5 Must-Read Articles, and an Online Course, to Help Children with ADHD

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Giv­en the ongo­ing changes and con­tro­ver­sies sur­round­ing ADHD diag­no­sis and treat­ment, let us high­light 5 key arti­cles writ­ten by Duke Uni­ver­si­ty’s Dr. David Rabin­er to sum­ma­rize recent sci­en­tif­ic find­ings and their impli­ca­tions, plus a very rel­e­vant online course to help par­ents and pro­fes­sion­als help chil­dren with ADHD.

1. Study finds large gaps between research and prac­tice in ADHD diag­no­sis and treatment

• Key insight: Evi­dence-based guide­lines from the Amer­i­can Acad­e­my of Pedi­atrics on the eval­u­a­tion and treat­ment of ADHD are fre­quent­ly not fol­lowed. Many chil­dren are diag­nosed with ADHD in the absence of clear­ly meet­ing DSM diag­nos­tic cri­te­ria, and behav­ioral treat­ment is rarely recommended.
• Key data point: Pedi­a­tri­cians pre­scribed ADHD med­ica­tion to rough­ly 93% of youth diag­nosed with ADHD. Doc­u­men­ta­tion that behav­ioral treat­ment was rec­om­mend­ed, how­ev­er, was present in only 13% of the charts.

2. Study shows why chil­dren with ADHD should be reeval­u­at­ed each year: Atten­tion prob­lems per­ceived by teach­ers are far less sta­ble than we imagine

• Key insight: Clin­i­cal­ly-ele­vat­ed atten­tion prob­lems as per­ceived by teach­ers are less sta­ble than imag­ined, high­light­ing the impor­tance of care­ful­ly reeval­u­at­ing chil­dren each year so that chil­dren do not con­tin­ue to car­ry a diag­no­sis that may no longer apply and to be treat­ed for prob­lems at school that are no longer evident.
• Key data point: Data from 3 diverse sam­ples indi­cates that more than 50% of ele­men­tary school chil­dren rat­ed by their teacher as hav­ing clin­i­cal­ly sig­nif­i­cant inat­ten­tive symp­toms one year do not show sim­i­lar prob­lems the fol­low­ing year.

3. Don’t over­look sleep dif­fi­cul­ties in chil­dren with ADHD; they may impair func­tion­ing as much as ADHD itself

• Key insight: Although the link between ADHD and sleep dif­fi­cul­ties is well-doc­u­ment­ed, eval­u­at­ing sleep dif­fi­cul­ties dur­ing an ADHD assess­ment may be rou­tine­ly over­looked. In some cas­es,  sleep prob­lems may cre­ate sig­nif­i­cant dif­fi­cul­ties for their dai­ly func­tion­ing beyond what ADHD symp­toms explain, so treat­ing the child’s sleep dif­fi­cul­ties should be an impor­tant treat­ment target.
• Key data point: The most preva­lent sleep prob­lem – report­ed for 42% of the sam­ple – was exces­sive day­time sleepi­ness, and it con­tributed to sig­nif­i­cant­ly low­er life skills even after con­trol­ling for ADHD symp­toms. The sec­ond most preva­lent sleep prob­lem was insom­nia (for 30% of the sam­ple), and it pre­dict­ed greater social impairment–above and beyond impair­ment explained by ADHD symptoms.

4. Reduc­ing the Need for High Med­ica­tion Dos­es with Behav­ior Therapy

• Key insight: The real­ly inter­est­ing find­ings from this study con­cern the com­bi­na­tion of med­ica­tion and behav­ioral treat­ment. On vir­tu­al­ly all ADHD mea­sures, adding high inten­si­ty behav­ior man­age­ment to the low­est med­ica­tion dose of med­ica­tion yield­ed com­pa­ra­ble improve­ments to those pro­duced by the high dose med­ica­tion alone. For a num­ber of mea­sures, even low inten­si­ty behav­ior man­age­ment com­bined with the low­est med­ica­tion dose was as effec­tive as high dose medication.
• Key data point: Results sug­gest­ed that a typ­i­cal child with ADHD could be treat­ed with the equiv­a­lent of 5 mg of methylphenidate 2X/day if he/she con­cur­rent­ly received mod­er­ate to high inten­si­ty behav­ior ther­a­py. With­out behav­ior ther­a­py, the same child would require a 20 mg dose 2X/day to attain com­pa­ra­ble ben­e­fits. Thus, the dai­ly reduc­tion in methylphenidate would be 30 mg/day.

5. Mind­ful­ness train­ing for chil­dren with ADHD and their parents

• Key insight: Mind­ful­ness train­ing for chil­dren and par­ents can be a help­ful inter­ven­tion for ADHD. Par­ents can observe reduc­tions in their child’s ADHD symp­toms fol­low­ing train­ing. In addi­tion, they can observe declines in their own ADHD symp­toms and par­ent­ing stress.
• Key data point: From pre- to post test, chil­dren who received mind­ful­ness train­ing were rat­ed by their par­ents as show­ing sig­nif­i­cant declines in inat­ten­tive and hyper­ac­tive impul­sive symp­toms; the mag­ni­tude of the decline was large for atten­tion prob­lems and mod­er­ate for hyper­ac­tiv­i­ty. These declines remained evi­dent and of sim­i­lar mag­ni­tude at the 8‑week follow-up.

We hope you enjoy those 5 must-read arti­cles sum­ma­riz­ing recent sci­en­tif­ic find­ings and their implications.

To learn more, par­ents and allied pro­fes­sion­als may also want to access the 6‑hour, self-paced, online course How to Nav­i­gate Con­ven­tion­al and Com­ple­men­tary ADHD Treat­ments for Healthy Brain Devel­op­ment, fea­tur­ing Dr. David Rabin­er and Sharp­Brains’ Alvaro Fernandez.

Learn More & Register Here

(10%-off dis­count code: sharp2017)

 

Course descrip­tion: In order to suc­cess­ful­ly pro­mote children’s healthy brain devel­op­ment, every par­ent whose child has been diag­nosed with ADHD should learn how to sys­tem­at­i­cal­ly nav­i­gate and mon­i­tor the range of poten­tial ADHD treat­ments based on the lat­est sci­en­tif­ic evi­dence. This course aims at pro­vid­ing the nec­es­sary infor­ma­tion, frame­works and toolk­its to make well-informed deci­sions, in con­junc­tion with pro­fes­sion­al advice, about med­ica­tion, behav­ioral ther­a­py, exer­cise, neu­ro­feed­back, work­ing mem­o­ry train­ing, med­i­ta­tion, diet and supplements.