ADHD Studies Target Underlying Conditions, Parent and Teacher Input

by Rick Nauert PhD on October 29th, 2012

ADHD Studies Target Underlying Conditions, Parent and Teacher Input Mayo Clinic researchers have presented two new studies on treating child and adolescent attention deficit hyperactivity disorder (ADHD).

The interventions focus on improving early care for children as well as improving the diagnosis of underlying disorders that may complicate traditional treatment regimens.

Key to the intervention philosophy is obtaining input from parents and teachers of children who are being diagnosed with ADHD allowing for more effective treatment upon the first consultation.

In a second study, researchers developed a tool that can help clinicians better diagnose and treat children who have both ADHD and oppositional defiance disorder.

In the first study, Mayo Clinic researchers required parents and teachers of children coming in for their first ADHD consultation to complete extensive background forms and analysis.

Children were referred by parents and teachers if they exhibited some combination of problems such as difficulty sustaining attention, hyperactivity and impulsive behavior.

By offering incentives and stressing the importance of being prepared for the first consultation, clinicians were able to boost parent and teacher compliance from 25 to 90 percent at the Mayo Clinic Child and Adolescent ADHD Clinic.

As a result, researchers have been able to better recommend treatment and therapy right off the bat.

“I’d compare treating a child with ADHD for the first time to consulting with someone who has type II diabetes — we need to measure a diabetic patient’s blood sugar level before we can properly treat them,” says study lead author Jyoti Bhagia, M.D., a Mayo Clinic psychiatrist.

“The same goes for ADHD. The more we know about children in the early stages of treatment, the more quickly we can get them the help they need.”

In the second study, Mayo Clinic researchers gave 75 patients with ADHD at the Mayo Clinic Child and Adolescent ADHD Clinic a written, subjective evaluation to test for oppositional defiance disorder, a persistent pattern of tantrums, arguing, and angry or disruptive behavior toward authority figures.

They found that the test was far better able to pick up whether the child had the disorder than an anecdotal physician diagnosis. Of the 75 patients in the study, 27 percent, or less than a third, were diagnosed with oppositional defiance disorder by their providers.

After taking the subjective test, 48 percent tested positive for oppositional defiant disorder. That shows the presence of oppositional defiance disorder with ADHD is under-diagnosed and children may not be receiving the behavioral treatment they need.

Children who have both ADHD and oppositional defiance disorder benefit from a combination of medication and behavioral therapy, said Bhagia.

Source: Mayo Clinic

Child at school photo by shutterstock.

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Parent and Physician Teams Can Lead to Best ADHD Care

by Rick Nauert PhD on October 24th, 2012

Parent and Physician Teams Result in Best ADHD CareResearchers from The Children’s Hospital of Philadelphia believe a new first-of-its kind tool will foster shared decision-making among physicians and patients and improve care for children with attention deficit hyperactivity disorder (ADHD).

Experts believe the new, three-part survey will improve communication and teamwork among families and physicians. Similar models of shared-decision making have been used to improve health care results in adults.

The results of the CHOP study are published in the journal Academic Pediatrics.

“Shared decision-making in health care means that doctors and families make decisions together. Doctors contribute their professional knowledge, and families weigh their values and personal experience,” said lead author Alexander Fiks, M.D., M.S.C.E.

“We chose to focus on ADHD for this study, because it is a relatively common diagnosis with two recommended treatment options — prescription medication and behavioral therapy — that require the family to make decisions about what will work best for them.

“Choosing a treatment that doesn’t ‘fit’ can lead to unsuccessful results. We wanted to see if we could create a tool to help guide families and physicians through this process.”

Appropriate treatment of ADHD is a pressing concern as studies suggest the number of physician outpatient visits in which ADHD was diagnosed in children under age 18 was 10.4 million. Psychostimulants such as Ritalin were prescribed in 87 percent of the visits.

The CHOP study involved 237 parents of children aged 6-12 who were diagnosed with ADHD within the past 18 months.

