(by 3 people)
My experiences as a special education teacher
You are probably searching for information on medication such as Ritalin or Concerta, because your child or student has been prescribed a specific dosage.
As an educational psychologist and special education teacher, I see these medications as one of the last options when treating attention deficits or hyperactive behaviour. There are more ways to try to decrease hyper behaviour and to try to increase positive behaviour.
Before a physician prescribes medication to decrease hyperactivity and increase impulse control, a series of assessments should have been done. Learn more about these assessments below.
Why is this Lens Different from the others?
I am writing this Lens to give you objective information. Most other lenses on ADHD were created to promote a specific product or to discourage you from medicating your child.I am neither pro or against medication. But I have met many parents who were against prescribing medications such as Concerta(R), just because they heard so many bad things about them. I give a simple logical explanation for why medication could help a child:
If a child has a kidney failure, you give medication to help the body adapt to the failure. This is medication against a physical touchable disorder. Now, the same parent does not want to give medication to a child with a hyperactivity disorder, because she cannot physically "see" the disorder. But there is still a failure and the child is suffering from it. This happens quite often.
I am against giving products or treatments without a solid scientific research done in a statistically correct way. You should never give any supplement to your child, just because the seller says: works 100% or money back guaranteed!
Psychological Evaluation
done by an educational psychologist
Everybody knows what it feels like to fail over and over again at a certain task. After a while, a person tends to try to avoid those certain tasks. This happens in school as well. I have seen many students displaying hyperactive behaviour due to anxiety to a specific task or subject.If a child is acting out in class, it is important to get a clear picture of the achievements and ability of that child. Sometimes an underlying discrepancy between age and ability can explain behaviour.
What should be included in an assessment?
I will describe some of the psychological assessments. Remember, it is up to the professional to make the final decision in choosing the best instrument to diagnose a child.
- ACHIEVEMENT TEST. There are many standardized achievement tests.The purpose of these tests are to rate your child's academic levels. The scores can be reported as age-equivalent or grade-equivalent. Example: Johnny is 9 years of age, but his age equivalent in reading is 7 years 8months: a difference of 1 year and 4 months. The WIAT-2(R) is one of the best standarized Achievement tests and should only be administered by a qualified special education teacher. It is important to remember that the results should be recent (not older than 3 months).
- INTELLIGENCE TESTS. Different from an achievement test, the Intelligence Test measures the childs IQ. I always explain IQ as the ability to learn. An average IQ lies between 95 and 105 standard score points. IQ tests measures many abilities. The WISC-IV(R) is currently a very reliable IQ test and can be linked to the WIAT-2(R). Only a qualified psychologist or psychometrician is able to administer and interpret an IQ test.
- ADAPTIVE BEHAVIOUR CHECKLISTS. Next to Achievement and Ability, it is important to know if a child is able to adapt to a new behaviour or situation. To determine a student's adaptive behavior capacities, professionals focus on the student's conceptual skills, social skills, and practical skills. To measure adaptive skills, professionals use adaptive behavior scales that have been normed on individuals with and without disabilities. Most adaptive behavior scales are completed by interviewing a parent, a teacher, or another individual who are familiar with the student's daily activities. Students may have a combination of strengths and needs in any or all of the areas regarding conceptual, social and practical skills. A widely used Adaptive Behaviour checklist is the Vineland-2(R).
- a CONTINUOUS PERFORMANCE TEST measures different variables of attention and sustained attention, including average reaction time, levels of errors of omissions and errors of commissions, which reflect inattention, and impulsivity. The Conners' Continuous Performance Test (CPT(R) is widely used.
