Presented by the National Resource Center on ADHD

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1 Presented by the National Resource Center on ADHD

2 Chris A. Zeigler Dendy & Tommy Dendy, authors

Save 25% if you join/rejoin CHADD Use Promo Code: JUNA14 If you are currently up for renewal please call CHADD directly at 800-233-4050 and ask for Membership in order to receive your discount.

3 Save 25% if you join/rejoin CHADD Use Promo Code: JUNA14 If you are currently up for renewal please call CHADD directly at and ask for Membership in order to receive your discount. This is a limited time offer. This offer will expire on May 31, Join online, and instantly access members-only content and CHADD Exchange, our online community. What Our Members Love: CHADD Exchange CHADD Exchange is a private community for you, plus our expert moderators, volunteers and staff. Attention Magazine Providing helpful tips and science-based information about ADHD since ADHD Toolkits Virtual roadmaps that address many of your ADHD concerns, including understanding ADHD and getting the support that you need... all in one place. Access webinars, conference recordings and informative articles. Resource Directory CHADD's resource directory is the most popular section of our website.

4 Chris A. Zeigler Dendy & Tommy Dendy, authors Disclaimer: The information provided here is supported by Cooperative Agreement Number 1U84DD from the Centers for Disease Control and Prevention (CDC). The Ask the Expert webinars contents are solely the responsibility of the invited guest Expert and do not necessarily represent the official views of CDC. Neither CHADD, the National Resource Center on ADHD, nor the CDC endorses, supports, represents or guarantees the accuracy of any material or content presented in the Ask the Expert webinars, nor endorses any opinions expressed in any material or content of the webinars. CHADD and the National Resource Center on ADHD offer webinars for educational purposes only; the information presented should not be regarded as medical advice or treatment information.

5 To Ask A Question:

7 Send us your feedback about today s webinar! Following the webinar, a survey will appear on your screen. Please take a moment to complete this survey. Thank you for helping us plan future webinars that meet the interests of the ADHD community!

8 Chris A. Zeigler Dendy & Tommy Dendy, authors

10 CHADD Ask the Expert Chat June 18, 2014 Chris A. Zeigler Dendy & Tommy Dendy

11 Chris A. Zeigler Dendy

12 1. Prevalence rate: 5-12 percent (11%) Over-diagnosis vs under-? (gifted, girls, minorities) 2. A complex neurobiological disorder 3. Two distinct categories of ADHD 4. Brain: Three year delay in brain maturation 30 percent developmental delay (4-6 yrs, teens) Reduced brain chemistry makes boring work difficult 5. Coexisting conditions: 69 % CDC; Wolrich; Barkley

13 6. People with ADHD are not all alike 7. Executive function deficits 33-50% vs 89-98% 8. Inherited: runs in families % 9. Medication works: % 10. Lifelong challenge: don t outgrow ADHD MTA; Biederman; Smalley; Barkley 13

14 In children with ADHD, the cortex reached peak thickness at age 10.5 years, compared with 7.5 years with normal children. The cortex thickening peaks during childhood, then starts to thin after puberty as unused neural connections are pruned. Dr. Philip Shaw, NIH, NIMH (2007)

Less activity in Nucleus accumbens & Caudate nucleus Impact motivation & attention (Swanson/Interest Deficit) So not easily engaged, unless work is rewarding

15 Less activity in Nucleus accumbens & Caudate nucleus Impact motivation & attention (Swanson/Interest Deficit) So not easily engaged, unless work is rewarding Fewer dopamine receptors and transporters Explains why they play Game Boy or read sports mags, yet can t focus on schoolwork. N. Volkow, J Swanson, JAMA, 9/2009

17 90 % will struggle academically % have learning disabilities More frequent days absent; more Ds/Fs % will fail a grade % drop out of high school 71 % suspended or expelled % do not graduate from college Predictor of substance use & JJ issues Barkley 17

18 Learning Disabilities up to 50 percent ADHD/I 28% slow processing speed Slow reading & writing Slow color/letter/object fluency Output: Oral Expression Written Expression 65% Math Calculation (math - 26%) Input: Listening Comp Reading Comp %

19 Working memory and recall. Alertness, activation, and effort Reconstitution analyze, problem solve, synthesize Internalizing language (self-talk) Controlling emotions Shifting, inhibiting Organization/planning Organization of materials Monitoring Barkley, Brown, & Gioia Barkley, Brown, BRIEF

20 1. Academics writing essays, completing complex math & projects reading comprehension memorizing words, multiplication tables, facts completing long-term projects 2. Academically Related Skills (Looks like choice) being organized getting started and finishing work remembering chores and assignments analyzing and problem solving planning for the future controlling emotions

21 (Internal reminders weak) External - Visual vs Auditory 21

22 Fact 9: Effective for 70-92% Up to 55% of teens are on meds 50% on doses that are too low

Learning Decreased Activity levels Impulsivity

23 Increased Attention Concentration Compliance Effort on tasks Amount & accuracy of school work Speed of Learning Decreased Activity levels Impulsivity Negative behaviors Physical & verbal Hostility Swanson; Bonci 23