Using a combination of parent interviews, current research, and input from parent advocates and professional experts, researchers developed a standardized three-part questionnaire to help parents define and prioritize their goals for treatment; attitudes toward medication; and comfort with behavioral therapies.

The completed survey serves as a guide to support families and health care providers to reach the most effective and workable treatment for a child’s ADHD.

“It’s important to know whether a parent’s primary goal is to keep a child from getting in trouble at school, improve academic performance, or maintain more peace with family members or peers,” said Fiks.

“We also need to learn about the family’s lifestyle and attitudes toward behavioral therapy and medication. All of these factor into making the best treatment decision for each individual child and family.”

Historically, pediatric care providers make unilateral decisions with minimal input regarding families’ preferences and treatment goals for ADHD.

A new philosophy promulgated by The Institute of Medicine and the American Academy of Pediatrics recommends that healthcare providers use shared decision-making to help families select the best treatment option for ADHD.

A well-designed questionnaire may help both patient-families and providers to feel more satisfied with their child’s ADHD treatment. The researchers say this is a promising model for more widespread use to aid with treatment decisions for children with ADHD and, in the future, could be tailored for use with other medical conditions.

Until the approach is more widely adopted, Fiks and his colleagues recommend parents ask themselves a few questions to help get the most out of their office visit:

  • What do you and your child want to achieve as a result of ADHD treatment? (Better behavior or better grades at school? More self-control at home? Less teasing by other kids?)
  •  Consider your attitudes and your family’s attitudes about medication and behavioral therapy, and why they may or may not be right for you. Write down any questions you have about these treatment options to help remind you during your appointment.

“For the pediatrician’s part, it is our responsibility to fully inform parents about their options for treating ADHD and to seek guidance from families about which options will best meet their treatment goals and be manageable for their lifestyle,” said Fiks.

“Research shows that patients adhere much better to the treatment options that they are comfortable with and that are the most practical for them. We need to make sure we’re asking the right questions.”

Source: Children’s Hospital of Philadelphia

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Can Treating Moms with ADHD Help Their Kids?

by Traci Pedersen on October 18th, 2012

Can Treating Moms with ADHD Help Their Kids?Researchers at the University of Illinois at Chicago are conducting a study to see whether treating moms with attention deficit hyperactivity disorder — either with parent training or medication — will help their children who are at risk for the disorder.

The Treating Mothers First Study will identify mothers of children between ages 4 and 8 with behavior problems who are at risk for ADHD and evaluate both the child and mother. 

The goal is to determine if the need for stimulant medication for the child can be delayed if the mother is treated first.

“About 25 percent of the time, when a child has ADHD, there’s a parent that has ADHD,” said Mark Stein, Ph.D., UIC professor of pediatrics and psychiatry and principal investigator of the study.

“We realize this is a weakness in our service delivery models, because often clinicians focus on just treating the child and ignore the fact that another family member has ADHD.”

For children with ADHD, two treatments are effective: behavior modification and stimulant medication.

Both types of treatment require “a very dedicated, organized person, which, if you have ADHD, that’s going to be a challenge for you,” said Stein.  He noted that it is often the mother who administers treatment, and that women are less likely to have their ADHD identified.

For eight weeks, mothers diagnosed with ADHD will receive either a long-acting stimulant or behavioral training. Then, the mother, family and child will be re-evaluated and receive treatment for another eight weeks with either the same treatment or a combination of medication and parent training.

According to Stein, parents with ADHD may have trouble enforcing consistent rules and consequences, and they may not respond correctly to a child’s appropriate or positive behavior.

As part of the study “we observe the parent trying to play with the child, trying to get the child to do things like homework or cleaning up their room,” he said.

In women, ADHD is often misdiagnosed as depression or anxiety, and it often contributes to marital, parenting, sleep and medical problems, said Stein. Many health care providers have not been trained in diagnosing and treating adult ADHD.

“When a mom complains about how bad her life is, she’s given a prescription for Prozac versus understanding that she’s always had issues with inattention, distractibility, or impulsivity, and that’s why she’s having problems,” Stein said.

