Wednesday, April 27, 2011

Why Do Executive Function Deficits Matter?

Chris Zeigler Dendy is this week’s guest blogger.

Executive function is a term parents and professionals have been hearing more and more often in recent years. If you’re wondering why executive functions are so important, you don’t want to miss my keynote address at the CHADD regional conference in Long Island on May 14. My presentation entitled Executive Function: Why Does It Matter? will explain what a profound impact these functions have on school performance and everyday life.

I first heard of executive function deficits in a presentation by Russell Barkley some fifteen years ago. I was stunned; everything he said described our son to a “T.” Ultimately I realized, that the deficits in executive functions were the primary reasons for our son’s school struggles, even more so that the ADHD symptoms themselves. Barkley had just provided the missing piece of the puzzle for me—the reason why our gifted son was failing four of six classes as a freshman in high school.

You probably don’t realize it, but you already know what executive functions are, it’s just that you may never have heard the term before. If your child has trouble getting started and finishing work, memorizing facts such as multiplication tables, is often late, forgets books and assignments, loses things, is disorganized and has a messy room, backpack and locker, then you’ve been dealing unknowingly with deficits in executive functions for several years.

I do hope you’ll join us on May 14. Not only will I identify key executive function deficits, but I’ll also suggest specific strategies to address these deficits. After my presentation, I’ll be available to autograph the second edition of my brand new book, Teaching Teens with ADD, ADHD, and Executive Function Deficits.

I look forward to seeing you soon.

Chris Zeigler Dendy

Chris Zeigler Dendy, MS, is co-producer of a new DVD, Real Life ADHD! featuring thirty teens who are affected by ADHD.

Wednesday, April 20, 2011

I Love a Good Conference!

Ari Tuckman is this week's guest blogger.

I love my family and I love my job, but I really love getting away from everything for a good conference. So I'm really excited about the upcoming CHADD regional conference on May 14th on Long Island.

I love to hear what other experts in the field are saying about ADHD. I love to run into old friends (my wife calls them my "CHADD buddies"). And I love meeting new people (future CHADD buddies).

I also love presenting, and I am really looking forward to doing the Lunch and Learn at this year's conference. I will be talking about the important but often overlooked topic of acceptance. I am a firm believer in the value of good strategies to help people perform better in their lives so they can feel better about themselves and take on greater challenges. But what do you do when certain struggles remain? Hopefully you have made at least some progress, but perfection is hard to come by.

I will talk about how to feel good about yourself or others by letting go of unfulfilled expectations. This isn't giving up—it's making a conscious and intentional choice to move on. My guiding philosophy is "change what you can, accept the rest." The other presenters will talk about ways to change things in your life. I will talk about how to feel happy even when some things don't change. When you put the two together, life is much better.

Ari Tuckman

A clinical psychologist based in West Chester, Pennsylvania, Ari Tuckman, PsyD, MBA, is the author of More Attention, Less Deficit: Success Strategies for Adults with ADHD and Integrative Treatment for Adult ADHD.

Thursday, April 14, 2011

Take a Chance on Tomorrow

Steven Peer is today’s guest blogger.

If you had a chance to make each tomorrow better, simpler, and more understandable for you and the ones most important in your life, would you take it?

Whether you are a psychologist, mental health professional, parent, caregiver, or educator, embrace this opportunity on May 14, 2011 to make such a difference at the CHADD regional conference in Long Island, New York.

Attendees will choose from 22 breakout sessions and a keynote by Chris Zeigler Dendy, MS. And they will hear from top experts on current topics of executive function, alternative treatments, ADHD and co-occurring disorders in the classroom, practical answers for home, school, and workplace, and more.

Here are some comments from attendees at one of CHADD's past regional conferences:

"The different presenters were extremely diverse and were experienced. It was a pleasure to have them and listen to these experiences."
- Parent, 2009 Regional Conference

"... can apply many of these strategies/suggestions in my classroom."
- Educator, 2009 Regional Conference

There are many ways to learn. I prefer face-to-face conferences best. Here are a few of my reasons why.

1. Ask anyone who's attended a conference. The joy, the fun, and the connecting at a conference come from what happens before, during, and after sessions.

2. Teleconference attendees learn only what is directed at them. There's no overhearing of questions and comments; there's no body language; no inference; no bumping into world-class presenters in the hallway. There's nothing like face-to-face, live learning.

3. Checking-OUT of your routine and INTO a conference changes everything. No crying, barking, or other distractions. Many folks with ADHD learn best in this immersion-style setting.

4. Ask the presenters at a teleconference what they prefer—it's as awkward for them as it is for you.

5. What no teleconference operator can claim is CHADD's 23-year history of local and international, life-changing events. You owe it to yourself to find out for yourself.

