Download Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity
Disorder
Inappropriate behavior, including poor attention skills,
impulsivity, and hyperactivity
Attention Deficit Hyperactivity Disorder
• Behavioral disorder emerges before the age of seven
• Symptoms include inattentive, impulsive and hyperactive
behaviors
• ADHD is not a reflection of a child's intelligence nor caused
by poor parenting
• ADHD is more common in people who have a close relative
with the condition
• Twice as many boys are diagnosed with ADHD as girls
What Is The Difference Between ADD
and ADHD
• The current Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV-TR) outlines the diagnostic criteria for
mental conditions.
• Although the terms ADD and ADHD are used
interchangeably, ADHD is the official name used by the
American Psychiatric Association, and it encompasses
hyperactive, impulsive, and/or inattentive behaviors.
• ADD is the older term thus in some older literature you will
find this term as a synonym for ADHD
Attention Deficit Hyperactivity Disorder:
Prevalence
• Affects children, adolescents and adults
• It is one of the most common childhood psychiatric
conditions in the United States.
• The National Institute of Mental Health (NIMH) estimates
that 5 million children in the United States have ADHD – that
is about 5% of all children!
• Studies show that up to 70% of children with ADHD
continue to have symptoms as adults
Attention Deficit Hyperactivity Disorder:
In Children
• Childhood ADHD -- attention-deficit/hyperactivity
disorder -- is diagnosed after a child has shown six
or more specific symptoms of inactivity and/or
hyperactivity on a regular basis for more than six
months in more than two settings.
• There is no single test for ADHD
• Diagnosis is based on questionnaires
Attention Deficit Hyperactivity Disorder:
In Children
• A doctor can diagnose ADHD with the help of
standard guidelines.
• The diagnosis of ADHD involves the gathering of
information from several sources, including school,
caregivers, and parents.
• The doctor will consider how a child's behavior
compares with that of other children the same age.
TYPES OF ADHD
• Combined Type (Inattentive/Hyperactive/Impulsive).
Children with this type of ADHD show all three symptoms.
This is the most common form of ADHD.
• Hyperactive/Impulsive Type. Children show both
hyperactive and impulsive behavior, but are able to pay
attention.
• Inattentive Type. Formerly known as attention deficit
disorder (ADD), these children are not overly active. They
do not disrupt the classroom or other activities, so their
symptoms might not be noticed.
Attention Deficit Hyperactivity Disorder:
In Teens
• Typically diagnosed in childhood, ADHD still affects
many teens.
• The symptoms -- inattention, impulsivity, and
hyperactivity - are intrusive, which means they
interrupt and seriously interfere with a teen's life.
• During teen years, especially as the hormonal
changes of adolescence are going on, symptoms of
ADHD may intensify.
Attention Deficit Hyperactivity Disorder:
In Teens
• It's not uncommon for teens with ADHD to forget
assignments, misplace textbooks, and become
easily bored with their daily class work.
• Teens may become inattentive, or excessively
attentive -- not waiting for their turn before blurting
out answers.
• They may interrupt the teacher and classmates,
and rush through assignments.
Attention Deficit Hyperactivity Disorder:
In Teens
• Teens with ADHD may also be fidgety and have a
difficult time sitting still in class.
• Often, teens with ADHD are so busy focusing on
other things they forget about the task at hand. This
can be seen especially with homework and athletic
skills and in relationships with peers.
• This lack of attention to what they're doing often
leads to poor performance on tests and being
rejected from sports teams, extracurricular
activities, and peer groups.
Attention Deficit Hyperactivity Disorder:
In Teens
• Teens with ADHD are more likely to be heavy
drinkers than teens without ADHD.
• In clinical studies, researchers confirmed that teens
with ADHD were twice as likely to have abused
alcohol within the past 6 months.
Attention Deficit Hyperactivity Disorder:
In Teens
• They also found that teens with ADHD were likely
to abuse drugs and three times more likely to
abuse drugs other than marijuana.
