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Newsletter Volume 6, Issue 1

January 2014

CONTENTS

Heidi: CADDAC in 2014 1

CADDAC Initiatives: ADHD & Human Rights

2

ADHD RESEARCH and NEWS

ADHD and Aggression: Two-Drug Combination

2

Ritalin as Addiction Treatment?

3

Brain Development and Recovery from Child-

hood ADHD 3

How Do ADHD Medica-tions Work?

4

Do Sunny Climates Lower ADHD?

5

ADHD: Social and Eco-nomic Disadvantage 5

New Screening Tool for Autism Spectrum Disor-der to Rule Out Others

Like ADHD

6

ADHD Rats and Omega-3 Supplementa-

tion 6

ADHD and Eating Dis-orders Lead to Poorer

Prognosis 7

Drugs over Therapy as Treatment for ADHD –

But at What Risk? 7

ADHD Children: Risk of Bowel Issues 8

ADHD Treatment Choices Guided by

Parents’ Goals 8-9

ADHD Diagnosis May Be Confirmed with Brain

Imaging 9

Mindfulness Meditation Shown to Assist ADHD

Adults in New Study 9-10

GUEST COLUMN

How to Spot a Great Summer Camp for Kids and Teens with ADHD

10-11

Other ADHD News

2013 CADDAC Annual ADHD Conference

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CADDAC in 2014

Welcome to 2014, another exciting year of CADDAC ADHD advocacy efforts. In 2013 various CADDAC board members, myself included, met with a variety of MPPS and MPs to discuss the newly published socioeconomic paper. After reviewing our joint feedback it became very obvious that one topic in particular proved to be of interest to federal politicians from all political parties: the area of ADHD in the justice system. For this reason CADDAC has decided that this topic would provide us with the best opportunity of potential interest and movement within the political system and warrants follow-up. Our Chair, John Tucker, and I will be focusing our federal advocacy efforts on this area of ADHD during 2014.

CADDAC will, of course, continue our efforts to have students with ADHD more readily recognized as exceptional students in need of special education services within the elementary and secondary settings. CADDAC will be working in unison with some other organizations on this matter and has also formed a committee of educational experts and interested board members to spearhead this effort. We will also be looking into issues that have arisen within certain universities making it significantly more difficult for university students with ADHD to receive accommodations. A committee of experts and interested stakeholders has been formed to look into this and develop appropriate documentation around advocacy efforts.

CADDAC will be moving forward with a program to allow ADHD support groups to form under CADDAC’s umbrella. Although we are happy to advertise any groups that exist across Canada we have been asked by several groups is they might be able to form under CADDAC. At this time we have decided to keep the relationship somewhat informal and haven chosen not to have these groups labeled as official chapters. These support groups will remain independent, but have a strong working relationship with CADDAC, sharing information, resources and advocacy efforts.

I would sincerely like to hear from those of you in existing groups or those thinking of forming a group who might be interested in such an arrangement. I would like to know how CADDAC could assist you in your efforts, what we can offer you, or supply you with, and what you are currently finding a challenging. For those of you who currently attend meetings of an existing support group, or have done so in the past, what things did you find worked well and where did you experience annoyances or difficulties?

In 2014, CADDAC’s aim is to revamp our social media efforts. Although we can currently be found on Facebook, both under the CADDAC and ADHD Awareness Week pages, a blog and on Twitter, we will be scaling up our efforts and visibility in all of these mediums. Stay tuned for further updates in the near future.

We are currently in discussion about the 2014 conference, educational events, and Awareness Week. Our limited budget means making decisions around reaching the biggest audience for the most reasonable cost. I would love to hear back from you about topics and speakers you would be interested in hearing, any venues that might be exceptionally reasonable, and formats for presentations you would find acceptable.

Warm Regards,

Heidi Bernhardt

CADDAC UPDATES Heidi Bernhardt, President & Executive Director

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CADDAC INITIATIVES

Update on ADHD and Human Rights

Of interest to those who may be following ADHD Human Rights cases is a recent BC case of a medical resident. A detailed description of the case and actual ruling of findings of discrimination, can be accessed here http://www.cdn-hr-reporter.ca/sites/default/files/12-0032_Kelly_0.pdf. The judgment begins on page 89.

While, as with most Human Rights Cases, the details of the case makes a big difference to the outcome of the ruling, what I found significant in this ruling is that the complainant, a medical resident, was

found to have a legitimate mental disability (ADHD and NVLD). This is important because I am often asked whether ADHD is legally recognized as a disability. Here is an example of exactly this, for those of you require this to back your own advocacy efforts.

