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Two ADHD Factors You May Not Know About

admin — Thu, 31 Mar 2011 16:39:10 +0000

A.D.H.D, attention deficit hyperactive disorder currently affects 5 to 10% of school age children in the United States. Your child may have ADHD if he has difficulty focusing, difficulty waiting in line, interrupts conversations, has difficulty keeping still, cannot remain seated in the classroom, is easily distracted, procrastinates, makes careless mistakes with schoolwork or homework and is disorganized. Children with ADHD tend to have difficulty in school and at times socializing with others. Approximately 50% of children with ADHD grow up to be adults with ADHD. The same issues make it more difficult to obtain and sustain employment as adults. A recent study in the scientific journal Attention Deficit Disorder found two factors associated with ADHD which everyone concerned with this condition should be a aware of especially since these factors are modifiable. Specifically, the study found a more than two fold increase in the incidence of ADHD from mothers who smoked during their pregnancy. Obviously, if your child has already been born and has ADHD, you can not go back in time. However, if you’re an expectant mother or planning to have children and are concerned about having a child with ADHD then not smoking during pregnancy should be a top priority for you. If you have a child that has ADHD you should be aware that this study also found the rate of children with ADHD is five times as great in children with obesity. Thus, if you are pregnant and smoke or your child is overweight, these are issues that are difficult to deal with but will certainly make a difference over your child’s lifetime and is worth putting in the effort.

Methylphenidate Not Effective For Executive Functions

admin — Thu, 10 Feb 2011 21:31:20 +0000

One in 10 school age children have ADHD and half of those children will grow up to have ADHD as an adult. ADHD is defined as having difficulty with inattentiveness, hyperactivity and impulsivity. This tends to lead to children having difficulty in school and adults having difficulty with employment. Those with ADHD, particularly adults, commonly complain of difficulties with executive functions. The medical dictionaries defines executive function as ” the cognitive process that regulates an individual’s ability to organize thoughts and activities, prioritize task, manage time effectively and make decisions.” One can easily see how this would make it difficult to maintain and progress in a job especially one that requires any type of managerial duties. By the time those suffering from ADHD become adults most have tried the stimulant medications which are commonly prescribed for this condition. Having treated many adults with ADHD is very common to hear that the medication does not help them with organizational type skills and other types of skills which are executive function type task. A recent study in the European Journal of Neuropsychopharmachology seems to confirm what those of us that treat ADHD and those that have its already were aware of. The study found that methylphenidate the chemical compound in many of the commonly prescribed stimulant medications was not effective in moderating psychometric measures dealing with executive function. Translation- methylphenodate did not help with executive functions such as organization, planning and regulating inappropriate actions. Recently, there was a study published using children but not adults that found that a restricted elimination diet was effective in dealing with symptoms related to ADHD. Also studies relating to physical activity have been published which have demonstrated improvement in ADHD symptoms. There is also literature published which reflects that certain nutritional supplementation can at times be as effective as the stimulant medications. Hemispheric Integration Therapy also recently published a study in which significant objective progress with psychometric testing was made in a 12 week period. Most of the research is done on children and many times the adult with ADHD has been forgotten. In this case, it was nice to see a study done with adults. So there are alternatives available to treat adults with ADHD. For those who would like to simply manage their ADHD as adults, there are certain organizational skills which can aid you with executive functions. These include things such as using list, setting up a filing system, prioritizing your list and your activities, using a calendar or day planner and limiting your activities so as to not become overwhelmed.If you’re interested in improving your situation and not just managing it, consult a physician that is familiar with not only ADHD but the treatment interventions listed above.

Eur Neuropsychopharmacol.2011 Feb 7. [Epub ahead of print]

Are stimulants effective in the treatment of executive function deficits? Results from a randomized double blind study of OROS-methylphenidate in adults with ADHD.

Biederman J, Mick E, Fried R, Wilner N, Spencer TJ, Faraone SV.

Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry at Harvard Medical School, Boston, MA, USA.

