Toddlers Medicated for ADHD Against Guidelines

By Alan Schwarz

Toddlers Medicated for ADHDMore than 10,000 American toddlers 2 or 3 years old are being medicated for attention deficit hyperactivity disorder (ADHD) outside established pediatric guidelines, according to data presented on Friday by an official at the Centers for Disease Control and Prevention (CDC).

The report, which found that toddlers covered by Medicaid are particularly prone to be put on medication such as Ritalin and Adderall, is among the first efforts to gauge the diagnosis of ADHD in children below age 4. Doctors at the Georgia Mental Health Forum at the Carter Center in Atlanta, where the data was presented, as well as several outside experts strongly criticized the use of medication in so many children that young.

The American Academy of Pediatrics standard practice guidelines for ADHD do not even address the diagnosis in children 3 and younger — let alone the use of such stimulant medications, because their safety and effectiveness have barely been explored in that age group. “It’s absolutely shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant to the Carter Center. “People are just feeling around in the dark. We obviously don’t have our act together for little children.”

Dr. Lawrence H. Diller, a behavioral pediatrician in Walnut Creek, CA, said in a telephone interview: “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.”

Friday’s report was the latest to raise concerns about ADHD diagnoses and medications for American children beyond what many experts consider medically justified. Last year, a nationwide CDC survey found that 11 percent of children ages 4 to 17 have received a diagnosis of the disorder, and that about one in five boys will get one during childhood.

A vast majority are put on medications such as methylphenidate (commonly known as Ritalin) or amphetamines like Adderall, which often calm a child’s hyperactivity and impulsivity but also carry risks for growth suppression, insomnia and hallucinations.

Read more: http://mobile.nytimes.com/2014/05/17/us/among-experts-scrutiny-of-attention-disorder-diagnoses-in-2-and-3-year-olds.html?referrer=&_r=2

Related Online Continuing Education Courses:

Attention Deficit Hyperactivity Disorder (ADHD) is a 1-hour online continuing education (CE/CEU) course that gives a brief update on the various facets of ADHD.

Mental Health Medications is a 1-hour online continuing education (CE/CEU) course that describes the types of medications used to treat mental disorders, side effects of medications, directions for taking medications, potential interactions with other drugs, and warnings about medications from the FDA.

The Impact of a Life of ADHD: Understanding for Clinicians and Clients is a 3-hour online continuing education (CE/CEU) course that discusses the many ways a lifetime of ADHD can affect a person’s life.

Diagnosing ADHD in Adults is a 3-hour online continuing education (CE/CEU) course that describes the unique ways symptoms of ADHD manifest in adults, including the distinction between attention deficit and attention regulation.

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

ADHD: Myths & Facts

By Sarah Klein

What Everyone Gets Wrong About ADHDDespite an increase in diagnoses, plenty of stigma still surrounds attention deficit hyperactivity disorder, or ADHD. Adults with ADHD (or parents of children with the disorder) are often somehow blamed for the condition — as if they’re not trying hard enough to control a wide range of symptoms, which can include difficulty focusing, difficulty processing information quickly, fidgeting, impatience and more.

Every year, ADHD affects more than 4 percent of Americans over the age of 18 — adults who are learning, working and living fulfilling, successful lives alongside people who assume those with ADHD are somehow less than. Here are a few things we should all know about ADHD.

Myth: ADHD isn’t a real medical disorder.

Fact: Critics use a lot of different arguments in the service of discrediting ADHD. They blame bad parenting for “unruly” kids, pharmaceutical companies for “fabricating” the illness in search of a profit or students looking for an unfair “advantage” in the classroom. There’s even one theory that ADHD is the result of a culture with “a growing intolerance of childhood playfulness.” But ADHD is a valid condition, recognized by the National Institutes of Health, the U.S. Surgeon General and countless other medical professionals. What’s more, there’s even evidence to support a genetic predisposition for the condition in studies in twins — a hallmark of legitimacy.

Myth: It’s caused by eating too much sugar.

Fact: There’s little evidence to support a link between eating sugar and acting hyper, ADHD or no, even though many parents still believe in the so-called sugar rush. There’s also little evidence that links sugar to causing or worsening symptoms of ADHD.

Interestingly, it’s more likely that parents are affected by their children’s sugar intake: One study found that mothers who thought their sons were drinking a sugary beverage rated their children’s behavior as more hyperactive, criticized their sons more and kept a closer watch over them, the BBC reported.