Secondly, although UBC implemented some accommodations, they did not fully discharge their duty to the level of undue hardship. This is also an important point for those of you currently being told that a minor accommodation is all that the system you are working within can be asked to provide. Lastly, UBC stated that since ADHD and NVLD were lifelong disorders, this person could not be expected to graduate and be a successful practising physician. This was found to be discriminatory.

The lawyers seem to be very interested in the amount of the damages awarded $75,000. This amount is apparently a high water mark for this type of case. The highest previous ward being $35,000. Please see this link for further details: http://www.harrisco.com/resources/legal-news/919.

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ADHD NEWS, RESEARCH, AND STUDIES

Children with ADHD and Aggression Helped by Two-Drug Combination

A study conducted by researchers at The Ohio State Univer-

sity Wexner Medical Center published online in December

2013 revealed that children who exhibited physical aggres-

sion and were diagnosed with ADHD experienced a reduc-

tion in aggression and behavioural issues when, along with

teaching parents effective behaviour management strate-

gies, they were treated with both a stimulant and an anti-

psychotic drug in combination. In this study, 168 children

diagnosed with ADHD, ages 6 to 12, and displayed a high

amount of physical aggression were placed into two groups.

All 168 children received a stimulant called OROS

methylphenidate and their parents received behaviour

management training for a period of nine weeks.

The antipsychotic drug risperidone was added in

week three for the experimental group, and a placebo for

the control group. Compared to the control group, the

group receiving dual drug therapies showed significant im-

provement on the Nisonger Child Behaviour Rating Form

(NCBRF) Disruptive-Total Scale, the NCBRF Social Compe-

tence subscale, and the Reactive Aggression portion of

the Antisocial Behaviour Scale.

Although dual therapy poses some risks, the two

drugs seemed to cancel out some of the significant side

effects of medication; for instance, the experimental

group tended to not have as much trouble falling asleep

due to the addition of risperidone. The behaviour issues

were considered serious and critical enough to conduct

the dual treatment in spite of the risks, and are not rec-

ommended in cases where physical aggression is not a

significant problem. This is the first evidence-based

study to examine and discover that stimulants and anti-

psychotic medication work more effectively when care-

fully staged and administered in tandem.

READ FULL ARTICLE HERE

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Brain Development

Pattern Reveals Possible

Link to Recovery from

Childhood ADHD

Half of children diagnosed with

ADHD as children continue to experience

it throughout their adult lives.

Researchers are attempting to determine

why and if any factors contribute to the

difference between those who recover

and those who do not. Dr. Philip Shaw at

the National Human Genome Research

Institute and his fellow researchers

conducted a study focused on linking

symptoms to patterns of brain

development, and specifically, the

structure of cortical regions in the brain

that control attention; from previous

studies, it has been determined that

cortical structure in the brain is thinner in

adults with ADHD – specifically in the

regions that control cognitive functioning

and attention.

The researchers followed a

sample of 92 children – with a mean

of 11 years of age – into adulthood,

utilizing repeated structural imaging

scans and clinical assessments. In

addition, they followed 184

volunteers who were not diagnosed

with ADHD to determine a set of

control scans and assessments. In

40% of the participants who were

diagnosed with ADHD in childhood,

the disorder persisted into

adulthood, and was also shown to

have increased rates of cortical

structure thinning. Compared to

those who experienced recovery

from their childhood ADHD, the

cortical structure developed a

normal range of thickness.

The researchers concluded

that the differences in pattern of

brain growth are linked specifically

to differences in the development of

childhood ADHD to adult ADHD.

Those differences persisted

specifically in the regions of the

brain that control attention; the

cortical thickness in that area is

thinner in adults whose ADHD has

persisted from childhood into

adulthood. In those who recovered,

the regions of the brain were not

unlike those of the control group.

Cortical development appears to be a

critical factor that influences recovery

from childhood ADHD into adulthood.

There is still much to be

determined about why this pattern

occurs. Data collected suggest that the

excessive pruning of brain pattern

connections in the prefrontal cortex is a

risk factor for the persistence of

childhood ADHD into adulthood, which

would explain the cortical thinning. But

researchers have not yet determined

the cause for the pruning, which

specific connections are pruned, why

this occurs, and how these particular

pruned connections contribute to the

persistence of ADHD symptoms into

adulthood. This study is the first step in

developing tools to assist in

determining the likelihood of the

persistence of ADHD from childhood

into adulthood.

READ FULL ARTICLE HERE

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Ritalin as Addiction Treatment? Methylphenidate was administered in a study of 18 cocaine addicted adults randomized among the population; the

rest received a placebo. Measured by fMRI (functional magnetic resonance imaging), the researchers assessed brain

connections known to be particularly active before and during peak drug affects in addicts. Areas of the brain implicated in the

formation of habits – including drug-seeking and craving behaviour – were noted to have decreased in connectivity when the

subject was treated with even just one dose of methylphenidate. The methylphenidate was also responsible for increases to

brain connectivity in areas responsible for emotional regulation and self-control. The results indicate that methylphenidate

may have significant potential as a treatment for those addicted to stimulants.

