Archive for ADHD Treatment

Long Term Stimulant Use Improves School Grades

When kids or teens are diagnosed with ADD/ADHD, doctors generally recommend medication to help to control the symptoms.The most commonly used medications include the stimulant medications – namely medicines like: Concerta, Adderall, Adderall XR, Vyvanse, Metadate CD, Ritalin LA, Methylphenidate, Dextroamphetamine, and others.

While there are many studies showing that the ADHD symptoms of inattention, hyperactivity and impulsivity improve with the medicine, and cause short term academic improvements, there has been a lack of research to show long term academic benefits.

The studies summarized here clearly document that ADHD stimulant medication helps with long term academic success.

In this research, the research team followed 5700 children from birth until 18 years old. In that group, 277 boys and 93 girls were diagnosed with ADHD. Of those with the diagnosis, some decided to use medication, and some did not. When kids took ADHD medication, they generally started in elementary school, and took it for (on average) 30 months (i.e. just under 3 years).

Of the ADHD kids who were taking medication, by 13 years old, the medication children had improved reading scores compared to the kids with ADHD who had not taken medication. Children taking medication were more likely to attend school (i.e. less absenteeism), and they were 1.8 times less likely to be held back a year at school.

The lead researcher, Dr. Barbaresi was quoted as saying: “We can’t simply focus on the symptoms of ADHD,” Barbaresi said. “We really need to be focusing on the risk for poor outcomes in school and in other aspects of the child’s life,” he said. “That’s why we have to recognize these children and make sure they get appropriate treatment.”

To read more about these studies, click here.

What do you think? Has ADHD medication helped your child (or yourself) over the long term? Please share your thoughts in the comments below.

Best,

Dr. Kenny

Technorati Tags: , , , ,

ADHD Coaching: What Is It?

coach 199x300 ADHD Coaching: What Is It?As part of the diagnosis of ADD/ADHD, one has to have ‘impairment’ in functioning, in addition to the required number of symptoms.
In my experience, people often don’t put enough importance on the impact of  this impairment.

Having ADD/ADHD symptoms can be problematic on its own…
But the real issue is when your (or your child’s) functioning is impaired.

How does this show up?

In adult ADD/ADHD, impairment in functioning can come out in these types of situations:

  • Paying bills and keeping up with paperwork
  • Meetings
  • Setting goals and achieving them
  • Handling relationships
  • Coping with frustrations
  • and much more…

In child/teen ADD/ADHD, impairment in functioning can come out in these types of situations:

  • Homework
  • Completing tasks/chores
  • Handling frustration
  • Social situations
  • Listening to and following instructions
  • And much more…

While all treatments for ADD/ADHD aim to improve functioning – they don’t always succeed. Medication can have a big impact on ADD/ADHD symptoms, and can often have an impact on functioning. Though often the improvement in functioning is not enough with medication on its own.

We aim for ‘multi-modal’ treatment – i.e. treatment which includes medication, as well as other modalities to help, because ‘pills don’t teach skills’.

One modality which has grown in its popularity and usefulness in the field of ADD/ADHD treatment is coaching.

What is coaching for ADD/ADHD?

Coaching for ADD/ADHD starts with a trained coach. Coaches who specialize in working with ADD/ADHD are trained life coaches, and may be certified by the ICF – the International Coach Federation, or other organizations like the International Association of Coaches (IAC) or others. In addition to having this qualification, ADD/ADHD coaches also specialize in ADD/ADHD (and they have taken specialized training in ADD coaching from organizations like: ADD Coaching Academy (or others))- so that they can tailor the coaching methodology to suit the specific needs of individuals with ADD/ADHD.

What Do ADD Coaches Do?

ADD/ADHD Coaches work with people in a collaborative way. Whereas therapy is often looking backward – i.e. at previous issues or challenges and how they can understood differently – coaches are forward focused – i.e. on functioning in the present and in the future.

ADD/ADHD Coaches help people to:

  • Find their strengths
  • Develop strategies for their areas of challenge
  • Pull in the resources they need
  • Develop skills to take care of themselves
  • And a whole lot more…

The coaching relationship is a very collaborative one – where the coach works with the individual to work on his/her own goals, challenges and issues.

The ADD/ADHD coach provides: accountability, support and encouragement.
When someone has been challenged with functional issues with their ADD/ADHD for some time – these three things can make a world of difference for someone who has been struggling.

How Does ADD/ADHD Coaching Work?