Preliminary research has suggested certain food additives may be linked to ADHD, but the results are inconclusive, according to the FDA. More and better research is needed to fully understand the implications.

Myth: ADHD only affects children.

Fact: The average age of ADHD onset is 7, according to the National Institute of Mental Health, but many children will continue to experience symptoms as they grow older. In fact, WebMD reported, about 70 percent will experience symptoms in their teens and 50 percent into adulthood.

Myth: ADHD is more common in boys and men than in girls and women.

Fact: According to the National Institute of Mental Health, “boys are four times at risk than girls” for ADHD. But research suggests that our cultural and societal stigma may be at work here. Some studies have suggested ADHD is more “internal” than “external” in girls; they may not exhibit what most of us deem hyperactivity the same way as boys. Girls with ADHD may be more likely to have mood disorders, lower IQs and more difficulty socially, while boys may be more disruptive in school settings, leading to more referrals and diagnoses, according to the National Resource Center on ADIHD. More research is needed to fully understand gender differences in ADHD.

Myth: Adults with ADHD will struggle to complete school and succeed at work.

Fact: There is zero evidence to suggest ADHD affects a person’s intelligence or drive, and successful examples like Adam Levine, Michael Phelps and Solange Knowles certainly show that adults with ADHD can be creative, focused and successful.

Some people may find medication helpful, and many adults develop coping mechanisms and skills to assist them in reaching their goals. “Living with ADHD is not impossible,” Karen Ann Kennedy wrote in a recent HuffPost blog about her life with ADHD, “but it does take some careful planning to keep things in check.”

Source: http://www.huffingtonpost.com/2015/02/13/adhd-myths-misconceptions_n_6663394.html?ir=Healthy%20Living&utm_campaign=021315&utm_medium=email&utm_source=Alert-healthy-living&utm_content=Title&ncid=newsltushpmg00000003

Related Online Continuing Education Courses:

Attention Deficit Hyperactivity Disorder (ADHD) is a 1-hour online continuing education (CE/CEU) course that gives a brief update on the various facets of ADHD.

The Impact of a Life of ADHD: Understanding for Clinicians and Clients is a 3-hour online continuing education (CE/CEU) course that discusses the many ways a lifetime of ADHD can affect a person’s life.

Diagnosing ADHD in Adults is a 3-hour online continuing education (CE/CEU) course that describes the unique ways symptoms of ADHD manifest in adults, including the distinction between attention deficit and attention regulation.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by theTexas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

Attention Deficit Hyperactivity Disorder

attention deficit hyperactivity disorder

Excerpted from the National Institute of Mental Health (NIMH) Publication Attention Deficit Hyperactivity Disorder (ADHD), 2012.

What is Attention Deficit Hyperactivity Disorder?

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). These symptoms can make it difficult for a child with ADHD to succeed in school, get along with other children or adults, or finish tasks at home.

Brain imaging studies have revealed that, in youth with ADHD, the brain matures in a normal pattern but is delayed, on average, by about three years. The delay is most pronounced in brain regions involved in thinking, paying attention, and planning. More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall, and a brain structure important for proper communications between the two halves of the brain shows an abnormal growth pattern. These delays and abnormalities may underlie the hallmark symptoms of ADHD and help to explain how the disorder may develop.

Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it.

What are the symptoms of ADHD in children?

Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for six or more months and to a degree that is greater than other children of the same age.

Children who have symptoms of inattention may:

• Be easily distracted, miss details, forget things, and frequently switch from one activity to another
• Have difficulty focusing on one thing
• Become bored with a task after only a few minutes, unless they are doing something enjoyable
• Have difficulty focusing attention on organizing and completing a task or learning something new
• Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
• not seem to listen when spoken to
• Daydream, become easily confused, and move slowly
• Have difficulty processing information as quickly and accurately as others
• Struggle to follow instructions.

Children who have symptoms of hyperactivity may:

• Fidget and squirm in their seats
• Talk nonstop
• Dash around, touching or playing with anything and everything in sight
• Have trouble sitting still during dinner, school, and story time
• Be constantly in motion
• Have difficulty doing quiet tasks or activities.

Children who have symptoms of impulsivity may:

• Be very impatient
• Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
• Have difficulty waiting for things they want or waiting their turns in games
• Often interrupt conversations or others’ activities.

