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Cogmed Working Memory Training Outline: Everything You Want To Know About ADHD
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Return to ADDvisor, Volume 1 1999 Index Number 6, November 1, 1999 ================================================ In this issue:
===================================================== CHADD CONVENTION ===================================================== I just wanted to add a couple of personal thoughts about the CHADD National Convention that took place in Washington D.C. a few weeks ago. I think what was most evident is how many people, both professional and non-professional, there are out there that care deeply about our ADHD children. Through research, counseling, coaching, mentoring, supervising, parenting and teaching, the future looks bright for those needing help with the difficulties that ADHD creates. Also very evident was how vital and impressive the CHADD organization is. Parents and professionals are very fortunate to have an organization like CHADD at their side. ===================================================== ADHD: HOW IS IT DIAGNOSED? ===================================================== Perhaps the best way to answer this question is “very carefully”. ADHD is often misdiagnosed/over diagnosed for a couple of reasons. ADHD is called a “spectrum disorder”. In other words, whether or not someone is diagnosable with ADHD is a matter of degrees. Most everyone experiences some of the symptoms of ADHD, it’s how many of the symptoms, for how long, and in what situations that makes the difference for diagnosis. It is like trying to decide if someone is “short”. Is 5’1” short? It depends on where we decide to draw the line and what factors we decide to include such as males vs. females, what culture, race, etc. It is also difficult to diagnose because other disorders both resemble it and accompany it. Someone who is depressed often has difficulty concentrating or paying attention, someone who is angry may act before thinking, and someone who has a learning disability may get poor grades in school. All of these are characteristics of ADHD, but in all of these examples, the individual may have a different problem. Accompanying disorders are called “co-morbid disorders” and they occur quite frequently with ADHD. If a co-morbid disorder is overlooked the ADHD treatment will be only partially effective. Common disorders include: depression, anxiety, conduct disorders, learning disabilities and substance use disorders. Needless to say ADHD cannot be properly diagnosed in 20-30 minutes. There are too many factors to consider and the price of misdiagnosis is too high. One final note – positive response to medication is not diagnostic. Many people will experience a positive response to stimulant medication whether or not they have ADHD. So, how then, is it diagnosed? A comprehensive evaluation of ADHD includes a number of factors. Usually 3 or 4 checklists are filled out by the parents (or if an adult – themselves and their spouse) these checklists provide diagnostic information very specific to the symptoms of ADHD and provide diagnostic information relevant to any possible co-morbid disorders. It is also important to obtain specific medical information, especially as it relates to prenatal and infancy developmental periods. Checklists are also provided to one or more teachers to obtain information from the school setting. This, again, looks at both ADHD specific diagnostic criteria and co-morbid disorders. In the office, a thorough clinical interview is an essential component to make an accurate diagnosis. The clinical interview, which includes parents or significant others, explores specific symptom areas, behaviors, family history and attitudes relevant to ADHD. In addition, the interview carefully examines possible co-morbid conditions such as conduct disorders, depression, anxiety disorders, learning disorders, substance abuse and more. Also in the office setting a computerized test called a “Continuous Performance Test” is often administered for additional information. Finally since ADHD is an hereditary disorder the parents are often invited to complete questionnaires about themselves. A parent who is accurately diagnosed and effectively treated can provide much better help than an untreated parent to their ADHD child. Once all this information has been scored and synthesized it is provided in summary form to the parents and/or client and thoroughly discussed so that whatever the diagnosis, it is understood. At this point, on occasion, additional testing may be recommended (e.g. testing for learning disabilities) and detailed treatment recommendations are made. Although it is, at times, relieving to know the reason for an individual’s difficulties. The ADHD diagnosis is a mixed blessing at best. An accurate ADHD diagnosis means that the individual has a chronic neurological disorder that will, most likely, effect them for the rest of their lives. They will often need to take medication, change their way of doing things, develop a large number of coping strategies and seek professional treatment from time to time to help them attain and maintain an optimally functional lifestyle. The next article in this series will look at specific ADHD treatment methods. =================================================== RESEARCH OF THE MONTH =================================================== I would like to highlight a research article in the April 1999 issue of the Journal of Attention Disorders written by L. E. Arnold (Multi-Health Systems). This article entitled “Treatment Alternative for Attention-Deficit/Hyperactivity Disorder (ADHD)”, compared the research results of twenty-three alternative treatments. The author did not include medication or behavioral treatments because they “have already been extensively and well reviewed...with undoubted efficacy.” What were his conclusions? None of the twenty-three alternative treatment studies except for two had significant support in the scientific literature. The two that were supported were thyroid treatment in children found to have abnormal thyroid function and a “few foods diet” (oligoantigenic) in a subpopulation of children (suspected to be rather small) with ADHD. It was noted that simple sugar restriction has not garnered convincing scientific support. Thus, it appears that medication, behavior management, parent education and training, and environmental interventions are the best ways to help kids improve. Please stay in touch. We are here to help you. If you have a topic of particular interest, please let us know. Questions are also welcome.
CONTACT INFORMATION _______________________ Alan R. Graham, Ph.D. Bill Benninger, Ph.D. ADDvisor.com Voice: 1-866-ADDvisor Fax: 847-824-2386 Email: Alan@ADDvisor.com Bill@ADDvisor.com Web: www.ADDvisor.com
c) Copyright 1999 ADDvisor.com, Ltd. All rights reserved The above material may be retransmitted or distributed to whomever you wish as long as not a single word is changed, added or deleted, including the contact information. However, you may not copy it to a web site. Republication of "The ADDvisor" in paper media is encouraged and permitted by organizations and associations which serve parents of ADHD children at the national, state and/or local level as long as the issue is reprinted in its entirety without charge and includes the contact information. With advance permission, we are happy to edit an issue to fit your space requirements. Republication is also encouraged under other circumstances, however, the advance permission of Alan R. Graham and/or Bill Benninger must be obtained in the event that changes in the text are desired or republication is to be made by individuals or by organizations other than those mentioned above.
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