taken just once a day.

The long-acting versions of ADD/ADHD medication are often preferred, since people with ADHD often have trouble remembering to take their pills. Taking just one dose a day is much easier and more convenient.

Common side effects of stimulants for ADD & ADHD:
Feeling restless and jittery
Difficulty sleeping
Loss of appetite
Headaches
Upset stomach
Irritability, mood swings
Depression
Dizziness
Racing heartbeat
Tics
Stimulant medications may also cause personality changes. Some people become withdrawn, listless, rigid, or less spontaneous and talkative. Others develop obsessive-compulsive symptoms. Since stimulants raise blood pressure and heart rate, many experts worry about the dangers of taking these ADD/ADHD drugs for extended periods.

ADD / ADHD Stimulant safety concerns
Stimulant Medication Red Flags

Call your doctor right away if you or your child experience any of the following symptoms while taking stimulant medication for ADD or ADHD:

chest pain
shortness of breath
fainting
seeing or hearing things that aren’t real
suspicion or paranoia
Beyond the potential side effects, there are a number of safety concerns associated with the stimulant medications for ADD/ADHD.

Effect on the developing brain — The long-term impact of ADD/ADHD medication on the youthful, developing brain is not yet known. Some researchers are concerned that the use of drugs such as Ritalin in children and teens might interfere with normal brain development.
Heart-related problems — ADD/ADHD stimulant medications have been found to cause sudden death in children and adults with heart conditions. The American Heart Association recommends that all individuals, including children, have a cardiac evaluation prior to starting a stimulant. An electrocardiogram is recommended if the person has a history of heart problems.
Psychiatric problems — Stimulants for ADD/ADHD can trigger or exacerbate symptoms of hostility, aggression, anxiety, depression, and paranoia. People with a personal or family history of suicide, depression, or bipolar disorder are at a particularly high risk, and should be carefully monitored when taking stimulants.
Potential for abuse — Stimulant abuse is a growing problem, particularly among teens and young adults. College students take them for a boost when cramming for exams or pulling all-nighters. Others abuse stimulant meds for their weight-loss properties. If your child is taking stimulants, make sure he or she isn’t sharing the pills or selling them.
ADD / ADHD stimulants are not recommended for those with:
Any type of heart defect or diseases
High blood pressure
Hyperthyroidism
Glaucoma
High levels of anxiety
A history of drug abuse
Non-stimulant medications for ADD & ADHD
In addition to the traditional stimulant drugs, there are several other medications used to treat ADD/ADHD, including Strattera, atypical antidepressants, and certain blood pressure medications. In most cases, non-stimulant medications are considered when stimulants haven’t worked or have caused intolerable side effects.

Strattera
Strattera Suicide Risk in Children

Strattera may cause an increase in suicidal thoughts and actions in some children and teenagers, especially if your child has bipolar disorder or depression in addition to ADD/ADHD.

Call the doctor immediately if your child shows agitation, irritability, suicidal thinking or behaviors, and unusual changes in behavior.

Strattera, also known by its generic name atomoxetine, is the only non-stimulant medication approved by the FDA for ADD/ADHD treatment. Unlike stimulants, which affect dopamine, Strattera boosts the levels of norepinephrine, a different brain chemical.

Strattera is longer-acting than the stimulant drugs. Its effects last over 24 hours—making it a good option for those who have trouble getting going in the morning. Since it has some antidepressant properties, it’s also a top choice for those with co-existing anxiety or depression. Another plus is that it doesn’t exacerbate tics or Tourette’s Syndrome.

On the other hand, Strattera doesn’t appear to be as effective as the stimulant medications for treating symptoms of hyperactivity.

Common side effects of Strattera include:

Sleepiness
Headache
Abdominal pain or upset stomach
Nausea and vomiting
Dizziness
Mood swings
Sleepiness
Headache
Abdominal pain or upset stomach
Nausea and vomiting
Dizziness
Mood swings
Straterra can also cause insomnia and appetite suppression, but these side effects are more common in stimulants.

Other ADD & ADHD medication options
The following medications are sometimes used “off-label” in the treatment of attention deficit disorder, although they are not FDA approved for this purpose. They should only be considered when stimulants or Strattera aren’t viable options.

High blood pressure medication for ADD/ADHD – Certain blood pressure medications can be used to treat ADD/ADHD. Options include clonidine (Catapres) and guanfacine (Tenex). But while these medications can be effective for hyperactivity, impulsivity, and aggression, they are less helpful when it comes to attention problems.
Antidepressants for ADD/ADHD – For people suffering from both ADHD and depression, certain antidepressants, which target multiple neurotransmitters in the brain, may be prescribed. Wellbutrin, also known by the generic name bupropion, is most widely used. Wellbutrin targets both norepinephrine and dopamine. Another option is the use of tricyclic antidepressants.
ADD/ADHD medications and your child
Even when armed with all the facts, deciding whether or not to let your child take ADD/ADHD medication isn’t always easy. If you’re unsure, don’t rush the decision. Sometimes other medical conditions–or even normal childhood behavior–can be mistaken for ADD/ADHD symptoms, so be sure to eliminate all other possible causes before considering medication for your child. Take your time to weigh the options and get your child’s input in the decision-making process.

Most importantly, trust your instincts and do what feels right to you. Don’t let anyone–be it your physician or the principal at your child’s school–pressure your child into medication if you’re not comfortable with it. Remember: medication isn’t the only treatment option. For young children especially, medication should be viewed as a last resort, not the first course of treatment to try.

Questions to ask an ADD / ADHD specialist
Consulting with an ADD/ADHD specialist or an experienced psychiatrist can help you understand the pros and cons of medication. Here are some questions to ask:

What ADD/ADHD treatments do you recommend?
Can my child’s symptoms be managed without medication?
What medications do you recommend and what are the side effects?
How effective is medication for my child’s ADD/ADHD?
How long will my child have to take medication?
How will the decision be made to stop medication?
For Parents: Helpful questions about ADHD medication and your child
When deciding whether or not to put your child on medication, Jerome Schultz, Ph.D., ADHD expert, says to first consider the following questions:
Has my child been helped by non-medication approaches? Self-calming techniques, deep breathing, and yoga often can help children with ADHD.
Has the school tried to teach my child to be more attentive and less active?
Is the decision to put my child on medication the result of behavioral observations over time and in different settings, such as in school and at home?
When is my child at his or her best? Fishing with his uncle or playing video games? Help the physician understand how pervasive or selective the problem is.
Does my child have other conditions that can be mistaken for hyperactivity? Children exposed to toxic chemicals or who have undiagnosed learning disabilities and low-level anxiety disorder may produce similar behaviors.
Source: Family Education Network
Talking to your child about ADD / ADHD medication
Many kids and teens with ADD/ADHD don’t take their medication correctly—or stop taking it without talking to their parents or doctor—so if your child is on ADD meds, make sure that he or she understands how to take the medication correctly and why following prescription guidelines are important.

Encourage your child to come to you with any medication-related concerns so you can work together to solve the problem or find another treatment option. It’s also important to remember that ADD/ADHD medication should never have a numbing effect on a child’s energy, curiosity or enthusiasm. A child still needs to behave like a child.