ADHD Can Be Mistaken for Other Problems

Parents and teachers can miss the fact that children with symptoms of inattention have ADHD because they are often quiet and less likely to act out. They may sit quietly, seeming to work, but they are often not paying attention to what they are doing. They may get along well with other children, whereas children who have more symptoms of hyperactivity or impulsivity tend to have social problems. But children with the inattentive kind of ADHD are not the only ones whose disorders can be missed. For example, adults may think that children with the hyperactive and impulsive symptoms just have disciplinary problems.

What Causes ADHD?

Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD.

Genes. Inherited from our parents, genes are the “blueprints” for who we are. Results from several international studies of twins show that ADHD often runs in families. Researchers are looking at several genes that may make people more likely to develop the disorder. Knowing the genes involved may one day help researchers prevent the disorder before symptoms develop. Learning about specific genes could also lead to better treatments.

A study of children with ADHD found that those who carry a particular version of a certain gene have thinner brain tissue in the areas of the brain associated with attention. This research showed that the difference was not permanent, however, and as children with this gene grew up, the brain developed to a normal level of thickness. Their ADHD symptoms also improved.

Researchers are also studying genetic variations that may or may not be inherited, such as duplications or deletions of a segment of DNA. These “copy number variations” (CNVs) can include many genes. Some CNVs occur more frequently among people with ADHD than in unaffected people, suggesting a possible role in the development of the disorder.

Environmental factors. Studies suggest a potential link between cigarette smoking and alcohol use during pregnancy and ADHD in children. In addition, preschoolers who are exposed to high levels of lead, which can sometimes be found in plumbing fixtures or paint in old buildings, have a higher risk of developing ADHD.

Brain injuries. Children who have suffered a brain injury may show some behaviors similar to those of ADHD. However, only a small percentage of children with ADHD have suffered a traumatic brain injury.

Sugar. The idea that refined sugar causes ADHD or makes symptoms worse is popular, but more research discounts this theory than supports it. In one study, researchers gave children foods containing either sugar or a sugar substitute every other day. The children who received sugar showed no different behavior or learning capabilities than those who received the sugar substitute. Another study in which children were given higher than average amounts of sugar or sugar substitutes showed similar results.

In another study, children who were considered sugar-sensitive by their mothers were given the sugar substitute aspartame, also known as Nutrasweet. Although all the children got aspartame, half their mothers were told their children were given sugar, and the other half were told their children were given aspartame. The mothers who thought their children had gotten sugar rated them as more hyperactive than the other children and were more critical of their behavior, compared to mothers who thought their children received aspartame.

Food additives. There is currently no research showing that artificial food coloring causes ADHD. However, a small number of children with ADHD may be sensitive to food dyes, artificial flavors, preservatives, or other food additives. They may experience fewer ADHD symptoms on a diet without additives, but such diets are often difficult to maintain.

If you would like the full text of this publication, it is in the public domain and available at no cost at http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml

If you would like to read this entire booklet and receive one hour of continuing education credit, visit Professional Development Resources at https://pdresources.org/course/index/6/1167/Attention-Deficit-Hyperactivity-Disorder-ADHD

 

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Attention Deficit Hyperactivity Disorder (ADHD)

Excerpted from the National Institute of Mental Health (NIMH) Publication Attention Deficit Hyperactivity Disorder (ADHD), 2012.

ADHD Free ResourcesWhat is Attention Deficit Hyperactivity Disorder?

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). These symptoms can make it difficult for a child with ADHD to succeed in school, get along with other children or adults, or finish tasks at home.

Brain imaging studies have revealed that, in youth with ADHD, the brain matures in a normal pattern but is delayed, on average, by about three years. The delay is most pronounced in brain regions involved in thinking, paying attention, and planning. More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall, and a brain structure important for proper communications between the two halves of the brain shows an abnormal growth pattern. These delays and abnormalities may underlie the hallmark symptoms of ADHD and help to explain how the disorder may develop.

Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it.

What are the symptoms of ADHD in children?

Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for six or more months and to a degree that is greater than other children of the same age.

