1. What
medications are
used to treat
ADHD? Why is a
cortical stimulant
prescribed when
a child is
hyperactive?
2.What is the
difference
between ADHD
and auditory
processing
problems?
8. How is ADHD 9. What are
executive
diagnosed? Is
functions?
it diagnosed
differently in
adults and
children?
15. What are
the
similarities and
differences
between
Cocaine and
Ritalin?
22. How does
ADHD affect
academic
success?
29. What is the
relationship
between ADHD
and reading
disorders?
3. What problems
are seen with
ADHD in school
aside from
academic
issues?
10. Will colleges
accept students
diagnosed with
ADHD?
4. Can Celiac
Disease,
sensory
difficulty, etc.
cause
ADHD
symptoms?
11. Can teens or
adults develop
ADHD?
5. What
differences are
found in the
cerebral cortex of
individuals
diagnosed with
ADHD and normal
individuals?
12 .Do people
with ADHD
complain of sleep
disorders?
16. Is there a
specific
remarkable
history found in
individuals with
ADHD?
17. Can a special
diet help
individuals who
have ADHD?
18. Why are
there difficulties
with transitions
in individuals
diagnosed with
ADHD?
19. How
prevalent is
ADHD?
23. Why does it
take more time
for an individual
with attention
issues to learn?
24. When does
ADHD begin?
25. What are
some of the
treatments for
ADHD?
26. What can a
student with
ADHD do to
improve
performance?
30. What is
internal speech?
What is the
relationship b/w
internal speech
and attention?
31. Can
counseling help
an individual
with ADHD?
32. Why do
ADHD individuals
wait until the
very last minute
to do things?
33. What is the
difference
between
remediation and
accommodations?
6. Is there a
relationship between
ADHD and OCD?
13. What is ODD and
how is it related to
ADHD?
7. What are the
comorbid
conditions
associated with
ADHD?
14. Do students
with ADHD suffer
from anxiety?
What happens if
the problem is
anxiety and not
ADHD?
20. Is there a
relationship between
ear infections and
ADHD?
21. What are the
differences in
symptoms and
diagnosis of ADHD
in adults?
27. Do food additives
affect ADHD?
28. What
makes
diagnosis
difficult? Why is
it missed?
34. Why is the
symptom presentation
so variable with ADHD?
Why do only some
individuals show
impulsivity?
35. What can
teachers do to
help ADHD
individuals?
•
•
•
•
•
Stimulants
Sharpen concentration and increase the
activity of the brain chemicals called
dopamine and norepinephrine, which are
believed to be imbalanced in adults with
ADHD.
The FDA has approved several stimulants
for the treatment of adult ADHD.
In some individuals a stimulant is
contraindicated because of seizures,
worsening depression, etc.
Non-stimulant options also exist.



Problems occur when the medication runs out in
the middle of the day or when the medication
keeps the individual awake at night
The relatively new ADHD medication Daytrana is
composed of the same chemical compound as
Ritalin and Concerta (methylphenidate),
Daytrana offers the distinct advantage of existing
in the patch form, which is typically worn on the
hip. At the present moment, this medication is
used exclusively for children with ADHD and
related disorders, although it can also be used
off-label for adults with the disorder.

remains the most popular choice of
medications for individuals with ADHD.
However, the combination of dosing
difficulties and negative side effects
connected with oral administration left room
for an alternate form of delivery: the
methylphenidate transdermal delivery system,
more commonly known as Daytrana.


A new drug called Vyvanse
(Lisdexamfetamine) has entered the world of
ADHD stimulant medications relatively
recently.
Vyvanse was originally marketed as an ADHD
treatment for children, but was approved by
the FDA for adult and adolescent use this
past April. A cousin of the popular ADHD
medications Dexedrine and Adderal, Vyvanse
includes some key modifications of these
medications.


