ADD Health and Wellness SeminarPresentation Transcript
Welcome to ADD Health & Wellness Centers, Inc . April 15 th , 2007
Presenters Theresa Cerulli, MD – Chief Medical Officer Theresa Lavoie, PhD – Director Psychological Services Gillian Botha-Harvey – Regional Manager
Our Commitment & Team Approach Our mission is to provide a comprehensive array of professional services for adults and children with attentional disorders such as ADHD, coexisting conditions, and learning disorders that will help them lead happier, more productive lives through a balanced, integrative and holistic, asset-based treatment model.
What is ADHD? 1930’s Minimal Brain Dysfunction 1968 DSM II Hyperkinetic reaction of Childhood 1994 DSM-IV ADHD: Predominately inattentive type Predominately hyperactive type Combined type 1980 1987 DSM III Attention Deficit + or - Hyperactivity DSM III-R Attention Deficit Hyperactivity Disorder
Three Subtypes of ADHD
Predominately Inattentive Type (30-40%) ADD
Predominately Hyperactive Type (10%)
Combined Type (50-60%)
Symptoms of Inattention Often:
Makes careless mistakes
Has difficulty sustaining attention
Is easily distracted
Distracted from tasks by background noises ignored by others
Avoids tasks requiring sustained attention
Has difficulty paying attention to conversations
Doesn’t seem to listen
Fails to finish tasks
Shifts from one uncompleted activity to another
Symptoms of Hyperactivity/Impulsivity Often:
Unable to stay seated at mealtime, watching TV, or doing homework
Cannot sit still and listen to a story
Fidgets, shakes feet & legs
Excessive running, climbing, and jumping
Has difficulty playing quietly
Constantly “on the go”
Has difficulty awaiting his turn-impatient
Blurts out answers
Interrupts or intrudes
Makes excessive noise when engaging in quiet activities
ADHD & Executive Functioning
Executive functioning refers to the ability to demonstrate knowledge and is impacted by:
1. Demands and expectations at a given time:
Middle school vs. High school vs. College
Single vs. Married vs. Becoming a Parent
2. Learned strategies:
Time management systems
Strategies for memory
Choosing the best fit academically and professionally
3. Support by a spouse or parent in regulating, monitoring,
and structuring of the environment.
Doesn’t everyone have ADHD?
The differences are that people with ADHD experience a greater severity and higher frequency of symptoms compared to the general population AND these symptoms are significantly impacting their daily functioning.
Our comprehensive evaluation is critical because it allows us to compare an individual (adult or child) who questions ADHD with a “normative sample” which refers to a large sampling of peers the same age from the general population.
Myths About ADHD
He is just lazy and unmotivated.
Adults don’t have ADHD.
Treatment for ADHD will cure it. The goal is to get off medication as soon as possible.
He focuses on video games for hours. He can’t have ADHD.
ADHD is caused by poor parenting.
If I just try harder .....
ADHD Prevalence Rates
ADHD affects 4 - 5% of the adult population
Only 2 of 9 million adults are currently diagnosed
Half of children with ADHD still meet full criteria in adulthood
Of the adults diagnosed with ADHD, very few are aware of treatment options other than medication
7 - 8% of school aged children or 4.5 million children are affected by ADHD
67% of children with ADHD are treated by their primary care physician with medication only and receive no additional education, therapy, coaching, academic guidance, or support
Comorbidities with ADHD
ADDH&W - A Team Approach
ADD Health & Wellness How Are We Different?
We thought to ask you. Extensive History Questionnaire and Rating Scales
We ask others too . Interview with patient and family. Collaborative data from school, parents, doctors, teachers, and spouse
We’re objective . Attentional Testing or Neuropsychological Testing
We give results . Review Testing. Non-Medication and holistic approach
We’re integrated . Cutting-edge, Latest therapies, Multimodal team approach
We prove client success . Outcome Database to measure client results
State of the Art Evaluation of Attention and Executive Functioning
Areas of Attention Assessed in Adults and Children:
Auditory Attention (Simple and Complex)
Visual Spatial Attention (Simple and Complex)
The Ability to Shift Attention
Areas of Executive Functioning Assessed:
ADHD is Frequently Associated with Learning Disabilities
ADHD is associated with an extremely high rate of coexisting psychiatric conditions such as depression and anxiety and is frequently accompanied by a learning disability.
Language disorders, reading disorders, and reduced processing speed frequently co-occur with ADHD. In one report, 45% of children with ADHD had at least one element of language impairment
What is a Neuropsychological Evaluation?
Attentional Assessment PLUS:
Speed of processing
Fine motor skills
Comprehensive review of all previous testing, I.E.P’s and school accommodations.
Who does ADHD impact?
Primary model : Take 2 ritalin and call me next month?
Our Integrated ADHD Treatment Model :
Emphasis on Patient Education, Family, Career, and School Support
Individual Cognitive and Behavioral Therapy and Relaxation Training
ADHD Coaching for Adults and Children
Support and Strategies Focused Groups for Adults
Social Skills Groups for Children, Adolescent Groups
Complimentary & Alternative Therapies
Nutritional Counseling, Supplementation
Child / Adolescent Supports:
We Address Specific Symptoms for Children and Teens:
Attention in the classroom and during sports practice
Completing work on time
Difficulty memorizing facts
Friendships, social skills training, anger management
Study skills and Procrastination
Organization of school materials
Focus on assets/strengths
Mindfulness training helpful in reducing stress
* It is critical to address the impact of symptoms on self-esteem and any co-occurring symptoms of depression or anxiety.
Learn Tools for Success to address time management, procrastination, organization, and increasing attention, and improving memory.
Cognitive Therapy addressing self-esteem, well-being, and any co-occurring symptoms of anxiety or depression.
Group Therapy , social support, strategies and skills training with others, and techniques for self-care.
Home-Life Strategies , mindfulness, relaxation techniques for reducing stress and anxiety.
Workplace Strategies , employer accommodations and career choices
Couples Therapy educating couples together about ADHD and its impact on relationships, finances, and family life.
An ADHD coach is professionally trained to guide and support a person in overcoming the challenges of living with ADHD and its impact at work, at school, and at home.
Specifically, ADHD coaches help their clients:
Set and reach individual goals (school, work)
Provide structure needed for day to day tasks
Emphasize the use of tools to stay on track
Improve organizing skills & design organizing systems
Plan projects, prioritize tasks, manage time effectively
Renovate lifestyle habits such as diet, sleep, and exercise
Our comprehensive evaluation takes out the guessing component and allows for a more specialized psychopharmacological intervention.
Expertise in attentional disorders allows for careful selection of the most appropriate medications to get
the benefits and avoid side effects.
First rule of thumb: Do no harm
Close monitoring by our team of professionals
Ritalin, Ritalin SR, Ritalin LA Metadate ER, Metadate CD Concerta, Focalin IR, Focalin XR