Articles about ADHD.
By: Bernstein, Linda, Current Health 2, 0163156X, Feb2006, Vol. 32, Issue 6
Can't find your focus? You aren't alone.
Dan's parents and teachers became concerned about his behavior when he was in grade school. His mind wandered during class--and his body did too; Dan would get up and walk around, even out of the room. "Until middle school, I couldn't understand why anyone was fussing. I just thought of myself as normal," says Dan, 14, from Fairfield, Conn. One day he realized, "Hey, other kids don't have so much [of a] problem paying attention."
The ABCs of ADHD
Dan was showing the classic symptoms of attention-deficit/hyperactivity disorder (ADHD), according to Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital in New Hyde Park, N.Y. Adesman explained that ADHD is "a biological disorder characterized by significant difficulty with attention span." This isn't just doctorspeak. People with this condition really do have a hard time staying focused. To complicate matters, ADHD often teams up kith impulse control problems and learning disorders. The Centers for Disease Control and Prevention estimates that 8 percent of 4- to 17-year-olds (4.4 million) are diagnosed with ADHD, and 56 percent of those are taking medication for the condition.
No one knows exactly what causes ADHD, though there may be "a genetic component," says Dr. Stephanie Hamarman, chief of psychiatry at the Stanley S. Lamm Institute in Brooklyn, N.Y., who has been working with children with ADHD for many years. In other words, people are probably born with ADHD, and scientists think it may run in families.
However, other biological and environmental factors may be involved, Adesman explains. "The part of the brain that controls how we pay attention is delicate and susceptible to injury," he adds.
Though other genetic conditions, such as asthma, epilepsy, and diabetes, can be determined through blood tests, X-rays, or other exams, no medical test yet diagnoses ADHD. "That doesn't mean that doctors won't ever be able to use a brain scan to detect ADHD," Hamarman says. "We are discovering more about the brain and about ADHD every day."
Diagnosing the Invisible
Most doctors diagnose ADHD by observing behavior, Dr. David W. Goodman, an ADHD specialist at the John's Hopkins University School of Medicine in Baltimore, explains. People with ADHD have difficulty concentrating and may not be able to get organized enough to begin a task, let alone finish it. The person also may interrupt people, forget things (such as homework), and have trouble keeping track of time.
But not all people who have trouble paying attention have ADHD. Perhaps they're not getting enough sleep; perhaps there are problems in the home, and they're preoccupied. Maybe they have a hearing or a vision problem, Goodman suggests. Doctors look at the severity of the symptoms.
Unfortunately, many people with ADHD are not diagnosed and treated--which can involve medication (including stimulants and antidepressants), behavior modification or alternative treatments--because their conduct isn't really unusual. "This is especially true with girls; for some reason we don't understand, girls are less frequently hyperactive," Hamarman says.
The brighter a person is, the later he or she is likely to be diagnosed, because a very smart person can compensate for the disorder. "The child isn't paying attention, but she's still getting B's. That's pretty good, so no one worries," Goodman elaborates.
The Teen Factor
An early diagnosis, coupled with a treatment routine, is important for several reasons, says Adesman. First, the sooner a person is treated, the more he Or she will benefit from treatment. Second, teens with untreated ADHD are much more likely than others to smoke cigarettes and abuse drugs. And although teens take many risks, "those with untreated ADHD take even more risks," Goodman adds. "A big problem is that someone with undiagnosed ADHD may prompt other kids to do something really dangerous," he warns.
High school students with untreated ADHD are also three times as likely as other teens to get into car accidents and lose their licenses. They are more likely to drop out of school too. Experts agree that teens with untreated ADHD are more likely to have poor self-esteem and social problems.
The earlier ADHD treatment begins, especially medication, the more likely the person is to stick with it in high school. "High school is an especially sensitive time. The less-structured environment can be very stressful, and medication helps kids deal better with stress and other teenage issues," Adesman says.
Still, newly diagnosed teens benefit from treatment almost immediately. Gabriel from New York City was diagnosed with ADHD late--his freshman year of high school. Not having a diagnosis earlier led to serious consequences; Gabriel flunked all his courses that year. "I felt that no matter what, I couldn't do the work, and the more I fell behind, the worse it got," Gabriel, now 15, remembers. When Gabriel was diagnosed with ADHD, he began taking medication. "Now I'm more hopeful," he says. He went to summer school to make up his courses and started adopting strategies that would make it easier for him to concentrate in school. Gabriel's experience shows that even if a person's ADHD isn't identified until high school or adulthood, he or she can still immediately benefit from treatment and can function as well as others.