“When you think of ADHD, you think of a 7-year-old boy, not a mom who says ‘I am overwhelmed, easily distracted, and just can’t get things done,’” he said.

Source:  University of Illinois at Chicago


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Kids Get Their Say on ADHD Meds in New Study

by Rick Nauert PhD on October 18th, 2012

Kids Get Their Say on ADHD Meds in New StudyA new study from the U.K. reviews the management of attention deficit hyperactivity disorder (ADHD) by recounting child and family experiences.

The research initiative, termed ADHD VOICES (Voices on Identity, Childhood, Ethics and Stimulants), has involved 151 families in the U.K. and U.S. The study has focused on the ethical and societal issues surrounding treatment of ADHD.

According to the researchers, children living with ADHD tend to feel they benefit from medication to treat the condition and do not think the medication turns them into “robots.”

In fact, they report that medication helps them to control their behavior and make better decisions.

The study, which gives a voice to the children themselves, provides valuable insights into their experiences and the stigma they face.

Biomedical ethicist Dr. Ilina Singh and colleagues interviewed children and their families about ADHD, behavior, medication and identity across four contexts: home, school, the doctor’s office and peer groups. The written findings of their study are accompanied by a series of short films by award-winning animators The Brothers McLeod.

The report is intended not only to highlight ethical and social issues surrounding ADHD but also to help families, doctors, teachers and the children themselves to understand from a child’s perspective what it is like to live with ADHD.

“ADHD is a very emotive subject, which inspires passionate debate. Everyone seems to have an opinion about the condition, what causes it, and how to deal with children with ADHD, but the voices of these children are rarely listened to,” Singh said.

“Who better to tell us what ADHD is like and how medication affects them than the children themselves?”

According to Singh, in many cases and with a correct diagnosis, treatment using stimulants is appropriate and beneficial, particularly if it is complemented by other interventions. The evidence from the children she interviewed suggests that they think medication improves their ability to make their own moral choices.

Glenn (age 10), from the U.S., said: “If you’re driving in a car, and there’s two different ways, and you usually always go this way…and then one day you want to go the other way, but… the ADHD acts as a blocker, so you can’t.

“[The medicine] opens the blocker so that you can go [the right] way. But you still have the choice of going the wrong way… It’s harder [without medication], that’s what’s the truth. But it’s not like [on medication] you’re a robot.”

Researchers found that patient-centered care often took a back seat as children often did not understand their condition or why they were receiving medication. Many children in the study reported that they had little meaningful contact with their doctors.

Investigators discovered that after the initial evaluation, clinic visits tended to focus on side-effect checks, during which children were weighed and measured. Most children were not asked any questions during these visits.

Roger (age 13), from the U.K., said: “I’ve only just started going to the ADHD clinic, but I haven’t actually been to it properly. I’ve seen the doctor and he’s talked about [ADHD] and I get weighed. But… they’ll just say parts of what it is but then they’ll stop, so they will only say some of it and then change the subject.”

Singh argues that children need to be better informed and able to discuss their condition.

“Given the ethical concerns that arise from ADHD diagnosis and stimulant drug treatment, it is imperative that children are able to openly discuss the value of diagnosis and different treatments with a trusted professional.”

The report concludes with a series of recommendations for how parents, doctors and teachers can help children cope with and better understand the condition, and begin to tackle the stigma that currently exists around it.

Peter Hill, M.D., a child and adolescent psychiatrist, said: “We hope that the VOICES Study and the ‘ADHD and Me’ animations will inspire people to think differently about ADHD, drug treatments and children with behavioral difficulties.

“Behaving differently around these children is the main challenge. We hope that the strategies we have outlined will help improve the interactions with these children and help improve their lives.”

Experts are glad that children are finally being included in the debate on how best to care for the condition. Clare Matterson, Director of Medical Humanities and Engagement at the Wellcome Trust, comments: “It is refreshing to hear the voices of children included in the debate about ADHD.

“This report sends a clear message to doctors, teachers and parents about the importance of talking to children about their condition — and more importantly, listening to what they have to say.”

