SemiAnnual Publication of the Baltimore County Chapter of CH.A.D.D.
Articles from this Issue Fall/Winter 1998/99
SemiAnnual Publication of the Baltimore County Chapter of CH.A.D.D.
In This Issue:
This is certainly an exciting time to be involved with CH.A.D.D. as a national organization and the Baltimore County Chapter in particular. We are a dynamic group of families and individuals committed to raising the consciousness of all those who are involved in the lives of people with ADHD.
The National office has reaffirmed their commitment at the local level by continuing to provide support through increased communications, supplies and mentoring programs for new chapters. They are publishing a new coordinator’s book that will guide us and answer many questions about running a chapter. At the national meeting in New York this fall, the coordinators and co-coordinators will go through a new intensive series of workshops to improve our competencies and community services. Other exciting news at the National level is that CH.A.D.D.’s new Executive Director, John Heavener, is from our state. He will remain in Maryland since our CH.A.D.D. headquarters will move to D.C. within the next year.
Our call for new volunteers did not go unnoticed this past spring. We have well over 25 people who are volunteering on a regular basis. We are also very proud to have Carol Watkins, M.D. as our advisor and secretary. Her computer skills are unsurpassed! Please take a peek at our new Web site she designed.
We also welcome the members of the Catonsville chapter who were reassigned to us. They are joining our forces because their coordinator resigned. We hope to energize them enough to find a new coordinator! (But please don’t take any of our good people!)
The state government of Maryland has shown a very strong interest in ADHD in our schools. They will be sponsoring a conference this fall with many excellent speakers. As a matter of fact, CH.A.D.D.’s President, Mary Robertson, and Executive Director, John Heavener, have graciously agreed too attend and participate in the Maryland Interdisciplinary Conference on ADHD. Please see our conference report for further details on this exciting event.
We are pleased to announce that professionals can now obtain Continuing Education Units for attending our meetings and workshops. Our thanks to Anna Ballon for obtaining the CEUs’ for our chapter. We hope you will enjoy this upcoming program we put together with your needs in mind. Don’t be shy, introduce yourselves and make new friends! See you soon.
Betsy Campochiaro, Chapter Coordinator
Tish Michel, Chapter Co-Coordinator
Barbara D. Ingersoll, Ph.D.
As a psychologist who has worked with ADHD children for almost 30 years, I’m chagrined that it’s only been within the past year or so that I became aware of how many ADHD children have their lives further complicated by living in alternative families; that is, families formed by adoption, by separation and divorce, and by remarriage. The fact that there are no books or articles in the lay or professional literature devoted to the needs of these “doubly different” youngsters is astonishing when we look ,at the number of these children in the population. It’s not that this is new knowledge: we’ve known for years, for example, that adopted children are referred to mental health clinics at a much higher rate than children raised by their biological parents. Among these children the rate of ADHD is unusually high.
We’ve known for years, too, that children of separation and divorce are high-risk candidates for emotional and behavioral problems. Currently, more than a million children each year experience their parents’ divorce. If only 5% of these children have ADHD, that means that 50,000 ADHD children each year have their lives further complicated by the losses, upheaval, and loyalty conflicts that so often accompany divorce.
Finally, we know that about 20-25% of children under 18 live in step-families. Again, if only 5% of these children have ADHD, this represents a huge group of ADHD children who face the ups and downs of adjusting to life in a step-family.
What special problems might these groups of doubly different youngsters face?
STEPS TOWARD SOLUTIONS
As the adoptive, biological, or step-parent of an ADHD child in an alternative family, what can you do to resolve these knotty difficulties? Of course, there aren’t any simple solutions to such complex problems but the following guidelines should point you in the right direction.
And that includes a look at factors within the family that might contribute to a child’s difficulties. If there is family dysfunction in the form of depression, substance abuse, or marital problems – – or if you and your former spouse continue to wage war long after the separation and divorce – – get help for these problems. Otherwise, you cannot hope to help your child come to grips with his problems.
Tish Michel, CPA, MBA
Every summer I find myself thinking how happy I am to finally have “my nice kid” back once the school year is over. I discussed this “summers are sooo much better” theory with other parents of ADDers attending Camp New Horizons and they felt the same way.
It really is true that our children with ADHD have a difficult and stressful time during the school year because of their disability. Now that the school days are quickly approaching, I have been thinking about what key skills will help families and school personnel bring out the best in our children with ADHD. Two words come to mind as most essential; they are communication and empathy. So often I hear the phrase “they just don’t get it.” I hear this from parents, teachers, administrators, medical professionals, and children with and without ADHD. Let’s make this the year where we all try a little harder to “get it”.
The two sources I rely on most when providing an inservice workshop for educators on ADHD are the CH.A.D.D. Educators Manual and How to Reach and Teach ADD/ADHD Children by Sandra Reif. In her chapter entitled “Communication with Parents and Mutual Support”, Ms. Reif addresses the issues I mentioned above. I have edited excerpts from this book and hope the good advice offered will help you get the school year off to a great start.
“We all know how important it is to elicit support from parents if we expect any success from their children, especially those with special needs. Children with learning or attentional problems don’t outgrow their “disorders.” They will generally need assistance, monitoring, structuring, and support for a number of years. Parents who are trying to help their children at home and wish to be supportive to the teacher’s efforts, need the following:
When the parent is able to open a notebook, see a consistent format of recording homework assignments and receiving feedback on a regular basis on how their child is doing, it is very helpful. Some teachers have weekly newsletters informing parents about what is being studied in class that week and when long-range projects are due. Some teachers send home notices to parents whenever a homework assignment has not been turned in, requiring the parent’s signature. “
I would like also to suggest that when parents send notes to school, they ask the teacher to sign and return the note so the parents know their message was received and read.
