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Adhd daft jun 08


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Adhd daft jun 08

  2. 3. Narrative Therapy and Unique Outcomes <ul><li>In striving to make sense of life, persons face the task of arranging their experiences of events in sequences across time in such a way as to arrive at a coherent account of themselves and their world around them. Specific experiences of events of the past and present, and those that are predicted to occur in the future, must be connected in a lineal sequence to develop this account (White & Epston, 1990, p.10). This account can be seen as a story, a self-narrative or an identity. </li></ul><ul><li>Thus a narrative conceptualisation of identity goes beyond stories that are told about people, rather identity is a phenomenon in flux that finds its expression through one’s ‘own narrativization’ (Gee, 2001) which is collective and performative in nature (Sfard & Prusak, 2005). This line of thinking draws on the work of Bateson (1972) that argues any mapping of reality must include a temporal dimension, as well as that of Bruner (1986) which presents life experience as richer than dominant discourses or the dominant story. As a consequence, new identities can be created with each new telling as it encapsulates and expands on the previous telling (White & Epston, 1990). These new identities can identify ‘unique outcomes’ that plot trajectories outside the available ‘repertoire of identities’ to resist deficit views and the adoption of deficit identities. Such ideas have found currency within elements of the counselling profession which have used a narrative conceptualisation of identity as a foundation to ‘narrative therapy’. </li></ul><ul><li>One example of the use of narrative therapy with youth in the middle years can be found in the work of Nylund and Corsiglia (1997) and Law (1997). Often a focus on behaviour management in schools can reframe students with problems in schooling as problem students, with one prominent example of this process being found in Attention Deficit Hyperactivity Disorder (ADHD). Nylund and Corsiglia (1997) saw ADHD as a discourse located within individual deficit and thus argued that ADHD lends itself to a discursive or narrative therapy approach, not only because it is more accessible to those with lower linguistic ability, but also because it wrests back the ownership of the label for the individual. They propose that a young person should be encouraged to use their expertise to develop their own metaphors to reclaim their gifts and talents which have been narratively hijacked by the ADHD discourse. </li></ul><ul><li>Similarly, Law (1997) describes his use of narrative therapy with young people diagnosed ADHD. The basis of his approach was the belief that ADHD was a construction located in the social and cultural practices of pathologising behaviour, mother blaming, and the infantisation of children. In response he used the narrative therapy model to deconstruct the dominant view of ADHD, thus allowing more scope for the discovery of strengths and success. </li></ul><ul><li>Hattam, R., Prosser, B. & Brady, K. (2005). Unsettling deficit views of students and their communities </li></ul>
  3. 4. women / mothers with adhd
  4. 5. Executive functions and ADHD Adam J. Cox, Ph.D Has trouble remembering things, even for a few minutes; when sent for something forgets what s/he was supposed to get Holding information in mind for the purpose of completing a specific and related task Working Memory Is too easily upset, explosive; small events trigger big emotional response Modulating / controlling one’s own emotional response appropriate to the stressor or situation Emotional Control Does not check work for mistakes; is unaware of own behaviour and its impact on others Checking on one’s own actions during, or shortly after finishing, the task or activity to assure appropriate attainment of the goal Self-Monitor Has a scattered, disorganised approach to solving a problem; is easily over-whelmed by large tasks or assignments Establishing or maintaining order in an activity or place; carrying out a task in a systematic manner Organise Starts assignments at the last minute; does not think ahead about possible problems Anticipating future events, setting goals, and developing appropriate steps ahead of time to carry out an associated task or action Plan Gets stuck on a topic or tends to perseverate Freely moving from one situation, activity, or aspect of a problem to another as the situation demands Shift Has trouble ‘putting the breaks’ on behaviour, acts without thinking Not acting on impulse or appropriately stopping one’s own activity at the proper time Inhibit Has trouble getting started on chores or homework Beginning a task or activity Initiate DYSFUNCTION DEFINITION SUB-DOMAIN
  5. 6. ADHD, MEMORY AND EXECUTIVE FUNCTION Louise Keeton <ul><li>“ ADHD children generally show more problems on tasks requiring immediate memory [STM or WM] and recall than non-ADHD children” (Mealer, 1996). </li></ul><ul><li>Conners, who developed rating scales used extensively by parents and teachers to note symptoms in ADHD children, says, “Without working memory there is only automatic reaction to sensory events and fixed memories of past events which are inflexible in the face of changing reality” (1996). </li></ul><ul><li>The areas of the brains that are active during memory function are also different in ADHD children from those used in memory function of non-ADHD children. Positron Emission Tomography has shown ADHD patients use parts of the brain associated with visual tasks (the occipital regions) when WM is being used, rather than the prefrontal cortex that non-ADHD patients use (Fine, 2001). </li></ul>
  6. 7. <ul><li>Impulsivity - Go and Stop in the ADHD Brain </li></ul><ul><li>We have often felt sorry for those impulsive children who blurt out the first thing that comes to their mind when asked a question, especially if they are about to get into trouble. As most parents know, that first thing that comes out as the answer is usually a lie. And then the child has to spend the rest of the hour covering up the lie, that both he and his parents know is a lie. This is a classic scene of a child with ADHD getting into trouble because of his impulsivity. </li></ul><ul><li>As a remedy, we encourage parents to warn the child that they are about to be asked a very serious question, and that their honesty is absolutely required. And that the child is not to answer the question for 30 seconds after being asked, so that they can clearly think about what they want to answer and get it right the first time. This works. </li></ul><ul><li>Impulsivity in ADHD is seen in two ways: (1) either doing or saying something without thinking first; or (2) not saying “no” to yourself, inhibiting yourself, when you ought to do so. </li></ul><ul><li>It seems that a person with impulsivity as a part of their ADHD has a normal ability to say “Go” at the neurological level, but their ability to say “No” or “Stop” comes just a fraction of a second slower. As a result, things are often done, or said, without much self-control practiced. </li></ul>
  7. 8. Brain Matures A Few Years Late In ADHD, But Follows Normal Pattern ScienceDaily (Nov. 13, 2007) — In youth with attention deficit hyperactivity disorder (ADHD), the brain matures in a normal pattern but is delayed three years in some regions, on average, compared to youth without the disorder, an imaging study by researchers at the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH) has revealed. The delay in ADHD was most prominent in regions at the front of the brain's outer mantle (cortex), important for the ability to control thinking, attention and planning. Otherwise, both groups showed a similar back-to-front wave of brain maturation with different areas peaking in thickness at different times.
