Posts Tagged medication

5 Must-Read Articles, and an Online Course, to Help Children with ADHD

Given the ongoing changes and controversies surrounding ADHD diagnosis and treatment, let me highlight 5 key articles written by Duke University’s Dr. David Rabiner to summarize recent scientific findings and their implications, plus a very relevant online course to help parents and professionals help children with ADHD.

1. Study finds large gaps between research and practice in ADHD diagnosis and treatment

  • Key insight: Evidence-based guidelines from the American Academy of Pediatrics on the evaluation and treatment of ADHD are frequently not followed. Many children are diagnosed with ADHD in the absence of clearly meeting DSM diagnostic criteria, and behavioral treatment is rarely recommended.
  • Key data point: Pediatricians prescribed ADHD medication to roughly 93% of youth diagnosed with ADHD. Documentation that behavioral treatment was recommended, however, was present in only 13% of the charts.

2. Study shows why children with ADHD should be reevaluated each year: Attention problems perceived by teachers are far less stable than we imagine

  • Key insight: Clinically-elevated attention problems as perceived by teachers are less stable than imagined, highlighting the importance of carefully reevaluating children each year so that children do not continue to carry a diagnosis that may no longer apply and to be treated for problems at school that are no longer evident.
  • Key data point: Data from 3 diverse samples indicates that more than 50% of elementary school children rated by their teacher as having clinically significant inattentive symptoms one year do not show similar problems the following year.

3. Don’t overlook sleep difficulties in children with ADHD; they may impair functioning as much as ADHD itself

  • Key insight: Although the link between ADHD and sleep difficulties is well-documented, evaluating sleep difficulties during an ADHD assessment may be routinely overlooked. In some cases, sleep problems may create significant difficulties for their daily functioning beyond what ADHD symptoms explain, so treating the child’s sleep difficulties should be an important treatment target.
  • Key data point: The most prevalent sleep problem – reported for 42% of the sample – was excessive daytime sleepiness, and it contributed to significantly lower life skills even after controlling for ADHD symptoms. The second most prevalent sleep problem was insomnia (for 30% of the sample), and it predicted greater social impairment–above and beyond impairment explained by ADHD symptoms.

4. Reducing the Need for High Medication Doses with Behavior Therapy

  • Key insight: The really interesting findings from this study concern the combination of medication and behavioral treatment. On virtually all ADHD measures, adding high intensity behavior management to the lowest medication dose of medication yielded comparable improvements to those produced by the high dose medication alone. For a number of measures, even low intensity behavior management combined with the lowest medication dose was as effective as high dose medication.
  • Key data point: Results suggested that a typical child with ADHD could be treated with the equivalent of 5 mg of methylphenidate 2X/day if he/she concurrently received moderate to high intensity behavior therapy. Without behavior therapy, the same child would require a 20 mg dose 2X/day to attain comparable benefits. Thus, the daily reduction in methylphenidate would be 30 mg/day.

5. Mindfulness training for children with ADHD and their parents

  • Key insight: Mindfulness training for children and parents can be a helpful intervention for ADHD. Parents can observe reductions in their child’s ADHD symptoms following training. In addition, they can observe declines in their own ADHD symptoms and parenting stress.
  • Key data point: From pre- to post test, children who received mindfulness training were rated by their parents as showing significant declines in inattentive and hyperactive impulsive symptoms; the magnitude of the decline was large for attention problems and moderate for hyperactivity. These declines remained evident and of similar magnitude at the 8-week follow-up.

We hope you enjoy those 5 must-read articles summarizing recent scientific findings and their implications.

To learn more, parents and allied professionals may also want to access the 6-hour, self-paced, online course How to Navigate Conventional and Complementary ADHD Treatments for Healthy Brain Development, featuring Dr. David Rabiner (and myself).