Source: Wellcome Trust

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Exercise Boosts School Performance for Kids With ADHD

by Janice Wood on October 17th, 2012

Exercise Boosts School Performance for Kids With ADHD  A few minutes of exercise can help children with attention deficit hyperactivity disorder (ADHD) perform better academically, according to a new study.

Led by a researcher at Michigan State University, the study shows that a single bout of exercise can help kids with ADHD drown out distractions and focus on a task.

“This provides some very early evidence that exercise might be a tool in our non-pharmaceutical treatment of ADHD,” said Matthew Pontifex, Ph.D., MSU assistant professor of kinesiology, who led the study, which was published in the Journal of Pediatrics.

“Maybe our first course of action that we would recommend to developmental psychologists would be to increase children’s physical activity.”

For the study, Pontifex and his colleagues asked 40 children aged 8 to 10, half of whom had ADHD, to spend 20 minutes either walking briskly on a treadmill or reading while seated.

The children then took a brief reading comprehension and math exam similar to longer standardized tests. They also played a computer game in which they had to ignore visual stimuli to determine which direction a cartoon fish was swimming.

The results showed all of the children performed better on both tests after exercising. In the computer game, those with ADHD also were better able to slow down after making an error to avoid repeat mistakes, a particular challenge for those with the disorder, according to the researcher.

Pontifex said the findings support calls for more physical activity during the school day. Other researchers have found that children with ADHD are less likely to be physically active or play organized sports.

Meanwhile, many schools have cut recess and physical education programs in response to shrinking budgets.

“To date there really isn’t a whole lot of evidence that schools can pull from to justify why these physical education programs should be in existence,” he said. “So what we’re trying to do is target our research to provide that type of evidence.”

Pontifex conducted the study for his doctoral dissertation at the University of Illinois before joining the MSU faculty.

Source: Michigan State University

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FDA OKs Extended Release Liquid ADHD Medication, Quillivant

by Rick Nauert PhD on October 3rd, 2012

FDA OKs Extended Release Liquid ADHD Medication, QuillivantAttention deficit hyperactivity disorders (ADHD) is now a common diagnosis with the U.S. Center for Disease Control and Prevention estimating that almost one in ten (9.5 percent) children aged 4-17, has at some time, received a diagnosis of ADHD.

Common treatment strategies for ADHD include cognitive-behavioral therapy and pharmaceuticals. The Food and Drug Administration has now approved Quillivant XR (methylphenidate hydrochloride), the first once-daily, extended-release liquid methylphenidate available for patients with ADHD.

The new medication is a welcome addition to traditional medication regimens as authorities say that in 2011, there were more than 52 million prescriptions filled for ADHD medications, representing a 10 percent increase over 2010.

“The approval of Quillivant XR fills a void that has long existed in the treatment of ADHD,” said Ann Childress, M.D., president of the Center for Psychiatry and Behavioral Medicine, Las Vegas, who was an investigator in the Quillivant XR laboratory classroom study.

“We routinely see the struggles of patients who have difficulty swallowing pills or capsules. Having the option of a once-daily liquid will help alleviate some of these issues while still providing the proven efficacy of methylphenidate for 12 hours after dosing.”

Researchers determined the efficacy of Quillivant XR by performing a randomized, double-blind, placebo-controlled study of 45 children with ADHD.

For the study children received an initial 20mg dose of Quillivant XR once daily in the morning. The dosage was then titrated weekly until an optimal dose or maximum dose of 60mg per day was reached.

After this, a two-week double-blind study was performed on the study using a crossover design (meaning that kids would alternate between receiving the medication or a placebo.

At the end of each week, trained observers evaluated the attention and behavior of the patients in a laboratory classroom using an established behavioral rating scale.

Quillivant XR significantly improved ADHD symptoms compared to placebo at the primary endpoint of four hours post-dose, and in a secondary analysis, showed significant improvement at every time point measured, from 45 minutes to 12 hours after dosing.

“We are pleased with the FDA’s approval of Quillivant XR and believe it will address an important need for many patients with ADHD and their caregivers,” said Jay Shepard, President and CEO of NextWave Pharmaceuticals.

