next meeting:Motivation, Alienation and ADHD

Not   the usual how to motivate yourself with ADHD, but a discussion of    possible interactions between the motivation problems that we, as people with ADHD are especially prone to, and alienation in modern life arising from compartmentalisation of different aspects of life; work, family, social, school and neighbourhood.

Hopefully some practical ideas for bringing immediacy and meaning to our work will emerge …  More Background to this topic below this message

Background: link to  an interview with Dr Rogoff , who  inspired this topic

  Some researchers have emphasised that motivating children to learn the skills they need is not only not a problem; but also an unimaginable problem to adults in unschooled societies   to e.g.

In contrast to American parents, who seem to feel that knowledge is something like medicine – its good for the child and must be crammed down his throat even if he does not like it – Rotuman parents acted as if learning were inevitable because the child wants to learn. (Howard, 1970)

Rogoff and others have shown that children (and adults) in a range of unschooled societies are self-motivated to learn through observation and intent participation in the meaningful work of their community *.  However, schooled societies seclude children    from the work and concerns of parents and communities into age graded cells to   learn abstract material presented and organised for them by an unrelated adult in preparation for uncertain future work of an unknown nature. This industrial mechanisation of children’s learning is both influencing   and influenced by the segregation and  organisation of   adult work environments

* Also interesting is that the unschooled learner’s attention is described as broader than schooled learners, variously as ‘simultaneous time shared’ (Correa-Cha ́vez, Rogoff, & Mej ́ıa Arauz, 2005) ‘or ‘open ‘ attention. (Gaskins & Paradise, 2010) A form of attention hypothised to support observational learning of complex skills by facilitating event detection and processing of a broad range of information.

Thus   there is no one optimal attentional style for all learning: raising the question if interindividual differences in attention were adaptive in other environments? Another time!

Christmas Quiz

A. The nitty gritty – medical conceptualisation and treatment of ADHD

1) What does the DSM in DSM-IV (the influential American guide to diagnosis often used in Europe to guide ADHD diagnosis) stand for? (2)

a) Diagnostic, Standardised Manual of Mental Disorders

b) Dictionary of Symptoms of Mental Disorders

c) Diagnostic and Statistical Manual of Mental Disorders

d) Dictionary of Symptoms of Medical Disorders

2) What is the acronym of the World Health Organisations equivalent to the DSM? (2)

3) According to the DSM-IV to meet diagnostic criteria for ADHD you need to have significant difficulties with two or more from the classical triad of symptoms

What are these three symptom groups- choose from: hyperactivity, distractibility, hypoactivity, executive functions, inattention, poor working memory, poor planning, poor social skills, and procrastination? (3)

4) For which of the problems below is there good evidence that they are increased in people with ADHD (1 point for each right, -1 point for each wrong)

a) Committing a violent crime

b)    Having children at a younger age

c)     Addictive behaviours

d)    Problems at work

e)     Being victims of violent street crime

f)     Driving problems

g)    Physical health problems

5) Which of the characteristics below have evidence suggesting increased ability in people with ADHD? (Dropped the ‘good’ as ADHD advantages rarely studied by more than one researcher, whether or not ADHD has an advantage, there is no large body of evidence)(1 point for each right, -1 point for each wrong)

a)     Emotional intelligence

b)    Creativity

c)     Self transcendence (a character trait associated with spirituality and humbleness)

d)    Integrative complexity

e)     Autobiographical memory

f)     Short term memory

g)    Incidental memory

h)    Use of incidental memory in problem solving

6) Who is associated with the ‘hunters-farmers’ model of ADHD? (2)

7) The NICE guidelines on ADHD  (we gold standard UK guidelines) recommend   medication as a first line treatment for adults unless the adult themselves prefer a psychological approach.  (Contrasting with recommendations for children with moderate ADHD in which psychological treatments are recommended as the first line treatment approach, unless parents wish otherwise)

8)What reason did they give? (2)

a)     Psychological approaches have been shown to be ineffective in adults

b)    There is a lack of research into the efficacy of psychological approaches for adults

c)     Medication is cheaper than psychological approaches

B. History of ADHD

1) ADHD has had many changes of name –give three former medical names for ADHD (1 mark for each name)

2) In which decade were stimulants first used to treat hyperactive children? (2)

a)     The 1900s

b)    The 1920s

c)     The 1930s

d)    The 1950s

e)     The 1970s

f)      The 1980s

3) What did Patrick Van Kiebohm do in 2007 after a Flemish judge dismissed a joint petition from three of his neighbours to stop his three children with ADHD playing outside? (2)

a) Key the neighbours’ cars

b) Write a novel about the incident

c) Throw a street party for his local ADHD group

d) Use it as material for a stand up comedy tour

e) Countersue his neighbours for hate crime

4) How did teenager with ADHD, Michael Fay cause an international furore in 1994? (3)

5) In which of these decades (from question 8) was Ritalin first licensed for hyperactive children?

a)     The 1900s

b)    The 1920s

c)     The 1930s

d)    The 1950s

e)     The 1970s

f)      The 1980s

6) Which International body made an embarrassing goof over ADHD, in 1999 following being lobbied by scientologists?

C.ADHD and culture

1) Which Shakespearean character excused himself for not answering the summons of the Lord Chief Justice Summons because he suffered from a  ‘ disease of not listening’ or a ‘ malady of not marking’. (2)

2) ADHD is not over diagnosed in Europe- But fictional characters exhibit a high rate of false diagnosis, ADHD symptoms often lasting only one episode. Name a character or group of characters diagnosed with one -Episode -ADHD (2)

3) Sometimes a character is misdiagnosed with ADHD when a superpower is misinterpreted. Which hero of a series of popular children’s books was told?

‘The ADHD-you’re impulsive, can’t sit still in a classroom. That’s your battlefield reflex. In a real fight, they’d keep you alive. As for your attention problems, that’s because you see too much, not too little. Your senses are better than a regular mortals”

4) Further, TV and film   characters are prone to striking medication side effects of an entertaining and salutary nature. Name such a character (1) and the side effects suffered (1)

(5) Which   three of these famous people has a confirmed diagnosis of ADHD? (3)

Russell Crowe, David Cassidy, Albert Einstein, Susan Boyle, Billy Connolly, Usain Bolt, Bart Peeters, Patrick Van Kiebohm, Oscar Schindler,

6) On what did Courtney Love blame Kurt Cobain's addiction to heroin? (2)

7) Was she right? Did your answer to the question above cause his addiction to heroin (1)? Give your reasoning (1)

8)The entity Kryon (through his human channeller, a businessman Lee Carroll) commented on the birth of increasing numbers of a new more advanced type of child into the human race. These children are often claimed by followers to be have been wrongly diagnosed with ADHD   

