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05.07.2014

Treatments for add adhd, insomnia cures nhs - Reviews

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Medication can help a child with adhd in their everyday life and may be a valuable part of a child’s treatment.
From detecting symptoms of attention deficit to pursuing an adhd diagnosis and treatment plan, learn the process for diagnosing, treating, and controlling add in. In their Treatment Guidelines for Attention Deficit Hyperactivity Disorder (1), the American Academy of Pediatrics clearly states that a care plan for children with this condition should include behavioral treatment along with any prescribed medication. According to a study conducted at State University of New York at Buffalo, “combining behavior modification therapy with medication is the most effective way to improve the behavior of many ADHD children. Unfortunately, behavioral treatment is often only minimally addressed or left out entirely. Making appropriate educational materials easily available may prove to be difficult for a busy practice. One major finding of the MTA Study conducted by the National Institute of Mental Health (2) was that the children of parents who developed a disciplined yet positive approach to parenting were able to maintain treatment gains during the 14 month period of the study. When parents implement the major components of the program, they end up developing a family culture that is healthy and supportive to the entire family and therefore likely to endure for many years if not become a permanent fixture in their daily lives. Some of the psychological interventions such as problem solving training and social skills training included in Total Focus have not always been recommended as part of a treatment plan for a child with ADHD due to research based on the use of these techniques in a group setting.
PARENT SKILLS TRAINING, offered by therapists or in special classes, gives parents tools and techniques for managing their child’s behavior. Evidence: The MTA Study (2) concluded that “long-term combination treatments and the medication-management alone were superior to intensive behavioral treatment and routine community treatment. PSYCHOTHERAPYworks to help people with ADHD to like and accept themselves despite their disorder. Evidence: The MTA Study (2) found that the combined treatment (medication management with behavior therapy), compared with medication alone, offered improved scores on academic measures, measures of conduct, and some specific ADHD symptoms (although not on global ADHD symptom scales).
Total Focus: Audio and workbook lessons teach problem solving techniques for use at home and school. Total Focus: The workbook provides a series of cognitive rehab exercises in the form of simple tasks and games designed to improve attention, concentration, memory and executive functioning through repetitive practice. Recognizing the need for a methodology to increase access to evidence-based psychological treatment for children, Child Development Institute has produced a multi-media program known as Total Focus that involves the parents and children working together as a team to help the child achieve success at school and enjoy life at home and in the community. The program can be used instead of medication for children with mild to moderate symptoms or as adjunctive therapy for those taking stimulant medication.
Please see a review of Total Focus by ADHD researcher and clinical expert, Stephen Hinshaw, PhD. Conners CK, Epstein JN, March JS, Angold A, Wells KC, Klaric J, Swanson JM et al Multimodal treatment of ADHD in the MTA: an alternative outcome analysis.
Kerns KA Investigation of a Direct Intervention for Improving Attention in Young Children with ADHD Developmental Neuropsychology.
Klingberg T, Fernell E, Olesen PJ, Johnson M, Gustafsson P, Dahlstrom K, Gillberg CG, Forssberg H, Westerberg H.
Pfiffner, LJ Social skills training with parent generalization: treatment effects for children with attention deficit disorder. Therapy that addresses both psychological and social issues (called psychosocial therapy), usually combined with medications, is the best method of treating ADHD.
For 70 years, psychostimulant medication has been used to treat symptoms of ADHD, and stimulants are still considered the first-line medication for treating ADHD. Stimulant use in children with ADHD has been associated in some studies with sudden death in a small number of cases, leading to widespread concern; however, subsequent studies have found no difference in sudden death rates among children taking stimulants for ADHD and the general population using no medication. One of the drugs that has been used for treating ADHD, pemoline (trade name Cylert) is not recommended as a first-line approach to ADHD because of the potential for serious side effects related to the liver. More minor side effects associated with stimulantbased treatment include decreased appetite, insomnia, increased anxiety, and irritability. Another drug, modafinil, had stirred up a great deal of interest because it was effective in treating ADHD in a couple of double-blind, placebo-controlled trials, but the FDA recently declined approval of the drug for clinical use.
Other prescription drugs used in the treating ADHD are not FDA-approved for that purpose and therefore their use in treating this disorder is ‘‘offlabel.’’ These drugs include tricyclic antidepressants such as imipramine, the antidepressant buproprion, and guanfacine, a mimic of a specific form of neurotransmitter (nerve-signaling molecule). Drug therapy may control the symptoms of ADHD, but most experts recommend that drug therapy accompany concerted efforts involving behavioral therapy to address the underlying causes.