Children who have symptoms of inattention may:

  • Be easily distracted, miss details, forget things, and frequently switch from one activity to another
  • Have difficulty focusing on one thing
  • Become bored with a task after only a few minutes, unless they are doing something enjoyable
  • Have difficulty focusing attention on organizing and completing a task or learning something new
  • Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
  • not seem to listen when spoken to
  • Daydream, become easily confused, and move slowly
  • Have difficulty processing information as quickly and accurately as others
  • Struggle to follow instructions

 

Children who have symptoms of hyperactivity may:

  • Fidget and squirm in their seats
  • Talk nonstop
  • Dash around, touching or playing with anything and everything in sight
  • Have trouble sitting still during dinner, school, and story time
  • Be constantly in motion
  • Have difficulty doing quiet tasks or activities

 

Children who have symptoms of impulsivity may:

  • Be very impatient
  • Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
  • Have difficulty waiting for things they want or waiting their turns in games
  • Often interrupt conversations or others’ activities


ADHD Can Be Mistaken for Other Problems

Parents and teachers can miss the fact that children with symptoms of inattention have ADHD because they are often quiet and less likely to act out. They may sit quietly, seeming to work, but they are often not paying attention to what they are doing. They may get along well with other children, whereas children who have more symptoms of hyperactivity or impulsivity tend to have social problems. But children with the inattentive kind of ADHD are not the only ones whose disorders can be missed. For example, adults may think that children with the hyperactive and impulsive symptoms just have disciplinary problems.

What Causes ADHD?

Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD.

Genes. Inherited from our parents, genes are the “blueprints” for who we are. Results from several international studies of twins show that ADHD often runs in families. Researchers are looking at several genes that may make people more likely to develop the disorder. Knowing the genes involved may one day help researchers prevent the disorder before symptoms develop. Learning about specific genes could also lead to better treatments.

A study of children with ADHD found that those who carry a particular version of a certain gene have thinner brain tissue in the areas of the brain associated with attention. This research showed that the difference was not permanent, however, and as children with this gene grew up, the brain developed to a normal level of thickness. Their ADHD symptoms also improved.

Researchers are also studying genetic variations that may or may not be inherited, such as duplications or deletions of a segment of DNA. These “copy number variations” (CNVs) can include many genes. Some CNVs occur more frequently among people with ADHD than in unaffected people, suggesting a possible role in the development of the disorder.

Environmental factors. Studies suggest a potential link between cigarette smoking and alcohol use during pregnancy and ADHD in children. In addition, preschoolers who are exposed to high levels of lead, which can sometimes be found in plumbing fixtures or paint in old buildings, have a higher risk of developing ADHD.

Brain injuries. Children who have suffered a brain injury may show some behaviors similar to those of ADHD. However, only a small percentage of children with ADHD have suffered a traumatic brain injury.

Sugar. The idea that refined sugar causes ADHD or makes symptoms worse is popular, but more research discounts this theory than supports it. In one study, researchers gave children foods containing either sugar or a sugar substitute every other day. The children who received sugar showed no different behavior or learning capabilities than those who received the sugar substitute. Another study in which children were given higher than average amounts of sugar or sugar substitutes showed similar results.

In another study, children who were considered sugar-sensitive by their mothers were given the sugar substitute aspartame, also known as Nutrasweet. Although all the children got aspartame, half their mothers were told their children were given sugar, and the other half were told their children were given aspartame. The mothers who thought their children had gotten sugar rated them as more hyperactive than the other children and were more critical of their behavior, compared to mothers who thought their children received aspartame.

Food additives. There is currently no research showing that artificial food coloring causes ADHD. However, a small number of children with ADHD may be sensitive to food dyes, artificial flavors, preservatives, or other food additives. They may experience fewer ADHD symptoms on a diet without additives, but such diets are often difficult to maintain.

More information on ADHD can be found here: http://psycom.net/adhd

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How is ADHD Diagnosed?

How is ADHD Diagnosed?Attention deficit disorder can’t be diagnosed based on the presence of one symptom. That’s because it’s not abnormal for people to feel distracted, unfocused and scattered sometimes. Not to mention that ADHD symptoms can be confused with other issues. This leads to misdiagnoses of disorders such as emotional issues and/or learning disabilities. Therefore, only a mental health specialist has the qualifications needed to make an accurate diagnosis.

What You Should Know About Diagnosing ADHD

Just as there’s no single symptom as proof of ADHD, there’s no single test that can determine its existence. A precise diagnosis can only be made with the involvement of a mental health professional or a doctor. Even then, multiple tools are used, including:

  • a symptoms checklist
  • past and present issues are examined
  • medical exam conducted to rule out other symptom-related causes


Always remember that there are various ADHD symptoms that can be confused with other medical issues or disorders. Hyperactivity and concentration problems are two problems that may look like ADHD. But, after a thorough assessment, a professional diagnosis may determine that ADHD doesn’t exist.

