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 Bo...
Our Commitment &  Team Approach  Our mission is to provide a comprehensive array of professional services for adults  and ...
What is ADHD?  1930’s Minimal Brain Dysfunction 1968 DSM II Hyperkinetic reaction of Childhood 1994 DSM-IV ADHD: Predomina...
Three Subtypes of ADHD <ul><li>DSM-IV  </li></ul><ul><li>Predominately Inattentive Type (30-40%)  ADD </li></ul><ul><li>Pr...
  Symptoms of Inattention   Often: <ul><li>Makes careless mistakes </li></ul><ul><li>Has difficulty sustaining attention <...
Symptoms of Hyperactivity/Impulsivity   Often: <ul><li>Unable to stay seated at mealtime, watching TV, or doing homework <...
ADHD & Executive Functioning   <ul><li>Executive functioning refers to the ability to demonstrate knowledge and is impacte...
Doesn’t  everyone  have ADHD? <ul><li>The differences are that people with ADHD experience a  greater severity  and  highe...
Myths About ADHD <ul><li>He is just lazy and unmotivated. </li></ul><ul><li>Adults don’t have ADHD. </li></ul><ul><li>Trea...
ADHD Prevalence Rates <ul><li>ADULTS </li></ul><ul><li>ADHD affects 4 - 5% of the adult population  </li></ul><ul><li>Only...
ADHD Untreated
Comorbidities with ADHD
ADDH&W - A Team Approach
ADD Health & Wellness How Are We Different? <ul><li>We thought to ask you.  Extensive History Questionnaire and Rating Sca...
<ul><li>Attentional Assessment   </li></ul><ul><li>State of the Art Evaluation of Attention and Executive Functioning  </l...
ADHD is Frequently Associated with  Learning Disabilities <ul><li>ADHD is associated with an extremely high rate of coexis...
What is a Neuropsychological Evaluation?  <ul><li>Attentional Assessment  PLUS: </li></ul><ul><li>IQ testing </li></ul><ul...
<ul><li>Treatment Options </li></ul>Who does ADHD impact?
Treatment Services <ul><li>Primary model : Take 2 ritalin and call me next month? </li></ul><ul><li>Our   Integrated  ADHD...
Child / Adolescent Supports: <ul><li>We Address Specific Symptoms for Children and Teens: </li></ul><ul><li>Attention in t...
Adult Supports  <ul><li>Learn Tools for Success  to address time management, procrastination, organization, and increasing...
ADHD Coaching <ul><li>An ADHD coach is professionally trained to guide and support a person in overcoming the challenges o...
Medication Option <ul><li>Our comprehensive evaluation takes out the guessing component and  allows for a more specialized...
ADHD Medications   <ul><li>Stimulants </li></ul><ul><li>Ritalin, Ritalin SR, Ritalin LA Metadate ER, Metadate CD Concerta,...
Stimulants <ul><li>Diet and Nutrition </li></ul>Brain Neurotransmitters Dopamine Norepinephrine
Diet & Nutrition   <ul><li>What we eat determines how effectively our brain operates </li></ul><ul><li>Food affects metabo...
The Role of Carbohydrates <ul><li>General Dietary Guidelines: </li></ul><ul><li>Increased sugar consumption does not cause...
Nutritional Supplements <ul><li>Studies have shown altered Fatty Acid  </li></ul><ul><li>metabolism in ADHD! </li></ul><ul...
Exercise:  Schedule  30 Min. Daily <ul><li>Exercise promotes general health as well as mental focus. It’s a natural stimul...
Positive Traits with ADHD <ul><ul><ul><li>Lots of energy </li></ul></ul></ul><ul><ul><ul><li>Entrepreneurial: thinking “ou...
How are we different? <ul><li>A team of experts – all together </li></ul><ul><li>Many choices and options available </li><...
Upcoming SlideShare
Loading in …5
×

ADD Health and Wellness Seminar

4,097 views
3,820 views

Published on

Published in: Health & Medicine
1 Comment
7 Likes
Statistics
Notes
  • Love slide 13! We're much on the same path!
    You might appreciate this additional set of criteria on the biomedical side here:

    http://slidesha.re/1aLiWuA
    Thanks!
    cp
    Author: New ADHD Medication Rules - Brain Science & Common Sense
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
No Downloads
Views
Total views
4,097
On SlideShare
0
From Embeds
0
Number of Embeds
54
Actions
Shares
0
Downloads
0
Comments
1
Likes
7
Embeds 0
No embeds