Learn more about this exciting event and join me on Long Island on May 14th.

Steven Peer

P.S. If you belong to any national professional organizations (NASSP, COPAA, APA, NAPO, etc.) please spread the word about this conference on their member listservs, message boards, or forums.

Steven Peer is the president of CHADD.

Wednesday, April 13, 2011

Shortages of ADHD Medications

Timothy MacGeorge, MDiv, MSW, is this week’s guest blogger.

Are you experiencing difficulty in getting prescriptions filled for ADHD medications such as Adderall, Metadate, or their generic forms?

Earlier this week, the U.S. Food and Drug Administration (FDA) added two major ADHD medications to its list of Current Drug Shortages. These shortages, which are apparently not widespread and seem to be sporadic throughout the country, are due to shortages in the “active pharmaceutical ingredient” (API) used to make brand medications such as Adderall XR, generically an Amphetamine Mixed Salt, and Metadate, a brand version of the generic Methylphenidate. It is expected that these shortages, which are the result of quotas imposed by the U.S. Drug Enforcement Administration (DEA) on the manufacturers, should be resolved within the next six to eight weeks.

What to do? If you experience difficulty in filling an ADHD prescription due to this shortage, here’s what you can do:
• Ask your pharmacist if the medication is available from another location, especially if you use a large chain pharmacy.
• Contact the manufacturer to help locate a pharmacy that has your medication in stock (see the customer service numbers below).
• Contact the doctor who prescribed the medication to see if he/she has any samples you can use.
• Ask your pharmacist about the availability of other medications used to treat ADHD.
• As a last resort, discuss with your prescribing physician whether or not any of these available medications might be appropriate for you or your child.

Finally, if you’ve exhausted all avenues and still can’t get a prescription filled due to a medication shortage:
1. Tell the FDA: Send an email to or call 888-INFOFDA or 888-463-6332.
2. Tell CHADD: 800-233-4050.

Not sure which company makes your medication? Check the prescription label or ask your pharmacist.

Pharmaceutical companies that produce Amphetamine Mixed Salts ER Capsules:
• Shire Customer Service Number: 800-828-2088 (select “Option 5” for assistance in locating a pharmacy in your area with product availability)
• Teva Customer Service: 888-838-2872
• Global Customer Service: 215-558-4300

Pharmaceutical companies that produce Methylphenidate HCL:
• UCB Customer Service: 800-477-7877
• Covidien Customer Service: 800-325-8888
• Sandoz Customer Service: 609-627-8500
• Watson Customer Service: 973-355-8300

Timothy MacGeorge, MDiv, MSW, is the director of the National Resource Center on ADHD: A Program of CHADD that is funded by the Centers for Disease Control and Prevention (CDC).

Wednesday, April 6, 2011

What Do I Do When Nothing Is Working?

This week's guest blog is by Marie S. Paxson.

If you have a family member with ADHD and you are looking to cut through the clutter of information and advice, then One Day, One Location, Many Solutions to ADHD and Co-Occurring Conditions, a conference sponsored by CHADD, is the place to go! By the end of the day, you will have a clear understanding of ADHD. And, more importantly, you will have strategies to manage it.

I will be presenting a program entitled What Do I Do When Nothing is Working? When Someone You Care About Is Struggling with Risky Behaviors. I would love to tell you that I learned this information from a book, but I am probably a lot like you. As the parent of two children (now young adults) with ADHD and co-occurring conditions, I've been witness to some of the negative aspects of ADHD. I've been on the receiving end of some really upsetting phone calls. ADHD doesn't just affect academic performance, and the consequences of "ready, fire, aim" can be very serious.

This session will be more than just a recounting of my family's story (let's face it, we could all do that). It will include the valuable lessons I learned along the way. And time will be allotted for audience members to share their insights on how they are managing the troubling side of ADHD.

If this topic doesn't speak to you, the conference will offer a myriad of other ADHD-related presentations. The planning committee worked very hard to provide a wide selection of topics to help you manage ADHD on a daily basis. I hope to see you in Long Island on May 14!

Marie Paxson,
Immediate Past President, CHADD

Friday, April 1, 2011

Artificial Food Dyes and ADHD

This week's news is all about food dyes and ADHD. For more than 30 years there has been concern about synthetic food dyes and ADHD (think Feingold diet) and a fair amount of research has been done to investigate this connection. The conclusion of the scientific community has been that artificial food dyes are not a major factor in ADHD. But a small subset of people diagnosed with ADHD who also have food hypersensitivities may see symptom improvement when the food dyes or the offending foods are eliminated.