Sandra Reif further explains “It has proven helpful to communicate to parents about services and classes available to them. Our support staff believes strongly in informing and educating parents. We try to find and provide support for families in many different ways.
Our parents would be so grateful to see the policies followed by Ms. Reif s school district adopted in the Baltimore County School System. Sandra Reif concludes by stating “coping with a hard-to-manage child at home and school is stressful, draining, and frustrating for both parents and teachers alike. It is helpful for parents to spend time in the classroom to acquire an appreciation of how difficult a teacher’s job is–teaching, managing and caring for thirty or more children and their many special needs. By attending a parent support group meeting, listening carefully to parents, and becoming well informed on ADHD issues that influence the home and social arena, teachers will also gain awareness and greater respect for parents. Once again, it is through the coordination of efforts and mutual support between home and school that we enhance the chances for our children’s success.”
How to Reach and Teach ADD/ADHD Children and Sandra Reif’s latest book entitled The ADD/ADHD checklist An Easy Reference for Parents & Teachers can be purchased through our chapter web site http://www.ncpamd.com/BaltoCHADD.htm. The CH.A.D.D. Educators Manual can be purchased at our monthly meetings and is included in our Educator Workshops.
Carol E. Watkins, MD
Ever since our country established a system of universal compulsory education, educators and clinicians have begun to notice students with ADHD-like symptoms. It has gone by many names and has been addressed in many different ways.
Accepting the Diagnosis
Many families go through a period of uncertainty during the time leading up to the eventual diagnosis. Sometimes, but not always, school problems trigger the ADHD diagnostic work up. The experience of “getting diagnosed” is powerful and can either be a blessed relief or a crushing blow. Many parents experience this as a loss and need to go through a process of mourning so that they can eventually accept their child as he or she is. The classic stages of mourning, denial, anger, grief and acceptance all apply here. Parents and teachers may have different perspectives on this phase of the process of acceptance. The professionals need to be patient with parents as they come to terms with their child’s condition. They should not be too quick to pathologize parents who become emotional or angry in meetings. Some of the nicest, most conscientious parents may become angry and tearful in meetings. Parents and children may go through repeated episodes of mourning as they experience the effects of the ADHD in different settings and at different ages.
Parents need to listen carefully to teachers’ observations. However, they must remember that teachers and schools do not make medical diagnoses. The classic symptoms of ADHD, inattention, impulsivity, and sometimes hyperactivity, can be due to a variety of causes. A parent might request that a specialist observe the child in class or go to observe the class himself. Conferences with teachers and guidance counselors are useful ways of gathering and sharing information. Finally, a thorough diagnostic work up is crucial. It is not a good idea to diagnose and medicate a child based on a few checklists and a brief office visit. The psychiatrist or other clinician should take a complete individual and family history, interview the child, and review data from the school. The clinician should assess the child for the presence of depression, anxiety disorders and learning disabilities. These disorders are over represented in ADHD children. The clinician should discuss a comprehensive program for addressing the child’s difficulties. Although there are a few children who seem “cured” when they are on the right medication regimen, most need other interventions too.
Medication is often an important part of the comprehensive treatment of an individual with ADHD. Ritalin is the most commonly prescribed medication for ADHD. It is important to remember that it is a short-acting drug and only lasts 2.5 to 4 hours. Often children are given a morning dose at 7AM before leaving home and do not get their second dose until Noon. If this is how your child’s medication is scheduled, check to make sure that he is doing well in the two hours before lunch. Some children may experience a rebound effect as the medication wears off. If there is a problem during this period, talk to your child’s doctor about adjusting the timing of the medication doses or switching to a different medication. Sometimes a small change in the timing of Ritalin dosing can make a big difference. Since teachers and some clinicians may not understand the short -acting nature of this medication, they may interpret the rebound irritability as deliberate acting out. When teachers note difficult behavior in a child on Ritalin, be sure to find out whether it is occurring at a specific time of day. There are a number of medications that can be helpful for ADHD if the stimulants are not sufficient. If the current regimen is not adequate, a comprehensive psychiatric evaluation may clarify the roles of medication and other interventions.
Part of dealing with medication is dealing with the issue of stigma. Some children may think that only the “bad” kids go to the nurse to get stimulants. Other children enjoy their daily visits to the nurse. When students line up to see the nurse, the students sometimes figure out who is getting the Ritalin. For some sensitive children, this may be a reason to consider other medications. In other cases, classroom education about ADHD and medications may suffice.
Advocating for Your Child’s Educational Needs
Often simple interventions can make a big difference for a child with a short attention span. The teacher can place him near the front of the class and work out secret cues to remind him to stay on task. The parent should suggest more frequent telephone or face-to-face contact to monitor and coordinate school and home progress. The parent and teacher should work out a system of helping keep the child accountable for work.
Sometimes, the parent feels that further educational intervention is needed. Educational funding is not plentiful, so then the parent may need to become a more active advocate. When advocating for your child, try to start off with a positive attitude. Be aware of your child’s educational and legal rights, but do not start off by quoting the law to staff. For children in the public schools, there is a specific, legally mandated system to help determine the child’s educational needs. If you feel that your child needs educational testing or special education resources, ask for an official meeting to review your child’s educational plan. Often parents can assist the school in gathering information to determine whether the child needs testing or special help. If your child has a special educational plan (IEP), always review it carefully before the formal meeting. If possible, both parents should come to the meeting. If one parent is feeling angry or frustrated, try to have the calmer parent do the talking. If the special education process is confusing, you may seek out an educational advocate to come to the meeting with you. If the school does the testing, you do not have to pay for it. You may obtain outside evaluations, at your own expense, to bring to the school meeting.