Making an Accurate ADHD Diagnosis

If you examine a group ADHD sufferers, you’ll find that the disorder looks different in each individual. This is one reason why there’s a need for such a wide-array of testing measures for helping professionals reach diagnosis. Therefore, potential sufferers must be honest and open during evaluations. That’s the only way for the specialist to come up with an accurate conclusion.

Factors Evaluated with ADHD is Diagnosed

There are some really strong hallmark symptoms related to ADHD. A combination of them is needed for an ADHD diagnosis. Some of the hallmark symptoms include lack of attention, becoming very impulsive and hyperactivity. These are some of the other factors your mental health professional will examine during the assessment:

  • The Severity of the Symptoms – Do the symptoms have a negative impact on the life of the potential sufferer? Generally people with ADHD will exhibit serious problems in in the family relationships, finances and/or careers.
  • The Beginning of the Symptoms – At what age did the ADHD symptoms begin to show themselves? Because ADHD begins during childhood, your therapist or doctor will look into how soon the symptoms appeared. When it comes to adults, they should be traceable all the back to childhood.
  • The Length of the Symptoms – How long have the symptoms been causing a disturbance? If the symptoms have been bothering the potential sufferer for less than six months, a proper ADHD diagnosis can’t be made just yet.
  • The Where and When of the Symptoms – ADHD symptoms have to present within more than one environment, such as at school and home. If symptoms only appear in one setting, more than likely, it’s not related to ADHD.


A proper ADHD diagnosis can be the encouragement you need to get control over your symptoms. Oftentimes, without help, your ADHD symptoms will stop you from obtaining success and happiness in your life. The sooner you begin treatment, the sooner you can take control of your life and your destiny.

Information compliments of Liahona Academy: http://www.liahonaacademy.com/

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ADHD & Domestic Violence Awareness Month Specials

25% Off ADHD & Domestic Violence CE

25% Off ADHD & Domestic Violence CETo help promote awareness and education of ADHD and Domestic Violence, we are featuring all of our ADHD and Domestic Violence online CE courses at 25% off during October:

 

ADHD is a non-discriminatory disorder affecting people of every age, gender, IQ, and religious and socioeconomic background. Do you know what appropriate treatment is? Are you up-to-date on what kind of help is available? A lot has changed in the last 20 and even in just the last five years. Click here for ADHD resources.

 

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These online courses provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account after purchasing) and mark your answers on while reading the course document. Then submit online when ready to receive credit.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDRProvider #PR001); the California Board of Behavioral Sciences (#PCE1625); theFlorida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Illinois DPR for Social Work (#159-00531); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

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Attention and Learning Problems: Which Came First?

By Karen J. Miller, MD

Attention and Learning Problems: Which Came First?Charlie looks around his first grade classroom when it’s reading time. He needs frequent reminders to get back to work. His teachers and his parents are puzzled why such a bright boy is having trouble in school. Could it be an attention deficit causing the problem? Could a learning problem cause the inattention? How can they help Charlie succeed?

Learning and attention problems are common and can range from mild to severe. From 5 to 10% of school-age children are identified with learning disabilities (LD). At least 5 to 8% are diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD). Many of these children have both. Although the studies vary, 25 to 70% of children with AD/HD have a learning disability and from 15 to 35% of children with LD have AD/HD. There are many children who have milder learning or attentional problems but the additive effects can be significant. Even mild dysfunctions in these critical brain functions can create problems as demands increase in secondary school, college and in life.

Attention and learning are related brain processes, separate but dependent on each other for successful functioning. “Learning” is the way the brain uses and remembers information like a factory taking in raw materials, storing parts and then manufacturing and shipping a finished product. “Attention” involves brain controls which regulate what information gets selected as important and gets acted on.the attention/behavior control system acts like the executives at the factory distributing the “brain energy” budget, setting priorities, deciding what to produce and monitoring quality control. Late shipments or poor quality products could be the result of any number of “glitches” in either system. Minor problems in one system can be compensated for but when both systems are affected failure looms. Sorting out the breakdown points is critical but can be complicated.

