Many children with ADHD have difficulty with transitions, especially very young children. A five year long study out of Lehigh University reviews the benefits of counting down the time before switching activities and found that at least in children, youngsters are better able to control outbursts spurred by ADHD. The five-year study, paid for by the National Institutes of Health, provided a range of behavioral-only therapies to 135 preschoolers with severe ADHD. Families were given either parent-education classes only, or parenting classes plus home and preschool visits by researchers who customized techniques for each child. After a year, aggression and other problem behaviors had dropped, and learning improved, by about 30 percent, the researchers report this month in a journal of the National Association of School Psychologists.

What helped? Stressing consistent rules and routines, and more praise for good behavior than punishment for bad. Surprisingly, both groups fared equally well, raising questions about how to tell which children need more intense aid. Preschoolers with ADHD learn best through repeated practice so the study stressed role-playing things like how to ask to share a toy. Parents were taught to reserve stronger punishments for worst cases, and to try reward systems where children gain or lose “points” for behavior instead. Even the time-out standby was to be used sparingly.

I am excited to share with you news that the adult version of the Cogmed working memory training program will soon be available in the U.S! Jonas Jendi, CEO of Cogmed, announced that this adult tool for improving focus and concentration should be arriving in the next 2-3 weeks. The Cogmed home-based software program originated in Sweden and is based on the neuroscience research work of Dr. Torkel Klingberg at the Karolinska Institute.  For those of you interested in the science behind working memory training, Dr. Torkel’s website, www.klingberglab.se, posts full journal articles on the benefits of training working memory in multiple conditions such as ADHD, stroke, and normal aging.

Over the past 6 months we at ADD Health and Wellness have had great success with the child version of the software and are pleased to now be able to extend this treatment option to our adult clients as well. Clients completing the program report signficant improvements in attention, learning, and academic skills with this brain training.

The working memory training program offers great flexibility. It can be done -

• in both children and adults
• in person or by phone.
• in individuals with other co-existing condtions or learning disabilities
• in conjunction with multiple other treatment modalities

For a free demo of the software, visit www.Cogmed.com 

This past weekend the regional ADDA conference was sponsored by Brown University and held in Providence RI. As a presenter at the conference, I thought I would share with you some of my experiences and some information I found interesting. For example, did you know that the founder of Johnny Rockets (148 Restaurants Nationwide), Lloyd Sugarman is diagnosed with ADHD. His story is inspiring and encouraged many in the audience with ADHD to remain positive and focus on ADHD strengths such as being creative, taking risks, and thinking outside of the box.

In addition to traditional approaches to treatment, there were seminars on Laughter Yoga (one of my favorites) and how walking a Labyrinth helps adults and children deal with some of the symptoms of ADHD. In addition, there were many success stories shared over the course of the weekend. During the last forum, Vicki Ball, a leader in the ADHD coaching field encouraged a panel of highly successful professionals with ADHD to answer the question: “What gadgets/strategies have helped you the most with managing your ADHD?” the responses were at times emotional and heart felt. Here are some of my favorites:

-  Always utilizing Outlook pop-ups for reminders about meetings and important due dates.

-  Using Post-it notes for urgent items only. For example, one successful lawyer described putting a post-it on her front  door with a list of items “not to forget”- again not everyday, just urgent items. Similarly she places a post-it on the  corner of her computer if she must send an email by the end of the day and places a post it on her telephone if she  must return a call that day.  

-  One heavy sleeper who had great difficulty getting up in the morning used an alarm clock for the deaf to make certain that she woke up.

-  For people who work in a cubicle, wear a headset to improve concentration on telephone calls and to limit other people interrupting you.

-  Turn wristwatch around as a reminder that something important has to be done. It was reported that the discomfort was a great trigger/reminder

-  Respect your energy! Use your energy when you know you have it

-  Ask yourself regularly: “Does it have to be me and Is it really important?”

