Understanding ADHD and Learning Disability Part VIII

‘ADHD is an attention difference not an attention disorder.’

This inspiring video reinforces the view that we as a society must embrace cognitive diversity.

 

Related Reading

Part 1: Understanding ADHD and Learning Disability

Part 2: Understanding ADHD and Learning Disability

Part 3: Understanding ADHD and Learning Disability

Part 4: Understanding ADHD and Learning Disability

Part 5: Understanding ADHD and Learning Disability

Part 6: Understanding ADHD and Learning Disability

Part 7: Understanding ADHD and Learning Disability

 

Understanding ADHD and Learning Disability Part VII

In this final part of my series on understanding Attention Deficit/Hyperactivity Disorder (ADHD),  we delve more into the underlying mechanisms of the disorder.

Hyperactive flies can help us understand ADHD and learning disability.

Many researchers are seeking a better understanding of ADHD and the medications used to treat it by studying ADHD’s underlying mechanisms and working towards a better knowledge of this disorder.  In this video Professor David Anderson explains how our current understanding of ADHD (and the learning disability which can accompany it) as merely chemical imbalances in dopamine and noradrenaline is not working and shows that by studying a strain of hyperactive fruit fly (Drosophila) we can study the different nerve pathways involved in ADHD and learning disability which will help in providing safer and more effective treatments.

Small cold-water fish

There is no cure for ADHD at this time. However a recent (2012) study in the Journal of the American Medical Association  reports that fish consumption during pregnancy protects against ADHD in the child. In addition, many ADHD sufferers also report a beneficial effect of daily fish oil. If you are considering including fish in your diet then the study recommends small cold-water fish such as herring, mackerel, sardines and salmon rather than larger fish such as tuna which live much longer and thereby may accumulate the toxic metal mercury.

Further reading for those interested in the scientific experiments:

  1. Lebestky et al. (2009). Neuron, 64 (4), 522-36 PMID: 19945394
  2. Wang L, & Anderson DJ (2010). Nature, 463 (7278), 227-31 PMID: 19966787

Other Sources:

http://www.brainfacts.org/Diseases-Disorders/Childhood-Disorders/Articles/2012/Confronting-Attention-Deficit-Hyperactivity-Disorder

Related Reading

Part 1: Understanding ADHD and Learning Disability

Part 2: Understanding ADHD and Learning Disability

Part 3: Understanding ADHD and Learning Disability

Part 4: Understanding ADHD and Learning Disability

Part 5: Understanding ADHD and Learning Disability

Part 6: Understanding ADHD and Learning Disability

 

 

Understanding ADHD and Learning Disability Part VI: How is ADHD treated?

This is the sixth in a series on understanding Attention Deficit/Hyperactivity Disorder (ADHD).

Treatment

ADHD is commonly treated with parent education, school-based interventions, and medications such as stimulants (e.g., methylphenidate) and newer, nonstimulant drugs such as atomoxetine. Adults benefit from the same medications as children and may find some behavioural therapies helpful. On the behavioral side, children can be taught strategies for staying focused on a task such as following a detailed schedule, or for organizing materials. Adult ADHD can be a family problem as well as an individual problem. Because the symptoms of the disorder often wreak havoc on every member of the family, not just the individual with adult ADHD, it’s important for the entire group to undergo family therapy, even if the ADHD parent is already getting individual counselling. It is best to begin family therapy as soon as it becomes clear that the symptoms of adult ADHD are interfering with normal family functioning and thus avoid crises and emergencies that may take months or years to resolve. Family therapy may include teaching family members new skills and coping strategies, and therapy in which family members support and encourage each other and learn to communicate more effectively.

Drug treatment of ADHD

Many children with ADHD may also need medication. The use of stimulants to treat ADHD was first described in 1937.Since the late 1960s, stimulants such as Ritalin® or Adderall® have been prescribed to treat children with ADHD.

2011-12 shortage in U.S. market

In 2011 and 2012, there was a shortage of Ritalin® and Adderall® in U.S. pharmacies. Some say the shortage was caused by the US Drug Enforcement Administration’s (DEA) annual limits on the manufacture of controlled substances. The DEA argues that drug manufacturers had caused the shortage by applying their quotas toward more lucrative kinds of amphetamine-based medications. The shortage was resolved by November 2012. Currently, between 4 and 6 million children in the United States take one of these medications, which reduce hyperactivity and impulsivity, help improve the ability to focus, and even improve physical coordination. In fact, medications are so effective in helping people with ADHD that a recent shortage wreaked havoc for many families

Drug action

Nonetheless, there is concern about giving children a drug that is potentially addictive. Methylphenidate, the active ingredients in Ritalin®, acts like a weak form of cocaine to increase dopamine and noradrenaline levels but tend to do it all over the brain sometimes resulting in unwanted side-effects such as nervousness, drowsiness, insomnia, suspicion and paranoia. Concerta®is a slow release of methylphenidate while Daytranta® delivers the drug via a skin patch, similar to those used for nicotine replacement therapy.Adderall® is a mixture of amphetamine salts which also increase dopamine and noradrenaline levels but has a higher potential for abuse than Ritalin®.

