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Archive for the ‘ADHD’ Category

ADHD May Be Overdiagnosed in Children with Autism

03 Nov

From Children’s Hospital of Philadelphia

ADHD Overdiagnosed in Children with AutismPediatric researchers report that children with ASD may mistakenly be diagnosed with ADHD because they have autism-related social impairments rather than problems with attention. This is important for understanding what are the right services and treatments for a child.

The study team, including one of the psychologists who developed the ADHD screening tool, concludes that the tool needs to be refined to better identify the correct disorder, and that clinicians should supplement the screening tool with careful clinical interviews.

“One of our best current screening measures for ADHD may be over-diagnosing ADHD in children with autism,” said study leader Benjamin E. Yerys, PhD, a researcher in the Center for Autism Research at Children’s Hospital of Philadelphia (CHOP). “This is important because medications that work for ADHD may be less effective for a child on the autism spectrum.” Scale scores are used in recommending school-based services as well as treatment options.

The study, from researchers at CHOP, the Perelman School of Medicine at the University of Pennsylvania, and Baylor University, appeared online Oct. 13 in the Journal of Autism and Developmental Disorders.

One complicating factor is comorbidity — an estimated 30 percent or more of children with ASD also have ADHD. The researchers suggest that the tool they analyzed, the ADHD Rating Scale Fourth Edition (ADHD-RS-IV), while well-validated in assessing ADHD in a general population of children, may overestimate ADHD in children with ASD. The scale asks parents and teachers to provide numerical ratings in reply to 18 items about a child’s behavior: nine items on inattention and nine on hyperactivity and impulsivity.

Study co-author Thomas J. Power, PhD, director of CHOP’s Center for Management of ADHD, developed ADHD-RS-IV in the 1990s (An updated version, the fifth edition, was published earlier this year, but not used in the current study). “I’m excited to be involved in this study, and in efforts to refine our screening tools,” he said, “especially since few researchers have previously investigated using this scale in children with ASD. Our research raises questions not only about this rating tool, but all such measures that rely on parent and teacher ratings to assess ADHD in children with ASD.”

The current study analyzed ratings of 386 children, aged 7 to 17, who had ASD without intellectual disability. To test whether the ADHD rating scale was valid in children on the autism spectrum, the research team used a procedure called factor analysis. They found that some questions on the ADHD rating scale were high for children with ASD instead of being high just for the subset of children who had significant ADHD symptoms.

“One underlying problem,” said Yerys, “may be in how we ask these questions.” For example, he explained, parents and teachers are asked “Does the child respond when spoken to directly?” However, supplying a yes or no answer to this question doesn’t distinguish between actual inattention (a symptom of ADHD) and a child’s lack of understanding about how to behave in a social situation in responding to another person — a social impairment often found in ASD. Similarly, other questions focus on how well a child stays on task with play activity. ADHD may cause a child to be easily distracted from an activity, but another child may instead stop playing because of ASD-related difficulties with social play.

The study team recommends modifying the rating scale to better minimize the influence of ASD on ratings of target ADHD behaviors. Moreover, until a more nuanced rating scale is available, clinicians need to combine the ratings with a follow-up interview with parents to better understand whether a child’s behaviors stem from ADHD symptoms or social impairments.

Ideally, said Yerys, a clinician should be experienced in evaluating both ADHD and ASD. Large pediatric facilities such as CHOP are particularly well positioned to provide such evaluations, having premier clinical and research centers in both conditions. Yerys added that, as precision medicine efforts expand, differentiating ADHD from ASD will be essential in providing safer and more effective treatments based on a child’s specific condition.

“Until we’re able to develop and validate a new rating scale that takes symptoms of autism into account, parents who are concerned should seek out clinicians who are conducting evaluations for ADHD and are also taking into account the possibility of autism,” added Yerys.

Going forward, concluded Power, it will be important to strengthen local resources by improving training for community-based providers such as pediatricians and school psychologists in recognizing key distinctions in diagnosing and treating both ADHD and ASD.

Note: Power receives financial compensation for the ADHD-RS-IV. The National Institutes of Health (grants MH086111, MH092615, MH088791 and HD026979), the Pennsylvania Department of Health, the Philadelphia Foundation, the Robert Wood Johnson Foundation and Pfizer, Inc. provided funding support for this study.

Original Article: https://www.sciencedaily.com/releases/2016/10/161027143526.htm

 

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Epidemiological studies indicate a progressively rising prevalence trend in the number of individuals identified with autism spectrum disorder (ASD) over the past decade. Yet, compared with general population estimates, children and youth with mild to moderate symptoms of ASD remain an underidentified and underserved population in our schools and communities. The DSM-5 conceptualizations of autism require professionals in clinical, school, and private practice settings to update their knowledge about the spectrum. In addition, professionals should be prepared to recognize the presence of risk factors and/or early warning signs of ASD and be familiar with screening and assessment tools in order to ensure that individuals with ASD are being identified and provided with the appropriate programs and services. The objectives of this course are to identify DSM-5 diagnostic changes in the ASD diagnostic criteria, summarize the empirically-based screening and assessment methodology in ASD, and describe a comprehensive developmental approach for assessing children, adolescents, and young adults with ASD.