The children are known as

a) Indigo children

b) Rainbow children

c) Crystal children,

d) Metatranscedent children

e) Magenta children

ANSWERS

Stephanie Clark

Adult Anglophone ADHD group

Part of Aandacht, Belgium

Sleep and ADHD

the problems
1) Going to bed
• Getting a second wind, i.e. feeling drowsy than waking up again, when everyone else is going to bed
• Feeling you need time to unwind / do own thing after everyone else has gone to bed
• Difficulty stopping doing something in order to go to bed: watching TV, reading book, computer etc
2) Getting to sleep
• Resisting sleep. Some adults with ADHD report resenting sleep / fighting it
• Often can’t shut mind off and relax
3) Sleeping
• Restless sleep- may disturb partner, may not feel refreshed
• Scary/ anxious dreams
• Staying asleep frequently waking up during the night and staying awake.
4) Getting up and daytime
• Often eventually fall deeply asleep (about 4pm) and have difficulty waking
• Feeling sleepy or falling asleep in the daytime
• Generally, lack of structure and regular bedtimes / wake times
5) Finally sleep problems may worsen as you get older both because older people (ADHD or not) generally have more sleep problems than younger people but that does not mean you need put up with insufficient sleep especially as it becomes harder to manage on insufficient sleep
Problem solving hints
People with ADHD often feel that standard solutions don’t address their problem- so I have tried to list as many as possible below- find what speaks to you or use a sleep diary to problem solve,
In general –
• Sleep problems can be caused by common health problems; acid reflux, asthma, B12 deficiency (a lot of people have problems absorbing this, especially as they get older).For severe sleep problems whatever the cause -do consult a doctor.
• Beware of high short term expectation. this is the ADHD Achilles heel in achieving change . Don’t try to change too much immediately. Credit yourself for your progress, do not berate yourself for your difficulties Don’t give up when you backslide.. If you have ADHD you will backslide, but that does not mean you are not progressing. You can achieve anything slowly!
The tips-
• Ambient temperature affects sleep - bedroom should not be too warm.
• Problems with circadian rhythm - Light and dark affect sleep rhythms .Get some sunlight / use light box in daytime
• Dim lights in the later part of evening, Avoid TV, computer screens, reading from a backlit device such as an iPad . Here is a link to a free program that moderates computer screen brightness with the time of day
• Meal times affect sleep rhythms. So establish regular meal times and avoid eating a large meal late in the evening (also because digestion process may disturb sleep in addition to circadian rhythm,). NB There is a theory that protein should be eaten in the morning and lunchtime and carbohydrates at evening meal (which supports serotonin production for sleep but mixed scientific evidence that this improves sleep quality). Protein also positively affects alertness levels, so may be useful if you wish to be alerter in daytime.
• Establish a winding down pre sleep routine- what works for you bath, read a book, meditation.
• All of the following can negatively affect sleep if taken in the evening alcohol (may help you fall asleep, but subsequent sleep is broken), caffeine, chocolate, exercise (good to improve sleep, but not the last few hours before bed), heavy meal. (Also as you get older metabolism slows, so foodstuffs and drugs and eating late may begin to impact sleep even if it did not do so previously). Caffeine may affect sleet in some individuals taken as early as 3 pm.
• If you are sleepy go to bed before you get a second wind.
• If that fails and you get a second wind- some find that reading something light, comforting, dry, or technical helps clear their mind and induce sleep. In my case trying to learn something by heart, vocabulary or a presentation for example exhausts me again quickly, but not doing something that demands deep thought such as writing the presentation.
• Relax, if you can’t sleep, it can be better to make relaxation the aim .Accept that some nights you won’t sleep
• Scary dreams-- some good evidence that rethinking the dream story and reframing it as more pleasant can diminish anxiety caused by nightmares over time. E.g. my ADHD grandson was having nightmares about a second big bang accompanied by a sense of loneliness and devastation, a solution is to think of him in a safe and returnable space witnessing one possible, incredible, fantastic, infinitely distant astrophysical event.
• Anxiety and worrying about sleep- keep a notebook by the bed- if you’re awake worrying about something make a note of it so you can deal with it in the morning. (Also useful for writing any good ideas you have going to sleep.)
• Difficulty getting up at your planned time, especially for those working from home. It really helps if you are getting up for something you want to do- an exercise session in the gym, time to watch a breakfast show, a run with a friend.
• Sometimes sleep problems are triggered by stress or illness and continue after the original trigger. Often this is because you have built negative associations with being in bed i.e. with lying awake, tired and worrying. Break the association using sleep restriction, get up as soon as you wake and can’t sleep- aiming to gradually extend the time you spend asleep.
• Needing a little relaxation time after everyone else has gone to bed more than you need sleep? - try to cut the time down spent relaxing- often you stay up after you have successfully wound down, or stay up on nights when you feel you could go to sleep immediately because this alone time has become a habit. Be aware of the minimum unwind time you need. Alternately or additionally , Try exploring the possibility of unwinding earlier (if you have family, partner you need to negotiate this and offer something attractive in return)
• Finally, don’t know where to start? Keep a sleep diary how much you slept, and anything that may have affected sleep: stress. Wine, caffeine, stimulants, dark chocolate, bed time, getting up time, illness.

Concentration for people with ADHD

How to concentrate

These notes are not intended to cover issues such as motivation and procrastination which also contribute to concentration difficulties-(they require a separate topic)

Ground Rules

These apply across all changes to behaviour (not just concentration span!)
1) A little at a time. What are your long term goals? Select one or two short term goals - what will help fulfill these goals? Will power is limited, but a trainable resource – don’t try to change too much at once. Scientists have showing that using will power to change one thing depletes it in other areas.

1) Believe you can change, you can.
2) Forgive your failures- they are part of life and of ADHD
3) If your plan is not working, try something else.
4) Think about diet and exercise. Doesnt cause the ADHD, but the better your health the easier it is to handle symptoms
5) Compete with yourself not other people


Get a timer to measure your concentration span

How long can you work at the tasks that you find most difficult before getting distracted?
Try to work a few minutes longer every day before taking a break

Work with your daily fluctuations in concentration. Most people have a distinctive pattern of concentration: Morning is normally better for routine concentration tasks; billing, learning foreign language vocabulary, editing. Afternoon for putting things in perspective understanding difficult foreign grammar, planning an article. If you have patterns in concentration, plan your work to reflect this.

Environment If not confined to an office- where do you work best in your home? make a work station there. Do you work better with the radio/TV on or not? If ‘yes’ try working without-onetime - I am beginning to think we often delude ourselves about this.

An easy way to avoid distraction is to set up different ‘work stations’ for different tasks: financial paperwork; sewing; carpentry: personal correspondence; language study. When your concentration begins to lag move to another workstation.

Working on the Computer. Internet as a source of distraction
Try
1) Turning modem of before working.
2) If you turn it on again, try working somewhere without internet access
If you need internet access to work:
Try using an internet blocking or monitoring programs. John recommended Rescue time. I have found this useful and if anyone wants I can demonstrate how the free version works next week.

