Do you have ADHD or a language impairment?

Do you have ADHD or a language impairment?

Read more: Journal of Child Psychology and Psychiatry

The Journal of Child Psychology and Psychiatry published a study that examined language impairments (LI) and ADHD. They found an association, but perhaps not what you’d expect.

The research indicates that testing for LI is very important when testing for ADHD.

Language impairment may be defined as significant difficulties affecting listening comprehension, oral expression, social interaction, reading, writing, or spelling. Its very definition reads like a checklist for ADHD symptoms.

The researchers found that LI are commonly observed among children referred for psychiatric services — especially ADHD. This would seem to makes sense; many children with ADHD have the same symptoms as LI:

1. They have poor social interactions manifesting in an inability to make friends.
2. They have poor listening comprehension manifesting when they cannot take multiple step instructions (e.g. Go to your bedroom, put your pajamas on, brush your teeth, get in bed).
3. They have difficulty expressing themselves orally resulting in frustration and angry outbursts.
4. They often have difficulty with reading, writing, and spelling.

The researchers concluded that children with LI were at the most disadvantage regardless of the nature of the psychiatric diagnosis.

Furthermore, the researchers noted that “…caution must be exercised in attributing to children with ADHD what might be a reflection of problems for children with language impairment generally. As most therapies are verbally based it is notable that language competence is rarely evaluated systematically before such therapies are undertaken.”

In another study performed in Norway, Speech Therapist Wenche Andersen Helland noted, “There is often a one-sided focus on the behavior of kids with ADHD. But these children may have communication problems as they grow older, particularly in a school situation, if their language skills are not given enough attention. If we don’t work hard enough to strengthen language development in children with ADHD, we increase the risk that they
won’t learn what they should in school. They’ll also be more likely to fall short in social interactions with their peers. We need to intervene early to prevent a downward spiral.”

In other words, check for LI when checking for ADHD. This cannot be accomplished in the typical 20 minute session with a pediatrician. A speech language pathologist can determine a language impairment. The bottom line is that it is wise to get a full evaluation from a specialist that includes a full physical, vision test, language impairment test, and others.

School Testing and the Rising Rate of ADHD

A new book finds a startling connection

Read the Interview: http://www.nbcnews.com/health/kids-health/could-school-testing-be-driving-adhd-n55661

Is the increased demand for performance behind the increased diagnoses of ADHD? Two University of California professors have released a book this month titled, “The ADHD Explosion.” They call it a “reality check” for parents, providers, educators and politicians.

The Berkeley professors, Dr. Stephen Hinshaw and Dr. Richard Scheffler, are noted researchers on ADHD. Their research tells them that federal policy issues may be behind the recent explosion in cases of ADHD.

“When you look at that [national testing policy], you get the
closest thing there is to a smoking gun,” says Dr.Scheffler.

The Journal of the American Medical Association (JAMA) Pediatrics, found that rates of ADHD in California have jumped by 24% since 2001. Additionally, the Center for Disease Control (CDC) reports increases from 7.8 percent in 2003 to
9.5 percent in 2007 and to 11 percent in 2011— a rate of 5 percent a year.

It looks for all the world like a growing epidemic. But ADHD wasn’t even something people noticed until recently,” says Hinshaw.

“It started about the same time in history that we made kids go to school,” Hinshaw told NBC News in an interview.

Then come the 1990s, and a crisis of falling test scores. “What happened is that a number of states began to pass accountability laws,” Hinshaw said.

Hinshaw and Scheffler examined the correlation between diagnoses of ADHD and maps of states that had passed accountability laws.

According to NBC News, by the turn of the century, 30 states had passed accountability laws. They tended to be Republican-leaning states in the South, such as North Carolina. In 2007, 15.6 percent of all children in North Carolina had been diagnosed with ADHD at some point, including nearly one in three teenage boys.

Two things happening together don’t prove a correlation. Is it coincidence? Hinshaw and Scheffler were persuaded to look further.