Managing ADHD
One of Gabriel's strategies involves watching how good students function. "I see what they do, and I copy it," he says. In class, Gabriel turns his chair so that he's facing the board and can't be distracted by others--a practice experts recommend. They also suggest the following:
• Keep one set of books at home to always be prepared to do homework.
• Ask family for help in getting organized. A parent can remind a teen of a project's due date and help him or her work on it every day instead of at the last minute.
• Do only a little work at a time, taking a break, and then getting back to work. "If I try to do homework all at once, I'm more likely to get distracted," Dan says.
• Take advantage of coaching. Many schools have resource rooms where smaller classes make it easier for students to pay attention.
Doing Well With ADHD
Here's the good news: Young people who receive treatment for ADHD are just as likely to do well in school and in life as anyone else. "A patient of mine just graduated [from] college at the top of her class," Adesman says.
Still, there are things kids with ADHD wish others knew. "You don't have to talk slowly," says Gabriel. "I understand English."
Dan adds, "Teachers need to be patient, but at the same time, they need to know that if I want to be treated like everyone else, I know I have to live up to expectations."
New treatments make life easier for people with ADHD. But one of the biggest breakthroughs has been the change in attitude over the past two decades, says Adesman. For instance, studies show that teens are less likely to stigmatize ADHD than are grown-ups.
So if your class includes students with ADHD, treat them as you would want to be treated. Teens with ADHD need people to be patient and helpful. In other ways, they're just like everyone else.
ADHD Didn't Stop Me!
Type "famous people" and "ADHD" into an Internet search engine, and you'll find Web page after Web page claiming that Mozart, Einstein, and other well-known dead people had ADHD. However, there's no need to search history books to find successful people who had the disorder. The following celebrities have talked about having ADHD:
Ellen DeGeneres, comedian and actor Scott Eyre, relief pitcher for the San Francisco Giants David Neeleman, founder and CEO of JetBlue Airways Philip Manuel, jazz musician
The Trouble With Boys , By: Tyre, Peg, Murr, Andrew, Juarez, Vanessa, Underwood, Anne, Springen, Karen, Wingert, Pat, Newsweek, 00289604, 1/30/2006, Vol. 147, Issue 5
They're kinetic, maddening and failing at school. Now educators are trying new ways to help them succeed.
Spend a few minutes on the phone with Danny Frankhuizen and you come away thinking, "What a nice boy." He's thoughtful, articulate, bright. He has a good relationship with his mom, goes to church every Sunday, loves the rock band Phish and spends hours each day practicing his guitar. But once he's inside his large public Salt Lake City high school, everything seems to go wrong. He's 16, but he can't stay organized. He finishes his homework and then can't find it in his backpack. He loses focus in class, and his teachers, with 40 kids to wrangle, aren't much help. "If I miss a concept, they tell me, 'Figure it out yourself'," says Danny. Last year Danny's grades dropped from B's to D's and F's. The sophomore, who once dreamed of Stanford, is pulling his grades up but worries that "I won't even get accepted at community college."
His mother, Susie Malcom, a math teacher who is divorced, says it's been wrenching to watch Danny stumble. "I tell myself he's going to make something good out of himself," she says. "But it's hard to see doors close and opportunities fall away."
What's wrong with Danny? By almost every benchmark, boys across the nation and in every demographic group are falling behind. In elementary school, boys are two times more likely than girls to be diagnosed with learning disabilities and twice as likely to be placed in special-education classes. High-school boys are losing ground to girls on standardized writing tests. The number of boys who said they didn't like school rose 71 percent between 1980 and 2001, according to a University of Michigan study. Nowhere is the shift more evident than on college campuses. Thirty years ago men represented 58 percent of the undergraduate student body. Now they're a minority at 44 percent. This widening achievement gap, says Margaret Spellings, U.S. secretary of Education, "has profound implications for the economy, society, families and democracy."