  8. 9. The Worldwide Prevalence of ADHD: A Systematic Review and Meta-regression Analysis Guilherme Polanczyk, M.D., Maurício Silva de Lima, M.D. Ph.D., Bernardo Lessa Horta, M.D. Ph.D., Joseph Biederman, M.D., Luis Augusto Rohde, M.D., Ph.D. Am J Psychiatry 164:6, June 2007
  9. 10. Family factors associated with attention deficit hyperactivity disorder and emotional disorders in children Gregor Lange, Declan Sheerin, Alan Carr, Barbara Dooley, Victoria Barton, David Marshall, Aisling Mulligan, Maria Lawlor, Mary Belton and Maeve Doyle Journal of Family Therapy (2005) 27: 76–96 <ul><li>Few well-controlled studies have identified psychosocial profiles of families of boys with ADHD and boys with emotional disorders compared with normal controls. However, the clinical and theoretical literature pinpoints four domains in which distinctive profiles would be expected to occur. </li></ul><ul><li>In this study, twenty-two mothers and thirteen fathers of twenty two boys with ADHD; twenty mothers and fifteen fathers of twenty boys with a mood or anxiety disorder; and twenty-six mothers and sixteen fathers of twenty-seven normal controls were compared on: (1) stress, support and quality of life; (2) current family functioning; (3) parenting style and satisfaction in the family of origin and current family; and (4) current and past parental functioning. </li></ul><ul><li>The two clinical groups showed higher levels of stress and lower levels of both social support and quality of life than did normal controls. Both clinical groups showed deficits in current family functioning, but contrary to expectations the ADHD and emotional disorder group did not show distinctly different profiles. </li></ul><ul><li>Parents of ADHD children reported higher levels of authoritarian parenting styles, and parents from both clinical groups reported less parenting satisfaction than did normal controls in both their current families and their families of origin. </li></ul><ul><li>Parents of children with ADHD and emotional disorders reported greater parenting satisfaction in their families of origin than in their current families. This discrepancy was greatest for parents of ADHD children. </li></ul><ul><li>Parents of children with ADHD and emotional disorders reported greater psychological health problems and more childhood ADHD symptomatology than did normal controls. </li></ul><ul><li>Parents of children with ADHD and emotional disorders have significant psychosocial difficulties in family and personal functioning. </li></ul><ul><li>Family intervention is highly appropriate for families with children who are referred for help with both types of difficulties. </li></ul>
  10. 11. SIBLING ACCOUNTS OF ADHD – JUDY KENDALL FAMILY PROCESS, SPRING 1999 (VIA FINDARTICLES.COM) <ul><li>Theoretical Schema </li></ul><ul><li>CORE CATEGORY </li></ul><ul><li>= Disruption </li></ul><ul><li>EFFECTS OF DISRUPTION </li></ul><ul><li>= Victimization </li></ul><ul><li>= Caretaking </li></ul><ul><li>= Sorrow and loss </li></ul><ul><li>MANAGING STRATEGIES </li></ul><ul><li>= Retaliation </li></ul><ul><li>= Accommodation </li></ul><ul><li>= Avoidance </li></ul>“ I worry about him getting hurt by somebody else. He doesn't listen, and one of these times he's going to get into real trouble, and like if he bad-talks somebody and he doesn't have control of himself and then they say, ‘I'm going to punch you,’ and he doesn't hear them, then he's going to get his lights knocked out. So I try to make sure he doesn't get into that kind of trouble.&quot; “ I've learned to check to see how he's feeling before I even say hi when I come home from school. If he looks upset I don't say anything because I know he will yell at me. If he looks bored then I know I better talk with him or he'll yell at me. If I don't do what he wants right when he says it I know he will be awful to me all night. I dread coming home sometimes. You know, it's like, when you get home don't ask him how his day was and have him just start talking and all that stuff. But when he wants you to listen, listen, and that way he won't get so mad. So--when you're listening to him, don't like butt in or anything because that also gets him real mad. I've learned not to talk to him about what's important to me because he won't listen or he'll say its stupid. So I only talk to him about what he wants to talk about and that way he won't get mad at me.”
