Attention Deficit Hyperactivity Disorder Inappropriate behavior, including poor attention skills, impulsivity, and hyperactivity

Attention Deficit Hyperactivity Disorder

Inappropriate behavior, including poor attention skills, impulsivity, and hyperactivity


• Behavioral disorder emerges before the age of seven• Symptoms include inattentive, impulsive and hyperactive

behaviors• ADHD is not a reflection of a child's intelligence nor caused

by poor parenting• ADHD is more common in people who have a close relative

with the condition• Twice as many boys are diagnosed with ADHD as girls

What Is The Difference Between ADD and ADHD

• The current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) outlines the diagnostic criteria for mental conditions.

• Although the terms ADD and ADHD are used interchangeably, ADHD is the official name used by the American Psychiatric Association, and it encompasses hyperactive, impulsive, and/or inattentive behaviors.

• ADD is the older term thus in some older literature you will find this term as a synonym for ADHD

Attention Deficit Hyperactivity Disorder: Prevalence

• Affects children, adolescents and adults• It is one of the most common childhood psychiatric

conditions in the United States.• The National Institute of Mental Health (NIMH) estimates

that 5 million children in the United States have ADHD – that is about 5% of all children!

• Studies show that up to 70% of children with ADHD continue to have symptoms as adults

Attention Deficit Hyperactivity Disorder: In Children

• Childhood ADHD -- attention-deficit/hyperactivity disorder -- is diagnosed after a child has shown six or more specific symptoms of inactivity and/or hyperactivity on a regular basis for more than six months in more than two settings.

• There is no single test for ADHD

• Diagnosis is based on questionnaires

Attention Deficit Hyperactivity Disorder: In Children

• A doctor can diagnose ADHD with the help of standard guidelines.

• The diagnosis of ADHD involves the gathering of information from several sources, including school, caregivers, and parents.

• The doctor will consider how a child's behavior compares with that of other children the same age.

TYPES OF ADHD

• Combined Type (Inattentive/Hyperactive/Impulsive). Children with this type of ADHD show all three symptoms. This is the most common form of ADHD.

• Hyperactive/Impulsive Type. Children show both hyperactive and impulsive behavior, but are able to pay attention.

• Inattentive Type. Formerly known as attention deficit disorder (ADD), these children are not overly active. They do not disrupt the classroom or other activities, so their symptoms might not be noticed.

Attention Deficit Hyperactivity Disorder:

In Teens• Typically diagnosed in childhood, ADHD still affects

many teens. • The symptoms -- inattention, impulsivity, and

hyperactivity - are intrusive, which means they interrupt and seriously interfere with a teen's life.

• During teen years, especially as the hormonal changes of adolescence are going on, symptoms of ADHD may intensify.


In Teens• It's not uncommon for teens with ADHD to forget

assignments, misplace textbooks, and become easily bored with their daily class work.

• Teens may become inattentive, or excessively attentive -- not waiting for their turn before blurting out answers.

• They may interrupt the teacher and classmates, and rush through assignments.


In Teens• Teens with ADHD may also be fidgety and have a

difficult time sitting still in class.• Often, teens with ADHD are so busy focusing on

other things they forget about the task at hand. This can be seen especially with homework and athletic skills and in relationships with peers.

• This lack of attention to what they're doing often leads to poor performance on tests and being rejected from sports teams, extracurricular activities, and peer groups.


In Teens• Teens with ADHD are more likely to be heavy

drinkers than teens without ADHD.

• In clinical studies, researchers confirmed that teens with ADHD were twice as likely to have abused alcohol within the past 6 months.


In Teens• They also found that teens with ADHD were likely

to abuse drugs and three times more likely to abuse drugs other than marijuana.

• Getting proper treatment for ADHD in teens may cut the risk of later alcohol and drug abuse.


In Adults• It is now known that these symptoms continue into

adulthood for about 70% of children with ADHD.

• That translates into 4% of the US adult population, or 8 million adults.

• However, few adults are identified or treated for adult ADHD.


In Adults• Adults with ADHD may have difficulty following

directions, remembering information, concentrating, organizing tasks or completing work within time limits.

• If these difficulties are not managed appropriately, they can cause associated behavioral, emotional, social, vocational and academic problems.


In Adults• The following behaviors and problems may stem

directly from ADHD or may be the result of related adjustment difficulties:– Chronic lateness and forgetfulness.– Anxiety.– Low self-esteem.– Employment problems.– Difficulty controlling anger.– Impulsiveness.