With millions of parents wringing their hands, educators are searching for new tools to help tackle the problem of boys. Books including Michael Thompson's best seller "Raising Cain" (recently made into a PBS documentary) and Harvard psychologist William Pollack's definitive work "Real Boys" have become must-reads in the teachers' lounge. The Gurian Institute, founded in 1997 by family therapist Michael Gurian to help the people on the front lines help boys, has enrolled 15,000 teachers in its seminars. Even the Gates Foundation, which in the last five years has given away nearly a billion dollars to innovative high schools, is making boys a big priority. "Helping underperforming boys," says Jim Shelton, the foundation's education director, "has become part of our core mission."
The problem won't be solved overnight. In the last two decades, the education system has become obsessed with a quantifiable and narrowly defined kind of academic success, these experts say, and that myopic view is harming boys. Boys are biologically, developmentally and psychologically different from girls--and teachers need to learn how to bring out the best in every one. "Very well-meaning people," says Dr. Bruce Perry, a Houston neurologist who advocates for troubled kids, "have created a biologically disrespectful model of education."
Thirty years ago it was girls, not boys, who were lagging. The 1972 federal law Title IX forced schools to provide equal opportunities for girls in the classroom and on the playing field. Over the next two decades, billions of dollars were funneled into finding new ways to help girls achieve. In 1992, the American Association of University Women issued a report claiming that the work of Title IX was not done--girls still fell behind in math and science; by the mid-1990s, girls had reduced the gap in math and more girls than boys were taking high-school-level biology and chemistry.
Some scholars, notably Christina Hoff Sommers, a fellow at the American Enterprise Institute, charge that misguided feminism is what's been hurting boys. In the 1990s, she says, girls were making strong, steady progress toward parity in schools, but feminist educators portrayed them as disadvantaged and lavished them with sup-port and attention. Boys, meanwhile, whose rates of achievement had begun to falter, were ignored and their problems allowed to fester (page 53).
Boys have always been boys, but the expectations for how they're supposed to act and learn in school have changed. In the last 10 years, thanks in part to activist parents concerned about their children's success, school performance has been measured in two simple ways: how many students are enrolled in accelerated courses and whether test scores stay high. Standardized assessments have become commonplace for kids as young as 6. Curricula have become more rigid. Instead of allowing teachers to instruct kids in the manner and pace that suit each class, some states now tell teachers what, when and how to teach. At the same time, student-teacher ratios have risen, physical education and sports programs have been cut and recess is a distant memory. These new pressures are undermining the strengths and underscoring the limitations of what psychologists call the "boy brain"-- the kinetic, disorganized, maddening and sometimes brilliant behaviors that scientists now believe are not learned but hard-wired.
When Cris Messler of Mountainside, N.J., brought her 3-year-old son Sam to a pediatrician to get him checked for ADHD, she was acknowledging the desperation parents can feel. He's a high-energy kid, and Messler found herself hoping for a positive diagnosis. "If I could get a diagnosis from the doctor, I could get him on medicine," she says. The doctor said Sam is a normal boy. School has been tough, though. Sam's reading teacher said he was hopeless. His first-grade teacher complains he's antsy, and Sam, now 7, has been referring to himself as "stupid." Messler's glad her son doesn't need medication, but what, she wonders, can she do now to help her boy in school? For many boys, the trouble starts as young as 5, when they bring to kindergarten a set of physical and mental abilities very different from girls'. As almost any parent knows, most 5-year-old girls are more fluent than boys and can sight-read more words. Boys tend to have better hand-eye coordination, but their fine motor skills are less developed, making it a struggle for some to control a pencil or a paintbrush. Boys are more impulsive than girls; even if they can sit still, many prefer not to--at least not for long.
Thirty years ago feminists argued that classic "boy" behaviors were a result of socialization, but these days scientists believe they are an expression of male brain chemistry. Sometime in the first trimester, a boy fetus begins producing male sex hormones that bathe his brain in testosterone for the rest of his gestation. "That exposure wires the male brain differently," says Arthur Arnold, professor of physiological science at UCLA. How? Scientists aren't exactly sure. New studies show that prenatal exposure to male sex hormones directly affects the way children play. Girls whose mothers have high levels of testosterone during pregnancy are more likely to prefer playing with trucks to playing with dolls. There are also clues that hormones influence the way we learn all through life. In a Dutch study published in 1994, doctors found that when males were given female hormones, their spatial skills dropped but their verbal skills improved.