Monitoring Medication’s Effects on Your Child
Here is a list of questions you should ask when your child begins medication therapy, changes dosage, or starts taking a different medication.
Is the medication having a positive impact on your child’s mood and/or behavior?
Do you think the dosage or medication is working?
Does your child think the dosage or medication is working?
Does the dose need to be increased or decreased?
What was the change in a specific behavior or set of behaviors that caused you to conclude that the medication needed to be evaluated?
Is your child experiencing any side effects, such as headaches, stomachaches, fatigue or sleeplessness, (or suicidal thoughts if taking Strattera)?
What is the likelihood those side effects will last? (Ask your doctor)
Do any lasting side effects (if any) outweigh the medication’s benefits?
Do you or your child think a medication or dosage level has stopped working?
Source: From Chaos to Calm: Effective Parenting of Challenging Children with ADHD and Other Behavioral Problems, by Janet E. Heininger and Sharon K. Weiss.
Medication alone is not enough
Treatment for attention deficit disorder isn’t just about seeing doctors or taking medication. There is a lot you can do to help yourself or your child tackle the challenges of ADD/ADHD and lead a calmer, more productive life. With the right tips and tools, you can manage many of the symptoms of your ADD/ADHD on your own. Even if you choose to take medication, healthy lifestyle habits and other self-help strategies may enable you to take a lower dose.

Exercise regularly. Exercising is one of the most effective ways to reduce the symptoms of ADD/ADHD. Physical activity boosts the brain’s dopamine, norepinephrine, and serotonin levels—all of which affect focus and attention. Try walking, skateboarding, hiking, dancing or playing a favorite sport. Encourage your child to put down the video games and play outside.
Eat a healthy diet. While diet doesn’t cause ADD/ADHD, it does have an effect on mood, energy levels, and symptoms. Set regular snack and meal times. Add more omega-3 fatty acids to your diet and make sure you’re getting enough zinc, iron and magnesium.
Get plenty of sleep. Regular quality sleep can lead to vast improvement in the symptoms of ADD/ADHD. Simple changes to daytime habits go a long way toward resting well at night. Have a set bedtime and stick to it. Avoid caffeine later in the day.
Try therapy. ADD/ADHD professionals can help you or your child learn new skills to cope with symptoms and change habits that are causing problems. Some therapies focus on managing stress and anger or controlling impulsive behaviors, while others teach you how to manage time, improve organizational skills, and persist toward goals.
Maintain a positive attitude. A positive attitude and common sense are your best assets for treating ADD/ADHD. When you are in a good frame of mind, you are more likely to be able to connect with your own needs or your child’s.
Guidelines for taking ADD & ADHD medication
If you decide to take medication for ADD/ADHD, it’s important to take the drug as directed. Following your doctor and pharmacist’s instructions will help you maximize the effectiveness of medication for ADD/ADHD and minimize the side effects and risks. Here are some guidelines for safe use:

Learn about the prescribed medication. Find out everything you can about the ADD/ADHD medication you or your child is taking, including potential side effects, how often to take it, special warnings, and other substances that should be avoided, such as over-the-counter cold medication.
Be patient. Finding the right medication and dose is a trial-and-error process. It will take some experimenting, as well as open, honest communication with your doctor.
Start small. It’s always best to start with a low dose and work up from there. The goal is to find the lowest possible dose that relieves you or your child’s symptoms.
Monitor the drug’s effects. Pay close attention to the effect the medication is having on your or your child’s emotions and behavior. Keep track of any side effects and monitor how well the medication is working to reduce symptoms.
Taper off slowly. If you or your child wants to stop taking medication, call the doctor for guidance on gradually decreasing the dose. Abruptly stopping medication can lead to unpleasant withdrawal symptoms such as irritability, fatigue, depression, and headache.
Dealing with the side effects of ADD & ADHD medication
Most children and adults taking medication for ADD/ADHD will experience at least a few side effects. Sometimes, side effects go away after the first few weeks on the medication. You may also be able to eliminate or reduce unpleasant side effects with a few simple strategies.

Tips for minimizing side effects
Loss of appetite – To deal with reduced appetite, eat healthy snacks throughout the day and push dinner to a later time when the medication has worn off.
Insomnia – If getting to sleep is a problem, try taking the stimulant earlier in the day. If you or your child is taking an extended-release stimulant, you can also try switching to the short-acting form. Also avoid caffeinated beverages, especially in the afternoon or evening.
Stomach upset or headaches – Don’t take the medication on an empty stomach, which can cause nausea, stomach pain, and headaches. Headaches can also be triggered by medication that’s wearing off, so switching to a long-acting drug may help.
Dizziness – First, have you or your child’s blood pressure checked. If it’s normal, you may want to reduce your dose or switch to a long-acting stimulant. Also make sure you’re drinking enough fluids.
Mood changes – If medication is causing irritability, depression, agitation, or other emotional side effects, try lowering the dose. Moodiness may also be caused by the rebound effect, in which case it may help to overlap the doses or switch to an extended-release medication.
If troublesome side effects persist despite your best efforts to manage them, talk to your doctor about adjusting the dose or trying a different drug. Many people respond better to the long-acting or extended release formulations of ADHD medication, which build gradually in the bloodstream and then wear off slowly. This minimizes the ups and downs caused by fluctuating medication levels and causes less of a rebound effect, where symptoms return, often worse than before, as the drug wears off.

Authors: Lawrence Robinson, Melinda Smith, M.A., Jeanne Segal, Ph.D., and Damon Ramsey, MD.

By RICK NAUERT PHD Senior News Editor

1st Trimester Antidepressant Use Tied to Autism RiskA new Johns Hopkins study discovers an association between prenatal exposure to antidepressant medications, autism spectrum disorder (ASD), and developmental delays (DD) in boys.

Researchers from the Bloomberg School of Public Health found that early prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) — commonly prescribed for depression, anxiety, and other disorders — increased the risk for ASD three-fold.

Common SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft).

The study of 1,000 mother-child pairs is published in the online edition of Pediatrics. In the study, investigators analyzed data from large samples of ASD and DD cases, and population-based controls.

Importantly, researchers used a uniform protocol to confirm ASD and DD diagnoses by trained clinicians using validated standardized instruments.

The study included 966 mother-child pairs from the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study, a population-based case-control study based at the University of California at Davis’ MIND Institute.

The researchers broke the data into three groups: Those diagnosed with autism spectrum disorder (ASD), those with developmental delays (DD), and those with typical development (TD).

The children ranged in ages two to five. A majority of the children were boys — 82.5 percent in the ASD group were boys, 65.6 percent in the DD group were boys, and 85.6 percent in the TD were boys.

While the study included girls, the substantially stronger effect in boys alone suggests possible gender difference in the effect of prenatal SSRI exposure.

“We found prenatal SSRI exposure was nearly three times as likely in boys with ASD relative to typical development, with the greatest risk when exposure took place during the first trimester,” said Li-Ching Lee, Ph.D., Sc.M.

“SSRI was also elevated among boys with DD, with the strongest exposure effect in the third trimester.”

“Serotonin is critical to early brain development; thus, exposure during pregnancy to anything that influences serotonin levels can have potential effect on birth and developmental outcomes,” said the researchers.

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In the U.S., the prevalence of ADS continues to rise. According to the Centers for Disease Control and Prevention, an estimated one in 68 children in the U.S. is identified with ADS, and it is almost five times more common among boys than girls.

One may question whether the increased use of SSRI in recent years is a contributor to the dramatic rise of ASD prevalence.

“This study provides further evidence that in some children, prenatal exposure to SSRIs may influence their risk for developing an autism spectrum disorder,” said Irva Hertz-Picciotto, Ph.D., M.P.H.

“This research also highlights the challenge for women and their physicians to balance the risks versus the benefits of taking these medications, given that a mother’s underlying mental-health conditions also may pose a risk, both to herself and her child.”