  12. 13. Noted Psychologist Esther Thelen By Louie Estrada Washington Post Staff Writer Sunday, January 2, 2005 <ul><li>Esther Thelen, 63, a prominent developmental psychologist who studied how the brains of human babies help them move, learn and generally function, died Dec. 29 at a hospital in Bloomington, Ind. She had cancer. </li></ul><ul><li>Based at Indiana University, Dr. Thelen was a psychology professor and director of the university's Infant Motor Development Laboratory. She and colleagues studied infant movement, perception and cognition and how perceptual motor skills in infancy can say much about how people will adapt later in life. </li></ul><ul><li>Her work at Indiana University, and before that at the University of Missouri, has been credited with presenting a new view of how babies learn to reach for toys, walk and accomplish some of the earliest mental tasks, such as remembering where things are. </li></ul><ul><li>For years, most researchers believed that infants reached and walked when parts of the brain responsible for these activities &quot;matured.&quot; But based on 19 years of research, Dr. Thelen believed that these accomplishments reflect a complex interplay of factors that includes babies' changing bodies and their external environments, as well as their growing brains and nervous systems. </li></ul><ul><li>&quot;Babies are constantly trying to figure out things like 'How am I going to look around?' and 'How am I going to see that nice smiley face?' &quot; Dr. Thelen told Indiana University's Research & Creative Activity journal in spring 2003. &quot;I believe the behavior we see is not residing somewhere in the brain. Instead, it emerges in the movement.&quot; </li></ul><ul><li>Mixing theory with experiment, Dr. Thelen applied what is known as dynamic systems theory -- popularized under the name &quot;chaos theory&quot; -- to gain an understanding of the overall behavior of a system. </li></ul>
  13. 14. DYNAMIC SYSTEMS THEORY <ul><li>Dr. Thelen observed that the developmental sequences of children are more variable than was previously believed. Yet, almost all children arrive at certain milestones such as crawling, standing, and walking, although by way of different routes. She theorized that certain movements are “attractors” , but the paths to these attractors are variable. Children are drawn to these attractors, but each finds his or her own pathway through trial and error . In other words, the process depends more upon experimentation, curiosity, and learning than was previously thought. </li></ul><ul><li>Eventually, Dr. Thelen summarized the system by which children learn by the acronym EVASO : </li></ul><ul><ul><li>E: Explore </li></ul></ul><ul><ul><li>ADD/H: Ability to find alternative paths to overcome obstacles; Likes learning new things; Outgoing; Playful; Takes initiative; Willing to explore; Willing to take risks. </li></ul></ul><ul><ul><li>V: Variations: Experiment with variations in moving. </li></ul></ul><ul><ul><li>ADD/H: Constantly evolving; Eager to try new things; High energy – go, go, go; Impulsive (in a good way) not afraid to act; Spontaneous; Unconventional. </li></ul></ul><ul><ul><li>A: Attend to how new systems self-organize. </li></ul></ul><ul><ul><li>ADD/H: Adaptive/collaborative; Creates connections easily; Detail oriented; Pragmatic; See and remember details – recount them later; Sees the big picture; Visionary. </li></ul></ul><ul><ul><li>S: Select patterns that are better </li></ul></ul><ul><ul><li>ADD/H: Being able to see the patterns in the chaos; Holistic thinking; Philosophical; Problem-solver; Think outside the box; Thinks two metres ahead of the world; Very creative – able to generate lots of ideas; Thinks big, dreams big. </li></ul></ul><ul><ul><li>O: Optimize for functional effectiveness and movement quality. </li></ul></ul><ul><ul><li>ADD/H: Can create order from chaos; Comfortable with change and chaos; Conceptualizes well; Goal oriented; Not contained by boundaries; Resourceful; Versatile; Won’t tolerate boredom </li></ul></ul><ul><ul><li>ADD/H positives taken from a list of 151 at </li></ul></ul>
  14. 15. FAMOUS PEOPLE WITH ADD(H)? <ul><li>Mozart and ADHD </li></ul><ul><li>A review of Mozart´s life shows that he displayed many of the hallmarks of Attention Deficit Hyperactivity Disorder (ADHD). He was a whirlwind of energy, agitated, impatient, impulsive, easily distracted, creative, innovative, provocative, irreverent and a maverick. He has composed some the world´s most complex beautiful music. </li></ul><ul><li>Famous ADHD Scientists & Inventors </li></ul><ul><li>Here are a few people who changed the world and they had ADHD. Thomas Edison, Albert Einstien, Alexander Graham Bell and Benjamin Franklin. </li></ul><ul><li>Famous Business people with ADHD </li></ul><ul><li>Henry ford had ADHD. Henry Ford invented mass production and started the Ford Motor Company. Richard Branson, founder of the hudge Virgin business empire. As a child in the United Kingdom in the 1940s it is unlikely that his childhood behavior would have formally been diagnosed as ADHD but he is almost a textbook case of a youngster with learning challenges. In his offical biography he was a slow learner and at the age of 8 could barely read. &quot;High-spirited&quot; &quot;headstrong&quot; and &quot;a handful&quot; are words used to describe young Branson. His daredevil, rule breaking behavior as a youth served him well as an adult businessman. Even today is office is described as &quot;cluttered&quot; and his desk &quot;virtually invisible under a sea of papers&quot;. </li></ul><ul><li>Famous Comedians and actresses with ADHD ADD </li></ul><ul><li>Here are a few famous successful people that have attention deficit hyperactivity disorder. Jim Carey, Whoopie Goldberg, Mariette Hartley & Robin Williams. </li></ul>
