ADHD on the Rise

ADHD on the Rise

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The Centers for Disease Control reports a rise in the number of children diagnosed with ADHD.

Their report indicates a 10% rise in pediatric ADHD in the Midwest in the past 10 years. The looming question—to which no one can provide a definitive answer—is this: Does the increase mean more kids with “real” ADHD, or just more kids with the ADHD label? The difference is critical.

ADHD is considered a “mental disorder,” and as such is defined by the American Psychiatric Association (APA). It is believed to affect, according to APA’s most recent diagnostic manual, 3%-7% of school-aged children. If prevalence rates are said to be significantly higher (and they are, according to this article by the CDC), it is fair to use the term “epidemic” to describe the rise in ADHD.

ADHD symptoms can be “caused” by numerous triggers: vision problems, hearing problems, spinal misalignments, poor sleep and/or diet, underdeveloped prefrontal lobes in the brain, and structural “abnormalities” in other brain parts. Environmental triggers such as television, video games, and busy schedules can add to a child’s propensity to develop ADHD symptoms.

Are symptoms the same thing as the diagnosis? No. A psychiatric diagnosis confers that that the caues of “problems” are known. It is not simply confirming that a variety of symptoms are present. When a mental health professional diagnoses ADHD, she confirms that she KNOWS, for example, that hearing problems are not the primary cause of a child’s inattention. An ADHD diagnosis confirms that food allergies are not the primary cause of hyperactivity. An ADHD diagnosis proposes that ADHD problems do not stem from an untreated sleep disorder. The problem with the current ways in which children get diagnosed is that many (competent and well-meaning) care providers simply do not have the time, information, or other resources to properly evaluate a child for ADHD. Is it any wonder that ADHD is so easily and so often misdiagnosed and, thus, mistreated?

To get an accurate ADHD diagnosis, Plum Tree evaluates a child with a series of interviews, observations, and tests to determine if ADHD is the appropriate diagnosis. An ADHD diagnosis should only be applied after the mental health provider has:

  • Spent lots of time with your child (more than 15 minutes)
  • Obtained a detailed and structured history of your child’s health, behavior, and functioning from you AND others, including school professionals, babysitters, etc.
  • Administered a computer test (TOVA) to measure objectively your child’s inattention and impulsivity rates
  • Ruled out other mental health conditions and the possibilities of other health conditions

 

Social Media Effects on Children

Social Media Effects on Children

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A CNN article reviews the role of electronic media in children’s lives—the good, the bad, and the narcissistic. The research was conducted by Larry D. Rosen, Ph.D., professor of psychology at California State University, Dominguez Hills, and technology researcher. Below is a summary of the major trends observed by Dr. Rosen. Social Media Effects on Children.

Positive Results

– Social media is a great tool for engaging and captivating children
– Online networking can teach socialization
– Online users show more “virtual empathy”
– Social Media can help children establish a sense of self

Negative Results

– Students using social media during study breaks received lower grades
– Children who use social media tend to be more narcissistic
– Research suggests social media can increase anxiety and depression in children

Dr. Weller suggests that parents stay up-to-date on social media trends. Become familiar with what sites your child uses. (St. Charles school district has recently offered teen-led classes to parents for help with this). Like anything done in mindful moderation, social media can play a role in a well-balanced life.

What is a Child and Adolescent Psychologist

What is a Child and Adolescent Psychologist?

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Clinical psychologists have doctoral-level training to provide therapy (including coaching) and consultation, and psychological testing.

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Healthy Eating

Healthy Eating

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The American Psychological Association (APA) posted an article about helping children develop better eating and exercise habits. Below are the benefits of good nutrition and daily exercise, according to the APA.

Good nutrition is essential to healthy brain development in children which is, of course, critical to learning.

Mental and behavioral benefits

– perform better academically
– feel better about themselves, their bodies, and their abilities
– cope with stress and regulate their emotions better
– avoid feelings of low self-esteem, anxiety, and depression.

Establishing healthy eating and exercise habits early in life can lead to long term healthy behavior in adulthood.

Physical benefits

Children need a wide variety of nutrients (e.g., protein, complex carbohydrates, healthy fats, minerals, vitamins) to assist in their daily growth and development and to protect them from childhood illnesses.