READ FULL ARTICLE HERE

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How Do ADHD Medications Work?

Controversy surrounding the way ADHD medication works continues to

thrive unabated. A new study released in Biological Psychiatry provides evi-

dence that methylphenidate (Ritalin) and atomoxetine (Strattera) have differing

effects on performance, but both improve the activation of brain centers that

play a role in making distinctions in time management and estimation. This area

is known to be impaired in individuals with ADHD. Research that utilizes brain

imaging scans has shown that these areas of the brain are under-activated in

individuals who perform cognitive tasks involving time distinctions.

Researchers at King’s College London have produced a study that com-

pared stimulant and non-stimulant treatments for ADHD to determine their

effects on performance and brain activation. Three imaging scans of 20 individual males with ADHD during which they performed

a time distinction task were performed. Each individual received a single dose of methylphenidate, atomoxetine, or a placebo pri-

or to each scan, one week apart. These results were compared to a control group consisting of 20 males who do not have ADHD.

The study determined that methylphenidate acted quickly upon the subjects’ performance on timing tasks that those with

ADHD (untreated) would find quite difficult. But more importantly, methylphenidate or the non-stimulant atomoxetine were both

shown in the scans to increase activation in the frontal lobes of the brain – bringing them to “normal” levels seen in children who

do not have ADHD.

This appears to suggest that both stimulant medication and non-stimulant medication are comparable in the way they

work to normalize the activation of frontal brain regions normally compromised in individuals with ADHD. Although the medica-

tions work differently, they both have been shown to improve cognitive functioning in under-functioning frontal brain regions

characteristic of ADHD. Methylphenidate works by blocking the norepinephrine and dopamine transporters, while atomoxetine

blocks only the norepinephrine transporter.

Norepinephrine affects the brain areas involved in regulating attention, sleep, learning, and emotions. When produced at

normal levels, it stimulates the emotional and cognitive centers of the brain. Low levels of norepinephrine cause a depression

effect, but high levels create a feeling of hyper-arousal and heightened anxiety.

Dopamine affects the brain in several areas, including cognition, punishment, motivation, attention, mood, sleep, volun-

tary movement, balance, walking, learning, happiness, sexual desire, pleasure, reward, immune function, and insulin regulation,

physical energy, thinking, and working memory. The body also uses dopamine to produce norepinephrine. Low levels of dopamine

are linked with ADHD.

Even though dopamine is also used to produce norepinephrine, norepinephrine transporters contribute to the inactiva-

tion of dopamine in the cortex. Both contribute to maintaining alertness, increasing focus, and sustaining thought, effort, and mo-

tivation. Although very similar, the differences in how they affect the brain and behaviours suggest they were designed to have

complementary functions within the brain.

This study shows that, although both treatments block norepinephrine transporters, they are different in how they raise

dopamine levels in the brain. Only methylphenidate was shown to improve behaviour, while both enhanced cognitive functioning

in the area of time discrimination. Therefore, the researchers have concluded that methylphenidate (Ritalin and Ritalin-based

stimulant medication) influences ADHD-related behaviour to a much greater extent than atomoxetine (Strattera, non-stimulant

medication), though they both improve cognitive functioning in the frontal lobes of the brain.

READ FULL ARTICLE HERE

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The average worldwide prevalence

of ADHD ranges from about 5-7% according

to the latest data, but it varies significantly

region by region. Dr. Martijn Arns and his

researchers investigated whether or not

there was an association between sunlight

and prevalence of ADHD by collecting and

analyzing data from the U.S. and nine other

countries. Their findings have been pro-

duced in the current October 2013 issue of

Biological Psychiatry. Evidence gathered

showed a correlation between solar intensi-

ty and prevalence of ADHD.

It is important to note that this cor-

relation does not equate to causation: more

studies must be procured in order to deter-

mine such. However, it is documented that

sleep disorder treatments – including light

exposure therapy – have been shown to

have a positive effect on individuals with

ADHD symptoms.

Regions with higher sunlight inten-

sity did indeed evince a lower ADHD popu-

lation. To further validate this theory, re-

searchers examined the same relationship

for autism and major depressive disorder.

The correlation was not found with these

other two disorders, only in ADHD preva-

lence.

These results indicate that methods

like syncing playtime outdoors in accord-

ance to the biological clock and exposure

in the classroom to plenty of natural sun-

light may be explored as options to help

reduce ADHD symptoms in classrooms.

