Top Ten Tips for Parenting ADHD Kids

by Dr. Lara Honos-Webb

Published on December 8, 2010

1. Advocate for your child. This means you need to "spin" your child's behavior to friends, family and teachers. Has your child's antics been any worse than our leading politicians? Probably not. Imagine the spinmeisters on talk shows who try to get their politicians elected. Do the same for your child.

2. Coach your child to name and feel ok with all their emotions. Kids act bad when they are mad, sad or afraid. When you coach your child to tell you what she feels, her bad behavior will heal.

3. Look inside yourself. Sometimes kids act out unexpressed conflicts of their parents. Are you struggling with depression, anxiety, rage? Get help for yourself and your kids will shape up.

4. Think of yourself as a coach. Your job is to coach your child to success in social, emotional and educational settings. Sometimes the answer is practice, practice, practice. Don't get discouraged if you have to repeat yourself over and over again.

5. Ask yourself: "If my child's most frustrating behavior was meant to teach me something - what would it be?" Many parents find themselves half distressed and half impressed at their child's indifference to people pleasing. Sometimes this is just the lesson parents need to learn in their own lives - many parents have become imbalanced in attending too much to seeking approval from others.

6. Forget about the competition. Your child can still strive to be outstanding without it being about comparisons to other children. ADHD children are sensitive to tension produced by parents' competitiveness and the fear based motivation inhibits them.

7. Keep Yourself Alive! It takes a lot of energy to keep up with ADHD kids. You need to become your own energy source. Feed your own passions. If you are married work to increase your intimacy with your partner. If you are single, keep your own love life alive.

8. Honor the kernel of self-reliance in all acts of defiance. Every time your child doesn't do what you asked them to do, ask them for an explanation. Honor their independent thinking and consider what part of it you may want to incorporate into your discipline. Continue to insist that your child respect your rules while demonstrating respect for their own rhythm and logic.

9. Practice preventative medicine. Many times children's bad behavior is a misguided attempt to get some precious attention. Fuel your child up with the highest octane energy you can early in the day. Spend a few minutes being entirely present with your child. Look them in the eyes, touch them lovingly and listen closely to your child. This intense presence will give them what they need and head off desperate pleas for attention. Sometimes just a few minutes will prevent large energy draining hassles.

10. Connect with your child's teacher. Research has shown over many decades that your child's educational outcomes are very closely linked with how much the teacher  expects from your child. This is why you need to advocate for your child at the same time as you connect with your child's teacher. Show enormous respect for your child's teachers and try to forge a close alliance with him or her. They will go the extra mile for your child.




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ADHD and Medication: What's New?

by Tracy Packiam Alloway, PhD

To medicate or not? Research in children with ADHD.

Published on March 21, 2011

The topic of medicating individuals with ADHD is still controversial. That is why I am always interested when research on this topic is published. I was recently asked to write a commentary on one such article that will appear in ‘Developmental Medicine and Child Neurology'.

Children with ADHD exhibit deficits in both cognitive and behavioral domains. In particular, response inhibition has been proposed as a core element of individuals with ADHD that can impact both these types of functioning. Given the widespread prevalence of ADHD, with some reports as high as 16% of children receiving this diagnosis, treatment is a priority.

Stimulant medication, such as methylphenidate, is considered to improve certain cognitive functions in children with ADHD. The suggestion is that methylphenidate acts to increase levels of dopamine and norepinephrine, which are associated with attention and focus.

However, most research in this area has focused primarily on immediate-release stimulant medication. Clinical studies in continued-release of stimulant medication have produced mixed results and it is as yet unclear which cognitive and behavioral functions associated with response inhibition can be improved as a result of stimulant medication.

Thus, the authors-Blum et al-sought to investigate this issue. Children aged 6 to 12 participated in a double-blind placebo controlled crossover trial, using the individual's most effective dose of OROS- methylphenidate. The benefit of this approach is that neither the person administering the medication, nor the child taking it was aware of whether they were receiving the medication or the placebo. The conditions were then switched, so the Medication group took the placebo, and the Placebo group took the medication.

The findings indicated that hyperactive and inattentive behaviors (measured by both parent and teacher ratings) improved when the child was receiving their optimal dose of OROS- methylphenidate. Cognitive functions also improved in some cases, but not all. For example, the students were no better at tasks involving motor inhibition and working memory.

Studies like this one by Blum et al. are very valuable because they raise the issue of the efficacy in using this approach for individuals with ADHD. Amidst increasing concerns regarding side effects and the potential for abuse, some parents and clinicians are seeking alternative methods to ameliorate the cognitive and behavioral deficits associated with ADHD.