ADHD individuals have less energy in
the brain which is why they fidget or
through paper airplanes.
Functioning for them is like trying to
work when you are very tired and
uninterested in the work at hand.


Because auditory processing disorders and
ADHD have very similar symptoms, many
ADHD individuals are not diagnosed with
auditory processing disorders because they
are never tested for it.
While auditory processing disorders affect the
student during class lectures, it is not a
diagnosis that will get accommodations for
tests (except oral tests) since it does not
affect the written aspect of test taking.
Auditory processing disorders are independent
from the mechanical process of hearing (in
other words, the peripheral hearing, or ability
to pick up background sounds is not
affected), but rather have difficulties in the
screening, filtering and differentiating
"important" sounds from background noise.
Difficulties in this result in an impaired ability
to utilize important auditory information
properly.

ADHD and Auditory Processing
Disorders can share a number of
overlapping symptoms and behaviors in
children. However, when these two
disorders exist alongside each other as
comorbid disorders, then the two can
feed off of each other and increase the
likelihood of onset of a third (or fourth)
psychological or developmental
disorder.

One of the biggest challenges in diagnosing and
treating ADHD is trying to separate it out from
other disorders that often present similarlooking symptoms. One such disorder is known
as celiac disease. When gluten (a type of plant
protein found in corn and wheat and other
carbohydrates) is ingested in individuals with
celiac disease, an inflammatory response in the
upper portion of the small intestine occurs.
When repeatedly challenged by gluten exposure,
damage can occur to this portion of the
digestive system, which leads to painful
symptoms and impaired digestive and
absorptive function.


Sensory processing disorders are often
seen in the ADHD population, especially in
children. This includes more "physical"
dysfunctions including the ability of the
child to maintain balance and equilibrium.
To the frustrated parent of coach of an
ADHD child, this may introduce another
complication with regards to sports or
other activities which involve coordination
and balance, such as basketball, baseball,
tennis, soccer, gymnastics, musical
instruments, dance, etc.



The areas that organize and direct
behavior are smaller
The area that is responsible for holding
and computing is smaller
The area of the brain responsible for
self concept is not utilized as much.




There is less energy used by the brain of
people diagnosed with ADHD so they sort of
feel like they can’t get enough energy
The areas that organize and direct behavior
are smaller
The area that is responsible for holding and
computing is smaller
The area of the brain responsible for self
concept is not utilized as much.

A number of studies have confirmed
the hypothesis that individuals with
ADHD have reduced bloodflow levels
marking a recuction of activity to
multiple key brain regions


Oppositional Defiant Disorder
is a disorder in which a child exhibits
disobedience, irritability and hostility towards
authority figures beyond the range of normal
age-appropriate behaviors.

Of course there is a significant gray area with
regards to what is age appropriate, especially
when the child's environment is considered.





Major Depressive Disorder, Oppositional
Defiant Disorder, General Anxiety Disorder
(Depression sometimes is expressed as angry
outbursts especially in children)
20.8% had MDD.
20.8% ODD.
18.6% GAD.
Many undiagnosed individuals are considered
under achievers. Parents usually use other
words.




Oppositional Defiant Disorder, General
Anxiety Disorder
41.9% had ODD.
22.2% GAD.
19.4% MDD.



50.7% had ODD.
22.7% MDD.
12.4% GAD.





Total Sample: 3082
AD/HD all types: 222
Inattentive subtype: 95
Combined type: 72
Hyperactive-Impulsive type: 55





Some are emotional
Some are other learning disabilities
Some are behavioral
Some have to do with relationships
Other learning disabilities
The percentage of each condition depends on
who does the study







There is no standard battery of tests.
History is very important. This includes family, social, academic as
well as medical history.
On the IQ there are usually indicators that the processing speed is
slow and there are difficulties with working memory.
On the fluency tests, there are indicators that the individual has
difficulty with timed tasks.
There are instruments given to the parents and teachers to get
feedback regarding the students’ performance in class.
There are tests that measure continuous performance and these
often indicate difficulty.
Memory is often compromised, especially short term memory.