In general, all of the panel agreed that negative self-talk was pervasive before they learned about ADHD and that it was invaluable to them to learn to “kill the ANTs” which stands for Automatic Negative Thinking. Finally, the group finished with an inspirational quote from Henry Ford: “Whether you think you can or you think you can’t, you’re right”

A study of 202 adult men and woman age 40 and older published in Psychosomatic Medicine found that those who went through group-based exercise therapy did as well as those treated with an antidepressant drug. A third group that performed home-based exercise also improved, though to a lesser degree.

Participants who were all diagnosed with major depression were randomly assigned to one of four groups: one that worked out in a supervised, group setting three times per week; one that exercised at home; one that took the antidepressant sertraline (Zoloft); and one that took placebo pills. After 16 weeks, the patients completed standard measures of depression symptoms.

By the end of the study, 47 percent of participants on the antidepressant no longer met the criteria for major depression. The same was true of 45 percent of those in the supervised exercise group. In the home-based exercise group, 40 percent had their symptoms go into remission. That compared with 31 percent of the placebo group.

There are several theories on why exercise might improve depression. For example, physical activity seems to affect key nervous system chemicals — norepinephrine and serotonin — that are targets of antidepressant drugs, as well as brain neurotrophins, which help protect nerve cells from injury and transmit signals in brain regions related to mood. Exercise may also boost people’s feelings of self-efficacy and promote positive thinking.

There is mounting evidence that artificial colors can exacerbate hyperactivity. A 6 week study conducted by reseachers at Southampton University and recently published in The Lancet showed the artificial food colors sunset yellow, carmoisine, tartrazine, and ponceau 4R mixed with sodium benzoate as commonly found in sweets adversely impacted the childrens behavior. The 297 sujects in the study were children ages 3, 8, and 9 years old. Authors concluded that children who were given a drink mix containing food coloring additives showed a higher percentage of hyperactivity than the subjects who drank a placebo mix.  

This is not to say that all ADHD is caused by food additives. There are many reasons children and adults have difficulty paying attention and in many cases genetics is the most influential factor. However, in using all available tools to control ADHD symptoms, parents and practitioners should consider removing food additives from a child’s diet.

Just say no to sunset yellow! http://afp.google.com/article/ALeqM5gxkT4USWDK5tgUrClrwGN0UIh–A

The good news is that most children treated from an interdisciplinary treatment approach for Attention Deficit Hyperactivity Disorder (ADHD) showed sustained improvement after three years in a major follow-up study funded by the National Institute of Mental Health (NIMH). However, the bad news is that increased risk for behavioral problems, including delinquency and substance use, remained higher than normal.

The report, published in the August, 2007 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), stated that after three years, 45-71 percent of the youth in the original treatment groups were taking medication; however, continuing medication treatment was no longer associated with better outcomes by the third year. More specifically, they identified three groups of children with different patterns of response. One group, about a third of the children, showed a gradual, moderate improvement; a second group, about half of the children, showed larger initial improvement, which was sustained through the third year; and a third group, about 14 percent of the children, responded well initially, but then deteriorated as symptoms returned during the second and third years. Swanson and colleagues suggested “trial withdrawals” for some children to determine if they still need to take medications.

In a follow-up study of 485 children ages 10-13, the study found that intensive medication management alone or in combination with behavioral therapy produced better outcomes than just behavioral therapy. Furthermore, ratings from families and teachers favored the combination treatment, which allowed for lower medication doses. Of particular concern was that found by Brooke Molina, Ph.D., University of Pittsburgh, and his colleagues. They reported that, despite treatment, the children with ADHD showed significantly higher-than-normal rates of delinquency (27.1 percent vs. 7.4 percent) and substance use (17.4 percent vs. 7.8 percent) after three years. Earlier evidence of lower substance use rates among children who had received intensive behavioral therapy had lessened by the third year. “These findings underscore the point that ADHD treatment for one year does not prevent serious problems from emerging later,” noted Molina.

