Conference Proceedings Hippocrates & Socrates XII 5 and 6 September 2007 John Loewenthal Auditorium Education Block Westmead Hospital Darcy Road Westmead, Sydney Putting Evidence into Practice to Reach and Teach ADHD CHERI s conference and clinical programs are proudly supported by
our mission To be internationally recognised for research that promotes children s health and well-being through improvements in the interface between health and education. our objectives To achieve a significant program of applied collaborative research related to the interface between health and education. To offer clinical services and resources in educational and family counselling for children with medical, developmental, and psychological conditions. To conduct interdisciplinary conference and seminar programs which focus on improving the interface between health and education thus indirectly promoting children s health and welfare. our sponsors CHERI and the Conference Committee gratefully acknowledges the following organisations for their generosity and support. All sponsorships and donations provide enormous assistance in ensuring our ongoing commitment to improving children s health and well-being. CHERI s conferences and clinical programs are proudly supported by Pens for the conference delegates proudly supplied by dates for your diary Research Forum - Friday 30 November, 2007 (topics to be confirmed). Conference - Friday 14 March 2008 (Back on Track program, for students with cancer - topics to be confirmed). CHERI Annual Conference - Thursday 4 and Friday 5 September 2008 Hippocrates and Socrates XIII (tentative date, topics to be confirmed). To receive further information or to register your interest in attending CHERI s future events, please email: KirrillG@chw.edu.au or visit CHERI s website: www.cheri.com.au/conferences.html to view future programs.
wednesday 5 september 2007 All presentations will be held in the Auditorium 8.30am 9.00am 9.15am 9.30am 10.45am 11.15am 12.15pm 12.30pm 1.30pm 2.00pm 2.15pm 2.30pm 3.10pm 3.40pm 4.10pm Registration Welcome to Country Mr Gil Saunders Opening Address Professor Loretta Giorcelli Pay Attention to Inattention: Implications for Education Prof Rosemary Tannock MORNING TEA ADHD: Comprehensive Views and Current Challenges Dr Paul Hutchins ADHD in Society: Practice, Policy and Philosophies Dr Paul Hutchins/Dr Daryl Efron LUNCH ADHD in Special Populations Dr David Dossetor ADHD in Children with Neurological Disorders Dr Richard Webster Investigating Attentional Problems in Special Populations Dr Belinda Barton Putting Research into Practice in Training Teachers to Manage ADHD and Associated Problems Prof Derrick Armstrong ADHD and Paediatric Practice, The Reality Dr Linette Gomes ADHD: The Child s Perspective Dr Daryl Efron CLOSE Evaluation Collection
thursday 6 september 2007 Please find below the location for the lectures 8.30am Registration 9.00am Auditorium The Universal Struggle - Problems of Sharing Information about Children with Complex Needs Ms Jude Foster 9.30am Auditorium Reach and TeachADHD: Teacher Professional Development Prof Rosemary Tannock 10.30am 11.30am A Auditorium B Theatre 2 C Theatre 3 Parallel Sessions A B C Literacy, Behaviour and Auditory Processing. Building Fences at the Top of the Cliff in Preference to the Provision of Belated and Costly Ambulance Services at the Bottom Dr Ken Rowe & Dr Kathy Rowe Tailoring Management of ADHD to the Needs of the Adolescent Patient Prof Phil Hazell ADHD Medications in 2007 - Fears and Facts Dr Patrick Concannon MORNING TEA 12.00pm As above Parallel Sessions A B C Repeated 1.00pm LUNCH 2.00pm Auditorium Challenges of Living with ADHD in Adulthood Dr Caroline Stevenson 2.45pm Auditorium Reaching and Teaching Students with Inattention and Reading Difficulties Prof Rosemary Tannock 3.45pm 4.00pm Evaluation Collection Forum/Questions CLOSE DISCLAIMER: The speakers, topics and times are correct at the time of printing. In the event of unforseen circumstances, CHERI reserves the right to delete or alter items in the conference program.
