Attention Deficit Hyperactivity Disorder:An Overview for People with ADHD and

Parents of People with ADHD

By Brenda McCreight Ph.D.

http://www.lifespancounselling.comhttp://www.theadoptioncounselor.comhttp://www.hazardousparenting.com

What is a.d.h.d.?

• Adhd is a neurobiological disorder • Adhd is a developmental disorder – children develop

more slowly in some areas, such as the capacity to inhibit their own behaviors

• Adhd is an emotional self regulation disorder• Adhd is a chronic disorder• Adhd is the most treatable disorder currently known in

the field of psychiatry

• Brenda McCreight PH.D. training series

What adhd isn’t…

• Adhd is not an attitude problem• Adhd isn’t a result of good or bad parenting• Adhd is not a moral problem• Adhd is not a choice • Adhd is not laziness• Adhd, by itself, does not lead to criminal or violent behaviors

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The challenges…• Adhd makes it hard or impossible to move towards a goal • When it comes to taking action, there is no sense of past or

future, and no ability to plan and implement the plan• Easily distracted, can’t maintain a thought, a task or a

conversation to completion• Can process information without a problem, but can’t

respond appropriately to the information• Can’t stop at the right time, perseverates• Can’t take action until the need for action is NOW and is compelling Brenda McCreight Ph.D. training series

Let’s talk about the lack of inhibition…

• Chronic and shows up early in life• There is no pause between thought/impulse

and action• Presents as intrusive and disruptive behaviors• Over time, the physical impulsiveness slows or

stops -- adults show less of this part of the trait, but the thinking part of impulsiveness/lack of inhibition continues – often shows up emotionally

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Emotional Impulsiveness means…• Low tolerance for frustration• Quick to anger, easily irritated• Show emotions quickly, react quickly on an

emotional level• Have normal feelings, but can’t regulate or

modify them to meet social standards• The emotions, like the behaviours, are

compulsive and disordered• Brenda McCreight Ph.D. training series

Inability to self regulate means…

• The person can’t engage in self directed actions

• Can’t monitor or regulate her own behaviors• Can’t think about delayed consequences • Can’t delay gratification• Can’t learn from experience – understands

how the past impacted him, but can’t prevent himself from doing it again

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Impairment of working memory

• Working memory can be defined as: a brain system that provides temporary storage and manipulation of the information necessary for such complex cognitive tasks as language comprehension, learning, and reasoning (U.S. National Library of Medicine definition).

• This is highly significant – it means that the person who has adhd has a severe problem understanding information, learning anything new, and using reasoning to make decisions.

• This is a big deal – and rarely respected or understand by others.

And a few other challenges…

• Adhd prevents self motivation• Adhd delays the development of problem solving

skills• Adhd delays the ability to plan and to implement a

plan• Adhd prevents the person from remembering the

rules of a social situation or social interaction• Adhd prevents the ability to self soothe so the person

always needs to seek others to relieve his boredom or make him feel happy or entertained

Impact of adhd on social relationships…

• Frequent conflict with peers and adults due to failure to follow through and intrusive behaviors

• Early rejection by peers due to inability to follow rules and regulate temper• When social isolation occurs, the child is then not

able to experience and learn appropriate social skills which leads to further social rejection

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• As the person reaches adolescence and adulthood, the a) inability to follow through and b) the inability to respond to social cues and c) the inability to engage in reciprocal conversations leads to:

• problems with dating• problems with maintaining a relationshipBrenda McCreight Ph.D. training series

Other ways adhd impacts daily life…

• Poor academic and poor work performance leads to early school drop-out

• Co-existing symptoms of depression or an anxiety disorder resulting from social isolation

• Substance abuse from an early age – self medicating

• Poor social relationships due to lack of social skills, lack of emotional regulation, lack of conversational reciprocity etc.

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When all of these issues and challenges exist, secondary problems may developPlease note – Oppositional Defiant Disorder and Conduct Disorder are not part of adhd, but may co-exist with it in some individuals.