In elementary-school classrooms--where teachers increasingly put an emphasis on language and a premium on sitting quietly and speaking in turn--the mismatch between boys and school can become painfully obvious. "Girl behavior becomes the gold standard," says "Raising Cain" coauthor Thompson. "Boys are treated like defective girls."
Two years ago Kelley King, principal of Douglass Elementary School in Boulder, Colo., looked at the gap between boys and girls and decided to take action. Boys were lagging 10 points behind girls in reading and 14 points in writing. Many more boys --than girls were being labeled as learning disabled, too. So King asked her teachers to buy copies of Gurian's book "The Minds of Boys," on boy-friendly classrooms, and in the fall of 2004 she launched a bold experiment. Whenever possible, teachers replaced lecture time with fast-moving lessons that all kids could enjoy. Three weeks ago, instead of discussing the book "The View From Saturday," teacher Pam Unrau divided her third graders into small groups, and one student in each group pretended to be a character from the book. Classes are noisier, Unrau says, but the boys are closing the gap. Last spring, Douglass girls scored an average of 106 on state writing tests, while boys got a respectable 101.
Primatologists have long observed that juvenile male chimps battle each other not just for food and females, but to establish and maintain their place in the hierarchy of the tribe. Primates face off against each other rather than appear weak. That same evolutionary imperative, psychologists say, can make it hard for boys to thrive in middle school--and difficult for boys who are failing to accept the help they need. The transition to middle school is rarely easy, but like the juvenile primates they are, middle-school boys will do almost anything to avoid admitting that they're overwhelmed. "Boys measure everything they do or say by a single yardstick: does this make me look weak?" says Thompson. "And if it does, he isn't going to do it." That's part of the reason that videogames have such a powerful hold on boys: the action is constant, they can calibrate just how hard the challenges will be and, when they lose, the defeat is private.
When Brian Johns hit seventh grade, he never admitted how vulnerable it made him feel. "I got behind and never caught up," says Brian, now 17 and a senior at Grand River Academy, an Ohio boarding school. When his parents tried to help, he rebuffed them. When his mother, Anita, tried to help him organize his assignment book, he grew evasive about when his homework was due. Anita didn't know where to turn. Brian's school had a program for gifted kids, and support for ones with special needs. But what, Anita asked his teachers, do they do about kids like her son who are in the middle and struggling? Those kids, one of Brian's teachers told Anita, "are the ones who fall through the cracks."
It's easy for middle-school boys to feel outgunned. Girls reach sexual maturity two years ahead of boys, but other, less visible differences put boys at a disadvantage, too. The prefrontal cortex is a knobby region of the brain directly behind the forehead that scientists believe helps humans organize complex thoughts, control their impulses and understand the consequences of their own behavior. In the last five years, Dr. Jay Giedd, an expert in brain development at the National Institutes of Health, has used brain scans to show that in girls, it reaches its maximum thickness by the age of 11 and, for the next decade or more, continues to mature. In boys, this process is delayed by 18 months.
Middle-school boys may use their brains less efficiently, too. Using a type of MRI that traces activity in the brain, Deborah Yurgelun-Todd, director of the cognitive neuroimaging laboratory at McLean Hospital in Belmont, Mass., tested the activity patterns in the prefrontal cortex of children between the ages of 11 and 18. When shown pictures of fearful faces, adolescent girls registered activity on the right side of the prefrontal cortex, similar to an adult. Adolescent boys used both sides--a less mature pattern of brain activity. Teenage girls can process information faster, too. In a study about to be published in the journal Intelligence, researchers at Vanderbilt University administered timed tests--picking similar objects and matching groups of numbers--to 8,000 boys and girls between the ages of 5 and 18. In kindergarten, boys and girls processed information at about the same speeds. In early adolescence, girls finished faster and got more right. By 18, boys and girls were processing with the same speed and accuracy.
Scientists caution that brain research doesn't tell the whole story: temperament, family background and environment play big roles, too. Some boys are every bit as organized and assertive as the highest-achieving girls. All kids can be scarred by violence, alcohol or drugs in the family. But if your brain hasn't reached maturity yet, says Yurgelun-Todd, "it's not going to be able to do its job optimally."