Some parents choose to arrange for private evaluations or tutoring. Speech therapy, occupational therapy and other services may be covered by some insurance plans. Some companies have dependent medical care plans which allow the parent to put pre-tax money aside for medical and child care expenses. This can be used to cover certain kinds of assessments and treatments not covered by insurance. Check with your employer or tax specialist. Many private schools have arrangements with tutors and speech therapists. In these cases, the parents usually pay for the services. In some situations, a child in a private school may qualify for free services funded by the public schools. In this case, the parent usually has to drive the child to a public school to get the services there.
A child with a short attention span may have more difficulty sitting down, turning off the TV and doing homework on his own. It helps to have a specific time and place for the child to do homework. In some cases, supportive parental supervision can be valuable. This can be a positive opportunity for the parent to see what the child is doing academically. The parent can also go over concepts that the child may have missed when not paying attention. As the student enters middle and high school, the direct supervision of homework shifts more to a coaching model which I will discuss later.
Some students may need medication adjustment so that they can focus enough to do their homework. For some students, particularly those with learning disabilities, the standard amount of homework is just too much. They and their parents spend the entire evening struggling and arguing about getting it done. There is no enjoyable family time left before bedtime. If this is truly the case, the parent should talk to teachers about allowing shortened assignments or setting a time limit on homework.
It is always tricky to tell a parent when and how to gradually move from direct supervision of homework to more of a coaching role. For some adolescents, the parent must continue to supervise homework for more years than would the parent of a non-ADHD teen. Parents may accomplish this gradual pullback by the use of calendars, checklists, and Day Planners. Some adolescents are more motivated to use these than others. Regular contact with teachers can give the parent feedback on whether they need to be as directly involved in homework supervision.
Ultimately, it is most important to teach your child to have a positive self-esteem and an attitude of responsibility and mastery. The child should be encouraged to learn all he can about ADHD and should learn to take responsibility for his or her actions.
This will certainly be an exciting fall for those of us hoping to further our understanding of ADHD and related issues. Please mark your calendars for the following events; come to our chapter meetings to obtain more information on these conferences. Some continuing education credits are available for all conferences.
Maryland’s First Annual Respite Awareness Day Conference will be held at the Maritime Institute Conference Center in Linthicum Heights, Md. on September 28, 1998. Patricia McGill Smith, Executive Director of the National Parent Network on Disabilities will be the keynote speaker for this event. The workshop is geared for families, caregivers, self-advocates, respite care workers, providers, and professionals interested in learning more about respite care and in forming a statewide coalition to improve and expand this essential support service. For additional information, call 410 – 341-0307.
CH.A.D.D.’s Tenth Annual International Conference on ADHD will be held in New York City at the Hilton Towers on October 15 through 17, 1998. This year’s conference is entitled “A World of Understanding: A.D.H.D. Issues and Answers”. The keynote speaker will be Richard Lavoie, M.Ed., producer of the PBS videos “F.A.T. City – Frustration, Anxiety and Tension” and “Learning Disabilities and Social Skills: Last One Picked… First One Picked On”. New tracks have been added this year for psychologists and attorneys; in addition, there are two strands for parents (beginners and advanced). The conference will present the very latest thinking on all the diverse issues impacting ADHD. Conference brochures will be available at our September meeting or you can call 954-587-3700 for additional information.
Annual Learning Disabilities Day Conference will be held at Towson University on November 7, 1998. Unfortunately, I have been unsuccessful in obtaining information on this year’s conference, but past LD conferences at Towson University have been quite good. For further information call 410-265-8188.
The Maryland Interdisciplinary Conference on ADHD will be held at the Inn and Conference Center at the University of Maryland in College Park, Maryland on November 13 and 14, 1998. The conference is sponsored by the Governor’s Task Force to Study the Use of Methylphenidate and other Drugs on School Age Children. As a member of the task force and conference planning committee, I must admit I am very excited about this event. Our featured speakers include Peter Jensen, M.D. – Associate Director for Child and Adolescent Research, the National Institute of Mental Health; Barbara Ingersoll, Ph.D. – Clinical Director of the Montgomery Child and Family Health Services and author of many books on ADHD including her latest Daredevils and Daydreamers; Larry Silver, M.D. – a leleading expert in the field of ADHD and the Director of Training in Child and Adolescent Psychiatry at Georgetown University; Patricia Quinn, M.D. – Developmental Pediatrician and a leading author on ADHD and co-editor of ADDvance; Mark Riddle, M.D. – a leading researcher on ADHD and a Pediatric Psychiatrist from Johns Hopkins, and Sidney Seidman, M.D. – Chair of the Task Force to Study the Use of Methylphenidate and other Drugs on School Age Children and Chair of the State Board of Physicians Quality Assurance. In addition to these main speakers, numerous workshops will be offered on both days during the afternoon sessions. I am so pleased to announce that CH.A.D.D.’s President, Mary Robertson, and CH.A.D.D.’s Executive Director, John Heavener, will attend the conference and have agreed to participate on a services and support groups panel I have organized. Please plan to attend both days. Conference brochures will be available at our September meeting or you can call 410-767-4269 for additional information.