One promising alternative is adaptive working memory training, where the intensity and difficulty of working memory sessions are individually customized to the aptitude of the child. Traditionally, working memory was viewed as genetically fixed, and thus unable to be modified by an individual's environmental experiences or opportunities. However, an increasing body of recent studies has challenged this notion, demonstrating that considerable cerebral plasticity exists within the developing brain and that working memory capacity may potentially be improved by environmental intervention and support.

Such findings highlight important opportunities for improving the learning, behavioral and social opportunities of the large number of children with working memory problems. Working memory impairments are widely reported in students with ADHD, and several studies have found that adaptive working memory training can improve behavior ratings by parents (Klingberg et al., 2005), as well as IQ and attainment scores (Alloway, 2009).

Research like Blum et al.'s illustrates the limited impact of continued-release of stimulant medication and highlight the need to consider alternative forms of intervention. When such measures prove to be insufficient, then the option to prescribe stimulant medication can be discussed with a physician who is aware of the severity of the individual's symptoms. Care should also be taken when considered the type of stimulant medication-immediate vs. continuous release; as well as the optimal dose for the individual.

References

Alloway TP. Cognitive Training: Improvements in Academic Attainments. Professional Association for Teachers of Students with Specific Learning Difficulties 2009; 22: 57-61.

Klingberg T, Fernell E, Olesen PJ, Johnson M, Gustafsson P, Dahlstrom K. et al. Computerised training of working memory in children with ADHD -a randomized, controlled trial. J of the Am Acad of Child and Adolescent Psychiatry 2005; 44: 177-186.

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Study: Diet May Help ADHD Kids More Than Drugs

by NPR Staff

March 12, 2011

Hyperactivity. Fidgeting. Inattention. Impulsivity. If your child has one or more of these qualities on a regular basis, you may be told that he or she has attention deficit hyperactivity disorder. If so, they'd be among about 10 percent of children in the United States.

Kids with ADHD can be restless and difficult to handle. Many of them are treated with drugs, but a new study says food may be the key. Published in The Lancet journal, the study suggests that with a very restrictive diet, kids with ADHD could experience a significant reduction in symptoms.

The study's lead author, Dr. Lidy Pelsser of the ADHD Research Centre in the Netherlands, writes in The Lancet that the disorder is triggered in many cases by external factors — and those can be treated through changes to one's environment.

"ADHD, it's just a couple of symptoms — it's not a disease," the Dutch researcher tells All Things Considered weekend host Guy Raz.

The way we think about — and treat — these behaviors is wrong, Pelsser says. "There is a paradigm shift needed. If a child is diagnosed ADHD, we should say, 'OK, we have got those symptoms, now let's start looking for a cause.' "

Pelsser compares ADHD to eczema. "The skin is affected, but a lot of people get eczema because of a latex allergy or because they are eating a pineapple or strawberries."

According to Pelsser, 64 percent of children diagnosed with ADHD are actually experiencing a hypersensitivity to food. Researchers determined that by starting kids on a very elaborate diet, then restricting it over a few weeks' time.

"It's only five weeks," Pelsser says. "If it is the diet, then we start to find out which foods are causing the problems."

Teachers and doctors who worked with children in the study reported marked changes in behavior. "In fact, they were flabbergasted," Pelsser says.

"After the diet, they were just normal children with normal behavior," she says. No longer were they easily distracted or forgetful, and the temper tantrums subsided.

Some teachers said they never thought it would work, Pelsser says. "It was so strange," she says, "that a diet would change the behavior of a child as thoroughly as they saw it. It was a miracle, a teacher said."

But diet is not the solution for all children with ADHD, Pelsser cautions.

"In all children, we should start with diet research," she says. If a child's behavior doesn't change, then drugs may still be necessary. "But now we are giving them all drugs, and I think that's a huge mistake," she says.

Also, Pelsser warns, altering your child's diet without a doctor's supervision is inadvisable.

"We have got good news — that food is the main cause of ADHD," she says. "We've got bad news — that we have to train physicians to monitor this procedure because it cannot be done by a physician who is not trained."

Article retrieved from: http://www.npr.org/2011/03/12/134456594/study-diet-may-help-adhd-kids-more-than-drugs?ps=rs

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FDA Holds Off On New Heart Warnings For ADHD Medicines

by Scott Hensley

Steady as you go on ADHD medicines.

The Food and Drug Administration has finally received data from a massive analysis of health records to tease out whether there is a link between normal use of ADHD medicines and potentially lethal heart problems. And, for now, the FDA says it's not recommending any changes in safety instruction or use of such popular meds as Vyvanse and Adderall.

The agency has been looking at a possible link between the drugs for attention deficit/hyperactivity disorder and sudden cardiac death in otherwise healthy people since 2009, when a federally funded study suggested there might be one.

The study that sparked concern compared ADHD drug use among 564 young people (ages 7 to 19) who died suddenly from unexplained causes with an identical number killed in car crashes. Ten of the young people who died suddenly were taking ADHD meds compared with just two in the group who died in accidents. Those results were published in the American Journal of Psychiatry.