Daily exercise also helps children to build stronger muscles and bones and limit excess body fat.

Healthy eating also cuts down on risk for cavities, eating disorders and unhealthy weight control behaviors (i.e., fasting, skipping meals, eating very little food, vomiting, using diet pills, laxatives, or diuretics), malnutrition, and iron deficiency.

Healthy eating and consistent physical activity help to prevent chronic illnesses that appear in adulthood associated with obesity, e.g., heart disease, diabetes, high blood pressure, and several forms of cancer.

The relationship between a healthy diet and a healthy mind is perhaps intuitive. But scientists are discovering more every day about how what-children-eat is related to their behaviors. Particularly ADHD research shows how food allergies and sensitivities can mimic ADHD sypmptoms. Before starting any medication, Dr. Weller recommends ruling-out food-related issues. A visit to a Registered Dietician is a good first step.

Sleep Hygiene

Sleep Hygiene

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Sleep is an integral part of children’s health. Amazing things happen while they sleep, including bursts in physical growth and solidification of learning. Studies show that a good night’s sleep helps buoy moods, improve cognitive performance, and build the body’s resilience against illness and accidents. Problems with sleep are parts of major mental illnesses, including mood disorders. Some scientists suggest that depression is linked to prolonged REM sleep. There is also a growing body of evidence suggesting that ADHD may stem from “a sleepy brain.” Specialists have said that as many as 40% of children who meet the diagnostic criteria for ADHD also meet criteria for a sleep disorder.

An article from the Wall Street Journal reviews findings that link sleep problems with depression, anxiety, substance abuse, aggression, learning problems, and obesity.

Good sleep hygiene is a must. It is also the first place to start when you notice patterns of childhood misbehavior or under-performance. Sleep hygiene includes:

  1. Routine: Regular, predictable soothing activities cue the brain that sleep is on the way. Reading, baths, relaxing music, calm activities, low lights, soft pajamas—integrate these into a pattern for your child. Start 1 hour before sleep is to begin.
  2. Children need more than 8 hours of sleep per night. The American Academy of Sleep Medicine recommends the following sleep guidelines:
    • Infants: 14 to 15 hours
    • Toddlers: 12 to 14 hours
    • Preschoolers: 11 to 13 hours
    • School-age kids: 10 to 11 hours
    • Teenagers: 9 to 10 hours
  3. Turn off electronic media 2 hours before bed. Studies show that children with TVs and video games in their rooms get less sleep. Cell phones (including texts, email, games, and other apps) can also rob many teenagers of a good night’s sleep.

 

Catch Your Child Being Good

Catch Your Child Being Good

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Limit children’s time with television and video games

Limit children’s time with television and video games

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Today’s parents are usually good at monitoring the content of TV and video games, ensuring that children are not exposed to violence, sexuality, and other adult themes. However, in many households, children may spend hours each day watching TV and playing video games. There is solid evidence that too much TV and video games increase the likelihood of a child developing problems with attention. A good rule of thumb for TV/video game usage is less than 2 hours daily, the less the better.

Limiting time spent with TV and video games is especially important for very young children. According to Dimitri Christakis, MD, MPH, Director of the Child Health Institute and author of The Elephant in the Living Room: Make Television Work For Your Kids, children as young as a few months old are watching too much TV, and may be developing permanent attention problems. In an article on education.com, author Rose Garrett writes, “For every hour of television toddlers watch a day, they are ten percent more likely to develop attention problems at school,” according to Dr. Christakis.

What’s more, according to a recent study about children who watched who watched more than 2 hours of TV per week 40% more likely to have symptoms of ADHD in adolescence than children who watched less TV. The problem is the speed of the frames. Fast-paced electronic media seem to train children’s brains to attend only to faced-paced stimulation (e.g., the opposite of a teacher at a whiteboard). Click for video game and TV time recommendations.

I like this MSN Health article by Rich Maloof: It nicely summarizes medical research and recommendations about TV & ADHD.

 

 

Mental Illness in Children and Adults

Mental Illness in Children and Adults

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Even beyond childhood traits (such as impulsivity, emotional reactivity, hyperactivity, etc), kids’ brains and bodies seem to experience and certainly to express mental discomfort differently than adults. For example, when adults are tired they tend to be lethargic and sleepy. Tired children often become agitated and irritable.