AN NBC News article reports that the professors then examined date related to the No Child Left Behind federal policy enacted in 2002. It was one of the first official acts of President George W. Bush after he took office.NCLB required standardized testing to show if schools were, in fact, educating students. A truly salient aspect of NCLB was that it held teachers and principals directly responsible for the results and removed federal and state bureaucrats who mandate curriculum and educational policy.

According to the NBC News article:

“Now what happens is a natural experiment,” says Hinshaw. The other states raced to write accountability laws, requiring schools to show they are actually educating children.

“When you incentivize test scores above all else, there is probably pressure to get kids diagnosed with ADHD.”

Hinshaw and Scheffler compared ADHD rates in the 30 states that had been requiring testing with the 20 states that had to play catchup.

Rates of ADHD diagnoses soared.

“Children ages 8 to 13, living in low-income homes and in states without previous consequential accountability laws, went from a 10 percent to a 15.3 percent rate of ADHD diagnoses once No Child Left Behind started,” they wrote. That’s a 53 percent increase over four years.

California’s current rate, post-testing? It’s 7.3 percent. North
Carolina’s rate actually fell slightly, to 14.4 percent in 2011.

“When you incentivize test scores above all else, there is probably pressure to get kids diagnosed with ADHD,” Hinshaw said. “We know from our own research that medication not only makes you less fidgety but also can bump up your test scores.”

That would be the benign interpretation, that testing has
encouraged parents to get their kids in to see specialists for
much-needed medical care. But there’s also a more sinister
possibility and one that Hinshaw and Scheffler say is at work in
some states.

“If you can identify the children with ADHD, you can take them out of the pool that measures how schools are doing,” says Scheffler.

He says some districts — he won’t say where — do seem to have been doing so. State school officials and the federal Department of Education did not respond when contacted by NBC News.

No Child Left Behind ties federal funding to test scores, Scheffler points out.“You can see the incentive for schools to get kids diagnosed with ADHD,” he says.

Either way, Scheffler and Hinshaw say the increase in ADHD cases is real, and it’s not just affecting kids. Recent studies show adult diagnoses are on the rise, too.

“Although often ridiculed, ADHD represents a genuine medical
condition that robs people of major life chances,” they write in the book.

“You can see the incentive for schools to get kids diagnosed with ADHD.”

Scheffler doesn’t see the increase in adult ADHD diagnoses as
surprising. “This has nothing to do with the schools. This has to do with global competition and performance,” he says. People are under pressure to perform better at work.

And news about adult ADHD in turn sends more people to their doctors, and diagnoses spike even more, Hinshaw adds. “Here are we are in 2014 with evidence that medications can benefit. Adult ADHD clinics spring up,” he says.

“That’s not necessarily a bad thing,” says Hinshaw.

What is bad is if ADHD is not being diagnosed with the proper care, Hinshaw says. A 10-minute pediatrician visit is not adequate for an ADHD diagnosis and certainly not as the basis for writing a prescription for a powerful stimulant, such as Ritalin or Adderall, to treat it.

“Many pediatricians are not trained in the emotional disorders of childhood, or not reimbursed for the time it takes,” Hinshaw said.

“It is easy to pull out prescription pad at the end of a visit.”

He calls the book a “reality check” and says parents, providers, educators and politicians should take note, and make sure the right kids are being diagnosed, and helped, properly.

 

ADHD Isn’t Real

ADHD Isn’t Real
Pediatric neurologist claims ADHD is a sham

Read More: http://www.examiner.com/article/pediatric-neurologist-richard-saul-claims-adhd-does-not-exist-upcoming-book,
A controversial upcoming book by Pediatric Neurologist, Dr. Richard Saul, is titled, “ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder.”

ADD was first appeared in the Diagnostic and Statistical Manual(“DSM”) in 1980. Its name was changed to ADHD in 1987 and diagnoses have skyrocketed to reach all time highs. Dr. Saul claims that ADHD shouldn’t even be in the DSM.

