Attention Deficit Disorder

Attention Deficit Disorder
Early described as a clinical syndrome in the 1930s with the name hyperkinesias, this syndrome has evolved over the last sixty years. Dr. Bradley described the paradoxical calming that Benzedrine caused in these children in 1937. In the 1960s this syndrome was called Minimal Brain Dysfunction. Later, it became Attention Deficit Disorder with Hyperactivity (ADDH). By 1980 the diagnosis shifted to Attention Deficit Disorder which remains current.

Types of Attention Deficit Disorder

Inattention/distractibility

Impulsivity

Hyperactivity

The first two must be present and documented by the age of seven, according to the Diagnostic and Statistical Manual. There is a great deal of debate about whether ADD is true illness, a personality variant, or a cultural response.

The Statistical of ADD in United States 6% of school age children receive this diagnosis and associated pharmacological treatment, whereas in other countries such as England it is closer to 1%. The occurrence of ADHD varies from 2% to 6.3% on numerous studies. Some communities show rates as high as 12% of school-age children. The proportion of Boys and girls at least 4:1 with ADHD, whereas girls are more likely to evidence ADD. Often, children with ADHD grow out of it, typically in puberty. The hyperactivity is often the first trait to disappear. Now a day 40% to 60% of children carry these traits, especially inattention and impulsivity into adulthood. Therefore ADD has been much more attention given to diagnosing and treating adults.

The most frequent symptoms for adults are difficulty in finding and keep jobs, poor job performance, inability to concentrate, poor organization, poor self-discipline, and low self-esteem. Inattention and impulsivity are a rather nonspecific neurological expression. Often, it is the result of a neurodevelopment delay. As would be expected, there is a significant genetic component. They have a first degree relative with this pattern. Furthermore, studies in twins show that 50% of the explainable variance is accounted for by genetics.

Symptoms of Attention Deficit Disorder (ADD)

The syndrome of ADD remains somewhat nonspecific. People of ADD symptoms can be triggered by a number of wide-ranging causes. The condition of mild to moderate lead intoxication causes a pattern of ADD symptoms. Childhood depression can make children inattentive, restless, or impulsive. Children with PTSD or severe anxiety can exhibit all of these traits as well. Fetal alcohol syndrome typically causes a rather severe and unremitting form of ADHD. Also, Fragile X and Tourette’s syndrome are typically associated with ADHD symptoms. Many mild to moderate closed-head injuries result in similar symptoms.

Reasonable Scientific Basis

Herbs

There is no solid evidence for using single herbs to treat ADD. However, there is good evidence for the use of herbs in psychiatric disorders: St. John’s Wort for depression and anxiety, Kava for anxiety. It makes some sense to use these in cases where anxiety or depression is a component. Ginkgo Biloba has been documented to improve cerebral blood flow. This could enhance frontal lobe function, which appears to be deficient in ADD. I commonly prescribe Ginkgo Biloba, 60-120 mg twice daily, as an adjunct treatment.

Thyroid Hormone Resistance

A recent article in NEJM documented a correlation of resistance to thyroid hormone and ADHD. If the child has a positive family history of thyroid disorder or clinical indicators, evaluation and appropriate treatment is indicated.

Amino Acids

Amino acids, which enhance the effect of nor epinephrine and dopamine should be of benefit. DL Phenylalanine and L-Tyrosine are the respective amino acid precursors of those neurotransmitters. 500-1000 mg of each twice daily between meals is a safe method to assess response.

Cranial Manipulation

The gentle manipulation of cranial bones is a variation of osteopathic manipulation. Some early research is coming out now which supports this in PTSD. The University of Arizona is exploring its value in otitis media. Any history of head trauma or complicated delivery makes this a reasonable recommendation.

Prayer

Authors such as Larry Dossey, M.D., have documented the efficacy of prayer for many medical problems. We can always pray for our patients.

Some Research Base

EEG Biofeedback.

In this treatment children receive biofeedback training to modulate their own EEG. Preliminary research is promising, but it takes many sessions and is quite costly.

Use of Vitamins and Minerals

A few studies indicate a benefit to nonverbal intelligence / academics with a simple multivitamin/mineral supplement. It’s cheap and has no down side. A daily multivitamin plus a separate calcium/magnesium and B-6 (50 mg) is my recommendation.

