Friday, May 28, 2010

Parenthood and AD/HD Tips

Most parents feel overwhelmed by the constant demands of parenthood, and having one or more children with AD/HD likely intensifies this feeling. Try to lighten your load by preparing meals several days or even a week in advance and consider simple meals such as frozen lasagna or stir fry. Help yourself and your children leave on time in the mornings by laying out your children’s school clothes and having them bathe at night.

Thursday, May 27, 2010

AD/HD and Employment

Even if an individual graduates high school or college, he or she is not through dealing with AD/HD-related difficulties. As discussed earlier, AD/HD affects all aspects of daily life, including jobs. Adults with AD/HD tend to have higher rates of unemployment than “normal” adults; they tend to use more sick days, be less productive and change jobs more often than their peers, and they are more likely to be dismissed or fired by employers.

As mentioned in my previous post, Effects of AD/HD on Education, vocational assessment often helps guide adults with AD/HD into the most appropriate areas of employment based on their individual skill sets. Working jobs appropriate to your skills or habits will increase your ability to perform acceptably, retain your position and receive satisfactory ratings from supervisors.

Appropriate medication or other treatment is also important for job success. Individuals with AD/HD tend to be more accident prone, even on the job. Effectively treating your AD/HD symptoms can not only help you succeed in your career, it can also help prevent work-related injuries or accidents.

Much like primary school and college instructors, many employers are willing to make small concessions for employees who have AD/HD; thus, it is important to tell your supervisors about your AD/HD-related difficulties. You should also feel free to request reasonable workplace adjustments (e.g. asking to be placed in a quieter or more secluded office) to help you focus and increase productivity.

Because of their difficulties in supervised professional settings, many adults with AD/HD start their own businesses; this often results in a positive economic impact by creating specialty or niche markets. However, self-employed adults with AD/HD should establish quotas or guidelines for themselves to ensure that their business remains productive and profitable - otherwise, they may find themselves right back in the job pool.

The Effects of AD/HD on Education

While AD/HD affects all aspects of daily life, education appears to be the most severely impacted area. Children and young adults with AD/HD tend to pay less attention during class, be more hyperactive and disruptive during class and complete less work than their “normal” peers. As a result, many fall behind in school, are held back, placed in special education, suspended or expelled or eventually drop out on their own. Students with AD/HD tend to have lower test scores, class ranking, and GPA’s; moreover, fewer students with AD/HD go to college and, those that do go often do not earn a degree.

Given these dismal effects, what can we do to minimize the negative impact of AD/HD on education? First is early detection of AD/HD. As previously stated, the vast majority of the AD/HD testing patients at the Neuropsychology Clinic are college students. Most of them had difficulty learning and fell behind early on, struggled through high school and then hit a brick wall in college. Many parents avoid having their child tested because they don’t want to admit that their child might have AD/HD or another related difficulty, they don’t want to medicate their child or they try to avoid the cost of AD/HD testing. As a result, parents inadvertently cause their child to struggle, often to the point that they feel “dumb” or “worthless,” or have dropped or failed several classes by the time they actually seek diagnosis and treatment. Having your child tested for AD/HD at the first sign of difficulty and effectively treating the disorder, along with any other conditions that may exist, is the first proactive step to ensure the best educational outcomes for your child.

Next is getting the teachers involved. To most teachers, there is a big difference between a child who has difficulty in school because he or she is simply not trying and a child who is genuinely trying but has trouble because of AD/HD-related difficulties. Many teachers are willing to take extra time with children who have AD/HD. In addition to extra assistance from instructors, some students qualify for and benefit from academic accommodations (e.g. separate room to complete tests or assignments, longer time to complete tests or assignments, front row seating, etc.).

Third is a vocational assessment and job skills training during high school. This will help evaluate your child’s unique skills and guide his or her career choices or areas of college study.

Because many students feel overwhelmed by the greater demands of a college course schedule, it may be helpful for a college-bound student with AD/HD to start out at a community college. This will encourage a more smooth transition and allow the student to gradually work up to the four-year college level. Regardless of whether your child starts out at a two-year or four-year college, it is important to involve instructors and advisors. Much like in primary education, making educators aware of your child’s AD/HD and corresponding school-related difficulties will help them guide him or her through a more beneficial college experience. There are also academic accommodations similar to those offered in primary school available for the college level. In fact, many of our college-age patients seek testing to see if they qualify for university accommodations.

In short, untreated AD/HD can have profound negative effects on education. However, with early diagnosis and treatment and a little help along the way from parents and teachers, many students with AD/HD are able to excel at even college-level courses and go on to enjoy fulfilling careers.

