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ADHD and Medication

First of all, I’d like to thank Kirsten for posting the email on the discussion board. Medicating children has been a hot topic of discussion in the realms of medicine and education for decades and for a few of the reasons stated in the email. Before delving in to pharmaceuticals, I think it is important to understand the basics about ADHD and why some people opt to medicate.

ADHD is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), and in some cases, are overly active (Center for Disease Control and Prevention, 2010).  It is often diagnosed as one of the following: ADHD-I (primarily inattentive), ADHD-HI (primarily hyperactive and impulsive), and ADHD-C (combination of both types).  In order to make a diagnosis, a child must exhibit six criteria for inattention OR six criteria for hyperactivity/impulsivity for a period of at least six months and to a maladaptive degree (DSM-IV). CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) provides the list of characteristics for each category:

AD/HD - Primarily Inattentive Type:

• Fails to give close attention to details or makes careless mistakes.

• Has difficulty sustaining attention.

• Does not appear to listen.

• Struggles to follow through on instructions.

• Has difficulty with organization.

• Avoids or dislikes tasks requiring sustained mental effort.

• Is easily distracted.

• Is forgetful in daily activities.

AD/HD - Primarily Hyperactive/Impulsive Type:

• Fidgets with hands or feet or squirms in chair.

• Has difficulty remaining seated.

• Runs around or climbs excessively.

• Has difficulty engaging in activities quietly.

• Acts as if driven by a motor.

• Talks excessively.

• Blurts out answers before questions have been completed.

• Has difficulty waiting or taking turns.

• Interrupts or intrudes upon others.

Displaying six of the criteria is not the only element in determining a diagnosis. It is also essential to:

-    Determine that symptoms are present in two or more of a child’s settings (eg home and school)

-    Determine that the symptoms adversely affect the child’s academic or social functioning for at least six months

-    Ensure that the evaluations are initiated by the primary-care physician

-    Include assessment informationf rom both parents and scohol professionals

-    Include evaluation for coexisting disorders such as depression, anxiety, and learning disabilities (Webber & Plotts, 2008).

Once a diagnosis is made, depending on the severity of the disorder, one may choose to medicate.

But why medicate? Why do people with ADHD need to be medicated? What’s going on in their bodies that needs regulating?

Although there is no one cause to ADHD, the research shows a strong neurobiological basis with a focus on neurotransmitter disturbances (National Resource Center on AD/HD, 2010; CDC, 2010; Webber & Plotts, 2008; & CHADD, 2010). While most people think ADHD is caused by an overstimulation of the brain, it is actually linked to an UNDERarousal of the anterior frontal lobes which is caused by dopamine and/or norepinephrine depletion. For more information about cause(s) and risk factors, visit the National Resource Center on ADHD or the National Institute of Mental Health .

So what’s basically happening is that the brain is understimulated, causing the child to be overstimulated. How do you combat that? Stimulate the brain -- get the brain to function at the level it should. By stimulating the brain, it actually calms those with ADHD. It is because of this fact that doctors prescribe (can you guess what’s coming?) STIMULANTS. The National Institute of Mental Health (NIMH) has a fabulous chart regarding the various drugs commonly used for ADHD, click here: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml#pub6 .

However, medication is not the ONLY treatment of ADHD. Effective treatment of ADHD in children and teens requires a comprehensive approach that professionals call multimodal. This means that the best outcomes are achieved when multiple interventions work together as part of a comprehensive treatment plan. The elements of a multimodal treatment approach include:

• Parent training

• Behavioral intervention strategies

• An appropriate educational program

• Education regarding AD/HD

• Medication, when necessary

Positive behavior intervention can be critical. The most important techniques are consistency and positive reinforcement, in which the child is rewarded for desired behavior. Classroom success may require a range of interventions, from making minor adjustments in the regular classroom to requiring special education programs. For many children with AD/HD, medication may be an integral part of treatment. Both stimulant and nonstimulant medications are now available to physicians and parents.

So what’s the problem with medicating? Why do we keep seeing meds in a negative light?

In the email Kirsten presented, they listed the following as results that are “covered up”:

* Have a high potential for abuse

* Be habit forming

* Impair vision

* Cause serious heart problems

* Create blood-vessel problems

* Result in sudden death.

Which they aren’t. At all. Studies are always accessible and warnings are always on the label. In FACT, you can access medication guides from the U.S. Food and Drug Administration (FDA) as well as drugs.com. In my personal opinion, problems with medication arise due to:

-    Incorrect dosage

-    Lack of supervision

-    Lack of reporting effects (on part of the parent or child)

-    Contraindicated medication

-    Incorrect reporting of effects by parent(s) and/or teacher(s)

-    Lack of knowledge and/or awareness

-    Others

The common theme is that something is missed, intentionally or not, resulting in undesirable outcomes. Medication, if used correctly and under appropriate supervision, could most definitely be beneficial to a person with ADHD. Although it’s not listed under the area of treatment, I think it would be a great idea for these kids to undergo therapy before, during, and after taking a drug to have their behavior closely monitored as well as help walk them through and understand the changes they are experiencing.