Abstract

The objective of this study was to evaluate the association between executive function deficits (EFDs) and response to methylphenidate treatment in ADHD in adults. We conducted a 6-week, parallel design, randomized, placebo controlled study in adults with DSM-IV ADHD. Our psychometric index of executive function used standardized neuropsychological testing. We assessed behaviors reflective of EFDs using the Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A). Subjects with available measures of executive functioning (OROS-MPH N=40; Placebo N=47) were included for analysis. There was no difference in the percent of subjects completing the 6-week acute efficacy Phase I of the trial (100% (N=40) vs. 98% (N=46), p=0.4). The mean daily dose at Phase I endpoint was 84.6±31.6mg (1.04±0.29mg/kg) OROS-MPH and 100.5±21.9mg (1.20±0.11mg/kg) placebo (p=0.0007). Based on the neuropsychological testing at the baseline assessment, 40% of the ADHD subjects (N=35/87) were considered to have EFDs but 93% (N=81) of subjects had ≥2 BRIEF-A clinical scale T-scores >65. Regardless of the definition used, however, EFDs did not impact the clinical response to OROS-MPH. This randomized clinical trial showed that executive function deficits do not moderate the response to methylphenidate and measures of executive function deficits are not associated with response to OROS-MPH.

PMID: 21303732 [PubMed - as supplied by publisher]

Another Negative Association with Obesity and Our Diets

admin — Wed, 18 Aug 2010 22:27:11 +0000

Diet related chronic diseases such as heart disease, high blood pressure and diabetes represent a large portion of the morbidity (disease ) and mortality (death) rates the United States and other westernized cultures. The dictionary defines the Western diet as one high in saturated fats, red meats, ‘empty’ carbohydrates–junk food, and low in fresh fruits and vegetables, whole grains, seafoods, poultry. Attention deficit hyperactive disorder has also been found to be associated with overeating, obesity and the Western diet. Many times as we evaluate both children and adults for conditions such as ADHD, the question as to whether diet and supplements can help with these conditions always seem to come up. Our experience has been that lifestyle changes such as reducing glycemic load, normalizing the acid/base balance, increasing fiber, evaluating vitamins and minerals as well as addressing fatty acids and supporting adrenal function can be beneficial for these patients. This of course presupposes that the appropriate testing has been done to identify if any of the above factors are an issue for the ADHD patient. When I find information supporting these associations and these types of treatments, I feel compelled to get the word out. Therefore if you are eating a lot of junk food, please make efforts to clean up your diet and that of your children. If the heart disease and diabetes didn’t motivate you I hope that the ADHD will. Below please find to recent articles associating obesity and the Western diet with ADHD.

J Atten Disord.2010 Jul 14. [Epub ahead of print]

ADHD Is Associated With a ‘Western’ Dietary Pattern in Adolescents.

Howard AL, Robinson M, Smith GJ, Ambrosini GL, Piek JP, Oddy WH.

Telethon Institute for Child Health Research.

Abstract

Objective: To examine the relationship between dietary patterns and ADHD in a population-based cohort of adolescents. Method: The Raine Study is a prospective study following 2,868 live births. At the 14-year follow-up, the authors collected detailed adolescent dietary data, allowing for the determination of major dietary patterns using factor analysis. ADHD diagnoses were recorded according to International Classification of Deiseases, 9th Revision coding conventions. Logistic regression was used to assess the relationship between scores for major dietary pattern and ADHD diagnoses. Results: Data were available for 1,799 adolescents, and a total of 115 adolescents had an ADHD diagnosis. Two major dietary patterns were identified: “Western” and “Healthy.” A higher score for the Western dietary pattern was associated with ADHD diagnosis (odds ratio = 2.21, 95% confidence interval = 1.18, 4.13) after adjusting for known confounding factors from pregnancy to 14 years. ADHD diagnosis was not associated with the “Healthy” dietary pattern. Conclusion: A Western-style diet may be associated with ADHD. (J. of Att. Dis. 2010; XX(X) 1-XX).

PMID: 20631199 [PubMed - as supplied by publisher]

Curr Psychiatry Rep.2010 Jul 15. [Epub ahead of print]

Attention-deficit/Hyperactivity Disorder: Associations with Overeating and Obesity.

Davis C.

York University, 343 Bethune College, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada, cdavis@yorku.ca.

Abstract

In the past decade, we have become increasingly aware of strong associations between overweight/obesity and symptoms of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. This review addresses the prevalence of the comorbidity and discusses some of the mechanisms that could account for their relationship. It is suggested that the inattentive and impulsive behaviors that characterize ADHD could contribute to overeating in our current food environment, with its emphasis on fast food consumption and its many food temptations. It is also proposed-based on the compelling evidence that foods high in fat, sugar, and salt are as addictive as some drugs of abuse-that excessive food consumption could be a form of self-medication. This view conforms with the well-established evidence that drug use and abuse are substantially higher among those with ADHD than among the general population.