• Getting proper treatment for ADHD in teens may
cut the risk of later alcohol and drug abuse.
Attention Deficit Hyperactivity Disorder:
In Adults
• It is now known that these symptoms continue into
adulthood for about 70% of children with ADHD.
• That translates into 4% of the US adult population,
or 8 million adults.
• However, few adults are identified or treated for
adult ADHD.
Attention Deficit Hyperactivity Disorder:
In Adults
• Adults with ADHD may have difficulty following
directions, remembering information, concentrating,
organizing tasks or completing work within time
limits.
• If these difficulties are not managed appropriately,
they can cause associated behavioral, emotional,
social, vocational and academic problems.
Attention Deficit Hyperactivity Disorder:
In Adults
• The following behaviors and problems may stem
directly from ADHD or may be the result of related
adjustment difficulties:
– Chronic lateness and forgetfulness.
– Anxiety.
– Low self-esteem.
– Employment problems.
– Difficulty controlling anger.
– Impulsiveness.
Attention Deficit Hyperactivity Disorder:
In Adults
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Substance abuse or addiction.
Poor organization skills.
Procrastination.
Low frustration tolerance.
Chronic boredom.
Difficulty concentrating when reading.
Mood swings.
Depression.
Relationship problems.
Attention Deficit Hyperactivity Disorder:
In Adults
• These behaviors may be mild to severe and can
vary with the situation or be present all of the time.
• Some adults with ADHD may be able to
concentrate if they are interested in or excited
about what they are doing. Others may have
difficulty focusing under any circumstances.
• Some adults look for stimulation, but others avoid it.
Attention Deficit Hyperactivity Disorder:
Interesting Facts
• Adults with ADHD are more likely to:
– Change employers frequently and perform poorly.
– Have had fewer occupational achievements
– Have a lower socioeconomic status.
– Have driving violations such as: be cited for
speeding; have their licenses suspended; be
involved in more crashes; rate themselves and
others as using poorer driving habits.
Attention Deficit Hyperactivity Disorder:
Interesting Facts
• Adults with ADHD are more likely to:
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Use illegal substances more frequently.
Smoke cigarettes.
Self-report psychological maladjustment more often
Have more marital problems and multiple marriages.
Have higher incidence of separation and divorce.
• Much of this functional impairment diminishes with
remission of the disorder and can be mitigated by
appropriate treatment.
Common Conditions That Coexist With
ADHD
COMORBIDITY
Learning Disorders
Anxiety & Depression
Bipolar Disorder
Oppositional Defiance Disorder
Conduct Disorder
Tourette’s Syndrome
Substance Abuse
Obsessive Compulsive Disorder
Intermittent Explosive Disorder
Panic Disorder
Specific Phobia
CHILDREN ADOLESCENT
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ADULT
X
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Attention Deficit Hyperactivity Disorder
The Medical Approach
Medication for ADHD
• A class of drugs called
psycho-stimulants or
stimulants have been used to
effectively treat ADHD for
years.
• They work by increasing the
production of two
neurotransmitters – dopamine
and norepinephrine
Medication for ADHD
• These medicines help users to focus their thoughts
and ignore distractions.
• Stimulant medications are effective in 70% to 80% of
patients.
• However there are short and long term effects
related to these drugs
Medication for ADHD
• Stimulant drugs to treat ADHD include:
– Adderall and Adderall XR
– Concerta
– Dexedrine
– Focalin and Focalin XR
– Metadate CD and Metadate ER
– Methylin
– Ritalin, Ritalin LA
– Vyvanse
– Desoxyn
Side Effects of ADHD Drugs
• ADHD drugs sometimes have side effects
• The most common side effects of ADHD drugs
include:
– Decreased appetite/weight loss
– Sleep problems
– Headaches
– Jitteriness
– Social withdrawal
– Stomach aches
Side Effects of ADHD Drugs
• Rarely, medications for ADHD can cause more
serious side effects.