Regarding treatment, the authors note that maternal depression itself carries risks for the fetus, and the benefits of using SSRI during pregnancy should be considered carefully against the potential harm.

The researchers also note that large sample studies are needed to investigate the effects in girls with ASD.

Limitations of the study acknowledged include the difficulty in isolating SSRI effects from those of their indications for use, lack of information on SSRI dosage precluded dose-response analyses, and the relatively small sample of DD children resulted in imprecise estimates of association, which should be viewed with caution.

Source: Johns Hopkins

By MARGARITA TARTAKOVSKY, M.S.

9 Tips to Deal with Forgetfulness in ADHD

Forgetfulness is a symptom that “can impact everything” for adults with attention deficit hyperactivity disorder (ADHD), said Mindy Schwartz Katz, MS, ACC. Mindy’s a coach who empowers clients with ADHD to get over, around and through the obstacles that get in the way of living their unique life.

It can affect how you work. For instance, one of Katz’s clients, a contractor, bought the wrong paint color for a job, costing him extra time and money. Another client got fired from a production line because they forgot a safety procedure.

It also can affect your home life. You might forget to pay the bills, run important errands and acknowledge special occasions. Your spouse and family may interpret your forgetfulness as a sign that you don’t care about them, Katz said.

“Forgetfulness is related to the executive functions in the brain — processes which help us manage, organize, and disseminate information,” according to Stephanie Sarkis, Ph.D, NCC, a psychotherapist who specializes in ADHD.

These functions also include planning and thinking ahead. In ADHD these functions are dysfunctional, she said.

But there are strategies you can employ to effectively reduce and manage forgetfulness. Here are nine suggestions.

1. Take advantage of technology.

Use an electronic calendar, such as Google Calendar, and set it up to text you reminders for appointments and tasks, Katz said. Have it send you the same reminders throughout the day.

Sarkis suggested the apps TravelPro, which creates packing lists for trips, and Errands, which helps you keep track of professional tasks and personal errands.

2. Automate tasks.

Like sending yourself reminders, automating other tasks also helps. For instance, Katz’s client eats the same breakfast every morning because it used to take her too long to locate all the ingredients she needed for different meals.

Katz travels often, so she keeps a toiletry bag with everything she needs. When she purchases a new product, she just adds it to her bag.

You can do the same with a backpack for school and a briefcase for work. Get duplicates and extras of inexpensive items, too, she said.

3. Use self-talk.

Katz suggested pausing, paying attention to what you’re currently doing, and practicing self-talk, such as: “Here are my keys, they’re in my hands, and I’m putting them next to my purse, which is where I always put my keys.”

Sometimes, your self-talk may sabotage your efforts. Many people will say, “I’ll remember that,” Katz said. Instead, it’s better to remind yourself of what really works. So you might say: “I need to write it down. I write everything down. I’m going to put this in my calendar.”

Sarkis also stressed the importance of writing things down. “The more you write down, the less you have to keep track of tasks in your head.”

4. Have a launch pad.

One of Katz’s clients used to spend an hour and a half every morning searching for her purse, keys, ID badge and other items. Katz suggested she create a launch pad with everything she needs to take to work. She cut down her time to 30 minutes.

Make sure this launch pad is close to the door. As soon as you get home, put all your items in it. Also, if you need to bring something new to work, put it in your launch spot right away. This way, the next morning, you don’t waste time scouring your home, and you won’t forget it.

5. Create visual reminders.

Katz works with another client who’s a case manager. She found herself forgetting a lot of details because she has so many clients and so much information to keep track of. Instead of using scores of sticky notes, she created one circle for every client. In that circle she puts anything about that client.

Adults with ADHD also may forget to do the things they enjoy, she said. A different client forgets what she likes to eat for dinner, so she posts dinner menus on the fridge.

Another part of creating visual reminders is labeling things, Katz said. “I sort of chuckle about how many systems I started and forgot about it. [I had] a drawer for the scissors but couldn’t remember where I put them.”

That’s why it’s key to have a place for everything, and for everything to have a label, she said.

6. Create simple systems.

“Set up your life so that the things you need are where you need them,” Katz said. Another client, who’s in sales, works out of his car. He uses crates to house the different kinds of samples he sells. Once he’s done with a sample, he returns it to its respective crate, which is clearly labeled.

7. Create lists.

“Lists are key to organizing and remembering,” Katz said. Her client, who has significant memory issues, has checklists for everything from cleaning the house to transitioning from work to home to packing for vacation. She writes these checklists on index cards, which she keeps on a binder clip by her front door.

8. Ask others to remind you.

“Let people know that you don’t mind reminders,” Katz said. Sometimes people worry that they’re nagging you. But there’s a difference between “You never remember to ___” and “You asked me to remind you at 3 p.m. that you have an appointment in an hour.”

9. Get help.

“Reach out for help from a mental health clinician; trusted family members or friends; and financial professionals, if your forgetfulness is causing you issues with money management,” said Sarkis, also author of several books on ADHD, including 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals.

Katz suggested hiring a virtual assistant to give you reminders and review your daily schedule and to help with accounting and billpaying. She knows a businessman who hired a high school student to be his “body double.” “Just having someone else in the room, you’re more inclined to do the things you need and want to do.”

Sometimes adults with ADHD can feel defective, Katz said. They think, “I should be able to remember this.”

But your forgetfulness isn’t a defect. It’s a symptom of ADHD. And it’s a symptom you can successfully manage. Focus on finding strategies that work for you, and don’t hesitate to seek help.

Years ago, doctors were mostly concerned with how a child’s health would be affected the longer a mom delayed birth. Now, a father’s age may be a big factor.

Dads who wait until age 45 to have a child may face a significantly increased risk their offspring may have mental health and academic problems including autism, ADHD, schizophrenia, suicidal ideation, low IQ scores and failing grades.

Researchers examined all births that happened in Sweden between 1973 and 2001, and found a child born to a 45-year-old dad was 25 times more likely to have bipolar disorder, 13 times more likely to have ADHD, 3.5 times more likely to have autism, 2.5 times more likely to exhibit suicidal behavior or a substance abuse problem, and twice as likely to have a psychotic disorder like schizophrenia when compared to kids born to a 24-year-old father.

That’s in addition to the increased risk for academic problems.

“We were shocked by the findings,” study author Dr. Brian D’Onofrio, an associate professor in the department of psychological and brain sciences at Indiana University Bloomington, said in a statement.

It presents a worrisome public health risk, given that the average age for childbearing has been on the rise in the past 40 years for both men and women. On average, U.S. married men are about 25.6 years old when they have their first child, compared to 22.5 for single men, according to government statistics. The researchers said fathers in the northeast tend to be older than elsewhere in the country.

For most of the mental health risks identified by researchers, the likelihood for disorders increased steadily the older a dad got, which means there isn’t one particular age threshold that a dad should aim to stay under.

“While the findings do not indicate that every child born to an older father will have these problems, they add to a growing body of research indicating that advancing paternal age is associated with increased risk for serious problems,” said D’Onofrio.

Even when the researchers controlled for other factors that may influence risk for mental health woes in children, including parental income and education levels, the findings remained “remarkably consistent.”

They also compared their findings to siblings born when dad was a younger age, which accounted for different environmental factors since they’d have similar upbringings. They found the risk was even higher for psychiatric and mental health conditions when comparing dad’s age across siblings. The researchers also looked at cousins, finding consistent results for these risk increases.

