12 Tips to Navigate Summertime When Your Child Has ADHD

By MARGARITA TARTAKOVSKY, MS

Parenting a child with ADHD can be especially tough during the summer. “Kids with ADHD blossom when they have a structured schedule, and summertime is notorious for having a lack of scheduling,” according to Stephanie Sarkis, PhD, a psychotherapist and author of Making the Grade with ADD: A Student’s Guide to Succeeding in College with Attention Deficit Disorder.

Psychotherapist and ADHD expert Terry Matlen, ACSW, agreed. Because most parents can’t mimic the tight structure of school, kids often get bored — and may get into trouble, she said. That’s because when kids with ADHD get bored, they seek out stimuli, which can be anything from picking fights with their families to playing with fire, she said.

Some parents discontinue their child’s medication during the summer, which poses another challenge, said Matlen, also author of Survival Tips for Women with ADHD. “That can create a situation where the child has a hard time with self-control, mood regulation [and] social behaviors.”

But while the summer can be challenging, you can absolutely overcome these obstacles and enjoy a fun break. Below, Sarkis and Matlen offer their excellent suggestions.

1. Create Structure

Again, structure keeps your child focused. You can create structure by engaging your child in activities at the same time each day or meeting on the same day each week.

Because ADHD runs in families, one of you may have ADHD as well, making it harder to establish structure. Enlist the help of your non-ADHD spouse to assist with planning out the day.

2. Incorporate Physical Activities

Physical activities are especially helpful for kids who are impulsive and hyperactive. It helps them direct their energies in acceptable, healthy ways. If your child is clumsy, try non-competitive activities such as swimming, running and biking. (Some kids with ADHD have fine and gross motor skills that may not be on par with others their age.)

3. Start a Rotating Playgroup

Sarkis suggested that parents set up a weekly playgroup with other parents around their neighborhood. You can meet once a week at a different home for a few hours. This is an inexpensive way of providing structure to a child, and it also giving parents time off in the process.

4. Consider Camps

According to Matlen, young kids do great in day camps that offer outdoor, structured activities, while overnight camps with physical outlets are ideal for older kids. If your child has a specific interest, such as art, horses or computers, specialized camps are another excellent option, she said.

Both Sarkis and Matlen also suggested camps for kids with ADHD. To find a camp, contact your local CHADD group or post on an ADHD forum, Sarkis said. “Look in your local paper, and ask your pediatrician, teacher, or school counselor,” she added.

(Also, this article has several helpful suggestions on finding a good camp.)

5. Try Local Facilities

If camp isn’t feasible, try a local swim club or the Y, Matlen said. These facilities offer an array of fun activities at an affordable cost.

6. Get Creative

Parents can also set up a badminton set in the backyard, purchase a trampoline [or] set up an obstacle course with tunnels and objects to hop over.

7. Engage Them in Nature

For instance, show your kids how to garden. Kids can get dirty while learning about nature. Also, setting up bird feeders and tending to the food gives kids the opportunity to learn how to care for living creatures.

8. Visit the Library

Kids with the inattentive type of ADHD often prefer quiet and calm activities. During the summer, many libraries offer either free or low-cost programs for kids.

9. Check out the Arts

Kids who prefer quieter activities also might enjoy attending concerts, plays and art classes.

10. Encourage Older Kids to Work

If your kids are older, talk to them about the many ways they can earn money, such as dog walking, pet sitting or even having a lemonade stand. This improves math skills and promotes a healthy independence and solid self-esteem.

11. Let Your Child Have a Say

Ask your child what they’d like to do this summer, including the new skills they’d like to learn, such as playing the guitar, camping or cooking. Once he sees that he has input and that his opinion is valued, the parent has a much better chance at getting him to try new things.

If your child already has a certain skill, ask if they’d be willing to teach that skill to a younger child. According to Matlen, this can “do wonders for his self-esteem, which for many kids, can get pretty battered during the school year.”

12. Consult your Doctor about Medication

Some parents take their kids off medication during the summer since there’s no schoolwork. However, it’s important to thoroughly discuss this decision with your child’s doctor, Matlen said. She’s seen kids significantly struggle without their medication. For instance, because of their hyperactivity and impulsivity, they may lose friends, she said. And their behaviors might cause tremendous stress on the family.