More study is needed to deter-

mine whether or not sunny climates do

indeed cause a reduction in ADHD symp-

toms or the prevalence of ADHD overall,

and if so, how this relationship exists. It

also raises the question – do those with

ADHD tend to move away from sunlit

climes and if so, why?

READ FULL ARTICLE HERE

The study determined that

more children with ADHD had families

below the poverty line than in the

UK’s general population. Parents in

social housing were three times more

likely to have a child with ADHD com-

pared to those who owned their own

homes. Having a child with ADHD was

determined to be significantly higher

for younger mothers than for others,

and mothers with no qualifications

were twice as likely to have a child

with ADHD as those with degrees.

Single parents were also more likely

to have a child with ADHD than two-

parent families.

Although the study’s leader,

Dr. Ginny Russell, cites this study as

“strong evidence that ADHD is also

associated with a disadvantaged so-

cial and economic background,” Heidi

Bernhardt notes that “There is solid

evidence that children with ADHD

more often than not have at least one

parent with ADHD. We know that

adults with ADHD are more likely to

be in poverty, social housing, to be

divorced, to have unplanned pregnan-

cies at a younger age, and to not com-

plete post-secondary education. The

study may show a correlation, but

that does not necessarily mean it also

indicates causation, between socio-

economic disadvantages and ADHD.

The results of this study may only fur-

ther indicate a genetic component to

ADHD rather than a caused by envi-

ronmental factors. CADDAC recently

put forth a Socio-Economic Policy

Paper that outlines many of these

issues in detail.

READ FULL ARTICLE HERE

Is There a Relationship Between Sunny Climates and A Lower Incidence of ADHD?

Social and Economic Disadvantage Linked to ADHD

A study led by a research team at the

University of Exeter Medical School analyzed

data provided by the Millennium Cohort Study,

a database of more than 19,500 UK children

born between 2000 and 2002, to determine a

link between social and economic disadvantage

and childhood ADHD in the UK. The study has

been published in the Journal of Child Psychol-

ogy and Psychiatry.

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New Screening Tool Able to Discern Autism Spectrum Disorder from

Other Psychiatric Disorders Including ADHD

A new screening tool presented in the scientific journal

Molecular Autism has been developed by researchers at Karolin-

ska Institutet in Sweden which compares those diagnosed with

Autism Spectrum Disorder to those diagnosed with other psy-

chiatric disorders, including ADHD. The screening tool is a ques-

tionnaire containing 14 self-screening questions called the

RAADS-14 Screen. It includes three subscales that measure cog-

nitive difficulties, social anxiety, and sensory hypersensitivity.

The scale was evaluated in a study that included 135

adults diagnosed with Autism Spectrum Disorder, 508 individu-

als suffering from another psychiatric disorder, and a control

group containing 509 individuals who have not received any

psychiatric diagnoses. The researchers were able to conclude

from the study that their evaluation tool was able to clearly

distinguish between Autism Spectrum Disorder from other psy-

chiatric disorders like ADHD. The tool identified 97 percent of

the participants with Autism Spectrum Disorder.

Other testing scales have only utilized a control group of

the general population, and not against participants with other

psychiatric disorders. Therefore, this scale can assist in diag-

nosing the Autism Spectrum Disorder group apart from other

psychiatric disorders like ADHD.

READ FULL ARTICLE HERE

ADHD Rats Experience Reduction in Symptoms

Due to Omega-3 Supplementation Researchers at the Universi-

ty of Oslo have produced a new

multidisciplinary study – a study

that includes contributions from

behavioural sciences, medicine,

psychology, nutritional science, and

biochemistry – that has produced

evidence of a strong connection between Omega-3 supple-

mentation and the reduction of ADHD symptoms in rats. Not

only did the researchers observe the rats’ behaviours, they also

measured biochemical processes in their brains. The study did

show a marked difference between the sexes, however: male

rats received a much better effect from the supplementation

than did the female rats.

ADHD diagnosis is largely based on behavioural criteria

due to the biological processes and genetic background of the

disorder remaining shrouded in mystery. Although ADHD has

been shown to be a genetic trait, scientists still do not under-

stand much of how the disorder is inherited or what effects it

produces in the brain chemistry.

The rats used in the study exhibited hyperactivity, poor

ability to concentrate, and impulsivity – three criteria critical to

an ADHD diagnosis in humans. The rats also responded to Ri-

talin in the same way ADHD humans do. Therefore these spe-

cific rats were used as a model for ADHD.

Omega-3 supplementation was administered to female

rats prior to impregnation and throughout their pregnancies

and nursing. The offspring were also administered Omega-3

supplementation in their own food following weaning. A con-

trol group was also established. Rats with the Omega-3 sup-

plementation, males especially, experienced a marked in-

crease in concentration related to reward-driven tasks com-

pared to the control group. However, there was a reduction in

hyperactivity and attention problems in both male and female

rats that had been administered the supplements.

