ADHD and Depression

 
  ADHD and Depression Kristen DiPaolo | CWK Network
 
 
“I try to do something, but I can’t because of the ADD, and it frustrates me. Then that makes me very nervous and anxious and that goes to the anxiety. And then when I get like that, I’ll go ‘Oh my god! I can’t do anything! I can’t do anything!’ And that leads to the depression.”
- Ariel, 20

  Related Information What Parents Need To Know Resources

20-year-old Ariel has been living both with anxiety and depression since the eighth grade. She says, “It got so bad where I just slept all day, I didn’t get out of bed, I didn’t do anything.”

That is in addition to attention deficit disorder. Ariel says, “I was already upset and depressed about the fact that I had ADD and had to take medications for that. When I found out I had two more things, I was like, ‘Oh my God! What’s going on?’”

New research out of Harvard University shows girls with attention deficit are 19 times more likely to be depressed…and 15 times more likely to have bi-polar disorder than other girls.

Dr. Richard Winer, a psychiatrist in metro-Atlanta says, “There is a very high likelihood that there will be something else besides ADHD going on, probably at least a 70 percent chance if not more.”

Why is one person so likely to have several disorders? Researchers say the conditions are genetically linked…and tend to aggravate each other.

Dr. Jacque Digieso, who is the executive Director of the Cottage School for students with ADHD in metro-Atlanta says, “If you have ADHD, and you have a goal but you are not able to achieve that goal because of the characteristics of lack of sequencing, lack of attention, lack of follow through, lack of motivation…you are going to get depressed.”

Ariel says, “I try to do something, but I can’t because of the ADD, and it frustrates me. Then that makes me very nervous and anxious and that goes to the anxiety. And then when I get like that, I’ll go ‘Oh my god! I can’t do anything! I can’t do anything!’ And that leads to the depression.”

Experts say girls like Ariel often need one medication for ADHD and another for depression.

Dr. Winer says, “I generally will try to treat ADHD first if I think there is also mild to moderate depression alongside. If the depression appears to be extremely severe in nature, then that takes precedence over treating ADHD in terms of what do you treat first.”

Ariel often skips her medication. She says it’s a crutch, but it does work. Her mom Arlene says, “She started taking some anti-depressants, and all of a sudden she was back to the way she had been six months earlier.”

Another study out of Harvard University shows boys with ADHD are also at risk for having another mental health problem, but the statistics are slightly less dramatic than they are for girls.

By Larry Eldridge
CWK Network, Inc.

Many parents seem to be ignoring medical advice when it comes to treating their child’s attention deficit hyperactivity disorder (ADHD). A recent study conducted at New York University reveals that of 500 parents whose children have ADHD, 45 percent say behavioral therapy has been recommended, but less than one-quarter (21 percent) say that their child actually participates in it. In addition, 89 percent of parents with an ADHD child say medication has been prescribed for their child to help manage symptoms, but only 55 percent report their child is taking medication.

The study also included the following findings:

  • More than twice as many parents of children with ADHD (43 percent) than parents of children without ADHD (18 percent) believe their child is likely to be picked on at school.
  • Nearly half (49 percent) of parents of ADHD children say their child is likely to have difficulty getting along with other neighborhood children (compared to 18 percent of parents of children without ADHD).
  • Seventy-two percent of parents of ADHD children report their child has trouble getting along with siblings or other family members, compared to 53 percent of parents of children without ADHD.
  • Less than half (48 percent) of parents of children with ADHD say their child adapts easily to new situations, compared to 84 percent of parents of children without ADHD.
  • According to their parents, children with ADHD are half as likely to have many good friends (18 percent vs. 36 percent) and are less likely to play with a group of friends (38 percent vs. 50 percent), compared to children without ADHD.

If you believe your child may have ADHD, keep an eye out for the following symptoms listed by the American Academy of Child and Adolescent Psychiatry:

  • Has trouble paying attention
  • Shows no attention to details and makes careless mistakes
  • Easily distracted
  • Loses school supplies and forgets to turn in homework
  • Has trouble finishing class work and homework
  • Has trouble listening
  • Has trouble following multiple adult commands
  • Blurts out answers
  • Demonstrates impatience
  • Fidgets or squirms
  • Leaves seat and runs about or climbs excessively
  • Seems “on the go”
  • Talks too much and has difficulty playing quietly
  • Interrupts or intrudes on others
 
By Larry Eldridge
CWK Network, Inc.