conference proceedings
index Opening Address 9 Professor Loretta Giorcelli Pay Attention to Inattention: Implications for Education 10 Prof Rosemary Tannock ADHD: Comprehensive Views and Current Challenges 12 Dr Paul Hutchins ADHD in Society: Practice, Policy and Philosophies 14 Dr Paul Hutchins/Dr Daryl Efron ADHD in Special Populations 16 Dr David Dossetor ADHD in Children with Neurological Disorders 18 Dr Richard Webster Investigating Attentional Problems in Special Populations 20 Dr Belinda Barton Putting Research into Practice in Training Teachers to Manage ADHD and Associated Problems 22 Prof Derrick Armstrong ADHD and Paediatric Practice - The Reality 24 Dr Linette Gomes ADHD: The Child s Perspective 26 Dr Daryl Efron The Universal Struggle - Problems of Sharing Information about Children with Complex Needs 28 Ms Jude Foster Reach and TeachADHD: Teacher Professional Development 30 Prof Rosemary Tannock Literacy, Behaviour and Auditory Processing. Building Fences at the Top of the Cliff in Preference to the Provision of Belated and Costly Ambulance Services at the Bottom. 32 Dr Ken Rowe & Dr Kathy Rowe Tailoring Management of ADHD to the Needs of the Adolescent Patient 34 Prof Phil Hazell ADHD Medications in 2007 - Fears and Facts 36 Dr Patrick Concannon Challenges of Living with ADHD in Adulthood 38 Dr Caroline Stevenson Reaching and Teaching Students with Inattention and Reading Difficulties 40 Prof Rosemary Tannock
ADHD (Attention Deficit/Hyperactivity Disorder) and associated difficulties commonly limit success in learning, behaviour and social interaction. Common overlaps include language impairment, specific learning disabilities and emotional vulnerability. The spectrum of ADHD depends on how intrinsic variations in resilience and vulnerability are matched by the world s demands and the provision of appropriate strategies and supports. There is much debate regarding the detection, diagnosis and management of ADHD. What is the evidence? What are the options? How do we achieve the best outcomes for children, adolescents and adults with ADHD? What strategies work in a classroom environment? Accurate, relevant and up-to-date information is essential in order to prioritise strategies and resources which promote the most successful outcomes for individuals and society. This conference presents modern research about transactions between nature and nurture. Models, mechanisms and methods to support professional development and best practice in health and education will be discussed. Optimal management of the spectrum of ADHD demands the consideration of comprehensive, individualised and sustained approaches. Successful management must be sustained through adolescence into adulthood. The impact of chronic conditions such as epilepsy and developmental disorders on the presentation of ADHD will also be presented at this conference. Keynote Speaker conference overview Professor Rosemary Tannock holds a Canada Research Chair in Special Education and Adaptive Technology, Ontario Institute for Studies in Education, University of Toronto. She is also a Senior Scientist at the Hospital for Sick Children in Toronto, Canada and Professor of Psychiatry and Special Education at the University of Toronto. Prof Tannock is internationally recognised for her research investigating the causes and treatment of ADHD. Professor Tannock will discuss the significance of ADHD (particularly inattention, working memory and executive function) for academic outcomes and will outline appropriate strategies to reduce inattentive behaviour. Professor Tannock will describe the TeachADHD program - a systematic approach which blends science and practical approaches that can be used by teachers to help students with ADHD and associated difficulties succeed at learning. Information on most of the presentations of the Putting Evidence into Practice to Reach and Teach ADHD conference will be made available on the CHERI website, www.cheri.com.au/presentations.html shortly after the conference. - Page 8 -
opening address Professor Loretta Giorcelli Professor of Special Education, Giorcelli Educational Consultancy Services Professor Giorcelli trained as a primary/special education teacher in Queensland in the late 1960s and has taught profoundly deaf students, as well as students with a range of disabilities, at pre-school, primary and secondary levels in segregated and integrated settings in both the United Kingdom and Australia. She has a Bachelor s degree in Education, a Master s degree in Special Education and a PhD (Linguistics and Communication Disabilities) from the University of Illinois (USA). She also worked as a teacher, consultant and school principal in Queensland and London schools, before accepting a position in the New South Wales Department of School Education in 1984. Professor Giorcelli was the NSW Director of Special Education and Equity Programs (Aboriginal Education, Migrant Education, ESL, Early Childhood Education, Disadvantaged Schools etc) with the Department of School Education in New South Wales until April 1993. She has been associated in Honorary capacities with the Macquarie University, the Children s Hospital Sydney, the University of Western Sydney and the Beijing ENT Institute in the People s Republic of China. Professor Giorcelli now heads her own educational consultancy company working extensively in Hong Kong, New Zealand, Sth Africa and the UK as well as throughout Australia. - Page 9 -