Across the nation, educators are reviving an old idea: separate the girls from the boys--and at Roncalli Middle School, in Pueblo, Colo., administrators say, it's helping kids of both genders. This past fall, with the blessing of parents, school guidance counselor Mike Horton assigned a random group of 50 sixth graders to single-sex classes in core subjects. These days, when sixth-grade science teacher Pat Farrell assigns an earth-science lab on measuring crystals, the girls collect their materials--a Bunsen burner, a beaker of phenyl salicylate and a spoon. Then they read the directions and follow the sequence from beginning to end. The first things boys do is ask, "Can we eat this?" They're less organized, Farrell notes, but sometimes, "they're willing to go beyond what the lab asks them to do." With this in mind, he hands out written instructions to both classes but now goes over them step by step for the boys. Although it's too soon to declare victory, there are some positive signs: the shyest boys are participating more. This fall, the all-girl class did best in math, English and science, followed by the all-boy class and then coed classes.
One of the most reliable predictors of whether a boy will succeed or fail in high school rests on a single question: does he have a man in his life to look up to? Too often, the answer is no. High rates of divorce and single motherhood have created a generation of fatherless boys. In every kind of neighborhood, rich or poor, an increasing number of boys--now a startling 40 percent--are being raised without their biological dads.
Psychologists say that grandfathers and uncles can help, but emphasize that an adolescent boy without a father figure is like an explorer without a map. And that is especially true for poor boys and boys who are struggling in school. Older males, says Gurian, model self-restraint and solid work habits for younger ones. And whether they're breathing down their necks about grades or admonishing them to show up for school on time, "an older man reminds a boy in a million different ways that school is crucial to their mission in life."
In the past, boys had many opportunities to learn from older men. They might have been paired with a tutor, apprenticed to a master or put to work in the family store. High schools offered boys a rich array of roles in which to exercise leadership skills--class officer, yearbook editor or a place on the debate team. These days, with the exception of sports, more girls than boys are involved in those activities.
In neighborhoods where fathers are most scarce, the high-school dropout rates are shocking: more than half of African-American boys who start high school don't finish. David Banks, principal of the Eagle Academy for Young Men, one of four all-boy public high schools in the New York City system, wants each of his 180 students not only to graduate from high school but to enroll in college. And he's leaving nothing to chance. Almost every Eagle Academy boy has a male mentor--a lawyer, a police officer or an entrepreneur from the school's South Bronx neighborhood. The impact of the mentoring program, says Banks, has been "beyond profound." Tenth grader Rafael Mendez is unequivocal: his mentor "is the best thing that ever happened to me." Before Rafael came to Eagle Academy, he dreamed about playing pro baseball, but his mentor, Bronx Assistant District Attorney Rafael Curbelo, has shown him another way to succeed: Mendez is thinking about attending college in order to study forensic science.
Colleges would welcome more applications from young men like Rafael Mendez. At many state universities the gender balance is already tilting 60-40 toward women. Primary and secondary schools are going to have to make some major changes, says Ange Peterson, president-elect of the American Association of Collegiate Registrars and Admissions Officers, to restore the gender balance. "There's a whole group of men we're losing in education completely," says Peterson.
For Nikolas Arnold, 15, a sophomore at a public high school in Santa Monica, Calif., college is a distant dream. Nikolas is smart: he's got an encyclopedic knowledge of weaponry and war. When he was in first grade, his principal told his mother he was too immature and needed ADHD drugs. His mother balked. "Too immature?" says Diane Arnold, a widow. "He was six and a half!" He's always been an advanced reader, but his grades are erratic. Last semester, when his English teacher assigned two girls' favorites--"Memoirs of a Geisha" and "The Secret Life of Bees" Nikolas got a D. But lately, he has a math teacher he likes and is getting excited about numbers. He's reserved in class sometimes. But now that he's more engaged, his grades are improving slightly and his mother, who's pushing college, is hopeful he will begin to hit his stride. Girls get A's and B's on their report cards, she tells him, but that doesn't mean boys can't do it, too.
Elementary School
Boys start off with lower literacy skills than girls, and are less often encouraged to read, which only widens the gap.
Girls ages 3 to 5 are 5% more likely than boys to be read to at home at least three times a week.
Girls are 10% more likely than boys to recognize words by sight by the sprint of first grade.
Boys ages 5 to 12 are 60% more likely than girls to have repeated at least one grade.
Girls' reading scores improve 6% more than boys' between kindergarten and third grade.