24 Zeigler; Zeigler Dendy 24

25 8-10 hrs 6-8 hrs. *** 7:30 8:30 10:30 11: :30 3:30 4:30 5:30

26 Initial Meds After Med Adjustment

27 When children are on medication their brains mature more than non-medicated ADHDers brains! ADHD brain on meds comes closer to hitting milestones of cortical thickness than non-med ADHD brain! Medication affects the child s experience, the experience affects brain maturation Makes children reachable & teachable!!! Denckla 27

29 Assignment Book Write Assignments Student Others (pairs ck.) Row/team captain ck Teacher double cks Photocopy Assignts. Stu. makes 5 copies Wk./mo. at a time Remind 101 app /fax to Parent Teacher Web Page Homework Pattern Extra Book at Home Phone # for Others Weekly Report Accept Late Work Develop plan

30 Modify assignments Break into 2-3 segments Give separate due dates and grades. Organizational support & supervision. Prompt about the project due dates/ include in IEP. Notify parents; involve them in monitoring Monitor progress. Teach to schedule time backward. Provide a job card. Provide a graphic organizer. Show completed model projects or reports

31 Set a timer for start time Review instructions with your child Get a phone number for a child in the class Ask your child to call a friend for clarification Check the school website for assignments Break the assignment into segments Sit with your child while he studies or at least work in the same room with him Review homework tip sheet

1. Linking episodic & semantic information improves LT memory Easier to remember episodic events/pictures Hands on activities also provide this link 2.

32 1. Linking episodic & semantic information improves LT memory Easier to remember episodic events/pictures Hands on activities also provide this link 2. Connection to prior knowledge 3. Elaboration of information > LT memory 4. Mnemonics (memory tricks) > LT memory 5. Organization of information > LT recall Graphic organizers are helpful.

33 New Research When sit 15 min, blood pools in seat & feet; Exercise increases blood flow; builds new brain cells Brain break, 15% increase blood/oxygen in brain Laugh/chew gum increases blood flow to the brain. Children more active when need working memory. Low oxygen and glucose = lethargic/sleepy Water breaks : move neuron signals through brain & keep lungs moist to transfer oxygen to blood. Glucose foods like raisins boost performance and accuracy of memory & attention. 33 Barkley, Ratey, Rappaport, Sousa

36 Place where the box can be seen at breakfast.

38 Event Required response Outcome If E, R, O close in time, no problem. If add a time lag, you disable the child!

39 Advice from Alex & Teen Experts: Establish sleep routine. Milk, cookies, bath, cool down time music Consider medicine talk with doctor. Melatonin or Benadryl Clonidine, trazadone Avoid medicine too late in day. Exercise routine not at night. A Bird s-eye View of Life with ADD & ADHD

40 Advice from Alex & Teen Experts: Set two alarm clocks. Set one across the room. Set it to a station you don t like or static. Buy a loud alarm. Clocky & vibrating alarm Find creative reason to wake up. TV show; call from girlfriend, grandfather Wake up early; take meds; go back to sleep. A Bird s-eye View of Life with ADD & ADHD

42 Reduced suspensions. Better test scores & grades. Remember facts better without interim testing. Builds new brain cells. So increase physical activity 30 minutes daily Fitness based PE programs Napierville IL; Hillman

44 Remember Traits that are not valued in children are often valued in adults!

45 Bossiness Hyperactivity Strong-willed Daydreamer Daring Laziness Leadership, albeit carried too far Energetic, high energy, 10 project Tenacious Creative, innovative, imaginative Risk-taker, tries new things Laid-back, Type B, not Type A

46 Instigator Manipulative Aggressive Initiator, innovative Delegates, gets others to work Assertive, others can t take adv. Argumentative Persuasive, may be an attorney Questions authority Poor handwriting Independent, free thinker May be a doctor one day

47 Please be respectful of them! Their job is NOT easy! no job description! 47

48 None of these terms are instructive! They don t tell parents what to do and in fact they are judgmental and hurtful! 48

49 49

50 To Ask A Question:

51 Chris A. Zeigler Dendy & Tommy Dendy, authors

Attention, Language, or Both? Guest Expert Linda Spencer, Ph.D.

52 El TDAH: Diagnóstico y Tratamiento de los Niños y Jóvenes Guest Expert F. Xavier Castellanos, MD Children's Communication Challenges: Is It Attention, Language, or Both? Guest Expert Linda Spencer, Ph.D., CCC-SLP Tuesday, June 24, 3 p.m. Wednesday, July 9, 3 p.m. Register Now at

54 The information provided in this episode of Ask the Expert is supported by Cooperative Agreement Number 1U84DD from the Centers for Disease Control and Prevention (CDC). The Ask the Expert webinars contents are solely the responsibility of the invited guest Expert and do not necessarily represent the official views of CDC. Neither CHADD and the National Resource Center on ADHD, nor the CDC endorses, supports, represents or guarantees the accuracy of any material or content presented in the Ask the Expert webinars, nor endorses any opinions expressed in any material or content of the webinars. CHADD and the National Resource Center on ADHD offer webinars for educational purposes only; the information presented should not be regarded as medical advice or treatment information.

Presented by the National Resource Center on ADHD

Presented by the National Resource Center on ADHD Robert Tudisco, Esq. roberttudisco@optimum.net Save 25% if you join/rejoin CHADD Use Promo Code: NOVA13 If you are currently up for renewal please call