pay attention to inattention: implications for education Professor Rosemary Tannock Canada Research Chair in Special Education, Ontario Institute for Studies in Education at the University of Toronto, Professor of Psychiatry and Special Education, University of Toronto, and Senior Scientist, The Hospital for Sick Children, Canada Professor Rosemary Tannock holds a Canada Research Chair in Special Education and Adaptive Technology (Tier 1) at the Ontario Institute for Studies in Education in the University of Toronto. She is also a Senior Scientist at the Hospital for Sick Children in Toronto, Canada, a Professor of Psychiatry and Special Education at the University of Toronto and holds research appointments with the Graduate Departments of Education and Psychology at the University of Western Australia. Her research investigates the causes and treatment of ADHD with a specific focus on the cognitive and academic difficulties and overlap with LDs. Professor Tannock and her colleagues have developed a multi-media set of resources on ADHD for teachers to use in Professional Development [www.teachadhd.ca]. In this presentation, Professor Tannock looks at inattention, which is a core feature of ADHD and is also evident in many other neurodevelopmental disorders and in normal development. Inattention is not as noticeable as disruptive behaviour in the classroom or other settings, and so poses challenges for its assessment. However, research indicates that inattention is linked with poor working memory and other cognitive difficulties. Not surprisingly, therefore, inattention has an insidious effect on children s development of numeracy and literacy skills, and an increased risk for poor adult outcomes. The good news is that there are several effective intervention approaches designed to reduce inattentive behaviour, including both medical and educational, alone and in combination. - Page 10 -
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adhd: comprehensive views and current challenges Dr Paul Hutchins Head, Child Development Unit and Honorary Senior Paediatric Consultant, Children s Hospital Education Research Institute, The Children s Hospital at Westmead Dr Paul Hutchins is an Honorary Senior Paediatric Consultant for CHERI and is also Head of the Child Development Unit, The Children s Hospital at Westmead. At the end of his training in the United Kingdom he established an exchange with The Children s Hospital, and returned in 1982 to work in the Child Development Unit. He worked for several years in child protection, in newborn follow up and head injury, and as a paediatrician to a special school for physical disability. He currently coordinates a program for children receiving ventilator support at home. He represented The Children s Hospital at Westmead in the advocacy and collaboration which established CHERI and, as part of the Children s Assessment Centre, in the move to the new hospital, promoted its concepts, activities and resources. Dr Hutchins participates in the activities of CHERI as part of his vigorous collaboration with educators, parents and health professionals in patient management and teaching. In this presentation, Dr Hutchins discusses the current common-ness of ADHD and overlaps with other developmental disorders, particularly in language and learning disability. Collaborative information sharing in management is crucial, particularly at the extremes of age and ability. Diagnosis is clinical, with increasing research in relevance of biological methods. The package of help must be individualised, comprehensive and sustained. Several medications exist with the choice to be tuned to the individual needs and responses. Many complementary and alternative approaches claim some success, though few have been rigorously evaluated. Current challenges in this broad view will be highlighted and illustrated by case histories. - Page 12 -
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adhd in society: practice, policy and philosophies Dr Paul Hutchins/Dr Daryl Efron Please refer to Page 12 for Dr Paul Hutchins biography. Please refer to Page 26 for Dr Daryl Efron s biography. In this presentation, Drs Hutchins and Efron will provide a brief summary of how broad knowledge from professional practice, training and research can effectively come together to share valid information, commitment and skills in promoting best collaborative practice and outcome in ADHD and associated disorders. - Page 14 -
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adhd in special populations Dr David Dossetor Senior Staff Psychiatrist and Area Director for Mental Health, Department of Psychological Medicine, Children s Hospital at Westmead and Clinical Senior Lecturer, University of Sydney Dr David Dossetor has a special interest in psychiatry of intellectual disability and autism. He has had 20 years of practice, teaching and clinical research in this area. In this presentation, Dr Dossetor will consider some of the models for understanding and managing ADHD in young people with other developmental disorders and genetic conditions. Some of the evidence validating ADHD in other developmental disorders will be presented, as well as drawing on clinical experience and wider literature. - Page 16 -