 

The first section of this course traces the history of the diagnostic concept of Autism Spectrum Disorder (ASD), culminating in the revised criteria of the 2013 version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, with specific focus on the shift from five subtypes to a single spectrum diagnosis. It also aims to provide epidemiological prevalence estimates, identify factors that may play a role in causing ASD, and list the components of a core assessment battery. It also includes brief descriptions of some of the major intervention models that have some empirical support. Section two describes common GI problems and feeding difficulties in autism, exploring the empirical data and/or lack thereof regarding any links between GI disorders and autism. Sections on feeding difficulties offer interventions and behavior change techniques. A final section on nutritional considerations discusses evaluation of nutritional status, supplementation, and dietary modifications with an objective look at the science and theory behind a variety of nutrition interventions. Other theoretical interventions are also reviewed.

 

Autism Movement Therapy® is an emerging therapy that combines movement and music with positive behavior support strategies to assist individuals with Autism Spectrum Disorder (ASD) in meeting and achieving their speech and language, social and academic goals. Its purpose is to connect left and right hemisphere brain functioning by combining patterning, visual movement calculation, audile receptive processing, rhythm and sequencing into a “whole brain” cognitive thinking approach that can significantly improve behavioral, emotional, academic, social, and speech and language skills. This course is presented in two parts. Part 1 summarizes what is known about the brain functioning of individuals with ASD and illustrates how participation in dance, music and the arts can render the brain more amenable to learning social and language skills. Part 2 is a documentary created by Joanne Lara – Generation A: Portraits of Autism and the Arts, which spotlights – from a strikingly positive perspective – the challenges and accomplishments of eight individuals with ASD.

 

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Professional Development Resources is a non-profit provider of online continuing education courses accredited by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and is CE Broker compliant (all courses are reported within one week of completion).

 

 

Cerebral Palsy and Depression

27 Oct

From Cerebral Palsy Guidance

Children with motor impairments such as cerebral palsy, especially coupled with associated disorders, are at a heightened risk of developing depression. Depression rates are three to four times higher for people with disabilities, when compared to non-disabled people. As a parent or caregiver, it’s crucial to understand the signs of depression, including warning signals of when to get help immediately.

The Link Between Cerebral Palsy and Depression

Cerebral Palsy and DepressionAccording to a study published in The Scientific World Journal (Volume 2013, Article ID 468402), children with cerebral palsy or similar neurodevelopmental disorders are prone to psychiatric issues. One out of every two children with CP will meet the criteria for some form of psychiatric disorder, with attention deficit hyperactivity disorder (ADHD) being the most prevalent. The study indicated that around 40% to 50% of school-aged children with cerebral palsy exhibit emotional and behavioral problems.

Children with cerebral palsy who exhibited depressive disorder and anxiety issues were generally on the same academic and functioning level of their peers. Researchers suggest that depression may manifest be due to having shortcomings because of their disabilities, as they probably had the same expectations in the classroom as other non-disabled kids.

Problems with peers seems to be a large factor in children with CP developing depression, specifically bullying issues. Bullying can happen at any age in school, but middle school tends to be the highest association of bullying, name calling, and ridiculing.

The study also indicated that overlapping conditions were overwhelming in children with CP who developed depression. For example, many of the children with depressive disorders also had ADHD and/or oppositional defiance disorder (ODD).

Symptoms of depression can vary greatly according to each child. While one child may exhibit sadness and isolation, another one may become easily irritated and angered. Biochemistry, genetics, personality, and the child’s environmental factors all play a part on how a child with depression will react.

Learn more @ https://www.cerebralpalsyguidance.com/cerebral-palsy/associated-disorders/depression/

Related Online Continuing Education (CE/CEU) Courses:

Depression is a 1-hour online continuing education (CE/CEU) course that provides an overview to the various forms of depression, including signs and symptoms, co-existing conditions, causes, gender and age differences, and diagnosis and treatment options.

The Impact of a Life of ADHD: Understanding for Clinicians and Clients is a 3-hour online continuing education (CE/CEU) course that discusses the many ways a lifetime of ADHD can affect a person’s life.

Anxiety: Practical Management Techniques is a 4-hour online continuing education (CE/CEU) course that offers a collection of ready-to-use anxiety management tools that can be used in nearly all clinical settings and client diagnoses

Professional Development Resources is a non-profit organization approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

ADHD Symptoms Often Persist into Adulthood

27 Sep

From Wiley

ADHD in AdultsSixty percent of children with ADHD in a recent study demonstrated persistence of symptoms into their mid-20’s, and 41 percent had both symptoms and impairment as young adults.

Investigators noted that rates of ADHD persistence into adulthood have varied greatly in earlier studies, depending on how information is collected and analyzed. In a 16-year follow-up of the Multimodal Treatment Study of Children with ADHD (the “MTA”), they found that a combination of parent and self-reports plus a symptom threshold that is adjusted for adulthood (rather than based on traditional childhood definitions of ADHD) may be optimal.

“There has been a lot of recent controversy over whether children with ADHD continue to experience symptoms into adulthood,” said Dr. Margaret Sibley, lead author of the Journal of Child Psychology and Psychiatry study. “This study found that the way you diagnose ADHD can lead to different conclusions about whether or not an adult still has the disorder that started in childhood. First, if you ask the adult about their continued symptoms, they will often be unaware of them; however, family members or others who know them well often confirm that they still observe significant symptoms in the adult.”