Evaluation: Look Beyond Symptoms

Comprehensive assessment is needed as some of the symptoms of learning and attention problems may look similar, at least on the surface. A child may be “distractible” because weak attention controls are unable to filter out unimportant sights or sounds. However, if reading is too difficult the child may look around because it doesn’t make sense. A child might be “disruptive” because their behavior controls are weak and they impulsively call out or annoy others. Some children with learning problems may act-up out of frustration or embarrassment. They would rather be considered “bad” than dumb. Other difficulties that can occur with either learning or attention problems might be:

  • Underachievement despite good potential
  • Inconsistent concentration
  • Difficulty with time-limited tasks
  • Problems with starting/completing work
  • Messy writing or disorganized papers
  • Low self-esteem
  • Problems with peer relations
  • Behavior problems
  • Secondary emotional problems due to repeated failure and frustration

 

Read more: http://www.ncld.org/types-learning-disabilities/adhd-related-issues/adhd/attention-learning-problems-when-you-see-one-look-for-other

 

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Preschoolers With ADHD Often Treated Incorrectly

By Rachael Rettner, MyHealthNewsDaily Senior Writer

Preschoolers With ADHD Often Treated IncorrectlyDoctors usually do not follow guidelines for treating very young children with attention-deficit/hyperactivity disorder (ADHD), a new study suggests.

In the study, about 90 percent of doctors surveyed did not strictly adhere to new guidelines recommended for treating preschoolers with ADHD, such as guidelines that address when to start medications, and which medications to use.

For instance, some doctors started preschoolers on medication too soon — before trying any non-drug treatment, such as counseling parents on how to manage their child’s behavior.

The findings are concerning because doctors should recommend behavior treatments first, the researchers said.

“At a time when there are public and professional concerns about over-medication of young children with ADHD, it seems that many medical specialists are recommending medication as part of their initial treatment plan for these children,” said study researcher Dr. Jaeah Chung, of Cohen Children’s Medical Center in New Hyde Park, N.Y. [See ADHD Medications: 5 Vital Questions and Answers.]

The researchers surveyed 560 doctors who specialize in diagnosing and managing children ages 4 to 6 with ADHD.

Results showed that only 8 percent of doctors followed all guidelines from the American Academy of Pediatrics — the rest either prescribed medications too soon, prescribed medications without first checking to see if behavior therapy was working, or did not use the drug methylphenidate as the first drug treatment.

One in five doctors said they often prescribe medications to preschoolers with ADHD as their initial treatment. The AAP said in 2011 that doctors should attempt to treat ADHD in preschoolers with behavioral therapies before prescribing medications.

In addition, about 40 percent of doctors said that when they did prescribe medications, they initially used a medication other thanthe ADHD drugmethylphenidate(sold under the brand name Ritalin). According to the AAP, methylphenidate should used first in preschoolers because it has been more rigorously studied in young children than other medications such as amphetamines.

About 20 percent of doctors said they expected the number of children they treated with medications would increase in the future.

Study researcher Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s, noted that the AAP guidelines are written for general pediatricians, and it’s possible that specialists see children with more severe ADHD (who are more likely to need medications).

Still, “Doctors collectively should recommend their patients pursue behavior therapies first,” Adesman said.

There may be obstacles to providing behavior therapy — the treatment is not always covered by insurance, and families may live in an areas without a specialist who provides behavior therapy, Adesman said. If this is the case, the AAP recommends that doctors weigh the risks of starting medication at an early age against the risks of delaying treatment.

Pass it on: In general, preschoolers with ADHD should attempt behavior therapy before they try medications.

Source: http://www.myhealthnewsdaily.com/3797-adhd-preschoolers-treatment.html?cmpid=525453

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Is Marijuana an Appropriate Treatment for ADD/ADHD?

Is Marijuana an Appropriate Treatment for ADD/ADHD?Recently, an article appeared in the New York Times reporting on the use of marijuana for treating children with ADD/ADHD. The Times article is just one of several that have been popping up since medical marijuana initiatives have been passed in a handful of states.

Initially, the use of marijuana to treat pain and suffering related to the side effects of chemotherapy and to increase appetite in HIV patients were used as the rationale for the medical marijuana initiatives. Now, however, a patient can get a prescription for almost any type of complaint. Anxiety, depression and other behavioral disorders are at the top of the complaint list, so it is not surprising that more disorders are being added to the list.

The Pharmacology of Marijuana

Briefly, marijuana is of the plant genus Cannabis. There are at least 66 active compounds found in marijuana but the most psychoactive compound is delta9-tetrahydrocannabinol (THC). The human brain contains several groups of cannabinoid receptors where they are concentrated and distributed in different areas. These receptors are activated by the neurotransmitter anandamide, which THC mimics.

The main neuropsychological effects of THC and, perhaps the other 65 identified compounds, are on short-term memory, coordination, learning and problem solving. Physical endurance and performance functions also are affected by cannabinoids. THC is recognized as a very powerful psychoactive compound.