Symbol search: This subtest of the IQ test
involves identifying whether a particular
symbol is present in a row of symbols. It has
direct implications on one's ability to pay
attention to detail as well as the ability to
quickly scan through information to find what
is relevant.
The improvements in post-methylphenidate
scores were about twice as large for the nonanxiety group of ADHD children for tests like
symbol search.


Arithmetic: This is a timed test on the IQ in
which arithmetic questions are orally
presented to the children and the responses
are measured, assessing both speed and
accuracy.
With this subtest there was little help with
medication, no help if there is comorbid
anxiety








Managing frustration
Restraining outbursts
Problem solving
Memory recall
Sustaining effort
Focusing
Organizing
Planning





Those that involve planning or decision
making.
Those that involve error correction or
troubleshooting.
Situations where responses are not welllearned or contain novel sequences of
actions.
Dangerous or technically difficult situations.
Situations which require the overcoming of a
strong habitual response or resisting
temptation.




Students with a documented disability can get
various services.
Services are usually supplied at a fee.
Students who qualify can get the reasonable
and necessary accommodation of extended
time and a low distraction environment.
Students should check the college web site
which will explain what documentation is
necessary in order to receive
accommodations.
•
•
•
•
ADHD is related to brain physiology and
does not develop spontaneously.
Adults diagnosed with ADHD had
symptoms as a child, but sometimes their
teachers made informal accommodations
for them.
Some individuals do poorly in school,
because they had ADHD but were not
diagnosed
The ratio of males to females seems to
even out by adulthood.

scientific explanation behind reasons why
ADHD children stay up until three in the
morning on a consistent basis.
while impulsivity is often more associated
as a "morning" behavior, the inattentive
subcomponent of ADHD appears to be
more affiliated with the evening. Omega-3
deficiencies may disrupt circadian rhythms
possibly due to an impairment in
melatonin production (melatonin, a
hormone, is associated with the sleepwake cycle and has implications on the
circadian rhythm patterns).



Always seen with another diagnosis
Most likely this will be ADHD
It is a willful pattern of disobedience


Oppositional Defiant Disorder
is a disorder in which a child exhibits
disobedience, irritability and hostility towards
authority figures beyond the range of normal
age-appropriate behaviors.

Of course there is a significant gray area with
regards to what is age appropriate, especially
when the child's environment is considered.

By and large, it appears that memorybased tasks are the hardest hit by an
accompanying anxiety disorder when
methylphenidate is administered as an
ADHD treatment.

For the teacher, however, an
improvement in classroom behavior
due to medication, but a lack of
improvement in academic work
(especially in memory-related tasks)
may be a tip-off that an undiagnosed
accompanying anxiety disorder may be
in place in this ADHD child.


SIMILARITY: Uptake patterns into the
brain: Both methylphenidate and
cocaine enter the brain at similar rates
and target similar specific regions of
the brain.
Brain Regions Targeted by each drug: In
addition to similar uptake patterns in
the brain between the two drugs, there
is a relatively large degree of overlap
for particular brain regions targeted.


the method of delivery not only affects the speed
of uptake of a drug (injected is almost always
faster than snorted, which is almost always faster
than ingested), but also the actual brain regions
targeted by the drug.
the Nucleus Accumbens is targeted by cocaine
and injected methylphenidate. However, when
methylphenidate, such as Ritalin, Concerta or
Metadate is taken orally, this nucleus accumbens
region is not targeted (at least not anywhere near
the level of injection).


The nucleus accumbens is believed to play an
important role in the addiction potential of a
number of drugs, including many stimulant
medications.
Thus, proper use of the methylphenidate
medication actually bypasses a key brain
region believed to be critically involved in the
"high" or addiction process of a stimulant
drug.
Low birth weight, which has a number of
implications for other disorders, was
found to be a good indicator of
childhood conduct problems appearing
alongside of ADHD in its own right. It is
believed that low birth weight is a good
indicator of a poor prenatal
environment, which is why so many
disorders and developmental issues are
often associated with low birth weights.