Dr. Sibley added that if the classic childhood definition of ADHD is used when diagnosing adults, many cases will be missed because symptom presentation changes in adulthood. “By asking a family member about the adult’s symptoms and using adult-based definitions of the disorder, you typically find that around half of children with moderate to severe ADHD still show significant signs of the disorder in adulthood.”

Source: https://www.sciencedaily.com/releases/2016/09/160919110059.htm

Related Online Continuing Education Courses

Section I of this course involves a detailed discussion of the many ways that a lifetime of ADHD can affect a person’s life. This is important information for all clinicians working with adults who have ADHD, partly for their own understanding, but also to help clients understand their own ADHD. It will include descriptions of situations that can obscure ADHD and will highlight the executive, academic, occupational, psychological, and social aspects of adult functioning that are impacted by ADHD. The second section involves educating clients about the many ways that ADHD has affected their life trajectories. This goes beyond the obvious academic difficulties and includes current functioning as well, offering less pejorative explanations for their weaknesses. Included are techniques for involving family members, creating an ADHD-friendly lifestyle, and finding a better fit in the classroom and the workplace. This education is a crucial first step in the treatment of ADHD in adults and builds the foundation for medication, coaching, and therapy.

 

In the Zone: Finding Flow Through Positive Psychology is a 2-hour online continuing education (CE) course that offers a how-to guide on incorporating flow into everyday life. According to the CDC, four out of ten people have not discovered a satisfying life purpose. Further, the APA reports that most people suffer from moderate to high levels of stress, and according to SAMSHA, adult prescription medication abuse (primarily to counteract attention deficit disorders) is one of the most concerning health problems today. And while clinicians now have a host of resources to mitigate distress and reduce symptomatology, the question remains: how do clinicians move clients beyond baseline levels of functioning to a state of fulfillment imbued with a satisfying life purpose? The answer may lie in a universal condition with unexpected benefits…This course will explore the concept of flow, also known as optimal performance, which is a condition we are all capable of, yet seldom cultivate.

 

Professional Development Resources is a Florida nonprofit educational corporation 501(c)(3) approved to offer continuing education by the American Psychological Association (APA): the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners. We are CE Broker compliant (all courses are reported within one week of completion.

 

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When A Child Starts School Can Impact An ADHD Diagnosis

11 Mar

By Honor Whiteman

When A Child Starts School Can Impact An ADHD DiagnosisAccording to a new study published in The Journal of Pediatrics, the age at which a child starts school can influence the likelihood of a attention deficit hyperactivity disorder diagnosis.

Attention deficit hyperactivity disorder (ADHD) is estimated to affect around 6.4 million children aged 4-17 in the US, making it one of the most common childhood conditions.

ADHD is characterized by poor attention, hyperactivity and impulsive behavior. It is most commonly diagnosed at the age of 7, and boys are more likely to be diagnosed with the condition than girls.

The causes of ADHD remain unclear, though some studies have suggested that it may be down to genes, use of alcohol, cigarettes or drugs during pregnancy, exposure to environmental toxins – such as lead – at a young age or brain injury.

Now, Dr. Mu-Hong Chen, of the National Yang-Ming University in Taipei, Taiwan, and colleagues suggest a diagnosis of ADHD may be related to the age at which they start school.

Risk of ADHD diagnosis higher in August-born schoolchildren
To reach their findings, the team analyzed 1997-2011 data involving 378,881 children aged 4-17 years.

Fast facts about ADHD

1. Between 2003-2011, the number of children diagnosed with ADHD in the US increased from 7.8% to 11%
2. Boys are more than twice as likely to be diagnosed with ADHD than girls
3. Children with a history of ADHD have almost three times as many peer problems as those without a history of ADHD.

The researchers assessed the prevalence of ADHD diagnosis among the children and whether they were prescribed medication for the condition.

They also looked at what age the children were enrolled in school, taking into account the annual cut-off date for school entry in Taiwan: August 31st.

The team compared ADHD prevalence and medication prescription among the youngest children in a grade (those who were born in August) with the older children in a grade (those born in September).

The researchers found that preschool and elementary school children born in August were more likely to be diagnosed with ADHD and receive medication for the disorder, compared with those born in September.

Adolescents who were born in August, however, were at no higher risk of an ADHD diagnosis than those born in September.

“This result may imply that as age and maturity level increased in teenage years, the influence of birth month would have less of an impact on ADHD diagnosis and treatment,” say the authors. Read More…

 

Continuing Education Courses on ADHD

 

This introductory course, from the National Institute of Mental Health (NIMH), gives a brief update on the various facets of attention deficit hyperactivity disorder (ADHD). It details the core symptoms, including behavioral manifestations of each, notes what is known about its causes, and lists the components of a comprehensive diagnostic protocol. It also describes a multifaceted treatment approach that includes combined medication, psychotherapy, and behavioral therapy. The course includes sections on comorbid disorders, dealing with ADHD at school, and treating it in teens and adults.

 

This is a test only course (book not included). The book (or e-book) can be purchased from Amazon. This CE test is based on the book “Treating Explosive Kids: The Collaborative Problem-Solving Approach” (2006, 246 pages). This book provides a detailed framework for effective, individualized intervention with highly oppositional children and their families. Many vivid examples and Q&A sections show how to identify the specific cognitive factors that contribute to explosive and noncompliant behavior, remediate these factors, and teach children and their adult caregivers how to solve problems collaboratively. The book also describes challenges that may arise in implementing the model and provides clear and practical solutions. Two special chapters focus on intervention in schools and in therapeutic/restrictive facilities.