“These approaches allowed us to control for many factors that other studies could not,” D’Onofrio said.

Other studies have found similar links. Researchers have reported increased risks for autism as dads got older, as well as increased risk in grandchildren. Earlier studies also found intelligence levels dropped in offspring the older the dad got. In many of these studies, genetic mutations transported through a father’s sperm were suspected to increase the risks.

D’Onofrio’s team explained men continue to produce new sperm throughout their lives, and each time they replicate, there’s a chance a DNA mutation might occur. Women meanwhile have a set number of eggs they are born with.

Men also may be exposed to more environmental toxins as they age, which might also cause DNA mutations in sperm.

“Regardless of whether these results should lead to policy changes, clarification of the associations with (advanced aging in dads) would inform future basic neuroscience research, medical practice, and personal decision-making about childbearing,” the researchers concluded.

Their new study was published Feb. 26 in JAMA Psychiatry.

Children diagnosed with attention deficit/hyperactivity disorder (ADHD) at ages 4 to 6 are more likely to suffer from depression as adolescents than those who did not have ADHD at that age, according to a long-term study published in the October issue of the Archives of General Psychiatry. Although it was an uncommon occurrence, the children with ADHD also were somewhat more likely to think about or attempt suicide as adolescents.

“This study is important in demonstrating that, even during early childhood, ADHD in is seldom transient or unimportant” said study director Benjamin Lahey, Ph.D., a professor of health studies and psychiatry at the University of Chicago. “It reinforces our belief that parents of young children with ADHD should pay close attention to their child’s behavior and its consequences and seek treatment to prevent possible long-term problems.”

Children with ADHD have trouble paying attention and controlling impulsive behaviors and are often overly active. This can cause poor performance in school, difficulties in social situations, and a loss of confidence and self esteem. The Centers for Disease Control and Prevention estimate that about 4.4 million children, including about four percent of those aged 4 to 6, have ADHD.

Earlier studies of the long-term connections between ADHD, depression and suicidal thoughts produced mixed results. This study benefited from a more comprehensive assessment of depression over a decade, a focus on specific child and family factors that predict which children are most at risk, and consideration of other factors associated with suicidal ideas.

The study, performed by researchers at the University of Chicago and the University of Pittsburgh, followed 123 children diagnosed with ADHD at age 4 to 6 for up to 14 years, until they reached ages 18 to 20. It compared them with 119 children from similar neighborhoods and schools, matched for age, sex, and ethnicity. The children were assessed annually in study years 1 through 4, 6 through 9, and 12 through 14.

The researchers found that 18 percent of children diagnosed early with ADHD suffered from depression as adolescents, about 10 times the rate among those without ADHD. Children with early ADHD were five times as likely to have considered suicide at least once, and twice as likely to have made an attempt.

“Suicide attempts were relatively rare, even in the study group,” cautioned Lahey. “Parents should keep in mind that more than 80 percent of the children with ADHD did not attempt suicide and no one in this study committed suicide.”

Although the subtypes of ADHD–based on whether they had attention deficit or hyperactivity or both–predict subsequent depression and suicidal thoughts, distinct forms of the disease at age 4 to 6 were moderately predictive for specific problems later on. Children with inattention or combined subtype were at greater risk for depression. Those with combined type or hyperactivity were at greater risk for suicidal thoughts.

Far more boys that girls suffer from ADHD, but being female increased the risk of depression. Children whose mothers suffered from depression were also at increased risk.

Children with more complicated ADHD were most at risk, the authors conclude. “Greater numbers of depression, anxiety, oppositional defiant disorder, and conduct disorder symptoms at ages 4 to 6 among children with ADHD robustly predicted risk for depression during adolescence. Children with uncomplicated ADHD with few concurrent symptoms of other disorders were at low risk for depression, but children with many concurrent symptoms were at very high risk.”

Source: University of Chicago Medical Center

Written by Samantha Gluck

Ever wonder how adult ADD and relationships work? It’s easy to fall in love. The brain sends a rush of neurotransmitters responsible for the euphoric feeling associated with falling in love. Those with ADHD have less pleasure-producing chemicals available in their brains, causing them to focus on new love and romance with a laser-like acuity in an attempt to increase the levels of dopamine and other pleasure chemicals. But this initial rush does not last; nor, do they build the foundation required for lasting ADHD relationships.

Adult ADD and Relationships
Building a lasting, satisfying relationship is challenging for everyone, but especially for the adult with ADHD. Consider the difficulties facing adult ADHD relationships:

Learn about ADD and relationships and how adult ADHD affects relationships. Info detailing solutions to problems facing ADHD relationships.People without ADHD can experience a bond and connection with their partner at any time, day or night. For the adult with ADD/ADHD, sporadic connections are the norm. This disconnect in the eyes of the non-ADD adult can foment doubt and suspicion in ADHD relationships.
Frequently, the ADD adult’s irritation with touching and closeness can create a sharp disconnect in the relationship. Sometimes people with ADD experience heightened senses, causing physical contact to feel annoying. This rejection can create a significant wound in a relationship with a non-ADD person.
The poor memory skills exhibited by many suffering from ADHD can cause hurt feelings when they forget a birthday, anniversary, or important meeting.

All couples argue at times, even in the best of relationships. But adults with poorly managed ADHD are quick to anger, often over insignificant matters. This can create an environment of tension and friction in an otherwise good relationship.

Chronic boredom represents another issue that plagues adults with ADD and relationships. People with ADHD become bored more frequently than those without the disorder. This can cause relationship issues when the normal adult feels his or her partner is bored with their company and the activities they participate in together.

The impulsiveness associated with ADD can certainly cause a rift in the ADHD relationship. While some level of spontaneous activity is attractive, adults have responsibilities and goals that do not lend themselves well to the unhealthy levels of impulsive behavior shown by adults with poorly managed ADD.
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Managing Adult ADD and Relationships
Managing symptoms of adult ADHD by properly taking ADD drugs and by following advice given by a behavioral therapist, an ADHD coach, or adult ADHD support group is the first step toward healing many causes of breakdown in ADHD relationships.

Creating an environment in which an ADHD relationship can thrive requires diligence and commitment. Consider the following strategies:

Keep a notebook with a calendar handy to jot down daily and weekly “to do” lists for the home as well as grocery lists. Keep the calendar updated with important dates and occasions highlighted inside.
Mitigate the clutter in your mind by cleaning up the clutter in your home and personal spaces.
Create a routine for repeating tasks and duties and stick to it.
Ask your partner to request that you repeat back his or her requests and needs to ensure that you were ‘on board’ and listening to the conversation.
Share your feelings honestly. If you feel heightened sensitivity to touch and sound at the moment, tell your partner in advance so he or she will not feel hurt by a rejection.
Budget your money by sitting down with your partner at a designated day and time each week. Plan expenses, entertainment expenditures, and menus for the entire week ahead. This relieves you of dealing with this burden on a daily basis.
Finally, relationships are hard. They are hard for everyone. Do not allow ADD to adversely affect your relationships. Take steps now toward a fulfilling life.

Joey is a seven year old referred by his pediatrician because he has difficulty paying attention in school. His mind wanders, he responds to his teacher’s questions in class with “What, I don’t know,” and he is a bit self-conscious about his declining grades. Joey is a super sweet little boy, he does not squirm in his seat, bother other kids or anger the teacher. She simply wonders, “Why is he always day-dreaming?”

The answer, as pediatric neuropsychologist Dr. Paul Beljan may be, “Joey’s boss is out.” Here’s a useful audio ADHD and Executive Function: When the boss is out on the boss in Joey’s brain.