The main culprit for attentional deficits is
often believed to be the result of hearing loss
(even mild), early in a child's life due to
complications with the middle ear, including
infections, allergy-related causes or build-up
of fluids in the canal.
As a result, the child begins to miss out on
verbal cues, and does not develop the same
level of response to an adult voice.

During early childhood, the actual positioning
of the ear canal is still adjusting, the pathway
into the middle part of the ear is actually at a
flatter angle than in a mature adult. This
difference in positioning actually makes
younger children much more prone to ear
infections than older children or adults.
These infections increase the risk of further
complications down the road, including an
increased onset of attention difficulties,
including ADHD.
This is a controversial area:
 Some experts believe foods that provide
quality brain fuel could reduce symptoms.
High-protein foods, including nuts, meat,
beans
 Replacing simple carbs with complex carbs,
like whole-grain pasta levels blood sugar
levels
 Avoid sugar and artificial colors



It consistently has been shown that
individuals with ADHD are often deficient in
omega-3 fatty acids.
Low blood sugar has been linked to difficulty
with concentration, and therefore worsens
ADHD
High protein diets may be helpful for ADHD
individuals

http://images.google.com/imgres?imgurl
=http://4.bp.blogspot.com/_B4FBju9poGc
/SZrkZgaNnCI/AAAAAAAAAGg/AR6boqNG
hYs/s400/ADHD%2Bcingulate%2Bgyrus.jpg
&imgrefurl=http://adhd-treatmentoptions.blogspot.com/2009/02/nicotinewithdrawal-effects-differin.html&usg=__1RIon18bFKf6vRi4bC9gZ3s
w0H4=&h=280&w=400&sz=34&hl=en&st
art=218&sig2=LLXFP8GfrwoHUwqKKJVbw&tbnid=VwHAMeR4FuxMM:&tbnh=87&tbnw=124&prev=
/images%3Fq%3Dadhd%26gbv%3D2%26nds
p%3D21%26hl%3Den%26sa%3DN%26start%
3D210&ei=P0yzStvuBsbSlAf9m_mSDw

http://images.google.com/images?gbv=2&hl
=en&q=adhd&sa=N&start=210&ndsp=21



ADHD occurs because how the individuals
cerebral cortex is formed and functions
These specific structures affect how other
structures which are adjacent to them and
who have communication with them function.
Because the structures are identified and the
difficulty with them are consistent from
individual to individual, the symptoms are
very similar
1, Rostrum of corpus
callosum
2. Genu of corpus
callosum
3 .Body of corpus callosum
4. Splenium of corpus
callosum
5. Septum pellucidum
6. Anterior commissure
7. Fornix
8. Hippocampus
9. Cingulate gyrus
10.Paraterminal gyrus





Centers for Disease Control and Prevention
(CDC) publication Vital and Health
Statistics (PDF; September 2007).
There are 4.5 million children ages 3 to 17
(7% of this age group) with AD/HD.
Boys are more than twice as likely to have
AD/HD, with 11% of boys in this age range
having the disorder and 4% of girls.
When compared with children who have
excellent or very good health, children who
have fair or poor health status are nearly 3
times more likely to have AD/HD (7% vs.
19%).

CDC


ADHD afflicts approximately 3% to 5% of
school-age children
An estimated 60% of those maintain the
disorder into adulthood. (That means the
symptoms still create some level of distress
in 60% of adults.


The main culprit for attentional deficits is
often believed to be the result of hearing loss
(even mild), early in a child's life due to
complications with the middle ear, including
infections, allergy-related causes or build-up
of fluids in the canal.
As a result, the child begins to miss out on
verbal cues, and does not develop the same
level of response to an adult voice.