  15. 16. VIA CHARACTER STRENGTHS AND VIRTUES (1) CHRISTOPHER PETERSON AND MARTIN SELIGMAN, 2004 <ul><li>Wisdom and Knowledge (strengths that involve the acquisition and use of knowledge) </li></ul><ul><ul><li>creativity (personified for example by Albert Einstein ) </li></ul></ul><ul><ul><li>curiosity (personified for example by John C. Lilly ) </li></ul></ul><ul><ul><li>open-mindedness (personified for example by William James ) </li></ul></ul><ul><ul><li>love of learning (personified for example by Benjamin Franklin ) </li></ul></ul><ul><ul><li>perspective and wisdom (personified for example by Ann Landers ) </li></ul></ul><ul><li>Courage (strengths that allow one to accomplish goals in the face of opposition) </li></ul><ul><ul><li>bravery (personified for example by Ernest Shackleton ) </li></ul></ul><ul><ul><li>persistence (personified for example by John D. Rockefeller ) </li></ul></ul><ul><ul><li>integrity (personified for example by Sojourner Truth ) </li></ul></ul><ul><ul><li>vitality (personified for example by the Dalai Lama ) </li></ul></ul><ul><li>Humanity (strengths of tending and befriending others) </li></ul><ul><ul><li>love (personified for example by Romeo and Juliet ) </li></ul></ul><ul><ul><li>kindness (personified for example by Cicely Saunders ) </li></ul></ul><ul><ul><li>social intelligence (personified for example by Robert Kennedy ) </li></ul></ul>
  16. 17. VIA CHARACTER STRENGTHS AND VIRTUES (2) CHRISTOPHER PETERSON AND MARTIN SELIGMAN, 2004 <ul><li>Justice (strengths that build healthy community) </li></ul><ul><ul><li>active citizenship / social responsibility / loyalty / teamwork (personified for example by Sam Nzima ) </li></ul></ul><ul><ul><li>fairness (personified for example by Mohandas Gandhi ) </li></ul></ul><ul><ul><li>leadership </li></ul></ul><ul><li>Temperance (strengths that protect against excess) </li></ul><ul><ul><li>forgiveness and mercy (personified for example by Kim Phuc ) </li></ul></ul><ul><ul><li>humility and modesty (personified for example by Bill W. , co-founder of AA) </li></ul></ul><ul><ul><li>prudence (personified for example by Fred Soper ) </li></ul></ul><ul><ul><li>self-regulation and self control (personified for example by Jerry Rice ) </li></ul></ul><ul><li>Transcendence (strengths that forge connections to the larger universe and provide meaning) </li></ul><ul><ul><li>appreciation of beauty and appreciation of excellence (personified for example by Walt Whitman ) </li></ul></ul><ul><ul><li>gratitude (personified for example by G. K. Chesterton ) </li></ul></ul><ul><ul><li>hope (personified for example by Martin Luther King, Jr . ) </li></ul></ul><ul><ul><li>humor and playfulness (personified for example by Mark Twain ) </li></ul></ul><ul><ul><li>spirituality (personified for example by Albert Schweitzer ) </li></ul></ul>
  17. 18. NORMOTIC PERSONALITY? <ul><li>For Eric Fromm, Freud’s most important discovery was the capacity of the individual to distort the reality of his or her experience in order to adapt to socially established norms. He argued that the most impressive aspect of Freud’s discoveries was not what his patients repressed, but the fact that they had renounced so much of themselves, so many basic dimensions of their experience in order to adapt. These dimensions are denied or unacknowledged through the process of socialization, and the loss of these experiences is subsequently rationalized and covered up through complex processes of repression, self-deception, “bad luck,” or, in the language recently used by Schafer, “refraining from action.” </li></ul><ul><li>For Fromm, however, a person that has adapted well to an unproductive economic and social structure, who functions well and is capable of working and carrying this burden, is actually suffering from a “socially formed defect,” a “pathology of normalcy”. </li></ul><ul><li>For Christopher Bollas, a “normotic personality” is a person with the specific drive to be “normal,” characterized by the paralysis and ultimate cancellation of the personality, in favor of a self that is conceived as a material object among other manufactured products in the world of objects. This type of person has succeeded in neutralizing the subjective element of their personality, and their minds are characterized less by the psychic (symbolization through representation of feelings, sensations and inter-subjective perceptions) than by the objective. “This mentality,” Bollas says, “is not destined to represent the object, but rather to be the ‘echo’ of material objects, to be an object of commodity in the world of human production.” </li></ul><ul><li>They like to be members of an institution, since this allows them to identify with the existence of the impersonal: the tasks of an institution or the products of a corporation. To be a part of the team, to be at ease in a committee, secure in social groups, where pseudo-intimacy serves as an alibi for not forming a profound friendship with anyone. </li></ul><ul><li>In Bollas’ words: “If the psychotic condition is characterized by a break in the orientation toward reality, the Normotic condition is uniquely characterized by a radical break with subjectivity and a profound absence of the subjective element in daily life. We may say that if the psychotic “has shut himself up in the extreme depths,” the normotic “has shut himself up in the extremely superficial”. We are dealing, therefore, with a person that gives us to understand that the psyche as such, and particularly the unconscious, is an anachronism, a thing that should be abandoned in the pursuit of human progress. </li></ul><ul><li>,%20C.,%202001.pdf </li></ul>