Future goals or in the moment? much motivational advice focuses on the future – thinking about the reward for doing this task; promotion, getting your girlfriend back etc. Whilst it’s important to know why you want to do what you want to do, many people with ADHD can overthink the future to produce distracting daydreams about when you are promoted etc.

If this is a problem- make concentration itself the reward! Promise yourself how much better you will feel right now if you are working steadily right. Picture yourself working concentrated, in the flow, enjoying getting the work done. When you catch yourself drifting patiently focus yourself with this mind image again. It’s about conning yourself in to thinking the work itself is immediately pleasurable. It can work!
Eye Movements-- moving your eyes from left to right rapidly can make you more alert and enhance memory. However one study found that this enhanced memory performance in people who are strongly right handed, but harmed performance in people who weren’t! (many people with ADHD are rather mixed handed). Try it and see!

Other people. Use them .Delegate, swap chores. Get together to do stuff: e.g. get a friend to help you paint your kitchen one week, help her do hers the next-I think works best with more physical chores – gardening, tiling etc. However my daughter one spent a productive weekend helping me set up a filing system. Her efficiency was puzzling as all her papers are in an unstable heap in the kitchen!

Topic for meeting on September 29th, 2010

What is ADHD?

What is ADHD?

link to a short animation about ADHD in children

Non genetic factors that have been proposed as causes of ADHD

Criticisms of the concept of ADHD as a disorder are often linked to suggestions that ADHD develops as a result of bad parenting or too much television or some other societal factor – What is the evidence for the influence of these factors on ADHD? –
Note: some of the causes here are likely to lead to more profound problems then pure ADHD, or a different cognitive profile. But they are often not distinguished in the diagnostic process and are likely to make up a subgroup of people diagnosed with ADHD .
We will split causes into two groups because causes not affecting the vast majority of children in society today are unlikely to have a significant effect on the incidence of ADHD ( we would not then find so high a genetic effect.)
1. GENETICS
If one parent has ADHD your risk of having ADHD is increased 500%. It is more inheritable then height, any personality factor or any psychiatric disorder and is linked to inheritance of a cluster of genes. For example studies in a number of countries comparing fraternal twins (50% same genes) with identical twins (100% same genes) both being brought up together (so that environment should be similar) Found that if is 0.8 to 0.97.

1. I. INFREQUENT PROPOSED ENVIRONMENTAL RISK FACTORS FOR THE DEVELOPMENT OF ADHD
Because of the high heritability, as already said it is not possible that any of these play a significant causal role in ADHD. Could they perhaps play a tiny role – We will look at the evidence for each…

ADHD IS DUE TO POOR PARENTING OR A LACK OF LOVE WITHIN THE FAMILY

Blaming parents for their kids has always been a satisfying neighbourly activity. (So... I am bitter!). Freud elevated such gossip to intellectual respectability, paving the way for some great twentieth century injustices ‘Schizophrenogenic’ mothers were responsible for their children’s development of schizophrenia (Lidz);’ refrigerator mothers’ for the development of autism (Bettelheim). These theories are now completely discredited.
This school of thought has applied itself to ADHD, but is thankfully now dwindled to the fringes of mental health care in many countries. To be fair, theory has moved with the times, replacing the misogyny of Bettelheim and Lidz with a more PC misanthropy; parents not mothers alone are now held jointly responsible for their children’s’ mental disorders.
Is there any factual basis for a causal link between poor parenting and ADHD?
Bettelheim confused cause and effect, for example many parents of autistic children to avoid eye contact with the child if they know the child will be upset by it. That is the parental lack of eye contact is in response to the children’s autism and not the other way around.
Similar causal relationships between the child’s ADHD and parenting have been demonstrated i.e. CHILDREN’S’ ADHD SYMPTOMS TRIGGER APPARENTLY POORER PARENTING BEHAVIOURS not the other way around e.g., Barkley and Cunningham (1979) found that negative parenting behaviours spontaneously improved after children with ADHD were placed on medication.
Poor parenting must have some consequences for the child?
YES BREAKDOWN IN PARENTAL SKILLS PLAYS A ROLE IN DEVELOPING AGGRESSIVE AND OPPOSITIONAL BEHAVIOURS; likewise early attachment disruption (e.g. foster care placement) appears to be associated with OPPOSITIONAL AND CONDUCT DISORDERS AND AGGRESSIVE BEHAVIOUR RATHER THAN ADHD.
Some studies found weak evidence for ADHD developing with some parenting styles, but failed to control for parental ADHD. (That is if the parenting behaviours are associated with parental ADHD, the child’s ADHD is likely to be hereditary) An example is Carlson, Jacobvitz and Sroufe (1995) who found that intrusive, insensitive mothers were more likely to have insecurely attached kids with inattention and hyperactivity symptoms
Some research suggests that children who showed greater persistence of ADHD symptoms from preschool to early childhood are more likely to have parents with poorer parenting skills. THUS PARENTING SKILLS PLAY LITTLE PART IN THE DEVELOPMENT OF ADHD BUT BETTERQUALITY PARENTING MAY BRING BETTER OUTCOMES FOR CHILDREN WITH ADHD.
Following from that -Do parents of children with ADHD have to be better parents then parents of other children?
Seems like it: a study of Posner’s found that infants with the DRD4 7 rpt allele (highly associated with the personality trait of sensation seeking and ADHD) developed less sensation seeking behaviour as toddlers when better quality parental interactions were assessed by researchers when the children were infants. The children without the allele developed normally irrespective of ratings of parental quality. None of the parents were assessed as poor IN OTHER WORDS ONE OF THE GENES ASSOCIATED WITH ADHD SEEMS TO HYPERSENSITIVE TO VERY GOOD PARENTING SKILLS.
Are Parents with ADHD especially bad parents for children with ADHD?
No. A lot of attention has focused on factors such as lack of structure and inconsistency in ADHD parents, but it seems there are compensatory factors.
See (Thompson & Sonuga-Barke, 2008) who found THAT PARENTAL RESPONSE TO CHILDREN WITH ADHD ARE MORE AFFECTIONATE AND POSITIVE WHEN THE MOTHER ALSO HAS HIGH ADHD SYMPTOMS (so that maternal ADHD seems to protect against the negative effect of the child’s ADHD on parenting behaviours described above
Conclusion: There is no evidence that poor parenting causes ADHD symptoms. However it is tough for parents of children with ADHD: Research shows that not only is it harder for parents to avoid responding more negatively to children with ADHD, but children with the DRD4 7 rpt allele , weakly associated with ADHD seem to be abnormally positively responsive to greater parenting quality . Disruptive and aggressive behaviour and conduct disorders are somewhat linked to parenting and conflict at home- and it may be that children with ADHD are more vulnerable to these additional problems.
TRAUMA AND ABUSE
Children who have been sexually abused AND develop PTSD (post traumatic stress disorder) can exhibit greater activity and impulsivity (children who have been sexually abused and do not develop PTSD tend to show more depressive symptoms). So extreme trauma can (but not in every case) lead to impulsivity and higher levels of activity.
MATERNAL SMOKING IN PREGNANCY
Since 1979 US attorney general has warned that smoking during pregnancy can harm the foetus and retard growth. It has became s associated with a range of child development anomalies, including low birth weight (LBW), reductions in growth, learning and/ or cognitive problems and increased motor One route is
Maternal smoking-in pregnancy can cause LBW in addition to other effects of nicotine toxicity. Studies that have controlled for LBW in order to look at nicotine toxicity may have underestimated problems caused by maternal smoking. The Link to ADHD is not clearly established as many studies have concentrated on the effect on conduct problems rather than ADHD. However prenatal nicotine found to be among the strongest correlates in Massachusetts General Hospital study of pre and prenatal correlates of ADHD. A weakness of this study was that it did not control for maternal ADHD. If parents with ADHD are more likely to smoke then correlation may be only apparent, that is the association id due to genetics rather than smoking However ADHD does not seem to predict smoking, those with comorbid ADHD and CD are most likely to smoke.
This suggests a further study weakness in that researchers did not screen for maternal ADHD and CD, which will make a mother more likely to smoke and separately from the direct effects of smoking more likely to pass both disorders to her child.