PostTraumatic Stress Disorder (PTSD)
All children and adolescents experience stressful events which can affect them both emotionally and physically. Their reactions to stress are usually brief, and they recover without further problems. A child or adolescent who experiences a catastrophic event may develop ongoing difficulties known as posttraumatic stress disorder (PTSD). The stressful or traumatic event involves a situation where someone's life has been threatened or severe injury has occurred (ex. they may be the victim or a witness of physical abuse, sexual abuse, violence in the home or in the community, automobile accidents, natural disasters (such as flood, fire, earthquakes), and being diagnosed with a life threatening illness). A child's risk of developing PTSD is related to the seriousness of the trauma, whether the trauma is repeated, the child's proximity to the trauma, and his/her relationship to the victim(s).Why am I writing this? Because lots of the symptoms PTSD children have are the same as in ADHD. Currently I work in an environment where lots of children suffer from different forms of trauma. Therefore, it is very important to separate the behaviours and the symptoms.
Case example I
based on true occurences
School complains about Peter being very impulsive and disruptive. He cannot sit still. It started suddenly this school and the teacher is beginning to send Peter to detention. During past school years Peter was a model student, who was eager to learn. Now, it looks like he rather is outside of his classroom. Peter is 8 years old. School thinks Peter might have ADHD.
Further investigation shows Peter does not have the same impulsive behaviour at home or at his favourite sports club. It looks like the behaviour is almost only displayed during school time. Attention Deficit and Hyperactivity Disorders are not limited to a single setting but the symptoms should occur in at least two different settings.
Peter is more likely struggling with some kind of anxiety problem.
Further investigation shows Peter does not have the same impulsive behaviour at home or at his favourite sports club. It looks like the behaviour is almost only displayed during school time. Attention Deficit and Hyperactivity Disorders are not limited to a single setting but the symptoms should occur in at least two different settings.
Peter is more likely struggling with some kind of anxiety problem.
ADHD on Youtube
Treatment of Attention Deficit Disorder
A discussion of the largest trial of treatment for ADHD, comparing drug treatment with intensive behavioral intervention.
Runtime: 6:51
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Case example II
based on true occurences
Jasper is 7 years old and is a very lively young man. He likes to run around and enjoys the outdoors more than sitting in a chair. Jasper has been in many small accidents due to his own doing. It seems Jasper almost never things about the consequences before he does something.
Jasper cannot sit still at school. He always has to experience every sudden change in the classroom. On the playground, he always gets into fights, because he accidentally knocked somebody over when playing ball.
Parents decided to stop sending Jasper to piano lessons. He enjoyed going there, but after 10 minutes he was bored and did not want to play anymore. He could not concentrate and got very frustrated easily.
Jasper fits multiple criteria for ADHD. Further investigation revealed he had been displaying this behaviour for a couple of years. Normal correctional behaviour interventions did not seem to work. A Psychiatrist decided to diagnose attention Deficit Hyperactivity Disorder, Combined Type.
Jasper cannot sit still at school. He always has to experience every sudden change in the classroom. On the playground, he always gets into fights, because he accidentally knocked somebody over when playing ball.
Parents decided to stop sending Jasper to piano lessons. He enjoyed going there, but after 10 minutes he was bored and did not want to play anymore. He could not concentrate and got very frustrated easily.
Jasper fits multiple criteria for ADHD. Further investigation revealed he had been displaying this behaviour for a couple of years. Normal correctional behaviour interventions did not seem to work. A Psychiatrist decided to diagnose attention Deficit Hyperactivity Disorder, Combined Type.
Best books on ADHD
not randomely picked, but hand selected.
There are many publications on ADHD and related disorders. I have selected a few of which I know are good books.