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adhd in children with neurological disorders Dr Richard Webster Paediatric Neurologist, Children s Hospital Education Research Institute and T.Y. Nelson Dept of Neurology and Neurosurgery, Children s Hospital at Westmead Dr Richard Webster is a paediatric neurologist with an interest in the biological causes of paediatric language disorders. He completed his medical training in 1986, and spent a short period of time in general practice before undertaking further training in paediatrics at Sydney Children s Hospital. He completed his paediatric training in 1998, and then trained in paediatric neurology at both Sydney Children s Hospital and The Children s Hospital at Westmead. He completed his training in paediatric neurology in September 2001, and was awarded his MSc in October 2003. In this presentation, Dr Webster will discuss attention disorders as a common occurance in children with neurological disorders. Disorders of attention and executive function are a well-recognised complication of traumatic brain injury in childhood. There is increasing evidence that impairments in attention contribute to the cognitive impacts of other common childhood neurological diseases such as epilepsy, Tourette syndrome and neuro-muscular disease. This presentation will explore the common factors that lead to impairments in attention in these children. Dr Webster will also review neurological diseases in which attention disorders are an important co-morbidity. Evidence for the effectiveness of treatment of attention disorders in children with neurological disease will be examined. - Page 18 -
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investigating attentional problems in special populations Dr Belinda Barton Head, Children s Hospital Education Research Institute, Children s Hospital at Westmead Dr Belinda Barton was appointed Head of CHERI in January, 2005, and is a registered psychologist. Dr Barton s long standing commitment and involvement with CHERI is reflected in the various appointments she has held since CHERI commenced in 1996, from Coordinator and Research Associate to Acting Director between February, 2003 and December, 2004. Dr Barton has also had an ongoing involvement with CHERI s clinics since their inception in 1997. In this presentation, Dr Barton will provide a brief overview of the different models of attention and its proposed components. A number of models have been developed to conceptualise attentional functioning. Measures that are proposed to assess each component such as continuous performance tests will be examined. Research findings from studies conducted at CHERI on the attentional functioning of children with ADHD, learning disabilities and genetic conditions (neurofibromatosis type 1 and velocardiofacial syndrome) will be presented. - Page 20 -
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putting research into practice in training teachers to manage adhd and associated problems Professor Derrick Armstrong Acting Deputy Provost (Learning & Teaching) and Pro-Vice Chancellor and Dean, Faculty of Education & Social Work, The University of Sydney Professor Derrick Armstrong is currently Acting Deputy Provost (Learning & Teaching) and Pro-Vice Chancellor and Dean of the Faculty of Education and Social Work at the University of Sydney. He is also Co Director of a 1.5m Research Network funded by the UK Economic and Social Research Council investigating young people: Pathways Into and Out of Crime: Risk, Resilience and Diversity. The Network centres on a collaboration between five universities in the UK and partners in Australia and the USA. The research is exploring the experiences and perspectives of children and young people in relation to anti-social and criminal behaviour. Before this he jointly directed the national evaluation of the On Track Crime Reduction Programme in the UK, which was concerned with the role of multiple interventions in crime reduction for six to twelve year olds. Other recent projects have included work on the history of special educational policy since 1944, a project on Self-advocacy, Civil Rights and the Social Model of Disability and a long standing interest in special educational assessment and the perspectives of children and parents. A further strand of research over the last ten years, in collaboration with Ann Cheryl Armstrong, has focused on educational development in the Caribbean where he has worked with teachers, NGOs and Education Ministries and undertaken research funded by the UK s Department for International Development. Professor Armstrong is (co) author/editor of six books and over sixty articles, book chapters and international conference papers. In this presentation, Professor Armstrong will discuss how what teachers are expected to do and how well they are expected to do it has in recent times undergone significant change. This is due both to an increase in student diversity and the level of educational achievement these students are now expected to attain. In effect, teachers today are teaching higher academic standards to a wider population of students than at any time previously. Through accountability regimes and standardised testing, they are also being held to account via narrow measures of student achievement. In such an environment, key teacher practitioner attributes are flexibility, creativity, persistence and positive attitudes towards difference. The challenge, to which modern universities are responding, is to develop inclusive teaching professionals who can draw on a rich pedagogical repertoire capable of responding to the breadth and depth of student needs now present in the local school. - Page 22 -
