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ADD Health and Wellness Seminar

ADD Health and Wellness Seminar






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    ADD Health and Wellness Seminar ADD Health and Wellness Seminar Presentation 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
      • DSM-IV
      • 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
      • Loses things
      • Has difficulty paying attention to conversations
      • Is forgetful
      • 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”
      • Talks excessively
      • 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
              • Career Responsibilities
      • 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
      • ADULTS
      • 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
      • CHILDREN
      • 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
    • ADHD Untreated
    • 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
      • Attentional Assessment
      • 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)
            • Divided Attention
            • The Ability to Shift Attention
            • Sustained Attention
            • Areas of Executive Functioning Assessed:
            • Working Memory
            • Organization
            • Planning
            • Impulsivity
            • Distractibility
            • Problem-Solving
    • 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:
      • IQ testing
      • Language processing
      • Visual/spatial Skills
      • Memory
      • Learning style
      • Speed of processing
      • Academic
      • Fine motor skills
      • Comprehensive review of all previous testing, I.E.P’s and school accommodations.
      • Treatment Options
      Who does ADHD impact?
    • Treatment Services
      • 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
      • Medication Management
      • 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.
    • Adult Supports
      • 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.
    • ADHD Coaching
      • 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
        • Increase self-awareness
        • Renovate lifestyle habits such as diet, sleep, and exercise
    • Medication Option
      • 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
    • ADHD Medications
      • Stimulants
      • Ritalin, Ritalin SR, Ritalin LA Metadate ER, Metadate CD Concerta, Focalin IR, Focalin XR
      • Adderall XR, Adderall XR, Dextrostat, Dexedrine span
      • Cylert
      • Non-Stimulants
      • Strattera
      • Wellbutrin SR, Wellbutrin XL
      • Clonidine, Tenex
      • TCA’s
    • Stimulants
      • Diet and Nutrition
      Brain Neurotransmitters Dopamine Norepinephrine
    • Diet & Nutrition
      • What we eat determines how effectively our brain operates
      • Food affects metabolism and brain chemistry
      • Poor diet alone can lead to distractibility, impulsivity and restlessness and look like ADHD when it is not
      • Why it is important to eat breakfast?
    • The Role of Carbohydrates
      • General Dietary Guidelines:
      • Increased sugar consumption does not cause ADHD but can exacerbate symptoms of ADHD
      • Eat lower Glycemic Index foods
        • Increase protein, decrease carbs in your diet
        • Reduces insulin, cortisol, improves concentration
    • Nutritional Supplements
      • Studies have shown altered Fatty Acid
      • metabolism in ADHD!
      • Consider Nutritional Supplements:
        • Assist in managing ADHD
        • To support traditional approaches to medical care
      • Omega-3 Fatty Acids (DHA, EPA)
        • Depression, Bipolar, ADHD benefits
    • Exercise: Schedule 30 Min. Daily
      • Exercise promotes general health as well as mental focus. It’s a natural stimulant and antidepressant!
      • Builds mental endurance and reduces mental fatigue.
      • Excellent treatment for an ADHD emergency : A quick burst of exercise is like pushing the reset button on your brain.
      • Children with ADHD should not miss recess or be denied sports as discipline.
    • Positive Traits with ADHD
          • Lots of energy
          • Entrepreneurial: thinking “outside of the box”
          • Charismatic, fun to be with
          • Spontaneous
          • Adventurous
          • Sense of humor
          • Creative
          • Eager to help others
          • Compassionate
    • How are we different?
      • A team of experts – all together
      • Many choices and options available
      • Individualized Treatment Plan
      • Clinicians who talk to each other
      • Clinicians who listen to you