“ADHD makes a great excuse,” Saul notes. “The diagnosis can be an easy-to-reach-for crutch. Moreover, there’s an attractive element to an ADHD diagnosis, especially in adults — it can be exciting to think of oneself as involved in many things at once, rather than stuck in a boring rut.”

Dr. Saul bases his conclusions on his many years of treating patients. He concludes that ADHD is nothing more than a collection of symptoms and not a disease. ADHD is often called a ‘garbage pail’ diagnosis as many different symptoms are often dumped together to make the diagnosis.

Dr. Saul sought out different causes for his patients’ symptoms. He found that by searching deeper into his patients’ specific situations, he could make a proper diagnosis and resolve their problems. For example, Dr. Saul treated a young girl who was unruly in school, but it turned out to be that she couldn’t see the blackboard and only needed glasses. Another example he cites was a 36-year-old man who thought he had ADHD was simply drinking too much coffee and not getting enough sleep.

Dr. Saul lists other causes that are associated with what he considers a wrongful ADHD diagnosis:

Tourette’s
OCD
Fragile X Syndrome (a genetic mutation linked to mental retardation)
Autism
Fetal Alcohol Syndrome
Learning disabilities
Substance abuse
Poor hearing

Not every case needs to be diagnosed concludes Dr. Saul. For example, Saul treated a female adult who was convinced she had ADHD and who had been prescribed stimulants. Saul realized she was not coping with her life because she was greatly overwhelmed. He simply advised her to return to regular exercise and cut back on her work schedule.

Your opinions are welcomed.

Should You Get an MRI?

An expert weighs in
ADHD expert Larry Silver, MD

In our search for answers and solutions, we often are faced with choices outside our fields of experience or expertise. Brain scanning is a newer technology that parents often encounter. It is costly so it’s important to understand what we’re getting for the money. Does it make sense to get an MRI? Here’s what ADHD expert Larry Silver, MD has to say:

No, it doesn’t. An MRI won’t help your doctor diagnose ADHD. At this time, we do not have firm evidence as to the precise areas of the brain that cause ADHD behaviors.

ADHD is diagnosed clinically. A professional talks with your daughter, you and your husband, and teachers, and tries to determine the following: Does your daughter show behaviors that suggest that she is hyperactive, inattentive, has difficulty with organization, or is impulsive? If so, does the history of these problems suggest that they are chronic (have been noted since early childhood) and pervasive (occur at home, in school, with peers, in activities). You should educate your daughter’s physician about diagnosing ADHD or find another practitioner.

http://www.additudemag.com/adhdblogs/11/10096.html

Is Brain Imaging a Good Diagnostic Tool?
www.additudemag.com
Can brain imaging help in diagnosing my daughter? We think she has ADHD, and the doctor recommended an MRI. Does this make sense?

Introducing Dear Sheer Genius

Dear Sheer Genius,

We are pleased to introduce our new advice column, Dear Sheer Genius. This advice column will be sent out every week and we invite all of you to write to our very own attention specialist, Sheer Genius. You may write Sheer Genius and ask questions about Play Attention, attention problems, education, behavior shaping, parenting concerns, peer relationships etc.!

Sheer Genius is here to help!

Who is Sheer Genius?

Sheer Genius is the virtual member of the Play Attention family. His outstanding knowledge and experience is incorporated into Play Attention to help guide you through our program every step of the way!

How do I submit a question?

To submit your question please click here or email sheergenius@playattention.net. If your question is selected you will receive a personal email from Sheer Genius and your question/answer will be posted on our website as well as our Facebook page. We will only use your first name if you provide it.

Sheer Genius looks forward to hearing from you!