“We are eager to enter into the ADHD market and believe the unique liquid formulation of Quillivant XR—which was developed in conjunction with NextWave’s technology and manufacturing partner Tris Pharma—will provide another treatment option for patients with ADHD.”

Quillivant XR is expected to become available in pharmacies in January 2013. Quillivant XR was developed using Tris Pharma’s patent protected drug delivery platform.

Source: New Wave Pharmaceuticals

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Eye Movements Can Help Diagnose ADHD, Parkinson’s

by Janice Wood on September 8th, 2012

Eye Movements Can Help Diagnose ADHD, Parkinson's Studying how people move their eyes while watching television could help identify those who have attention deficit hyperactivity disorder (ADHD), fetal alcohol spectrum disorder (FASD), and Parkinson’s disease, according to a new study.

Researchers at the University of Southern California suggest that each of those conditions involve “ocular control and attention dysfunctions.”

Such dysfunctions can be easily — and cheaply — identified through an evaluation of how patients move their eyes while they watch television.

Typical methods of detection for these disorders, including clinical evaluation, structured behavioral tasks and neuroimaging, are expensive, labor-intensive and limited by a patient’s ability to understand and comply with instructions, the researchers said.

To solve this problem, doctoral student Po-He Tseng and Dr. Laurent Itti of the Department of Computer Science at the USC Viterbi School of Engineering, along with collaborators at Queen’s University in Canada, devised the new screening method.

Study participants were instructed to “watch and enjoy” television clips for 20 minutes while their eye movements were recorded. Eye-tracking data was then combined with a computational model of visual attention to extract 224 quantitative features, allowing the team to use new machine-learning techniques to identify features that differentiated patients from control subjects.

With eye movement data from 108 subjects, the researchers said they were able to identify older adults with Parkinson’s disease with nearly 90 percent accuracy, and children with either ADHD or FASD with 77 percent accuracy.

“For the first time, we can actually decode a person’s neurological state from their everyday behavior, without having to subject them to difficult or time-consuming tests,” Itti said.

Source: University of Southern California


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Girls with ADHD More Prone to Self-Harm, Suicide in Later Years

by Traci Pedersen on August 16th, 2012

Girls with ADHD More Prone to Self-Harm, Suicide in Later YearsAs girls with ADHD become adults, they are especially prone toward internalizing their problems and feelings of inadequacy — that in turn can lead to self-injury and even attempted suicide, according to new findings from the University of California, Berkeley.

In the US, over 5 million children (about one in 11) ages 3-17 have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. The disorder is characterized by distractibility, poor concentration, impulsiveness and hyperactivity.

The research was based on the  largest-ever sample of girls whose ADHD was first diagnosed in childhood.

“Like boys with ADHD, girls continue to have problems with academic achievement and relationships, and need special services as they enter early adulthood,” said lead study author Stephen Hinshaw, UC Berkeley professor of psychology.

“Our findings of extremely high rates of cutting and other forms of self-injury, along with suicide attempts, show us that the long-term consequences of ADHD females are profound,” he added.

The findings are consistent with previous research by the UC Berkeley team showing that, as girls with ADHD get older, they exhibit fewer visible symptoms of the disorder, but continue to suffer in less visible ways.

The study challenges the idea that girls can “outgrow” ADHD, and highlights the need for long-term monitoring and treatment of the disorder, said Hinshaw.

Beginning in 1997, Hinshaw and his colleagues followed a racially and socio-economically diverse group of girls (ages 6-12) with ADHD in the San Francisco Bay Area through early childhood summer camps, adolescence and now early adulthood.

Ten years later, 140 of the girls were given an evaluation, ages 17-24, in which researchers compared their behavioral, emotional and academic development to that of a demographically similar group of 88 girls without ADHD.

The study also measured the symptoms of two major ADHD subtypes: those who entered the study with poor attention alone versus those who had a combination of inattention plus high rates of hyperactivity and impulsivity.