In addition to creating structure and engaging your child in a variety of enjoyable activities, don’t forget to find some alone time for yourself, Sarkis added.

Source: http://psychcentral.com/blog/archives/2012/05/14/12-tips-to-navigate-summertime-when-your-child-has-adhd/H

 

Helping Children Thrive with LD/ADHD

By Marilyn Price-Mitchell, PhD

According to the U.S. Department of Education, almost 1 million children have some form of learning disability for which they receive special education. Parents report that over 5.4 million children have been diagnosed with ADHD, a figure that the Centers for Disease Control and Prevention (CDC) claims are continuing to increase annually. Millions more have varying diagnoses that affect learning and life success, including autism spectrum disorders.

For those of us who have parented children with learning disabilities, ADHD, and associated mental health issues, these figures not only represent challenges for our educational and health systems, they are deeply personal matters that affect the core of our families and our children’s happiness.

Beyond the logistics of educational assessments, tutoring, and daily homework challenges lies the responsibility of all adults—parents, teachers, and counselors—to foster a positive mindset that helps kids overcome the many obstacles they face.

Like millions of other students, my daughter’s story is unique. Among her many hurdles was learning to compensate for a reading speed in the lowest one percentile, a challenge that continues today as a 29-year-old.

But with acceptance and encouragement, children and young adults are surprisingly resilient and learn to embrace their differences. Recently, my daughter wrote about five ideas that fueled her success from middle school through law school as a student with learning disabilities and attention deficit disorder. She presented these ideas as part of an article, To Parents & Educators: From an Attorney with LD/ADHD and gave me permission to reprint them here.

Needless to say, I am very proud of how my daughter developed a path to accomplish goals she set for herself. But more importantly, what she outlines below as critical steps in her journey to understand and embrace her differences supports much of the research on positive youth development. All children must learn to overcome obstacles in order to believe in themselves!

In her own words, here are the five steps that were critical to my daughter’s success, ideas she now tries to instill in other young people.

Understand your Disabilities

Every student has strengths and weaknesses. But kids with diagnosed disabilities need to understand their academic and emotional assets and liabilities really well. By middle school, educational testing can help students look inside themselves and understand how their disabilities impact their studies and social lives. Knowing what they need from teachers, tutors, counselors, peers, and parents is a foundation for future growth.

Ask for Help 

It’s okay to be different; embrace it. I can’t emphasize this enough. I have friends who were told to hide their disabilities from teachers. As a result, they felt unhappy and defeated. It wasn’t until they got tested, shared their disabilities, and requested accommodations that they were able to finally get into a college and get the degree they wanted. The earlier students learn to work with their disability and understand it as part of their identities the better. Embracing our disabilities give us the confidence to talk with teachers, administrators, and trusted friends about what we like, what we are good at, and what we need help with. We often can’t, and don’t have to do it alone.

Never Use your Disability as an Excuse

It can be easy to say to a teacher, “I need an extension on this paper because I am slow at writing.” While this may be okay early on in school, it doesn’t work in college or the real world. So why get used to it? Rather than using a disability as an excuse, students must find ways to compensate. Figure out how to work efficiently and effectively, rather than longer and harder. Most kids with learning disabilities need help developing efficient work habits. Ask for help!

Use Compensatory Strategies

Working longer hours is necessary at times. But it can also lead to burnout. There are lots of compensatory strategies for learning, and many books on the topic. You’ve likely heard of many, including, making lists, getting organized, using memory tricks, etc. The key is finding the strategies that work and altering others to make them your own.

For example, I’m a very slow reader and got frustrated when I couldn’t finish reading assignments. But I’m a good listener and I understand high-level concepts. My strategy was to listen in class, research the topic, and then boil down the minimum reading necessary. Finding strategies that worked for me helped me set limits on my school work, gave me time to socialize, and helped me have time for myself.

Taking time away from stressful school work is essential for students with learning disabilities and contributes to better mental health. It also allows students to focus on bigger dreams, careers that might take 4-8 years of secondary education!

Know you can Achieve your Goals

Setting goals is important for all of us. And most importantly, we have to develop the determination to achieve them! I encourage students with LD/ADHD to find adults who give them positive messages of encouragement, who listen to them when they express self-doubt. With the right support and strategies, we can do anything we set our minds to!