For more information:

CDC ADHD Homepage
www.cdc.gov/ncbddd/adhd/index.html

Children and Adults with AD/HD
www.chadd.org

Drugs@FDA
www.accessdata.fda.gov/scripts/cder/drugsatfda/

Drug Information Online
www.drugs.com

National Resource Center on AD/HD
www.help4adhd.org/index.cfm?varLang=en

NIMH ADHD Homepage
www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml

bind it up

So in our house, we are big book fans - in fact, our floors look like a library upchucked half it's contents creating a minefield of picture and board books. Although we have an exorbitant amount of books, we're always on the look out for something new and exciting to feast our eyes and ears on. We decided to be adventurous and take the kids to the library in hopes of introducing the world of rent-a-books to the kids. Cayden absolutely LOVES to be read to and Kaylee just likes to carry books around like a caveman dragging its prey. We're trying to continue fostering the love of reading with both our kids (although it's much simpler with Cayden than Kaylee). On the walk to the library, Cayden was noticing every, literally, EVERY SINGLE ANT. When we got to the library, there was a big, fat "Killer Ants" book on display. I snatched that puppy up in a heartbeat ; ) Unsurprisingly, it's been the least favorite book of the bunch. So what all was our take? Let me share ; )

1. I Love Bugs! by Emma Dodd
This is a super cute book and is GREAT for the (non)insect lover ; ) The rhyme scheme and fun descriptive words make it a joy to read. The illustrations go along with the playfulness of the story. The end of the story involves a spider and running away squealing - I make my hands like a spider and attack Cayden and, as you'd expect, he runs away laughing and squealing ; ) "I Love Bugs" is super great for real world interaction - whether you become the spider or decide to go look for bugs afterwards!






2. The Zoo I Drew by Todd H. Doodler
With mod, playful pictures and adorable rhymes, Doodler creates an enjoyable animal journey through the ABCs that can be enjoyed over and over and over again.










3. Killer Ants by Nicholas Nirgiotis
The aformentioned ant book. If you are curious about the anatomy of the ant, you've gotta check this out. This book is FILLED with some crazy facts about ants and, although Cayden's not a huge fan, Adam and I thoroughly enjoyed reading through it and checking out all the illustrations (which are FANTASTIC).








4. Bees, Snails, and Peacock Tails: Patterns and Shapes... Naturally by Betsy Franco
Illustrated by one of my FAVORITES, Steve Jenkins, Franco (a mathematician) weaves a story taking you through nature finding honeycombs, moth wings, and other cool patterns and shapes. This is an excellent tool to introduce the concepts of complex patterns and shapes.








If you get the time, I highly recommend checking out any (or all) of these books ; ) The best thing about books is you can simply read for enjoyment or use them as an aid at home or in the classroom!

eBAY

From now through July 4th, tell eBay who
your favorite nonprofit is and help them secure one of
three grants for $15,000, $10,000 or $5,000! 

Go to http://mynonprofit.ebay.com/

Find organizations like the Autism Society of America, Children's Miracle Network, American Red Cross, March of Dimes, and more! Not only does eBay Giving Works make generous contributions like this one, but you can SHOP listings that support your favorite nonprofit, SELL items and donate 10%-100% of the proceeds, or DONATE immediately. How fantastic is that?? You can also follow via Facebook and Twitter ; )  

Go to it, friends! Help your favorite organizations - it only takes a click!

TWITTER

It's official: I'm on Twitter! Follow me as xspediter ; ) See you around everyone!

NATIONAL SPEAK UP CAMPAIGN

GET WITH THE PROGRAM GUYS!!! SAVE JOBS!!!

NATIONAL CALL-IN DAY TO SPEAK UP FOR EDUCATION & KIDS
WEDNESDAY, MAY 26, 2010

Wednesday, May 26, 2010 is the start of the National Speak Up for Education & Kids Campaign. It begins with a
NATIONAL CALL-IN DAY

Take Action:

• On Wednesday, May 26th, call 1-866-608-6355 to contact your representative in Congress.
• You will hear talking points and will be connected to the United States Capitol Switchboard – ask for your House Member. To find out who your House Member is, either ask the operator or click here.
• Tell your Representative to protect the future of our children by supporting funding to save education jobs in the emergency funding bill.
• With 300,000 education layoffs expected, our students are the ones who will suffer – in overcrowded classrooms, with less time in school, and without the teachers and school staff needed to give them individual attention and help.
• Share this call-in day information with your friends, Ask them to call Congress on May 26th and inform their friends about this crucial legislation

Other Actions You Can Take to Speak Up for Education & Kids:

• E-mail your Members of Congress to support funding to save education jobs in the emergency supplemental appropriations bill.
• Become a “fan” of Speak up for Education and Kids on Facebook – a community of educators and concerned citizens – now more than 16,000 strong – who believe our nation has a responsibility to invest in education and avoid the short-sighted cuts that could deprive our students of the bright futures they deserve.
• Print the poster for our event and post at your school or workplace.

