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Hey everyone, welcome back to our channel.The go to place for information and strategies on learning disabilities, especially ADHD.(Start slides) In this video series, we’re going to sharesome of the potential treatments specialists can recommend for your child’s ADHD.That way you know what to expect and how to go about treating ADHD.Specifically, we’re going to cover exactly how official and authoritative resources thathave actually proven their legitimacy, like: * the Mayo Clinic* The National Institute of Mental Health or (NIMH)* The Child Mind Institute * Children and Adults with Attention-Deficit/HyperactivityDisorder (CHADD) * WebMD* and the American Psychiatric Associationrecommend ADHD treatments for Children and Adults.---These are the exact same resources, Dan Kramarsky,a school administrator for over 30 years and the lead instructor for our upcoming courseon: how to help parents handle the transition to middle school, for their kids with ADHD.has used to treat his own ADHD, AND that of his daughter, who is now a successful universitystudent.We know most parents would be happy knowing their kids will make it through high-schoolsafely, so take Dan as an example case study and listen closely.--- This series will cover 4 standard treatmentsfor ADHD in children including:* Medications: like stimulants, other medications, and how to give medications safely* Behavior therapy: like social skills training and parent skills training* Counseling: like psychotherapy, family therapy, and lifestyle / home remedies* and Education Services: like school programs, individualized education programs (IEPs),and 504 plans---You and your provider should jointly develop a “treatment plan” that prioritizes andaddresses each problem area for your child.These areas can include: * school challenges* Self-esteem * anger management issues* co-occurring disorders such as depression or anxiety* any learning concerns * and peer and family relationships--- Now, a more comprehensive treatment plan,that really covers all your bases would include all or some of the following, based on theunique needs of your child:* Learning more about ADHD as a disorder and its causes* Learning more about diagnosing ADHD and the potential options for treatment (hopefullywe’ve got you covered there) * Setting up behavioral therapy for your childto help manage his/her behaviors and also to acquire new skills for handling them autonomously* Understanding the differences between ADHD medications and prescriptions and how to setup regular monitoring after trying a new medication * Getting mental health counseling for you,your child, or the whole family to address things like: relationships, self-esteem, discipline,and other parenting concerns * Setting up educational program modificationsand supports, including 504 Plans, tutoring and special education programs* And finally, whether you should consider taking parent training classes or programsfrom an ADHD coach to address your child’s behavior both at school and at home.An ADHD coach can also potentially help with marriage counseling, since we know that, statistically,parents of kids with ADHD are twice as likely to get a divorce than other parents of neurotypicalkids--- If you would want to set up a comprehensiveplan like that, sign up for our upcoming course taught by Dan and other ADHD experts like,psychiatrists, school psychologists, occupational therapists, physical therapists, and ADHDcoaches.It’ll help you: * set up and execute your child’s personalizedtreatment plan * better your relationships both at schooland at home * and handle the entire process of transitioningto middle school.Check out the link to the course in the description below.--- So, treating ADHD often requires medical,educational, behavioral, and psychological intervention.This comprehensive approach to treatment is sometimes called “multimodal” becauseit incorporates so many different modes of treatment.HOWEVER, although these treatments can relieve many of the symptoms of ADHD and even improvephysical coordination, they do not cure it.While there is no cure for ADHD, currently available treatments, can help reduce symptomsand improve functioning.Know that it may take some time to determine what works best for your child.--- Also, as both a medical and health disclaimer,I am not a doctor and this video does not provide medical or health advice.It is intended for informational purposes only.It is not a substitute for professional medical advice, diagnosis, or treatment.Never ignore professional medical advice in seeking treatment because of something youhave heard on this YouTube channel or from Smart Course as a whole.If you think you may have a medical emergency, immediately call your doctor or dial 911.ADHD patients’ symptoms vary significantly so it is extremely important to speak withyour physician or medical professional in order to come up with a tailored approachthat works specifically for you and your child.That being said and all things being clear, let’s go over some of the best informationout there.---First, you’re probably watching this video because you’re wondering, “What is themost effective ADHD treatment?”Well, based on both The Child Mind Institute’s and the American Psychiatric Association,research shows that a combined approach of medication AND behavioral therapy is the mosteffective treatment.For moderate to severe cases of ADHD the first line of treatment is usually medication.More specifically ADHD medications called “psychostimulants”, which increase theamount of certain chemicals in the brain, help children focus, and curb impulsivityand hyperactivity.Behavioral therapies, on the other hand, help kids rein in impulsive behavior and be betterorganized.In general, more than one intervention is needed.By working closely with your health care providers and school personnel, you will be able tofind the treatment options that are most suited to the unique needs of your child and family.Close cooperation among therapists, doctors, teachers, and parents is therefore very important.