Why observing Behavior of a child in Multiple Settings is vital for the ADHD diagnosis process?

Aniesa Schneberger, a licensed mental health counselor at Tampa Life Change, says it’s necessary to observe whether or not a child is routinely acting inattentive or hyperactive – or both – while in a variety of settings. ADHD symptoms, she says, should be prevalent in at least two environments, which is another DSM-5 criterion.

For example, if a child is acting out at school but not at home, then this could indicate an ability to control their behavior. If this is the case, it may not be a sign of ADHD after all.

“This is an important one,” she says, adding that a child with ADHD can’t switch their symptoms on and off depending on the environment. Behavioral consistency across a host of settings is a telltale indication that a child may have this disorder. It’s also the reason why obtaining a diagnosis when a child is under the age of 5 – the traditional age of entering school or a structured learning environment – can be challenging. Without exposure to various environments to serve as a basis for comparison, it’s difficult to accurately assess if a child has ADHD. “Because of this, children are typically diagnosed around the age of 5 or 6, after being involved in these types of environments for a couple of years,” Schneberger says.

Another reason it’s important to observe your child in a variety of settings is to take note of their interaction with others. In particular, look for behaviors that are inconsistent with children their age. “It’s important to take note of how your child is interacting with other children,” Schneberger says. “Often times children diagnosed with ADHD can be intrusive during activities and conversations, don’t respect the space of other children and can’t seem to wind down when playtime is over while other children are resting.”

Additionally, medical exams, which involve vision and hearing screenings, are also part of this assessment, as is involvement of pediatricians, psychiatrists, psychologists and psychotherapists. “The diagnosis will involve information from various sources,” she says.

Taken from http://health.usnews.com/wellness/articles/2017-03-29/im-worried-my-child-has-adhd-what-can-you-tell-me-about-the-disorder

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‘I Got This’ app helps kids with ADHD stay focused — and helps their parents keep them on track

Developer has ADHD and has kids with ADHD, too

When Rich Schramm was a child, he had teachers who tried to deal with his attention-deficit/hyperactivity disorder (ADHD) by beating it out of him.

“I got swats for not bringing my pencil to class,” the Montgomery resident said.

Now, he’s come up with a more humane solution: I Got This LLC, a startup that makes an app of the same name designed to help kids with ADHD stay focused and help parents keep them on track.

WCPO Insiders can learn how this new app works, why it’s different than other apps for ADHD, and what it will cost.

Know more @ http://www.wcpo.com/news/insider/i-got-this-app-helps-kids-with-adhd-stay-focused-and-helps-their-parents-keep-them-on-track

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What’s Causing The Increased Rate Of ADHD?

The rate of ADHD diagnosis in children, teens and adults is increasing. In the United States, the Center for Disease Control documents that in 2003, 7.8% of children had ever been diagnosed with ADHD. In 2011, the rate had gone up to 11%. There are also recent increases in teens and adults diagnosed with ADHD. With such a significant increase in diagnosis, people wonder: Why is the rate of ADHD going up?

There are common theories about why ADHD is diagnosed more often. They include: More awareness of the condition, better recognition and diagnosis, pharmaceutical marketing, educational reforms and more. But recent research may hold a suprising answer. It relates to smoking during pregnancy.

Maternal smoking during pregnancy causes an increased rate of ADHD in their children. The research suggests that nicotine harms a baby’s developing brain. The impact on the baby’s brain makes it more likely to be diagnosed with ADHD later on. This is an environmental cause of ADHD, and suggests we could lower the risk of ADHD by helping pregnant mothers to quit smoking.

But that may not actually solve the problem…

New research is showing that smoking during pregnancy leads to a multi-generational change in risk for ADHD. This risk is transmitted through the mother’s side of the family. In other words, if the maternal grandmother smoked during pregnancy, then her child and her grandchild is at higher risk of developing ADHD. Cigarette smoking’s effect on brain development reaches down the generations, beyond just one.

Realizing that smoking was common in the twentieth century, many of our parents and grandparents smoked. Mothers didn’t know they needed to stop smoking during pregnancy. Doctors didn’t realize that smoking in pregnancy could increase the risk of ADHD in the child. They certainly didn’t realize that smoking during pregnancy could lead to a multi-generational risk in the occurrence of ADHD. Smoking mothers 2 generations ago contributed to the current increased levels ADHD, without knowing it.