 

Section I of this course involves a detailed discussion of the many ways that a lifetime of ADHD can affect a person’s life. This is important information for all clinicians working with adults who have ADHD, partly for their own understanding, but also to help clients understand their own ADHD. It will include descriptions of situations that can obscure ADHD and will highlight the executive, academic, occupational, psychological, and social aspects of adult functioning that are impacted by ADHD. The second section involves educating clients about the many ways that ADHD has affected their life trajectories. This goes beyond the obvious academic difficulties and includes current functioning as well, offering less pejorative explanations for their weaknesses. Included are techniques for involving family members, creating an ADHD-friendly lifestyle, and finding a better fit in the classroom and the workplace. This education is a crucial first step in the treatment of ADHD in adults and builds the foundation for medication, coaching, and therapy.

 

Clinicians and teachers working with students struggling at grade level are committed to raising their students’ achievement potential by creating opportunities to learn. In order to accomplish this, they need to learn new techniques that can help encourage discouraged students – particularly those who have different ways of learning – by supporting and motivating them without enabling self-defeating habits. This course will provide strategies and techniques for helping students minimize the patterns of “learned helplessness” they have adopted, appreciate and maximize their strengths, develop a growth mindset, value effort and persistence over success, view mistakes as opportunities to learn, and develop a love of learning that will help them take personal responsibility for their school work.

 

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

 

Can ADHD Medications Make Kids a Target for Bullying?

10 Feb

From the University of Michigan

ADHD Medications and BullyingRitalin is often prescribed to treat attention-deficit hyperactivity disorder, and a study finds that kids taking it are twice as likely to be physically or emotionally bullied by peers who don’t suffer from ADHD.

At even higher risk were middle and high school students who sold or shared their medications–those kids were four-and-a-half times likelier to be victimized by peers than kids without ADHD.

The main findings are the same for both sexes, said the study’s first author, Quyen Epstein-Ngo, research assistant professor at the U-M Institute for Research on Women and Gender and a fellow at the U-M Injury Center. Carol Boyd, professor of nursing, is the principal investigator.

It’s long been known that kids with ADHD have a harder time making and keeping friends and are bullied and victimized more. This study is believed to be the first known to look at how stimulant medications affect their relationships with peers.

“Many youth with ADHD are prescribed stimulant medications to treat their ADHD and we know that these medications are the most frequently shared or sold among adolescents,” said Epstein-Ngo, a licensed clinical psychologist.

The U-M researchers surveyed nearly 5,000 middle and high school students over four years. About 15 percent were diagnosed with ADHD and roughly 4 percent were prescribed stimulants within the past 12 months.

Of those who took ADHD meds, 20 percent reported being approached to sell or share them, and about half of them did.

When looking at the overall figures, relatively few students were asked to divert their medications or did. However, Epstein-Ngo said the numbers don’t tell the entire story.

“Having a diagnosis of ADHD has lifelong consequences,” she said. “These youth aren’t living in isolation. As they transition into adulthood, the social effects of their ADHD diagnosis will impact a broad range of people with whom they come into contact.”

From 2003 to 2011, there was a 42 percent increase in ADHD cases diagnosed in the U.S., and between 2007 and 2011, there was a 27 percent increase in stimulant-treated ADHD.

Epstein-Ngo said the findings shouldn’t scare parents away from considering a stimulant medication. Rather, the study reinforces why parents must talk to kids about never sharing their medications.

“For some children stimulant medications are immensely helpful in getting through school,” Epstein-Ngo said. “This study doesn’t say ‘don’t give your child medication.’ It suggests that it’s really important to talk to your children about who they tell.”

It’s unclear why kids with prescriptions for stimulant medications are more at risk for bullying and victimization, but Epstein-Ngo said it’s probably several factors.

“Is it a function of the fact that they are in riskier situations, or are they being coerced and forced to give up their medications? Probably a little bit of both,” she said.

Epstein-Ngo believes the biggest takeaway is to have compassion for kids with ADHD.

“I think the biggest misconception about ADHD is that these kids aren’t trying hard enough, and that’s just not the case,” she said. “If these kids could do better they would. With the proper support and treatment they can overcome this.”

The study, “Diversion of ADHD stimulants and peer victimization among adolescents,” is scheduled to appear in the Journal of Pediatric Psychology. It was funded by the National Institute on Drug Abuse. Article Source

Story Source:

The above post is reprinted from materials provided by University of Michigan.

Continuing Education Courses for Mental Health

This introductory course, from the National Institute of Mental Health (NIMH), gives a brief update on the various facets of attention deficit hyperactivity disorder (ADHD). It details the core symptoms, including behavioral manifestations of each, notes what is known about its causes, and lists the components of a comprehensive diagnostic protocol. It also describes a multifaceted treatment approach that includes combined medication, psychotherapy, and behavioral therapy. The course includes sections on comorbid disorders, dealing with ADHD at school, and treating it in teens and adults.

 

This is a test only course (book not included). The book (or e-book) can be purchased from Amazon. This CE test is based on the book “Treating Explosive Kids: The Collaborative Problem-Solving Approach” (2006, 246 pages). This book provides a detailed framework for effective, individualized intervention with highly oppositional children and their families. Many vivid examples and Q&A sections show how to identify the specific cognitive factors that contribute to explosive and noncompliant behavior, remediate these factors, and teach children and their adult caregivers how to solve problems collaboratively. The book also describes challenges that may arise in implementing the model and provides clear and practical solutions. Two special chapters focus on intervention in schools and in therapeutic/restrictive facilities.