Depression is not limited to kids with ADHD, although having ADHD may lead to depression in some cases. According to the National Mental Health Association (NMHA), depression among teenagers is increasing at “an alarming rate.” The NMHA says as many as one in five teens suffers from clinical depression at some time during their teenage years. Depression can take several forms, including bipolar disorder (formerly known as manic depression). Depression can be difficult to diagnose in teens because adults often expect teens to be moody, and they often are. But depression is more than typical moodiness.

The following symptoms may indicate depression, particularly when they last for more than two weeks:

  • Poor performance in school
  • Withdrawal from friends and activities
  • Sadness and hopelessness
  • Lack of enthusiasm, energy or motivation
  • Anger and rage
  • Overreaction to criticism
  • Feelings of being unable to satisfy ideals
  • Poor self-esteem or guilt
  • Indecision, lack of concentration or forgetfulness
  • Restlessness and agitation
  • Changes in eating or sleeping patterns
  • Substance abuse
  • Problems with authority
  • Suicidal thoughts or actions

It is extremely important that depressed teens receive prompt, professional treatment. Depression is serious and, if left untreated, can worsen to the point of becoming life threatening. If depressed teens refuse treatment, it may be necessary for family members or other concerned adults to seek professional advice. Contact your local mental health association or a school counselor for suggestions on treatment.

Some of the most common and effective ways to treat depression in adolescents are:

  • Cognitive-behavioral therapy – Helps teens change negative patterns of thinking and behaving; several studies support the effectiveness of this treatment
  • Psychotherapy – Provides teens an opportunity to explore events and feelings that are painful or troubling to them; psychotherapy also teaches them coping skills
  • Interpersonal therapy – Focuses on how to develop healthier relationships at home and at school
  • Medication – Relieves some symptoms of depression and is often prescribed along with therapy
 
New York University
American Academy of Child and Adolescent Psychiatry
National Mental Health Association
 

Occupational Therapy for ADHD

 
  Occupational Therapy for ADHD Robert Seith | CWK Network
 
 
It’s going to be hard for him even with all the intervention. And like I said it would have been ideal had I heard about Susan when he was in 4 th or 5 th grade and started off a lot earlier.
– Karin Szwec, explaining how her 14-year-old son, who has ADHD, could have benefited if he had tried occupational therapy earlier.

  Related Information What Parents Need To Know Resources

14-year-old Cameron has always had trouble in school.

Whether it’s following instructions…

“He would think about what the teacher was saying and only hear part of it and start doing the work and not complete it effectively,” says his mother, Karin Szwec.

Or staying focused…

“I might look up at the board and see something in the room and just not really, just get distracted by something,” explains Cameron.

Cameron has attention deficit disorder…

Medications helped… but they weren’t the cure-all.

So this summer, he’s trying something new: occupational therapy.

It looks like simple exercises…bouncing a basketball, balancing a balloon on a racket… but before everything, the therapist gives him detailed instructions: exactly how many steps to take, for instance, and how many dribbles to make.

“I structured in there he had to repeat a pattern for sequencing, he had to be able to sub-vocalize what the pattern was… so he was learning strategies for assimilating and processing that information,” says Occupational Therapist Susan Orloff.

She says it’s a fun, low stress way to teach a-d-d children listening skills, how to pause before they act, how to focus.

A new study from Temple University backs that up. Of 88 children who took 40 hours of occupational therapy, 85-percent improved in their ability to remember instructions from a teacher, and finish test assignments.

“He’s toning down on his impulsivity,” says Mrs. Szwec, “He used to be very impulsive. He would hear an instruction and jump right in before the instruction was completed.”

Experts say occupational therapy isn’t a replacement for a-d-h-d drugs… but used with medication… can greatly add to gains.

“We’re not the white horse that’s going to come through and clean up everything,” says Orloff, “We’re part of that package.”

By Larry Eldridge
CWK Network, Inc.

According to the American Academy of Child and Adolescent Psychiatry, ADHD occurs in 3 to 5 percent of school age children. The following are given as symptoms of ADHD:

  • Inattention
  • Distractibility
  • Impulsivity
  • Excessive talking
  • Impatience
  • A tendency to interrupt or intrude on others

In addition, researchers found that boys with ADHD move two to three times as much and cover four times as much area as normal boys. Girls with ADHD move as frequently but their movements cover a smaller area.

 
By Larry Eldridge
CWK Network, Inc.