In Adults– Substance abuse or addiction.– Poor organization skills.– Procrastination.– Low frustration tolerance.– Chronic boredom.– Difficulty concentrating when reading.– Mood swings.– Depression.– Relationship problems.


In Adults• These behaviors may be mild to severe and can

vary with the situation or be present all of the time. • Some adults with ADHD may be able to

concentrate if they are interested in or excited about what they are doing. Others may have difficulty focusing under any circumstances.

• Some adults look for stimulation, but others avoid it.


Interesting Facts• Adults with ADHD are more likely to:

– Change employers frequently and perform poorly.– Have had fewer occupational achievements– Have a lower socioeconomic status.– Have driving violations such as: be cited for

speeding; have their licenses suspended; be involved in more crashes; rate themselves and others as using poorer driving habits.


Interesting Facts• Adults with ADHD are more likely to:

– Use illegal substances more frequently.– Smoke cigarettes.– Self-report psychological maladjustment more often– Have more marital problems and multiple marriages.– Have higher incidence of separation and divorce.

• Much of this functional impairment diminishes with remission of the disorder and can be mitigated by appropriate treatment.

Common Conditions That Coexist With ADHD

COMORBIDITY CHILDREN ADOLESCENT ADULT

Learning Disorders X XAnxiety & Depression X X XBipolar Disorder X X XOppositional Defiance Disorder X XConduct Disorder X XTourette’s Syndrome X XSubstance Abuse X XObsessive Compulsive Disorder X XIntermittent Explosive Disorder XPanic Disorder XSpecific Phobia X


The Medical Approach

Medication for ADHD

• A class of drugs called psycho-stimulants or stimulants have been used to effectively treat ADHD for years.

• They work by increasing the production of two neurotransmitters – dopamine and norepinephrine

Medication for ADHD

• These medicines help users to focus their thoughts and ignore distractions.

• Stimulant medications are effective in 70% to 80% of patients.

• However there are short and long term effects related to these drugs

Medication for ADHD

• Stimulant drugs to treat ADHD include:– Adderall and Adderall XR– Concerta– Dexedrine– Focalin and Focalin XR– Metadate CD and Metadate ER– Methylin– Ritalin, Ritalin LA– Vyvanse– Desoxyn

Side Effects of ADHD Drugs

• ADHD drugs sometimes have side effects• The most common side effects of ADHD drugs

include:– Decreased appetite/weight loss– Sleep problems– Headaches– Jitteriness– Social withdrawal– Stomach aches

Side Effects of ADHD Drugs

• Rarely, medications for ADHD can cause more serious side effects.

• For instance, some stimulants are associated with an increased risk of cardiovascular problems and sudden death.

• They may also exacerbate psychiatric conditions like depression or anxiety.

Stimulant Safety ConcernsEffect On The Developing Brain

• The long-term impact of ADD / ADHD medication on the youthful, developing brain is not yet known.

• Some researchers are concerned that the use of drugs such as Ritalin in children and teens might interfere with normal brain development.

Stimulant Safety ConcernsHeart Related Problems

• ADHD stimulant medications have been found to cause sudden death in children and adults with heart conditions.

• The American Heart Association recommends that all individuals, including children, have a cardiac evaluation prior to starting a stimulant.

• An electrocardiogram is recommended if the person has a history of heart problems.

Stimulant Safety ConcernsPsychiatric Problems

• Stimulants for ADD / ADHD can trigger or exacerbate symptoms of hostility, aggression, anxiety, depression, and paranoia.

• People with a personal or family history of suicide, depression, or bipolar disorder are at a particularly high risk, and should be carefully monitored when taking stimulants.

Stimulant Safety ConcernsPotential for Abuse

• Stimulant abuse is a growing problem, particularly among teens and young adults.

• College students take them for a boost when cramming for exams or pulling all-nighters.

• Others abuse stimulant meds for their weight-loss properties.

• If your child is taking stimulants, make sure he or she isn’t sharing the pills or selling them.

Stimulant Contraindications

• ADD / ADHD stimulants are not recommended for those with:– Any type of heart defect or diseases – High blood pressure – Hyperthyroidism – Glaucoma – High levels of anxiety – A history of drug abuse


The Brain

ADHD AND BIOLOGICAL FACTORS

• First identified in 1902• Initially classified as serious brain damage• Precise causes still unknown• New research proves that ADD/ADHD is closely

tied to:– Brain size– Brain density– The way brainwaves are produced

PREFRONTAL CORTEX

• Smaller Prefrontal Cortex• Key functions include impulse

control, socialization, reason and judgment

• ADHD children are more prone to drifting off, making sudden outbursts or using poor judgment

NERVE TISSUE

• Nerve tissue is smaller and thinner

• Less connections• Scientists believe that

these variations can affect a child's attention and impulse control.