Food Allergies

Numerous studies document the value of a hypoallergenic diet in some children with ADHD. The diets are tedious and can be difficult to enforce. Start with elimination of dairy products, peanuts, corn, citrus, and tomatoes, all of which are common allergens. If you believe in a food allergy-related cause for the current epidemic of otitis media, then you can begin to understand the documented correlation between recurrent otitis media and later ADD/ADHD. I push this avenue if significant indicators of allergies exist (hay fever, history of colic, rhinitis, asthma, eczema, etc.).

Essential Fatty Acids (EFAs).

The Omega-3 and Omega-6 oils control the functioning of the pervasive prostaglandin system. Also, eicosanoids are produced from EFAs. These hormone-like substances mediate physiological functions throughout the body and the prostaglandin system. ADD children are found to have deficient patterns of EFAs in their plasma. The associated symptoms are dry skin, increased thirst, frequent urination, eczema, and asthma. Other symptoms of this imbalance are somatic complaints (headaches, stomachaches, diarrhea, constipation, or insomnia). Supplementation with Omega-3 and Omega-6 oils makes great sense. Also, we are now seeing in psychiatry the use of fish oil (Omega-3) as an effective treatment for mood disorders and mood instability.

I generally recommend supplementation with EPA/DHA (fish oil/Omega-3) 1,000 mg once or twice daily before meals or on an empty stomach. Also, Black Current, Borage, or Evening Primrose Oil (Omega-6), 1,000 mg once or twice daily with meals. Additional Vitamin E (400 u/d) makes sense as well. The herbs Ginger and Turmeric may also be of benefit in balancing these pathways. There is very little evidence concerning the use of EFA to treat ADD/ADHD, but the basic science and documentation of deficiency pushes this toward solid science.

Mentalin

This proprietary ayurvedic preparation, which contains the herbs Gotu Kola, Rosemary, Ginger, and Bacoba, has significant research efficacy in India. In my experience, it works well for mild to moderate cases of ADD/ADHD by providing a centering, calming effect. Dosage is two to four tablets twice daily.

Homeopathy and Acupuncture

It has a breadth of scientific support as well as a research base. Very little specifically relates to ADD. But it can be considered as a reasonable adjunct in some cases.

No Clear Scientific Base

A variety of supplements

It has been proposed as effective treatments for ADHD. Such things as pycnogenol like an antioxidant and spirulina like blue green algae are marketed for this. If the product is presented as a cure-all, has a multi-level marketing distribution, and has vague documentation, I am immediately suspicious.

Complex Homeopathy

This involves the use of various computerized biofeedback devices that give a detailed printout of imbalances as well as creating its own homeopathic remedy. Often, many combination remedies are taken concomitantly. Although popular and occasionally miraculous, I know of no research at any level that supports this approach. I remain curious but skeptical.

Irlen Approach

This controversial approach uses color filters to help children read and focus. It seems to help those with perceptually-based learning and attention problems.

ADHD is a common syndrome in child psychiatry. Often misdiagnosed and mistreated, the most important step is solid diagnosis. From there we now have many effective conventional and a number of promising alternatives to offer our young patients. Matching treatment recommendations to both the severity of the patient and the belief system of the family makes good sense.

Special Education

The first push for special education started when a group of parent-organized advocacy groups surfaced. In 1947 one of the first organizations, the American Association on Mental Deficiency, held its first convention. The parent advocacy groups dating back to 1947 laid the ground floor for government legislation being approved by Congress in 1975 that was called the education for All Handicapped Children Act (Public Law 94-142). This act went into effect in October of 1977 and it was the beginning for federal funding of special education in schools nationwide. The act required public schools to offer "free appropriate public education" to students with a wide range of disabilities.

The law from 1977 was extended in 1983 to offer parent training and information centers. Later in 1986 the government started programs targeting youngsters with potential learning disabilities. The Act from 1975 was changed to the "Individuals with Disabilities Education Act" (IDEA) in 1990.

Children with special education needs are guaranteed rights to services in schools under federal and state laws. These laws include Americans with Disabilities Act (ADA), Section 504 of the Vocational Rehabilitation Act, Individuals with Disabilities Education Improvement Act (IDEA 2004), Individuals with Disabilities Education Act of 1997 (IDEA 1997), and No Child Left Behind (NCLB). These laws guarantee special education programs and financial assistance for disabled children and youth in the United States.

Special education refers to unconventional education services designed to cater to the needs of individuals suffering from physical and mental drawbacks such as physical handicaps, sensory of visual and hearing impairments, intellectual capacity like mental retardation and autism, learning disabilities reading and writing skills, speech impairment and those with behavior disorders. Special education seeks to address problems of the individual, as well as provide effective solutions through a set of formulated instructions, service aids and supports, learning techniques and transitions services.