Conclusion: Small but robust effect has survived in the most well controlled studies. No real research into the exact nature of the effect of smoking on development. Is it the same as ADHD with a non smoking mother?



‘NATURE DEFICIT DISORDER’.
Several studies have found that outdoor related activities reduced ADHD symptoms e.g. (Kuo & Taylor, 2004)); other research suggests that we all benefit from exposure to nature. Older people live longer if there is a park nearby; all other factors being the same, students do better in a cognitive test if their dorms overlook a garden. Louv extended this argument to suggest that all children suffer from a ‘nature deficit disorder’ (rather a lot!)Causing among other things attentional problems, and thus by extension ADHD. But as far as I know no studies used a group of control children to see if nature also produced positive benefits for children without ADHD. Other research suggests that we all benefit from exposure to nature
Conclusion Lack of exposure to nature is not a trigger for development of ADHD .Increased exposure to nature probably has beneficial effects for children with ADHD (not all children with ADHD, see photo), but we have reason to think this applies to all children.
25. II MORE COMMON ENVIRONMENTAL RISK FACTORS FOR THE DEVELOPMENT OF ADHD
Very common experiences that could affect almost all twin studies, thus not ruled out by strong genetic correlation
DIETARY FACTORS
Dietary factors are usually considered to be more or less ubiquitous in the western world and therefore to lie in the second class of factors. I have followed that convention here, but have some reservations, see my remarks on omega 3.
SUGAR
High sugar intake does not explain ADHD symptoms. (Wolraich, Wilson, & White, 1985). But antibiotic sugar interactions in a small number of children are under investigation
FOOD ADDITIVES
Feingold theory that allergic reactions to chemicals in food could affect behaviour. Early studies did not bear this out-. But more recent studies have suggested a subset of children may be at slight risk, the design of some of these studies has been criticized.
OTHER FOOD ALLERGIES OR INTOLERANCES
As yet very limited evidence of other dietary intolerances in a sub group of people with ADHD that my worsen ADHD symptoms; gluten, dairy, citrus fruits.


OMEGA 3 FATTY ACID DEFEICIENCIES
The Evidence is generally considered to show that dietary shortage of omega 3 ubiquitous in many parts of western world.Theoretical considerations suggest some children may be genetically less good at conversion of precursor molecules therefore genetically more susceptible to effects of modern diet
Dietary fatty acids play a preventive role against a number of disorders such as cardiovascular disease, and since they help form the neuronal membrane they may affect mood and behaviour. Theoretical case is good. Speculation therefore that a DFA deficiency is involved in schizophrenia, LDs and ADHD
I have been rather sceptical about this for a number of reasons the ‘Durham’ studies were much publicised in Brussels but we were mislead about the quality of the evidence. Also there does not seem to be much variation in ADHD rates with variation in national diets e.g. the Cretan diet is said to be the healthiest diet in the world, a so ‘super Mediterranean’ diet. Lots of olive oil (30% daily calories), fish, low red meat, low sugar, lots of vegetables, especially green ones, low alcohol. Consequently low rates of heart disease, of some cancers, of Parkinson’s and Alzheimer’s etc- yet the Cretan ADHD rate seems to be at least as high as anywhere else in Europe. - 8.8 % in boys, 4.4 % for girls (Skounti, Mpitzaraki, Vamvoukas, & Galanakis, 2006)
Evidence: Some early studies found children with ADHD had lower serum free fatty acid levels. (Bekaroglu, Aslan, Gedik, & Deger, 1996) Studies into supplementation of diet of children with ADHD have had mixed results; some even finding a negative effect. Other studies have found that supplementation with a full array of fatty acids did lead to significant improvements in ADHD symptoms. (Richardson & Puri, 2002)A study comparing diet of adolescents with and without ADHD found that despite the ADHD kids consuming similar levels of DHAs, blood levels of the omega 3s were much lower. (Colter, Cutler, & Meckling, 2008) Supporting suggestions of differences in metabolic handling of fatty acids in ADHD. Similar results had previously been obtained in Taiwan.
Lower levels of fatty acids are also found in adults with ADHD, but were not found to be related to symptom severity.
Summary: There is evidence of lower blood levels of fatty acids in people with ADHD compared with normals eating a similar diet. This suggests a problem with metabolism for least some people with ADHD. Evidence of the benefits of dietary supplementation in righting this problem, has been very mixed but is growing.
IRON DEFECIENCY
Research by Dr Konofal in France has found low levels of Iron in the blood of many children with ADHD, with the lowest blood levels being linked to most marked ADHD symptoms. Again (as in the case of omega 3) there was nothing abnormal about the children’s diet. This suggests dietary supplementation could help a subgroup of children with ADHD.

Takes me back, Mum used to take me to the doctors complaining about my low activity level in the fifties and sixties. He would say my iron was a bit low; start iron supplementation and then again the following year because Iron was still a bit low and so on. If anything I became more inactive possibly because I was stuck to the fridge, in a magnetic sort of way.