Most importantly, researchers found that the girls with combined inattention and hyperactivity-impulsivity during childhood were significantly more likely to attempt self-injury and suicide in early adulthood.

Furthermore, over half of the members of this group were reported to have engaged in self-injurious behavior, and more than one-fifth had attempted suicide, Hinshaw said.

“A key question is why, by young adulthood, young women with ADHD would show a markedly high risk for self-harm. Impulse control problems appear to be a central factor,” said the authors.

In the first study on this group, published in 2002, the 6- to- 12-year old girls attended five-week camps where they were closely watched as they engaged in art and drama classes and outdoor activities.

Girls who had been taking ADHD medication volunteered to go off the drug treatment for much of the summer camp study. The counselors and staff observing all the participants were not informed as to which girls had been diagnosed with ADHD.

According to the findings, girls with ADHD were more likely to struggle academically and to be rejected by the other kids, compared to the comparison peer group.

When these girls were 12 to 17 and experiencing early to mid-adolescence, the fidgety and impulsive symptoms seemed to drop. But the learning gap between these girls and their non-ADHD peers had widened, and eating disorders and substance abuse had also come into play.

For the latest study, in which 95 percent of the original sample of girls participated, the researchers interviewed the participants and their families about behaviors such as self-harm and suicide attempts, drug use, eating habits and driving behavior.

“The overarching conclusion is that ADHD in girls portends continuing problems, through early adulthood,” said the authors.

“Our findings argue for the clinical impact of ADHD in female samples, the public health importance of this condition on girls and women, and the need for ongoing examination of underlying mechanisms, especially regarding the high risk of self-harm in young adulthood.”

Hinshaw also added, “ADHD is a treatable condition, as long as interventions are monitored carefully and pursued over a number of years.”

The study is published in the Journal of Consulting and Clinical Psychology.

Source:  University of California, Berkeley


Depressed and anxious young woman photo by shutterstock.

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Colleges Gear Up to Help Students with ADHD

by Rick Nauert PhD on August 3rd, 2012

Colleges Gear Up to Help Students with ADHDSummer is winding down and colleges are ramping up for a new influx of recent high school graduates.

Given the steady increase in students diagnosed with attention-deficit hyperactivity disorder (ADHD), some colleges are proactively developing programs to help the student make a successful transition to college.

Attention-deficit hyperactivity disorder, or ADHD, affects 1 to 4 percent of college students, according to national studies. For freshmen with ADHD, the transition to college can be especially difficult.

Many previous studies have shown ADHD among college students can be a serious disorder that is an everyday struggle.

Kristy Morgan, a recent Kansas State University doctoral graduate in student affairs and higher education, studied how students with ADHD make the transition from high school to college.

“Nobody had really studied the transition from high school to college,” Morgan said.

“Transitions can be the toughest time for people. This can be especially true when the transition is from the home environment where parents have been involved in daily plans, schedules and medication.”

“Kristy’s research is an important contribution to understanding and facilitating the transition to college for students with ADHD,” said Kenneth Hughey.

“The results and the recommendations that followed are intended to help students with ADHD make a successful transition, their parents as they support their children in the transition, and student affairs professionals who work with the students once they are on campus.”

In her small exploratory study, Morgan interviewed eight freshmen — four men and four women — to talk about their transition during their first semester of college. The freshmen were all living on campus and were at least an hour away from home.

Morgan found a common thread among these students with attention deficit disorder was a failure to adequately plan their college transition.

The students did not factor ADHD into their decision-making about college, but rather chose a college based on how the campus felt, the reputation of the school or that it was where they had always wanted to attend.

“Most of the students found college to be tougher than they had expected,” Morgan said. “Even with the availability of resources, they still felt overwhelmed with accessing these resources.”

Morgan found that preplanning was a significant factor for success. Students who had established an ADHD management strategies — such as ways to keep a schedule or study for tests were able to adjust to the new college life — while students who did not have strategies in place before they went to college, felt overwhelmed.

“A big struggle for students was adjusting to increased freedom and increased responsibility,” Morgan said.