Congress can’t ignore a strong message from all across the nation. Make your voice heard! Participate in the National Call-in Day and speak up for education and kids!

MY OWN KIDS

Okay, so you all know that my own kids have special needs - both are developmentally delayed. I figured it's about time for an update ; )

Since November, Cayden's been attending the local public special education program. He has made such tremendous progress! It's amazing to hear him these days. Although he still babbles nonsense, his expressive vocabulary has come leaps and bounds. He'll tell us that we're being silly or what he wants to eat. It's somewhat mind-blowing to think that a year ago he was throwing himself on the ground, crying, screaming, breaking toys in frustration. Those fits would last for an hour sometimes - it was out of control. Now when he gets upset, he can recognize it. He'll even say, "Go Time Out. I angry. Go time out." It catches us off-guard sometimes lol He's such a fun little guy and we're so happy that we're getting to FINALLY understand what he's been saying the past few years.

As for Kaylee, she still remains without services. The early intervention (EI) services are sucking at life mostly due to the state of Illinois. In case you didn't know, the state of Illinois cut the budget on EI services. This means that they haven't been paying the therapists. So since the therapists aren't getting paid, they aren't coming out. Since they aren't coming out, Kaylee remains without services. Interestingly, EI COULD refer us to a clinic setting HOWEVER because there is a tremendous emphasis on helping children in the home environment, they won't do it. So, again, Kaylee goes without services.

However, me being me, I decided to say "eff that" and called up Sertoma. Sertoma is an organization that works solely with speech and hearing. Although this will come out of our pocket, our children are our priority. They will be providing Cayden with summer services through their Bridge program in order to keep him on track. Don't get me wrong, he's come a LONG way, but he's still REALLY far behind. Since he's shown such tremendous progress over the past few months at school we don't want to lose what he's attained and we want to bank on the forward momentum. As for Kaylee, they can and will do a hearing test (FINALLY) as well as provide speech services for her. If the outcome for her hearing is normal, we plan on going through the diagnosing process either through RUSH or Children's Memorial since they have Pediatric Neuropsychologists.

We also plan on having the kids participate in Gymnastics over the summer. This is not only to get some of their spastic energy out but to help with their coordination, balance, and motor skills. Adam wants Cayden to do hockey (there's a surprise), but I think we will stick with gymnastics this year and branch out next year when he turns 5. ZOMG HE'S GOING TO BE 5 NEXT YEAR. Okay, done spazzing. ; )

So things are moving in a forward fashion for the kids and I couldn't be happier. I hate that we have to go through Sertoma and we have to pay out of pocket BUT I want to hear Kaylee talk. I want to know what the Doods has to say about things. I have a feeling it'll be somethin' sassy. ; )

SMART IEPs

It's a concept that makes nothing but the utmost sense. As a reminder for our non-SpEd people, IEP stands for Individualized Education Plan. IEPs provide a plan to adapt lessons and classrooms for the benefit of the student and their learning.

On fetaweb.com (From Emotions to Advocacy), the sister site of Wrightslaw.com (a site specializing in special education law), there was a description of a SMART IEP. So what does that entail?

S Specific
M Measurable
A Use Action Words
R Realistic and relevant
T Time-limited

By ensuring that an IEP entails each of those concepts in relation to the particular child, the team (and parent) can best create strategies for that child's success. To read the full chapter, check it out: http://www.wrightslaw.com/bks/feta2/ch12.ieps.pdf

What I enjoy about WrightsLaw is the breakdown factor. They take the large concepts and explain them in a way that everyone can understand. The main goal of WrightsLaw and fetaweb is to ensure parents' understanding of special education so they can secure the services their children so rightly deserve.

BLOGS, SOCIAL NETWORKING, AND WEE ONES

Allright guys, I know it's been awhile but I'm back! I know you missed me. Currently, I'm taking an Ed Tech class (so to speak) and one of the discussion topics presented was this:

"Social Networking and "Blogs", "Online Journals", etc. are important for ALL users of the internet, but more so when we are using the internet for teaching children and youth. Tonight, I want you to explore and identify
POSITIVE uses of Social Networking, Blogs, Journals and the Internet. How young is too young for Blogs?
What sites did you find? What kind of lesson would you develop?"

I know what I wrote, but I'm curious to see what YOU guys think. Are there actually benefits for our elementary students and teachers to utilize social networking sites as well as blogs? What about high schoolers? Is there a way to incorporate them in to the classroom?