The Role of Executive Function

"Executive function" refers to the brain's ability to take in and organize information in ways that allow a person to accomplish goals - whether short or long term. A helpful analogy might be to think of executive function as performing the same tasks for the brain as a conductor does for an orchestra - organizing and guiding different instruments to play alone or together, loudly or softly - to accomplish the goal of playing a certain piece of music. Deficits in executive function may cause academic problems for students with ADD or ADHD.

"Although the impact of executive function deficits on school success is profound, this fact is often unrecognized by many parents and teachers. I learned the hard way with my own son that a high IQ score alone is not enough to make good grades."

In particular, poor working memory - one attribute of executive function - affects a student's ability to recall past events, prepare adequately for upcoming events, remember instructions, or memorize facts. Students with ADD or ADHD will greatly benefit from modified lessons that take executive function issues into consideration. Writing demonstrations, active learning techniques, and modified testing are just a few.

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ADHD Might be Temporary in Some

A team from the National Institute of Mental Health recently published the results of a study in which they found that the brains of some children with ADHD develop more slowly but eventually catch up with those of other children. The study seems to indicate that, while not true for everyone, some children will "outgrow" their ADHD.

"'Finding a normal pattern of… maturation, albeit delayed, in children with ADHD should be reassuring to families and could help to explain why many youth eventually seem to grow out of the disorder,' Philip Shaw of the National Institute of Mental Health, who led this most detailed study of the problem to date, said in a statement."

To this point, the debate among researchers focused on whether the brain of an ADHD child deviates from normal development or is simply delayed. This most recently study points strongly toward there being a delay in development, which may - over time - affect the way ADHD is treated and managed.

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Parents Medication Guide

The American Academy of Child and Adolescent Psychiatry, in partnership with the American Psychiatric Association, has published the ADHD Parents Medication Guide intended to help parents navigate the sometimes confusing waters surrounding ADHD treatment.

"As a parent or guardian of a child or teenager diagnosed with ADHD, you may be aware of the debate surrounding the medication used to treat this condition. Recently, the U.S. Food and Drug Administration (FDA) reviewed several research studies involving children and adolescents who were prescribed medication for ADHD and concluded that these medications are effective and that the risks associated with these medications are known and can be managed."

Some of the topics covered in the guide include "side effects & ADHD medication", "school & the child with ADHD" and even "unproven treatments".

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I'm Not Anti-Ritalin, I'm Pro-ADD

Ben Goldfard didn't know growing up that he had ADD. He knew that staying focused was a struggle and that his mind often jumped from one topic to another, but it wasn't until he was a husband and father that he was actually diagnosed. He offers his tongue-in-cheek opinion of the benefits of not using medication to "control" his ADD.

"With some mentoring, mind-mapping, and push-ups, I have turned my ADD into effective multi-tasking. I can't speak for everyone, because it would take too long, but for me, Ritalin would have been a chemical straight jacket. It would have closed the window of opportunity to attain above-average success..."

Though he's not suggesting that people with ADD throw away their medication, Goldfard is challenging people to view ADD and ADHD not as disabilities, but as blessings.

Miscommunication Complicates ADHD Treatment

A new study has found that differing perceptions between parents and doctors regarding an ADHD child's most concerning behaviors is complicating treatment.

"...parents of children with attention deficit hyperactivity disorder are concerned with behaviors such as aggression and defiance, while pediatric psychiatrists focus on associated mental health conditions including depression, bipolar and learning disabilities."

The differing opinions mean that behaviors parents are most concerned about often go unaddressed. Researchers hope the study will help doctors and parents find common ground to ensure that children with ADHD are receiving the best treatment possible.

Finding Balance with Doctors

Parents and pediatricians have the same goals; to keep children healthy, happy, and on a positive developmental path. But they sometimes have differing ideas of how to achieve those goals. As a parent, how do you get past the roadblock (or avoid it altogether) when a pediatrician's suggested treatment goes against your parental experience or instinct?

"The trick here [Dr. Delia Chiaramonte] says, is to stand firm, even when you know you're annoying the doctor. 'You have to let go of the desire to be the good patient and make everyone like you,' she says. She recommends questioning the doctor thoroughly."