 

This is a test only course (book not included). The book can be purchased from Amazon or some other source.This CE test is based on the book “The Complete Guide to Special Education, 2nd Edition” (2010, 372 pages) and should appeal to a wide variety of professionals, including: clinical psychologists, school psychologists, social workers, professional counselors, speech-language pathologists, as well as educators and school administrators. The course explores the special education process, from testing and diagnosis to IEP meetings and advocating for children with special needs. The stages of identification, assessment, diagnosis, eligibility, and intervention are discussed step by step to help readers better understand the legal rights of children with special needs and the roles of the many professionals who make up the child’s educational team. This course provides clear and concise information about the special education process; addresses Response-to-Intervention (RTI), a new approach to identifying students with a learning disability. Special topics such as executive functioning, behavior management and discipline are discussed and supported with practical professional suggestions.

 

School refusal is a problem that is stressful for children, for their families, and for school personnel. Failing to attend school has significant long and short-term effects on children’s social, emotional, and educational development. School refusal is often the result of, or associated with, comorbid disorders such as anxiety or depression. Careful assessment, treatment planning, interventions, and management of school refusal are critical to attainment of the goal of a successful return to school as quickly as possible. Interventions may include educational support, cognitive therapy, behavior modification, parent/teacher interventions, and pharmacotherapy.

 

Clinicians and teachers working with students struggling at grade level are committed to raising their students’ achievement potential by creating opportunities to learn. In order to accomplish this, they need to learn new techniques that can help encourage discouraged students – particularly those who have different ways of learning – by supporting and motivating them without enabling self-defeating habits. This course will provide strategies and techniques for helping students minimize the patterns of “learned helplessness” they have adopted, appreciate and maximize their strengths, develop a growth mindset, value effort and persistence over success, view mistakes as opportunities to learn, and develop a love of learning that will help them take personal responsibility for their school work.

Professional Development Resources is approved to offer online continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

Have Trouble Focusing as an Adult? It May Be Undiagnosed ADHD

20 Jan

By Patti Neighmond

ADHD in AdultsTrouble focusing and staying on track as an adult may be symptoms of ADHD. This article mentions how this surprising condition may be the culprit behind the inability to focus, completing tasks, and paying attention.

When Cathy Fields was in her late 50s, she noticed she was having trouble following conversations with friends.

“I could sense something was wrong with me,” she says. “I couldn’t focus. I could not follow.”

Fields was worried she had suffered a stroke or was showing signs of early dementia. Instead she found out she had attention deficit hyperactivity disorder, or ADHD.

Fields is now 66 years old and lives in Ponte Vedra Beach, Fla. She’s a former secretary and mother of two grown children. Fields was diagnosed with ADHD about eight years ago. Her doctor ruled out any physical problems and suggested she see a psychiatrist. She went to Dr. David Goodman at Johns Hopkins School of Medicine, who by chance specializes in ADHD.

Goodman asked Fields a number of questions about focus, attention and completing tasks. He asked her about her childhood and how she did in school. Since ADHD begins in childhood, it’s important for mental health professionals to understand these childhood experiences in order to make an accurate diagnosis of ADHD in adulthood. Online screening tests are available, too, so you can try it yourself.

Goodman decided that Fields most definitely had ADHD.

She’s not alone. Goodman says he’s seeing more and more adults over the age of 50 newly diagnosed with ADHD. The disorder occurs as the brain is developing, and symptoms generally appear around age 7. But symptoms can last a lifetime. For adults, the problem is not disruptive behavior or keeping up in school. It’s an inability to focus, which can mean inconsistency, being late to meetings or just having problems managing day-to-day tasks. Adults with ADHD are more likely than others to lose a job or file for bankruptcy, Goodman says. They may overpay bills, or underpay them. They may pay bills late, or not at all.

For Cathy Fields, the more she thought about it, the more she realized distraction and the inability to focus was the story of her life. It was also the story of her mother’s life. Her mother “never got things done,” Fields says.

This is typical, according to Goodman; ADHD often runs in families. According to Children and Adults with Attention-Deficit/Hyperactivity Disorder, or CHADD, an advocacy group, the disorder can be inherited. If a parent has ADHD, the child has more than a 50 percent chance of also having it. If a twin has ADHD, the other twin has up to an 80 percent chance of having the disorder.

But because many of today’s older adults grew up during the 1950s and ’60s when there wasn’t much awareness of ADHD, many were never diagnosed. And increasingly, Goodman says, he’s seeing more and more patients who are concerned about dementia but who actually have ADHD — just like Cathy Fields.

Goodman also sees patients who are diagnosed after their child or grandchild gets a diagnosis. “That’s the genetic link,” says Goodman, “from Grandmom to Mom to daughter.”