When we look at current smoking rates, they are lower than they were in the twentieth century, but a significant number of people still smoke. Research in ADHD shows that teens and adults with ADHD are two times more likely to smoke cigarettes than non-ADHD individuals. We also know that ADHD is highly heritable – i.e. it is passed genetically through families. When we combine the genetic risks for ADHD with the fact that adults with ADHD are more likely to smoke cigarettes, there are significant risks here.

Public health measures can support women to stop smoking before or during pregnancy. This may lower the rate of ADHD in their children. It will also help their grandchildren – in other words, the multi-generational impact of smoking can be lowered.

ADHD is a complex neurodevelopmental condition. Its causes are not fully known. Cigarette smoking in pregnancy gives us an environmental cause of ADHD which affects a child’s brain development. It doesn’t provide the whole answer to why the rate of ADHD is increasing, but it is still an important one.

Know more @ http://www.huffingtonpost.ca/dr-kenny-handelman/childhood-adhd-rates_b_15470714.html

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ADHD Meds May Not Improve Symptoms But Can Lead to Height Reduction

Children with ADHD who take medication until adulthood may end up significantly shorter than their peers, according to new data from a long-term study — without a corresponding decrease in ADHD symptoms to make up for it.

The Multimodal Treatment Study (MTA) is a long-term follow-up study — funded by the National Institute of Mental Health (NIMH) — that began as a 14-month trial comparing the efficacy of medication and behavior therapy as childhood ADHD treatments. After its primary results were published in 1999, the study continued as an observational study, with follow-up assessments taking place every two years. The study focuses on 515 patients with ADHD — who were between the ages of seven and nine when the study first started — along with 289 control subjects of the same age.

The latest results, published March 10 in the Journal of Child Psychology and Psychiatry, showed that the (now adult) patients who had continued to take stimulant medication to treat their ADHD were, on average, 2.36 centimeters shorter than their counterparts with ADHD who had stopped taking medication or who took it only periodically. But the two groups showed no difference in symptom severity — though members of the former had, on average, taken more than 100,000 mg. of stimulant medication over the course of their lifetimes.

Taken from http://www.additudemag.com/adhdblogs/19/12385.html

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CBC documentary explores ADHD in adults

ADHD: Not Just for Kids examines why the disorder, most commonly diagnosed in children, is often undetected in adult

Director Michael McNamara decided to make a documentary about attention deficit hyperactivity disorder (ADHD) in adults after learning that a friend and colleague was diagnosed with it at the age of 56.

His friend’s diagnosis had upended McNamara’s assumptions about the disorder, which is most commonly diagnosed in school-aged children. Until then, he didn’t know it could affect individuals into adulthood. But as he began researching and conducting interviews for the film, McNamara found the main symptoms, including inattentiveness, procrastination and impulsiveness, seemed all too familiar.

It turns out McNamara has ADHD himself.

His film ADHD: Not Just for Kids, premiering on CBC’s The Nature of Things on March 16, examines why ADHD often goes undetected in adults. It explores research into the biology of the disorder, how it affects individuals’ lives and how adults cope with the symptoms.

As McNamara explains to The Globe and Mail, many adults may be struggling with the disorder as he did, without realizing they have it.

How common is ADHD in adults?

It’s estimated the percentage of children worldwide who have the disorder is about 7 per cent. Not all of those kids actually get diagnosed or treated. In about half of those kids, it will carry on into adulthood. There’s varying levels and severity of symptoms, so it’s kind of hard to put a figure on, but somewhere around 2 per cent or 3 per cent of adults have it.

What symptoms did the adult subjects of your film have in common?

The primary one is inattentiveness, an inability to concentrate. Hyperactivity, adults don’t tend to have the same way children do, which is one of the reasons they fall under the radar. They have problems organizing their time and their schedules, procrastination, having an inability to get a task started and following through, and also problems with short-term memory.

All of these are part of a host of skills we have in our brains called executive functions. The experts figure executive functions are affected by the neurotransmitter dopamine. With ADHD, it’s believed there’s a problem with dopamine reaching certain parts of your brain – the supply is low, and that may be the root of the symptoms.