Children with mental illness behave differently than adults with mental illness. When adults are depressed, they tend to be characterized by sadness, slowing down, and gloominess. Depressed children tend to be grumpy—not sad—and they may have extra energy and agitation. While adults with ADHD are usually just restless, most children with ADHD cannot sit still for more than a few moments. Adults with PTSD (Posttraumatic Stress Disorder) usually use words to relive trauma, while younger children with PTSD show their trauma in play and behavior. Adults with Bipolar Disorder tend to have discrete “cycles” of moods that last for long periods of times. But children with Bipolar Disorder tend to have many mood changes each day.

Helping children with mental illness hinges on the understanding that most children do not have the vocabulary or concepts to accurately describe their internal experiences. They almost never know “why” they behave as they do. They are often unaware of how events link together—for example, how an argument with mom in the morning led to poor test performance in their first period class. Children tend to be more resilient than others would suppose, and each child has strengths and resources available to them on their road to a happier, more fulfilling life.

For more information about childhood and adolescent mental illness, visit the website for National Institute of Mental Health.

 

How Kids Think, Feel, and Behave

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Children’s brains are not fully developed (and won’t be until they are about 25 years old). This means that they do not solve problems like adults. Younger children tend to be:

  • Concrete (“If Grandma died and went to up to heaven, then I could totally take an airplane to see her”)
  • Impulsive (Karate-kick a houseplant)
  • Inquisitive (“Would my dog like chocolate pudding?”)
  • Magical-in-thinking (“If I think a tarantula is under my bed, then it absolutely is.”)
  • Under-Informed (“Sponge Bob can see me through the television.”)
  • Hypothesis-Testers (“What will mom do if I put my hand on the power outlet…again?”)
  • Repetitious (“Anything worth doing once, should be done ten more times”)
  • Distractible (Attention spans are limited, getting longer over time)
  • Unreliable cause-and-effect understanding (“Mom and Dad got divorced because of me.”)
  • Hyperactive (Most 3-year-old boys would meet criteria for a diagnosis of ADHD, but very few actually have it.)
  • Imbue innate objects with sentience (“My stuffed animal needs a hug.”)
  • Emotionally reactive (“Since I didn’t get ice cream, this is the worst day of my life.”)

With age, children’s reasoning becomes more sophisticated (but may not yet be rational). Then, bodily changes (including hormones and changes in neurochemistry) play a bigger role in the thoughts, feelings, and behaviors of older children. Older children tend to be:

  • Convinced of their uniqueness (“No one has ever felt this way, and no one can ever understand me.”)
  • Egocentric (“Everyone in the world is looking at my zit.”)
  • Easily influenced (peer pressure)
  • Peer-focused (social life is more important than family life)
  • Variable in identity (try on different “selves” to answer critical questions about who I am, what I like, what I want to be)
  • Rebellious (challenging social, familial, and cultural norms)
  • Judicious (sensitive to “unfair” behaviors)
  • Impulsive (Diving into a shallow pool)
  • Under-Informed (starting a romantic online relationship)
  • Emotionally reactive (a break-up is the end of life)
  • Limit-testing (seeing how far parents’ rules can be bent)

For more information about normal childhood development, visit this website  (it’s an offshoot of American Academic of Pediatrics):

 

Coping Skills Activities

ADHD Resources

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As ADHD becomes better understood, many resources have become available. The most succinct, accurate, and effective resources that Dr. Weller has used include:

  • www.kolbe.com. This website has evaluations that folks with ADHD (children and adults) have found very helpful. Evaluations clarify each person’s unique modus operandi in dealing with the world. It is a strength-based model that can help families better understand how to make the most of ADHD.
  • “Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood,” by Dr. Edward Hallowell. Dr. Hallowell is a national expert in ADHD (he calls it ADD) and his books are easy-to-read, strength-based, and practical. They suggest cutting edge and real world strategies to manage ADHD.
  • “Overcoming ADHD: Helping your child become calm, engaged, and focused—without a pill,” by Stanley Greenspan. This book is a must-have for parents of children with ADHD. Even if children are on medications, it offers lifestyle and relationship suggestions to optimize the ADHD family experience.

More recommendations and ADHD resources can be found here.