About 60 percent of children with ADHD go on to become adults with ADHD, says Dr. Lenard Adler, a professor of psychiatry at the New York University School of Medicine. As these older adults weren’t diagnosed, they learned to work around the problem, Adler says. They developed coping systems to deal with their inability to focus or pay attention. Read more…

Source: http://www.npr.org/sections/health-shots/2016/01/18/462978127/cant-focus-it-might-be-undiagnosed-adult-adhd

Related Continuing Education Courses

Section I of this course involves a detailed discussion of the many ways that a lifetime of ADHD can affect a person’s life. This is important information for all clinicians working with adults who have ADHD, partly for their own understanding, but also to help clients understand their own ADHD. It will include descriptions of situations that can obscure ADHD and will highlight the executive, academic, occupational, psychological, and social aspects of adult functioning that are impacted by ADHD. The second section involves educating clients about the many ways that ADHD has affected their life trajectories. This goes beyond the obvious academic difficulties and includes current functioning as well, offering less pejorative explanations for their weaknesses. Included are techniques for involving family members, creating an ADHD-friendly lifestyle, and finding a better fit in the classroom and the workplace. This education is a crucial first step in the treatment of ADHD in adults and builds the foundation for medication, coaching, and therapy.

 

This introductory course, from the National Institute of Mental Health (NIMH), gives a brief update on the various facets of attention deficit hyperactivity disorder (ADHD). It details the core symptoms, including behavioral manifestations of each, notes what is known about its causes, and lists the components of a comprehensive diagnostic protocol. It also describes a multifaceted treatment approach that includes combined medication, psychotherapy, and behavioral therapy. The course includes sections on comorbid disorders, dealing with ADHD at school, and treating it in teens and adults.

 

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; by the National Board of Certified Counselors (NBCC) to offer home study continuing education for NCCs (#5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

Exposure to Lead Linked to ADHD in Children with Gene Mutation

08 Jan

From the Association for Psychological Science

ADHD in ChildrenAccording to new research published in Psychological Science, exposure to small amounts of lead may contribute to ADHD symptoms in children with a particular gene mutation.

“This research is valuable to the scientific community as it bridges genetic and environmental factors and helps to illustrate one possible route to ADHD. Further, it demonstrates the potential to ultimately prevent conditions like ADHD by understanding how genes and environmental exposures combine,” says lead researcher Joel Nigg, professor of psychiatry and behavioral neuroscience at the OHSU School of Medicine.

To conduct this research, Nigg and colleagues evaluated lead blood level in 386 healthy children aged 6 to 17. Half of the children had been carefully diagnosed with ADHD. All children were within the safe lead exposure range as defined by the Centers for Disease Control and Prevention, and the blood lead level in the sample was typical of the national U.S. population of children.

The analysis showed a heightened association between lead exposure and ADHD symptoms — particularly hyperactivity-impulsivity — in those with the HFE C282Y gene mutation, present in approximately 10 percent of US children.

“Because the C282Y gene helps to control the effects of lead in the body and the mutation was spread randomly in the children, the findings of our study are difficult to explain unless lead is, in fact, part of the cause of ADHD, not just an association,” explained Nigg.

The study also found that lead effects were more robust in males, which is consistent with previous research specific to neurodevelopmental conditions and gender. Children without HFE C282Y mutations showed amplified symptoms as lead exposure increased, but not as consistently.

The scientists do not purport that lead is the only cause of ADHD symptoms, nor does the research indicate that lead exposure will guarantee an ADHD diagnosis; rather, the study demonstrates that environmental pollutants, such as lead, do play a role in the explanation of ADHD.

Despite U.S. government regulations that drastically reduced environmental exposure to lead, the neurotoxin is still found in common objects such as children’s toys and costume jewelry, and continues to be ingested in small amounts via water from aging pipes, as well as contaminated soil and dust.

“Our findings put scientists one step closer to understanding this complex disorder so that we may provide better clinical diagnoses and treatment options and, eventually, learn to prevent it,” says Nigg. Article Source

 

How to Manage and Reduce Overwhelming Feelings from ADHD

18 Sep

Managing and Reducing Overwhelming Feelings in ADHDBy Carey Heller, PsyD
 
When people think about attention-deficit hyperactivity (ADHD), they typically envision a person who experiences difficulty focusing and sitting still. Other related issues, however, can be even more concerning for those with ADHD. One such issue is the ease with which some people with ADHD can feel overwhelmed.

There are many explanations as to why this may occur. Some individuals with ADHD have co-occurring anxiety, which can contribute to feelings of overwhelm. However, one of the most overlooked reasons many individuals with ADHD experience overwhelm is that it is difficult for them to plan ahead.

If one has five different tasks to complete, not only may the five tasks themselves be overwhelming, but thinking about all the steps involved to complete each one may add to feelings of overwhelm. Difficulties staying focused may make it even harder to get tasks completed or to remember to do them.
 
What can be done? Physical and mental planning are essential to reducing feelings of overwhelm. The following are some suggestions.
 

Physical Planning

 
Use a calendar to keep visual track of appointments.
 
Use a task list to keep track of tasks that need to be completed. Some people find it helpful to organize tasks into general categories (chores, school work, bill paying, etc.). Using task-list apps can be helpful for this.
 
Schedule time in your calendar to complete groupings of tasks or specific tasks.
For larger tasks with many parts, break them down into smaller parts and list each part in your to-do list.
 
Set deadlines for yourself or plan out days when you will complete specific items.
Estimate how long items will take to complete, and factor in travel time as needed.
If you need help from a parent, partner, etc., discuss your needs and find a mutually agreeable system that keeps you in control, progressing toward less need for assistance.
 