At what point did you find out you have ADHD?

I was initially kind of skeptical. I thought, “Okay, I’m projecting myself onto this.” It was about four or five months before I actually did the tests, went to a specialist and went through the battery of things you go through when you’re diagnosed. And they’re like, ‘Oh yeah. For sure. You have it with flying colours.’

What was your reaction?

It was kind of a relief in a lot of ways. There were some symptoms that had always given me problems, such as procrastination and having an inability to focus. I still have problems with some of those things. But now that I have a diagnosis, I’m better able to figure out why they’re happening and not kick myself for not trying hard enough. It makes a very big difference when you can actually put a name to why certain things are so easy for some people and you have such a hard time doing them.

Why is ADHD in adults often missed or misdiagnosed?

From my own discussions with medical professionals and others, general practitioners don’t tend to know a lot about it. It’s one of those things that gets covered in medical schools very quickly. There are still a few medical professionals who don’t quite believe in it.

And ADHD kind of looks like normal behaviour, but exaggerated. Everyone may have a hard time getting started with things they don’t want to do, or lose track of time. But this is chronic, it’s a whole host of these things all at once, and it happens in all areas of your life – at home, at work, in relationships. So because it looks like normal behaviour, when you go to your doctor and your doctor asks, ‘How are you feeling?’ you’re probably feeling fine. But the doctor might not ask, ‘How are you doing?’ And well, you might be having all sorts of problems in your life.

With hyperactivity in particular, people expect to see someone who fidgets and can’t keep still in a meeting. There are adults who have those problems, but they tend to find socially acceptable ways of dealing with it. For instance, at a meeting, they might excuse themselves and go to the washroom.

Know more @ http://www.theglobeandmail.com/arts/film/cbc-documentary-explores-adhd-inadults/article34302160/

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Nonadherence to ADHD Medication in Adolescents Transitioning Into College

Nonadherence to ADHD medication in adolescents, especially during their transition to college, can have significant repercussions on academic performance and long-term goals. In a recent study, published in the Journal of Adolescent Health, 10 freshmen with ADHD were interviewed regarding their medication self-management experience as they transitioned to college life.

Nonadherence to medical treatment is a major problem, especially in adolescents and young adults whose nonadherence rates can be as high as 75% for chronic illnesses. Majority of nonadherence studies in adolescents have primarily focused on illnesses like asthma, cancer, HIV, and diabetes. However, very little adherence literature exists on conditions that affect mental health, like attention-deficit/hyperactivity disorder (ADHD) characterized by inattention, hyperactivity, and impulsivity. Nonadherence to ADHD medication can have significant consequences for individuals including greater symptom severity, poor academic performance, less productivity, decreased focus, and impaired communication skills. Long-term consequences can include the inability to successfully complete college degrees, little to no progress in career development, poor social life, and low work performance ratings. It is important to better understand the challenges individuals with ADHD face, especially while transitioning to college. Complications at this stage of life can have significant long-term repercussions on social health and career development.

A recent study, published in the Journal of Adolescent Health, interviewed 10 freshmen with ADHD, to better understand the experiences and challenges they face during their transition to college. All 10 participants were 21 years of age or younger, in their second semester of college, living away from home, and taking daily oral medication for their ADHD. Over the course of the study, several important themes emerged. For starters, participants reported not being fully prepared for the abrupt transition to independence in college. Before college, parents were highly involved in the participant’s medical care, whereas after transition to college, responsibilities were primarily shifted to the individuals themselves. Participants reported saying that the transition to college was a “smack in the face” and “kind of a shell shock”. Furthermore, purposeful nonadherence to medication was common amongst participants. This is due to inaccurate beliefs about their ADHD, the desire to avoid medication’s negative side effects, and the participant’s belief that they would eventually outgrow their ADHD. As a consequence of skipping medication, participants were more likely to skip and fail classes, and had difficulties focusing on particular tasks like studying or completing assignments. In addition, participants expressed pressure from peers to share their medication, which negatively affected their social functioning and adherence. Selling their medication impacted their daily functioning, whereas not selling their medication led to a loss of significant friendships and social standing. All 10 individuals expressed that ADHD was an isolating experience. They reported that guidance from higher year mentors with ADHD or academic counselors, specifically trained to work with ADHD individuals, could have made their transition much easier.