First-to fifth-grade boys are 47% more likely than girls to have disabilities such as emotional disturbances, learning problems or speech impediments.
Fourth-grade girls score #% higher on standardized reading tests than boys.
Fourth-grade girls score 12% higher on writing tests than boys.
GRAPH: AVERAGE SCORES: FOURTH-GRADE STUDENTS
Middle School
Coming of age in a culture that discourages bookishness, boys are more likely to fall victim to drugs and violence.
Eighth-grade girls scores an average of 11 points higher than eighth-grade boys on standardized reading tests.
Eighth-grade girls score 21 points higher than boys on standardized writing tests.
Between 1993 and 2003, the number of ninth-grade boys who skipped school at least once a month because they didn't feel safe increased 22%.
Boys between the ages of 5 and 14 are 200% more likely to commit suicide than girls.
Ninth-grade boys are 78% more likely than girls to get injured in a fight at least once a year.
Between the ages of 5 and 14, boys are 36% more likely to die than their female counterparts.
High School and Beyond
Many boys continue to fall behind girls in reading and writing proficiency, and fewer are going to college.
Boys are 33% more likely than girls to drop out of high school.
Twelfth-grade girls score 16 points higher than boys on standardized reading tests.
High-school boys are 30% more likely to use cocaine than high-school girls.
Twelfth-grade girls score 24 points higher than boys on standardized writing tests.
High-school girls are 36% more likely to take Advanced Placement or honors biology than high-school boys.
22% more high-school girls are planning to go to college than boys.
The percentage of male undergraduates dropped 24% from 1970 to 2000.
AVERAGE TEST SCORES*
WRITING
Girls Boys
1998 159 140
2002 160 136
READING
Girls Boys
1980 289 282
2004 292 278
*TWELFTH-GRADE SCORES
ADHD and Exercise in the Child, Teen and Adult
Exercise has a profound affect on ADHD and the child, teen or adult. In addition to promoting health, a regular exercise program can modifying behavior in the ADHD child and may even promote brain growth.
Aerobic exercise increases levels of the neurotransmitters dopamine, serotonin and norepinephrine. These neurotransmitters provide emotional stability, the ability to focus, mental alertness and calmness. Conversely, a deficiency in neurotransmitters can cause depression, mood swings, irritability, anxiety, attention problems, stress and sleep problems.
Exercise also releases endorphins, the opiate-classified messengers of our emotional system that elevate mood, increase pleasure and minimize pain.
The degree of chemical change is dependent on the intensity, duration and frequency of the aerobic activity.
Current fitness and exercise research makes a correlation between an active lifestyle and positive changes in brain chemistry, brain growth and development. Studies also show that exercise has a positive affect on curbing negative behaviors common in the ADHD child.
A 2001 State University of New York, Buffalo study showed the positive benefits of exercise on ADHD children. The study group - ADHD children between the ages of 5 and 12 - participated in 40 minutes of intense exercise five days per week.
Children involved in this study showed a significant improvement in behavior over the six-week duration of the study. Behavior changes were generally noticeable two to four weeks after beginning the exercise program and children with oppositional behaviors made the greatest improvements with exercise.
This study makes good common sense; give hyperactive an outlet for their excess energy and they will have less to cause trouble with.
National statistics show that today’s children are increasingly less active than children 10 years ago. Not so coincidentally, psychosomatic disorders and ADHD prescriptions have skyrocketed over the same time frame.
If you have an ADHD child or teen or if you are an adult with ADHD, the kindest most healthy treatment plan is one that focuses on routine intense aerobic exercise, and one that includes a nutritious diet and an attentional supplement program to fill any gaps.
The child, teen or adult with ADHD needs to incorporate at least 30 minutes of activity to each day. At least 20 minutes of this exercise needs to be at a moderate to intense level. Below are a few aerobic exercises to incorporate into your and your child’s life:
_ Bicycling at 10 mph.
_ Brisk walking at 4 mph (15 minutes/mile).
_ Jogging.
_ Hiking.
_ Ice skating.
_ In-line skating or roller skating.
_ Jumping roping.
_ Raking leaves.
_ Shoveling snow.
_ Skateboarding.
_ Washing and waxing the car.
_ Weight training.
_ Circuit training.
It is important for an adult to make the exercise effort a family affair. An adult displaying a positive attitude and a shared interest in exercise supports and encourages the child or teen to follow suit. This may be the time to start addressing those extra pounds that have made way to the body over the years.