Attention-Deficit Hyperactivity Disorder, Third Edition: A Handbook for Diagnosis and Treatment
Amazon Price: $64.00 (as of 10/10/2008)
Usually ships in 24 hours
Taking Charge of ADHD: The Complete, Authoritative Guide for Parents (Revised Edition)
Amazon Price: $13.57 (as of 10/10/2008)
Usually ships in 24 hours
ADD/ADHD Behavior-Change Resource Kit: Ready-to-Use Strategies & Activities for Helping Children with Attention Deficit Disorder (Ready-To-Use)
Amazon Price: $19.77 (as of 10/10/2008)
Usually ships in 24 hours
Driven To Distraction : Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood
Amazon Price: $10.88 (as of 10/10/2008)
Usually ships in 24 hours
Learning To Slow Down & Pay Attention: A Book for Kids About Adhd
Amazon Price: $10.36 (as of 10/10/2008)
Usually ships in 24 hours
Concerta vs Ritalin
I am not a medical doctor. But I can share my experiences with both medication. As a psychologist, I have seen more positive effects with Concerta than have seen with Ritalin.Both medications are based on methylphenidate. This is the active ingredient. Ritalin, Concerta and are the same except that they have different formulations as they have a different delivery system. Please read below as perhaps this will give you a better understanding:
CONCERTA (methylphenidate HCl) CII is an extended-release formulation of methylphenidate for ADHD treatment that lasts through 12 hours, with just one morning dose.
CONCERTA uses an advanced OROS® extended-release delivery system to deliver a controlled rate of medication throughout the day. The OROS trilayer tablet is designed to release the medication in CONCERTA in a smoothly delivered pattern leading to improved attention and behavior through 12 hours. Because of this unique delivery system, CONCERTA minimizes the ups and downs in blood levels experienced with stimulant medications taken several times a day. Research confirms that a single dose of CONCERTA is as effective as the standard three-times-a-day dosing regimen of methylphenidate, the most commonly prescribed medication for ADHD.
CONCERTA also eliminates the need for dosing in and out of school or work, since it is taken once in the morning (with or without food). This is especially important for patients who participate in academic, job-related, or social activities outside of school or work, as it may help to eliminate the feelings of embarrassment felt by having to take medication in the middle of the school or work day or during after-school activities. And, once-a-day dosing means the medication is kept in the home and in the hands of parents.
Ritalin®, Ritalin-SR®, Ritalin® LA
Ritalin is available in several forms: Ritalin (methylphenidate HCl) CII, Ritalin-SR (methylphenidate hydrochloride sustained release tablets USP) CII, and Ritalin LA (methylphenidate hydrochloride extended release capsules) CII.
Ritalin is given 2 to 3 times daily with an average duration of 3 to 4 hours after each dosage.
I recommend Concerta over Ritalin for two reasons:
1. Concerta is time released, so only 1 dosage per day is needed.
2. Concerta is unbreakable, which makes it hard to share.
I recommend Ritalin over Concerta for only 1 reason:
1. Ritalin is an older medicine and tons of research has been done on the effectiveness.
Always let your physician have the final decision in making a choice for the best medication for your child. There might be other health factors to be taken into consideration.
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Only medication
as many physicians have told me?
NO.
Next to the prescribed medication, there needs to be done something else. A student who has started to take medication could see a drastic positive change in his behaviour and emotional state. Since this change is totally new, s/he has to learn how to adapt to those changes. I have seen children transform into well behaved eager learners, from bullies who has no interest in academics.
Thus, it is very important to give your child psychological therapy in how to deal with the behaviour and emotional changes. in most cases, this would be a behaviour therapy to teach the child to adapt to the new acquired state of mind.
Also, your physician needs to follow your child at least once per month. He should have given you charts, to document positive and negative behaviour changes, as well as possible side effects. The initial dosage is a trial. Sometimes children need a higher or lower dosage and you and the teacher are the only persons who can document the childs needs.
Next to the prescribed medication, there needs to be done something else. A student who has started to take medication could see a drastic positive change in his behaviour and emotional state. Since this change is totally new, s/he has to learn how to adapt to those changes. I have seen children transform into well behaved eager learners, from bullies who has no interest in academics.
Thus, it is very important to give your child psychological therapy in how to deal with the behaviour and emotional changes. in most cases, this would be a behaviour therapy to teach the child to adapt to the new acquired state of mind.
Also, your physician needs to follow your child at least once per month. He should have given you charts, to document positive and negative behaviour changes, as well as possible side effects. The initial dosage is a trial. Sometimes children need a higher or lower dosage and you and the teacher are the only persons who can document the childs needs.