--- In today’s video, we’re just going tocover medications, specifically, stimulant medications.1I know what you’re thinking, isn’t it unusual to treat ADHD “the hyperactive disorder”1with a medication that is considered a stimulant, aren’t people with ADHD stimulated enough???1Well, not really, stimulants work because they appear to boost and balance levels of1neurotransmitters (which are basically brain chemicals)1mainly dopamine (which you’ve probably heard of as the "craving neurochemical" that stimulates1the pleasure and reward center in our brains.1It’s the same brain chemical tech companies try to stimulate when sending you a red push1notification).1and norepinephrine, which very simply explained, makes our body work as efficiently as possible.1To remember you can think of norepinephrine as the chemical released in your brain during1a “fight or flight” response because it causes several changes in our body function1including an increase in the amount of oxygen going to our brains - which helps us think1clearer and faster.1Something very useful for people with ADHD.1Both neurotransmitters play essential roles in thinking and attention.1--- Currently, stimulant drugs or “psychostimulants”1are the most commonly prescribed medications for ADHD.1These medications help improve the signs and symptoms of inattention and hyperactivity1— sometimes effectively in a short period of time.1According to the Child Mind Institute, studies show there’s an over 80% chance that a child1with ADHD will respond to stimulant medication with a significant reduction in symptoms.1--- There are two main classes of stimulant medications,1both are hard to pronounce:1Methylphenidate-based medications, (a mouthful, I know) which include:1Ritalin, Methylin, Concerta, Metadate, Focalin and the Daytrana Patch which is a long-acting1patch that can be worn on the hip.1and Dextroamphetamine-based medications like: Adderall, Vyvanse, Dexedrine, Mydayis1Of the children who respond to stimulants, half will respond equally well to both groups1of medications, and the other half will respond better to one or the other, so it may make1sense to try one medication from each group.1--- Also, stimulant drugs are available in both1short-acting and long-acting forms.1There are many different release formulas for stimulant medications, which make them1effective for different periods of time.1Immediate-release formulas (or short-acting stimulant drugs): are effective for about14 hours Extended-release formulas (or long-acting1stimulant drugs): last as long as 14 hours.1Within the extended-release group, medications vary in the doses they deliver morning and1afternoon.1Some deliver 50 percent in the first half of the day and 50 percent in the second; others1deliver just 30 percent in the first half and 70 percent in the second.1--- Finding the right dose1Since different children metabolize medication in different ways, the goal is to find the1formula that delivers an effective dose over a desirable period of time for your child.1Getting the right dosage for a particular child takes several weeks of trial.1The clinician normally increases the dosage gradually until it becomes effective.1If your child experiences undesirable side effects, it may mean that the dosage is too1high, or the medication isn’t right for her.1It’s important to note that some children respond differently to the two different stimulants1used in these medications—methylphenidate and dextroamphetamine.1Changing from one to the other, or even to a different release formula of the same basic1medicine, can help reduce or eliminate side effects.1Once an effective dosage is established, your child should be monitored periodically to1make sure it’s still meeting her needs as she grows.1---1Stimulant medications and certain health risks You should always ask your doctor about possible1side effects of stimulants.1Some research indicates that using ADHD stimulant medications with certain heart problems may1be a concern, and the risk of certain psychiatric symptoms may be increased when using stimulant1medications.1Heart problems Stimulant medication may cause an increased1blood pressure or heart rate, but the increased risk of serious adverse effects or sudden1death is still unproved.1However, the doctor should evaluate your child for any heart condition or family history1of heart disease before prescribing a stimulant medication and monitor your child during stimulant1use.1Psychiatric problems.1Stimulant medications may rarely increase the risk for agitation, psychotic or manic1symptoms.1If your child has sudden new or worsening behavior or sees or hears things that aren't1real while taking stimulant medication, contact the doctor immediately.1--- Some kids experience other adverse but less1severe side effects like:1Sleep issues If medication is interfering with a child’s1sleep, it’s because the medication is still active at bedtime.1If he’s taking a short-acting formula, it may mean that he is taking a second or third1dose too late in the day.1If he’s taking medication that lasts 12 or 14 hours, it may help to try one that’s1not quite as long-acting.1Sleep issues caused by the medication tend to get better over time, so it’s worth giving1kids four to six weeks to see if they adjust.1Trouble going to sleep may also be caused by kids being too stimulated at bedtime.1--- Eating issues1Extended-release medicines, which peak about four hours after they’re taken, cause some1children to lose their