CAN ADHD BE CAUSED BY TOO MUCH TELEVISION?
Studies show that effects of media on children are governed more by the content of programmes watched, rather than by number hours of TV watching. In fact hours of educational TV watching is linked positively to school achievement. Hours of watching violent TV and video programmes is linked to aggression (not ADHD) with by far the most effect carried by children with other signs of vulnerability for developing aggressive behaviour. Many children are able to watch violent TV with no effects on aggressive behaviour. These facts together suggest a genotype environment interaction.
A few studies however have suggested a link between TV and attention (Christakis, Zimmerman, DiGuiseppe, & McCarty, 2004) Linked the No of hours spent watching TV between 1 to 3 years to attention problems at 7 years.3 hrs TV a day between 1 and 3 years old leading to a 30% increased risk- Compared with kids watching no TV.But study had some big weaknesses- did not control for maternal ADHD or attentional problems already developed at 1-3 years. Latter especially, is in my experience very likely to increase the parental temptation to encourage the child to watch more TV.
One study did find a clear link between type of TV watched and temporary attentional symptoms in 4 to 5 year old normal children. The children watched 30 minutes TV, one group watching Power Rangers, which was fast paced and believed to require frequent attentional shifts, the others an educational program . The children were watched at free play afterwards and the group who had watched fast television showed more activity changes.
Conclusion: whilst there is a clear link between watching violent TV and aggressive behaviour for some more vulnerable children (with and without ADHD). The link between TV watching and core ADHD symptoms is as yet unclear. There may be small effects linked to the pacing and content of the programme.
Note: A factor that increases the chance of having ADHD by 30% is a very small affect. Say the chance of one person taken at random in the general population having ADHD in the general population is 5 %( or 1 in 20) then if you have some factor that increases your risk by 30%. Your chance of having ADHD is now increased to 6.5%.
LOW BIRTH WEIGHT (LBW)

Increases the chance of a whole lot of developmental risk factors including ADHD. LBW h as a lot of causes – prematurely birth., growth problems in the womb Further Advances in post natal care since the sixties onward have increased the survival rates of children with low birth rate (1500g >2500g and moderately low birth rate) And now children with birth weights less than 1500 grams can survive. (Very low birth rate)
Since 1980 rates of cerebral palsy and other disabilities stayed constant among children with LBW (about 1 in 12) whilst survival rates increased. Total rate of disabilities in developing countries therefore increased. In addition may be other neurological problems such as spatial, motor and verbal deficits, behavioural problems and hyperactivity
Low birth weight increases risk of ADHD. 16% of children with extremely low birth weight(less than a thousand grams) have ADHD compared with 5 % of controls but may have been largely explained by low birth weight developmental delay.
In conclusion very low birthrate may lead to a doubling or in combination with other risk factors of the chance of developing ADHD. Through this is often combined with lowered IQ and general, neuorocognitive problems the risk for ADHD does seem to be specific
PRENATAL ALCOHOL EXPOSURE
Heavy drinking in pregnancy may lead to fetal alcohol spectrum disorders. Although FAS leads to severe cognitive and behavioural problems association with ADHD is not clear. Because even category 1 FAS which includes physical abnormalities is often not diagnosed (5 categories of severity), it’s very possible that some cases of FAS are misdiagnosed as ADHD.

ENVIRONMENTAL TOXINS-
POPS
POPs are persistent organic pollutants including DDT, PCBs, dioxins very many having been released into the environment in the twentieth century with little knowledge of their effects on the nervous system. All are lipophilic (stored in human fat) and persistent in the environment.
PCBs have been of particular concern; despite now being banned they are ubiquitous in the environment; not biodegradable found in whale blubber, the arctic seal and human placenta... not biodegradable and have caused cognitive problems in the children of woman exposed to high levels in industrial accidents (among other things).
The big question is what does lower grade background exposure such as the 2 to 10 ppb do to human populations? Known to affect cognitive development of the foetus, theoretically thought likely to interact with hormone and dopamine systems. A number of studies have found that higher background levels of PCBs in children’s tissue links to increased motor and cognitive problems and executive level functioning problems, with breast feeding showing some protective effects. (Vreugdenhil, Mulder, & Emmen, 2004) PCP exposure does not correlate with hyperactivity but to problems with executive functioning
ORGANOPHOSPHURUS PESTICIDES
HEAVY METALS
High levels of Pre and post natal heavy metal exposure is known to - lead to multiple motor sensory and cognitive impairments that is clearly different from ADHD.
LEAD
What about lower levels of heavy metals such as lead, can they lead to ADHD like behaviours?
We have increasingly more info about the dangers of low levels of lead.
The WHO safe level was lowered from 25 Mg/dcl WHO to 10mcg/ dcl in 1991 Recent call to lower safe threshold to 5 mcg/dcl. (Chiodio, Jacobson, & Jacobson, 2004) Found an association with attention problems at levels as low as this. Average blood lead level kids in the US is 2-3mcg/dcl Can interfere with synapse formation and affect impulse control among other things.
Therefore quite low level exposures to lead (1 to 10mcg) correlate with lowered IQ and attention problems and could account for a percentage of children diagnosed with ADHD.
MERCURY
‘Acceptable’ levels of mercury like lead have dropped as research has shown more about the risks.Neurodevelopmental effects of mercury most notable on motor and visuospatial problems rather than attention but US national Academy of sciences estimated that 60,000 children at risk of affects of mercury exposure prenatally per year
MANGANESE

Replaced lead in petrol- but little known about its effects




FINALLY …OTHER WAYS TO LOOK AT ADHD
The prophet Kryon has said that Indigo children (‘who are often misdiagnosed with ADHD’) represent a leap in human evolution and are here to show humanity the way to a higher vibratory plane.
Whilst I could kiss Kryon for his positive a view of us, the prophet presents no evidence ... and such views are potentially harmful to children with ADHD



you might also be interested in

ADHD- A social construct?

REFERENCES
Chiodio, L., Jacobson, S., & Jacobson, J. (2004). Neurodevolopmental effects of postnatal lead exposures at very low lead levels. Neurotoxology and Teratology , 359-364.
Christakis, D., Zimmerman, F., DiGuiseppe, D., & McCarty, C. (2004). Early television exposure and subsequent attentional problems in children. Pediatrics. , 917-918.
Dankearts, M., & Sonuga-Barke, E. e. (2010). The quality of life in children withaAttention defecit/ hyperactivity disorder; a systematic review. European Journal of Child & Adolescant Psychiatry , 83-105.
Kuo, F. E., & Taylor, A. (2004). A potential natural treatment for attention defecit/hyperactity disorder: Evidence from a national study. American Journal of Public Health , 1580-1586.
Richardson, A., & Puri, B. K. (2002). A randomized double-blind, placebo controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning disabilities. Progress in Neuro-pyschopharmacology and Biological psychiatry , 2234-239.
Skounti, M. P., Mpitzaraki, K., Vamvoukas, M., & Galanakis, E. (2006). Attention-defecit / hyperactivity disorder in schoolchildren in Crete. Acta Paedeatrica , 658-663.
Thompson, M. J., & Sonuga-Barke, E. (2008). Do maternal attention defecit/hyperactivity symptoms excaberate or ameliorate the negative effects of child attention-defecit /hyperactivity disorder symptoms on parenting? . Development and Pyschopathology , 121-137.