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Let's look at reality
If your child is taking medication, maybe you could share some of your experience. Other parents could benefit from your feedback.
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Alternative treatments?
or are we dealing with quacks?
I would never trust an alternative method with no research data. Right? Get rid of ADHD in 2 days or ... Dyslexia does not exist!
Promises like these are easily made. And when a treatment is not working, it is almost always the clients fault, because s/he did not follow the treatment as described.
The problem with lots of non conventional treatments is the statistics. Most of the time, the creator of a specific method chooses its subjects to be included in the statistics. But if I was a creator of a supplement, I would truly choose only choose subjects who would benefit from my therapy or food supplement.
True science works different, because there is always a control group. The test results gets compared with data taken from the control group to see if all is reliable and not misleading.
Promises like these are easily made. And when a treatment is not working, it is almost always the clients fault, because s/he did not follow the treatment as described.
The problem with lots of non conventional treatments is the statistics. Most of the time, the creator of a specific method chooses its subjects to be included in the statistics. But if I was a creator of a supplement, I would truly choose only choose subjects who would benefit from my therapy or food supplement.
True science works different, because there is always a control group. The test results gets compared with data taken from the control group to see if all is reliable and not misleading.
A homeopathic option
the only non-medical product I recommend
Växa's Attend is a safe, homeopathic medicinal specifically formulated to help support the function of the Central Nervous System (CNS) and address the specific neurochemical deficiencies which are thought to occur within the population of Attention Deficited individuals, whether from child or adult populations. Taken regularly, this homeopathic medicinal is designed to complement the body's natural calming and balancing agents which help to focus attention and relieve over-and-under activity, as well as the body's appropriate, sometimes seemingly paradoxical, counterbalancing system of energy use, and the appropriate attenuation of specific stimulation.How Does Attend Work?
Quite uniquely, Attend is designed to complement the body's natural calming and balancing agents with specific homeopathic ingredients (Lithium bromatum, carbonicum) which help to target, direct and smoothly focus attention, while naturally complementing the activity of the Reticular Activating System. The homeopathic ingredients in Attend have exemplified the power of attenuation in remarkable ways and minimized exhaustion after moderate mental effort. Additionally the homeopathic ingredients in Attend have served to aid in prolonged mental exertion and brain fatigue. The inability to keep the mind fixed on any one subject may be a reason to consider taking Attend. Attend may also be helpful with other symptoms such as wandering thoughts, restless agitation, weakness of memory, and slow perception.
Are There Any Side-Effects With Attend?
No, Attend is safe and non-toxic! Unlike other medications, Attend works without the harmful side-effects that may stunt the growth of developing children. Indeed, Attend works to help naturally stimulate neural growth patterning and regenerative activity so as to forge more "connections" within the neural network. Interestingly, other ADD-specific pharmaceuticals have been suspected of retarding growth of ADD individuals, which ironically, is the last thing you would want to do with individuals who have been neurally limited! Furthermore, Attend works without diminishing overall processing, cognitive and learning activities, as do amphetamines, antidepressants or anticonvulsants normally prescribed for ADD, and all of which have been shown to detrimentally diminish cognitive activity.
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Your thoughts or comments
no advertisements for treatments or medication allowed.
yany
this information is great, I am an adult with ADHD. I will try the natural alternative. Can this be take for the wondering mind of a child with autism. thank you for a great information.
ymr
Posted May 03, 2008
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Yardbird
Thanks for the educated, balanced and objective viewpoint. I think for a child who has been properly diagnosed with ADHD, Researched FDA medicines are the best option, (unless contraindicated for some reason). I think that exercise, less processed foods, behavior training, and good nutrition can supplement the working of meds. Great lens! Posted March 16, 2008 |
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dr.chris
Hi, please leave your comments or feedback. I will delete every promotional entry. I want this lens to stay objective. Posted December 15, 2007 |