Having learning disabilities and/or ADHD is not easy. And it doesn’t end when we finish school. With every change, come new challenges and strategy adjustments. I always remember what the famous educator, Booker T. Washington said more than 100 years ago, “I have learned that success is to be measured not so much by the position that one has reached in life as by the obstacles overcome while trying to succeed.” Challenges are what make life exciting—they are what define who we are and who we become. Embrace the challenges!

Source: http://www.psychologytoday.com/blog/the-moment-youth/201204/helping-children-thrive-ldadhd

Related Online Continuing Education Courses:

• Understanding, Diagnosing, & Treating ADHD Through the Lifespan
• Attention Deficit Hyperactivity Disorder – Overview
• Diagnosing ADHD in Adults
• The Impact of a Life of ADHD: Understanding for Clinicians and Clients

 

Starting School Early May Affect ADHD Diagnosis

By Todd Neale, Senior Staff Writer, MedPage Today

Schoolchildren who are young for their grade may have a greater risk than their older classmates of being diagnosed with and treated for attention-deficit hyperactivity disorder (ADHD), researchers found.

Boys and girls born in the month before the age cutoff for entry into kindergarten were 30% more likely to be diagnosed with ADHD and 41% more likely to receive a prescription for an ADHD medication than those born in the month after the cutoff, according to Richard Morrow, MA, of the University of British Columbia in Victoria, and colleagues.

And those born in the month before the age cutoff for entry into first grade were 70% more likely to get an ADHD diagnosis and 77% more likely to be prescribed ADHD medication, the researchers reported online in CMAJ.

Although the appropriateness of diagnosis and treatment could not be evaluated, the findings raise concerns about possible overdiagnosis and overprescribing in children who are younger — and presumably less mature — for their grade, they wrote.

“Children who are given medications to treat ADHD are exposed to adverse effects on sleep, appetite, and growth,” Morrow and colleagues wrote. They also noted an increased risk of cardiovascular events, although that link was disputed in studies published last year in Pediatrics and the New England Journal of Medicine.

“Inappropriate diagnosis of ADHD in a child born late in the year might lead parents and teachers to treat the child differently or adversely change the child’s self-perceptions,” they explained. “Our analyses add weight to concerns about the medicalization of the normal range of childhood behaviors, particularly for boys.”

Previous U.S. studies have yielded similar findings, but the issue had not been explored in Canada, which has lower reported rates of ADHD diagnosis and treatment and differences in healthcare delivery, cultural attitudes, and marketing by pharmaceutical companies.

Morrow and colleagues tackled the issue using administrative health databases from British Columbia, where the annual cutoff birth date for entering kindergarten or first grade is Dec. 31. So children born in December are typically the youngest and those born in January are typically the oldest in each grade.

The study included 937,943 schoolchildren who were 6 to 12 years old at any time from Dec. 1, 1997 through Nov. 30, 2008, and were covered by the provincial health plan.

The average age for children born in December and those born in January was similar (7.8 years).

For all years combined, the percentage of children who received an ADHD diagnosis increased from January to September birth dates and then leveled off. The proportion rose from 5.7% for those born in January to 7.4% for those born in December for boys and from 1.6% to 2.7% for girls.

Similar trends were seen for ADHD medication prescriptions.

Being born in December versus January was associated with a greater risk of receiving an ADHD diagnosis for both boys (RR 1.30) and girls (RR 1.70), as well as a greater risk of being treated for the condition (RRs 1.41 and 1.77 for boys and girls, respectively).

The relationships remained relatively stable over the study period and were present for all ages included in the study. The magnitude of the associations diminished for older girls, however.

“The potential harms of overdiagnosis and overprescribing and the lack of an objective test for ADHD strongly suggest caution be taken in assessing children for this disorder and providing treatment,” Morrow and colleagues wrote.

“Greater emphasis on a child’s behavior outside of school may be warranted when assessing children for ADHD to lessen the risk of inappropriate diagnosis,” they continued. “Further research into the determinants of ADHD and approaches to its assessment and treatment should consider a child’s age within a grade.”

Source: http://www.medpagetoday.com/Pediatrics/ADHD-ADD/31489

Related Articles:

• The ADHD Prognosis Is Promising (everydayhealth.com)
• Is ADHD an American Fad? (everydayhealth.com)
• ADHD Symptoms In Toddlers (answers.com)

 

Brain Food: Fending Off Mental Illness With Diet

Written by Bret S. Stetka, MD, Editorial Director, Medscape From WebMD

Which Foods Are Best for the Brain?