Monday, May 17, 2010

ADD and AD/HD: What's the Difference?

When I refer to AD/HD while speaking to patients, many of them say “well, I think I just have ADD, I’m not very hyperactive.” So, what’s the difference between ADD and AD/HD?

Attention Deficit/Hyperactivity Disorder (AD/HD) is the official name used by the American Psychiatric Association; it is the preferred term because it encompasses both primary aspects of the condition: inattention and hyperactive-impulsive behavior.

However, the most meaningful difference comes with the three basic types of AD/HD: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined.

The type that most people think about when they think of AD/HD is the Hyperactive – Impulsive Type, as these are the individuals who are overactive, fidgety, talkative, impulsive, and who often exhibit behavioral problems. This type is much easier to recognize because the symptoms are often obvious and overt. However, there is also an Inattentive Type of AD/HD that is characterized by difficulty organizing and completing tasks, focusing on details and paying attention to instructions or conversations, etc. Although underlying distractibility and forgetfulness can have a significant impact on daily routines and performance, the absence of behavioral issues frequently causes this subtype to be overlooked. Finally, there is the Combined Type of AD/HD, which presents with a combination of the behavioral and attention deficits from the other two subtypes.
While the name ADD vs. AD/HD is of little significance, knowing your subtype is quite important. For instance, while the treatment options are generally the same for all three types, some are typically more effective for certain subtypes as opposed to others. For example, individuals with the Inattentive type of AD/HD typically do not respond as well to stimulant medications and, if they do respond, they typically do so at a lower dosage than do individuals with the Hyperactive/Impulsive or Combined types. Therefore, a non-stimulant medication alternative may be a more appropriate choice of medication to address the Inattentive type. Furthermore, as I like to tell my testing patients, ‘it’s good to know your strengths, but it’s also good to know your weaknesses;’ knowing your subtype helps you better understand your weaknesses. Individuals with the Hyperactive-Impulsive type tend to display hyperactive and impulsive actions, just like the name implies. As a result, they often make poor decisions while driving or blurt out things they never actually meant to verbalize. The sheer knowledge that you have these tendencies can help you moderate them (e.g. making a conscious effort to pay more attention or be more deliberate about making decisions while driving, thinking before you speak in general conversation, etc).
After you are tested for AD/HD, your doctor should go over the results with you and, in the process, tell you what subtype best describes you. If you are not told what subtype you have, feel free to ask; once again, knowing your subtype can help you more effectively treat or self-moderate your difficulties.

The Daily Planner: A Valuable Tool for Adults with AD/HD

While many adults with AD/HD have difficulty planning, organizing, and managing their daily schedules, many do not realize that one simple thing can help keep them on track- a planner!

While the idea of using a daily planner seems quite simple, many of our patients with AD/HD report difficulty selecting, consistently using, and keeping up with their planners. The following are suggestions for effectively using and getting the most benefit from your daily planner.

First, you have to choose the right planner for your lifestyle. A good daily planner should have at least three things; a calendar and space for “to do” lists and frequently used contact information (e.g. home and email addresses, phone numbers, etc.); these three basics will help you get on track and organize your day. You can also choose a planner with more “bells and whistles” such as built-in notepads and calculators or slots for business cards. However, if you choose a more detailed planner, make sure you don’t get something so complicated that it becomes overwhelming and confusing.

Now that you know what to look for in a planner, you can choose the type of planner you want. Planners can be paper (e.g. Day Timer and Planner Pad brands), electronic (e.g. Blackberry, Palm Pilot) or software-based (e.g. Windows Outlook). Electronic organizers have several advantages including portability, audible reminders and alarms and the ability to sort, organize and store more information. Software-based organizational tools also have the capability of sorting and organizing to specificity and are housed in the pc– a tool already frequently used by many adults. Still, some of us prefer the old-fashioned paper and pencil method. Regardless of which type you choose, your planner should be user-friendly, easily accessible, and something you can take with you wherever you go.

Once you have selected a planner, write your own contact information (e.g. name, phone number) in the front so, if you lose or forget it, someone can return it to you. Next, take advantage of the “contacts” section mentioned earlier. Record the contact information (e.g. names, phone numbers, physical and email addresses) of frequently used contacts (e.g. family members, friends, instructors, supervisors, co-workers, etc.) and emergency personnel (e.g. physicians, police and fire departments) so you will always have important contact information with you.