Scientists also analyzed the rats’ brains to determine

whether there was any difference in how the neurotrans-

mitters in the brain reacted in rats given supplementation.

Dopamine and serotonin transfer occurred much more quickly

among male rats that had been administered supplements.

The rate of serotonin transfer tripled compared to the control;

the rate of dopamine transfer was two-and-a-half times that

of the control. Female rats who received supplementation did

not evince such drastic effects; however both sexes did show

a small increase in the transfer of glutamate.

The researchers are cautious about drawing any con-

clusions between the ADHD rats and ADHD humans. Human

brain mapping is not nearly as precise as that of the rats and

rats do differ substantially in a genetic sense. However, this

research may help increase scientific knowledge of ADHD by

paving the way for further study.

READ FULL ARTICLE HERE

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Hyperactivity May Influence Adults with Eating Disorders

Leading to Poorer Prognosis Researchers from the Department

of Psychiatry and Mental Health at the Bell-

vitge Biomedical Research Institute

(IDIBELL) and the Unit of Eating Behaviour

Disorders of the Bellvitge University Hospi-

tal in collaboration with the Department of

Psychiatry of the Vall d’Hebron University

Hospital have published a recent study in

the online edition of the scientific journal

BMC Psychiatry. The study included 191

patients and found that hyperactivity and

impulsivity associated with ADHD led to a

worse prognosis for people who experi-

ence eating disorders such as: bulimia,

binge eating disorders, and other eating

disorders; however, anorexia patients did

not exhibit these symptoms, as they were

seen to exhibit a greater degree of self-

control. The research could lead to early

detection of risk factors that could lead

to a more severe eating disorder.

Research showed that those who

exhibited higher degrees of impulsivity

and were older in age have an increased

risk of developing an eating disorder, and

also a greater severity of the disorder.

Patients with ADHD symptoms were dis-

covered to have an increased risk of a

more severe prognosis due to low self-

direction – a trait that inhibits the ability

to plan and achieve goals in the medium

and long term. This makes it more diffi-

cult for these patients to accomplish

treatment goals.

This research may lead to assis-

tance in clinical assessments, but also in

the future investigation of brain connec-

tions that play a role in reward systems,

and may have related correlations to oth-

er behavioural pathologies such as eating

disorders, pathological gambling, and oth-

er behavioural addictions.

READ FULL ARTICLE HERE

Important and Controversial Study Supports Drugs over Therapy

as Treatment for ADHD – But at What Risk?

A twenty-year old study funded by

the U.S. National Institute of Mental Health

concluded that a combination of stimulant

medication treatment and therapies or

therapy alone were out-performed by med-

ication treatment. However, experts

(including some of the study’s own authors)

believe that relying on medication treat-

ment alone may detract children and their

families from effectively using coping strat-

egies to manage their ADHD.

The NIMH obtained more than a

dozen expert scientists to determine the

best treatment for ADHD for the study. The

participants, nearly 600 children diagnosed

with ADHD ages 7 to 9, received one of four

treatments for one year: medication, be-

havioural therapy, a combination of medi-

cation and behavioural therapy, or nothing

(as a control). In 1999, the researchers

came to the conclusion that medication

was the best treatment option.

There were several limitations to

the original study, one of the most glaring

was that the study examined only classic

ADHD symptoms (forgetfulness, restless-

ness) rather than overall academic

achievement and family and peer rela-

tions. The other serious limitation was

that study participants were not followed

into adulthood; therefore the results may

not persevere in the long-term. Unfor-

tunately, insurance companies use this 20

year old study to deny coverage of thera-

py in favor of medications, even though

therapy may have more long-term bene-

fits. Most experts now support a multi-

modal methodology of treatment: medi-

cation and behavioural therapies to man-

age ADHD.

READ FULL ARTICLE HERE

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ADHD Children Have Increased Risk of Bowel Issues

A recent study published online in the October 21,

2013 edition of the journal Pediatrics examined more than

700,000 children – and in those who were diagnosed with

ADHD, the conditions of chronic constipation tripled and fecal

incontinence were found to be six-fold than that of children

who were not diagnosed with ADHD. Dr. Cade Nylund, an as-

sistant professor of pediatrics at the Uniformed Services Uni-

versity of the Health Sciences, found that the children with

ADHD had more visits on average to the doctor, suggesting

that their bowel conditions tend to be higher in severity than

in the general population. Taking ADHD medication did not

seem to have an effect on these bowel conditions.

Children with ADHD most likely do not respond to

physical cues to make a bowel movement, preferring to re-

main engaged in other, more desirable, tasks. They may have

difficulty interrupting their tasks and making the transition to

bathroom time. Over time, this constipation leads to fecal

incontinence, when the child has lost the normal physical cues

to move their bowels entirely.