Respect the pediatrician's years of study and practice, but make sure he or she respects your knowledge and experience as a parent as well. When it comes to your child's care, ask all the questions you need to, don't be afraid to questions a diagnosis if a treatment isn't working, and exercise your right to get a second (even a third and fourth) opinion.

Including Dads

When University at Buffalo student Greg Fabiano started working with parents of children with ADHD, he noticed that many of the dads were missing. He tried to find some research that would explain why so many fathers were absent, but he found none - so he started conducting some research of his own.

"His new research program, designed for children 6-12 years of age, includes two formats: a control group of fathers and children who receive traditional, evidence-based treatments for ADHD families and another group that receives the same, plus a sports element - in this case, soccer games."

Fabiano says the results have been remarkable. Treatment drop-out rates for both fathers and children have decreased significantly and there's very little tension on the soccer field (which is unusual for kids with ADHD).

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The Pocket Parent Coach

Nationally-noted parent coach Tina Feigal, M.S., Ed., wanted to offer parents something more than theoretical information about parenting kids with ADHD. She wanted to offer something practical, so she put together a "pocket guide", with step-by-step instructions for improving the behavior of what she calls "intense" children.

"By learning specific methods for turning child behaviors around, parents gain new skills, new self-esteem and often-unimagined success. Feigal, founder of The Center for the Challenging Child, taps her experience as a school psychologist, a parent of three sons and a parent coach to bring a wealth of knowledge and intuition to her work."

The book is unique in that it enables parents to bring out the best in their kids, without having to rely on the "professionals" to do it for them.

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A Guide to Teaching ADHD Students

A child with ADHD spends as much time in the classroom as any other child, so his teacher's ability to interact well and teach effectively is vital. This article from David Blitz gives tips for teachers who have ADHD students.

"The first step in being successful in teaching an ADHD student is being able to develop with him/her a good rapport and a positive relationship. Like with any other student, the ADHD student is more likely to respond to you positively and you are more likely to be able to help them reach their true academic potential if your interaction with them is in a positive and non-judgmental manner."

Other tips include using positive reinforcement, creating a good learning environment, and breaking down lessons into smaller segments that are easier for an ADHD child to understand.

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Portsmouth School Board Considers ADHD Memo

In September, the School Board of Portsmouth, Virginia issued a memo warning parents of the "dangers" of ADHD medication. The memo went on to say that parents who accept their children have ADHD are admitting that their children are mentally ill.

"The School Board will consider sending parents new information about attention deficit hyperactivity disorder that would be drastically different from... [the] controversial memo it issued in September."

The new memo comes in the wake of a litany of comments from national ADHD organizations calling for the School Board to address the medical facts of ADHD in children and adolescents.

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Sensory Issues Sometimes Misdiagnosed

Children who have sensory issues often seek out more and more stimulation. They won't sit still in class, they're disruptive, talk loudly and chew non-food items.

"The behavior gets many kids mislabeled as having ADHD, Attention-Deficit Hyperactivity Disorder, Yoder says. But instead, they are having difficulty regulating the information taken in through their senses. The nervous system either overreacts or underreacts to what's going on around them. At either extreme - craving stimulation or avoiding it - the problem can be a sensory processing disorder that disrupts a child's daily life."

Extremes include craving loud music or other loud noises, a child who's nearly oblivious to his surroundings, or one who's such a picky eater that he gags when he smells food he doesn't like. A child who's displaying these types of behaviors should be evaluated by someone who's qualified to make distinction between ADHD and sensory issues.

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Diagnosing and Treating ADHD

Diagnosing ADHD isn't something that a parent or teacher can do by themselves. It takes a team of people to properly evaluate a child's behavior and form a proper diagnosis. Some of the more common characteristics of ADHD are occasionally observed in kids who don't have ADHD, so establishing a patter is important.

"One thing that I have found is that there is a huge division about whether to use medication to treat the disorder (after it has been properly diagnosed) or not. People are completely against or completely for the medication...So speaking as a parent of a hyperactive child, I believe you need to keep an open mind, do lots of research and ask LOTS of questions."

Remember that if you make a decision that doesn't seem to work for your child, you can change your decision. You're not "locked in" for life. If your child is diagnosed with ADHD, remember that physical activities can help your child manage the "hyperactive" part of the disorder.

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