Diet is inextricably linked to conditions such as heart disease, obesity, and diabetes. However, what we consume also seems to have significant implications for the brain: Unhealthy diets may increase risk for psychiatric and neurologic conditions, such as depression and dementia, whereas healthy diets may be protective. Based primarily on recent Medscape News coverage, the following collects some of the more prominent investigations on nutrition and the brain into a single resource to aid in counseling your patients.

Make for Malta in Depression, Stroke, and Dementia

A 2009 study published in Archives of General Psychiatry found that people who follow Mediterranean dietary patterns — that is, a diet high in fruits, vegetables, nuts, whole grains, fish, and unsaturated fat (common in olive and other plant oils) — are up to 30% less likely to develop depression than those who typically consume meatier, dairy-heavy fare. The olive oil-inclined also show a lower risk for ischemic stroke and are less likely to develop mild cognitive impairment and Alzheimer disease, particularly when they engage in higher levels of physical activity.

Fat: The Good and the Bad

A study conducted in Spain reported that consumption of both polyunsaturated fatty acids (found in nuts, seeds, fish, and leafy green vegetables) and monounsaturated fatty acids (found in olive oil, avocados, and nuts) decreases the risk for depression over time. However, there were clear dose-response relationships between dietary intake of trans fats and depression risk, whereas other data support an association between trans fats and ischemic stroke risk. Trans fats are found extensively in processed foods, including many commercial chocolates. A deficiency in polyunsaturated fatty acids has been linked to attention deficit/hyperactivity disorder in children.

Fish Oil to Fend Off Psychosis?

Thanks to their high levels of polyunsaturated fatty acids, namely omega-3 fatty acids, fish can help fend off numerous diseases of the brain. A 2010 study correlated fish consumption with a lower risk for psychotic symptoms, and concurrent work suggested that fish oil may help prevent psychosis in high-risk individuals. Although data are conflicting, new research shows that the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are beneficial in depression and postpartum depression, respectively, and other research suggests that omega-3 deficiency may be a risk factor for suicide. Oily, cold-water fish, such as salmon, herring, and mackerel, have the highest omega-3 levels.

Berries for Oxidative Stress

Polyphenols, namely anthocyanins, found in berries and other darkly pigmented fruits and vegetables may slow cognitive decline through antioxidant and anti-inflammatory properties. A study in rats from 2010 showed that a diet high in strawberry, blueberry, or blackberry extract leads to a “reversal of age-related deficits in nerve function and behavior involving learning and memory.” In vitro work by the same group found that strawberry, blueberry, and acai berry extracts — albeit in very high concentrations — can induce autophagy, a means by which cells clear debris, such as proteins linked to mental decline and memory loss. Berry anthocyanins may also reduce cardiovascular disease risk by reducing oxidative stress and attenuating inflammatory gene expression.

A “Whole” Diet: Make Room for Red Meat?

A so-called “whole” diet high in fruits, vegetables, whole grains, and high-quality meats and fish results in a 30% risk reduction for depression and anxiety disorders, compared with consumption of a “Western diet” high in processed foods and saturated fats, according to a 2010 study. Even unprocessed red meat seems to be protective against depressive and anxiety disorders, in contrast to many studies in which red meat often falls into the category of “unhealthy” food. In speaking with Medscape News, principal investigator Dr. Felice Jacka specifically addressed the importance of farming practices: Despite the growing locavore movement, much of the livestock in the United States is still raised on industrial feedlots, which “…increases saturated fat and decreases very important good fatty acids…pasture-raised animals have a much healthier fatty acid profile.” A “whole” dietary pattern may also reduce depression risk, as assessed at 5-year follow-up.

Alcohol: Always in Moderation

The Greeks touted “nothing in excess,” a refrain that still rings true: Low to moderate* alcohol consumption has been associated with numerous potential physiologic benefits, including improved cholesterol profiles, beneficial effects on platelet and clotting function, and improved insulin sensitivity. According to a recent meta-analysis, limited alcohol use is associated with a lower risk for overall and Alzheimer dementia, a finding supported by a 2011 study of German primary care patients. Moderate alcohol intake may also protect against cerebrovascular disease, with wine potentially having added benefit because of its polyphenolic antioxidant components (ie, resveratrol). However, the health costs of alcohol consumption beyond low to moderate intake can quickly outweigh benefits to the brain, as heavy and long-term alcohol use can lead to alcohol abuse and dependence, impair memory function, contribute to neurodegenerative disease, and hinder psychosocial functioning.