The agency noted a bunch of limitations with the research at the time and told parents not to stop kids' ADHD meds. Still, the agency said it would look into the issue.

In search of a more definitive answer, the FDA and the federal Agency for Healthcare Research and Quality teamed up to sponsor a look at health data for more than 500,000 people taking ADHD meds and 1 million people who weren't. Analysts also planned to pore over about 2,000 medical charts from hundreds of different hospitals.

The work took a lot longer than expected. So the preliminary findings, originally due in late 2009, have finally rolled in. The FDA has started reviewing them and doesn't seem worried. In a brief update online, the agency said:

    At this time, FDA is not recommending any changes to the drug labels and/or the use of these medications.

    FDA will update the public after the results of the final analyses are evaluated.

The current instructions for ADHD drugs, which are stimulants, say that misusing them "may cause sudden death and serious cardiovascular adverse events."

Article retrieved from: http://www.npr.org/blogs/health/2011/04/08/135234171/fda-holds-off-on-heart-warnings-for-adhd-medicines

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New Online Training For GPs - Identifying And Managing Autism Spectrum Disorders

Identifying and managing children with autism spectrum disorders (ASD) is the focus of a new online active learning module created by the Royal Australian College of General Practitioners (RACGP). 

The new Autism spectrum disorders Category 1 active learning module is available on the gplearning website and is suitable for GPs and paediatricians. Autism spectrum disorders highlights the importance of early identification and diagnosis, initiation of early intervention and family and individual support as a means of maximising outcomes for children and families affected by an ASD. 

Dr Ronald McCoy, RACGP spokesperson, said the rate of ASD diagnosis is increasing significantly within the Australian community and this new active learning module will provide GPs with timely and valuable insights into autism spectrum disorders. 

"The early diagnosis of autism spectrum disorder is the key to providing early intervention so that patients and their families can achieve the best outcomes, 

"For this reason, this learning activity places a strong emphasis on 'red flags', which are clinical symptoms and signs that help clinicians pick up autism early. 

"We've been incredibly fortunate in being able to achieve this through the creation of many new videos that plainly illustrate specific clinical symptoms and signs. This was only achievable through the generosity of families affected by ASD. 

"This module provides doctors with the skills to address the many myths that surround ASD, such as bogus causes and treatments that are widespread throughout the community. 

"In addition, case studies, interviews and actual clinical images provide a unique interactive learning opportunity for clinicians to become thoroughly acquainted with the current evidence based, state-of-the art approach to ASD in Australia," Dr McCoy said. 

By the end of the module, participants should be able to: 

- counsel and support patients, parents, family members and others affected by ASD, through diagnosis, treatment and ongoing management of ASD 
- discuss the evidence base for aetiology (study of causes) and management of ASD including medications, behavioural and educational interventions 
- describe the diagnosis, prognosis and management of ASD throughout key milestones and throughout a person's lifespan 
- discuss the multidisciplinary framework of care in ASD 
- identify barriers to delivering services for ASD e.g. rural location 
- identify individuals with possible ASD, including differential diagnoses 
- list the 'red flags' for ASD and be able to systematically implement identification of children with ASD, including using the practice systems. 

The new activity is supported by funding from the Australian Government Department of Health and Ageing and has been approved by the RACGP QI&CPD Program for 40 Category 1 points in the 2011-2013 triennium. 

This active learning module should take approximately 6.5 hours to complete. Participants can access and exit activities at their convenience. 

The following four learning activities are available as Category 2 activities but are included as part of this learning module: 

- the early detection of autism spectrum disorders (ASD) 
- selecting and assessing interventions for ASD 
- educational interventions for ASD 
- working with families managing ASD. 

Source: 
Royal Australian College of General Practitioners (RACGP) 
  

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Students Who Build Brain Fitness Improve Performance on State Tests

Students Who Build Brain Fitness Improve Performance on State Tests

Mar. 29, 2011 (Business Wire) — On state tests administered each spring, even bright young learners worry about their performance. Take Garrett, for example. The son of an elementary school principal, Garrett had the benefit of a strong preschool education and dedicated parents who read with him every day. Yet, Garrett struggled with reading in first and second grades, and scored below grade level on the Idaho Reading Indicator (IRI).

Then, in the third grade, everything changed. Garrett gained 3.7 years of growth, jumping from a second-grade to nearly a sixth-grade reading level. For the first time, he also scored at the proficient level in reading on his state test, the Idaho Standards Achievement Test (ISAT). What changed? From September to April, Garrett participated in a brain fitness program called Fast ForWord® that exercised his cognitive muscles and improved his brain function. This allowed Garrett to better take advantage of the content presented to him in school and at home, and maintain an accelerated rate of learning even after the program ended.