Controversy

In addition, there is a worry that ADHD may be over-diagnosed, leading to the diagnosis and treatment of high-energy children who have difficulty in the classroom, but are medically normal. For this reason the effectiveness of treatments should be re-evaluated in each person on a regular basis to determine if the current treatment continues to be optimal. There are some reports that daily intake of fish oil can be helpful.

Related Reading

Part 1: Understanding ADHD and Learning Disability

Part 2: Understanding ADHD and Learning Disability

Part 3: Understanding ADHD and Learning Disability

Part 4: Understanding ADHD and Learning Disability

Part 5: Understanding ADHD and Learning Disability

 

 

Understanding ADHD and Learning Disability Part V: Diagnosing ADHD

This is the fifth installment in a series on understanding Attention Deficit/Hyperactivity Disorder (ADHD).  

Diagnosing ADHD – it’s harder than you think.

Currently there is no diagnostic test for ADHD. Diagnosis requires a clinical interview, parent and teacher ratings for children, and self and other ratings for adults. In addition, it is estimated that two-thirds of children diagnosed with ADHD have additional learning disorders or other mental health or neurodevelopmental conditions.   This makes it all the more important that the diagnosis is made in a multi-disciplinary environment, where the child or adult is assessed by a medical doctor, counsellor, clinical psychologist and if necessary by a psychiatrist. This is important because problems with attention can be triggered by many other conditions; in particular, adults may have attention issues along with other disorders such as depression.

….and there’s more…

Other factors have been found to affect diagnosis of ADHD. For example, the youngest children in a class are much more likely to be diagnosed as having ADHD compared to their older counterparts in the same year. This is because these children may behave more hyperactively, not because they have ADHD, but because they are younger and developmentally behind their classmates. In fact, it is estimated that about 20% of children given a diagnosis of ADHD are misdiagnosed because of the month they were born with children born in December (the youngest in class) 39% more likely to be diagnosed with ADHD than those born in January (the oldest in class).

Journal reference: http://www.ncbi.nlm.nih.gov/pubmed/22392937

Part 1: Understanding ADHD and Learning Disability

Part 2: Understanding ADHD and Learning Disability

Part 3: Understanding ADHD and Learning Disability

Part 4: Understanding ADHD and Learning Disability

 

 

 

Could there an evolutionary advantage in having ADHD?

Ariaal Elder

Ariaal Elder. The Ariaal are northern Kenyan pastoralists.

This is the fourth in a series on understanding Attention Deficit/Hyperactivity Disorder (ADHD). Today I want to examine if there is in fact an evolutionary advantage in having ADHD.

ADHD is strongly genetic and the genes involved regulate the levels of two neurotransmitters called dopamine and noradrenaline (noradrenaline is called norepinephrine in North America) – chemicals which act as messengers between nerve cells.

Hyperactivity has long been part of the human condition and some ADHD – linked genes are more common in nomadic populations and those with more of a history of migration. In fact,the health status of nomadic men such as those from the Ariaal people in northern Kenya was higher if they had an ADHD – linked gene. However, recently settled Ariaal men seemed to have slightly worse health.

ADHD – ‘the don’t fence me in’ gene

In nomadic Ariaal society,  those with ADHD may be better in tasks involving risk, competition, and/or unpredictable behavior (i.e. exploring new areas, finding new food sources, etc.). For instance, an Ariaal person killing a lion is highly respected and in these situations, ADHD would have been beneficial to the society as a whole even while severely detrimental to the individual.In addition, women in general are more attracted to males who are risk takers, thereby promoting ADHD in the gene pool. This might help explain why ADHD-linked genes have survived to the present day but are more suited to a previous nomadic, risk-taking lifestyle.

Like mother – like son

More recent research suggests that because ADHD is more common in mothers who are anxious or stressed that ADHD is a mechanism of priming the child with the necessary traits for a stressful or dangerous environment, such as increased impulsivity and explorative behaviour etc.

Journal reference: BMC Evolutionary Biology (DOI: 10.1186/1471-2148-8-173)

Part 1: Understanding ADHD and Learning Disability

Part 2: Understanding ADHD and Learning Disability

Part 3: Understanding ADHD and Learning Disability

 

 

 

Dyslexia rules KO

Image Source: Corbis

In my previous neuroeducation post, I briefly outlined the latest scientific research which shows that learning actually changes the shape of the brain, allowing specific areas in the brain to grow or change and how most importantly this brain growth can be accelerated to improve learning and memory using certain approaches to teaching.

Neuroeducation also encompasses the study of common conditions such as brain injury, dyslexia, hyperactivity attention deficit disorder, learning disability, malnutrition, stuttering and indeed depression and anxiety disorder.

Today let’s take a look at one of these conditions in more detail.  

Dyslexia rules KO 

Research has shown that children with dyslexia suffer from two specific problems: trouble analyzing and processing sound (phonology) and difficulties with rapid naming of objects. 

Early intervention particularly with phonological therapies – before the child gets into trouble in school – appears to prevent dyslexia. The old idea was that dyslexia was somehow a hole in brain – a mental deficit – is not the case. These children appear to be just on the low end of an ability to learn to read instead of having some problem in their brains in much the same way as those children who find difficulty learning a musical instrument.

The problem for dyslexic children is that unlike learning a musical instrument, learning to read is regarded by society as an essential skill – thus putting these kids on the back foot.  The good news is that early detection and treatment for dyslexia is available and better and more effective treatments are being developed as we speak.