The National Consensus Forum on ADHD will be held in Washington DC, November 16 through 18, 1998. This conference is sponsored by the National Institutes of Health and National Institute on Drug Abuse. CH.A.D.D.’s immediate past President, Sheila Anderson represented CH.A.D.D. on the planning committee and will be presenting data on “Barriers to Treatment in the Health Care System”, recently collected through the CH.A.D.D. Web site. Sheila states “This forum will serve to heighten the interest in AD/HD in the research community as well as provide information to the practicing community and public.”
CH.A.D.D. of Baltimore County
First Wednesday of each month unless noted
September 9, 1998 Combined* Barbara Ingersoll, Ph.D.
Clinical Psychologist, author of several books and has published numerous scientific articles on ADHD. (Second Wednesday in September)
“ADHD: Current Insights”
October 7, 1998 Parent Marilyn Colson, M.S.
Educational counseling and placement specialist
“Getting The Most Out of Your School” or “Where Do We Go From Here?”
Adult Dianne Greyerbiehl, Ph.D.
Neuro-cognitive Psychologist and Communications Specialist
“Creating The Life You Want…Integrating Body, Brain and Emotions With ADD”
November 4, 1998 Parent Mark Reader, Ph.D., PA
Clinical and Research Psychologist
“Up Close and In Your Face With ADHD Adolescents“
Adult Carol Watkins, M.D.
Adult and Child Psychiatrist
“Neurobiological Diagnosis and Personal Responsibility: Does morality fit in with ADHD?”
December 2, 1998 Combined* Michael Labellarte, M.D.
Director of Outpatient Services, Department of Child and Adolescent Psychiatry and Behavioral Sciences of The Johns Hopkins Medical Institutions
“Drug Therapy in the 90’s For ADHD”
January 6, 1998 Parent Sheila Eller
American Camp Association Representative, Special Educator for Baltimore City Schools
“Summer Options: What To Ask and How To Choose”
Adult Panel Discussion of Successful ADD Adults
February 3, 1998 Parent Brett Spodak
Owner/Director of The Tutoring Connection
“Tips For Tutoring Your Child”
Adult Hillel Zeitlin, LCSW-C
Director of the Maryland Institute of Ericksonian Hypnosis and Psychotherapy
“Healing Attention…Inner Tools For Transforming The ADD Experience”
Location: Greater Baltimore Medical Center, 6701 North Charles Street, Physicians Pavilion East Conference Center
Directions: I-695 to Exit 25 (Charles Street), Go 2 miles south , past Towsontown Blvd., turning left into the hospital. Park in the Pavilion East Parking Garage, free of charge (see also attached map of the complex)
AGENDA: 6:30- 9:30——Library & Book sale 7:00- 8:00——Adult Small Group Support 7:00- 8:15——Parent Guest Speaker 8:15-9:30——-Adult Guest Lecture
8:30-9:00——-Parent Small Group Support *Combined meetings will begin at 7pm.
Donation: Members & Teachers—–free Non-members——$5.00
(can be applied towards membership)
Teachers are now eligible to obtain professional development credits!
Any changes will be announced on the CH.A.D.D. PHONE LINE 410–377-0249
Dr. Barbara Ingersoll is a clinical psychologist who has worked with ADHD children, adolescents and adults for more than 25 years. She has published numerous scientific articles and is the author of several books, including Your Hyperactive Child and Distant Drums, Different Drummers. With Dr. Sam Goldstein, she has also written Attention Deficit Disorder and Learning Disabilities and Lonely, Sad and Angry: A Parent’s Guide to Depression in Children and Adolescents.
Dr. Ingersoll served for several years on the professional advisory board of CH.A.D.D. National. She is also a founding member and past president of the National Organization for Seasonal Affective Disorder, a support organization for individuals with seasonal mood disorders.
Marilyn Colson, an experienced educator, academic counselor and a Certified Educational Planner has served as Chairperson of the Department of Mathematics at The Park School and as Lecturer in Mathematics at both Goucher College and Towson State University. She received her Bachelor of Arts degree from Goucher College and a Master of Science degree from The Johns Hopkins University. A specialist in academic placement, she is a member of the National Association for College Admission Counseling, the Independent Educational Consultants Association, the Secondary School Admission Test Board and the Mathematical Association of America. She is also a co-author of the book Unraveling the Myth of the College Admissions Process.
Diane Greyerbiehl, PhD., CCC/SLP is the founder of Change Dynamics, Inc. She holds a Ph.D. in neuro-cognitive psychology and communication, as well as an M.A. in business management. She has over 25 years experience as a speech-language pathologist, communications trainer, neuro-cognitive therapist, counselor and business consultant/trainer. She has made countless presentations at the local, state and national levels.
Mark Reader, Ph.D. received his doctoral degree in Child Clinical Psychology from Southern Illinois University at Carbondale. He interned at Children’s Hospital National Medical Center in Washington D.C. After his internship, he continued at CHNMC where he conducted neuropsychological and psychopharmacological studies with children with ADHD and/or dyslexia under the direction of C. Keith Conners, Ph.D. Since 1987 he has been affiliated with the Kennedy Krieger Institute. For the past 6 years, he has been on staff of the Department of Developmental Cognitive Neurology and the Learning Disabilities Research Center, both directed by Martha Denckla, M.D. His most recent publications are on the relationship between executive function and ADHD. Dr. Reader is also an Assistant Professor of Medical Psychology at Johns Hopkins Medical School. Dr. Reader is in private practice where he sees children, adolescents and adults–many of whom are ADHD. He also conducts neuropsychological evaluations at the Adult Attention Deficit Disorder Center of Maryland.