Since judging the symptoms of ADHD can be very subjective, some children may be diagnosed with ADHD without actually having the disorder. A recent study suggests that parents’ and physicians’ preconceived notions about children’s behavior may interfere with the identification and diagnosis of ADHD and other disorders.

Because this possibility exists, it is very important to find a good pediatrician who will properly diagnose your child and around whom you and your child will feel very comfortable. Experts at BJC HealthCare and Children’s Healthcare of Atlanta suggest keeping the following points in mind when choosing a pediatrician and/or occupational therapist:

  • Are you more comfortable with a specialist who is no-nonsense and businesslike, or do you need more handholding?
  • Would you prefer a specialist who sets aside a particular time each day to take phone calls or would you rather contact the office when questions arise and have the specialist return your call between patient visits?
  • Do you prefer a male or a female pediatrician or therapist?
  • Is age a factor for you? Are you more comfortable dealing with an older or younger specialist?
  • Are the office hours convenient for you? Do you need evening or weekend hours?
  • Is the office conveniently located?
  • How are after-hours calls and emergencies handled?

So how do you know if your child needs to see an occupational therapist? According to experts at Handwriting Without Tears, your child should be referred to an occupational therapist if …

  • The child consistently demonstrates difficulty with cutting, writing, or manipulating clothing fasteners, small objects, and toys.
  • The child has difficulty with gross motor functioning, sitting upright in their desk, playing on the playground or difficulty moving specific joints during an activity.
  • The child needs adaptations to their environment in order to make a task easier.
  • The child has a difficult time feeding himself or herself in the cafeteria, manipulating his/her clothing during school activities, or while toileting.
  • The child does not demonstrate hand dominance and it is affecting his/her work (speed, neatness, etc.).
The child has difficulty with perceptual skills that hinders academic performance (i.e. copying from the blackboard, can’t recall what objects look like, large amount of reversals in written work, difficulty copying designs).
 
American Academy of Child and Adolescent Psychiatry
Children’s Healthcare of Atlanta
BJC Healthcare
Handwriting Without Tears
Children’s Special Services
 

ADHD Over-Diagnosed?

 
  ADHD Over-Diagnosed? Karen Savage | CWK Network
 
 
It’s important to rule out the learning problems, the emotional, behavioral issues, adjustment concerns – whether it’s a change to a new school, or there might be changes in the family – divorces, deaths – things like that.”

- Thomas G. Burns, Psy.D., Director of Neuropsychology, Children’s Healthcare of Atlanta

  Related Information What Parents Need To Know Resources

Looking at her sitting quietly, reading intently, no one would ever think that ten year old Samantha had attention problems. But last year was a different story. Her grades dropped suddenly. She got distracted in class and she struggled to keep up with all of her 4 th grade assignments. Her teacher suggested she get tested for ADHD, Attention-Deficit/Hyperactivity Disorder. So her mom took her to a doctor for testing.

“She told me she was borderline ADHD and we were going to go ahead and treat her with 5 milligrams of Adderall,” says Connie Hodges, Samantha’s mother.

Both Samantha and her mom were unhappy with the results. “It was upsetting me because it was like she was drunk. She was moving really slow and just lethargic – just not Samantha,” says Hodges. And Samantha herself agrees. She wasn’t her normal energetic, active self. “It made me just want to sit down in one place,” she says.

So her mom took her to see a specialist for more tests. Thomas G. Burns, Psy.D., Director of Neuropsychology at Children’s Healthcare of Atlanta did the testing himself. “We did full cognitive battery of tests to rule out some of those other areas like learning disabilities or behavior problems. She did very well in testing – performed within the expected range – no evidence of any cognitive impairment. And from what I saw, at least in a one-on-one setting, she was certainly able to hold her attention and perform really well,” he says.

Burns says Samantha doesn’t have ADHD and that often, kids are diagnosed with the disorder when in fact, their attention problems are symptoms of something else.

“It’s important to rule out the learning problems, the emotional, behavioral issues, adjustment concerns – whether it’s a change to a new school, or there might be changes in the family – divorces, deaths – things like that,” he says.

Samantha was easily distracted and had trouble keeping up with multiple assignments. Dr. Burns and her teachers have taught her how to get organized, focus, and complete tasks one at a time.

Samantha says, “They help me learn how to take the right notes and learn how to study right.”

Her mother adds, “I worked with her teacher and her counselor at school. She has taught Samantha how to organize her – not only her book bag, her desk, but her thoughts.”

And it’s working – without medication.