Joey’s boss resides in the frontal lobes of the brain. His boss is in charge of the executive functions that help him to preview, plan, think, inhibit, organize and execute tasks of daily living. I call this area of the brain “The Thinker.” You can read all about The Caveman and The Thinker here The Family Coach Method.

Another helpful book on EF is Executive Skills in Children and Adolescents, Second Edition: A Practical Guide to Assessment and Intervention.

It’s also possible that day-dreaming may be beneficial.
1. Daydreaming may be a sign of creativity.

2. Daydreaming may be a signal that your child is looking for more stimulating or interesting things to think about.

3. Both inward reflection and outward attention are important, the skill is when to use which one.

4. The brain gets tired and occasionally needs a break for refueling, daydreaming can be like a little cat-nap for the brain.

5. Daydreaming may be the moment before a burst of cognitive energy is expended.

What do you observe in your children? Is daydreaming a sign of lack of attention or focus or might it actually be useful? Let us know @drlynnekenney

I am an educator and I’m currently working with a kindergartner with what could best be described as extreme ADHD. She is currently on Ritalin, which has allowed her to increase her attention span. However, it seems the medication makes her moody, tired and melancholy. Ritalin also seems to greatly alter her personality. She seems almost depressed when she is on the drug. Are there any interventions that would be helpful in such a case? Her parents seem receptive to advice and would really love to help this little girl.

We certainly can’t offer diagnoses or treatment recommendations from such a distance, but can offer some general information in response to your observations, questions and concerns that will no doubt resonate with educators and parents across the country.

Because there still is no definitive objective test for diagnosing Attention Deficit Hyperactivity Disorder (ADHD), doctors making this diagnosis must rely on careful observation of children’s behavior in their offices as well as thorough reports from teachers and parents.

ADHD is probably over-diagnosed in some settings, and under-diagnosed in others, but either way, there is clearly room for error. There is good evidence that stimulant medication is an effective treatment for ADHD, but when it is not, it is important to go back to the drawing board to be sure that ADHD is the correct diagnosis, and whether or not it is the only one.

Many children are very, very active without tipping over into hyperactivity. This distinction can be difficult to make unless the hyperactivity is truly extreme.

In young children, there is a wide range in the ability to sit still and concentrate in the classroom setting, and indeed, we are asking more and more compliance with traditional academic demands at earlier and earlier ages, despite the fact that there is no reason to believe that children’s capacities to handle these have started developing at earlier ages. (In fact, there may be some conditions in our world today that make it harder for some children to attend and focus. For example, one study found a correlation between long hours of television watching in children under age 3 with symptoms of attention difficulties at age 7, although a cause and effect link could not be made by the researchers.)

Excessive physical activity, fidgeting and restlessness, trouble concentrating, being easily distracted and impulsive behavior all are symptoms of ADHD. Yet they also can be more general signs of distress in young children. Just as fever suggests an infection without telling us what the cause of the infection is, these behaviors in young children may signal a range of other conditions, including anxiety, a mood disorder or even post traumatic stress in a child who has been abused or traumatized in some other way.

Stimulants such as Ritalin (methylphenidate) can bring about clear improvements, noticeably increasing attention and concentration, and decreasing hyperactivity. Sometimes, though, a child does begin to appear down, or even depressed when taking these medications. They can interfere with sleep, which might also be a cause for sleepiness and moodiness during the day. A switch to a different preparation (short or long-acting, for example) or kind of stimulant (dexedrine, for example, rather than methylphenidate) sometimes can help with either of these side effects, although there are some children who just won’t be able to tolerate these medications. If the Ritalin is stopped and the melancholy moodiness continues, there may be another problem that needs careful assessment. If parents express concerns that line up with yours, they may accept your suggestion to turn to a child psychiatrist, if they haven’t done so already, to address these specific questions about possible side effects, other treatment options and diagnostic reassessment.

While there now are studies that show that medication alone can be more effective than cognitive-behavioral treatments alone for ADHD, there are also a number of other measures to try that may be helpful. In the classroom, a child who is easily distracted and has trouble attending should be seated close to the teacher, and positioned so that all of the other children wiggling and jiggling are out of her line of sight. This must be done without making her feel singled out or humiliated – self-esteem all too often suffers in children with ADHD. It is also helpful to give such children regular, gentle reminders to tune back in again: The teacher can work out a private signal with the child that helps the child to feel special and valued rather than to stand out as the “trouble” child.

Reminders and disciplines should be framed positively and with hope, since these children often need so many that they will soon tune out anything that sounds like nagging to protect themselves from feeling worse and worse about themselves.

Special chores that allow them to work off steam, like getting up to sharpen the pencils, or pass out supplies, or to deliver the attendance list to the principal’s office can also help honor such children’s need for extra activity. These children often need frequent encouragement, praise and rewards, as it can be as hard for them to sustain their own motivation and keep themselves on track independently.

Careful and respectful back and forth sharing between parents and teachers can help create a more seamless experience of rewards and reminders for the child as she adapts each day to transitions between school and home. The long-term goal is for the child to understand and accept herself so that she can become increasingly independent in coping with and overcoming her challenges. For parents and teachers to help with this, they too will need to understand and accept.

For more information:

Children and Adults with Attention Deficit/Hyperactivity Disorder www.chadd.org

The American Academy of Child and Adolescent Psychiatry’s website at www.aacap.org

– See more at: http://families.naeyc.org/families-today/whats-best-kindergartner-adhd#sthash.t3aIM5wz.dpuf

Even as the rate of diagnosis has reached 11 percent among American children aged 4 to 17, neuroscientists are still trying to understand attention deficit hyperactivity disorder (ADHD). One classic symptom is impulsivity – the tendency to act before thinking.

Scientifically, impulsivity can appear as a choice for a small but immediate reward over a larger one that requires some delay. Choosing between present and future rewards is a fundamental need in schooling, says Luis Populin, associate professor of neuroscience at University of Wisconsin-Madison. “If you say to an impulsive child, ‘Do your homework so you will get a good grade at the end of the quarter,’ that has less appeal than ‘Let’s play baseball this afternoon instead of studying chemistry.'”

To study impulsive behavior, Populin and graduate student Abigail Zdrale Rajala selected two rhesus macaque monkeys with opposite behaviors. One was extremely calm, while the other was nervous, fidgety and impulsive. The monkeys were trained to stare at a dot on a screen and, when it went dark, to choose between two pictures placed to the side. Their choice of picture determined whether they got a small but immediate sip of water, or a larger sip, after a delay ranging up to 16 seconds.

As expected, the calm monkey, but not the impulsive one, quickly figured out that waiting would bring the sweeter result.

This willingness to take a smaller reward right away rather than a larger, delayed reward, called “temporal discounting,” is a common feature of “combined type” ADHD, which specifically lists impulsivity among its diagnostic criteria, Populin says.

When the monkeys were given a dose of methylphenidate, the active ingredient of the common ADHD drug Ritalin, they chose the delayed reward more frequently. The impulsive monkey actually showed the same preference for delayed rewards as the unmedicated, calm monkey. However, identifiable differences in their performance mean that methylphenidate improved the condition, but did not eliminate it.

“There is no perfect animal model of ADHD,” says Rajala, “but many studies are performed on rodents; this one was done in a non-human primate, which is much closer to humans.” The Society for Neuroscience adjudged the paper valuable enough to support Rajala’s travel to the conference in San Diego.

