Friday, March 3, 2017

ReFresh: •Parenting a Child with ADHD/Impulsivity



 
The Status of ADHD in the US



Per the CDC the prevalence of a diagnosis of ADHD has increased over time
 
Percent Diagnosed
2003
7.8 % of Children

2007
9.5% of Children

2014
11% of Children


The average age of diagnosis is 7.
Girls diagnosis are often missed or are diagnosed later.

 
What is ADHD?

•A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

•Six or more of the symptoms have persisted for at least six months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities. Please note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), five or more symptoms are required

•Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years

•Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities)

•There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning

•The symptoms do not occur exclusively during the course of another psychotic disorder and are not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication, schizophrenia or withdrawal)

 



What are the symptoms of Anxiety?

•The presence of excessive anxiety and worry about a variety of topics, events, or activities.

•Worry occurs more often than not for at least 6 months and is clearly excessive.

•The worry is experienced as very challenging to control.

•Worry in both adults and children may shift from one topic to another.

 

The anxiety and worry is associated with at least 3 of the following physical or cognitive symptoms (In children, only 1 symptom)

•Edginess or restlessness.

•Tiring easily; more fatigued than usual.

•Impaired concentration or feeling as though the mind goes blank.

•Irritability (which may or may not be observable to others).

•Increased muscle aches or soreness.

•Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep).

 

Many individuals will experience symptoms such as sweating, nausea or diarrhea.

•The anxiety, worry, or associated symptoms make it hard to carry out day-to-day activities and responsibilities. They may cause problems in relationships, at work, or in other important areas.

•These symptoms are unrelated to any other medical conditions and cannot be explained by the effect of substances

•These symptoms are not better explained by a different mental disorder.


 

What is Complex Post Traumatic Stress (PTSD)?

•The traumatic events connected to Complex PTSD are long-lasting and generally involve some form of physical or emotional captivity, such as childhood sexual and/or physical abuse or domestic violence. In these types of events, a victim is under the control of another person and does not have the ability to easily escape. Symptoms:

•Emotion Regulation Problems
 

•Changes in Consciousness
 

•Changes in How a Person Views Themselves
  

•Changes in How the Victim Views the Perpetrator
  

•Changes in Personal Relationships
  

•Changes in How One Views the World


 

So….What now- 

•My kids has behavioral difficulties

•They wiggles too much

•They get in trouble in school

•They have a hard time focusing on regular every day tasks

•They don’t seem to be doing the things their peers are doing.

•They just don’t seem to be getting it

•What can I do to help them concentrate and focus????

•Medications 

•Disclaimer—I am a parent and a LICSW, not a doctor.

•However, I can say a few things about this.

 

ADHD

Stimulant medications include:


•Amphetamine/Dextroamphetamine (Adderall and Adderall XR)

•Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)

•Dexmethylphenidate (Focalin and Focalin XR)


•Methylphenidate (Concerta, Daytrana, Metadate CD and Metadate ER, Methylin and Methylin ER, Ritalin, Ritalin SR, Ritalin LA, Quillivant XR)

Nonstimulant Medications for ADHD

•In cases where stimulants don’t work or cause unpleasant side effects, nonstimulants might help. These medications can all improve concentration and impulse control.

•Atomoxetine (Strattera) was the first nonstimulant medication approved by the FDA. It’s approved children, adolescents, and adults.

•Clonidine hydrochloride (Kapvay) has also been approved for use alone or in combination with a stimulant to boost the effectiveness.


 



•What if these medications don’t work?

It could be Anxiety or Depression or PTSD (a combo of both)

 

•What Other Medications Might Help?

•These medications include:

•Amitriptyline (Elavil), desipramine (Norpramin, Pertofrane), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), or other tricyclic antidepressants




 



•What can I do at home to try and help?

•Sight By Margarita Tartakovsky, M.S. 
 

Visual fidgets are all about noticing details in your surroundings or watching something while performing the task. These include:

•Using colorful tools, such as bright folders, highlighters or pens

•Watching a fish tank or water

•Glancing out the window

•Looking at the flame in a fireplace


 

 

•Sound
 

These fidgets include listening to something while you’re performing tasks such as reading or talking.