No notes for slide

ADD Health and Wellness Seminar

  1. 1. Welcome to ADD Health & Wellness Centers, Inc . April 15 th , 2007
  2. 2. Presenters Theresa Cerulli, MD – Chief Medical Officer Theresa Lavoie, PhD – Director Psychological Services Gillian Botha-Harvey – Regional Manager
  3. 3. 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.
  4. 4. 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
  5. 5. Three Subtypes of ADHD <ul><li>DSM-IV </li></ul><ul><li>Predominately Inattentive Type (30-40%) ADD </li></ul><ul><li>Predominately Hyperactive Type (10%) </li></ul><ul><li>Combined Type (50-60%) </li></ul>
  6. 6. Symptoms of Inattention Often: <ul><li>Makes careless mistakes </li></ul><ul><li>Has difficulty sustaining attention </li></ul><ul><li>Is easily distracted </li></ul><ul><li>Distracted from tasks by background noises ignored by others </li></ul><ul><li>Avoids tasks requiring sustained attention </li></ul><ul><li>Loses things </li></ul><ul><li>Has difficulty paying attention to conversations </li></ul><ul><li>Is forgetful </li></ul><ul><li>Doesn’t seem to listen </li></ul><ul><li>Fails to finish tasks </li></ul><ul><li>Shifts from one uncompleted activity to another </li></ul>
  7. 7. Symptoms of Hyperactivity/Impulsivity Often: <ul><li>Unable to stay seated at mealtime, watching TV, or doing homework </li></ul><ul><li>Cannot sit still and listen to a story </li></ul><ul><li>Fidgets, shakes feet & legs </li></ul><ul><li>Excessive running, climbing, and jumping </li></ul><ul><li>Has difficulty playing quietly </li></ul><ul><li>Constantly “on the go” </li></ul><ul><li>Talks excessively </li></ul><ul><li>Has difficulty awaiting his turn-impatient </li></ul><ul><li>Blurts out answers </li></ul><ul><li>Interrupts or intrudes </li></ul><ul><li>Makes excessive noise when engaging in quiet activities </li></ul>
  8. 8. ADHD & Executive Functioning <ul><li>Executive functioning refers to the ability to demonstrate knowledge and is impacted by: </li></ul><ul><li>1. Demands and expectations at a given time: </li></ul><ul><ul><ul><ul><ul><li>Middle school vs. High school vs. College </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Single vs. Married vs. Becoming a Parent </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Career Responsibilities </li></ul></ul></ul></ul></ul><ul><li> 2. Learned strategies: </li></ul><ul><ul><ul><ul><ul><li>Time management systems </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Strategies for memory </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Choosing the best fit academically and professionally </li></ul></ul></ul></ul></ul><ul><li> 3. Support by a spouse or parent in regulating, monitoring, </li></ul><ul><li> and structuring of the environment. </li></ul>
  9. 9. Doesn’t everyone have ADHD? <ul><li>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. </li></ul><ul><li>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. </li></ul>
  10. 10. Myths About ADHD <ul><li>He is just lazy and unmotivated. </li></ul><ul><li>Adults don’t have ADHD. </li></ul><ul><li>Treatment for ADHD will cure it. The goal is to get off medication as soon as possible. </li></ul><ul><li>He focuses on video games for hours. He can’t have ADHD. </li></ul><ul><li>ADHD is caused by poor parenting. </li></ul><ul><li>If I just try harder ..... </li></ul>
  11. 11. ADHD Prevalence Rates <ul><li>ADULTS </li></ul><ul><li>ADHD affects 4 - 5% of the adult population </li></ul><ul><li>Only 2 of 9 million adults are currently diagnosed </li></ul><ul><li>Half of children with ADHD still meet full criteria in adulthood </li></ul><ul><li>Of the adults diagnosed with ADHD, very few are aware of treatment options other than medication </li></ul><ul><li>CHILDREN </li></ul><ul><li>7 - 8% of school aged children or 4.5 million children are affected by ADHD </li></ul><ul><li>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 </li></ul>
  12. 12. ADHD Untreated
  13. 13. Comorbidities with ADHD
  14. 14. ADDH&W - A Team Approach