When someone works with an ADD/ADHD coach, they meet with their coach regularly. It is very common for these meetings, or appointments to occur on the telephone. There are times that someone can have sessions with their ADD/ADHD coach in an office (or even a coffee shop) for face to face sessions, but it is very common for telephone coaching to occur. Telephone coaching helps to eliminate the need for travel time, and it helps people to find a coach who suits them best, even if they are geographically far away from that coach.

In general, there would be a ‘getting to know you’ session, and the parameters of coaching would be discussed – so that the participant learns what he can expect from the coach, as well as the coaching process.

Then, there are coaching sessions which occur on a reasonably frequent basis – i.e. 2-4 times per month. Many coaches also include ‘check in’ emails on a more frequent basis. These emails help people to be more accountable, and to have more ongoing support between coaching calls.

How much does ADD/ADHD coaching cost?

Prices can vary – depending on the coach’s experience, and their expertise. For example – a new coach would charge less than someone who has been doing this for years. It is common for people to pay $300-$400 per month for the personalized support of an ADD coach.

Group coaching is an option which can make it more affordable for people to participate in ADD/ADHD coaching. This way, there is less personalized attention, yet the person is able to still benefit from the coaching process. Group coaching is less expensive, and thus it is often easier for people to participate in.

Does ADD/ADHD Coaching Work for Adults, Teens and Kids with ADHD?

ADD coaching has been done with adults right from its start. When an adult engages in coaching, he/she can take responsibility for his/her participation in the process and benefit from it.

When coaching is done with kids or teens with ADHD, it can be much harder. This can relate to many issues – including a child or teen’s comprehension of what is going on (i.e. do they even attribute problematic behaviors to their own symptoms or actions?), or their desire to work on challenging or frustrating issues. My understanding is that for older teens, ADD coaching can be a lot more helpful than for young kids.

That said, as with behavioral treatments for kids and teens with ADD/ADHD, when the parents learn the specific skills, they can help to support their child or teen with these on a day to day basis. Thus, if parents learn the skills that an ADD coach can provide, it can help the child or teen significantly.

Resources which you may be interested in:

This article is meant to be an introduction to coaching for ADD/ADHD. Please share your thoughts in the comments below.

Please let us know: Have you ever considered coaching for ADD/ADHD? Have you ever tried it?

Please share your comments below.

Best,

Dr. Kenny

Technorati Tags: , , , , , ,

Software That Helps With Learning

Often technology can help kids in school to learn effectively. This technology can be helpful for kids, teens or adults with ADD/ADHD – and it is particularly helpful when there is a co-existing learning disability – like dyslexia or any other LD.

Listed below are a few software programs which may assist you. This is a list of a few programs that I have heard about from colleagues. Please note that I don’t have direct personal experience to strongly endorse any of these outright – rather I provide this list as a place for you to get started and to do your own research from here. Hopefully, the power of this community will help you – because people can share their experiences with these programs in the comments below.

  1. Dragon Naturally Speaking: This software is probably the best voice to text software. I have used this one, and I find that the newer version is much more accurate than previous versions. I will say that one of the biggest drawbacks if if someone has a particular accent, or a speech articulation problem, it can be quite frustrating.
  2. Kurzweil 3000 Kurzweil is described on their site as: “Kurzweil 3000™ is a comprehensive reading, writing and learning software solution for any struggling reader, including individuals with learning difficulties, such as dyslexia, attention deficit disorder or those who are Enlish Language Learners.”
  3. Smart has a whole set of resources that help teachers be more interactive with students and use the technology to help with this.
  4. Word Q is a software program which helps with editing, by suggesting possible words and it also includes some aspects of speaking the words back to you.
  5. Text to Speech Software: This software helps to read text out loud to assist with learning.

Have you tried any of these software programs to help with learning (for ADHD or Dyslexia/Learning Disabilities)?

Have you used any other software programs which you would recommend?

Please share your thoughts and experiences in the comments below.

Best,

Dr. Kenny

Technorati Tags: , , , ,

ADHD Alternatives Video #2

In this second video about Alternative Treatments for ADD and ADHD, I share how most doctors are trained to think about ADD and ADHD when it comes to alternative treatments. I also share how I think differently about them…
I explain that ADHD treatment is like a marathon, not a sprint – so you need to take that into consideration when looking at which treatments to use.

Please share your thoughts and comments below.

Best,
Dr. Kenny

p.s. watch for video #3 coming soon!

Technorati Tags: , , , , , ,

Alernatives for ADHD Video #1

In this blog post, I’d like to share a video on Alternatives for ADD/ADHD. This is an area that I’ve been putting more focus on, and I’d like to share some of my findings.