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adhd and paediatric practice - the reality Dr Linette Gomes Developmental and Behavioural Paediatrician In this presentation, Dr Gomes will discuss the reality of ADHD and paediatric practice. Attention Deficit Hyperactivity Disorder (ADHD) is the most common, serious and disabling mental health problem in our society today. Although previous studies have examined management practices in this disorder, no research has addressed the nature or quality of medical expertise among doctors treating this disorder. As the understanding and conceptualisation of ADHD has changed, it has become increasingly important that evidence-based best practice occurs. An understanding of the nature of medical expertise in this disorder, its strengths and weaknesses, and the factors that influence it, is essential, so that changes may be effected to ensure that best practice continues to dominate medical practice. This study described and examined, by questionnaire survey, the constructs of medical expertise in ADHD: knowledge, experience, diagnostic accuracy and meta-cognitive skills. Possible influencing factors include self-confidence, training, area of specialisation and time in consultant practice. This survey included a saturation sample of Australian paediatricians and psychiatrists. Findings from this study indicate that there is a spectrum of medical expertise amongst the doctors treating ADHD. Those higher on the spectrum practise more in accordance with recommended guidelines, but, reassuringly, it appears that the majority of doctors treating this condition adhere to most of the essential recommendations of best practice. The parameters of expertise interact in accordance with the literature, and important influential factors are current experience, training and area of specialisation. Although patient outcomes and satisfaction were not significantly related to the spectrum of medical expertise, there were individual aspects of expertise which influenced these variables favourably. These findings increase our understanding of medical expertise and provide a valuable insight into the execution of best practice in the management of ADHD. - Page 24 -
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adhd: the child s perspective Dr Daryl Efron Paediatrician, Royal Children s Hospital, Melbourne Dr Daryl Efron is a general paediatrician with a particular interest in developmentalbehavioural paediatrics. His research interests include the management of ADHD, paediatric psychopharmacology and models of service delivery for children with learning and behavioural problems. In this presentation, Dr Efron will discuss the child s perspective of ADHD. Most ADHD treatment research examines outcomes such as behavioural symptoms as rated by adult informants (parents, teachers) rather than the entirety of the child s experience with this condition. Children with ADHD report deficits in ecologically valid constructs ie. everyday functions in their real worlds. This presentation will discuss the wide-ranging effects of ADHD and its treatment on children s quality of life (QOL) and self-perception, as well as addressing priorities from the child s point of view. A better understanding of the child s perspective of ADHD can help clinicians and educators improve outcomes, by focusing on the child s subjective experience. - Page 26 -
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the universal struggle - problems of sharing information about children with complex needs Ms Jude Foster Chief Executive Officer, mivitals Technology Pty Ltd Ms Jude Foster is the founder and CEO of mivitals Technology Pty Ltd. She was responsible for the development of the award winning, school based Wrap Around Kids Program (www.wraparoundkids.com) for which she was awarded a Churchill Fellowship in 2006. She has also convened a number of successful international conferences in the field of child and adolescent health, for example Steps to Success in the Management of ADHD, LD and related conditions. Ms Foster is a Registered Nurse, an endorsed GP trainer and President of the Learning Difficulties Coalition of NSW (peak advocacy body for families). In this presentation, Ms Foster will outline her work in investigating how families shared information using technology to promote interdisciplinary support for young people with complex needs for which she was awarded a Churchill Fellowship (2006). Time was spent in schools, advocacy organisations, hospitals, general practices, research centres and technology centres in Canada, USA and United Kingdom. Fragmentation of existing services appears to be universal. Families are often left as messengers between professionals with the responsibility of telling their child s story over and over. Demand from advocacy groups for a communication framework and the fellowship have been the catalyst for developing an online system for individuals to store and manage their own health information across the lifespan. - Page 28 -