Carol Watkins, M.D. received her medical degree from the University of Virginia School of Medicine and pursued her psychiatry residency and child and adolescent psychiatry fellowship at the University of Maryland where she received the Brodie Psychotherapy Award. She is board certified in Child, Adolescent and Adult Psychiatry. Over the past 14 years, she has been a consultant to several school and special education programs. She is currently co-chair of the Maryland Psychiatric Society’s Computer Committee, and co-chair of the Baltimore County Medical Society’s Committee on Women’s Issues. She serves as secretary for our CH.A.D.D. board and has been very active in our chapter for several years. She is private practice seeing children, adolescents and adults with Northern County Psychiatric Associates.
Michael Labellarte, M.D. is an assistant professor in the Department of Psychiatry, Johns Hopkins Medical Institutions. He is a child and adolescent psychiatrist in the Division of Child and Adolescent Psychiatry. He is currently an investigator in the Research Units of Pediatric Psychopharmacology (RUPP), which is funded by the National Institute of Mental Health. This year, Dr. Labellarte won a New Investigator’s Award from NIMH. His primary areas of interest are anxiety disorders (including obsessive-compulsive disorder, or OCD) and attention deficit hyperactivity disorder (ADHD). In clinical work, Dr. Labellarte combines medication management with parent management strategies, helping to foster self-esteem and creating more predictable patterns of behavior in children and adolescents with psychiatric issues. Dr. Labellarte has lectured on numerous topics in child and adolescent psychiatry, including anxiety disorders, OCD, ADHD, community violence, violence in the media, suicide, fostering self esteem;, and managing problem behaviors.
Sheila Eller is a graduate of Towson State University. She is trained as a speech and language pathologist and has been in education for 32 years. She is currently the assistant director of Beth Tfiloh Camp, one of the largest day camps in the country. She also holds workshops for teachers and parents sensitizing them to the needs of ADHD children. She is a strong advocate for children and has been very active in the Baltimore County Chapter of CHADD.
Bret Spodak is the founder and owner of The Tutoring Connection in Towson, Maryland. A graduate of the University of Michigan, he began tutoring at Loyola College four years ago. His first endeavor was Math Masters, the predecessor to the Tutoring Connection. The high demand for excellent tutors to help failing students prompted Mr. Spodak to enlarge his practice. The company now employs 36 tutors that cover most subject areas.
Hillel ZeitIin LCSW-C is founder and director of the Maryland Institute of Ericksonian Hypnosis Therapy, where he maintains a private practice and provides training, in-services and supervision for professionals. lie is on the teaching faculty of Sheppard-Pratt and is president of The Maryland Society for Clinical Hypnosis. He is an associate trainer with the International Core Transformation Training Team, a Neurolinguistic Programming Master Practitioner and has advanced training in Thought Field Therapy and EMDR. He also enjoys a good friendship with ADD writer, Thorn Hartman, who has contributed greatly to Mr. Zeitlin’s approach. He has presented widely at regional and international conferences.
Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Larry S. Goldman, MD; Myron Genel, MD; Rebecca J. Bezman, MD; Priscilla J. Slanetz, MD, MPH; for the Council on Scientific Affairs, Amarican Medical Association. JAMA Vol.279, No. 14, April 8, 1998.
The objective of this research was to address concerns from the public and professionals that medications used to treat AD/HD, primarily Ritalin, may be over-prescribed. This team of researchers reviewed issues related to diagnosis, optimal treatment and care of AD/HD patients, and evidence concerning patient misuse of medications.
Dr. Goldman et al researched all English-language studies on school age children from 1975 to the present concerning AD/HD, stimulant medications, and abuse and dependence of stimulants. The team also reviewed relevant documents from the Drug Enforcement Administration. The study reports that ADHD is not over-diagnosed nor is methylphenidate over-prescribed. The report attributes the increase in diagnosis of ADHD to increased awareness of the disorder, as well as broadening and refinement of the diagnostic criteria. “As a result, more children (especially girls), adolescents, and adults are being diagnosed and treated with stimulant medication, and children are being treated for longer periods of time.”
Research shows that using DSM IV criteria for diagnosis, 3% to 6% of school age children have AD/HD, yet this report finds that in the US, “youth being treated for ADHD is at most at the lower end of this prevalence range.” Dr. Goldman further reports that Ritalin and other stimulants have been extensively researched and he finds “no evidence in the literature to support concerns regarding abuse.”
The study concludes “although some children are being diagnosed as having ADHD with insufficient evaluation and in some cases stimulant medication is prescribed when treatment alternatives exist, there is little evidence of widespread over-diagnosis or misdiagnosis of ADHD or of widespread over-prescription of methylphenidate by physicians.”
Sheila Anderson, CH.A.D.D.’s immediate past president, states in the most recent issue of ATTENTION! “the American Medical Association has confirmed what CH.A.D.D. has been saying to its members and others for a long time. As the report points out, highly inflammatory public relations campaigns that label ADHD as a ‘myth,’ and the use of medication as a form of ‘mind control,’ have created serious misperceptions about the existence, prevalence, and treatment of the disorder. We are very pleased that the AMA study refutes those irresponsible claims with scientifically-based, objective data.”
As a member of the Governor’s Task Force to Study the Use of Methylphenidate and other Drugs on School Age Children in Maryland, I would like to add that this outstanding research will be of major significance to our study report due to be completed this year.