  18. 19. <ul><li>Whose Order is Being Disordered by ADHD? by Thom Hartmann </li></ul><ul><li>In the Seventies, when I was Executive Director of a residential treatment facility for disturbed children, I developed a metaphor to explain ADHD to children, a metaphor which I subsequently published in 1991. The metaphor was that hyperactive kids were actually &quot;good hunters,&quot; whereas the very steady, stable, classroom-capable kids were &quot;good farmers.&quot; The hunters, I suggested, would do great in the forest or battlefield: their constant scanning (&quot;distractibility&quot;) would ensure they wouldn’t miss anything; their ability to make instant decisions and to act on them (&quot;impulsivity&quot;) would guarantee they’d be able to react to high-stress and response-demanding situations; and their love of stimulation (&quot;need for high levels of stimulation&quot;) would cause them to enjoy the hunting world in the first place. </li></ul><ul><li>Too many psychologists, writing in respectable publications, insist that people with ADHD can make little or no contribution to modern society. They have called my farmer/hunter model a &quot;Just So Story&quot; after the fictional fables by Rudyard Kipling. These authors and others like them flatly state: &quot;In not a single instance of peer-reviewed, published literature have symptoms or consequences of ADHD been found to hold an advantage.“ </li></ul><ul><li>There are several problems with this assertion. The first is the word &quot;advantage.&quot; Of course, they mean &quot;advantage&quot; in the contemporary cultural context of a person’s ability to function in a public school or work in a factory or office cubicle. In fact, virtually all the studies which have been published in the peer-reviewed literature of psychology are looking at the ability of an ADHD child to function in a &quot;boring/farmer&quot; environment, as this is what society rewards and so is our current criterion for &quot;good.&quot; Failure in this arena makes one a potential customer for the drug companies that fund such research. No studies, to the best of my knowledge, have bothered to test ADHD kids against &quot;normal&quot; children on, for example, their ability to outscore in one of the new, high-stimulation video games or outperform on a skateboard … yet we all know how brilliantly these &quot;impaired&quot; children can function in these &quot;non-useful&quot; areas. </li></ul>
  19. 20. Thom Hartmann's Hunter and Farmer Approach to ADD/ADHD Taken from Thom Hartmann's book, &quot;ADD: A Different Perception.&quot; Nurturing; creates and supports community values; attuned to whether something will last. &quot;No time for niceties when there are decisions to be made!&quot; Lacking in the social graces. Careful. &quot;looking before you leap.&quot; Willing and able to take risk and face danger. Acts without considering consequences. Focused. Good at follow-through,  tending to details, &quot;taking care of  business.&quot; Bored by mundane tasks; enjoy  new ideas, excitement, &quot;the hunt&quot;  being hot on the trial. Daydreamer. Team player. Independent. Has difficulty following directions. Patient. Aware that good thing  take time willing to wait. Visual/Concrete thinker, clearly seeing a tangible goal even if  there are no words for it. Doesn't convert words into  concepts adeptly, and vice versa. May or may not have a reading disability. Conscious of time and timing.  They get things done in time,  pace themselves, have good &quot;staying power.&quot; Tireless: capable of sustained drives, but only when &quot;Hot on the trail&quot; of some goal. Impatient. Organized, purposeful. They have a long term strategy and they stick to it. Flexible; ready to change strategy quickly. Distorted sense of time: unaware of how long it will take to do something. Able to sustain a steady, dependable effort. Able to throw themselves into the chase on a moment's notice. Poor planner: disorganized and impulsive (makes snap decisions). Not easily distracted from the  task at hand. Constantly monitoring their environment. Attention spans short, but can become intensely focused for long periods of time. Opposite &quot;Farmer&quot; traits: How it appears in the &quot;Hunter&quot; view: Trait as it appears in the &quot;Disorder&quot; view:
  20. 21. People With ADHD Do One Month's Less Work Per Year, Study Finds <ul><li>ScienceDaily (May 28, 2008) — Workers with attention deficit hyperactivity disorder (ADHD) do 22 days less work per year than people who do not have the disorder, finds new research. So much work is being lost that the researchers recommend employers consider screening staff for ADHD and providing treatment for those affected, because it would be more cost-effective for their businesses. </li></ul><ul><li>People who have ADHD find it difficult to concentrate because they may be hyperactive, easily distracted, forgetful or impulsive. Children with the disorder are being increasingly diagnosed because they are likely to be tested for ADHD if they have problems with their schoolwork. However, many adults with ADHD do not know they have the condition. </li></ul><ul><li>More than 7,000 employed and self-employed workers aged 18-44 years were screened for ADHD as part of the World Health Organisation World Mental Health Survey Initiative. They were also asked about their performance at work in the last month. </li></ul><ul><li>On average 3.5 per cent of workers had ADHD. It was more prevalent in men and workers in developed rather than developing countries. </li></ul><ul><li>People with ADHD were found to spend 22.1 more days not doing work than other workers per year. This was made up of 8.4 days when they were unable to work or carry out their normal activities, plus 21.7 days of reduced work quantity and 13.6 days of reduced work quality. </li></ul><ul><li>The researchers, who are part of a WHO research consortium at Harvard Medical School, suggest adult ADHD might be a candidate for targeted workplace screening and treatment programmes because cost-effective therapies exist which could improve some aspects of affected workers’ performance. “It might be cost-effective from the employer perspective to implement workplace screening programmes and provide treatment for workers with ADHD,” they say. </li></ul><ul><li>The people studied came from Belgium, Colombia, France, Germany, Italy, Lebanon, Mexico, the Netherlands, Spain and the USA. </li></ul><ul><li>de Graaf et al. The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: results from the WHO World Mental Health Survey Initiative. Occupational and Environmental Medicine , 2008 DOI: 10.1136/oem.2007.038448 </li></ul>