As a consequence of skipping medication, participants were more likely to skip and fail classes, and had difficulties focusing on particular tasks like studying or completing assignments. In addition, participants expressed pressure from peers to share their medication, which negatively affected their social functioning and adherence. Selling their medication impacted their daily functioning, whereas not selling their medication led to a loss of significant friendships and social standing. All 10 individuals expressed that ADHD was an isolating experience. They reported that guidance from higher year mentors with ADHD or academic counselors, specifically trained to work with ADHD individuals, could have made their transition much easier.

The study revealed that the transition to college for adolescents with ADHD can be a very daunting task. Freshmen with ADHD expressed not being prepared for the transition and lacking self-management skills. They also reported inaccurate beliefs regarding their condition, academic demands, and medication side-effects, which contributed to their nonadherence. Furthermore, this nonadherence contributed to negative impacts on school performance and social standing. Parents are encouraged to continually teach their children self-management skills, provide rationale for specific health behaviors, and continually be involved in their children’s care. Furthermore, continued psychoeducation, long after diagnoses, could help individuals understand their condition better and therefore cope with it more appropriately. Finally, better support systems, whether it be continual monitoring by parents, networking with peers that have ADHD, or counselors trained to work with ADHD individuals, can significantly improve adolescents transition to college.

Know more @ https://www.medicalnewsbulletin.com/nonadherence-adhd-medication-adolescents-transitioning-college/

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First Ever App for ADHD Families, iGotThis, Launches Kickstarter Campaign

iGotThis, LLC. of Cincinnati, Ohio has launched a Kickstarter Campaign for the iGotThis solution.

“iGotThis is the first task management system designed specifically for ADHD families. It helps ADHD kids get stuff done and stay focused, while building their self-esteem. It has a built-in rewards system and badges to keep them motivated and gives real-time notifications to parents so they stay in the loop without hovering.” explains iGotThis founder, Rich Schramm.

Over 6 million children in the US alone have Attention Deficit Hyperactivity Disorder and NIH studies show that children with ADHD are much more likely to have low self-esteem, sometimes “pathologically low”.

“We are parents of three amazing kids who also have ADHD and I had it as a child myself. We needed a productivity tool to keep our kids, and ourselves, on track and also something that would help build self-esteem in our kids. We searched the market and found nothing designed for our kind of family, so we decided to build it ourselves.”

iGotThis delivers many features uniquely designed for families with kids having ADHD, including:

  • “Failsafe” Reminder System – ensuring kids can’t forget to start and complete tasks
  • Real-Time Parental Oversite – Parents keep tabs on what kids are doing from anywhere.
  • Built-in Rewards System – Kids earn tokens and redeem them for parent managed rewards.
  • Badges – More positive reinforcement through game dynamics.
  • ADDitives – Inspirational messages about ADHD

“Our goal was first, and foremost, to provide a tool to help ADHD families function better”, Schramm explains. “But our other priority is on building self-esteem in these kids by ensuring a stream of successes, providing positive reinforcement, and delivering inspirational messages.”

Users will sign up at the iGotThis.com web site and the app will be available to download in the Apple (NASDAQ:AAPL) App Store and the Google (NASDAQ:GOOGL) Play store upon release. There are also “voice apps” being released for Amazon (NASDAQ:AMZN) Echo and Google Home smart assistants.

The solution also features web and mobile dashboards, location based reminders, comprehensive task customization, optional project tracking, checklists and planning wizards for parents. Easy to use walkthroughs and video tutorials help everyone get the most of the solution from the first day

Taken from http://www.wbiw.com/state/archive/2017/03/first-ever-app-for-adhd-families-igotthis-launches-kickstarter-campaign.php

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Benefits of long-term use of ADHD medications questioned

In a study that followed more than 500 children with attention-deficit/hyperactivity disorder (ADHD) into adulthood, extended use of stimulant medication was linked with suppressed adult height but not with reduced symptoms of ADHD.

The findings suggest that short-term treatment of ADHD with stimulant medication is well justified by benefits that outweigh costs, but long-term treatment may be associated with growth-related costs that may not be balanced by symptom-related benefits.