“I’m me again,” says Samantha.

“She’s not struggling like she was last year. She doesn’t hate school anymore. She’s not even the same child she was last year,” says her mother
By Larry Eldridge
CWK Network, Inc.

According to the American Academy of Child and Adolescent Psychiatry, ADHD occurs in 3 to 5 percent of school age children. The following are given as symptoms of ADHD:

  • Inattention
  • Distractibility
  • Impulsivity
  • Excessive talking
  • Impatience
  • A tendency to interrupt or intrude on others

In addition, researchers found that boys with ADHD move two to three times as much and cover four times as much area as normal boys. Girls with ADHD move as frequently but their movements cover a smaller area.

 
By Larry Eldridge
CWK Network, Inc.

Since judging the symptoms of ADHD can be very subjective, some children may be diagnosed with ADHD without actually having the disorder. A recent study suggests that parents’ and physicians’ preconceived notions about children’s behavior may interfere with the identification and diagnosis of ADHD and other disorders.

Because this possibility exists, it is very important to find a good pediatrician who will properly diagnose your child and around whom you and your child will feel very comfortable. Experts at BJC HealthCare and Children’s Healthcare of Atlanta suggest keeping the following points in mind when choosing a pediatrician:

  • Are you more comfortable with a doctor who is no-nonsense and businesslike, or do you need more handholding?
  • Would you prefer a doctor who sets aside a particular time each day to take phone calls or would you rather contact the office when questions arise and have the doctor return your call between patient visits?
  • Do you prefer a male or a female pediatrician?
  • Is age a factor for you? Are you more comfortable dealing with an older or younger doctor?
  • Are the office hours convenient for you? Do you need evening or weekend hours?
  • Is the office conveniently located?
  • How are after-hours calls and emergencies handled?
  • Do you want a doctor who is board certified or board eligible in pediatrics? (Board eligibility means the doctor has completed training at an accredited medical school and residency program. Board certification in pediatrics means the doctor has completed not only the accredited training but also specialized examinations in pediatric medicine every seven years.)

When you have narrowed down your list of potential pediatricians, you may wish to interview each candidate. This will give you a chance to learn as much as possible about the pediatrician and to evaluate your level of comfort with him/her. Children’s Healthcare of Atlanta suggests asking the following questions during your interview:

  • How many doctors are in your group?
  • Has the size of your group changed recently?
  • What are the special interests of the doctors in your group?
  • Do you use nurse practitioners? If so, what are their roles?
  • If your office is very busy and my child needs to be seen today, what is your policy? Will I have a primary doctor, or do I see whoever is handling sick patients that day?
  • How are calls for advice handled during office hours? What about during evening and weekend hours? What is your philosophy of providing care via the telephone?
  • What are your average waiting times for scheduling a routine visit? What about after arrival at the scheduled time?
  • What is your philosophy about discipline? Medication use? Antibiotic use?
  • How do you handle payment for services?
  • Will you assist me in evaluating doctors recommended by my health plan?
  • Until what age will you continue to see my child?
  • Do you refer only to pediatric specialists?
  • Do all of the doctors in your group participate in my insurance company or managed care plan’s provider network?
  • Are you still accepting new patients for my managed care plan?

Once you make your decision, you can take several steps to get the most out of your relationship with your new pediatrician. BJC HealthCare suggests following these rules to make your parent-pediatrician relationship a success:

  • Know your child’s medications and administer them as prescribed.
  • Come back for a return visit when you are asked to come back.
  • Make sure your child is up-to-date on all immunizations.
  • If you have questions, it might be helpful to write them down and take them with you to the next office visit.
  • Listen to your pediatrician and take notes if necessary.
  • Ask questions.
 

American Academy of Child and Adolescent Psychiatry
Children’s Healthcare of Atlanta
BJC Healthcare

 

ADHD Black Market

   
Education Feature
ADHD Black Market
By Adam Wilkenfeld
CWK Network
 

“Sometimes different people, sometimes they’ll come back and be like, you know, have you changed your mind?”
-Devin McAdams, 15-

“This is the Concerta, and I was offered $5 per pill for that, and this is the Ritalin, and I was offered $10 per pill for that,” says 15-year-old Devin McAdams as he looks through his medicine cabinet.

For Devin, these pills are medicine – he has attention deficit hyperactivity disorder (ADHD). But for the many teens at his school that offer to buy his pills, these are black-market drugs. “In middle school, I was only approached by five or six kids, and then when I got to high school, I was approached by five or six kids per month,” Devin says.