Over the last several days, the US Food and Drug Administration convened a meeting to examine the scientific evidence on artificial food dyes and make recommendations in response to a petition from the Center for Science in the Public Interest, a food advocacy group opposed to the use of artificial food dyes in the food supply chain. One of the major questions before the FDA’s Food Advisory Committee was the effect of food dyes on all children, not just those with ADHD. This is the distinction many journalists missed in reporting on the meeting. I listened to the presentations by a number of scientists, including Dr. Gene Arnold (CHADD’s representative), and I want to share the discussion and conclusions of the FDA committee with our members.

The body of research to date, which has confusing and mixed results, suggests there may be a low-level, short-term effect on behavior for children in general. But both the severity and the chronicity of the symptoms of inattention, hyperactivity, and impulsivity needed for a diagnosis of ADHD are of a much higher magnitude than demonstrated in these studies. In addition, food dyes may lead to some mild increase in the level of symptoms for children who are diagnosed with ADHD.

An important change that led to this week's hearing was a study published in 2007 in the British journal The Lancet looking at the effect of two mixtures of food dyes on children who were NOT diagnosed with ADHD. The investigators, from the University of Southampton (UK), found a small increase in activity levels and inattention by parent report. The changes were short-term in nature and would not lead to a diagnosis of ADHD. When increases in hyperactivity are reported in the media, they are referring to the activity changes reported in this study and not the symptoms of ADHD.

The Southampton study did raise many questions about the safety of food dyes on all children. As a result the European Union made the policy decision to add a label to foods containing artificial food dyes, warning that this food "...may have an adverse effect on activity and attention in children." Although many food manufacturers in Britain and throughout Europe eliminated artificial food dyes rather than add the warning labels, the UK did not ban the use of these dyes, as some media have incorrectly reported.

At the end of the two-day meeting, the FDA’s Food Advisory Committee voted to take no action on our current use of food dyes. Concern was expressed that there are many unresolved questions about the studies done to date and many design concerns. For instance, the Southampton study included a preservative in both mixes in addition to the dyes, and this could account for the results. The behavior changes were only noticed by parents and not consistently picked up by teachers, clinicians, or performance scores on an objective test of attention. The Food Advisory Committee concluded, by a vote of 79% of its members, that the research to date is inadequate to conclude that food dyes have an adverse effect on children’s behavior.

Concern was also expressed about the public health impact of waiting for better-designed studies and a larger body of research. Given the finding in some studies that both attention and activity levels in children are affected by artificial food dyes, should the FDA be more proactive than the scientific evidence suggests? There was much discussion about warning labels or other methods to inform parents that there is some indication that artificial food dyes might have a mildly negative effect on attention and activity levels. But in the end, 57% of the committee members voted no action should be recommended because the scientific evidence is so muddled.

The FDA committee members were also asked to consider the prevailing guidance on food dyes and the impact on children diagnosed with ADHD. The committee voted no change by 93%, and were clear in the discussion that no new evidence had been presented that indicated any consistent connection between food dyes and ADHD. Current clinical guidance suggests that elimination of food dyes should not be considered a mainstream intervention, but should be considered if there is a history of food sensitivities or if parents notice a behavior change after ingesting certain foods.

And the FDA committee members agreed, by a vote of 93%, that more studies are needed to clarify these issues.

So what is the takeaway message for families coping with ADHD?

• A small number of kids who appear to be hypersensitive to foods and who are diagnosed with ADHD may respond well to a diet eliminating food dyes or other irritating foods.
• If your child's behavior or inattention gets worse after eating foods with artificial food dyes, then consider avoiding them. This will probably not make the symptoms of ADHD disappear, but it may reduce the severity.
• A healthy diet is important for all children, but especially for children with ADHD.
• If there does not seem to be an effect from eliminating foods with dyes and/or if avoiding food dyes is too expensive, too difficult, or creates too much tension in your relationship with your child, then this may not be a change that is important in your child’s overall treatment.
• About 80% of all ADHD appears to be related to genetics. It is inherited. Other things happening in the environment may make the symptoms worse (no treatment, family stress, poor diet) and other factors may help to reduce the symptoms (good parenting, multimodal treatment, healthy diet). Our job as parents is to provide the best treatment and supportive environment for our children that we reasonably can.
• If you are an adult with ADHD, there is no research available on the effect of food dyes in adults. Your best bet is to assume the effects may be similar, though we are not clear on what those effects are. How’s that for clarity!

CHADD’s job is to make sure you have the best information available so that you can make informed decisions about treatment and management of ADHD.

Ruth Hughes, PhD

If you would like more information on alternative treatments, the FDA hearing, artificial food dyes, or elimination diets, check out the following resources:

CHADD’s NRC What We Know #6: Complementary and Alternative Treatments for ADHD

Background Information on the FDA Hearing

Southampton Study

Food Dyes and ADHD

Elimination Diets