  21. 22. Medicalization, ambivalence and social control: mothers’ descriptions of educators and ADD/ADHD Claudia Malacrida (2004) health Vol. 8(1) 61-80 <ul><li>Education don’t want to label children, so they say! They say. ‘Follow the social model of disability.’ The social model’s trying to say we shouldn’t be using medical labels, and that the problem with disabilities are mainly due to people’s attitudes . . . But, I have no doubt Nottinghamshire Education are simply using this as an excuse to save money! (Becky) </li></ul><ul><li>I’ve told them what we do with him, and they think that it is good, but they seem to be, uhm, like I mean I’ve told them what works, and they seem to agree with me that shouting at him, for example, absolutely doesn’t work. I find, however, that even though the school says it does these things and they agree with me, they do shout at him a lot, and he gets sent out of the classroom on a daily basis. I’ve been told this by other mothers who volunteer at the school, and I’ve seen it myself. </li></ul><ul><li>Oh yes – one week he had been absolutely perfect with the chart, and so he used all his points to buy himself an ‘action man’. And the teacher actually wrote a note – she actually wrote down on his report, that I buy him toys to make him behave, to make him be good. I saw the notes, and I was absolutely furious. She wrote it as though I was spoiling him, as though this was what made him behave badly. (Diane) </li></ul><ul><li>The Head, the Ed Psych and the SENCO called me in for a meeting – and the SENCO didn’t want him to have Ritalin. She said they didn’t have any ADHD in that school. The SENCO had heard of ADHD, but she didn’t think it existed. She said, ‘if he’s got ADHD, then a good 20 percent of the children in this school have ADHD’. So they said they were going to write to the doctor saying they hadn’t noticed any difference, and recommending he be taken off it. </li></ul><ul><li>So, that week, I just didn’t give it to him. On the Monday morning I didn’t give him his 8 o’clock pill and I didn’t send him in with a lunchtime one. And at 2 o’clock that afternoon I had a call from the teacher asking what was wrong. </li></ul><ul><li>I said, ‘Oh, I’m sorry. Did I forget to tell you? I’ve taken him off the Ritalin because the school feels he doesn’t need it!’ (Laughs) </li></ul><ul><li>The teacher said, ‘ Who said that? I notice a tremendous difference!’ </li></ul><ul><li>And I said, I’m sorry, but because the Ed Psych and the SENCO and the Head haven’t noticed any difference. He’s got to go off for the next week. </li></ul><ul><li>And she said, ‘Well, I don’t think we can manage him for a week!’ </li></ul><ul><li>And I said, ‘Well, can I have that in writing please? Because unless you write and say it makes a difference, he will not be put back on it!’ Of course, I was lying through my teeth, but I was trying to make a point! (Penelope laughs) </li></ul>
  22. 23. Treating Huckleberry Finn - David Nylund, 2000 “Never let school interfere with your education” – Mark Twain <ul><li>“ Huck Finn said he hated school. He found the emphasis on sitting still, memorizing, doing monotonous drills, reading, and writing to be humdrum in comparison to being free in the wilderness, rafting down the Mississippi. School did not capture his curiosity and imagination. </li></ul><ul><li>Imagine Huck in a classroom today…My guess is that Huck would find today's school to be just as uninspiring and restrictive—perhaps even more so because of larger and more impersonal classrooms and increased pressures and homework demands. </li></ul><ul><li>In today's typical classroom, Huck would spend several hours a day sitting quietly in class, listening to a great deal of verbal information from the teacher. He would complete countless workbooks and read extensively from dry and often outdated textbooks. In most classrooms, he would not have the opportunity to be engaged by his teacher or the material in a manner that would appeal to his learning style and imagination. In addition, because recess and creative classes such as art and music have been cut to make more time for math and reading, Huck would find himself without relief from the rigors of traditional academic instruction. Huck would most likely respond with fidgeting, hyperactivity, restlessness, and inattentiveness—in short, the classic symptoms of so-called ADHD. </li></ul><ul><li>Today's U.S. school system was patterned after German schools, which were developed in the 1800s for the specific aim of producing obedient soldiers and factory workers (Gallagher, 1999). Our schools operate much like those in Huck's day. Back then, creativity and independent thought and action were discouraged because such characteristics were viewed as problematic in a war or factory (Gallagher, 1999). Similarly, these traits clash with our modern, cookie-cutter educational system. </li></ul><ul><li>Clearly, children who behave in such a way that they might be labeled ADHD have difficulty with a restrictive educational system—one that emphasizes repetitive drills and memorization. To place a child on Ritalin so that he can succeed in this environment ignores the wider problem: the structure, tools, methods, and resources of our schools. </li></ul><ul><li>What are the effects of our current direction in education? One is that students assume a passive role in their own learning. The trend toward less recess and more homework makes learning dull for huge numbers of children. Creative and weirdly able children often have autonomous and idiosyncratic learning styles that are incongruous with the conventional system. When such a child acts up or gets distracted due to this incompatibility, he is often labeled ADHD.“ </li></ul>
