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science of ADHD

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People often ask me if neurofeedback is an effective treatment for ADHD. Given that the expert consensus is “maybe” or “sometimes,” I try to answer along those lines, pointing out that many factors should be considered. For example:

  • How quickly do you need results (is a child about to fail a grade or an adult about to lose a job or relationship)?
  • How plentiful are your resources (if you try neurofeedback and it doesn’t work, is there money left in the budget for traditional treatment)?
  • What are the credentials and reputation of the clinician providing the neurofeedback?

Some people assume that neurofeedback is safer than medication, but the fact is that potential for its side effects has never been studied.

Thanks to David Rabiner,  Associate Research Professor at Duke University’s Department of Psychology  Neuroscience, I can share with you (below) a sophisticated analysis of the research.  Dr. Rabiner has long performed the excellent service of parsing the research around ADHD in his newsletter, Attention Research Update. You can subscribe to his free newsletter here, and read through the substantial archives once you are subscribed

As a layperson, I appreciate his clear writing style, but research terminology can be complex and this analysis might be “too much information” for some of us. Please consider that clear-cut answers aren’t always easy to give on complex subjects.

The bottom line, as Dr. Rabiner writes below:

“The research reviewed here indicates that if parents obtain high quality neurofeedback treatment for their child there is a reasonable basis for expecting that benefits will occur. The decision to do so should be made with the knowledge that medication treatment and behavioral therapy would be regarded as having stronger research support at this time.” Read the rest of this entry »

A quick note to let you know that my book, Is It You, Me, or Adult A.D.D.?, is available as a download from Amazon.com for Kindle devices and Kindle applications for iPads, iPhones, PCs, and so forth.  Just click on the book title above to go directly to the product page.

Please tell your friends in Germany, France, Spain, Italy, and the United Kingdom that the Kindle is available on Amazon.com in those countries. (This is the English version.)

Thank you for spreading the word.

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We’ve all heard claims about fish oil “curing” ADHD, but what does the latest research show? Mixed results, at best, though further study is warranted.

Make no mistake:  The human brain needs essential fatty acids to function properly; so does the rest of the body. But the question is this: Does fish oil supplementation actually diminish ADHD symptoms?

Following the last post on diet and ADHD, David Rabiner, Ph.D., explains the latest research on ADHD and fish oil, below.  (To subscribe to his free newsletter, Attention Research Update, click here.) Reprinted here with Dr. Rabiner’s permission. Cartoon reproduced under paid license from Cartoon Stock.

New findings: Does fatty acid supplementation help children with ADHD

Although medication treatment benefits an estimated 70 to 90% of children with ADHD, effective alternative treatments are needed for several reasons. First, even for children who respond well to medication, difficulties that need to be addressed often remain. Second, some children experience side effects that preclude the ongoing use of meds. Finally, most studies of stimulant medication treatment are relatively short-term, and data showing that stimulant medication improves long-term outcomes remain scarce. Read the rest of this entry »

We’ve seen the headlines and read the stories regarding a recent study on ADHD and diet.  But what is the real story behind the research? You’ll find out below. But first, a brief examination of the situation.

Increasingly, even legitimate news outlets lift stories verbatim from the press release, without bothering to ask important questions of experts not associated with the study or explaining the limitations of the study and its relative importance.

Read the rest of this entry »

Call me the Paul Harvey of the ADHD Roller Coaster blog. The fact is, I knew there were “issues” with the recent widely reported research on the genetic links of ADHD, especially in the media’s coverage of it. Because  I could not competently parse this complex study, however, I found an expert who could. Because her research institution requires that all information given to the media be cleared with the press office and because time is of the essence, I decided to share this expert’s comments, with her consent,  by identifying her simply as a respected neurologist with significant background in ADHD research.

The published paper is reporting a genetic association between ADHD and abnormalities in CNV in some areas of the genome that have been previously associated with autism and schizophrenia.

Some comments:

  1. The main association is found in a group of patients that the authors define as “ADHD with intellectual disabilities,” those patients have an IQ ranging from 43 to 69 (or less than 70). Those IQ scores fall in the range of Mental Retardation definition. Read the rest of this entry »

The study’s lead investigator, Professor Anita Thapar, explains the important new research behind the headlines. Congratulations and gratitude go to the hardworking scientists who teased out this discovery.  As for the reporting of this research, ADHD Cyber Command  finds that some did better than others, especially in implying that until now we had no evidence that ADHD wasn’t caused by bad parenting or that this is the first news of a genetic link to ADHD.