Make your new planner your one and only means of organizing your schedule. If you go the paper route, stop using your phone calendar or planning software; if you choose the more high-tech electronic route, get rid of your paper calendar and all those sticky notes! This way, you won’t have to remember where you wrote down what information and you won’t drop the ball on important obligations simply because you couldn’t find the reminder. Make sure to use your planner to organize ALL aspects of your life (e.g. work, school, family, recreation, personal time, etc.). Things will get very confusing very quickly if you try to use different organizational tools for different aspects of your life.

Next, select ONE SPECIFIC place to keep your planner. This could be on the top right-hand corner of your office desk, in the front zipper part of your backpack, beside your home phone or the front door, under your keys, or in a purse or satchel. Wherever you put it, make sure that it is clearly visible, even if the area where you put it gets messy - this will help prevent losing or forgetting your all-important schedule. When you decide on a location, put it there every single time- NO EXCEPTIONS!

Now that you have your planner and know where you will keep it, use it to record important information as it comes; don’t wait until you have two or three things to write down. If you wait until a more convenient time, you are more likely to forget or confuse important details. This leads us to the next point, keep you planner with you at ALL TIMES. If you don’t have your planner with you, it is impossible to record important information as you get it.

Next, check your planner regularly! Again, it does no good whatsoever to write notes and reminders if you forget to refer back to that information. Until you get use to relying on your planner, it may help to schedule certain times to read over your notes. For example, you could do this around mealtime or at particular times throughout the day; setting watch or phone alerts might help get you into the habit of consulting your schedule regularly.

Now that you’re actively using your daily planner, think about other ways you can use it to help keep yourself on track. For example, use that space for “to do” lists mentioned earlier. Whether it’s a reminder to water the plants, pick up skim milk on the way home from work, write a 20-page essay or attend Saturday’s yoga class, write it down in your “to do” list. You can prioritize your list in order of importance, by due dates, etc. Consult your list frequently and be sure to complete tasks by their due dates. When you complete something on your list, cross it off or put a check mark beside it so you know that task is complete and you don’t have to worry about it anymore.

These tips should put you well on your way to effectively using a daily planner to manage your time and organize your day. Though it may be a somewhat difficult adjustment at first, using a daily planner could potentially save time, effort and the frustration that comes when you realize you just dropped the ball on an important obligation.

Information taken from www.help4adhd.org

Thursday, May 13, 2010

What's Normal and What is AD/HD?

At some point in life, most of us will experience at least some symptoms of AD/HD. To further complicate matters, some ”normal” people have personality characteristics (e.g. hyperactivity, impulsivity) similar to the symptoms of AD/HD, and other non-related conditions have similar symptoms and can be mistaken for the disorder. The only definite and reliable way to determine whether or not you have AD/HD is through cognitive testing; however, as a starting point to help you figure out if you might be at risk for AD/HD, the following is a brief overview of the AD/HD diagnostic criteria.

In order to meet full diagnostic criteria, your difficulties must have begun in early childhood, must be chronic in nature, and must affect more than one area of daily life (e.g. home, school, work, social life). If your difficulties are recent, occurred only occasionally in the past or only affect one aspect of your life (e.g. school) you do not meet formal AD/HD diagnostic criteria.

You are at increased risk for AD/HD if:

· You have blood relatives (e.g. parent, sibling, cousin, etc.) with AD/HD or another mental health disorder
· You were born prematurely
· You were exposed to environmental toxins as a child
· Your mother was exposed to toxins during pregnancy
· Your mother smoked, drank alcohol or used illicit drugs during pregnancy

Some AD/HD symptoms include:

Inattention
· failure to pay close attention to details
· making careless mistakes
· difficulty sustaining attention during tasks or activities
· not listening when spoken to directly
· failure to follow through on instructions
· difficulty organizing tasks and activities
· reluctance to engage in tasks that require sustained mental effort
· losing things necessary for tasks and activities
· distractibility
· forgetfulness
Hyperactivity
· fidgeting
· getting up or excessive moving in inappropriate situations
· difficulty engaging in leisure activities quietly
· acting as if “on the go” or “driven by a motor”
· excessive talking
Impulsivity
· blurting out answers before questions are complete
· difficulty waiting turn
· interrupting or intruding on others

In addition, many individuals with AD/HD have:

· Poor school performance
· Behavioral problems
· Trouble with the law
· Problems at work
· Alcohol or drug abuse
· Frequent car or other accidents
· Unstable relationships

If you feel that you meet some of all of these criteria, you may have AD/HD. The next step is scheduling a testing appointment or speaking with your family physician. Prepare for both appointments by writing a list of your symptoms and how they affect different aspects of daily life. You should also write down any recent changes or stressors, along with your family history and any medications you are currently taking (including vitamins and minerals).