Methylphenidate changes the elimination of dopamine, a “reward” neurotransmitter that is elevated by drugs like cocaine and amphetamine. The result is that more dopamine remains in the brain, which is the most likely explanation for the altered reward processing in the medicated monkeys.

Some scientists have thought that temporal discounting in ADHD may result from cognitive processing, which relies on the highly evolved frontal cortex in the brain. The new results support an alternative, but less common, hypothesis: that temporal discounting is linked to the reward-processing mechanism, which is governed by more primitive parts of the brain.

By teasing apart one characteristic of ADHD, the study could help refine drug or behavioral treatments of a disability that has grown 16 percent more common just since 2007, Populin says.

By SARAH WHEELER

Shane Victorino has it all. He is a member of a Boston Red Sox team that is two victories away from a World Series title. He has a championship ring (won with the Philadelphia Phillies in 2008), three Gold Glove awards, and a yearly income of over $6 million. He has a beautiful wife and two insanely adorable children. He has the undying love of Boston sports fans, after hitting a pennant-clinching grand slam that sent the Red Sox to the World Series against the St. Louis Cardinals.

And he has attention deficit hyperactivity disorder, or A.D.H.D.

I have worked with children with A.D.H.D. for almost a decade, and I have been a Red Sox fan for as long as I can remember. So the sight of Victorino, the Red Sox right fielder, basking in the glory (and the Gatorade) after his performance in the final game of the American League Championship Series against the Detroit Tigers made me think about all of the children I have known with A.D.H.D., and what his story might mean for them.

In the mid-1980s, when Victorino first learned he had the disorder, an estimated 3 to 7 percent of children were thought to have A.D.H.D. (then called attention deficit disorder “with or without hyperactivity”). Today, the national average is estimated to be around 11 percent, with rates as high as 16 in every 100 children in some states.

The appalling rises in A.D.H.D. diagnoses in the United States have been getting a lot of attention lately, and the issue is certainly worthy of debate. Working in schools, it sometimes feels like pediatricians are handing out A.D.H.D. diagnoses, and an accompanying prescription for stimulants, like candy. The fact that there is no definitive lab test for A.D.H.D. makes these issues even murkier, and leads to all sorts of comments about how children are just too used to being overstimulated every second in this digital age, or how they are being turned into zombies by the pharmaceutical companies.

But for every student who has a little bit of trouble sitting still and following instructions, there are also children like Shane Victorino. Like many children with A.D.H.D. (PDF), Victorino had significant problems in school, repeatedly got into accidents, and became a constant source of concern to the adults around him. He reminds me of many athletically talented boys with A.D.H.D. I have known who are not just impulsive or energetic, but also perpetually one incident away from being asked politely — or not so politely — to skip Little League tryouts next year.

Jumbled in the conversation about the validity of A.D.H.D. is the fascinating and timely discussion of whether medical or manufactured “enhancements” to an athlete’s body or mind should be seen as breakthroughs or dangers.

Some may find it arbitrary that H.G.H. is considered illicit, while stimulants are not. Victorino is one of a number of professional athletes who are “out” about their A.D.H.D., so he is allowed to take stimulants, under a doctor’s care.

While many agree that social and behavioral interventions are a crucial component of any treatment plan for A.D.H.D., children who also use stimulant medications have been found to have the most promising outcomes over time. Would all baseball players be better on stimulants? Possibly. Would Shane Victorino be playing in the World Series right now — even though lower back tightness kept him out of Game 4 on Sunday night, and his status for Monday night’s Game 5 in St. Louis and any other remaining games in Boston is uncertain — if those early assessments had concluded that he was a “spirited” child who only needed an exploratory curriculum and a gluten-free diet? Not likely. Does Shane Victorino have an advantage? It’s unlikely that we’ll get clear answers to that question soon. It’s much more likely, however, that in Victorino’s case, giving his challenges a name and treating them chemically is not unreasonable.

Russell Barkley, one of the world’s leading experts on A.D.H.D., prefers that we not use the word “attention” to discuss issues related to the disorder. Instead, he sees A.D.H.D. as an “intention” deficit — meaning that those who have it are constantly unable to accomplish things they intended to do. Even on medication, Shane Victorino visibly struggles to inhibit what are called his “prepotent responses” — something he immediately, instinctively, wants to do, like approaching the mound to talk to a pitcher about a wild pitch (that one started a benches-clearing fight and led to a three-game suspension) or
flipping off an opposing team member’s family during a high school soccer game.

Like many people with A.D.H.D., Victorino also struggles with emotional regulation, or as he has been quoted as saying, “letting my emotions get the best of me.” We’re not talking about being “sensitive” or getting upset every once in a while, we’re talking about a lifetime of disruptive, embarrassing and emotional displays that have had very negative consequences.

It’s quite apt that the song that plays every time Victorino walks up to the plate in Fenway Park is “Three Little Birds” by Bob Marley. As the Boston fans wail out the lines, “Don’t worry about a thing, ’cause every little thing is gonna be all right,” you have to wonder how many times in the last 33 years Victorino has desperately recited this mantra, or something like it, to himself.

Sarah Wheeler is a former special education teacher and now a school psychologist in the San Francisco Bay Area. She is a doctoral candidate in education at the University of California, Berkeley.

In a small study that was published in the Journals of Gerentology, researchers in Israel gave a 10mg dose of the drug methylphenidate (Ritalin) to fifteen healthy adults, 70 and older who could walk without assistance. They compared this group to 15 others given a placebo. The dosed group showed improved gait and function while performing single tasks (i.e. walking) and when performing dual tasks (i.e. walking and reciting the days of the week in reverse). The drug’s ability to enhance mental focus (it is often given to help those with Attention Deficit Hyperactivity Disorder) is suspected of also impacting the area of the brain that controls balance and motor skills. Methylphenidate does have some documented addiction issues and it is not currently recommended for adults 65 and older nor is it for those having cardiac conditions. However the results of this initial work will hopefully result in larger clinical studies that may verify the findings and help to create a safe therapeutic regimen that can reduce the incidence of falls. – See more at: http://suddenlysolo.org/2013/10/24/adhd-and-walking-tall/#sthash.ODMqFuay.dpuf

On SEPTEMBER 25, 2013

Sensory processing disorders (SPD) are more prevalent in children than autism and as common as attention deficit hyperactivity disorder, yet it receives far less attention partly because it’s never been recognized as a distinct disease.

In a groundbreaking new study from UC San Francisco, researchers have found that children affected with SPD have quantifiable differences in brain structure, for the first time showing a biological basis for the disease that sets it apart from other neurodevelopmental disorders.

One of the reasons SPD has been overlooked until now is that it often occurs in children who also have ADHD or autism, and the disorders have not been listed in the Diagnostic and Statistical Manual used by psychiatrists and psychologists.
“Until now, SPD hasn’t had a known biological underpinning,” said senior author Pratik Mukherjee, MD, PhD, a professor of radiology and biomedical imaging and bioengineering at UCSF. “Our findings point the way to establishing a biological basis for the disease that can be easily measured and used as a diagnostic tool,” Mukherjee said.

The work is published in the open access online journal NeuroImage:Clinical.
‘Out of Sync’ Kids

Sensory processing disorders affect 5 to 16 percent of school-aged children.