Back to school is here again. For those with Attention Deficity Hyperactivity Disorder (ADHD) this can be a difficult time of year. Many schools do not have the resources to give students with learning differences what they need. With ADHD being one of the most common disorders in children and adolescents, affecting approximately 7% of school aged children, it is clear that additional supports are critical.

Good news for those looking for an alternative path. The newly established Hartford Accelerated Learning Center has been designed with the goal of teaching and accommodating children with ADHD and learning disabilities. Teachers incorporate physical activity and music instruction in the curriculum and allow students to build on their strengths and work at their own pace. I was particularly impressed with the school’s flex-time schedule which enables students to start and end their school day later if they are not early morning risers. It is very common for children, adolescents, and adults with ADHD to have a shifted sleep/wake cycle and struggle with their mornings, yet be on their game later in the day.

Most people with ADHD are generally above average intelligence, but may have difficulty in a standard classroom due to problems focusing, restlessness, and impulsive or disruptive behaviors. They need more stimulation and engaging activities to promote concentration and learning.

The to eligible for enrollment in the new school, the child must be in first through sixth grade and be diagnosed with ADHD and/or a learning disability. The tuition is $500 per month. For more information you can contact Dr. Anne Morris at 205-822-6363 or Flora Eaddy at 205-588-3952 http://www.dothaneagle.com/content/gulfcoasteast/dea/lifestyle.apx.-content-articles-DEA-2007-08-19-0008.html

Exciting research funded by the National Institute of Mental Health (NIMH) has found significant results indicating the effectiveness of non-medicinal interventions in preventing behavioral and academic problems associated with ADHD! This was the largest study of its kind with 135 children between the ages of three and five years who have shown significant symptoms of ADHD.

Over the last 5 years, Lehigh Valley Hospital found that parents reported on average, a 17% decrease in aggression and 21% improvement in their children’s social skills. Teachers saw similarly strong results; in the classroom, there was a 28% improvement in both categories. Early literacy skills improved up to three times their baseline status.

This study is particularly important since ADHD is a lifelong mental disorder that often becomes apparent in during a child’s preschool years. The researcher is consistent with ADD Health and Wellness Centers approach to treatment and reinforces a multi-tiered approach to intervention. This project which is called “Project Achieve” suggests that with careful assessment, such children can be accurately identified and appropriate behavioral interventions are an important part of the treatment plan.”

Teaching children from a young age to eat a low-fat diet can be effective — even as they reach their teens and begin eating more meals away from home, according to a new study. The study of children in Finland found that those who were taught to focus on healthy fats — those found in fish, nuts, seeds and oils from plants — had slightly lower cholesterol levels compared to those who ate an unrestricted diet. The researchers have been following the 1,062 children since the age of 7 months. About half of the children and their families were counseled to shift fat intake from animal-based saturated fats to healthier unsaturated fats. The rest did not get specific diet advice. The new study reported the results on the children at age 14. Dr. Harri Niinikoski, lead author of the study done at the University of Turku in Finland, said children begin forming their eating and lifestyle habits in childhood. “The earlier you intervene, the more likely you are going to be successful,” she said. 

A study published in the American Heart Association Journal recently compared 540 children assigned to a dietary counseling group to 522 who did not get special diet advice, starting from seven months of age and found that regular counseling of families and children about the benefits of avoiding saturated fats in their diet led to diets lower in fat and saturated fat, and reduced blood cholesterol levels in children up to the age of 14. There were no differences in stature between counseled children and those who were not, suggesting a low-fat diet can pay dividends from the start without affecting growth.  Among the findings, counseling seemed to have a bigger impact on the cholesterol level of boys than girls. The researchers were not sure why. The counseled children also ate more protein and carbohydrates than those who received no dietary advice. “At age 14, the dietary group had a small but statistically significant lower median cholesterol level,” the Heart Association said in a statement. Families in the counseling group received regular advice from a nutritionist and the children were counseled directly from the age of seven.