•Listening to music, such as classical music or jazz, or rhythmic beats

•Whistling, humming or singing

•Listening to a ticking clock

•Hearing background noise, such as traffic

 



•Mouth
 

These fidgets can help while reading and working.

•Chewing gum

•Sipping coffee or water

•Biting your cheek or lips

 



•Smell
 

Strategies that involve the sense of smell aren’t used as much as the ones above. But because it’s linked to the emotional center of the brain our sense of smell can trigger emotional reactions, “which are themselves stimulation strategies.”

•Scented candles

•Incense

•Aromatherapy

•Freshly baked foods like cinnamon rolls (yum!)

•Rotz and Wright stress the importance of giving yourself permission to fidget without shame, and finding the unique strategies that work for you.

 



•Taste
 

These tips use textures, flavors and temperatures of foods and beverages to help you better focus on reading, listening and working.

•Eating or licking different flavors, such as salty, sour or spicy foods (like hot peppers)

•Drinking hot beverages, such as tea, or cold ones, such as ice water

•Eating chewy snacks

 



•Touch
 

These strategies involve holding, feeling or handling something while you’re talking or listening.

•Using fidget toys, such as balls or a Slinky

•Playing with your hair

•Fiddling with your keys

•Taking notes

•Doodling

•Knitting

•Playing with paper


 

•Movement
 

These tips involve moving your body while you’re trying to focus on tasks such as studying or listening.

•Exercising, such as walking, jogging or bike riding

•Swiveling in a chair

•Rocking or fidgeting

•Standing

•Pacing

•Wiggling your toes

•Tapping a pen


 

Resources:

 

FIDGET IDEAS




 




 



Resources on Diagnosis and Understanding of ADHD:


•Updates to ADHD in the DSM-5 http://www.dsm5.org/Documents/ADHD%20Fact%20Sheet.pdf 

•National Resource Center for ADHD http://www.help4adhd.org/ 

•My ADHD http://myadhd.com 


 

NATIONAL Support Resource:



PUBLICATIONS:

Parenting Your Child with ADHD, A No-Nonsense Guide for Nurturing Self-Reliance and Cooperation Author: Craig Wiener EdD (Book)
Smart but Scattered: The Revolutionary "Executive Skills" Approach to Helping Kids Reach Their Potential by Peg Dawson and Richard Guare                                            

ADDITUED Magazine: Living well with ADHD http://www.additudemag.com 

A good list of books about ADHD by ADD Warehouse http://www.addwarehouse.com/shopsite_sc/store/html/parents.html 


 



OREGON Resources: 
Portland Metro CHADD has satellites in Eugene & Hillsboro/Beaverton: http://www.chadd.net/template.cfm?affid=246&p=about

Oregon CHADD Resource List: http://www.chadd.org/Support/Directory.aspx?state=279640047

Portland State University List of ADHD Resources: http://www.cwpsalem.pdx.edu/netlink/ADHDFundamentals/ADHD%20Resource%20list.pdf
WASHINGTON Resources:
Eastside CHADD http://www.eastside-chadd.org/Professional.html offers monthly classes to assist in parenting a child with ADHD.  The next class is on June 17th from 7 to 9 p.m. at Evergreen Health Care in Kirkland:
Dr. Harlan Gephart - ADHD in the Family. What do Families Need to Know? Dr. Harlan Gephart, noted national expert who trains pediatricians in the diagnosis and effective management of ADHD, will explain what parents, their children, and teachers need to know about ADHD. What is it? What do families need to know about ADHD? What strategies can families use to be more effective? Dr. Gephart will share his extensive expertise about ADHD to help us develop a comprehensive approach to treating this multifaceted condition.
Washington State CHADD Resource List: http://www.chadd.org/Support/Directory.aspx?state=279640062#sthash.M4wmxp0Z.dpuf  

APEX Summer Camp for Kids with ADHD with UW and Seattle Children’s http://depts.washington.edu/camp2013/Apex_Summer_Camp/Home.html

ADHD by ADD Warehouse http://www.addwarehouse.com/shopsite_sc/store/html/parents.html     
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