  15. 15. ADD Health & Wellness How Are We Different? <ul><li>We thought to ask you. Extensive History Questionnaire and Rating Scales </li></ul><ul><li>We ask others too . Interview with patient and family. Collaborative data from school, parents, doctors, teachers, and spouse </li></ul><ul><li>We’re objective . Attentional Testing or Neuropsychological Testing </li></ul><ul><li>We give results . Review Testing. Non-Medication and holistic approach </li></ul><ul><li>We’re integrated . Cutting-edge, Latest therapies, Multimodal team approach </li></ul><ul><li>We prove client success . Outcome Database to measure client results </li></ul>
  16. 16. <ul><li>Attentional Assessment </li></ul><ul><li>State of the Art Evaluation of Attention and Executive Functioning </li></ul><ul><ul><ul><ul><li>Areas of Attention Assessed in Adults and Children: </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Auditory Attention (Simple and Complex) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Visual Spatial Attention (Simple and Complex) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Divided Attention </li></ul></ul></ul></ul><ul><ul><ul><ul><li>The Ability to Shift Attention </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Sustained Attention </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Areas of Executive Functioning Assessed: </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Working Memory </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Organization </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Planning </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Impulsivity </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Distractibility </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Problem-Solving </li></ul></ul></ul></ul>
  17. 17. ADHD is Frequently Associated with Learning Disabilities <ul><li>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. </li></ul><ul><li>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 </li></ul>
  18. 18. What is a Neuropsychological Evaluation? <ul><li>Attentional Assessment PLUS: </li></ul><ul><li>IQ testing </li></ul><ul><li>Language processing </li></ul><ul><li>Visual/spatial Skills </li></ul><ul><li>Memory </li></ul><ul><li>Learning style </li></ul><ul><li>Speed of processing </li></ul><ul><li>Academic </li></ul><ul><li>Fine motor skills </li></ul><ul><li>Comprehensive review of all previous testing, I.E.P’s and school accommodations. </li></ul>
  19. 19. <ul><li>Treatment Options </li></ul>Who does ADHD impact?
  20. 20. Treatment Services <ul><li>Primary model : Take 2 ritalin and call me next month? </li></ul><ul><li>Our Integrated ADHD Treatment Model : </li></ul><ul><li>Emphasis on Patient Education, Family, Career, and School Support </li></ul><ul><li>Individual Cognitive and Behavioral Therapy and Relaxation Training </li></ul><ul><li>ADHD Coaching for Adults and Children </li></ul><ul><li>Support and Strategies Focused Groups for Adults </li></ul><ul><li>Social Skills Groups for Children, Adolescent Groups </li></ul><ul><li>Medication Management </li></ul><ul><li>Complimentary & Alternative Therapies </li></ul><ul><li>Nutritional Counseling, Supplementation </li></ul>
  21. 21. Child / Adolescent Supports: <ul><li>We Address Specific Symptoms for Children and Teens: </li></ul><ul><li>Attention in the classroom and during sports practice </li></ul><ul><li>Completing work on time </li></ul><ul><li>Difficulty memorizing facts </li></ul><ul><li>Friendships, social skills training, anger management </li></ul><ul><li>Study skills and Procrastination </li></ul><ul><li>Organization of school materials </li></ul><ul><li>Focus on assets/strengths </li></ul><ul><li>Mindfulness training helpful in reducing stress </li></ul><ul><li>* It is critical to address the impact of symptoms on self-esteem and any co-occurring symptoms of depression or anxiety. </li></ul>
  22. 22. Adult Supports <ul><li>Learn Tools for Success to address time management, procrastination, organization, and increasing attention, and improving memory. </li></ul><ul><li>Cognitive Therapy addressing self-esteem, well-being, and any co-occurring symptoms of anxiety or depression. </li></ul><ul><li>Group Therapy , social support, strategies and skills training with others, and techniques for self-care. </li></ul><ul><li>Home-Life Strategies , mindfulness, relaxation techniques for reducing stress and anxiety. </li></ul><ul><li>Workplace Strategies , employer accommodations and career choices </li></ul><ul><li>Couples Therapy educating couples together about ADHD and its impact on relationships, finances, and family life. </li></ul>