ADHD - A Social construct? A look at some criticisms of ADHD as a disorder.

This is a difficult and emotive subject. We are used to the very status of ADHD as a disorder being challenged in the media in such a lazy way that we develop a knee jerk reaction to these questions. Often reporting does not distinguish fact from opinion and confuses a balanced debate with giving equal space on the one hand to mainstream scientific or clinical personnel and patients groups representatives and on the other side an individual with some kind of agenda-
As Russell Barkley said of the critics:

‘Many of them approach it with political agendas such as the Church of Scientology and its Citizens Commission on Human Rights. They don’t care whether this is a real disorder or not, because they deny that there are any psychiatric disorders, period. That’s their political agenda.

‘
So let’s look at the current criteria for a mental disorder to decide if ADHD meets those criteria:
1. . CLINICAL CRITERIA FOR A DISORDER
Currently, the working definition for a disorder in clinical medicine is based on Wakefield’s definition of ‘harmful dysfunction’. Or as the DSM-V puts it - a disorder should be such that:
‘

The consequences of which is clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning)

’
This is a link to the criteria for a mental disorder as proposed for the DSM-V in 2013. (The DSM is the American manual of mental disorders, it is very influential, being more through then the only near equivalent the ICD-7 published by the world health organisation.).Thus to meet medical criteria for a disorder, ADHD must be shown to be harmful to the individual with ADHD, it must cause impairment in some major life activities e.g. relationships, work, education
1. i. Evidence for Impairment caused by ADHD
Extremely convincing evidence of impairment exists and is overwhelmingly accepted by scientists. This includes statistically increased chance of accidents, school failure, career underachievement, relationship problems, delinquency, addictions, depression, and anxiety and so on. See for example this recent paper on quality of life outcomes for children with ADHD (Dankearts & Sonuga-Barke, 2010),36 studies were reviewed and determined that ADHD had significant effects on the quality of life of children with ADHD and that quality of life outcomes were significantly improved by treatment.
1. ii other criteria that should also be met (in addition to impairment):
Diagnostic validity on the basis of various diagnostic validators (e.g., prognostic significance, psychobiological disruption, response to treatment) (DSM-V)
Good evidence that diagnostic procedures consistently identifies people in need of help (if diagnostic procedures are followed properly) that the syndrome is cohesive ,that is symptoms co-occur regularly and are distinct from other disorders. Evidence shows that treatment is effective, for example Biederman (2009) followed a group of children with ADHD for ten years, some treated with medication and some not. He found that the treated children were significantly less likely to develop comorbid disorders such as depression and conduct disorders.
iii Presence of other meaningful external associations
(Such a occurring in families well above chance levels consistent biological finding about ADHD that argue good clinical validity)
Conclusion: ADHD easily meets the clinical criteria for a disorder.
2. ETIOLOGICAL CRITERIA FOR A DISORDER
Etiological refers to causes, this traditional criteria refers to the extent to which the causes of the disorder and the nature of the impaired function is known. This criterion is difficult for ADHD to meet, for most other mental disorders including schizophrenia and even for disorders in other branches of medicine. Causes can often not be precisely known e.g. lung cancer in a smoker cannot be wholly attributed to smoking, but other factors such as genetic susceptibility, diet and occupation may play a part.
We do know that the etiology of ADHD is biologically based and Multifactorial (- complex with many causes).
3. THE SYMPTOMATIC CRITERIA FOR ADHD (BUT EVERYBODY HAS THIS!)
Multifactorial mental disorders are defined behaviourally and behavioural criteria are used as part of the diagnostic process Link to Criteria for adult ADHD based on the DSM-IV and developed by WHO
Such criteria are frequently criticized:’ doesn’t everyone have this symptoms sometimes’? This misunderstands how ADHD is diagnosed. Picking out one or two symptoms irrespective of frequency is misleading. For example to diagnosis an adult 4 criteria from the first section should be met very frequently (depending on the criteria). Almost all normal adults will meet one or two; diagnosis depends on a bunch of symptoms co occurring frequently. But that is not sufficient for a physician to give a diagnosis of ADHD, they must occur in different settings, have started in childhood, be causing impairment in major life activities and other disorders must be ruled out.

4. DOES ADHD SIMPLY REPRESENT AN EXTREME OF PERSONALITY FACTORS?
Traits are predictors of personality and can also predict mental disorders. The pathways of a child's development build on early temperamental precursors.
Research into Big 3 personality traits and ADHD.
Has found that Symptoms of inattention and disorganization are weakly related to low conscientiousness. Extraversion related weakly to hyperactivity and impulsivity (this relationship clearer for men than women).No strong correlations for ADHD as such.
Big five personality traits
Less clear correlations between personality traits and ADHD Neuroticism is related to all mental disorders.
Conclusion: there is a weak correlation with some personality traits and markers for different subtypes of ADHD


See ‘Causes of ADHD’ for an evaluation of factors such as television or parenting often cited by critics as significant causes of ADHD

Time Management

Talk notes by Maureen based on
The secrets of those who have more time then others by John Ellis

How many of you need more time? Does anyone wish that they have more time in their daily lives to get everything done? Today our worst enemy is lack of time, especially in urban and industrialised societies. We experience the urgency of things in our rapidly changing environment and mobile workplace. Modern gadgets have allowed us to communicate more rapidly and improved social connections. It is, therefore, important to organise our lives in a practical way in order to react rapidly to important decisions which affect our lives. Time does not change but the use of time varies from individual to individual. The first priority is to have a positive attitude towards time and see it as our friend. Create an inspirational and passionate vision. And spend at least 50% of our time on these activities Instead of drowning in an ocean of information, we must become selective in using this information and take as little time as possible in finding information.

I would like to share with you the "Secrets of those who have more time than others."

I will tell you about time and life-management; setting priorities and objectives, planning and time-management at work How to fulfil a number of objectives in a limited time.

Time Management:

The first thing is attitude - make a friend of time – it is not your enemy.

1. Consider your objectives as non-negotiable goals

2. Fix a deadline to realise your objectives

3. Be realistic and foresee unforeseen events

4. Be aware of your work style

5. Know your environment or workplace

6. Plan

Evaluate precisely the time required to carry out a given task taking into account unforeseen circumstances and delays.

Setting Priorities and Objectives:

Classify your tasks into four groups and make a list of the most important:

1. Important and Urgent

2. Less Important but Urgent

3. Less Urgent but Important

4. Less Urgent and Less Important

How can we create more Time?