Why some of this happens…• Not all of the parts of the brain that manage attention are affected• The frontal lobes lack the ability to kick start the motivation needed to do anything• The person can’t think in a way that helps him to move forward with a task • The person can’t resist distractions because she is compelled to respond, even for a moment, to each distraction • Once the person responds to the distraction, he can’t go back to what he

was doing before – his brain has forgotten and moved on from that interaction or task

• Brenda McCreight Ph.D. training series

Long term impact of adhd…

• Problems with attaining and maintaining employment• Problems with attaining and maintaining personal

relationships • Substance abuse for self medication – more adult use of

marijuana than any other group• High accident rate, in cars and on the job• High risk behaviors lead to early or unplanned pregnancies

and STDs• Financial problems • 3 times more likely to be dead by age 40 due to accidents

and life style risks

Treatment

ADHD RESPONDS WELL TO TREATMENT!Some treatments are controversial – not all experts agree on what is best – please use this as a review of treatments, not as a recommendation

Medication

• Medication is the most common treatment for adhd

• Many experts feel that denying a person with adhd the proper meds is the same as denying insulin to a diabetic

• There are many medications in use and more are being developed

• Brenda McCreight Ph.D. training series

Nutrition• Leading expert on adhd, Russell Barkley, does not believe that diet will help people with

adhd• Some experts believe that any diet that promotes overall brain health will benefit people

with adhd• Daniel Amen, MD, also an expert on adhd, recommends the following nutrition:• A high protein diet, including beans, cheese, eggs, meat, and nuts. Add protein foods in

the morning and for after-school snacks, to improve concentration and possibly increase the time that the meds work

• Reduce carbohydrate intake, such as candy, corn syrup, honey, sugar, products made from white flour, white rice, and potatoes without the skins

• Increase complex carbohydrates intake, such as vegetables and some fruits (including oranges, tangerines, pears, grapefruit, apples, and kiwi

• Add Omega-3 fatty acids, such as those found in tuna, salmon, other cold-water white fish, walnuts, Brazil nuts, and olive and canola oil and in supplements

• Brenda McCreight Ph.D. training series

Neurofeedback

• Neurofeedback – also known as EEG Biofeed back — is a computer based program in which indi vid u als are pro vided real-time feed back on their brain wave patt erns and are taught to alter their typ i cal EEG patt ern to one that is con sis tent with a focused, atten tive state.

Another form of neurofeedback…

• Entrainment glasses are another form of neurofeedback

Heartmath Biofeedback

• This can be used to help the child with adhd learn to relax and improve her focus, as well as helping with sleep induction

Cogmed

• Cogmed Working Memory Training is an evidence-based, computerized training program designed to improve attention by effectively increasing working memory and attention

• Cogmed uses a combination of software and personal coaching

Coaching

• An adhd coach is an ‘active guide’ who uses inquiry, structure, strategic planning, encouragement and constructive feedback to help the client learn how to successfully respond more appropriately

• Adhd coaches are trained and licensed

Education and advocacy…

• Adhd is not understood by the general population• Teachers and classroom support workers, as well as others in

the professional support network need to be updated on their training and understanding of adhd so that they can construct an effective learning environment for the child with adhd

• Adoption and foster care professionals require solid training in adhd so that they can properly prepare and support adoptive parents whose children have adhd

• Frontline mental health professionals require updated training in adhd so that they can recognize the disorder in patients and can effectively support the child and family

• Please check out Brenda McCreight’s courses at Udemy.com and her other power points at Slideshare

• More powerpoints and more courses are in development

Cognitive Behavioral Therapy

• Studies have shown that this does not work well with children who have adhd but can be successful with adults who have adhd

• Cognitive behavior therapy (CBT) is a psychotherapeutic treatment that helps a person understand the thoughts and feelings that influence his behaviors

• CBT is commonly used to treat many disorders, such as phobias, addiction, depression and anxiety

Change the way the environment responds…

• Russell Barkley asserts that the best point of intervention is at the point of performance – that is, when the person is in action of some kind, intervene at that moment – if you wait till later, it’s too late!

• Intervene with kindness and redirection• If a consequence is in order, make it short and

immediate• Be sure the consequence isn’t about punishing the

person for having adhd