  23. 24. How to help your child at secondary school Reviewed by Dr Chris Steer , consultant paediatrician and neurologist <ul><li>The problems ADHD causes are similar to those at primary school . Your child finds it hard to listen, remember and think of the consequences of his actions. His behaviour and performance tends to be erratic - he may be able to do something one day but not the next. But as your child gets older, the expectation is he takes more responsibility for his actions - especially with regard to punctuality, learning and behaviour. ADHD affects your child's ability to do this, which can also lead to your child being labelled immature. Secondary school brings added difficulties for children with ADHD, ie multiple teachers, classrooms and subjects, and the pressure of GCSE coursework and exams. </li></ul>What's expected of my child? The government sets targets for each stage of a child's education. These are known as Key Stages. Secondary school covers Key Stage 3 (ages 11-14) and Key Stage 4 (ages 14-16). At the end of each Key Stage, your child will take national tests, ie at age 14 and then GCSEs or GNVQs. The aim of applying for, and getting, extra help for your child through School Action and School Action Plus is to ensure your child achieves the targets for each stage.
  24. 25. Linda Metcalf – Teaching toward Solutions, 1998 <ul><li>Talk about students with a non-pathological approach. Describe their difficulties in a more positive way to make their problem solvable. </li></ul><ul><li>Do not worry about trying to figure out why a student is having a problem. Instead, watch for times when the problem is not there so much. </li></ul><ul><li>See students as people who are stuck in a problem but are not themselves the problem. This will make it easier to help them escape. </li></ul><ul><li>When a student has a problem, ask what he or she wants to be different. </li></ul><ul><li>Remember, when you change your strategy, students change behaviors. </li></ul><ul><li>Complex problems do not always call for complex solutions. Sometimes it just means we have to find problem-free times and learn what is different then. </li></ul><ul><li>When we step into our students' lives and try to understand where they are, we will have less resistance. </li></ul><ul><li>Motivation is necessary for change. Look for alternative, more positive ways to motivate students. Ask students what motivates them to learn. </li></ul><ul><li>If a lesson plan works, do it. If a lesson plan does not work, don't do it again. The same principle applies to behavioral interventions. Do something different! </li></ul><ul><li>Always focus on the possible and changeable when working with a student or parent. This will result in a solid goal that is achievable. </li></ul><ul><li>Go slowly to build successes. Think of making a slight change, not a big one. </li></ul><ul><li>Remember, rapid change can and does happen. Watch for changes and verbalize the changes to your students. Always ask them how they made even the smallest change. </li></ul><ul><li>Change is constant. It will always happen when we do things differently. </li></ul><ul><li>Always watch for “exceptions” to the problem. Notice what you are doing that helps exceptions happen. Notice what a student or a parent does. </li></ul><ul><li>Change the time and the place so problems can't happen as they did before. </li></ul><ul><li>See problems differently, as entities that influence a student but are not the student. </li></ul>
  25. 26. Building Close-Knit Communities: Handcraft Makes a Comeback <ul><li>Knitting is a great activity for students with ADHD. It makes a great recess activity, and it meshes with the multiple-intelligences philosophy. And it's catching on in schools around the USA! </li></ul><ul><li>Among all the activities that can be taught to students, why choose knitting? School counsellor Nancy DeClark says it is just the type of productive pursuit kids need. &quot;In this complex world of high tech, it's nice to know that knitting and crochet bring a way to relax and connect with others,&quot; she explained. &quot;I have found that it's a great activity for students who have a diagnosis of attention deficit/hyperactivity disorder. Knitting or crochet allows them to be busy with their hands and at the same time to listen to their teacher teach a lesson. The skill of artful conversation, sharing ideas, and helping others are all of therapeutic benefit when those ancient crafts are taught to young and old alike.“ </li></ul><ul><li>At Seth Boyden Demonstration School in Maplewood, New Jersey, handcraft has become more than a pastime -- it's a movement! At this K-5 magnet school based on Howard Gardner's theory of multiple intelligences, staff members use all kinds of ways to reach students and tap their interests and skills -- including knitting. </li></ul><ul><li>&quot;Knitting works well because it is portable and cheap,&quot; school founder Judith Symonds explained. She suggests that it also brings together many parts of the multiple intelligences approach -- mathematical-logical, visual-spatial, bodily-kinesthetic, interpersonal, and naturalist. </li></ul><ul><li>&quot;When we started out, we discovered that kids who did not succeed in other areas started to do well, and that gave them confidence,&quot; said Symonds. &quot;Sharing their knowledge of knitting made them feel successful and improved their attitude toward school and schoolwork.“ </li></ul><ul><li> </li></ul>