*The US Food and Drug Administration defines “moderate alcohol consumption” as up to 1 drink per day for women and up to 2 drinks per day for men. One drink is equivalent to 12 fluid ounces of regular beer, 5 fluid ounces of 12% alcohol wine, or 1.5 fluid ounces of distilled spirits.

Brewed Awakening: Coffee for Depression and Stroke

The world’s most widely used stimulant might do more than just wake us up: A 2011 meta-analysis found that consumption of 1-6 cups of coffee a day cut stroke risk by 17%. Although it may increase blood pressure, coffee beans contain antioxidant compounds that may reduce oxidation of low-density lipoprotein cholesterol, and coffee consumption has also been associated with increased insulin sensitivity and reduced concentrations of inflammatory markers. Another 2011 study reported that women who drink 2-3 cups of coffee per day have a 15% decreased risk for depression, compared with those who drink less than 1 cup per week. A 20% decreased risk was seen in those who drank 4 cups or more. The short-term effect of coffee on mood may be due to altered serotonin and dopamine activity, whereas the mechanisms behind its potential long-term effects on mood may relate to its antioxidant and anti-inflammatory properties, both factors that are thought to play a role in depressive illnesses.

Chocolate — and Still More Antioxidants

Chocolate — the darker the better — seems to help scavenge free radicals and improve endothelial and platelet function, likely via flavanols (such as catechin), a group of plant-derived polyphenols. A 2010 cohort study published in European Heart Journal found that consumption of 6 g of chocolate daily — a standard Hershey bar weighs 43 g — was associated with a 39% lower combined risk for myocardial infarction and stroke in adults,^[34] whereas data collected from the Swedish Mammography Cohort demonstrated a 20% decreased risk for stroke in women who regularly consume chocolate. Although chocolate has been associated with a positive influence on mood, possibly mediated by the dopamine and opioid systems, an extensive review by Parker and colleagues suggests that the benefits are not sustained, with emotional “comfort” eating actually contributing to depressed mood.

What Not to Eat?

Saturated fats and refined carbohydrates have highly detrimental effects on the immune system, oxidative stress, and neurotrophins, all factors that are known to play a role in depression. The study by Akbaraly and colleagues cited previously showed that a diet rich in high-fat dairy foods and fried, refined, and sugary foods significantly increases risk for depression. Similar findings were seen in another study from Spain, showing that intake of such foods as pizza and hamburgers increased the risk for depression over time, and in another study, women with a diet higher in processed foods were more likely to have clinical major depression or dysthymia. Research published last year also showed for the first time that quality of adolescents’ diets was linked to mental health: Healthier diets were associated with reduced mental health symptoms and unhealthy diets with increased mental health symptoms over time. Excess salt intake has been long known to increase blood pressure and stroke risk; however, recent data also correlate high salt intake, as well as diets high in trans or saturated fats, with impaired cognition.

Source: http://www.medscape.com/features/slideshow/brain-food?src=mp&spon=17

 

Ritalin Gone Wrong

By L. Alan Sroufe

THREE million children in this country take drugs for problems in focusing. Toward the end of last year, many of their parents were deeply alarmed because there was a shortage of drugs like Ritalin and Adderall that they considered absolutely essential to their children’s functioning. But are these drugs really helping children? Should we really keep expanding the number of prescriptions filled? Read more @ http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html?_r=3&pagewanted=1&hp

Related Online Continuing Education Courses:

• Understanding, Diagnosing, & Treating ADHD Through the Lifespan
• Attention Deficit Hyperactivity Disorder – Overview
• Diagnosing ADHD in Adults
• The Impact of a Life of ADHD: Understanding for Clinicians and Clients

Related Articles:

• ADHD: A Modest Proposal (pdresources.wordpress.com)
• Is ADHD really on the rise? (psychologymum.wordpress.com)
• Letters: Ritalin and the Hyperactive Child (nytimes.com)