Photo: Introducing Dear Sheer Genius,
We are pleased to introduce our new advice column, Dear Sheer Genius.  This advice column will be sent out every week and we invite all of you to write to our very own attention specialist, Sheer Genius.  You may write Sheer Genius and ask questions about Play Attention, attention problems, education, behavior shaping, parenting concerns, peer relationships etc.!
Sheer Genius is here to help!
Who is Sheer Genius?
Sheer Genius is the virtual member of the Play Attention family. His outstanding knowledge and experience is incorporated into Play Attention to help guide you through our program every step of the way!
How do I submit a question?
To submit your question please click here or email sheergenius@playattention.net.  If your question is selected you will receive a personal email from Sheer Genius and your question/answer will be posted on our website as well as our Facebook page.  We will only use your first name if you provide it.
Sheer Genius looks forward to hearing from you!

Breastfeeding — The New Ritalin?

New research suggest it is
Mimouni-Bloch, A, Kachevanskaya, A, Mimouni, FB, et al. Breastfeeding May Protect from Developing Attention-Deficit/Hyperactivity Disorder.

Breastfeeding Medicine. 2013; doi:10.1089. Accessed May 14, 2013. Full study: http://online.liebertpub.com/doi/full/10.1089/bfm.2012.0145

The May 14, 2013 issue of Breastfeeding Medicine reports that breastfeeding may offer a protective effect from ADHD. The Israeli scientists performing the study say breastfeeding may keep children from developing ADHD even as they get older.

The Israeli researchers recruited 6 to 12 year-olds diagnosed with ADHD.These children were matched up with two sets of healthy control groups. The control groups were the ADHD children’s siblings who did not have ADHD, and 6 to 12 year old children with similar backgrounds. Siblings were included because they likely have similar genetic and
environmental backgrounds as the children with ADHD.

The researchers found that children who had been diagnosed with ADHD were breastfed less often than their healthy peers. Here’s the breakdown:

* At one month of age, only 63 percent of children with ADHD were breastfed.

* At one month of age, the non-ADHD kids were breastfed 86 percent of the time while the ADHD children’s non-ADHD siblings were breastfed 79 percent of the time.

* By six months of age, only 29 percent of the ADHD children were breastfed while 50 percent of their healthy siblings and 57 percent of the non-related children were breastfed.

“A stepwise logistic regression … demonstrated a significant
association between ADHD and lack of breastfeeding at 3 months of age, maternal age at birth, male gender, and parental divorce,” the researcher wrote. “Children with ADHD were less likely to breastfeed at 3 months and 6 months of age than children in the two control groups. We speculate that breastfeeding may have a protective effect from
developing ADHD later in childhood.”

One can’t help but ask if the child’s propensity to be distracted, fussy, or moody could have a difference in the outcomes of this study. In other words, were they breastfed less because of ADHD like symptoms early on, or does the act of breastfeeding actually act as a protective effect.

Mimouni-Bloch, A, Kachevanskaya, A, Mimouni, FB, et al. Breastfeeding May Protect from Developing Attention-Deficit/Hyperactivity Disorder.

Breastfeeding Medicine. 2013; doi:10.1089. Accessed May 14, 2013. Full study: http://online.liebertpub.com/doi/full/10.1089/bfm.2012.0145

Is It More Than Just ADHD?

New study sheds some light
Reported in the journal Science
Study author: Brian Butterworth. Butterworth is a professor at the Institute of Cognitive Neuroscience of the University College London

Read full article. http://www.upi.com/Health_News/2013/04/19/10-percent-have-autism-dyslexia-ADHD-language-impairment/UPI-33851366345709/

Research in the journal Science reports that up to 10 percent of all children are thought to have learning disabilities. This would amount to two or three kids per classroom.The researchers found that the disabilities have complex causes.

It’s estimated that nearly 10% of all children have ADHD, but it usually doesn’t occur by itself according to the researchers. They cited that 33 percent to 45 percent of children with ADHD also have dyslexia and 11 percent also have dyscalculia.