Drugs and Paradoxical Reaction

The foundational premise related to the medication treatment of attention deficit symptoms is rooted in the concept of paradoxical reaction. That is, these patients seem to react contrary to the mechanism of action for the class of drugs. Psychostimulants, for example, activate, produce heightened alertness, increased energy, appetite suppression and sometimes euphoria.

The main symptoms of ADD/ADHD include inattention, hyperactivity and impulsivity. Psychostimulants, as a class of drug, should enhance many of the negative behaviors that are seen in ADD/ADHD, but behaviorally they do not. This is an example of paradoxical reaction.

Marijuana, generally, decreases alertness, memory, hyperactivity and impulsivity. It increases appetite and is a euphoric. The paradoxical reactions to marijuana may include heightened awareness and performance, paranoia, depression, anxiety, increased activity and impulsivity. Advocates of marijuana, such as psychiatrist Dr. Leonard Grinspoon, say that they would have no hesitation in giving youngsters with ADHD a trial of oral marijuana.

Moreover, they assert, “for some kids, it appears to be more effective than traditional treatments.” They also contend that marijuana has fewer potential dangers and side effects than the psychostimulants.

However, if psychostimulants do hold an edge over marijuana, it is that these drugs are standardized as to their composition, potency, dose and experience? Presently, there is no standardized marijuana compound, unless one wants to include Marinol, a drug synthesized from cannabis which is not under consideration as a treatment option.

Potency of marijuana varies significantly from plant to plant, region of origin and potency, among other variables. Moreover, there is no real control over the concentration of the other compounds found in marijuana, which clearly affect the mechanism of action of THC. Lastly, there is no control over potential adulteration through additives.

A Paradoxical Reaction to a Paradoxical Reaction

Without trying to use a play on words, it is easy to see that whatever the drug of choice, paradoxical reaction brings into question the entire treatment of ADD/ADHD with all medications. Adding marijuana into the mix, in my opinion, is questionable, at best.

There may be many good medical uses for marijuana but we need solid research and data to find out what they might be to justify its use in children and adults. There is sufficient data that casts significant doubt on the diagnoses of ADD/ADHD. There is a significant body of data that supports behavioral interventions as a first line treatment of these symptoms.

The common psyhopharmacological treatment for attention deficit disorders is psychostimulants, but there is a growing body of data on the potential danger of psychostimulants. Ritalin, Concerta and Strattera typically are the drugs of choice prescribed by physicians and psychiatrists.

Adding marijuana to the current list of medication options is very premature. Before even considering marijuana, it seems to me that the current use of psychostimulants also should be scrutinized as a treatment option. Many of the patients that I have treated after being referred for ADD/ADHD had long standing but undiscovered sleep disorders. Not surprisingly, psychostimulants do produce gains in performance with these patients. For too long many have accepted that ADD/ADHD are established conditions that need medical as opposed to behavioral treatment.

To date, not a solitary cause has yet been identified for ADHD. ADHD will likely prove to be an umbrella term for a number of behavioral and/or neurologically based disorders.

Furthermore, there hasn’t been any identified cause specific to ADD leaving open the likelihood that ADD may be a catch-all condition. The National Institutes of Health Consensus Development Conference and the American Academy of Pediatrics agree that there is no known biological basis for ADHD.

The more we review the literature on hyperactivity or ADD, the less certain we are as to what it is or whether it really exists as a standalone disorder. So, at issue, is not only the question of marijuana as a potential treatment for attention deficit problems, but should the use of psychostimulants in children also be re-evaluated?

Given the myriad, unknown pharmacological variables involved in the mechanism of action of marijuana, I believe that marijuana, at this time, is not and should not be taken as a serious treatment option for attention deficit symptoms.

By John Caccavale, PhD, ABMP

TNP Jan/Feb 2010

Excerpt from Psychotherapy Practice Tips, Part 1

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Medical Marijuana is a 3-hour online CEU course that presents a summary of the current literature on the various medical, legal, educational, occupational, and ethical aspects of marijuana.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

Discontinued Treatment of ADHD Could Impact Emotional & Social Well-Being

By (@BostonLara)

Continuing Education on ADHDYoung boys who discontinue treatment for attention deficit hyperactivity disorder (ADHD) are featured in a new study that many experts say highlights the importance of proper and continued treatment.