By eliminating time thieves:

- TV and Radio

- Telephone

- Waiting in queues

- Traffic-jams

- Avoid excess

- Managements of e-mails

Create FAQs, brief replies use the telephone, block spasm,

Planning:

Time Management at Work:

Work faster

1. Do not accept more than you can manage

2. Organise your documents

3. Move

4. Sleep sufficiently

5. Use tools which help you to gain time

6. Eat a light breakfast

7. Delegate: cleaning, shopping, cooking, repairs, gardening, preparation , writing, creation of a website,

Conclusion

I have spoken to you about time and life-management; managing your life; setting priorities and objectives; planning and time-management at work Time management is not difficult to learn. The first priority is to manage our attitude towards time, to see it as a friend and organise our lives to be effective at each moment.

I hope these tools will help you to manage your time and enjoy more free time

Links

Time Management Wikipedia

What is ADHD?

click to view Article in the original Flemish

Attention deficit / hyperactivity disorder (ADHD) is common in school children (2 to 5%). It is marked by concentration difficulties and can be accompanied by hyperactivity and impulsiveness. The cause lies in changes in brain functioning.

In the past, it was believed that the disorder disappeared in adulthood, but since the 1970’s science publications have described the persistence of adhd into adulthood in 30 to 50% of children. That means that 1 to 3% of adults suffer ADHD.

Adult ADHD

In adulthood the most common symptoms are impaired concentration, day dreaming, forgetfulness and frequent changes in activity. In adults, hyperactivity and restlessness are rarer; however ADHD is often associated with other problems such as boredom, chronic conflicts and social adjustment difficulties, leading to problems at work and home. Furthermore, alcohol or drug abuse, anxiety and depression are frequent complaints.

More and more often practitioners are confronted with patients’ questions about the diagnosis and treatment of ADHD. Professionals in the adult psychiatric sector may struggle to respond, professional training and traditional thinking often ill prepares them for this problem. A brief overview of the subject is of topical interest.

A little known pathology

The diagnosis of ADHD (attention deficit / hyperactivity disorder) has been generally recognized for many years in child psychiatry, and, according to the DSM-IV affects 2-5% of all children. The diagnostic term ADHD is of American origin and includes the non-hyperactive subtype, in contrast to Europe’s much more restrictive concept of hyper-kinetic syndrome in the ICD-10. In 30-50% of children with ADHD the origin is genetic. If ADHD persists into adulthood, the genetic contribution is greater; an adult with ADHD has an 84% chance that at least one of his children will have ADHD. It is known that 30 to 50 % of the children continue to have adhd related problems in adulthood.
However, in the adult psychiatric health sector a lack of familiarity with this disorder persists. Several factors may explain this:

1 In adults motor hyperactivity decreases and attention and organisational difficulties come to the fore, so one thinks less of it

2 In adults ADHD is often associated with mood instability and emotional reactivity, often interpreted as manifestations of a personality disorder.

3 Under the restrictive criteria of the ICD-10 diagnosis of hyper-kinetic syndrome cannot be made if there is a comorbidity such as depression

4 In the DSM-IV, ADHD is listed in the chapter about childhood disturbances; consequently adult psychiatry is less familiar with ADHD.

5 Child psychiatrists and adult psychiatrists have little or no contact, either in training or in practice, so that children reaching adulthood with ADHD are not automatically referred to adult services.

6 It is easier for people to accept and understand a disorder of self control in children then in adults.

Diagnosis

As with children, a patient history is the cornerstone of diagnosis. It is necessary to establish if the difficulties existed since childhood. The clinician should be aware of the possibility of ADHD and take a focused history; care should be taken to avoid colouring the childhood history with a priori psychodynamic or system theoretical perspectives. In adults it may be difficult to obtain an accurate retrospective view of childhood functioning. Additionally, adult life may be complicated by many factors, differential diagnoses, co morbidities, so that getting a clear perspective on adult problems is not always easy.

The diagnostic criteria listed in the DSM_IV are also applicable in adulthood. Several authors have suggested that the minimum criteria for adults should be four or five of the nine symptoms of hyperactivity/impulsivity (instead of six as stipulated in the DSM-IV for children) and four of five of the nine symptoms of inattention, because the severity of symptoms in adults is less marked.

The Utah criteria for ADHD in adults are the best validated (although drawn up solely for the hyperactive subtype):

· The symptoms must be present from childhood onwards.

· There should be clear mild difficulties with attention and motor unrest.

· At least two of the following five criteria should be met: mood swings, organizational problems, irascibility, emotional reactivity, impulsiveness.

Further, an EEG study of the cognitive evoked brain potential can be useful for an objective neuropsychological examination of the attentional and frontal lobe functions. The specificity and sensitivity of these tests have their limitations. However, against the background of these test results ,the patient can better understand and accept that there exist objective reasons for his difficulties, especially as the personal history data obtained is often questionable and subjective.

Differential diagnosis and comorbidity

1) Depression and Dysthimia (depressive neurosis): depression is present in 20-30% of patients with ADHD (in the general population it is 15%). The differential diagnosis can be difficult: Dysthymia can also express with chronic attention difficulties, however negative self-perception with an inability to experience pleasure are clearly central.

2) Addictions occur in 10-40% of patients with ADHD.

3) Borderline, antisocial and histrionic personality disorder: the differential diagnosis can be difficult. In borderline personality disorder a more markedly contorted personality exists , coupled with feelings of emptiness, more manipulative behaviour, suicidal behaviour , self mutilation, abandonment fears with attachment problems, and identity disorders. The impulsiveness in borderline personality disorder is more driven and often self-destructive (whilst the impulsiveness of ADHD is short-lived and more thoughtless). One needs to take in account the possibility of the combination of the 2 disorders with a more targeted patient history.

Treatment

1. Psycho-education: the provision and explanation of the diagnosis is in itself therapeutic. Often the patient has had many years of personal troubles and (troubles adapting to their environment) without understanding the reasons. Often the patient has had years of psychotherapy without success, often only resulting in further disappointments and misunderstandings However, the diagnosis should not be used as an excuse for every continuing problem: correct diagnosis should lead to measures for finding solutions. Any comorbidities must be explained, where a diagnosis of adhd does not cover all the problems. It is important that the practitioner not only knows the symptom lists, but is familiar with the current explanatory neuropsychological models- such as Barkley’s, in order to consider the broader picture. Also, the practitioner must be familiar with the impact of ADHD problems in the entire daily life, working life and partner relationships.

2. Medication: Although traditionally doctors in Europe are reluctant to prescribe psycho-stimulants (especially Ritalin, but also some stimulant antidepressants), in the United States it might be seen as a serious medical error not to offer medication. The recommended course is to offer a months trial (Ritalin 3 times a day, every 4 hours, at constructive dosages). In 25-78% of cases there is a positive result, although still often residual problems persist. This result is reflected in all areas: not just attention, hyperactivity and impulsiveness, but also self control over mood swings, motivation and emotional over reactivity and organizing functions. If this medication is clearly indicated and properly prescribed, under supervision, there is no reason to fear for addiction.