Mental Planning

 
Review tasks that need to be completed over the course of the day and make sure you run through your mind when you plan to complete them (these should also be written down in your to-do list as well).
 
If needed, put visual reminders around your living quarters, office, etc.
 
Keep calm by reminding yourself that you’ve planned out how to complete everything and will be OK as long as you follow your plan. In the moment you can focus on the short term, because the long-term items are planned out.
 
Think about possible distractions or pitfalls that would impede you from following your plan (playing video games, surfing the web, hanging out with friends, etc.). Write down ways you can minimize these.
 

Just Relax

 
Learning coping strategies to help you relax can also be helpful. Such strategies may include:
 

  • Engage in physical activity daily. Go for a run, work out, or go for a walk.
  • If feeling overwhelmed, engage in physical activity as a break to calm down.
  • Listen to music, soothing sounds, or use guided visual imagery.
  • Have fun plans scheduled for after you complete tasks (if you have to run errands, for example, set up plans for coffee with a friend afterward).

 
If you frequently feel overwhelmed, you don’t have to experience those feelings to the extent you currently do. Making a few simple changes in how you stay organized, plan, and carry out tasks can make a big difference. If you feel that you need professional assistance with implementing tools, learning coping strategies, etc., there are many different types of professionals who can assist you. To find one, search for a therapist in your area.

© Copyright 2015 by Carey A. Heller, PsyD, therapist in Bethesda, MD. All Rights Reserved.

Original Article: http://www.goodtherapy.org/blog/how-to-manage-and-reduce-feelings-of-overwhelm-due-to-adhd-0918154

Related CE Courses on ADHD

This introductory course, from the National Institute of Mental Health (NIMH), gives a brief update on the various facets of attention deficit hyperactivity disorder (ADHD). It details the core symptoms, including behavioral manifestations of each, notes what is known about its causes, and lists the components of a comprehensive diagnostic protocol. It also describes a multifaceted treatment approach that includes combined medication, psychotherapy, and behavioral therapy. The course includes sections on comorbid disorders, dealing with ADHD at school, and treating it in teens and adults.

 

Section I of this course involves a detailed discussion of the many ways that a lifetime of ADHD can affect a person’s life. This is important information for all clinicians working with adults who have ADHD, partly for their own understanding, but also to help clients understand their own ADHD. It will include descriptions of situations that can obscure ADHD and will highlight the executive, academic, occupational, psychological, and social aspects of adult functioning that are impacted by ADHD. The second section involves educating clients about the many ways that ADHD has affected their life trajectories. This goes beyond the obvious academic difficulties and includes current functioning as well, offering less pejorative explanations for their weaknesses. Included are techniques for involving family members, creating an ADHD-friendly lifestyle, and finding a better fit in the classroom and the workplace. This education is a crucial first step in the treatment of ADHD in adults and builds the foundation for medication, coaching, and therapy.

 

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; the National Board of Certified Counselors (NBCC) to offer home study continuing education for NCCs (Provider #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

 

Picky Eating Linked to Mental Health Issues

05 Aug

By Tia Ghose, Senior Writer @ Live Science

Picky EaterAlmost everyone knows a 4-year-old who’s never eaten an apple, subsists off hot dogs and spaghetti or eats only white food.

But a new study suggests that such picky eating isn’t the norm, and that it may even hint at future mental health issues, in some cases. Children who are selective eaters are likelier to develop anxiety, depression and attention deficit hyperactivity disorder (ADHD), according to the study, published August 3, 2015 in the journal Pediatrics.

It’s not clear how or why picky eating may be tied to these conditions, but it may be that children who have heightened sensory experiences overall are also more sensitive to the food they eat, the researchers at Duke University wrote in their paper.

Picky or Healthy

Pediatricians tend to shrug off parents’ fears about children who gag at eggs or shove their broccoli off their plates, saying it is just a phase that most kids will outgrow, the researchers said.

But the research team previously found that adults who are picky eaters tend to have higher rates of psychological disorders than the general public. And some studies suggest that there are a lot of adult picky eaters out there, but because they have more control over what’s on their plates than children do, they can conceal their food likes and dislikes, said Marcia Pelchat, a psychologist at the Monell Chemical Senses Center in Philadelphia, who was not involved in the new study.

To see whether picky eating was associated with mental health issues in children, the Duke researchers asked the parents of about 3,400 preschoolers to fill out several questionnaires about their children’s eating habits, and signs of depression, anxiety, ADHD and other psychological disorders, as well as their sensitivity to sensory experiences. About two years later, the team evaluated a subset of the little ones again.

The researchers considered the kids who only ate certain foods as having a “moderate level” of selective eating, whereas kids whose range of foods was so limited that it made it difficult for them to eat with others were considered as having “severe” selective eating. (Because so many kids avoid foods like broccoli and other cruciferous veggies, the team didn’t consider hating those foods as a sign of picky eating.)

Among all children in the study, about one-fifth had at least moderate levels of selective eating, and 3 percent of parents reported severely restricted eating. Compared with the children with no eating issues, the moderate and severe picky eaters were more likely to suffer from anxiety, depression and ADHD, both at the time of the survey and in the two-year follow-up.

Cause, Effect or Neither?

Picky Eating in Kids Tied to Anxiety, DepressionIt’s possible that picky eating causes such unpleasant mealtime battles that it increases family discord, and indirectly leads to anxiety and other mental health conditions, Pelchat said. But it’s also likely that the kids with a predisposition to anxiousness may simply have more fears surrounding food, Pelchat said.