  23. 23. ADHD Coaching <ul><li>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. </li></ul><ul><ul><li>Specifically, ADHD coaches help their clients: </li></ul></ul><ul><ul><li>Set and reach individual goals (school, work) </li></ul></ul><ul><ul><li>Provide structure needed for day to day tasks </li></ul></ul><ul><ul><li>Emphasize the use of tools to stay on track </li></ul></ul><ul><ul><li>Improve organizing skills & design organizing systems </li></ul></ul><ul><ul><li>Plan projects, prioritize tasks, manage time effectively </li></ul></ul><ul><ul><li>Increase self-awareness </li></ul></ul><ul><ul><li>Renovate lifestyle habits such as diet, sleep, and exercise </li></ul></ul>
  24. 24. Medication Option <ul><li>Our comprehensive evaluation takes out the guessing component and allows for a more specialized psychopharmacological intervention. </li></ul><ul><li>Expertise in attentional disorders allows for careful selection of the most appropriate medications to get </li></ul><ul><li>the benefits and avoid side effects. </li></ul><ul><li>First rule of thumb: Do no harm </li></ul><ul><li>Close monitoring by our team of professionals </li></ul>
  25. 25. ADHD Medications <ul><li>Stimulants </li></ul><ul><li>Ritalin, Ritalin SR, Ritalin LA Metadate ER, Metadate CD Concerta, Focalin IR, Focalin XR </li></ul><ul><li>Adderall XR, Adderall XR, Dextrostat, Dexedrine span </li></ul><ul><li>Cylert </li></ul><ul><li>Non-Stimulants </li></ul><ul><li>Strattera </li></ul><ul><li>Wellbutrin SR, Wellbutrin XL </li></ul><ul><li>Clonidine, Tenex </li></ul><ul><li>TCA’s </li></ul>
  26. 26. Stimulants <ul><li>Diet and Nutrition </li></ul>Brain Neurotransmitters Dopamine Norepinephrine
  27. 27. Diet & Nutrition <ul><li>What we eat determines how effectively our brain operates </li></ul><ul><li>Food affects metabolism and brain chemistry </li></ul><ul><li>Poor diet alone can lead to distractibility, impulsivity and restlessness and look like ADHD when it is not </li></ul><ul><li>Why it is important to eat breakfast? </li></ul>
  28. 28. The Role of Carbohydrates <ul><li>General Dietary Guidelines: </li></ul><ul><li>Increased sugar consumption does not cause ADHD but can exacerbate symptoms of ADHD </li></ul><ul><li>Eat lower Glycemic Index foods </li></ul><ul><ul><li>Increase protein, decrease carbs in your diet </li></ul></ul><ul><ul><li>Reduces insulin, cortisol, improves concentration </li></ul></ul>
  29. 29. Nutritional Supplements <ul><li>Studies have shown altered Fatty Acid </li></ul><ul><li>metabolism in ADHD! </li></ul><ul><li>Consider Nutritional Supplements: </li></ul><ul><ul><li>Assist in managing ADHD </li></ul></ul><ul><ul><li>To support traditional approaches to medical care </li></ul></ul><ul><li>Omega-3 Fatty Acids (DHA, EPA) </li></ul><ul><ul><li>Depression, Bipolar, ADHD benefits </li></ul></ul>
  30. 30. Exercise: Schedule 30 Min. Daily <ul><li>Exercise promotes general health as well as mental focus. It’s a natural stimulant and antidepressant! </li></ul><ul><li>Builds mental endurance and reduces mental fatigue. </li></ul><ul><li>Excellent treatment for an ADHD emergency : A quick burst of exercise is like pushing the reset button on your brain. </li></ul><ul><li>Children with ADHD should not miss recess or be denied sports as discipline. </li></ul>
  31. 31. Positive Traits with ADHD <ul><ul><ul><li>Lots of energy </li></ul></ul></ul><ul><ul><ul><li>Entrepreneurial: thinking “outside of the box” </li></ul></ul></ul><ul><ul><ul><li>Charismatic, fun to be with </li></ul></ul></ul><ul><ul><ul><li>Spontaneous </li></ul></ul></ul><ul><ul><ul><li>Adventurous </li></ul></ul></ul><ul><ul><ul><li>Sense of humor </li></ul></ul></ul><ul><ul><ul><li>Creative </li></ul></ul></ul><ul><ul><ul><li>Eager to help others </li></ul></ul></ul><ul><ul><ul><li>Compassionate </li></ul></ul></ul>
  32. 32. How are we different? <ul><li>A team of experts – all together </li></ul><ul><li>Many choices and options available </li></ul><ul><li>Individualized Treatment Plan </li></ul><ul><li>Clinicians who talk to each other </li></ul><ul><li>Clinicians who listen to you </li></ul>

×