Suggested parental strategies for relieving these bowel

conditions include: increasing fibre in their child’s diet, setting

a consistent bathroom schedule (i.e. before going to school or

bed, or before traveling), and never shaming the child for acci-

dents. Another method of treatment suggested by Dr. William

Muinos, associate director of pediatric gastroenterology at

Miami’s Children’s Hospital in Florida, is to place the child on

“lubrication therapy.” Medication that lubricates the bowel is

administered to the child to assist in stimulating a bowel

movement. Behaviour modification is another suggestion:

scheduling specific

times for the child to

use the bathroom

(usually twice a day).

Dr. Matthew

Lorber, acting direc-

tor of child and ado-

lescent psychiatry at

Lenox Hill Hospital in

New York City, be-

lieves that children with ADHD may digest their food more slowly

than children without ADHD leading to physiological issues that

can cause constipation or fecal incontinence. He also laments the

fact that parents and experts often ignore this issue and allow it

to go unaddressed.

The study examined data from nearly 750,000 children,

aged 4 to 12 years. Among this population, 33,000 children were

diagnosed with ADHD. Of the children who have ADHD, 4.1 per-

cent had issues with constipation compared to only 1.5 percent of

children who did not have ADHD. Also, 0.9 percent of the children

with ADHD suffered fecal incontinence, while only 0.15 percent of

the children without ADHD suffered fecal incontinence. The study

was adjusted to account for factors such as gender, age, and birth

order, but, even so, the researchers found that the risk for fecal

incontinence was more than six times higher in ADHD children,

and the risk for constipation was almost three times higher in

ADHD children than in those without ADHD. Though this study

does show a correlation between bowel problems and ADHD, it

does not prove a causal relationship.

READ FULL ARTICLE HERE

ADHD Treatment Choices Guided by Parents’ Goals New research, pub-

lished online September 2,

2013 and in the October

2013 printed version of the

journal Pediatrics, has shown

that the parents of ADHD

children tend to guide the

treatment of their child according to their specific goals. If a

parent was concerned by academic performance primarily,

they tended to prefer medication therapy. However, if parents

were concerned primarily by behavioural concerns, they opted

for behavioural therapy.

Most experts recommend a multi-modal treatment for

ADHD: medication and behavioural therapy combined. But par-

ents tend to prefer one or the other to both as a first-line trial.

The study included 148 parents of children between the ages of 6

and 12 who had received an ADHD diagnosis – but excluded

those whose children were receiving a multi-modal form of treat-

ment. The researchers developed a measurement tool – the

ADHD Preference and Goal Instrument – to determine the prefer-

ences and goals of the parents of ADHD children. Parents who

9 9

were chiefly concerned with academic performance were

more than twice as likely to choose the medication option as

a first-line treatment. If the parents’ chief concern was be-

havioural, they were 60 percent more likely to opt for behav-

ioural therapy as a first-line treatment. After six months, the

parents had lowered their expectations and goals surround-

ing their child’s academic performance and behavioural

standards.

Dr. Alexander Fiks, the study’s author and assistant profes-

sor of pediatrics at the Children’s Hospital of Philadelphia and the

University of Philadelphia, theorizes that parents may see behav-

ioural problems as distinct from medical problems, and that this

influences their goals and choices in terms of ADHD treatments for

their children. But he believes that it is vital to involve the parents

in treatment decisions nonetheless, which would likely lead to

more parental involvement and support surrounding the chosen

treatment option(s).

READ FULL ARTICLE HERE

ADHD Diagnosis May Be Confirmed with Brain Imaging A new technique using a version of MRI imaging called magnetic field correlation (MFC) imaging

may help in measuring the neurotransmitter dopamine and assist in confirming whether or not an indi-

vidual has ADHD has been developed. It measures iron levels in the brain; low iron levels have been

associated with impaired dopamine synthesis, a hallmark of ADHD. Researchers explored this new

technique measuring the iron levels in the brains of 22 children and adolescents diagnosed with ADHD

and 27 children without as a control group. Results showed that 12 ADHD patients not receiving medi-

cal treatment for their ADHD had significantly lower MFC (brain iron levels) than the 10 ADHD individu-

als receiving medication treatment or the 27 individuals in the control group. The lower iron levels

appeared to be in the normal range when the ADHD individual was receiving psychostimulant medica-

tion treatment for their ADHD.

This non-invasive new technique may assist in confirming ADHD diagnoses and guide treatment in the future. However,

further studies are needed to replicate the results in larger populations to confirm the results. The researchers hope to be able to

provide a non-invasive way for clinicians to confirm an ADHD diagnosis in cases where they are less confident provided on self-

reporting data alone.