The goal of special education is to address the needs of these special individuals for children, youth or adults and ensure that they gain equal access to quality education regardless of their condition. In effect, it encourages them to keep up with the challenges of normal education and help improve their chances for success in life.

The most important focus of this type of special education is to provide support and learning techniques to the individual. Children are properly educated in the most learning-conducive environment to help them discover their in-depth skills and abilities hidden behind the disabilities they might have.

But not everyone can employ this educational service. As such, before the person can avail of it, different levels of evaluations must take place. The processes can vary, though the primary stages include referral, parental consent, child evaluation and review and recommendation of appropriate institutionalized methods.

Now a day society there are more than 6 million children and youth estimated to be suffering from disabilities, and the demand for special education has grown by leaps and bounds. By properly dealing with the issues and problems concerned and finding solutions, special education can give them the chance to stand up and be on equal footing with their peers, drawing out their true potentials as key movers and prime contributors to society regardless of their physical and mental difficulties.

Online Special Education Courses

Online special education courses work primarily through a set of modules provided by facilitators to educators. Each of the modules highlights categories and sections designed for certain teaching goals or objectives such as: to properly introduce and acquaint the teachers to the nature of special education and their future students, to orient and prepare them to the kind of environment they will be working in, introduction to specialized theories and research; systematic teaching strategies and identifying needs, methods and applications for successful student-teacher learning and more.

Teaching methods and applications can vary depending on the school that you have chosen. There are those that give emphasis on service and assistance, improved effectiveness in handling special students, training performance and application, among others. While there are also those that focus on foundations and methodologies for higher learning, proper management of students, supervised student teaching and individualized teaching methods.

Nowadays, the need for special education is given priority attention, as it should. This is because the number of students who need to undergo special education is growing. And early identification and intervention is the first step in helping these students learn to rise above their situations and succeed in life.

It is a must for special education teachers to hold degrees to prove their competency, depth of training and exposure in the field. Although, because of the need, some are teaching with emergency certificates to immediately deal with the needs and requirements of these special kids. To address this issue, popular international schools have made special education courses available online to interested individuals regardless of where they maybe living. Thus, in effect, it speeds up the process of acquiring degrees and training certificates for those who want to teach children with special needs.

Special Education Teach

Special education can be defined as specially configured instructions and other education-related services to meet the educational, social, emotional, and vocational needs of students with disabilities. Special education teachers educate students who have various types of disabilities, including speech or language impairments, mental retardation, emotional distress, hearing impairments, orthopedic impairments, multiple disabilities, specific learning disabilities, visual impairments, autism, combined blindness and deafness, traumatic brain injury, and other health impairments. A special educator has to work with students of all ages from infants and toddlers, students in elementary, middle, and high schools, as well as youths. The special educator's job also involves working with a team of professionals, i.e., doctors, speech pathologists, social workers, orthopedists, psychiatrists, counselors, etc. The teaching methods and techniques in special education would vary based on the disability and it would also vary from individual to individual.

The teaching methods include individual instructions, problem-solving techniques, group work, and special assignments depending upon the needs of the individual. They can also develop individual educational programs for each student to help with the child's activities of daily living. As technology plays an important role in special education, a teacher is expected to instruct the students and their parents on the latest instrumentations and its usage in disability, as the case maybe. For instance, interactive software and computers that talk are now available in the market, which would be of great help for students with speech impairments. It requires a lot of enthusiasm, optimism, patience, tolerance, and perseverance for one to be a special education teacher as the job involves a lot of interaction with students of all age groups and with other people.

In the United States, all states demand special education teachers to be licensed. The special education teacher has to complete of a teacher's training program and must have a Bachelor's degree or a Master's degree. As they deal with students with mild to profound disabilities, their job demands specialization in either one or other areas of disability, which would enable the teachers to develop their own curriculum materials and teaching techniques to meet the needs of the student.

Special Education Inclusion

Special education inclusion signifies the participation of special education students in regular education classrooms and provision of support services to these students. The main objective of inclusion education is that all students in a school, regardless of their strengths and their weaknesses in any area, become part of the school community. Every student develops a feeling of belonging with other students, teachers, and support staff. In segregated special education, children will not learn how to function in a non-disabled world.

Section 504 and the ADA

Selection 504 of the Rehabilitation Act of1973 and the Americans with Disabilities Act (ADA) of 1990 are major federal legislative acts that are designed to protect the civil rights of individuals with disabilities. The intent of these two laws is to prevent any form of discrimination against individuals with disabilities who are otherwise qualified. Section 504 applies to entities that receive federal funds, and the ADA applies to virtually every entity except churches and private clubs.