Dyslexia is a reading, writing and spelling disability frequently associated with auditory processing issues. Dyscalculia is a math learning disability.

The researchers stated that learning disabilities are the result of abnormal brain development caused by complicated genetic and environmental factors.

“We now know that there are many disorders of neurological development that can give rise to learning disabilities, even in children of normal or even high intelligence, and that crucially these disabilities can also co-occur far more often that you’d expect based on their prevalence,” said study author Brian Butterworth in a university news release. Butterworth is a professor at the Institute of Cognitive Neuroscience of the University College London

Butterworth’s team noted that if a child has multiple learning disabilities, they may be overlooked when one gets an ADHD diagnosis. The diagnosis may overlook dyslexia for example. Not knowing may lead to frustration by both student and teache as well as inadequate instructionr. Knowing a student has both learning disabilities would allow the teacher to properly accommodate the student’s needs.

The study reinforces the fact that one needs to get a good evaluation form a specialist, not just a short 20 minute visit to one’s pediatrician. Proper instruction can come only when one has full knowledge of student needs.

ADHD Rates Are Skyrocketing

What’s behind the 53% increase?
Reported By: healthland.time.com
For the last few years the rate of ADHD was calculated to be between 4% to 6% of all school age children. New Center for Disease Control (CDC) data report that 11% of all school age children are now diagnosed with ADHD as well as nearly one in five high school age boys in the United States. The new data reflect a 53% rise over the last decade.This has alarmed man of the experts.“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.”

Read the full article: http://healthland.time.com/2013/04/02/understanding-the-rise-in-adhd-diagnoses-11-of-u-s-children-are-affected/?iid=tsmodule

Understanding the Rise in ADHD Diagnoses: 11% of U.S. Children Are Affected | TIME.com
healthland.time.com
The rates of U.S. children affected by attention deficit-hyperactivity disorder

Who’s Getting Diagnosed the Most?

Published in the January online edition of JAMA Pediatrics

As mentioned last week, an epidemic leap in ADHD diagnoses was revealed in a study published in the January online edition of JAMA Pediatrics. Diagnoses increased 24% over the 10-year period from January 1, 2001 through December 31, 2010.

Who? Caucasian children consistently had the highest rates of ADHD diagnosis over the term of the study (4.7% to 5.6% increase). However, the largest increases in diagnosis rates were seen in black children (2.6% to 4.1% increase) and Hispanic children (1.7% to 2.5% increase). Roughly, this translates into a 30% increase in Caucasian children, 67% in black children, and 60% in Hispanic children. Interestingly, ADHD diagnosis rates for Asians/Pacific Islanders remained unchanged at around 1%. This very low rate was not explained.

The researchers attributed the increase in diagnosis in black children to an increasing likelihood of diagnoses in black girls that heretofore had not been identified.

According to the study, children diagnosed with ADHD were more likely to be from higher income families.

The fact that Asian/Pacific Islanders had vastly lower rates is quite interesting. Could it be related to different parenting and expectations? Or is it related to cultural differences that circumvent western medicine? We cannot derive an answer from this study.

Does ADHD Last My Whole Life?

A new study sheds light
Reported in US News & World Report, published health.usnews.com

US News& World Report cites a study that shows ADHD persists as one ages and produces more problems in adulthood.

The researchers also shed light on our current process of diagnosis, stating:

“We should use caution in describing this constellation of behaviors as a ‘disease,'” he said.

The American Academy of Pediatrics says doctors should do an evaluation for ADHD for any child aged 4 to 18 who has behavioral problems or is falling behind at school. But that should also include a thorough assessment for learning disabilities, emotional issues or physical conditions that could be causing their symptoms — such as sleep apnea.

Barbaresi’s advice to parents: “Don’t accept a cursory evaluation and a prescription.”

Read the entire article: http://health.usnews.com/health-news/news/articles/2013/03/04/adhd-can-often-persist-into-adulthood?page=2