By: Shute, Nancy, McGrath, Anne, U.S. News & World Report, 00415537, 2/20/2006, Vol. 140, Issue 6
Alarmed by 25 sudden deaths in people taking certain drugs for attention deficit hyperactivity disorder, an FDA panel last week recommended a "black box" warning that the drugs might cause cardiovascular problems. The FDA also found 54 nonfatal problems, including heart attack and stroke in adults and children on Ritalin, Adderall, Concerta, and other stimulants. It's not clear whether the drugs were at fault; some people had high blood pressure and other underlying issues. People with heart problems and hypertension are already cautioned about stimulants. For others, for now, "I don't think the risk in any way justifies not using it, "says Larry Diller, a pediatrician and author of Running on Ritalin. Millions take the drugs safely each day, he notes.
Mixed messages on ADHD , USA Today, 07347456, FEB 15, 2006
Parents can face conflicting advice on drugs' safety
Section: Life, Pg. 13b
Parents who are concerned about the heart risks of stimulants to treat attention deficit/hyperactivity disorder may hear conflicting advice from doctors, depending on whom they consult.
Last week, an advisory panel to the Food and Drug Administration voted 8-7 to suggest adding the agency's strongest warning label to Ritalin, Adderall and similar medications. The panel based its decision on an FDA report that found 25 children and adults had died suddenly from 1999 to 2003 after taking ADHD drugs.
Steven Nissen, an advisory committee member, says many of the 4million people who use the drugs may not realize that they have serious side effects. "I want parents and doctors, before they prescribe amphetamines and amphetamine-like drugs to children, to think a little harder whether they need them," says Nissen, interim chairman of the Cleveland Clinic's department of cardiovascular medicine.
Nissen suggests patients ask their doctors questions such as: "Do I really need these drugs? Am I on the lowest possible dose? Are there safer alternatives?"
The FDA typically follows the advice of its advisory committees. But Thomas Laughren, director of the FDA's division of psychiatry products, says it would be unusual for the agency to issue a "black box" warning based on such thin evidence. He notes that the reported number of sudden deaths in patients taking stimulants is lower than the figure that experts would expect to see among people who aren't taking the drugs. A second FDA committee, which focuses on pediatrics, will consider the drugs' safety next month, Laughren says.
Edward Hallowell, a doctor and co-author of Driven to Distraction, notes that about one in 10 of his patients stop using stimulants for ADHD because of side effects, which can include loss of appetite, abnormal heartbeats, elevated blood pressure, tics and twitches. "These meds are far from perfect," Hallowell said in an e-mail. "But they are the best medication option we have and are very safe when used correctly."
Worried patients have been calling David Goodman for several days. Goodman, an assistant professor of psychiatry at the Johns Hopkins University School of Medicine, says he sees no reason for his patients to stop taking the drugs. Goodman notes that teenagers who do not treat their ADHD face risks because such children are more likely than others to use drugs, drop out of school or get into accidents.
Lawrence Diller, author of Running on Ritalin and Should I Medicate My Child?, notes that people often rush to use medications for problems that might be addressed by changing parenting strategies, exploring special education or improving classroom management. These non-medical options can help some children avoid prescription medications and allow others to reduce their doses.
Although stimulants might seem like an easy fix, Diller says, "just because it works doesn't make it an ethical substitute for giving kids the proper attention at home and school."
(c) USA TODAY, 2006
Warnings advised on ADHD drugs , USA Today, 07347456, FEB 10, 2006
It is estimated that between three and five percent of children--or approximately two million children in the United States--have attention deficit hyperactivity disorder (ADHD). This means that in a classroom of 25 to 20 students, it is likely that at least one will have ADHD.
Those statistics come from the National Institute for Mental Health (NIMH), which also points out that while a child with ADHD faces a difficult task in achieving his or her full potential, the task is not insurmountable. Since ADHD often continues into adulthood, it is important to help children learn to deal with it early on, and that takes teamwork from parents, guidance counselors, teachers and school administration.
According to the NIMH, it is the school's obligation to evaluate children it suspects may have ADHD. The diagnosis is becoming more common, however, and children may come into the classroom having already received treatment such as behavior modification and medication--as well as an Individualized Educational Plan (IEP).