A recent survey from the University of Wisconsin confirms that the problem is huge. Researchers say more than one third of students who take ADHD medicines have been asked to sell or trade them.

“These are controlled substances, and when [they] use them in ways they never were intended, then the outcomes can be very bad,” says Steven Garber, a clinical psychologist. For example, he says, “A particular kid who has an underlying cardiac problem or something else, or who just takes too much of this at one time, can be seriously damaged or can die from it.”

It’s dangerous. That’s why Devin says he won’t sell. “I can see that as a real temptation. I’m proud that Devin’s made the right decision because I know he’d love to have the money,” says Devin’s father, Ed McAdams.

“It really tells us that on the front end we need to be sure that the medications at home are secure, that they’re supervised when they’re given out,” Garber agrees.

At home, and at school, he says, students should be given their medicine one pill at a time to avoid the temptation. And parents should explain that selling any medicine without a prescription is both dangerous and illegal.

 

By Tom Atwood
CWK Network

Along with cocaine and methamphetamine, Ritalin (or methylphenidate) is a Schedule II drug under the Controlled Substances Act of 1970. It is legal, widely used and is effective in treating attention deficit hyperactivity disorder (ADHD). However, according to Prevention First, Inc., Ritalin is also one of the most popular street drugs in America. The Drug Enforcement Administration rates it as one of the top 10 controlled substances stolen from pharmacies and other licensed handlers. And it is one of the most abused controlled substances available legally today.

The most recent evidence of this comes from a study at the University of Wisconsin Human Development Center. Six hundred fifty-one students, aged 11-18, were asked if they were taking a stimulant medication for ADHD. Of the 50 who responded positively, 34% reported being approached to sell or trade their medication, and 53% of students not taking ADHD medication reported that some students taking Ritalin gave it away or sold it.

Prevention First, Inc., says Ritalin is popular enough on the black market to have earned several nicknames of which parents should be aware:

  • “Vitamin R”
  • “R-Ball”
  • “Skippy”
  • “Jif”
  • The “Smart Drug”

Ritalin is abused by crushing and snorting the pills or by dissolving the powder into intravenous solutions to be injected. Used in these ways, the drug produces short-term mood elevation, followed by a period of sluggishness, sleepiness or depression.

 
What Parents Need to Know

Prevention First, Inc., lists the following facts about Ritalin:

  • It was first developed in the 1940s.
  • It is a mild central nervous stimulant.
  • It was prescribed to 3 million children in 1996.

Although Ritalin is a stimulant, it has the opposite effect on children who are hyperactive. It reduces hyperactivity by increasing the amount of dopamine in the brain. Used effectively and in properly monitored doses, it improves children’s ability to learn by increasing the ability to concentrate and focus.

The American Academy of Child and Adolescent Psychiatry (AACAP) urges parents to find out as much as they can about any psychiatric medicine recommended as part of their children’s treatment plan. By asking the following questions, the AACAP says children, adolescents and their parents will gain a better understanding of psychiatric medications, such as Ritalin:

  1. What is the name of the medication? Is it known by other names?
  2. What is known about its helpfulness with other children who have a similar condition to my child?
  3. How will the medication help my child? How long before I see improvement? When will it work?
  4. What are the side effects that commonly occur with this medication?
  5. What are the rare or serious side effects, if any, which can occur?
  6. Is this medication addictive? Can it be abused?
  7. What is the recommended dosage? How often will the medication be taken?
  8. Are there any other medications or foods that my child should avoid while taking the medication?
  9. Are there interactions between this medication and other medications (prescription and/or over the counter) my child is taking?
  10. Are there any activities that my child should avoid while taking the medication? Are any precautions recommended for other activities?
  11. How long will my child need to take this medication? How will the decision be made to stop this medication?
  12. Does my child’s school nurse need to be informed about this medication?
 
Resources

American Academy of Child and Adolescent Psychiatry www.aacap.org
The Human Development Center, University of Wisconsin www.uwec.edu/hdc
Prevention First, Inc. www.prevention.org

 


 

ADHD Treatment Reduces Drug Use

   
Education Feature
ADHD Treatment Reduces Drug Use
By Adam Wilkenfeld
CWK Producer
 

“What happens is that a child with ADD who doesn’t get treatment actually becomes drug-seeking. And some people call that self-medicating.”
-Dr. Willliam Buchanan, a clinical psychologist-

The Mcever boys both have Attention Deficit Disorder. “I just, I say random stuff, people think I’m really weird,” says 14-year-old Hammond.