• For instance, some stimulants are associated with
an increased risk of cardiovascular problems and
sudden death.
• They may also exacerbate psychiatric conditions
like depression or anxiety.
Stimulant Safety Concerns
Effect On The Developing Brain
• The long-term impact of ADD / ADHD medication
on the youthful, developing brain is not yet known.
• Some researchers are concerned that the use of
drugs such as Ritalin in children and teens might
interfere with normal brain development.
Stimulant Safety Concerns
Heart Related Problems
• ADHD stimulant medications have been found to
cause sudden death in children and adults with
heart conditions.
• The American Heart Association recommends that
all individuals, including children, have a cardiac
evaluation prior to starting a stimulant.
• An electrocardiogram is recommended if the
person has a history of heart problems.
Stimulant Safety Concerns
Psychiatric Problems
• Stimulants for ADD / ADHD can trigger or
exacerbate symptoms of hostility, aggression,
anxiety, depression, and paranoia.
• People with a personal or family history of suicide,
depression, or bipolar disorder are at a particularly
high risk, and should be carefully monitored when
taking stimulants.
Stimulant Safety Concerns
Potential for Abuse
• Stimulant abuse is a growing problem, particularly
among teens and young adults.
• College students take them for a boost when
cramming for exams or pulling all-nighters.
• Others abuse stimulant meds for their weight-loss
properties.
• If your child is taking stimulants, make sure he or
she isn’t sharing the pills or selling them.
Stimulant Contraindications
• ADD / ADHD stimulants are not recommended for
those with:
– Any type of heart defect or diseases
– High blood pressure
– Hyperthyroidism
– Glaucoma
– High levels of anxiety
– A history of drug abuse
ATTENTION DEFICIT
HYPERACTIVITY DISORDER
AND
NEUROFEEDBACK
What is Neurofeedback Used For?
Over 40 years of peer reviewed, university
based research has demonstrated the
efficacy of neurofeedback in addressing
many neurological conditions
ADHD
Anxiety
Panic Attacks
Insomnia
Chronic Pain
Bedwetting
Migraine
Fibromyalgia
TBI
Tension Headache
PTSD
Depression
Learning Disorders
Autism / Asperger’s
Tics
As well as other conditions
BRAINCORE THERAPY AND ADHD
• Neurofeedback is a training procedure designed to
teach children with ADHD how to control their own
brainwaves bringing balance, harmony and
regulation to the brain
• The goal of neurofeedback is to transform an
unhealthy brainwave pattern into a healthy one
ADHD AND NEUROFEEDBACK
• A number of quality studies have been published that show
the effectiveness of neurofeedback in alleviating some or all
of the symptoms associated with ADHD
• Neurofeedback research is based upon the principle that
ADHD is connected with what is called hypo-arousal within
the brain and central nervous system. This hypo-arousal is
bio-electrical, or brainwave based in nature
• Mental states are associated with specific brainwaves
• Each brainwave represents a specific processing
speed of the brain– also known as arousal level
• These brainwaves include:
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Delta
Theta
Alpha
Beta
ADHD AND NEUROFEEDBACK
• Delta and Theta represent the slowest processing
speeds and are associated with a twilight state
• Alpha represents a slightly faster processing speed and
is associated with quiet wakefulness such as when you
meditate
• Beta represents the fastest processing speed and is
associated with external focus, thought and
concentration
THE AROUSAL SPECTRUM
A healthy, regulated brain is able to shift easily between
arousal states as the demands arise
LOW AROUSAL
SLOWER
PROCESSING
Delta and Theta
IDLE STATE OF
THE BRAIN
Alpha
HIGH AROUSAL
FASTER
PROCESSING
Beta
OPTIMAL ZONE OF PERFORMANCE
The Brain has an optimal zone of performance
LOW AROUSAL
SLOWER