Information taken from www.mayoclinic.com

Monday, May 10, 2010

Adult AD/HD


When we think of Attention Deficit/Hyperactivity Disorder (AD/HD), most of us picture a seven-year-old bouncing around the room, talking constantly, and disturbing everyone within a ten-mile radius. However, many people do not realize that AD/HD can also affect adults.
Though AD/HD, by definition, always starts in early childhood it is often not diagnosed until later in life; in fact, the vast majority of the AD/HD testing patients here at the Neuropsychology Clinic are college-age or older.

Statistically speaking, roughly one of every three people with AD/HD eventually grows out of their symptoms; one of every three continues to have fewer or less severe symptoms as adults; and one of every three continues to have significant symptoms as adults.

AD/HD affects adults much like it affects children, only in a broader scope; in children, AD/HD can typically affect only two basic areas: school performance and relationships. In addition to these, AD/HD in adults also affects areas such as professional achievement, marital relations, and driving skills. For example, many adults with AD/HD find it difficult to organize their day and complete daily tasks. As a result, they frequently miss deadlines, appointments, meetings and other important obligations – some even lose their job simply because of the way the disorder affects their ability to complete their responsibilities. On the hyperactive-impulsive side, adults with AD/HD frequently make poor decisions while driving (e.g. pulling out in front of other drivers, running red lights) and are more prone to substance abuse, risky behavior and accidents.
In short, AD/HD is a real disorder that affects children and adults alike. Having AD/HD as an adult doesn’t make you a freak of nature, it makes you like approximately four percent of the otherwise “normal” population. AD/HD affects every aspect of patients’ lives and, if untreated, can cause serious social, academic, professional, family, and health-related problems. If you suspect that you have AD/HD, you can take the first step by contacting us at the Neuropsychology Clinic to schedule a testing appointment.

Information taken from www.mayoclinic.com

Wednesday, May 5, 2010

Tip of the Day: Accommodations


AD/HD can make excelling at work and school a challenge to say the least. Although you may feel embarrassed about telling your boss or professor you have AD/HD, they likely will likely be happy to make small accommodations to help you succeed. Don’t feel embarrassed about asking for the things you need to improve your performance at work or school, such as more in-depth explanations or more time to complete certain tasks.

Tuesday, May 4, 2010

AD/HD Treatment


While getting tested for AD/HD is an important first step, it doesn’t do a whole lot of good to know you have AD/HD if you don’t treat it in some way or another. Fortunately, there are several methods of medical and non-medical AD/HD treatment available. The following is a brief overview of the more popular treatment methods:
First, is medication; medications effectively treat the disorder in 90-95% of the AD/HD population; they are effective in addressing core AD/HD symptoms (e.g. attentional issues, impulsivity, hyperactivity), and they improve functioning in all major aspects of daily life (home, work, school, relationships). They eliminate all AD/HD symptoms in 50%, and reduce the symptoms in 90% of cases; they can also enhance academic function, increase effort and compliance of task demands and improve recall of learned information. AD/HD medications are typically safe and have relatively few side effects. The top two side effects I have observed in my personal contact with medicated AD/HD patients are 1.) loss of appetite and 2.) withdrawal. More information regarding different types of medications and their benefits and side effects can be found at: www.mayoclinic.com
Next, is treating any other comorbid disorders. AD/HD has a high rate of comorbidity meaning that, if you have AD/HD, you are much more likely to have other cognitive difficulties. Studies indicate that as many as 65% of children with AD/HD will also have at least one other comorbid condition at some point in their lives. If you have another disorder along with AD/HD, treating AD/HD may help but it will only address part of the problem; you won’t see optimum results until you treat every aspect of the problem. The potential for comorbid conditions is one reason why testing is so important; at the Neuropsychology Clinic, we not only test for AD/HD, we also investigate the potential for other common comorbid conditions (e.g. anxiety, depression, learning disability, personality disorder, etc.)
Many people find counseling very helpful in addressing their AD/HD related difficulties. There are several different types of counseling available. First, is marital and family therapy. This type of counseling can help loved ones cope with the stress of living with someone who has AD/HD and learn what they can do to help. It can also help moderate problems linked to AD/HD that often place stress on relationships. For example, your spouse or other family members may feel like you're unreliable, messy, a poor listener or not contributing equally to family responsibilities. Understanding that your faults are not due to lack of effort or refusal to change your behavior can relieve tension and minimize conflict. Couples therapy and classes in which family members learn more about AD/HD often significantly improve relationships. The next type of counseling is psychotherapy, which focuses on helping develop skills to resolve specific issues. Psychotherapy can help:

· Improve your time management and organizational skills
· Learn how to reduce your impulsive behavior
· Develop better problem-solving skills
· Cope with past academic or social failures
· Improve your self-esteem
· Learn ways to have better relationships with your family, co-workers and friends
· Develop strategies for controlling your temper

Other forms of counseling focus on improving communication skills, peaceful conflict resolution and problem solving. In many situations, you can participate in all these forms of therapy with the same counselor.