“Sometimes the teacher will be like be quiet, stop talking. And then, you know, I usually don’t and keep going,” says his older brother, 17-year-old Taylor. “But when I have the medicine, you know, I don’t really talk,” he says.

They take the ADD medicines Concerta and Adderall to help them pay attention in class and concentrate on their studies. “I hear reports when they’re not taking it, that something’s going on,” says their mom, Kim Mcever.

Now researchers say these medicines, called stimulants, may have some other unexpected benefits. “A child who is ADHD, we will reduce the likelihood of them using drugs if we they get proper treatment. However if they don’t get proper treatment they are much more likely to abuse drugs later in life,” says Dr. William Buchanan, a clinical psychologist.

Studies show that stimulant treatments actually protect attention deficit kids from experimenting with drugs and alcohol. When they take their medicine, they tend not to take as many risks. But without the medicine,
“What you find is higher divorce rate, higher high school drop out rate, lower overall level of education, more criminal incarceration,” Buchanan says. “I mean they’re just less successful.”

So the bottom line? It’s really still the same. If you’re child has ADD, tell them to take their medicine. Because without it, as Hammond says, “You just do weird stuff that you don’t think you would do, but you don’t know why you do it.”

 

By Tom Atwood
CWK Network

Are children who take stimulant medications like Ritalin for ADHD more likely to become drug users as teenagers? Some parents may suspect the answer to that question is yes, but research indicates the opposite. A study conducted by researchers at Massachusetts General Hospital, Harvard School of Public Health, and Harvard Medical School shows that treating ADHD with medication was associated with an 84% reduction in the risk of developing a ‘substance abuse disorder.’ According to the study, published in Symposia:

  • Substance abuse rates were lower in children with ADHD who were treated with stimulants such as Ritalin (12%) when compared to the untreated groups (30%).
  • Use of medication was “ubiquitously associated with reduced substance abuse in all studies in which baseline treated vs. untreated groups were (compared).”
  • Results do not support the notion of a deleterious effect of stimulant treatment on later substance abuse.
  • The findings suggest a “protective effect” of medications on reduced substance abuse in adolescents and young adults.
 
What Parents Need To Know

Although medication is not the only way to treat Attention Deficit Hyperactivity Disorder (ADHD), the American Academy of Child and Adolescent Psychiatry (AACAP) says research clearly demonstrates that it can be helpful. Stimulant medication such as mathylphenidate, dextroamphetamine, and pemoline can “improve attention, focus, goal directed behavior and organizational skills.” Other medications such as guanfacine, clonidine, and some antidepressants may also be helpful, according to the AACAP.

Other treatment may include cognitive-behavioral therapy, social skills training, parent education and modifications to the child’s educational program. The AACAP says a child who is diagnosed with ADHD and treated appropriately “can have a productive and successful life.”

ADHD occurs in an estimated 3-5% of school-age children, beginning before age 7 and sometimes continuing into adulthood. ADHD runs in families with about 25% of biological parents also having the disorder. According to the AACAP, a child with ADHD often shows some of the following symptoms:

  • Trouble paying attention
  • Inattention to details and makes careless mistakes
  • Easily distracted
  • Loses school supplies, forgets to turn in homework
  • Trouble finishing class work and homework
  • Trouble listening
  • Trouble following multiple adult commands
  • Blurts out answers
  • Impatience
  • Fidgets or squirms
  • Leaves seat and runs about or climbs excessively
  • Seems “on the go”
  • Talks too much and has difficulty playing quietly
  • Interrupts or intrudes on others
 
Resources

American Academy of Child and Adolescent Psychiatry www.aacap.org
National Parent Information Network www.npin.org

 


 

Study Says ADHD Increases Teen Driving Risk

   
Education Feature
Study Says ADHD Increases Teen Driving Risk
By Tom Atwood
CWK News Director

“You have a lot of things coming at you at once and you don’t know what to focus on first.” Christine, Age 19.

At age 19, Christine is just now learning to drive with her father. She has been diagnosed with Attention Deficit Disorder, and that’s one reason Christine has waited this long to get her driver’s license.

“One of the biggest things that happens is confusion,” Christine says. “You have a lot of things coming at you at once and you don’t know what to focus on.”