An average of 9 percent of children ages 4 to 17 are diagnosed with ADHD each year, according to the U.S. Centers for Disease Control and Prevention. Considered one of the most common childhood disorders, the condition is defined by over-activity, and difficulty focusing and controlling impulsive behaviors.

The study, published Monday in the Archives of General Psychiatry, followed nearly 300 boys living in New York City for 33 years. Half of the participants were diagnosed with ADHD during childhood but stopped taking medications for their treatment by the time they were enrolled. The men with ADHD were recruited for the study during childhood by a teacher and either a parent or psychiatrist. The men without ADHD were selected because medical records showed no signs of behavioral problems.

The men with ADHD were seven times more likely to drop out of school, and made on average $40,000 less per year than their non-ADHD counterparts. They were more than twice as likely to be divorced. Some 16 percent of the men with ADHD also had a form of personality disorder compared with none in the non-ADHD group. And 36 percent of the men with ADHD had gone to prison at least once, compared with only 11 percent in the non-ADHD group.

Read more @ http://abcnews.go.com/Health/Wellness/boys-suffer-negative-effects-adhd-left-untreated/story?id=17483707#.UH2-_cXyqsg

Professional Development Resources offers online continuing education courses for healthcare professionals that address the impact of ADHD. Courses are accredited for psychologists, counselors, social workers, MFTs, occupational therapists, SLPs and registered dietitians.

Professional Development Resources is accredited by the entities listed below to offer continuing education for the professions listed. We recommend that you check with your licensing board to ensure our accreditations are applicable for your renewal requirements.

 


Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the Florida Board of Psychology and Office of School Psychology (CE Broker Provider #50-1635).
Professional Development Resources is approved by the National Board of Certified Counselors (NBCC) to offer home study continuing education for NCCs (Provider #5590). We adhere to NBCC guidelines. Professional Development Resources is also approved as a provider of continuing education by the National Association of Alcoholism & Drug Abuse Counselors (NAADAC, Provider #000279); by the Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (Provider #BAP346); by the California Board of Behavioral Sciences (Approval #PCE1625); by the South Carolina Board of Professional Counselors and Marriage & Family Therapists (Provider #193); and by the *Ohio Counselor, Social Worker and Marriage & Family Therapist Board (Provider #RCST100501). * Ohio Counselors: check CE accreditation statement for specific course approval – if Ohio is not listed, the course is not approved.
Professional Development Resources is approved as a provider of continuing education for social workers by the Association of Social Work Boards (ASWB Provider #1046, ACE Program). Professional Development Resources is also approved by the Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (Provider #BAP346); by the California Board of Behavioral Sciences (Approval #PCE1625); by the Illinois DPR as a Registered Social Work CE sponsor (Provider #159-000531); by the Ohio Counselor, Social Worker and Marriage & Family Therapist Board (Provider #RCST100501); and by the Texas State Board of Social Worker Examiners (#5678).
Professional Development Resources is approved as a provider of continuing education by the Association of Social Work Boards (ASWB Provider #1046, ACE Program); by the National Board of Certified Counselors (NBCC Provider #5590); by the American Psychological Association (APA); and by the National Association of Alcoholism & Drug Abuse Counselors (NAADAC, Provider #000279). Professional Development Resources is also approved by the Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (Provider #BAP346); by the California Board of Behavioral Sciences (Approval #PCE1625); by the Texas Board of Examiners of Marriage & Family Therapists (Provider #114); by the South Carolina Board of Professional Counselors and Marriage & Family Therapists (Provider #193); and by the *Ohio Counselor, Social Worker and Marriage & Family Therapist Board (Provider #RCST100501). *Ohio MFTs: check CE accreditation statement for specific course approval – if Ohio is not listed, the course is not approved

Professional Development Resources is an American Occupational Therapy Association (AOTA) approved provider of continuing education (#3159). The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Professional Development Resources is also approved by the Florida Board of OT Practice (#34) and is CE Broker compliant.
American Speech-Language-Hearing Association (ASHA) CEUs are awarded by the ASHA CE Registry upon receipt of the CEU Participant Form from the ASHA Approved CE Provider. Please note that the completion date that appears on ASHA transcripts is the last day of the quarter, regardless of when the course was completed. Provider #AAUM
Professional Development Resources is a CPE Accredited Provider with the Commission on Dietetic Registration (CDR Provider #PR001). CPE accreditation does not constitute endorsement by CDR of provider programs or materials. Professional Development Resources is also a provider with the Florida Council of Dietetics and Nutrition (Provider #50-1635).