A variation of this technique, cognitive-behavioral therapy, may work for some children to decrease impulsive behavior by getting the child to recognize the connection between thoughts and behavior, and to change behavior by changing negative thinking patterns. Individual psychotherapy can help children with ADHD build self-esteem, provide a place to discuss worries and anxieties, and help them to gain insight into behavior and feelings. Other important therapies for children with ADHD can include social skills training, in which the children learn appropriate social interactions from behaviors that are modeled for them.
If untreated, ADHD negatively affects the social and educational performance of children with ADHD and can seriously damage their sense of self-esteem. Approximately 70–80% of patients with ADHD treated with stimulant medication experience significant relief from symptoms, at least in the short term. Adult ADHD patients that use medical marijuana report that they feel peaceful are capable to focus on and complete a task that they normally could not do, are able to eat and sleep better, and overall have a better quality of life. Under no circumstances, should any suggestions be taken as a diagnosis, treatment, cure or direction against their current treating physician. For some children with mild to moderate symptoms behavioral treatment may prove sufficient to improve or alleviate symptoms. Thus, roughly one third of children diagnosed with ADHD may achieve normal behavior from a comprehensive program consisting of treatment strategies similar to those used in Total Focus.
This is often due to time constraints for the physician as well as the parents and the child. Referral to a mental health professional may be hindered by the cost of the care or the time and commitment involved and also the ability to connect the patient and family with a qualified mental health professional who specializes in the treatment of ADHD. One of the primary goals of the parent education module of Total Focus is to enable parents to adopt a parenting style that will work not only for the ADHD child but also for the entire family. 3572 (3) Evidence from scientific research studies indicating the usefulness for each component in Total Focus is provided below along with a description of how each component provides the recommended treatment. One such technique is the use of token or point systems for immediately rewarding good behavior or work.
And in some areas—anxiety, academic performance, oppositionality, parent-child relations, and social skills—the combined treatment was usually superior. In social skills training, the therapist discusses and models appropriate behaviors important in developing and maintaining social relationships, like waiting for a turn, sharing toys, asking for help, or responding to teasing, then gives children a chance to practice. The workbook provides materials that teaches appropriate skills for specific social situations and includes a “Feeling Faces” chart to teach recognition of emotions in others. Parents are directed to games and play activities that reinforce the skills as well as to online resources for a wide variety of computer programs to improve these functions.
Dr Bob also shares additional insights from his own experience successfully raising a son with ADHD which parents find both comforting and encouraging. The program not only provides parent education and behavior modification but provides psychological interventions that (1) teach coping skills, (2) improve motivation and self-esteem and (3) may address mild to moderate manifestations of possible comorbidity including anxiety, depression and ODD. Group cognitive-behavioral therapy versus sertraline for the treatment of children and adolescents with obsessive-compulsive disorder.
Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. Computerized training of working memory in children with ADHD–a randomized, controlled trial. Child- and family-focused cognitive-behavioral therapy for pediatric bipolar disorder: development and preliminary results. It may seem paradoxical to treat a disorder of hyperactivity with a stimulant medication, but people with ADHD typically experience a calming effect from stimulants.
All of these drugs have shown some effectiveness in various studies but are not specifically approved for treatment of ADHD. Children with ADHD perform better within a familiar, consistent, and structured routine with positive reinforcements for good behavior and real consequences for bad behavior. Although there is a lack of controlled studies to prove their efficacy, proponents report that they are successful in controlling symptoms in some ADHD patients. Children with ADHD have impaired relationships with their peers and may be looked upon as social outcasts. For those adolescents who have both ADHD and a conduct disorder, up to 25% go on to develop antisocial personality disorder and criminal behavior, substance abuse, and a high rate of suicide attempts that can be symptomatic of that disorder.