Children with SPD struggle with how to process stimulation, which can cause a wide range of symptoms including hypersensitivity to sound, sight and touch, poor fine motor skills and easy distractibility. Some SPD children cannot tolerate the sound of a vacuum, while others can’t hold a pencil or struggle with social interaction. Furthermore, a sound that one day is an irritant can the next day be sought out. The disease can be baffling for parents and has been a source of much controversy for clinicians, according to the researchers. “Most people don’t know how to support these kids because they don’t fall into a traditional clinical group,” said Elysa Marco, MD, who led the study along with postdoctoral fellow Julia Owen, PhD. Marco is a cognitive and behavioral child neurologist at UCSF Benioff Children’s Hospital, ranked among the nation’s best and one of California’s top-ranked centers for neurology and other specialties, according to the 2013-2014 U.S. News & World Report Best Children’s Hospitals survey.

“Sometimes they are called the ‘out of sync’ kids. Their language is good, but they seem to have trouble with just about everything else, especially emotional regulation and distraction. In the real world, they’re just less able to process information efficiently, and they get left out and bullied,” said Marco, who treats affected children in her cognitive and behavioral neurology clinic.

“If we can better understand these kids who are falling through the cracks, we will not only help a whole lot of families, but we will better understand sensory processing in general. This work is laying the foundation for expanding our research and clinical evaluation of children with a wide range of neurodevelopmental challenges – stretching beyond autism and ADHD,” she said.
Imaging the Brain’s White Matter

In the study, researchers used an advanced form of MRI called diffusion tensor imaging (DTI), which measures the microscopic movement of water molecules within the brain in order to give information about the brain’s white matter tracts. DTI shows the direction of the white matter fibers and the integrity of the white matter. The brain’s white matter is essential for perceiving, thinking and learning.

The study examined 16 boys, between the ages of eight and 11, with SPD but without a diagnosis of autism or prematurity, and compared the results with 24 typically developing boys who were matched for age, gender, right- or left-handedness and IQ. The patients’ and control subjects’ behaviors were first characterized using a parent report measure of sensory behavior called the Sensory Profile.

The imaging detected abnormal white matter tracts in the SPD subjects, primarily involving areas in the back of the brain, that serve as connections for the auditory, visual and somatosensory (tactile) systems involved in sensory processing, including their connections between the left and right halves of the brain.

“These are tracts that are emblematic of someone with problems with sensory processing,” said Mukherjee. “More frontal anterior white matter tracts are typically involved in children with only ADHD or autistic spectrum disorders. The abnormalities we found are focused in a different region of the brain, indicating SPD may be neuroanatomically distinct.”

The researchers found a strong correlation between the micro-structural abnormalities in the white matter of the posterior cerebral tracts focused on sensory processing and the auditory, multisensory and inattention scores reported by parents in the Sensory Profile. The strongest correlation was for auditory processing, with other correlations observed for multi-sensory integration, vision, tactile and inattention.

The abnormal microstructure of sensory white matter tracts shown by DTI in kids with SPD likely alters the timing of sensory transmission so that processing of sensory stimuli and integrating information across multiple senses becomes difficult or impossible.

“We are just at the beginning, because people didn’t believe this existed,” said Marco. “This is absolutely the first structural imaging comparison of kids with research diagnosed sensory processing disorder and typically developing kids. It shows it is a brain-based disorder and gives us a way to evaluate them in clinic.”

Future studies need to be done, she said, to research the many children affected by sensory processing differences who have a known genetic disorder or brain injury related to prematurity.

The study’s co-authors are Shivani Desai, BS, Emily Fourie, BS, Julia Harris, BS, and Susanna Hill, BS, all of UCSF, and Anne Arnett, MA, of the University of Denver.

By MICHELLE CASTILLO / CBS NEWS/ August 12, 2013, 5:56 PM
Having labor that is induced or augmented may lead to a greater chance of having a child with autism, new research reveals.

The U.S. government estimates that one in 50 school-aged kids has an autism spectrum disorder, which is the designation for a group of developmental brain disorders. All the conditions include some level of impairment when it comes to social skills, communication and behavioral issues.

Play VIDEO
New study links pollution to autism
Researchers looked at data from the North Carolina Detailed Birth Record and Education Research databases, which included 625,042 live births linked with school records. Of the group, 5,500 children had been diagnosed with autism.

Induced labor occurs when a medical professional intervenes in order to jump start the labor process. This usually happens when the woman is past her due date and has yet to go into labor or if there are problems with the baby or the mother’s health. The doctor or midwife can use hormone medication (Pitocin) or other methods to open the mother’s cervix, begin contractions and help her body prepare for vaginal birth.

According to the U.S. Census Bureau, about 23.1 percent of all births in 2008 were induced.

Doctors may also augment labor to help along the birth if the process stops or slows down for some reason. This method is less commonly used than inducing labor and often requires medication.

Overall, the researchers estimated two out of every 1,000 autism cases in boys could potentially be prevented by not inducing or augmenting labor. Though the numbers seemed small, they were statistically significant, meaning not due to random chance.

Mothers who had induced labor were 13 percent more likely to have a child with autism. Mothers with augmented labor were 16 percent more likely to have a kid with the disorder. If a mother had both methods used on her, the child was 27 percent more likely to be diagnosed with autism during childhood.

For comparison, the authors noted that a mom who had other pregnancy problems, like diabetes, increased the risk of autism in her children by 23 percent, and if the fetus was ever in distress, the chance went up 25 percent.

C-sections did not affect the rate of autism.

Play VIDEO
Study links flu with autism risk
Other conditions during pregnancy have recently been linked to increased autism risk. An August 2012 study showed that mothers who were obese were 67 percent more likely to have children with the disorder compared to those who maintained a normal weight during pregnancy.

Taking the anti-epilepsy drug valproate has been linked to a five-fold higher risk of having a child with an autism spectrum disorder in an April 2013 study published in JAMA. Exposure to air pollution while with child was also significantly connected to higher rates of autism, a June 2013 Environmental Health Perspectives study revealed.

Though the risk in the new study may seem alarming to some, Dr. Jeffrey L. Ecker, an obstetrician at Massachusetts General Hospital, told HealthDay that mothers shouldn’t be concerned if they need to have their labor assisted — nor should they go against their doctor’s recommendation.

“Women should not conclude that if they need induction or augmentation their child will have or be at high risk for autism. Nor should they seek to avoid induction (or) augmentation,” Ecker, who was not involved in the study, said. “The latter reaction would … almost certainly (increase rates of) cesarean delivery, an intervention that we know has important (negative) effects on both maternal and neonatal health.”

The study published in JAMA Pediatrics on Aug. 12.