Studies show teen drivers who have Attention Deficit Hyperactivity Disorder, or ADHD, are four times more likely to be involved in a wreck. “They are much more distracted,” says Dr. Betsy Gard, a psychologist. “They are much more unfocused and the number of car accidents they have is higher.”

Before allowing a teen with ADHD to drive, there are signs experts say parents should look for. Signs like good judgment in other areas of life, which may indicate a teen is ready to take the wheel.

“If the youngster shows good judgment,” Dr. Gard says, “good self control in various areas, particularly emotional, self-control and good judgment, that’s a good sign. That’s a good indicator.”

And as Cherise studies the Rules of the Road, she is hoping that soon she will feel confident enough to actually take her driving test.

“‘Cause every time I get in the car now,” Cherise says, “I have to sit there an go, ‘whew!'”

 
ADHD And Driving: A New Study
Recent years have seen a tremendous growth in parental, medical and scientific knowledge concerning attention-deficit hyperactivity disorder (ADHD). Research has shown that children and adolescents with early attention difficulties may be at an increased risk for a number of educational, medical psychosocial and other problems throughout their teenage years and into early adulthood. The problems include:
  • poor academic achievement
  • employment-related difficulties
  • physical illnesses and increased associated medical costs
  • an increased risk of substance abuse
  • delinquency
  • psychiatric disturbances
  • relationship difficulties

While the cause and effect relationship between ADHD and some of the problems listed above continues to remain subject to debate, researchers have also begun to study a potential relationship between ADHD and motor vehicle accidents involving young drivers. A new study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, has shown that adolescent attention difficulties contribute to injury accident risks and (possibly) risky driving behavior.

According to the authors, the results of this particular study confirmed previous research suggesting that increasing levels of attentional difficulties are associated with elevated driving risks including traffic accident involvement, drinking and driving, illegal and/or unsafe driving activities, and an increased tendency to ignore or violate traffic safety laws. The authors also point out, however, that other factors like gender, behavioral problems, driving experience, and distance traveled also play a part in the problem.

 
Suggestions for Parents

According to an article published in Attention!® Magazine, a publication of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), parents need to consider some key points before their ADHD teens begin to drive. For example, some of the factors that influence safe driving habits for anyone include basic good judgment, the amount of driving experience the individual may have had, and the person’s attitude while driving. Teenage drivers in general have to struggle with their knowledge of what makes a good driver in opposition to feelings of invulnerability and the age-old struggle for independence from their parents. Unfortunately, invulnerability and independence often win out over good driving practices, resulting in risk-taking behaviors. Teens with ADHD may be at an even greater risk for problems than the teenage population in general since they may not be as mature as some their peers, Consequently, teens with ADHD may take significantly longer than other teens in developing good judgment and a mature attitude toward driving.

Parents of ADHD kids should also make it clear that learning how to drive is a privilege to be earned. Another point for parents to consider is how safe they feel driving with their child. If they don’t feel reasonably comfortable (or as comfortable as any parent can be driving with their child), it may be a good idea to delay letting the child apply for his or her driving license until they feel better about the child’s driving skills.

Once parents of ADHD teens decide to let their children begin learning to drive, the following are some suggestions for helping those teens become safe drivers:

  • Model good driving behaviors for your children.
  • Try to provide as much supervised driving time as possible for the child when he or she has her learner’s permit.
  • Schedule frequent, short (30 minutes or less), well-planned driving sessions. Patience is essential, so try to model patient driving skills by remaining as calm and relaxed as possible during the sessions.
  • Prohibit late night driving that’s unsupervised. Teen outings late at night tend to be recreational and pose additional risk for accidents.
  • Insist on seat belt use at all times.
  • Strictly enforce no drinking and driving rules.
  • Choose safe cars for driving, and retain ownership of the car the teen drives. The combination of high-performance, flashy cars and a young, impulsive driver can be very dangerous.
  • Role-play emergency situations with your teen before he gets a license. Stress the importance of staying at an accident scene. Put together emergency situation packets and put them in the glove compartment of any of your cars the teen is allowed to drive. Recommendations for packet contents include: vehicle registration, insurance card and agent information, emergency phone numbers, home/office phone numbers for parents, coins for emergency phone calls, a list of what to do in case of an accident, and a letter about medications being taken and/or allergies.
  • Make sure that the child’s medication schedule supports their driving activities, in consultation with your child’s physician, administer medications to your teenager as needed to reduce impulsiveness and inattention without sacrificing their driving capability. Ask your physician to write a letter stating that the medications they prescribe for AD/HD are safe to use while driving. If your child is required to submit to a blood test or a urinalysis after displaying poor driving behavior, he should immediately supply law enforcement officers with the letter.
  • Follow through on predetermined consequences for breaking the agreed-upon rules as soon as possible. Delayed consequences decrease significance for teens with AD/HD. Restrict or remove driving privileges as needed. Also, require the teen driver to pay, or contribute to the payment of any fines, repairs, or increases in insurance premiums that they cause. Adolescents need to learn that they have financial as well as moral responsibilities associated with the privileges of driving.