Approximately half of children with ADHD seem to ‘‘outgrow’’ the disorder in adolescence or early adulthood; the other half will retain some or all symptoms of ADHD as adults.
Also, some research studies indicate that the use of behavioral treatment along with medication may reduce the dose of medication necessary for effective treatment. Also, there is about a 20% increase in the number of children normalized by combining medication with psychological treatment. A 1998 study of the treatment of ADHD among special education students found that almost 75% received their care from a primary care physician and 68% of those receiving care from a PCP had no contact with a mental health professional. Another advantage of combined treatment was that children could be successfully treated with lower doses of medicine, compared with the medication-only group”. Acronyms like HOME for developing coping skills around the home, IDEA to teach problem solving and phrases like “Stop the Stinking Thinking – Start Smart Talking” provide verbal intermediaries so necessary for these kids to remember and apply all that they learn through participation in the program. Or the support might be in self-monitoring one’s own behavior and giving self-praise or rewards for acting in a desired way such as controlling anger or thinking before acting.
In addition, parents and teachers of children receiving combined therapy were significantly more satisfied with the treatment plan.
This training also improves response inhibition and reasoning and resulted in a reduction of the parent-rated inattentive symptoms of ADHD”.
Family, friends, and caretakers should all be educated on the special needs and behaviors of children with ADHD so that they can act consistently. Children diagnosed with ADHD are also more likely to have a learning disorder, a mood disorder such as depression, or an anxiety disorder. With early identification and intervention, careful compliance with a treatment program, and a supportive and nurturing home and school environment, children with ADHD can and do flourish socially and academically.
Finally, after 2 years 97% of those in the psychological treatment only group remained normalized as compared to only 66% for the medication only group. During time-outs, the child is removed from the agitating situation and sits alone quietly for a short time to calm down.
Most professionals agree that this intervention should be available to all parents of kids with ADHD. The bonus lesson, “ADHD: First Aid for Parents” provides proven techniques that are easy to implement to handle a wide range of behavior problems. Food and Drug Administration (FDA) for treatment of ADHD are methylphenidate (which occurs under several trade names, including Ritalin), mixed amphetamine salts (trade name Adderall), and dextroamphetamine (trade name Dexedrine).
It is suggested as an alternative for children who cannot tolerate standard psychostimulant therapy. Communication between parents and teachers is especially critical to ensuring that children with ADHD have appropriate learning environments. When a certain number of stickers are collected, the child may trade them in for a bigger reward such as a trip to the zoo or a day at the beach. The parents (or teacher) identify a few desirable behaviors that they want to encourage in the child—such as asking for a toy instead of grabbing it, or completing a simple task.
The use of family meetings and encouraging parents to spend time each day having a fun time with their children promotes a climate of acceptance, support and cohesion that will produce healthy development in children whether they have ADHD or not.
Cognitive Behavioral Therapy with children has been shown to be effective and often the treatment of choice for childhood anxiety, depression, bipolar disorder and OCD.
Some long-acting forms are available, such as Ritalin LA and Adderall XR, and a transdermal patch (trade name Daytrana) is also available for delivery of methylphenidate through the skin. Behavioral therapy is often the first-line approach to treatment in preschool-age children diagnosed with ADHD. A reward can be small, perhaps a token that can be exchanged for special privileges, but it should be something the child wants and is eager to earn. The technique works well with all children, although children with ADHD may need more frequent rewards.



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