Tish Michel, CPA, MBA
T.A.C.T. Study at Johns Hopkins Hospital – Children between the ages of 7 and 14 years old who have a diagnosis of ADHD, and who also have a diagnosis of either Chronic Tic Disorder or Tourette Syndrome might be eligible to participate in the T.A.C.T. study (Treatment of ADHD in Children with Tics). The goal of this study is to find the best way to treat ADHD in children who have tics. This research is sponsored by the NIH and is being carried out at several sites across the country. The study includes a medication trial, classroom observations preformed by the child’s teacher and by a specially trained observer, and clinic visits for monitoring of tics. Parent input is also an important part of the study. All medicines, visits, and tests associated with the study (i.e. electrocardiograms) are provided free of charge.
Dr. Harvey S. Singer, Director of the Johns Hopkins Pediatric Movement Disorders Clinic and Co-Principal Investigator of the T.A.C.T. study, is in charge of the study site at Hopkins. If you think your child might be eligible to participate, or if you would like to receive an information flyer, contact Carmen Roig, BSN,RN, Program Coordinator, at 410-614-4869 or e-mail [email protected]. Enrollment is limited and final determination of eligibility is left to Dr. Singer.
PROJECT III Study at Johns Hopkins Hospital – is a comprehensive research study funded by a NIH grant to compare structural and functional activities in the brains of children with Tics, ADHD and OCD. There are three parts to the study:
All testing is preformed free of charge. Dr. Harvey S. Singer is the Director of this study as well as the T.A.C.T. Study. If you think your child might be eligible to participate, or if you would like to receive further information, contact Carmen Roig, BSN,RN, Program Coordinator, at 410-614-4869 or e-mail [email protected]. Enrollment is limited and final determination of eligibility is left to Dr. Singer.
Here are two opportunities for you to help further our knowledge about ADHD and TS. My family has participated in the Project III study. We found the experience to be pleasant, informative and beneficial. Please consider volunteering to take part in these worthy projects.
Tish Michel, CPA, MBA
In our continuing effort to meet the varied needs of adults with ADD, our monthly meetings will take on an improved format. Beginning at 7.30 p.m. our first fifteen minutes will feature “Success Strategies” that you have discovered and would be willing to share. As this will take the form of two or three interviews each night, we are asking that you sign up in advance to be interviewed at a future meeting. We are aware that many of you have discovered strategies through your experience with ADD, that could be used or adapted by others who are just beginning their ADD journey, or who simply have not discovered these strategies for themselves. We have also considered documenting your success strategies in written form to provide ongoing support for our members. We welcome your thoughts and opinions on this.
Following “Success Strategies”, will be a segment entitled, “Creative Concepts”, in which we plan to feature each night, the work or hobby of one member who has developed an outlet for his or her creativity. By providing such a forum to present your work, we hope to inspire others to discover and develop their own hidden talents. On a personal note, I had turned forty before I began to realize my own artistic abilities, and through developing them I continue to discover talents that are taking me places I never dreamed possible. Again, we will need to know in advance if you would like to be featured at one of our meetings. It’s a little hard to predict the response we will get to these ideas, so our format will maintain enough flexibility to accommodate your response.
At 8.00 p.m., following announcements, we will continue to feature a guest speaker, or panel discussion, on some pre-selected topic of interest to ADD adults. At the close of this segment (around 9.00 p.m.) the meeting will be open for general discussion and networking. It is our hope that, in this new format, each of you will find the support you are seeking from our CH.A.D.D. organization.
The new format outlined above will not be implemented at our combined meeting in September nor at any other combined meetings. Those scheduled meetings in which we join with the parent group will begin at their usual time of 7.00 p.m., hopefully allowing time for networking at the end. We welcome your ideas, and your help to turn those ideas into reality. We are aware of interest in smaller support groups that would meet on a more frequent basis, particularly a women’s group, and a college students’ support group. However, at this stage we do not have the necessary facilitators for these groups, so for now these interests must remain on hold. Thanks for all the support you’ve already given, and continue to give to CH.A.D.D.
My candle burns at both ends
By Edna St. Vincent Millay
I was walking home from college today wondering how such an underachiever as I have previously been, could possibly attain to the level of achievement I currently enjoy. It was the last class of my summer course on Health Policy, and our class discussion this week had focused on issues of medical ethics. I found myself wondering at the limited insight of some students—at how they could not see that failure to act in certain situations is just as much a life-or-death decision as choosing to act, or that the decision to save a life could mean denying life to another. Why these students could not see the farther implications of certain choices was a puzzle to me. In contrast, I thought about how easy it is for me, in general, to see the bigger picture. I have always had difficulty breaking things down into smaller, isolated chunks—a definite disadvantage when attempting tasks such as house cleaning, organizing, or writing essays with narrow theses.
However, I am beginning to value my ability to see associations everywhere I look, to recognize long term implications of choices and decisions, and to generally view issues from a wide-angled perspective. Is this some special ability I alone possess? I think not! It has been my observation that such an attribute is typically part-and-parcel of Attention Deficit Disorder. Our skills at extrapolation know no bounds. Our minds threaten to decimate at the speed with which one word or thought generates explosive patterns of associations, until we shut down from overload. Having ADD ensures our minds freedom to expand to fantastic dimensions. We might find our physical environment restrictive or downright imprisoning, but our minds cannot be captured or contained.