Some of our AD/HD testing patients report that regular, structured physical exercise such as yoga, karate, or gymnastics help moderate their AD/HD symptoms by teaching them to focus their minds and allowing them to release excess energy.
While little to no research actually indicates that changes or additions to the diet reduce AD/HD symptoms, some individuals with AD/HD find it helpful to reduce foods thought to increase hyperactivity, such as sugar or caffeine. Also, if you notice that a certain food causes an increase in your symptoms, you may want to try eliminating it from your diet to see if it makes a difference. However, always consult your physician before dramatically adjusting your diet; eliminating too many types of foods can be unhealthy because it may deprive you of necessary vitamins and nutrients.
While certain vitamins and minerals are necessary for and promote good health, there is no evidence that supplemental vitamins or minerals actually reduce AD/HD symptoms. In addition, some supplements, if taken in overabundance can exceed the body’s Tolerable Upper Limit (the maximum amount of a particular vitamin or mineral the body can handle) and become harmful.
It is unknown whether taking herbal remedies or supplements actually help with AD/HD, though some people claim they do.
While essential fatty acids (e.g. omega-3 oils) and glyconutrients (specific sugars believed to reduce symptoms by helping form compounds called glycoproteins), are necessary for proper brain function, it is again too soon to say whether they reduce AD/HD symptoms.
In summary, there are many different proposed AD/HD treatments available. Though some are more researched and proven than others, there is no ‘magic cure’ for AD/HD. Because AD/HD varies in severity and effect and each individual reacts differently to treatment, it is up to you and your health care provider to determine which form of treatment is right for you.


Information taken from www.mayoclinic.com
and
http://www.ncpamd.com/ADD_Comorbidity.htm

Monday, May 3, 2010

Diagnosing AD/HD: The Testing Process

by Brinkley C. Pearce, M.A.,


Contrary to some opinions, AD/HD cannot be accurately diagnosed just by talking to a doctor or filling out a questionnaire. Instead, properly diagnosing AD/HD requires a fairly lengthy and detailed testing process, like that offered here at the Neuropsychology Clinic.

When you come into our office for an AD/HD testing appointment, we begin by asking you to complete a checklist of commonly reported symptoms. We use this checklist as a starting point for the clinical interview, which is designed to gain an accurate understanding of all your symptoms and how they affect your daily life. During the interview, we ask a series of questions such as:

· When did you first notice your difficulties?
· Were you diagnosed with AD/HD before?
· Have you ever taken an attention enhancing medication?
· How do your symptoms affect your home or social life/ academic achievement/ job performance?
· How effectively do you manage your schedule and keep track of important obligations (e.g. deadlines, appointments, etc.)?

We will also ask about your medical history (e.g. are you currently or were you previously treated for any medical conditions? Are you currently taking any medications?) and educational background (e.g. what is the highest degree you have completed? What type of grades did you/do you currently make in school?) so we can keep in mind any medical conditions or medications that may contribute to your difficulties, along with any prior difficulties you may have experienced in school.

Following the interview is the actual testing process. We at the Neuropsychology Clinic offer two basic types of evaluations:

AD/HD Screen - using the screen, we can diagnose AD/HD and determine whether or not other common difficulties such as a learning disability or emotional dysfunction (e.g. anxiety, depression, etc.) are a likely contributing factor. The screen typically lasts two to three hours.

Full Evaluation – with the full evaluation, we can effectively diagnose AD/HD, learning disabilities, emotional dysfunctions, etc. and rule out other potential disorders. In addition, the full evaluation meets University of Alabama academic accommodations requirements. The full evaluation takes between four and six hours to complete and can be broken into two sessions, if needed.

If you’re not sure which evaluation is right for you or your child, we will be happy to discuss the specifics of each test and make a recommendation based on your individual difficulties and symptoms.

After the testing session(s) is complete, you will come back approximately one week later for the feedback appointment. During this appointment, you will receive the results of your evaluation, along with professional recommendations based on those results. This is also your time to ask questions about the diagnosis, potential treatments, etc.

After the feedback, we will send a copy of your report to your referring physician and, when applicable and with your permission, to other health care providers, schools, attorneys, insurance companies, or other authorized parties.