READ FULL ARTICLE HERE

Mindfulness Meditation Shown to Assist ADHD Adults in New Study Mindful Meditation Training has been recently ex-

plored as an option in the treatment of adult individuals diag-

nosed with ADHD. Mindfulness Training teaches individuals

to purposefully focus their attention on the present moment

and experience stimuli with a sense of curiosity, openness,

and acceptance. This helps with the self-regulation of atten-

tion, something ADHD individuals struggle with frequently. It

may also enhance aspects of executive functioning and emo-

tional regulation.

A study recently published in the online Journal of

Attention Disorders studied the impact of Mindful Meditation

practice on core symptoms, executive functioning, and emo-

tional dysregulation. The study assessed 22 individuals with

ADHD who participated in an 8 week program or a wait-listed

control group. Nearly all participants receiving medication

treatment for ADHD

continued with their

medication for the

duration of the study.

Each session

was 2.5 hours long.

Daily at-home practice

was required. In the

area of core symptoms, the adults reported on an ADHD symptom

rating scale which included 18 core symptoms. Also rated, were the

severity of the impairment of these core symptoms in the areas of

work, relationships, and home-life. Clinicians also completed rating

scales for their clients. Participants reported statistically significant

declines in core ADHD symptoms after completing Mindfulness

Meditation Training. Nearly 64% of adults reported at least a 30%

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decline in inattention, hyperactivity, and impulsivity compared

to 0% in the control group.

Rating scales of Executive Functioning using the Deficits

in Executive Functioning Scale and the Behaviour Rating Inven-

tory of Executive Functioning – Adult Version were obtained to

measure Executive Functioning tasks, including self-

management, organization, self-discipline, self-motivation,

emotional regulation, working memory, behavioural inhibition,

and planning skills. Clinicians also completed these rating

scales for their clients. A number of laboratory tasks were also

included in the evaluations of Executive Functioning. The par-

ticipants reported significant gains in areas of Executive Func-

tioning.

Emotional dysregulation was measured via Difficulties

in Emotion Regulation Scale and the Distress Tolerance Scale,

which were completed by participants only. Participants reported

significant gains in the area of emotional regulation.

Researchers concluded that Mindfulness Meditation Train-

ing showed promising gains for aiding in the treatment of Adult

ADHD. However, the sample was relatively small, so repeating the

findings with a larger sample is imperative before any definitive

conclusions can be reached. Also, the study was not blinded, and

therefore relies heavily on self-reporting mechanisms where the

clients are aware that they have received treatment. However,

findings from this study will add to growing evidence that Mindful-

ness Meditation Training could be a beneficial and valuable addi-

tion to ADHD treatment.

READ FULL ARTICLE HERE

GUEST COLUMN

How to Spot a Great Summer Camp for Kids and Teens with ADHD By Rob Deman & Donna Segal, Co-Directors of Camp Kennebec

As co-directors of Camp Kennebec, an overnight summer camp near Toronto, that’s been making kids and teens with ADHD and other special needs happy since 1967, we know what it takes to build a wonderful program for kids and teens with ADHD.

If you find choosing a summer camp for your child is a stressful decision – you are not alone. Like most parents, you want the right camp where your child will be safe, happy and have a great experience. If your child has ADHD, your camp re-search is even more difficult, since you also have to feel comfortable that camp can accommodate your child’s needs

So how do you know if a camp is right for your child? Ask the right questions and do your homework. While you will likely have many questions you want an-swered, here are a few that are mandatory:

1. Does the camp/director view ADHD as a medical condition or behavioural?

While this may seem like a strange question to start with – it will give you a great sense for a director’s approach. For example, some camps see ADHD symptoms and actions to be primarily behavioural, so the approach is to have very strict consequences for campers acting out or misbehaving -- actions which campers may not really be able to control.

At Kennebec, we see actions and reactions from campers with ADHD to be primarily a medi-cal condition that requires understanding, patience on the part of staff, and accommodation through flexible programing. We also find that with so much physical activity, fresh air, and fun, new, varied programs at camp, many ADHD symptoms lessen or even disappear over the summer.

Depending on your point of view, one camp may be a better fit for you.

2. What do parents of current campers, staff say about camp? Will the camp provide you with references?

Do your research and find out all you can about the camp from existing parents, past par-

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ents, the Internet. I cannot speak for all directors, but we regularly arrange for prospective camp families to call or email existing camp families with their questions.

3. Schedule an in person meeting with the camp director. You and your child should feel excited about camp by the end of the meeting. You should be able to answer yes to the ques-tion "Did you both enjoy spending time with the director?”