It was then I got to thinking about impulsivity—the trademark of ADD. Isn’t this the very opposite of looking at the big picture with it’s associations and implications? Perhaps. But then maybe it’s exactly the protective mechanism we need to prod us into action and keep us from living in our minds. Impulsivity is the perfect attribute to involve us in reality. Without it we’d most likely get lost in our fantasies, rarely touching down long enough to accomplish anything at all.
And so I have gained a new perspective on the wonders of our so-called disability. Our ADD minds, in fact, have been engineered with the greatest wisdom and deliberation—instilled with a delicate balance of attributes having both specific and complimentary functions. I’m not a rocket scientist, nor am I an esteemed scholar; however, such qualifications have been unnecessary to gain this insight—to discover this momentous realization.
But Shhhh! Keep it our secret! Let’s celebrate quietly and wear our pride modestly, for everyone would want ADD if she knew the real value of this marvelous possession of ours!
* Don’t believe everything you see, read or hear. Decide for your self what you’re going to believe.
* Critical thinking is important in order to:
*Critical Thinkers are:
October 3, 1998 from 10:00 AM – 12:30 PM at Greenwood, The Baltimore County Board of Education, ESS Building
February 20, 1999 from 10:00 AM – 12:30 PM at The Greater Baltimore Medical Center
October 3, 1998 from 10:00 AM – 12:30 PM at Greenwood, The Baltimore County Board of Education, ESS Building
February 20, 1999 from 10:00 AM – 12:30 PM at The Greater Baltimore Medical Center
Children with ADHD are high maintenance whether they are in the class room, on the playground, school bus, cafeteria, Sunday school, scouts, soccer practice, or home. Educators have looked to CH.A.D.D. for help in affectively working with children with ADD. Teachers and parents alike feel frustrated and helpless when they see a child not achieving near his potential, and loosing his zest for learning as his self esteem deteriorates. CH.A.D.D.’s National Education Committee developed the EDUCATORS MANUAL to provide a thorough picture of ADD from an educational perspective.
Dr. Sharon Rhodes and Tish Michel will incorporate materials from the EDUCATORS MANUAL at this In-Service Program on Attention Deficit Disorders. Topics will include: understanding educational implications of the disorders, identification and assessment protocols, interventions and accommodations, and problem solving techniques.
Dr. Rhodes is an Associate Professor of Education at Loyola College. She has over twenty years of teaching experience and currently provides educational consulting services. Dr. Rhodes received her Ph.D. in Clinical Reading from the University of Wyoming. She was a Post Doctoral Fellow at Kennedy Krieger Institute and a Research Associate at Francis Scott Key Hospital. Dr. Rhodes was an inner city school teacher prior to joining the Loyola College faculty.
Tish Michel, CPA, MBA, received her Bachelors in Distributive Education from Virginia Commonwealth University, and her MBA and ABD from George Washington University. She has taught at Loyola College, The College of Notre Dame and Towson University. She has been Co-coordinator of CH.A.D.D. of Baltimore County since 1996. She developed a five week summer day camp for children with ADHD and has been Coordinator of the camp for the past two years. Tish Michel serves on the Task Force to Study the Use of Methylphenidate and Other Drugs on School Age Children.
Come and learn how to help build a better sense of competence and self-worth for children with ADD. The workshop will be held on October 3, 1998 from 10:00 AM – 12:30 PM at Greenwood, The Baltimore County Board of Education, ESS Building, 6901 North Charles Street. The workshop will be repeated on February 20, 1999 from 10:00 AM – 12:30 PM at The Greater Baltimore Medical Center. Participants will receive an EDUCATORS MANUAL (value $14) and other valuable materials. Cost is $30 for members and $40 for non-members. Please call 410-377-0249 for further information and please register soon.
SATURDAY, JANUARY 30, 1999 FROM 10:00AM TO 12:30PM AT GBMC
Michael Sherlock, M.D., will present this workshop to assist parents, educators and health care professionals interested in learning more about ADHD. He will speak about the nature and varieties of ADD and ADHD, and their treatment with medication and other modalities. He will discuss which children are suitable for medication, and what can and cannot be expected of medication. What parents can do themselves to help their children will be covered, as well as what can be expected from the school system and how parents can work with their doctor as advocates for their children and their special needs. Time will be left for questions and answers. Handouts and suggested readings will be provided.
Michael Sherlock, M.D., is an old and dear friend of the Baltimore County CH.A.D.D. Chapter. He is a pediatrician in private practice who has had interest in ADD/ADHD since spending two years as a fellow in child psychology at Johns Hopkins Medical Institution and almost twenty years as a consultant in behavioral pediatrics at schools for special education in Baltimore County. Dr. Sherlock has been on our Professional Advisory Board since its inception and has given many presentations on ADHD.
Enrollment is limited to ensure that you can come meet with the Doc and have all your questions answered. Participants in the workshop will receive a copy of Daredevils and Daydreamers, Dr. Barbara Ingersoll’s latest text, which was reviewed in this spring’s HYPERTALK. The cost of the workshop, text and handouts is $30 for members and $40 for non-members. Please call 410-377-0249 for further information and please register soon.
SATURDAY, MARCH 20TH FROM 8:30AM TO 12:30PM AT GBMC
John Walkup, M.D., will present this workshop to assist parents in learning more about successful techniques for raising children diagnosed with ADHD. Dr. Walkup will discuss: how kids develop behavior problems; what to do if you have tried everything; why some behavioral programs don’t work; how to deal with bedtime, homework, allowances, etc.; roles of Mom and Dad in the behavior program; how to assess advice about parenting approaches; what is consistency; what is permissive; what is strict; how to ignore problem behaviors; and how to set limits. If these issues are of concern to you, please join us for this special four hour workshop.