During early childhood, the actual positioning
of the ear canal is still adjusting, the pathway
into the middle part of the ear is actually at a
flatter angle than in a mature adult. This
difference in positioning actually makes
younger children much more prone to ear
infections than older children or adults.
These infections increase the risk of further
complications down the road, including an
increased onset of attention difficulties,
including ADHD.



Many parents don’t learn that they have
ADHD until they get help for their child or
if they complain of mood disorders like
anxiety or depression.
To confirm the diagnosis, a practitioner
must verify that symptoms were present
in childhood even if it was not formally
diagnosed.
The same type of tests are used for both
children and adults.
Some symptoms disappear
ADHD affects males at higher rate than females
in childhood, but this ratio seems to even out
by adulthood.
Many boys are erroneously diagnosed because
of brain growth
Many girls are not diagnosed and labeled
underachievers
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Chronic lateness and forgetfulness.
Anxiety = the result of worrying about symptoms
Low self-esteem.
School problems become Employment problems.
Difficulty controlling anger.
Impulsiveness.
Substance abuse or addiction.
Poor organization skills.
Procrastination.
Low frustration tolerance.
Chronic boredom.
Difficulty concentrating when reading.
Mood swings.
Depression = the result of being distressed by symptoms.
Relationship problems.




Poorer educational performance
(underachievers)
Frequent school disciplinary actions.
Grade Retention
Adults with ADHD have dropped out of school
more often.
•
•
•
•
•
Lower socioeconomic status.
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.
Use drugs and alcohol more frequently
Smoke cigarettes
Self-report psychological maladjustment
more often



Change employers frequently and perform
poorly.
Have had fewer occupational achievements.
More relationship failures




Trouble getting projects done within a
specific time frame
Trouble getting tests done within a
specific time frame
Lower scores on tests than on class
projects
Lower scores on standardized tests
than on class tests




Difficulty keeping attention on a specific task.
Not being able to integrate information
occurring in the environment when the task
at hand is very interesting.
Difficulty with time management.
Not listening when being talked to directly.




A combination of reasons:
1. The student tends to be easily
distracted by internal as well as
external noises
2. The individual’s working memory
(the ability to hold and manipulate data)
does not work as well.
New tasks take more sustained
attention. ADHD students have
difficulty with sustained attention.


An ADHD individual has difficulty keeping out
distractions. His brain works on the premise that
you let in all distractions or you keep out all
distractions. If you let them in, then every sound in
the room catches his attention. Every time the air
conditioner turns on, every time someone turns a
page, every time the clock ticks.
The other thing the student does is to keep out all
distractions. In that case nothing is let in. He
doesn’t hear that you’ve called him, he doesn’t
notice what time it is, he blocks out everything.

The process of neurite outgrowth is a major
indicator of overall cell health with regards to the
nervous system. Additionally, this process is
especially critical during the neurodevelopmental
stages, which starts during embryonic
development, and can continue on until an
individual is in his or her 20's. However, the
period of greatest development (and greatest
potential sensitivity to chemical agents), is
between the sixth month of gestation to the first
few years after birth.






Remediation
Structure
Medication
Accommodations
Feedback
Using technology






The student chooses to use various methods to
help with organization and structure.
Calendars, colored pencils, lists, etc.
When the student is young this process is
supported by teachers and parents
As the student matures, the student takes over
the process
The student asks for assistance in organization,
etc.
The student learns to take an active role in the
learning process.



The student learns methods that help with
organization (putting keys and personal
belongings in a specific place; looking behind
as the student leaves to assure that nothing
is left behind, etc.)
The student has a specific place to study
where there are few interruptions and where
everything he needs is located (pens,
staplers, etc.)
The student puts aside adequate time for
studying and projects.



Focus on organization skills, such as
taking notes, keeping a daily planner,
and prioritizing a to-do list.
Put personal articles in the same place
every time
Use technology – there are a variety of
devices that can help with study and
production.