On a subconscious level, it may be that “if you have tremendous anxiety, for example, it is threatening to put food in your mouth,” Pelchat told Live Science. Humans have an adaptive tendency to avoid eating food that tastes weird or raises anxiety — this can prevent poisoning, she said. It may be that this tendency goes further than necessary in some people.

For instance, some of the most common foods in the “reject” pile have a slimy or gelatinous texture, or textural transitions (think bread with nuts in it, or tomatoes, which have crunchy seeds, slimy insides, mealy flesh and tough skin). In humans’ evolutionary past, such textures may have been tipoffs that something was spoiled or unsafe to eat, she said.

The study authors suggest that doctors should take picky eating seriously, because it could be a marker for future mental health issues. They also suggest that doctors should intervene when parents raise the issue.

As for ways to overcome picky eating, there’s not just one method that works, Pelchat said. But there are definitely some no-nos.

“What we found — and others have kind of confirmed — is that being a short-order cook and catering to the child is not helpful,” Pelchat said. “Punishing the child does not work, and rewarding or bribing does not work.”

Instead, taking pleasure in food, worrying less about it, taking time to prepare food and getting kids involved in the effort may help kids gradually reframe their experience with food, Pelchat said.

But there’s no evidence to suggest that working to overcome such picky eating on its own will help a child with anxiety or depression, Pelchat noted.

Follow Tia Ghose on Twitterand Google+. Follow Live Science@livescience, Facebook & Google+. Original article on Live Science.

Related Online CEU Courses:

Autism: The New Spectrum of Diagnostics, Treatment & Nutrition is a 4-hour online continuing education (CE/CEU) course that describes DSM-5 diagnostic changes, assessment, intervention models, dietary modifications, nutrition considerations and other theoretical interventions.

Attention Deficit Hyperactivity Disorder (ADHD) is a 1-hour online continuing education (CE/CEU) course that gives a brief update on the various facets of ADHD.

Anxiety: Practical Management Techniques is a 4-hour online continuing education (CE/CEU) course that offers a collection of ready-to-use anxiety management tools that can be used in nearly all clinical settings and client diagnoses

Depression is a 1-hour online continuing education (CE/CEU) course that provides an overview to the various forms of depression, including signs and symptoms, co-existing conditions, causes, gender and age differences, and diagnosis and treatment options.

Eliminating Self-Defeating Behaviors is a 4-hour online continuing education (CE/CEU) course that teaches you how to identify, analyze and replace self-defeating behaviors with positive behaviors.

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by theTexas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

Toddlers Medicated for ADHD Against Guidelines

08 Jun

By Alan Schwarz

Toddlers Medicated for ADHDMore than 10,000 American toddlers 2 or 3 years old are being medicated for attention deficit hyperactivity disorder (ADHD) outside established pediatric guidelines, according to data presented on Friday by an official at the Centers for Disease Control and Prevention (CDC).

The report, which found that toddlers covered by Medicaid are particularly prone to be put on medication such as Ritalin and Adderall, is among the first efforts to gauge the diagnosis of ADHD in children below age 4. Doctors at the Georgia Mental Health Forum at the Carter Center in Atlanta, where the data was presented, as well as several outside experts strongly criticized the use of medication in so many children that young.

The American Academy of Pediatrics standard practice guidelines for ADHD do not even address the diagnosis in children 3 and younger — let alone the use of such stimulant medications, because their safety and effectiveness have barely been explored in that age group. “It’s absolutely shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant to the Carter Center. “People are just feeling around in the dark. We obviously don’t have our act together for little children.”

Dr. Lawrence H. Diller, a behavioral pediatrician in Walnut Creek, CA, said in a telephone interview: “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.”

Friday’s report was the latest to raise concerns about ADHD diagnoses and medications for American children beyond what many experts consider medically justified. Last year, a nationwide CDC survey found that 11 percent of children ages 4 to 17 have received a diagnosis of the disorder, and that about one in five boys will get one during childhood.

A vast majority are put on medications such as methylphenidate (commonly known as Ritalin) or amphetamines like Adderall, which often calm a child’s hyperactivity and impulsivity but also carry risks for growth suppression, insomnia and hallucinations.

Read more: http://mobile.nytimes.com/2014/05/17/us/among-experts-scrutiny-of-attention-disorder-diagnoses-in-2-and-3-year-olds.html?referrer=&_r=2

Related Online Continuing Education Courses:

Attention Deficit Hyperactivity Disorder (ADHD) is a 1-hour online continuing education (CE/CEU) course that gives a brief update on the various facets of ADHD.

Mental Health Medications is a 1-hour online continuing education (CE/CEU) course that describes the types of medications used to treat mental disorders, side effects of medications, directions for taking medications, potential interactions with other drugs, and warnings about medications from the FDA.

The Impact of a Life of ADHD: Understanding for Clinicians and Clients is a 3-hour online continuing education (CE/CEU) course that discusses the many ways a lifetime of ADHD can affect a person’s life.

Diagnosing ADHD in Adults is a 3-hour online continuing education (CE/CEU) course that describes the unique ways symptoms of ADHD manifest in adults, including the distinction between attention deficit and attention regulation.

Professional Development Resources is approved to offer continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.