PROCESSING
IDLE STATE OF
THE BRAIN
HIGH AROUSAL
FASTER
PROCESSING
Depending on the circumstances and everyday demands, the brain
may move toward low arousal or high arousal but a well regulated
brain stays within its optimal zone of performance
THE DYSREGULATED BRAIN
UNDER-AROUSED
INHIBITED
OVER-AROUSED
• A dysregulated brain has a tendency to
habitually operate from one of the 3
arousal states
THE DYSREGULATED BRAIN
An individual’s habitual arousal state might be too high or
too low to support optimal function
UNDER-AROUSED
Impulsive
Socially
Inappropriate
Hyper-active
Easily Distracted
Excessive Speech
Disorganized
Hyper-emotional
INHIBITED
Victim Mentality
Excessive Self Concern
Rumination
Anger
Self Deprecation
Agitation
Irritability
Passive Aggressive
OVER-AROUSED
Excessive Rationalization
Poor Emotional Self
Awareness
Worry
Hyper-vigilant
Obsessive Thinking
Dislike of Change
Restless
THE DYSREGULATED BRAIN
An individual’s habitual arousal state might be too high or
too low to support optimal function
UNDER-AROUSED
Excessive
Delta and Theta
These patients usually
present with cognitive
impairment, focus and
attention issues,
ADHD, TBI, dementia,
learning disorders
INHIBITED
Elevated Alpha
These patients usually
present with symptoms of
depression, irritability,
lethargy, fibromyalgia,
metabolic issues
OVER-AROUSED
Elevated Beta
These patients usually
present with anxiety, panic
attacks, OCD, worry,
migraine, tension
headache, chronic pain,
insomnia
NEUROLOGICAL DYSREGULATION
• Brainwave Imbalance or Neurological Dysregulation
may be caused by:
– Variations in brain structure
– Drugs
– Toxins
– Poor Nutrition
– Subluxation
– Trauma
– Stress – both physical and emotional
BRAINCORE THERAPY
Painless
Drugless
Non-Invasive
No Side Effects
How is it Done?
All neurofeedback begins by performing a
Brain Map
The BrainCore Brain Map
A Brain Map provides us with the information
that is required to perform neurofeedback
training
THE BRAINCORE BRAIN MAP REPORT
The BrainCore Brain
Mapping software
analyzes thousands of
different variables and
compares your patient’s
brain map with a
database of normal
brain maps to produce a
the Brain Map report
THE BRAINCORE BRAIN MAP REPORT
The BrainCore Brain
Map Report provides
the neurofeedback
protocols that will be
used during the
neurofeedback
training
HOW IS NEUROFEEDBACK DONE
Individuals are hooked up to a computer using
wires and sensors and the computer reads
their brainwaves
Information about these brainwaves is
displayed on the doctors monitor
The software automatically detects when the
brainwaves are properly ordered and it feeds
that information back to the patient
This feedback appears in the form of a game,
movie, or sound which signals the patient that
the brainwaves are becoming more ordered
Rollercoaster Video
DVD’s and Movies
THE BIG IDEA:
When you have
information on what
your brain waves are
doing, your brain can use
that information to
change how it works.
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Learning Is Permanent
• Once we learn
something it becomes
a permanent part of
our behavior.
• Follow up studies in
neurofeedback show
that the effects
continue for up to 30
years.
How Long Does it Take to Get Results?
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Trainees typically come for 20 sessions of training.
Trainees come twice a week or more.
Each session is 30-45 minutes long.
They typically begin to see changes in about 5 to 8 sessions
NEUROFEEDBACK IS
BASED IN OVER 40
YEARS OF CLINICAL
RESEARCH PROVING IT’S
EFFICACY
In fact, Dr Frank H. Duffy, a Professor and Pediatric
Neurologist at Harvard
Medical School, stated that
“Neurofeedback should play a major therapeutic role in
many difficult areas. In my opinion, if any medication had
demonstrated such a wide spectrum of efficacy it would be
universally accepted and widely used”
BRAINCORE THERAPY
QUESTIONS
A GIFT