Brilliant Blue, also referred to as "Blue1" and
"E133" (in Europe)
Quinoline Yellow, also referred to as Yellow
13 or E104
Aspartame (Nutrasweet, Equal): and artificial
sweetener often used in diet soft drinks
MSG: short for Monosodium Glutamate or a
salt form of L-glutamic acid, often used in
Chinese foods and, (to a lesser extent now),
potato chips and french fries


The investigation into synergistic effects of food
additives stems from an article done by Lau and
coworkers on how four food additives, wellknown for their potential neurotoxic effects as
individual agents, can potentially be even more
devastating when used in combination.
The levels of these different chemical agents
done in the study by Lau were below
concentrations which typically cause neurotoxic
problems on their own.


Brilliant Blue, when combined with MSG,
showed a strong decrease in a process
called neurite outgrowth.
the combination of Quinoline Yellow
and Aspartame also showed a strong
additive effect on inhibiting neurite
outgrowth.








.
Trajectory differences create different functional levels in
boys and girls which is not accounted for in most tests.
There are different types of ADHD
There are many conditions with similar symptoms
Symptom effect differs with IQ and with the seriousness of
the condition as well as with comorbid conditions
It can present without any hyperactivity and be confused with
low achievement or low motivation
It can be mistaken for “laziness”
It is prevalent in young children who have difficulty
explaining the problem.
It can be very annoying and mistaken for a behavioral
problem




ADHD disappears with one-on-one
interactions
There is no specific test for ADHD
It can be mistaken for a reading problem
Symptoms change over time



The comorbidity of Reading Disorder and
ADHD is higher than for any other learning
disorder
When children have difficulty with
sound/symbol relationships, it takes them
longer to finish a reading task. Elongated
tasks are often automatically considered an
ADHD difficulty.
Since there is no specific test for ADHD, the
practitioner may not rule out a Reading
Disorder unless tests are given to rule it out.

Internal speech allows an individual to guide
their thoughts to find the answer

Therapy for individuals with ADHD often
highlights self confidence. Many of these
individuals have had a great number of
failures because their ADHD was
unrecognized for years and they were
repeatedly told that they were not trying.
Therapy often focuses on both remediation
techniques as well as discussing the poor
sense of self that has developed because of
negativity.
•
•
•
•
People often think the best treatment involves
medication.
Addressing poor habits and low self-esteem
is even more critical.
ADHD individuals should focus on
organization, routines, repairing
relationships, and improving social skills.
Medication combined with counseling can
ease ADHD symptoms and improve
Helps allow focusing
 Helps the individual set time limits
 Helps the individual set goals
However, most ADHD individuals have a
poor sense of how long it will take to
finish a project, so while
procrastination may improve focus, it
often means the project is not finished
on time.

Remediation is a strategy the student uses to
compensate for a learning difficulty.
Accommodation is a compensation that is
given to the student to allow the teacher to
understand the breath of his knowledge
Modification is a change in the curriculum to
compensate for the student’s learning issue.
Many professionals who study ADHD believe
that it is a diagnosis which has not been
carefully examined. It is a mixture of a
number of conditions, and therefore, the
symptom pattern varies considerably from
person to person. Additionally, ADHD
symptoms are often present in other
conditions such as anxiety.





Use attention getting techniques
Be interactive
Break large projects into parts where there
are different due dates for each part
Expect students to take notes on what they
are reading
Show students how to set goals.

blood flow patters to the brains of ADHD and
OCD (Obsessive Compulsive Disorders) can show
pronounced differences, which can aid the
diagnostic process between these two disorders
(while ADHD and OCD are often considered to be
on "opposite" ends of the spectrum with regards
to neuro-chemical signaling levels, these two
disorders can often exhibit similar symptoms,
such as a severe impairment in the response to
verbal directions. This is especially true in
younger children).