“The most recently published guidelines (American Academy of Pediatrics, 2011) recommend expanding the diagnosis and treatment beyond school-aged children and using stimulant medication as first-line treatment for adolescents as well as school-aged children,” wrote the authors of The Journal of Child Psychology and Psychiatry study. “Since this would increase the average duration of treatment and cumulative ME dose of medication in some individuals, the findings suggest growth-related costs may increase.”

Taken from https://www.sciencedaily.com/releases/2017/03/170313134942.htm

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ADHD kids way more creative than peers: Study

To most, a child with Attention Deficit Hyperactive Behavior (ADHD) is a person with disability. But a recent research in the city has shown that ADHD kids are more creative than their peers.

The research, titled Neural Alterations in ADHD Children of India, was carried out by Center for Bio Medical Research (CBMR) and psychiatry department of King George’s Medical University. Using advanced MRI, the researchers evaluated brain structure of ADHD kids and found that though they have subnormal neuro-anatomical structure, their creative sense is more evolved.

Principal author, assistant professor, CBMR, Uttam Kumar said, “In the course of study of the brain, several behavioural and IQ assessment exercises were also given to the kids which suggested that they were creative. It was also found that they liked certain activities more than other things which means that they can excel in a task of their liking. The findings are being examined further.”

Kumar, a neuro-imaging specialist, along with Prof Vivek Agarwal and Dr Amit Arya, has proved the utility of ‘Voxel Based Cortical Thickness’ and ‘Morphometry Analysis’ tools on ADHD kids, a one of its kind effort. While Voxel based cortical thickness is used to calculate the grey matter in the brain, Morphometry analysis is the quantitative measure of white matter, grey matter and distribution of the brain fluid.

“Grey and white matter are crucial brain cells that control central nervous system. A skewed ratio of the two translates into abnormality,” said Prof Agarwal. They have found that different regions of an ADHD child’s brain are anatomically different from the brain of a normal child.

Researchers claim that the work, which has been published in Brain and Development Journal (a high impact official journal brought out by Japanese society of Child Neurology), will help in early diagnosis of ADHD and a holistic individual specific treatment / management plan.

As of now, a psycho-behavioural questionnaire is used to conclude if a child has ADHD or not. “A lot of stigma is associated with ADHD and parents of such children treat them as people with disabilities. But the scenario isn’t as grim as commonly perceived. The biggest fear of such parents is that the child will always be dependent on others,” said Dr Arya.

An early diagnosis and inclusion of activities can shape an ADHD kids into creative people who can sing, paint or master a handicraft. “We can say this because our assessment showed that there is no significant difference in the total grey matter and white matter of ADHD kids when compared with their peers,” said Kumar.

The researchers claimed that ADHD kids should be exposed to several activities like bead making and colouring to prolong their attention span and build concentration.

Know more @ http://timesofindia.indiatimes.com/city/kanpur/adhd-kids-way-more-creative-than-peers-study/articleshow/57610876.cms

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Quality improvement project helps pediatricians diagnose, manage ADHD

A pilot project to improve the care of children with attention-deficit/hyperactivity disorder (ADHD) led to a reduction in symptoms as well as increased confidence among pediatricians in diagnosing and managing the disorder.

The Chapter Quality Network (CQN) led the project from December 2015 through January 2017 to improve the quality of care processes and outcomes by implementing the Academy’s clinical practice guideline on ADHD. Pediatricians, practices and chapters from Arkansas, Georgia, New York Chapters 1 and 2, Ohio and Texas used quality improvement (QI) methods to test evidence-based care processes and embed them into their workflows. They also participated in monthly calls to share best practices and review data, and attended four learning sessions.

At the end of the project, children with ADHD experienced a 12% reduction in symptoms, as measured by parent and teacher assessment. Furthermore, 70% of providers reported increased confidence in diagnosing ADHD and 83% reported increased confidence in managing and treating ADHD.

“With this grant, pediatricians have become comfortable evaluating, diagnosing, treating and providing ongoing care for the child and families with ADHD,” said Joseph J. Abularrage, M.D., M.P.H., M.Phil., FAAP, project physician leader from New York Chapter 2. “That’s been a big positive for the children, the families, the pediatricians and the neurologists in New York City who, in general, were actually happy to shift ADHD patients away from them.”

Know more @ http://www.aappublications.org/news/2017/03/09/Chapters030917

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