As Garrett’s story illustrates, successful preparation for state tests involves more than high quality, standards-based subject area instruction. Forward-thinking schools are accelerating learning and improving performance on high-stakes tests by building students’ brain fitness. By exercising the parts of the brain that contribute to learning — memory, attention, processing and sequencing — schools can improve students’ ability to learn and retain knowledge.

At Discovery Elementary, the Title I school in Idaho Falls where Garrett’s father, Ken Marlowe, serves as principal, students began using the Fast ForWord software in 2008 to exercise and train their brains to process more efficiently, and build critical reading skills. In 2010, students in grades three through six made significant gains on the ISAT in reading, language usage, and math. For example, from 2009 to 2010, the percentage of Discovery Elementary students achieving proficiency jumped from 86 to 95 percent in reading, 81 to 84 percent in language usage, and 85 to 95 percent in math. In addition, Discovery Elementary students surpassed district averages across all subjects.

“I have found the Fast ForWord program to be the difference maker in meeting the ever-growing expectations of student proficiency in reading, language, and math. This is not only true for the students I work with at Discovery Elementary, but for my own son as well,” said Marlowe. “Now, of course, I wondered if these skills would carry forward or not after a student stops using the Fast ForWord program. I’m here to tell you that at the end of fourth grade, my son scored in the advanced range on all state tests in reading, language, and math. The Fast ForWord program really turned things around for him. He went from dreading to read to loving to read, and you can’t stop him now. It’s a tribute to the Fast ForWord program and what it’s able to do. Students maintain their gains even after the program ends. And that’s just one story. I’ve got a school full of them.”

Building brain fitness can also improve high school students’ performance on state tests. At Collins Career Center, a vocational school for 11^th and 12^th graders in rural Chesapeake, Ohio, students improved their reading skill levels and achieved significant gains on the Ohio Graduation Tests (OGT) in reading, writing, mathematics, science and social studies. In 2009, for example, students who used the Fast ForWord program achieved a 10-to-1 gain over their peers on all five tests of the OGT.
“I was flabbergasted at how quickly we were able to move students forward in their reading ability and comprehension after purchasing the Fast ForWord program,” said Stephen Dodgion, superintendent of the Lawrence County Joint Vocational School District. “We were so excited about the results, we felt we needed to get the software to every student on this campus. Our scores have gone up considerably and I feel strongly that it is a result of this software.”

About Scientific Learning Corp.
We accelerate learning by applying proven research on how the brain learns. Scientific Learning’s results are demonstrated in over 200 research studies and protected by over 55 patents. Learners can realize achievement gains of one to two years in as little as eight to 12 weeks and maintain an accelerated rate of learning even after the programs end.

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Goodnight Room: Story Strategies for Building the Best Bedtimes

March 8, 2011 by Martha Burns, Ph. D

Remember Good Night Moon by Margaret Wise Brown? When I think of this book, I think about how the bunny is snuggled into bed, toys put a way, moon peeking in through the window, and everyone and everything is whispering “good night.” I’ve noted that the “old lady whispering hush” is rocking in her chair far across the room, and the book The Runaway Bunny sits on the bedside table; story time has ended for this little bunny and now it’s time for sleep.
Everything is perfect and quiet. What might the perfect story time have looked like in that “good night room” 15 minutes before the book opens? First of all, the old lady would have been sitting much closer, maybe on the edge of the bed. And her soft, clear voice would be helping that little bunny not only relax, but learn to love books as well as solidify the rudiments of language.
Whenever possible, make a consistent habit of 15-30 minutes each evening to tell or read stories before bed. Just as it did for your child at a year of age, for your tot it will serve two purposes: quiet him down and prepare him for sleep, as well as introduce the repetition of words and sentence forms that build the school-important left hemisphere. As your two-year old begins to develop a love of specific books or stories, you will have a wealth of material to settle her down on car and plane trips where sitting still for long periods is mandatory.
And remember, a bedroom is usually the quietest room in a home. All the soft materials (the bedding, window coverings, rugs, and even “goodnight socks and bears”) actually absorb what hearing specialists call ambient noise, rendering your speech clearer and easier to perceive. Reading in this quiet room helps your child learn to discriminate the subtle differences in speech sounds. As a bonus, if you read or tell stories to your tot in the bedroom, where you will be sitting right next to him, you will be providing the best speech signal available. The easy rule I use to describe this is, “An arms span, from mouth to ear, makes sure all bunnies’ hearing is clear.”
It probably doesn’t matter what stories you tell or read. It is the natural clarity of the speech signal that occurs in a ”goodnight room,” the repetition that results from your child’s own preference for certain stories, and the closeness and attention that the child receives from the most important people in her life that make this short period of the day so important to your child. And, it goes without saying that the benefit to you will be that after this small investment of time, you will have some time to yourself to relax, read, enjoy a favorite television show, or just interact with your spouse.
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