Dr. Walkup received his M.D. from the University of Minnesota. He is currently Deputy Director of the Division of Child and Adolescent Psychology and Department of Psychiatry and Behavioral Sciences at The Johns Hopkins Medical Institute. He serves as the Medical Director of the Research Unit of Pediatric Psychopharmacology and is also an Associate Professor of Psychiatry at JHMI.
Enrollment is limited to ensure that you can meet with the Dr. Walkup and have all your questions answered. The cost of the workshop and handouts is $30 for members and $40 for non-members. Please call 410-377-0249 for further information and please register soon.
Name____________________________ Circle Workshop and Date:
Occupation________________________ EDUCATORS’ INSERVICE ON ADHD October 3 or Feb.20
Organization_______________________ UNDERSTAND &HELP THE CHILD WITH ADHD Jan. 30
Address___________________________ POWER PARENTING THE CHILD WITH ADHD March 20
___________________________ Fees for each workshop and materials:
City _____________________________ $30/members and $40/ non-members
Mail check and registration form to CH.A.D.D. OF BALTIMORE COUNTY
6716 Sherwood Road, Baltimore, Md. 21239
The Maryland General Assembly established the task force in 1997. The task force is comprised of nineteen members from the fields of education, health care and the community. Mary Shiner of our Professional Advisory Board and I are members of the task force. The charge of the task force is to determine the prevalence of use of Methylphenidate among school age children, who is prescribing Methylphenidate, and the extent to which treatments other than Methylphenidate are available for ADHD.
The task force is also responsible for organizing a statewide conference on ADHD (see our conference section), developing materials and programs on ADHD, and writing a final report to the Maryland General Assembly by year end.
Numerous projects are underway by the task force. You may have already participated in some of these projects by attending the public hearings held through out the state last spring and by completing the parent surveys available at some of our monthly CH.A.D.D. meetings last year.
Further information about the task force can be obtained by contacting Dr. William Flook at the Maryland State Department of Education (410-767-0307) or Dr. Cheryl Duncan at the Department of Health and Mental Hygiene (410-767-5595).
~Tish Michel, CPA, MBA
If you could use some help to guide your child in how to find, make and keep friends, you will want to own this book. Dr. Frankel is the Director of UCLA’s Parent Training & Children’s Social Skills Programs. This book teaches clinically tested techniques to parents in a well organized, easy to understand and follow format.
Good Friends are Hard to Find Good Friends are Hard to Find is geared towards helping children ages 5 through 12 make friends and resolve problems with peers in an age appropriate manner. Each chapter begins by identifying the problem, gives a brief background and then addresses the problem clearly in a step-by-step approach. Most chapters conclude with a chart summarizing the techniques taught. For example, below is the checklist Dr. Frankel developed for helping a child meet other children at a playground.
1. “Search your neighborhood for a suitable public place to meet other children
2. Watch a group of children at play.
Bring a magazine or newspaper to pretend to read at the appropriate time.
3. Coach your child about how to join.
4. Review with your child why children are kept out of a game.
Bottom line: take no for an answer and move on to other children.
5. Coach your child to praise other children’s behavior.
6. Encourage your child to attempt to join.
7. Praise your child for the things she did well.”
I have discussed these techniques with my son and we will ty them this week. I am hopeful that my child will soon have a new friend in the neighborhood. Be sure to ask me how the “make a friend” campaign went at the next CH.A.D.D. meeting!
Dennis Cantwell, M.D. has been a significant contributor to research on ADHD and states “children with ADD/ADHD or Oppositional Defiant Disorder. . .have trouble making friends. . .Using these exercises will help them become more stable adults.” Cantwell concludes, and I concur, this is a much needed resource and I highly recommend it.”
Tish Michel, CPA, MBA
Plan time to browse our library before the next meeting. We have over 80 books, audio-tapes and videos related to these issues available for circulation among members.
You must be a current CH.A.D.D. member in good standing to borrow materials. Materials may be borrowed for up to one month. A $5.00 fine will be charged for overdue materials, and a replacement cost may be charged after two months. A deposit is requested for all videos borrowed. The library will be open at every general meeting. The materials are due back the following month or may be exchanged sooner by contacting the CH.A.D.D. line. Please make use of this great opportunity to broaden your knowledge base!!
Web site and On-line Book Store
http://www.ncpamd.com/BaltoCHADD.htm is our chapter Web site. It won the Brandi Valentine’s Heart of the Web award. You can use our site to access HYPER~TALK, check meeting schedules and other information about our chapter. You can help raise funds for our chapter by buying your books from Barnes and Noble on-line through our web site. This is an easy and painless way to help us while helping yourself at the same time. We get credit for any book you buy from our site, even if it’s a cookbook.
Special thanks to Dr. Carol Watkins for setting up our award winning web page and obtaining our designation as a Barnes and Noble affiliate.
Fall/Winter Fall/Winter 1998 – 1999
HYPER-TALK is a semi-annual publication by CH.A.D.D. of Baltimore County.
Placement of an advertisement in the newsletter does not represent an endorsement by CH.A.D.D.
CH.A.D.D. of Baltimore County does not endorse any schools, businesses, treatment, or theory. Articles and announcements are for information purposes only.
Articles, questions and letters to the editor/professional advisory board are welcome.
CH.A.D.D of Baltimore County #168
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Children and Adults with Attention Deficit Disorder
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