“When my aunt is at work, I take care of my 4-year-old cousin who has autism. Her doctor says that developmentally she’s like an 18 month old. I’m writing because she has really bad separation anxiety. Every few minutes she asks when her mommy is coming. Do you have any suggestions on how I can help her feel more comfortable?”
This week’s “Got Questions?” answer is from child psychologist Michelle Spader, of Ohio’s Nationwide Children’s Hospital, a member of the Autism Speaks Autism Treatment Network.
Thanks for your question. It’s helpful to know that your cousin is developmentally like an 18 to 24 month old. Children at this stage often have separation anxiety. So your cousin seems to be going through something that’s both common and normal. Sometimes separation anxiety eases over time. Meanwhile, here are some suggestions to help her through the day:
Talk with her autism therapy team
Hopefully your young cousin is receiving autism-related therapy. So first and foremost, I encourage you and your aunt to enlist the members of her therapy team in addressing her separation anxiety. A speech therapist, for example, can help her learn language related to understanding past, present and future. An understanding of “future,” in particular, can help her grasp that her mommy will come for her. Her behavioral therapist or psychologist can help your young cousin develop coping strategies.
Say it with pictures and stories
Children with autism or other developmental delays often do better with visual supports than repeated verbal explanations. For example, you can create a “Where is Mommy?” page. On the paper, paste a picture of her mom at her workplace. Next to it, have a picture of your young cousin with you in your home. When she asks if her mommy is coming, point to the picture of her mom and say, “Mommy is at work right now.” Then point to the picture of the two of you in your home and say, “She’s coming here to pick you up this evening.” (Learn more about visual supports and download the AS-ATN/AIR-P Visual Supports Guide here.)
Similarly, you might try writing and illustrating a simple social story. Social stories are short narratives designed to help those with autism understand a situation. Your social story might be about a little girl who goes to stay with her older cousin while her mother is at work. Have it illustrate how the little girl misses her mother but comes to understand that her mom always comes to get her at the end of the day.
Create a daily schedule
Many individuals with autism crave predictable routines. Consider making a daily schedule that illustrates the order of your young cousin’s day. Start with the first thing that happens – perhaps “Say goodbye to mommy. Give her a kiss.” Include a photo or drawing.
The next picture should illustrate what she does next while in your care. Eat breakfast? Watch Sesame Street? Continue, in order, with the day’s predictable events (a snack, going outside to play, going to the store, etc.) The last picture will be of her mother walking into the door.
Now when your little cousin asks when mommy is coming, you can show her in the context of the day’s events.
Establish a separation routine
When your aunt leaves in the morning, it may help if she and her daughter have a simple, consistent and cheerful routine. This might be a kiss and saying, “See you later. I love you!” Please caution your aunt against sneaking out of the house when her daughter isn’t looking. In the short term, that may avoid tears. But it can backfire by causing greater anxiety.
I hope these tips prove helpful. Please let us know at GotQuestions@autismspeaks.org

By Linda Hatch, PhD

Some people can look at internet pornography now and then and not become porn addicts. Others get hooked on porn very quickly and spend hours online, often jeopardizing their work, neglecting their families and wrecking their relationships.

Why are some people more at risk for internet porn addiction?

We look immediately for childhood trauma but there may be other contributing mental health issues which can be treated in order to reduce the risks and optimize the result.

ADHD and hyperfocus

There is enough research to strongly suggest that adults with ADHD are at much higher risk for addiction in general, including sex addiction. (See also my blog on ADHD and sex addiction.)

Being glued to the computer screen for hours on end looking at pornography can be seen in adults with ADHD as a symptom of that disorder, namely hyperfocus (or more properly perseveration) which is a form of rigid attention. The ADHD adult is more likely to be a porn addict because he cannot tear himself away from the pornography, meaning he cannot shift his attention away from one thing and onto another as easily as someone else.

ADHD testing involves evaluating 4 main factors or dimensions of attention.

•Inattentiveness
•Distractibility
•Problems Splitting Attention
•Problems Shifting Attention
The last of these, the ability to shift your attention from one thing to another as needed, is the factor that most obviously relates to the fixation that ADHD folks can have on internet porn.

Autism Spectrum” Disorder and hyperfocus

Dr. Russell Barkley has argued that what we call the ADHD “hyperfocus,” should really be called “perseveration” a symptom of the frontal lobe issues in ADHD.

He argues that “hyperfocus” is a term that more appropriately relates to autism spectrum disorders, where the person has a problem connecting different areas of the brain. The two terms seem to be used popularly to describe similar behavior of disappearing into the stimulus or activity.

However the reference to autism intrigued me because I have noticed that some sex addicts who have great difficulty staying abstinent form internet pornography also seem to have some symptoms of high functioning autism or Asperger’s Disorder. They have trouble with social relating, trouble understanding social/emotional cues, are obsessive and may have special talents.

The hyperfocus of the mildly autistic or Asperger’s Disorder person (as well as their social disconnect) would tend to place that person at risk for getting drawn into a compelling activity like porn viewing and would make it harder for them to abstain.

Posttraumatic Stress and Dissociation

Dissociation is a symptom of PTSD, a “zoning out” that can be mild or very severe. It is likely that posttraumatic stress and its resulting dissociative symptoms would add to the risk for internet pornography addiction.

Research suggests that it is not only the adult with a history of childhood trauma but also the veteran with service related stress or anyone with acute or chronic stress could have a greater risk for dissociation and addiction in general, including a fixation on internet porn.

To complicate matters, there is research that found prior ADHD leads to greater vulnerability to PTSD in veterans.

Trauma and ADHD seem to be intertwined and create a chicken-egg issue for further research. But regardless, both PTSD and ADHD separately or together create the risk for attentional issues related to porn addiction.

Evaluate and treat attention issues for a better outcome

Anyone with pornography addiction should be fully assessed for co-occurring psychological issues. ADHD, trauma and high functioning autism can stand in the way of progress. If they are identified and treated the outcome looks much brighter.

By Margarita Tartakovsky, M.S.

ADHD Tip: 5 Tricks to Manage Time Wasters For many of us, managing time is tricky, especially thanks to the pull of technology. Everything is simply a click or keyword away. Maybe you even do what I do: You decide to be strict with yourself, and pledge to hyper-focus on your project.

You close Twitter and email on your computer. Maybe you use a program that blocks the Internet in hopes of getting at least 30 minutes of work done, distraction-free.

But then your mind starts to wander, and so does your hand. Before you know it, you’re checking said Twitter and email on your smartphone. Somehow Instagram and Feedly get checked, as well.

As clinical psychologist Ari Tuckman, Psy.D, writes in his excellent, comprehensive book More Attention, Less Deficit: Success Strategies for Adults with ADHD, “Fortunately and unfortunately, technology has given us constant and immediate access to all sorts of fun distractions.”

For adults with ADHD, managing time effectively is especially difficult, he says. On some days, it might even feel utterly impossible. If you have ADHD, you’re probably easily distracted and struggle with impulsivity. In his book Tuckman shares five ways individuals with ADHD can resist impulsive time wasters.

1. Reduce wasteful temptations.

“The fewer temptations, the fewer you need to resist,” Tuckman writes. So make it your goal to “eliminate potentially exciting stimuli before they occur.”

For instance, you might unsubscribe from email alerts and magazines you don’t read. You also might block specific websites. And if you’re out and about, you might avoid the stores you spend too much time and money in, he says.

2. Build in downtime.

Build downtime into your schedule. As Tuckman writes, remember that “you can only run at a breakneck pace for so long before crashing … slow and steady wins the race.”

Making downtime part of your days decreases the chances that you’ll take that time when you really can’t afford to.

3. Post visual reminders.

When an impulse strikes, it helps to remind yourself of your priorities, so you stay on track. Keep visual reminders front and center.

For instance, you might make your computer wallpaper the image of the tropical getaway you’re saving for. Or you might write the date of your work evaluation on a whiteboard in your office.

4. Use helpful self-talk.

It can help to talk yourself through your tasks. For instance, according to Tuckman, “tell yourself things like, “Write report first, check email second.”

5. Return to your task without flogging yourself.

Sometimes, some days, you can try your best to resist time wasters. But before you know it, you’re knee deep in email or Twitter or Facebook or some other activity that pillages your productivity.

If so, simply get back to what you were doing. Avoid disparaging yourself. As Tuckman writes, “No knocking yourself, no giving up hope — just do it.”

Time wasters can be hard to resist, especially if you have ADHD. Fortunately, you can reduce distractions and employ other tips and tricks to help you stay on task and on track.

What have you found to be helpful in managing time wasters?