PMID: 20632134 [PubMed – as supplied by publisher

ADHD: Will my daughter be depressed and have less relationships?

admin — Wed, 23 Jun 2010 20:51:24 +0000

The latest statistics suggest that 10% of school age children have ADHD. As A doctor that treats learning disabilities as well as ADHD and Autism spectrum disorders on a daily basis it is common to here parents say things such as ” well its only ADHD, so its not such a big deal.” At presentations that I have presented on learning disabilities and spectrum disorders, I term this low spectrum comfort. Meaning that because children with ADHD have no speech delay, tics or compulsions for example some parents are not too concerned with the issue. But in reality children with ADHD have been implicated in the past to have issues such as higher substance abuse rates, incarceration rates and pregnancy rates. A new study published in June of 2010 adds fuel to the fire with findings that late adolescent girls teens to have more issues with depression as well as relationships including with mom and boyfriends. So the message becomes more compelling, ADHD is associated with many negative social issues and therefore is a condition that should be taken seriously and addressed by parents. Whether you choose to address you child condition with the standard pharmaceutical approach or with a drugless option such as Hemispheric Integration Therapy, please take action as it appears to be a factor that a parent can take on and make a difference in your child’s life. As a side note, most children present with combinations involving ADHD, tics, OCD etc and not solely with ADHD.

J Atten Disord.2010 Jun 18. [Epub ahead of print]

Late Adolescent and Young Adult Outcomes of Girls Diagnosed With ADHD in Childhood: An Exploratory Investigation.

Babinski DE, Pelham WE Jr, Molina BS, Gnagy EM, Waschbusch DA, Yu J, Maclean MG, Wymbs BT, Sibley MH, Biswas A, Robb JA, Karch KM.

Abstract

Objective: To characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood. Method: The study included 58 women from a larger longitudinal study of ADHD. A total of 34 (M = 19.97 years old) met DSM criteria for ADHD in childhood, whereas the remaining 24 (M = 19.83 years old) did not. Self- and parent-reports of psychopathology, delinquency, interpersonal relationships, academic achievement, job performance, and substance use were collected. Results: The findings suggest that girls with ADHD experience difficulties in late adolescence and young adulthood, such as more conflict with their mothers, being involved in fewer romantic relationships, and experiencing more depressive symptoms than comparison women. However, differences did not emerge in all domains, such as job performance, substance use, and self-reported ADHD symptomatology. Conclusion: The findings of this study add to the literature on the negative late adolescent and young adult outcomes associated with childhood ADHD in women. (J. of Att. Dis. 2010; XX(X) 1-XX).

PMID: 20562386 [PubMed

Linda Hurtado From ABC Action News Covers H.I.T

admin — Fri, 04 Jun 2010 15:38:23 +0000

Its has been a very exciting week for me. I started the week doing a brain dissection in San Francisco which was absolutely inspiring to me. To see, hold and feel hold the human brain in your hands is a once in a life time experience. Yes, this is what I consider a great way to spend a three day weekend. Yesterday, Linda Hurtado from ABC Action News came out to the office and did a story about Hemispheric Integration Therapy. She is super and really down to earth and it was truly a pleasure to meet her. That’s a great week for me, here’s the link http://www.youtube.com/watch?v=PHPkaUoNaeI&feature=youtube_gdata

I am Always Looking for Gluten Free Casein Free Recipes for You

admin — Wed, 26 Aug 2009 15:08:55 +0000

This one is gluten free, casein free, soy free. Enjoy!

http://gingerlemongirl.blogspot.com/2009/07/sweet-vanilla-blueberry-scones-recipe.html

Hypnosis for Attention Deficit Disorder?

admin — Tue, 25 Aug 2009 13:50:03 +0000

Here is something I had not thought about. It is not something I do, but something someone out there might be interested in pursuing. This is an interview with a psychologist who uses hypnosis. It is very brief but for some maybe a good place to start. This seems like it might be targeted more toward adult ADDers. Here is the link http://adderworld.com/blog1/

A Nice Intro 101 on ADHD

admin — Sun, 23 Aug 2009 17:30:01 +0000

As usual they are not aware of Hemispheric Integration therapy but that is my job to get the word out, none the less, this is a concise intro.