“They anticipated loving the freedom of college and being away from their parents. But they also realized that college required responsibility and that responsibility was overwhelming to them.”

Morgan was amazed to find that parents were very involved in the transition from home to college. She discovered that some parents were instrumental for students’ college activities — they served as alarm clocks, organized their rooms and continued to manage medical care.

“The parents filled prescriptions and contacted doctors even while the student was at college, which was surprising to me,” Morgan said. “The students really did not handle it independently.”

Morgan discovered the reliance on parents became a negative as students often lacked basic knowledge of ADHD and how their medication worked. However, students did understand that medication was crucial to their success in college because they needed it to help focus during lectures and studying time.

“There were some students who took medication sporadically prior to college,” Morgan said. “They realized that to be successful in college, their medication moved from optional to mandatory.”

Morgan discovered that side effects influenced how often students took medication. For example, some students would not take medication because they felt it made them not as fun in social situations.

The women in the study were more likely to consistently take medication because it helped suppress their appetites and manage weight. The men were more likely to skip their medication to have a good time.

Helping Students with ADHD

The findings suggest that a combined effort between families, students and the university staff is needed to help students with ADHD adjust and succeed in college.

Morgan has developed the following recommendations for universities and families to support college students who have ADHD:

  • Families should inform students about their diagnoses. All too often, families have not educated students with ADHD because they think it might be just a childhood condition that they will outgrow.
  • Universities can streamline processes and make it easier for students to access resources. Students with ADHD are not likely to wait in long lines or fill out a lot of paperwork for resources.
  • Academic advisers can help students carefully structure their schedules for success. Many students with ADHD benefit when classes are scheduled close to each other, rather than spread out during an entire day. Advisers can also help students schedule classes with engaging professors and in rooms that have few distractions, such as windows or high-traffic hallways.

Source: Kansas State University

Young college student with books photo by shutterstock.

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Delay in Brain Development Associated with ADHD

by Rick Nauert PhD on July 31st, 2012

Delay in Brain Development Associated with ADHDA new NIH study suggests a delay in brain development, rather than a total alteration in normal development, is the instigating factor for attention-deficit/hyperactivity disorder (ADHD).

In the current investigation, researchers expanded an earlier study that found thickening of the brain’s cerebral cortex is delayed in children diagnosed with ADHD.

The cerebral cortex is the folded gray tissue that makes up the outermost portion of the brain, covering the brain’s inner structures. This tissue has left and right hemispheres and is divided into lobes.

Each lobe performs specific and vitally important functions, including attention, cognition, language, and sensory processing.

Two dimensions of this structure are cortical thickness and cortical surface area, both of which mature during childhood as part of the normal developmental process.

In the study, published in Biological Psychiatry, researchers set out to measure whether surface area development is delayed in a similar manner to the thickening process. To do this they recruited 234 children with ADHD and 231 typically developing children.

Each child was scanned with neuroimaging equipment up to four times. The first scan was taken at about age 10, and the final scan was around age 17.

Using advanced neuroimaging technology, researchers were able to map the trajectories of surface area development at over 80,000 points across the brain. They found that the development of the cortical surface is delayed in frontal brain regions in children with ADHD.

For example, the typically developing children attained 50 percent peak area in the right prefrontal cortex at a mean age of 12.7 years, whereas the ADHD children didn’t reach this peak until 14.6 years of age.

“As other components of cortical development are also delayed, this suggests there is a global delay in ADHD in brain regions important for the control of action and attention,” said Dr. Philip Shaw, a clinician studying ADHD at the National Institute of Mental Health and first author of this study.

“These data highlight the importance of longitudinal approaches to brain structure,” commented Dr. John Krystal, Editor of Biological Psychiatry. “Seeing a lag in brain development, we now need to try to understand the causes of this developmental delay in ADHD.”

Investigators believe the finding suggests genes that control the timing of brain development are linked to development of ADHD.

As such, Shaw believes researchers should “search for genes that control the timing of brain development in the disorder, opening up new targets for treatment.”

Source: Elsevier

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