While some of these suggestions are specific to ADHD drivers, the majority of them make good sense for parents of any teenager embarking on the driving experience.

 
Resources

“Driving Outcomes of Young People With Attentional Difficulties in Adolescence”; Journal of The American Academy of Child and Adolescent Psychiatry 2000; 39: 627-634; Lianne J. Woodward, Ph.D.; David M. Fergussson, Ph.D.; L. John Horwood, M.Sc.; authors.

“Parents of Teen Drivers with AD/HD: Proceed with Caution” Children and Adults with Attention Deficit/Hyperactivity Disorder; Attention!® Magazine; Volume 5, Number 4, Page 42; Dr. Marlene Snyder, Rae Hemphill, authors
http://www.chadd.org/attention/attnv5n4p42.htm

 


 

ADD- Connecting with Kids

Attention Deficit Disorder

Researchers say a new kind of brain scan may be helpful in detecting and diagnosing attention deficit disorder. Many parents have been waiting for some kind of breakthrough in diagnosis since ADD is one of the most difficult and subjective disorders to detect.

Experts at the National Institutes of Public Health confirm there is no standard way to diagnose the disorder, which many say is just an overused label for difficult kids. Still, experts at the National Institutes of Public Health say ADD is a serious health problem and many parents of ADD children know their kids, without medication or other help would be in trouble.

So how does a parent know if a kid is just hyperactive or suffering from attention deficit disorder? Experts advise an extensive evaluation that includes interviews with teachers and significant adults in a child’s life. That evaluation should include a complete physical, emotional and genetic history as well as a specific battery of tests. “It’s amazing. Sometimes you find a child has a hearing problem or a vision problem or there are a lot of things going on at home and it’s an emotional problem,” says Dr. Marianne Garber, an educational consultant. “The main thing is to rule out other causes for the behavior before settling on the ADD diagnosis.”

Teachers are often the first to confirm a parents suspicion but complete evaluation is crucial. Many times without evaluation misdiagnosis results and kids with learning disabilities or other problems are improperly treated failing to get the help they need.

 Information about Medication

The most common medications used to treat attention deficit disorder are stimulants which increase activity in areas of the brain that are underactive in children with the disorder. Some anti-depressants and tranquilizers have also been used effectively in the treatment of ADD

90% of children respond well to drug therapy when they are correctly diagnosed and treated.

Doctors should be alerted to heart rhythm problems and family history of sudden death before prescribing Ritalin.

Side effects of medications used to treat attention deficit disorder include weight loss, decreased appetite, slower growth, trouble falling asleep. Many doctors believe the benefits of the medication outweigh the side effects which can often be controlled by lowering the dosage.

“The main thing is to rule out other causes for the behavior before settling on the ADD diagnosis.”

–Dr. Marianne Garber, Educational Consultant

Attention Deficit Disorder

Experts report that at many a 5% of children actually have attention deficit disorder and 1.5 million take medication to control the problem.

Attention deficit disorder and attention deficit hyperactivity disorder, which is the diagnosis that includes the hyperactive component, is usually first noticed in school age kids. It is often first recognized by teachers due to a child’s inability to sit still and pay attention as well as his or her peers.

Mind altering drugs like Ritalin are often used to treat this disorder but some doctors and parents worry about the long term effects of the drugs since many have not been studied for significant periods of time to determine long term implications.

Symptoms of Attention Deficit Disorder

If your child exhibits the following symptoms in most situations, an evaluation may be necessary:

  • restless inability to sit still
  • difficulty playing in group games
  • inability to control impulses
  • hyperactivity
  • little attention to detail
  • cannot stay organized
  • fails to finish things
  • easily distracted

Resources

Caring for Every Child’s Mental Health:
Communities Together Campaign

P.O. Box 42490
Washington, D.C. 20015
www.mentalhealth.org

For more information on
parenting issues contact us:
Connecting with Kids
Published by CWK Network
www.connectingwithkids.com

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