http://www.mahalo.com/adhd-attention-deficit-hyperactivity-disorder

Asperger’s Syndrome: Tips From a Recent Case

admin — Sat, 22 Aug 2009 13:33:47 +0000

Asperger’s Syndrome is a milder condition on the autism spectrum where the individuals are known for being highly intelligent yet have difficulty with social situations. Often as a child they are known as “Little professors” as they are smart and may show interest in scientific subjects such as dinosaurs or science fiction themes such as Star Wars. These individuals tend to be able to integrate into society fairly well as their verbal skills may be quite high and again the major deficiency relates to social interaction and social awkwardness i.e. little Johnny can’t seem to make friends. They may have difficulty with displaying appropriate sensitivity to others’ feelings. It is difficult at times for them to understand abstract concepts such as humor. Reading facial expressions and maintaining eye contact may be an issue. Usually, they show coordination difficulties and are not considered very athletic as children i.e. the goalie on the soccer team not the star forward.

This particular case relates to an adult with Asperger’s Syndrome. When someone with Asperger’s syndrome grows up they tend to be attracted to computer fields. Such was the case in this situation. The reason for this being that many times these individuals are very detail oriented and intelligent while they tend to avoid social interaction. Therefore, many computer-related jobs fit those aspects comfortably. Many computer-related jobs can be done at home on a computer without having to go to an official workplace on a daily basis. This allows them to feel accomplished at work, intellectually, while avoiding social contact with others.

The problem is that screen time, television, video games and the Internet have been shown to have negative effects on individuals that are on the autism spectrum(attention deficit disorder, attention deficit hyperactive disorder , Sensory Integration Disorders, Processing Disorders, Asperger’s Syndrome, Tourette’s syndrome , Pervasive Developmental Disorder and Autism.) This particular patient who also has attention deficit disorder relates to “being on the computer and then coming out of an almost trance like state realizing 20 hours have gone by and more than 20 tabs are open.” He also has made statements such as “now that I’m aware of the issue with screen time, I feel as if the computer screen is like kryptonite, sucking the life out of me.” In a perfect world, the best thing for this patient would be to discontinue all screen time.” The problem is he is now in his thirties and this is how he makes a living.

In a hemispheric integration model, Asperger’s Syndrome tends to be a right hemisphere deficiency. This does not mean that all Asperger’s Syndromes are a right hemisphere deficient and certainly the only way to determine this is with an appropriate functional neurological examination. In this particular case however, he did indeed have a right-sided deficiency with the basis of his issues localized to a left vestibular lesion. He in fact had played football in college. He was a running back. At first, I thought this somewhat unusual as Asperger’s patients tend not to be athletic. However, upon further questioning it was determined that the reason he was a running back was that he could not catch a ball. This then tended to fit in well with the common associations of balance issues and uncoordination with Asperger’s patients. Apparently, he was tough and determined but not the most coordinated. This was confirmed throughout the physical examination process . This was addressed with appropriate modalities relating to functional neurology and hemispheric integration therapy. These treatments were performed at the office on a regular basis during his therapy sessions.

The issue was that he had to go back home and go back to work. That meant that in this imperfect world, he would have to continue working at a job that required him to be on a computer to earn living. This was the only way he could maintain the standard of living that he was accustomed to. He may be able to make long-term changes into a field that does not require so much screen time, however in the near future that was not an option. In the hemispheric model postural muscles and proprioception are extremely important as is the side of the lesion. He did in fact work from home. This gave us a little bit more flexibility. Together we discussed what his workday was like and tried to come up with some adaptations he could make to lessen the impact of the computer screen on his condition. A treatment program at our office always involves in office treatments and what we like to term “homework” for the patient. We were able to come up with five adaptations which were helpful for him.
These were as follows:

He was to use the mouse with his left hand.
He was to do some core exercises for several minutes every hour as they break away from the screen.
He was to use a standing desk.
If he was in a sitting position he was to sit on a Swiss ball.
He was to place the screen slightly off center to the left.

These seemingly small and insignificant changes had a considerable effect in his ability to concentrate and be productive at work as well as his overall Asperger’s condition. As always, this is an illustration of home modifications that were made on a particular case. This is not to imply that all Asperger’s Syndromes are right functional hemisphere deficiencies of left vestibular origin and should be treated and prescribed the same home modifications. These types of changes should only be done with appropriate physician supervision.