In this first video – I share how you can use alternatives as part of a comprehensive treatment plan for ADD/ADHD. I also share the guiding principles you can use when deciding on an alternative treatment.

Please share your thoughts and comments below. I’d love to hear your perspectives.

Best,
Dr. Kenny

p.s. sign up for my newsletter to be notified of when video #2 is being posted

Technorati Tags: , , , , , , ,

ADHD in the Military

Recently, a previous patient of mine contacted me to ask if I could fill out a medical form for him, as he is in his 20′s and he is applying to the Canadian Armed Forces. I was surprised he is already in his 20′s (time flies!), and I started to wonder about how ADHD may impact people’s ability to get into the military. This young man actually had depression when he was 16 years old, so I won’t be able to report back to you how the Canadian Military handled his case (with respect to ADHD, I mean).

Searching online for ADHD and the military – I found a couple of resources that may help. The first is an article from the American Academy of Pediatrics. In this article from 1998, the author summarizes information from one scientific article, as well as information gathered from military sources.

A second resource came from a forum post, where the author shared his experience having had ADHD when he was younger, and then joining the US Air Force. Other people have joined the conversation, and you can find that here.

The ultimate question that will come up for someone considering the military is – can I get in if I have ADHD?

The short answer is: ‘maybe’.

Based on the sources mentioned above – it seems unlikely that one can get into the Army, Air Force, Navy and particularly the Marines (they are noted to be the most strict) if they have to take a daily medication. This applies to a thyroid condition, diabetes, or any medical condition that requires daily medicine.

This would apply to ADHD – if you take daily medicine. The articles suggest getting off your medication for approximately 1 year prior to applying to the military. If you are able to function well without the medication, then you may be eligible to enlist. The reason for this rule is that requiring a daily medication may present a risk in a combat situation.

Other criteria for the military include the fact that one could be excluded for a personality or behavioral disorder. If one has ADHD or ADD and has had numerous troubles associated with it – including substance abuse, trouble with the law, associated depression or suicidality, etc. – that may make it harder to enlist in the Army, Navy, Air Force or Marines.

One other key point mentioned in the article is that recruiters may or may not share accurate information with potential recruits. This is concerning – and suggests that an interested person should pursue information from multiple sources before feeling that he/she has an accurate answer.

It is important to note that the best reference I found (the American Academy of Pediatrics article written above) was from prior to September 11, 2001. It is an article from 1998. Now that the US is at war in Iraq and Afghanistan (and Canada is in Afghanistan), it is possible that the rules for obtaining a ‘waiver for ADHD’ may be different now. Again – it is worth reviewing this with a recruiter (or two or three).

It is my belief that people with ADHD can do extremely well in the structure of the military. In these times, their contribution can be most welcomed – if the military welcomes them.

Will the military welcome people diagnosed with ADHD?

The short answer is ‘maybe’.

I am hopeful that those of you reading this article will share your experiences, and help to update the policies described above to what is happening now (this is being written in August 2009). We have had a very productive discussion on this blog about the FAA requirements for pilots with ADHD, and I hope that this post can develop into a productive discussion to help people seeking answers to this question.

**Addendum – a further internet search found this article, on the ADDitudeMag site, entitled: Uncle Sam Doesn’t Want You! It describes more up to date information about the military. It notes that there are new standards in place. The article shares:

“Under newly revised standards, ADHD is disqualifying only if the potential recruit has been treated with ADHD medication within the past year, or if he or she displays “significant” evidence of ADHD symptoms, such as impulsivity and distractibility. (The definition of “significant” is up to the military medical examiner.) Documentation of any treatment of ADHD within the previous three years must be submitted in advance of the medical evaluation. “

This is certainly a step in the right direction, but I think not enough.

Please share your thoughts and experiences below.

Best,

Dr. Kenny

Technorati Tags: , , , , , , , ,

Nascar and ADHD

Nascar driver Jeremy Mayfield has shared that he has ADHD, and takes the medication Adderall for it.

This disclosure has come in a ’roundabout’ way. This relates to the reports that Mr. Mayfield was suspended from driving due to finding amphetamines in his urine during a random urine drug screen. Mr. Mayfield has explained that he takes Adderall medication for ADHD, as well as Claritin D. This issue is before the courts. You can read the news updates here.

While Mr. Mayfield is going through a rough time right now, I am happy to hear that he has openly disclosed his diagnosis of ADHD. This can lead to advocacy and support for the many kids diagnosed with ADD or ADHD each year.

I do wonder how many of the Nascar drivers have ADD or ADHD?