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reach and teachadhd: teacher professional development Professor Rosemary Tannock Canada Research Chair in Special Education, Ontario Institute for Studies in Education at the University of Toronto, Professor of Psychiatry and Special Education, University of Toronto, and Senior Scientist, The Hospital for Sick Children, Canada Please refer to page 10 for full biography. In this presentation, Professor Tannock discusses how ADHD, particularly inattention, has a detrimental effect on children s academic and adults occupational outcomes. Although pharmacological treatment is effective for reducing the behavioural symptoms, it has little or no effect on academic function. By contrast, educational intervention can have sustained positive effects. Promising educational approaches for ADHD are reviewed, including sustained Professional Development programs which are designed to increase teachers knowledge and understanding of ADHD as well as their use of effective instructional practices. - Page 30 -
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literacy, behaviour and auditory processing. building fences at the top of the cliff in preference to the provision of belated and costly ambulance services at the bottom Dr Ken Rowe Research Director, Australian Council for Educational Research Dr Ken Rowe is the Research Director for the Learning Processes Research Program at the Australian Council for Eduction Research (ACER). Dr Rowe s substantive and methodological research interests include: authentic educational and psychological assessment: mulitlevel, value-added organisations performance indicators and benchmarking; teacher and school effectiveness; and differential gender effects of schooling in the context of teaching and learning - especially in literacy and numeracy. Dr Rowe, along with his consultant paediatrican wife, Dr Kathy Rowe, is also involved in on-going research related to the impact of auditory processing and externalising behaviour problems on students learning outcomes: the educational/epidemiological effect of Attention-Deficit/Hyperactivity Disorder (ADHD) and Chronic Fatigue Syndrome (CFS) in children and adolescents. Dr Kathy Rowe Consultant Physician, Royal Children s Hospital, Melbourne Dr Kathy Rowe is a Consultant Paediatrician in the Department of General Medicine and in the Centre for Adolescent Health, at Melbourne s Royal Children s Hospital. Kathy is also a Senior Research Fellow of the Murdoch Institute of Child Health. She has extensive clinical and research experience in the management of children and adolescents with behaviour and learning difficulties (ADD, ADHD), ear, nose and throat problems, auditory processing difficulties, as well as those with Chronic Fatigue Syndrome. In this presentation, Drs Rowe will discuss how children who are inattentive or disruptive are at high risk of poor achievement progress, especially in literacy. Approximately 9% of school children have both literacy and externalising behaviour problems, and the long-term consequences of these are costly emotionally, socially, educationally and economically. Many of these children and adolescents are referred to paediatricians and psychologists to assess whether learning difficulties are contributing factors to their inattentive behaviours at school (including ADD/ADHD). Similarly, many are referred to audiologists to test hearing in the event that their observed difficulties in listening and following instructions may be due to hearing impairment. However, following audiological screening, most of these children return normal audiograms, but continue to experience functional auditory processing capacity (APC) difficulties in terms of reduced ability to recall accurately what is heard [note that this is a functional difficulty, not a diagnosis]. In the context of evidence-based research findings, this paper provides: (a) the normative data for more than 11,000 children and adolescents (5-15 year-olds) in terms of two measured indicators of APC, namely, digit span and sentence length; and (b) key features of practical teaching strategies that have strong positive effects on students literacy progress, their attentive behaviours in the classroom and general wellbeing. The findings from this research indicate that with common health and educational concerns, growing demands for the provision of ambulance services at the bottom of the cliff become increasingly difficult to justify when fences could and should have first been built at the top. - Page 32 -