Let’s face it. A meeting with a camp director should be fun, interesting, informative and reassuring. As a parent, you should leave the meeting feeling happy and confident to en-trust your child to the care of the camp and the director. Your child should like the camp director. Does the director bond with your child, make and keep eye contact, put your child at ease, and do they share a laugh? Has the camp director an-swered all the questions you both have to your satisfaction?

4. Ask the right questions of a camp director – here are some of the “must ask questions”

Is the camp accredited and by whom?

What is the camp director’s background?

What is their experience working with children — especially children with ADHD?

Why do they work in this field?

Differences between a camp geared for kids with ADHD and a mainstream camp

Tenure as a director at this camp and other summer camps

List of professional qualifications

Point of view on why their program will meet your child’s needs

Differences between their camp and others

What are the staff’s qualifications? How are staff recruited — including minimum qualifications, experience levels, and secu-rity screening procedures?

What is the camper-to-cabin counselor ratio? Find out the camper to cabin staff ratio, which is simply the number of campers divided by total cabin staff. You want to choose a camp with a 2:1 camper to cabin staff ratio.

What happens on the first day of camp and what is a typical day at camp like during the summer? The best way to reduce anxiety about attending camp is to explain in detail what the first day is like. Often, something as simple as explaining how campers find their counselors on the first day, goes a long way to reducing concerns. Anything a camp director can do to explain how things work will make your son or daughter more excited about going to camp.

Summer camp is a great experience for all kids. A one-of-a-kind opportunity to grow, have fun and make new friends. When you find the right overnight camp for your child, we promise you will see huge growth in social skills, self-confidence, self-esteem, self-control and independence that often last a lifetime.

About the authors:

Rob Deman and Donna Segal are co-directors of Camp Kennebec, an overnight summer camp for children with ADHD and other special needs located between Ottawa and Toronto, Ontario. Together they have more than 40 years of camp experience. Both bring a wealth of knowledge and hands on experience and have a shared vision that camp must be a fun, happy place that offers one-of-a-kind experiences and a huge sense of accomplishment that kids will cherish for years to come. For more information about Camp Kennebec, visit www.campkennebec.com, email Donna or Rob at info@campkennebec.com or call us at 613-335-2114.

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CADDAC 2013 Annual ADHD Conference We hosted four great speakers this year: Dr. Margaret Weiss, Dr. Candice Murray, Dr. Mark Berner, and Nili Berner.

Thursday’s presentations were geared toward educators, with workshops for elementary and secondary and post-secondary infor-mation on classroom accommodations. Friday’s audience included allied health professionals and human resource personnel, discussing adult ADHD in the workplace and red flags for impairments. On Saturday, presentations were provided for parents of children with ADHD, splitting into workshops for adolescents and children. Sunday, presentations were focused on adult ADHD and psychosocial treatments such as cogni-tive behavioural therapy and mindful meditation techniques.

On Friday and Sunday Nili Berner, an ADHD Coach, gave wonder-fully informative presentations loaded with practical organizational strat-egies and information on ADHD coaching.

Next year, there is discussion surrounding hosting the CADDAC Annual ADHD Conference in Vancouver.

We also received an email from a conference goer that we would like to share with you:

Dear CADDAC,

I am married to a wonderful man with ADHD and I have four beautiful

children. Our 9 year old son was diagnosed with ADHD three years ago

and our 6 year old son is currently being assessed for and medicated for

ADHD. It has been a long journey, as I’m sure you can understand better

than anyone.

I want you to know that during ADHD Awareness Week this year, I printed

off your fantastic posters and displayed them in our school staff room. I had a luncheon for the

teachers and, armed with articles in hand, hoped to bring more attention to ADHD. I kept seeing in-

formation regarding the conference in Toronto and finally bought a plane ticket; I live in Calgary,

Alberta! As you can imagine, it is difficult to leave children with needs alone (without their main caregiver) even for a couple of

days. But it was the best decision I’ve made.

I arrived Friday night and left late Saturday night, so I was able to attend

the workshop for parents. I just wanted to thank you for all that you do. I

recently read your response to a person who found some of the com-

ments made in the article to be negative. I think you articulated the need

for new programs and awareness beautifully. I learned that there is a big

difference between provinces in the way ADHD is diagnosed, treated,

and in terms of services available. I am so excited for next year’s confer-

ence. I returned to Calgary and could not stop talking about all the won-

derful information I received.

I feel refreshed! Thank you again!

Warmest Regards,

A New Member of CADDAC

Dr. Weiss gave numerous heartfelt and thoroughly

informative presentations.

Dr. Candice Murray presented each day garnering positive feedback on her speaking.

Dr. Mark Berner presented on alternative medications for the

treatment of ADHD. Nili Berner, ADHD Coaching

John Tucker, Chairman of the Board of CADDAC

Heidi Bernhardt, Executive Director and President of

CADDAC