NEUROLOGICAL DYSREGULATION

• Brainwave Imbalance• May be caused by:

– Variations in brain structure– Drugs– Toxins– Poor Nutrition– Subluxation– Trauma– Stress – both physical and emotional

NEUROLOGICAL REGULATION

• The ability of the brain to regulate itself• Mental states are associated with specific brainwaves• These brainwaves include:

– Delta– Theta– Alpha– Beta

DELTA BRAIN WAVES

• Produced during deep sleep• Associated with the release of

Human Growth Hormone

THETA BRAIN WAVES

• This is the predominant brainwave that your brain produces when you are just about to fall asleep

• It is associated with creativity and memory retrieval

• This is why you seem to get your best ideas just as you are falling asleep. It is also why you typically remember things when you are just about to fall asleep.

THETA BRAIN WAVES

• When the brain is dysregulated it sometimes produces high levels of Theta in the waking state

• In these cases it is associated with:– Distractibility– Inattention– Daydreaming

• Excessive amounts of Theta are typical in individuals with ADD

ALPHA BRAIN WAVES

• Associated with meditation and a sense of inner calm or peacefulness

• They are produced when the brain is in an idle state

• This mental state is sometimes described as a quiet alertness

BETA BRAIN WAVES

• The brain produces brain waves when we are:– Awake– Alert– Externally focused– Logical– Problem solving– Attentive

BETA BRAIN WAVES

• Beta Waves are produced in the cortex• Children with ADHD typically have a smaller cortex

so they very often produce less Beta Waves than normal

THETA BETA RATIO

A Key Diagnostic Finding in ADHD

THETA BETA RATIO

• Normal Theta / Beta ratios are – 2:1 in adults and – 2.5:1 in children

• Ratios higher than 3:1 suggest ADD/ADHD

• In several different studies it was demonstrated that 86% of the children diagnosed with ADHD using traditional criteria had a T/B ratio higher than 3:1

BRAINCORE THERAPY

BRAINCORE THERAPY AND ADHD

• Neurofeedback is a training procedure designed to teach children with ADHD how to control their own brainwaves bringing balance, harmony and regulation to the brain

• The goal of neurofeedback is to transform an unhealthy brainwave pattern into a healthy one

THE BRAINCORE APPROACH

• Painless• Drugless• Non-Invasive• And Has No Side

Effects

THE BRAINCORE EVALUATIONA Window To the Brain

• The EEG evaluation begins by placing surface sensors at specific sites on the scalp

• These sensors detect brain waves and display them on the computer screen

THE BRAINCORE EVALUATIONA Window To the Brain

• During the course of the next 10 minutes the patient is asked to perform several tasks while the BRAINCORE software monitors the brainwaves

• A report is generated demonstrating imbalances associated with ADHD such as a high Theta Beta Ratio

THE BRAINCORE TRAINING

• Based on the patient history and the BRAINCORE EEG Evaluation results, a customized training program is designed for the patient

• The training program is different for each individual case but typically it involves either training the patient to produce more of a certain brainwave or less of a certain brainwave


• During the training session the patient is connected to the EEG using the surface sensors and the patient’s brainwaves are displayed on the computer

• On a separate monitor the patient is watching a movie that is being controlled by the patient’s own brainwaves


• The movie will only play if the patient’s brain is producing the desired brainwave

• During the course of 20 training sessions, the patient’s brain learns how to produce the desired brainwave

• This new ability is associated with the alleviation of the ADHD symptoms


• The best part is that the changes experienced by the patient are permanent!

• It has been demonstrated that after 20 or more BRAINCORE training sessions, the brain actually remodels itself – a process known as Neuroplasticity

BRAINCORE THERAPY

30 Years of University Based Research Demonstrates a 76% Success Rate

THE EFFICACY OF NEUROFEEDBACK

• Dr Frank H. Duffy, a Professor and Pediatric Neurologist at Harvard Medical School, was asked about the effectiveness

of neurofeedback – this was his response:

“In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted

and widely used”

BRAINCORE THERAPY

QUESTIONS

A GIFT

Documents

Attention Deficit Hyperactivity Disorder Inappropriate behavior, including poor attention skills, impulsivity, and hyperactivity