>> Learn More & Register Here (10%-off discount code: sharp2017)

Course description: In order to successfully promote children’s healthy brain development, every parent whose child has been diagnosed with ADHD should learn how to systematically navigate and monitor the range of potential ADHD treatments based on the latest scientific evidence. This course aims at providing the necessary information, frameworks and toolkits to make well-informed decisions, in conjunction with professional advice, about medication, behavioral therapy, exercise, neurofeedback, working memory training, meditation, diet and supplements.

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Brain News: Lifelong Learning for Cognitive Health

Here you have the March edition of our monthly newsletter covering cognitive health Brain Fitnessand brain fitness topics. Please remember that you can subscribe to receive this Newsletter by email, using the box at the top of this page. I know I am biased – but do believe this Newsletter issue might well be our best so far. I hope you find the time to enjoy it!

Bird’s Eye View

Top Articles and Resources in March: Highlights – a) great articles in SciAm Mind and the Wall Street Journal, b) new resources (book and free DVD) by the Dana Foundation, c) research studies on how our cognitive abilities tend to evolve as we age, the impact of physical exercise on the brain, the lack of long-term effectiveness of ADHD drugs, and how working memory training may benefit math performance.

Brain Fitness Survey: Over 2,000 thoughtful responses to our January survey (Thank You!) reinforce the need for public awareness initiatives and quality information to help evaluate and navigate lifestyle and product claims, as well as the need for more research, an expanded healthcare culture, as more. Given this context, we are publishing The SharpBrains Guide to Brain Fitness in May 2009, a book with 18 Interviews with Scientists, Practical Advice, and Product Reviews, in addition to our annual market report for professionals and executives (to be published in April). If you have ideas to help us promote the book, please reply to this email and let us know!

Lifelong Learning

Elderhostel’s Marty Knowlton dies at 88: He helped launch Elderhostel, reinvented “aging”, “retirement” and “learning”, and contributed to the brain fitness of millions of individuals as a result.

MetLife Mature Market Institute Report: Gerontologist Fay Radding presents the findings of a recent MetLife report, concluding that “As individuals age, meaningful interactions and purposeful activity become even more valued and crucial to cognitive health- and cognitive health itself becomes more of a priority.”

Change Your Environment, Change Yourself: Dr. Brett Steenbarger explains in his recent book that, “The greatest enemy of change is routine. When we lapse into routine and operate on autopilot, we are no longer fully and actively conscious of what we’re doing and why. That is why some of the most fertile situations for personal growth—those that occur within new environments—are those that force us to exit our routines and actively master unfamiliar challenges.”

Food for Thought

Michael Merzenich: Brain Plasticity offers Hope for Everyone: Dr. Ginger Campbell recently interviewed Dr. Michael Merzenich. Podcast Quote: “Whatever you struggle with in a sense as it stems from your neurology, the inherent plasticity of the brain gives you a basis for improvement. This is a way underutilized and under-appreciated resource that well all have.”

Therapy vs. Medication, Conflicts of Interest, and Intimidation: What started as an academic dispute regarding disclosure of conflict of interest is now snowballing. Dr. Jonathan Leo criticized two important aspects of a recent a study published in JAMA that compared the efficacy of therapy vs. medication. JAMA editors then tried to intimidate Dr. Leo and his university. An investigation by the American Medical Association is under way.

ETech09 on Life Hacking and Brain Training: Here you have the presentation Alvaro Fernandez delivered at O’Reilly Emerging Technology Conference 2009, a gathering of technology pioneers with a growing interest in science and biology topics.

Attention!

Distracted in the Workplace?: In a very-thoughtful 2-part interview (part 1 here, part 2 here), author Maggie Jackson challenges us to “First, question the values that venerate McThinking and undermine attention.”

New Study Supports Neurofeedback Treatment for ADHD: Dr. David Rabiner reports the promising findings from the first well-designed controlled trial on the effect of neurofeedback treatment for ADHD.

Twitter

Finally, I wanted to let you know that you can follow quick SharpBrains updates and some of my thoughts via Twitter: http://twitter.com/AlvaroF

Have a great National Car Care Month in April! (now, wouldn’t you please pay at least equal attention to Brain Care than to Car Care?)

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