Although there is research which shows that people with untreated ADHD are at risk of more accidents while driving, my clinical experience in ADHD suggests that people with ADHD often excel at ‘extreme sports’. Whereas driving to the store at 40 miles per hour may be boring, driving on a Nascar track at speeds in excess of 200 mph can be exciting and can command one’s attention. And as Mr. Mayfield explains – he is taking an ADHD medication while driving.

I do hope that things work out well for Mr. Mayfield, and that he uses this situation as a springboard for advocacy for ADD/ADHD. I hope that he can be a role model for the thousands of boys (And girls!) diagnosed with ADD and ADHD each year.

What are your thoughts and experiences? Please share them below.

Best,

Dr. Kenny

Technorati Tags: , , , , ,

Who Needs ADHD Medication?

Let’s face it – medication treatment for ADD and ADHD is controversial.
It is often a really big decision about whether to start a medication or not.
One of the first questions is this:
Who even needs to take these medicines?
Another way to think about this is:
What is the rational for ADHD medication treatment?

I’ve created a free video for you to learn more about this.
You can see it here: ADHD Medication Mastery.

And when you click through to that site – you’ll be given the opportunity to sign up for free ADHD Medication updates. You’ll get more videos with useful tips to help you and the people that you love.

Click through to see the video now (while it’s still fresh in your mind).

Best,

Dr. Kenny

p.s. I’ll be giving you many free videos and lessons on ADHD Medication Treatment in the coming weeks – so make sure to take advantage of it!

Technorati Tags: ,

Price of ADHD Medication: A Concerning Trend

As the economy’s downturn is affecting businesses and families alike – it seems that Big Pharma has a plan to keep themselves thriving in this economy.

Quite simply: Raise prices.

A news report shares that Big Pharma are raising their prices to improve their income. Included in the example is Eli Lilly’s Strattera – a non-stimulant medication for ADHD.

I’m not sure if the same thing is happening with other ADHD medications, which are manufactured by other companies.

This is a very concerning trend – especially as people may be under-insured, or uninsured. The medication costs are often prohibitive – and if one needs the medication to survive at work and to keep one’s income, this can be quite a bind.

What has your experience been? Have the costs of your prescription gone up?

Please share your comments below.

** As further explanation – the information above refers to prices in the US. I have recently published two articles showing that the trend in Canada is that in fact the prices are coming down – particularly for Strattera and Adderall XR. You can read more details here: Strattera Price Drop in Canada, and Adderall XR Price Drop in Canada.

Best,

Dr. Kenny

Technorati Tags: , , , , , ,

ADHD: Marathon, Not Sprint

As a doctor who regularly assesses and treats ADD/ADHD in my office, I have developed a unique experience about treatment for ADD and ADHD.

Many of my medical colleagues feels that ADHD should be treated as soon as it is diagnosed – i.e. get the kids on medicine. Many of the parents are concerned about using medication, and don’t want to feel rushed.

Long term research indicates that ADHD tends to be present for most of childhood, and upwards of 60-70% of kids and teens still have ADD/ADHD as adults. In other words, this condition is a long term one, which can last into adult life.

From my perspective, it does not benefit anyone to rush a child or family into treatment (ANY treatment, though particularly medicine), when the condition is going to be there for a long time. The risk is that if they are rushed, and don’t feel comfortable with their decisions, families can get completely ‘turned off’ of treatment and they can literally lose years of help (until they ask for it again – often because of worsened circumstances).

My suggestion is that it is better to view ADD/ADHD treatment as a marathon, not a sprint. Don’t rush at the beginning, as you may not have the endurance to make it the distance. Take the time needed to make informed decisions about treatment for this condition, so that the decisions can last the test of time.

Are there times to rush to treatment?

There are a small number of assessments that I do where there is an ‘acute’ problem. For example, every year I get a few referrals for kids who have moderate to severe ADHD, who are about to be expelled from school if they don’t get help in the next few days. In this unique situation, it is best to try medication right away, stabilize the symptoms (and help to prevent a crisis in the school) , and then ‘regroup’, and go over things at a more slow and stable pace.

My advice to you as parents: Take the time you need to understand what you need to regarding the treatment decision that are recommended to you. If you feel rushed and pushed by your doctor, ask your doctor if there is a reason for the rush (i.e. is there a risk that you are unaware of), and then ask politely for more information so that you can make the decision you need to.

Let your doctor know that you consider the treatment of ADD/ADHD to be a marathon, not a sprint – so you need to ‘pace yourself’ appropriately. See what your doctor says…

(and come back and post your comments here to let us know how it goes…)

Best,

Dr. Kenny