Section 504 and the ADA are beginning to have a major impact on public schools across the United States. Originally, Section 504, which was part of the broader 1973 Rehabilitation Act, was rarely addressed by school personnel to ensure equal educational opportunities. Public Law 94-142, the Education for All Handicapped Children Act, passed in 1975, was the federal legislation that initially resulted in major changes in the way schools served children with disabilities. This law, now called the Individuals with Disabilities Education Act (IDEA), was accompanied by federal funds, was the focal point of schools in serving children with disabilities, and Section 504 and the ADA, which provided no funding, were often considered less important for schools.

Recently, the role played by Section 504 and the ADA in schools has increased substantially; no longer are schools able to ignore these two acts. As parents and other advocates for children with disabilities learn more about Section 504 and the ADA, schools are needing to respond to requests for protections and services under these laws. There are several reasons Section 504 and the ADA have become more prominent in public schools, but the primary reason is that Section 504 and the ADA use a different definition of disability and a different approach to eligibility than does the IDEA, resulting in many children who are not eligible under IDEA being protected by Section 504 and the ADA.

Regardless of the specific reason for the increase in attention to Section 504 and the ADA, more and more parents are beginning to request services and protections under these two acts. As a result, schools must learn the legal requirements of these acts and specific actions and services that are required.

Individuals covered under section 504 and the ADA

Because the definition of disability drives eligibility for protections and services under Section 504 and the ADA, it is the basis for determining who receives services and protections. Because the definition used in these two laws differs significantly from the definition used in the IDEA, different individuals are covered than would be eligible for special education services under the IDEA. Martin suggested that the following types of disabilities are likely covered under Section 504 and the ADA but not under the IDEA:

Students with attention-deficit disorder or ADHD,

Students with learning disabilities who do not manifest a significant discrepancy between intellectual ability and achievement,

Students who are transitioned out of special education programs,

Students who are considered to be socially maladjusted,

Special Education

The first push for special education started when a group of parent-organized advocacy groups surfaced. In 1947 one of the first organizations, the American Association on Mental Deficiency, held its first convention. The parent advocacy groups dating back to 1947 laid the ground floor for government legislation being approved by Congress in 1975 that was called the education for All Handicapped Children Act (Public Law 94-142). This act went into effect in October of 1977 and it was the beginning for federal funding of special education in schools nationwide. The act required public schools to offer "free appropriate public education" to students with a wide range of disabilities.

The law from 1977 was extended in 1983 to offer parent training and information centers. Later in 1986 the government started programs targeting youngsters with potential learning disabilities. The Act from 1975 was changed to the "Individuals with Disabilities Education Act" (IDEA) in 1990.

Children with special education needs are guaranteed rights to services in schools under federal and state laws. These laws include Americans with Disabilities Act (ADA), Section 504 of the Vocational Rehabilitation Act, Individuals with Disabilities Education Improvement Act (IDEA 2004), Individuals with Disabilities Education Act of 1997 (IDEA 1997), and No Child Left Behind (NCLB). These laws guarantee special education programs and financial assistance for disabled children and youth in the United States.

Special education refers to unconventional education services designed to cater to the needs of individuals suffering from physical and mental drawbacks such as physical handicaps, sensory of visual and hearing impairments, intellectual capacity like mental retardation and autism, learning disabilities reading and writing skills, speech impairment and those with behavior disorders. Special education seeks to address problems of the individual, as well as provide effective solutions through a set of formulated instructions, service aids and supports, learning techniques and transitions services.

The goal of special education is to address the needs of these special individuals for children, youth or adults and ensure that they gain equal access to quality education regardless of their condition. In effect, it encourages them to keep up with the challenges of normal education and help improve their chances for success in life.

The most important focus of this type of special education is to provide support and learning techniques to the individual. Children are properly educated in the most learning-conducive environment to help them discover their in-depth skills and abilities hidden behind the disabilities they might have.

But not everyone can employ this educational service. As such, before the person can avail of it, different levels of evaluations must take place. The processes can vary, though the primary stages include referral, parental consent, child evaluation and review and recommendation of appropriate institutionalized methods.

Now a day society there are more than 6 million children and youth estimated to be suffering from disabilities, and the demand for special education has grown by leaps and bounds. By properly dealing with the issues and problems concerned and finding solutions, special education can give them the chance to stand up and be on equal footing with their peers, drawing out their true potentials as key movers and prime contributors to society regardless of their physical and mental difficulties.