What? You say you already knew that ADHD is highly genetic?  Of course you did.  I can’t account for the headlines, but it seems these news outlets missed a key adjective in Dr. Thapar’s explanation of her team’s research findings: direct, as in “the first direct genetic link.” But even that is being contested; stay tuned for more info on that.

Meanwhile, here’s a sampling of how various news organizations covered the study, some of them as if stuck in a time warp from, oh, 30 years ago:

New Scientist:

Have gene findings taken the stigma from ADHD?

For the first time, evidence has emerged of genetic mutations linked to attention-deficit hyperactivity disorder. But how strong is the link, and how far does the finding undermine claims that children with the condition are simply naughty kids, victims of bad parenting or driven to hyperactivity by dietary additives? Read the rest of this entry »

There’s a cartoon floating around among my Facebook friends. One character says: “Come to bed, honey.” And the other character, at the computer keyboard, says, “I can’t. Someone is saying something wrong on the Internet, and I must correct it!”

For 10 years, I’ve resembled that character, rat-a-tat-tatting at my keyboard to counter fallacious information about ADHD on the Internet. The latest just this morning, which as both an ADHD advocate and responsible journalist, was too hard to resist.  (If you’d like to skip my preamble, scroll to the end of this post to get to a recent CNN article and my response to it.)

And yes, it’s been a  personal mission, though it hasn’t kept me up late at night and I aimed for surgical strikes, not omnipresence.   As a writer and editor with a long-held reputation for fairness and accuracy, though, I’ve found this new “medium” of the Internet by turns extremely exciting yet unsettling. Read the rest of this entry »

Lots of ADHD in the News for July and early August. Environmental groups call for ban of pesticides linked to ADHD. Western diet linked to ADHD. Lots of links, but what are the facts?

Please remember as you read some of these reports: Association is not causation. A “risk factor” is something that is associated with a condition. Whether that factor causes the condition or results from the condition, that is often the question that remains to be answered.

For example, in the first news story below, note that there is a link between the Western diet and ADHD.  As the study’s researcher rightly points out (far down in the story):

“This is a cross-sectional study so we cannot be sure whether a poor diet leads to ADHD or whether ADHD leads to poor dietary choices and cravings,” Dr Oddy said.

NUTRITION:

Western Diet Link to ADD, Australian Study Finds

ScienceDaily, July 29

A new study from Perth’s Tlethon Institute for Child Health Research shows an association between ADHD and a “Western-style” diet in adolescents. Read the rest of this entry »

This is perhaps the #1 question about Adult ADHD. To answer it, in part: I offer this adapted excerpt  from my book, Is It You, Me, or Adult A.D.D.?.

This post includes the current DSM criteria for ADHD as well as the criteria proposed by Dr. Russell Barkley and colleagues for the upcoming DSM revision (you know it’s “not just for kids” when one diagnostic point involves driving!).

Please use the handy links above and below (see the “share” tool) to spread the word about how an evaluation for ADHD should be performed.

The Adult ADHD Diagnose-o-Meter

There is no single test to evaluate for ADHD. No computer test. No fill-in- the-blank test. No blood test or genetic test. These practical facts are commonly wielded by the anti-psychiatry fringe element as proof that ADHD does not exist.  A-hem, just for the record, neither can you measure headaches, backaches, or many other maladies with a quiz, a blood test, or a genetic test.

More importantly, “You also cannot measure a person’s pain or suffering in life by clinical tests,” notes psychologist Thomas E. Brown, assistant clinical professor of psychiatry at the Yale University School of Medicine and associate director of the Yale Clinic for Attention and Related Disorders.

It’s important to remember that ADHD symptoms essentially represent an extreme on a normal continuum of behavior that varies in the population, much like IQ, weight, or height. That’s why its diagnosis is not a cut-and-dried matter. To ascertain if a person is “over the line” on this continuum, the evaluating professional must gauge the severity of the symptoms and impairment. Read the rest of this entry »

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Know some geeks who can’t sleep?  Please share this post with them. It might help.

Our monthly Adult ADHD Salon in Palo Alto ran late Wednesday night, as usual. (Call me a nerd, but this group is the social highlight of my month; we have fascinating conversations and it’s always great to cheer progress reports.)  So, I was a little fuzzy-headed the next morning when I read this story in our local paper: “The Quantified Self: Taking quantum leap in self-examination.”

It caught my attention, because one immense challenge with ADHD is self-monitoring. This can be a real liability when you are trying to figure out how you landed in certain circumstances, how you come across to others,  or even what you ate for breakfast and if you’re following through on a routine you’ve set for yourself.

Leave it to Silicon Valley’s geeks then (including the ones who might have ADHD but don’t know it) to come up with an entire self-monitoring movement where, as the story explains: Read the rest of this entry »

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