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tailoring management of adhd to the needs of the adolescent patient Professor Phil Hazell Director, Child and Adolescent Mental Health Service, Sydney South West Area Health Service and Conjoint Professor of Child and Adolescent Psychiatry, Central Clinical School, University of Sydney Professor Phil Hazell s output on ADHD includes papers on attentional processing, service delivery and unmet need, practice guidelines, treatment trials, reviews of treatment, special populations, ADHD subtypes and comorbidity. In 2004 he won the American Academy of Child and Adolescent Psychiatry s prize for research on ADHD. In this presentation, Professor Hazell will discuss how about one half of children medicated for attention-deficit/hyperactivity disorder (ADHD) will continue to experience sufficient impairment during adolescence to warrant the continuation of their treatment. The academic and social demands of adolescence can exaggerate the impairment caused by attentional problems. Adolescents, more so than children, have activities in the afternoon and evening that will tax their attentional abilities. Medications are likely to be as effective for adolescent patients as they are for younger children, provided treatment adherence is satisfactory. Patterns of comorbidity with ADHD change from childhood to adolescence, and may require a shift in treatment strategy. - Page 34 -
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adhd medications in 2007 - fears and facts Dr Patrick Concannon Senior Staff Specialist, Royal North Shore and Ryde Child & Family Health Dr Patrick Concannon has worked as a developmental paediatrician in community health for over 25 years. He is a fervent believer in multi-modal therapy for developmental disorders and has a special interest in ADHD and Autism. He is the current chairperson of the NSW State Stimulant Committee. In this presentation, Dr Concannon will discuss the fears and facts about the current use of ADHD medication. Stimulant medication has been used for ADHD since 1937 but it is only in the last 25 years that it has been used widely. The number of NSW children receiving these drugs increased significantly in the 1990 s but has been static since 2000. Methylphenidate and Dexamphetamine are the medications most often used. New forms of these have been recently released and other new medications have been approved for use in ADHD. Despite being widely researched and assessed, these medications remain the subject of much debate and controversy. Dr Concannon will also discuss the indications and ways of using the medications, the anticipated positive responses and the adverse effects, both real and imagined. - Page 36 -
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challenges of living with adhd in adulthood Dr Caroline Stevenson Clinical Psychologist, NSW Institute of Psychiatry/Private Practice Dr Caroline Stevenson is a Clinical Psychologist who completed a doctoral thesis on the management of ADHD in adulthood. She co-ordinated a clinic for adults with ADHD at The NSW Institute of Psychiatry between 2004-2006. Her research interests include evaluating coping strategies for adults with ADHD and approaches for differentiating ADHD from other conditions. In this presentation, Dr Stevenson will consider the challenges of living with ADHD in adulthood. Adults with ADHD typically present for treatment either when they have had a series of negative experiences at work or with relationships, or when their own children are diagnosed. The adult presentation of ADHD is usually complicated by co-occurring problems such as anxiety, depression or substance use. However, by adulthood, most patients with ADHD are highly motivated for change. Strategies for assisting adults move forward in their studies, careers, personal life and with their mental well-being will be discussed. - Page 38 -
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reaching and teaching students with inattention and reading difficulties Professor Rosemary Tannock Canada Research Chair in Special Education, Ontario Institute for Studies in Education at the University of Toronto, Professor of Psychiatry and Special Education, University of Toronto, and Senior Scientist, The Hospital for Sick Children, Canada Please refer to page 10 for a full biography. In this presentation, Professor Tannock will discuss the previous research which indicates that students who exhibit severe problems in attention and reading show poor response to enhanced instruction in reading. A promising combined treatment approach is presented, which was effective in improving both the behavioural and reading problems in children with ADHD plus Dyslexia. Results indicated that often the effects of focused, intensive reading instruction (either direct phonological training or word identification strategies) were enhanced when the children were also receiving medical treatment with stimulant medication. Thus, findings highlight the need for close collaboration between educators and physicians in enhancing these children s academic outcomes. - Page 40 -
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Locked Bag 4001 Wetsmead NSW 2145 Ph: +61 (0)2 9845 0418 F: +61 (0)2 9845 0421 Email: KirrillG@chw.edu.au Web: www.cheri.com.au