  26. 27. THE GIFT OF ADHD : LARA HONOS – WEBB <ul><li>What are the gifts of ADHD? </li></ul><ul><li>1. Creativity 2. Interpersonal Intuition 3. Emotional Sensitivity 4. Exuberance 5. Ecological Consciousness </li></ul><ul><li>ADHD symptoms in children are relieved after spending time in nature. </li></ul><ul><li>A recent study found that kids with ADHD were more able to concentrate, complete tasks, and follow direction after spending playtime in natural, especially green, settings. The authors suggest that these findings cannot be attributed to simply being active because they did not see similar results when the subjects played basketball on a paved court. </li></ul><ul><li>If every day were a field trip kids with ADHD would be considered geniuses. That’s because they are immensely curious and interested, but learn best by actively engaging with what they’re learning. </li></ul>
  27. 28. Move ADHD Parenting Classes To The Soccer Field To Get Dads Involved &quot;I was surprised to find there were no studies on dads with kids with ADHD and so I thought this would be a good area in which we could try to do something. My dissertation was trying out a parenting program specifically for fathers, using sports as a kind of hook to get the dads interested and the kids too,&quot; Fabiano said. His new research program, designed for children 6-12 years of age, includes two formats: a control group of fathers and children who receive traditional, evidence-based treatments for ADHD families and another group that receives the same, plus a sports element, in this case, soccer games. This second group is dubbed COACHES, or Coaching Our Acting-Out Children: Heightening Essential Skills. Traditional treatments include teaching parents strategies to deal with the disruptive behaviors that are hallmarks of the disorder. Adding the COACHES element, Fabiano hoped, would result in increased participation for the fathers and improved relationships with their children. &quot;We thought for a chronic disorder like ADHD where these fathers aren't going to be dealing with these problems for a couple weeks or a couple months, but for the child's entire life, the treatment has to be well-liked, palatable and engaging,&quot; Fabiano explained. The results, he said, have been remarkable. &quot;We had huge differences on things like drop-out rates for both the dad and the child. The dads in the COACHES group were more likely to try out the homework, which was a pretty big accomplishment,&quot; Fabiano said. &quot;They also rated the treatment as better.&quot; ScienceDaily (Oct. 26, 2007) — While working with parents of children with attention deficit hyperactivity disorder (ADHD) at the University at Buffalo, Gregory A. Fabiano noticed something was missing: the fathers.
  28. 29. 5 Tips for Children with ADHD <ul><li>1. Give your child less stuff and more time. More presents condition our kids to be unsettled and bored. Children with ADHD crave one-on-one time. So instead of buying more toys with short life-spans, create lasting memories by enjoying special experiences with your child. </li></ul><ul><li>2. Cultivate your child’s inner gifts, instead of focusing on buying gifts. The real treasure this Christmas should be found inside your child, not inside Best Buy. Confidence and a sense of purpose are built by reinforcing your child's natural gifts, talents and passions. Give presents that reinforce and develop your child’s gifts and talents—whether it is building ( LEGOS ), drawing ( easel and pad ) or being strategic ( chess, board games ). </li></ul><ul><li>3. Shower your child with praise, not presents. Our kids soak up positive reinforcement because they hear it so infrequently. Want to give a gift they will remember forever? Recognize and reward their positive qualities and catch them doing good things. </li></ul><ul><li>4. Make giving, not receiving, the centerpiece of your family’s traditions. Our kids have big, compassionate hearts and like to be part of something meaningful. So turn your family’s holiday efforts to the less fortunate. </li></ul><ul><li>5. Take a holiday from your stress and negativity. Spend the next few weeks building up your child. Say only positive statements. Reward progress, celebrate small wins. </li></ul>
  29. 30. COMMONSENSE REBELLION BRUCE E. LEVINE, CONTINUUM PUBLISHING, 2003 <ul><li>ADVICE FOR PARENTS </li></ul><ul><li>Re-humanise boredom. </li></ul><ul><li>Try to understand it, respect it, and don’t treat it as a disease. </li></ul><ul><li>Keep in mind that ADD kids do as well as ‘normals’ in one-to-one interactions with an adult, when they have chosen their learning activity, are interested in the activity, when it is novel, or when the activity is stimulating. </li></ul><ul><li>Grasp the lethal effect of television and video games on children’s attention spans. See how TV drains viewers, even adults, of the limited attention they have to give. </li></ul><ul><li>Attempt to find a different learning environment for your child – one in which he or she receives more attention and can follow intrinsic interests. </li></ul><ul><li>Remember that, while most schools are ‘one size fits all’, humans have different learning styles. </li></ul><ul><li>Take a look at Thomas Armstrong’s fifty strategies in The Myth of the A.D.D. Child. Some examples of conventional strategies are self-talk and development of organisational, problem-solving, and social skills. Unconventional strategies include meditation for focusing, martial arts for self-discipline, and having your child teaching a younger child. </li></ul><ul><li>Finally, forget about grades for a while and just enjoy and appreciate your child again. Without a positive relationship, even the most technically skilled parent can do little good. </li></ul><ul><li>Advice for adults with adhd: </li></ul>