3. Psychotherapy, coaching: Coaching and organization skill learning is important , one should, however, be aware that a finished plan, practical tips and good intentions often still lead to failures because often patients with ADHD know, by definition,’ what they should do, but do not do what they know’. Psychotherapy is only useful if there are difficulties; handling past failures, or adapting to new patterns of functioning under medication, or difficulties with comorbidities or relationships. But one should be careful of explaining ADHD symptoms in a psychodynamic or system theoretical manner.

4. Contact with Fellow-Sufferers: Regional Support Groups for adults with ADHD in Flanders started an organization ("Aandacht"), with its own website (www.adhd-volwassenen.be). The mutual recognition and validation is frequently a revelation and support for many participants. The exchange of experiences, tips and information, and the experience of seeking solutions jointly often has a major significance for group members and their surroundings.

Dr. W. Van den Bergh (Leuven)
De Agenda Psychiatrie Nr. 19, Mei 2001, p. 8-9

Thank you to Dr Van Den Bergh for permission to translate this article.

Stephanie Clark. With help from Anne.

Nice Guidelines for treatment and diagnosis of ADHD in the UK-Nice-er then I thought but the press liesI

Nice Guidelines for treatment and diagnosis of ADHD in the UK

I’ve been grumbling about the nice guidelines, fact is, I read about them in the press and learned that Nice says:

-That the ‘controversial chemical cosh ‘Ritalin (with often deadly side effects!)Is ‘severely overprescribed ‘

‘Should only be given to the ‘unruliest’ children,’

That discipline eliminates the need for drugs

That parents of adhd kids must go back to class and learn to be good parents.

Should you care to read them for yourselves, some links:

http://news.bbc.co.uk/1/hi/health/7630926.stm

http://www.bbc.co.uk/radio4/womanshour/02/2008_39_fri.shtml( contributed by John)

http://www.independent.co.uk/life-st...en-940308.html



http://www.dailymail.co.uk/health/ar...-children.html

http://www.telegraph.co.uk/news/news...ents-told.html

This week I bothered to read the nice guidelines and couldn’t find any of the points above.

The guidelines are a real step forward for ADHD treatment and diagnosis in Britain.

Click for a link to the full guidelines-

These Guidelines are important internationally because Nice is regarded as a centre of excellence for evaluating cost effective medical treatments- other health services will be watching!.

Some Key Points-

-For the first time in the UK guidelines and recommendations are made for the treatment of adult ADHD

‘Drug treatment for adults with adhd is the first line treatment but should always form part of a comprehensive treatment programme that addresses psychological, behavioural and occupational needs.’

(-Research shows that the multimodal treatment of medication, therapy parental and teacher guidance ensures the best outcome for a youngster- and nice have tried to follow this model in a cost effective way)

-Nice recommends a fuller range of treatments be offered to parents including parent education progammes- for pre school children this should be the first line of treatment

-Nice recommends networking between services( a keystone to good adhd support):

‘that NHS Trusts should ensure that specialist adhd teams for children, young people and adults jointly develop age appropriate training programmes for the diagnosis and management of adhd, for mental health, paediatric, social care, education, forensic and primary care providers who have contact with people with adhd.’

-Children with severe problems should be offered drug treatment without delay, as previously recommended in Einaq guidelines:

‘In school age children and young people with severe adhd, drug treatment should also be offered as the first line of treatment. Families should also be offered a group-based training/education programme.

-A full programme of treatment should be offered:
‘Drug treatment for children and young people should always form part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and intervention. ‘

Next Meeting ADHD Favourite Quotes and some interesting links

The next meeting will be on Wednesday October 22^nd.

Topic is Favourite Quotes (ADHD relevent):

Here is mine:

‘Karma is the hand dealt, and dharma is what the player does with it”.

Mahatma Gandhi was fond of bridge .He used the game to explain the difference between karma (predetermined fate) and dharma (man’s action)

For me-he means don’t compare yourself with other people .Play what you have as well as you can .Strive to beat you own best performance. Comparisons are irrelevant -we are all playing different deals.

Think of a favourite quote with an adhd connection. What does it mean to you ? Send it to me if you can’t come!

Some other Quotes- are at the bottom of this email.

-22nd November . Maureen will talk about time management .

-I’ve attached a final version of my notes on ADHD and Failure at the point of perfomance

Some interesting links-

(Rather random)

1/-Here’s a link from John, to a story about an ADHD college student learning to cope with higher education

.

http://www.npr.org/templates/story/story.php?storyId=94727139

2/-Here’s a collection of documents from teachers / education authorities on childen with special needs. Both funny and horribly familiar. (Part of a labyrinthine site run by a Special needs attorney. On other pages you can find very good advice for parents - not all specific to US education law)

Here’s my favourite:

from an email written by a teacher to the school psychologist about a child with clearly diagnosed SEVERE ADHD by several qualified medical professionals:

“STUDENT (name changed to protect the innocent) is a strange case. We all feel that his biggest problem is that his mom and dad are looking for any excuse to explain STUDENT’S bad behavior. I do believe that he is somewhat ADHD; however, we have had much more severe cases – (name omitted), for example. STUDENT doesn’t get along with any other student – he picks and complains and antagonizes one and all. I can also say that no one likes him. Not because it is the popular thing to do, but they really don’t like him. His academic levels are low because he has had the crutch of “it’s his disability” used so often that he no longer really tries. He and his parents expect everyone else to do his work and not hold him accountable because it is “his disability”. He won’t start working in class on assignments unless he is specifically told to do so, and he wants to try the excuse “I’m thinking’ when the exercise clearly doesn’t even take any thinking. I don’t know how to counteract a life of parents telling him that there is something majorily (sic) wrong with him. They have tried every test, counseling, medicine that is out there. I can’t imagine how he is to deal with constantly being told that there is something terribly wrong. We have found that if we tell him “that’s it, you act like that or do that again, and you’re outta here,” then he can control his behavior. However, theline (sic) must be drawn in the sand for him to see that he has reached the limit of what we’ll tolerate. The parents and the behavioral plan said we were to do three warnings, but we found that one worked as well as three. We’ll all be interested to get the results of his testing.

Click for More Funnies

Sometimes I think the problem is that everybody knows how to raise an ADHD child until they have one.

More Quotes- to inspire you before next meeting

We can't solve problems by using the same kind of thinking we used when we created them.- Albert Einstein

I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.- Maya Angelou

Do not dwell in the past; do not dream of the future, concentrate the mind on the present moment. – Buddha

The only people who don’t make mistakes are the ones who aren’t doing anything.—Anonymous

Perfectionism spells paralysis.- Churchill

A man cannot be comfortable without his own approval.-

Mark twain

To invent, you need a good imagination and a pile of junk.
--Thomas Edison

Never wrestle with a pig; you both get dirty, and the pig likes it.”-- Anonymous