appetite at lunchtime.1Some kids can compensate for this by eating a good breakfast before the medication kicks1in, and eating well at the end of the day when the medicine is wearing off, at dinner1and again before bedtime.1Another option is to switch to the immediate-release tablets, which will wear off by lunch.1--- Growth issues1Some kids, particularly boys, grow more slowly when they’re taking stimulant medication,1especially in the first year.1But studies show that by the second and third year they catch up.1Also, kids who take weekend breaks and summer vacations from the medication don’t show1the slow-down in growth.1--- Nausea and headaches1These problems tend to dissipate within a few weeks of beginning medication, and can1be minimized by taking the medication with food, and in some cases by changing the dosage1or schedule.1--- Rebound2In some cases, after the medication wears off a child becomes irritable and aggressive.2The Child Mind Institute calls this “rebound” and it means the medication is leaving the2body too quickly.2One way to avoid rebound, if it’s a problem, is by adding a smaller dose a half hour before2it usually happens, to ease off the medication more gradually.2Sometimes, rebound can be a sign that the clinician hasn’t got the right dose yet,2or that a different medicine should be tried.2Lastly, when a child rebounds, it’s important to consider whether there might be something2else going on, like an underlying anxiety or mood issue that comes into play when she2comes off her ADHD medicine.2--- Tics2Some children who take stimulant medication develop tics.2When that happens, the first thing your doctor might want to do is try a different stimulant,2to see if another medication will work without the tics.2If that doesn’t work, the doctor may try a non-stimulant medication, which affects2the brain in a different way.2We’ll cover those later in this video.2--- Mood changes2When a stimulant dose is too high for a child he may begin to look sedated or zombie-like,2or tearful and irritable.2If this happens the dose needs to be reduced.2But there is also a small subset of kids with ADHD who seem to get moody and sad or irritable2when they take stimulant medications, even at the best possible dose.2It usually happens right away, as soon as they start taking the medication, and goes2away immediately when they stop taking it.2If this happens, your doctor can try switching to a different stimulant, or a non-stimulant2medication.2--- Other Non-Stimulant Medications2After hearing about all those side-effects, you’re probably wondering: “Are there2non-stimulant medications for ADHD?2The answer is yes.2Non-stimulant medications are useful for kids who:2* don’t respond to stimulant medications * can’t take stimulant medications because2of health problems * experience adverse side effects from them2* or sometimes in combination with a stimulant to increase effectiveness2--- There are 3 types of medications that aren’t2stimulants that can help alleviate symptoms of ADHD.21.2Atomoxetine (sold as Strattera) is in a class of drugs called norepinephrine reuptake inhibitors.2Like we talked about earlier, norepinephrine is a natural substance in the brain that is2needed to control behavior.22.2Antidepressants such as bupropion (sold as Wellbutrin SR, Wellbutrin XL, and others)2Although not approved by the U.S. Food and Drug Administration (or FDA) specifically2for the treatment of ADHD, some antidepressants are sometimes used alone or in combination2with a stimulant to treat ADHD.2Antidepressants may help all of the symptoms of ADHD and can be prescribed if a patient2has bothersome side effects from stimulants.2Antidepressants can be helpful in combination with stimulants if a patient also has another2condition, such as an anxiety disorder, depression, or another mood disorder.2Although you should know that both Atomoxetine and antidepressants work slower than stimulants2do and may take several weeks before they take full effect.23.2Clonidine (sold as Catapres or Nexicon) and guanfacine (sold as Tenex) are called alpha-adrenergic2agonists.2(I’m sure at this point you’ve realized these names are going to be hard to pronounce2and remember.)2Clonidine and Guanfacine were developed to lower high blood pressure, but at the doses2given to kids for ADHD they rarely affect blood pressure.2Both clonidine and guanfacine come in a 24-hour-release version (sold as Kapvay or Intuniv), and they2are sometimes used to treat tics.2Finally, as a potential supplement or diet change, omega fatty acids can also be helpful2for ADHD, though not as helpful as stimulants or these other medications.2I’ve linked to a Web MD article in the description below that explains the benefits and dangers2of Omega Fatty Acids: https://www.webmd.com/healthy-aging/omega-3-fatty-acids-fact-sheet#12--- Suicidal Risk2Now, although it remains unproved, concerns have been raised that there may be a slightly2increased risk of suicidal thinking in children and teenagers taking nonstimulant ADHD medication2or antidepressants.2Contact your child's doctor if you notice any signs of suicidal thinking or other signs2of depression.2--- Giving medications safely2It's very important to make sure your child takes the right amount of the prescribed medication.2Parents may be concerned about stimulants and the risk of abuse and addiction.2Stimulant medications are considered safe when your child takes the medication as prescribed2by the doctor.2Your child should see the doctor regularly to determine if the medication needs to be2adjusted.2A doctor needs to monitor the dosage of the stimulant medication closely, both to determine2the most effective level of drug and to watch for any side effects.2On the other hand, there's concern that other people might misuse or abuse stimulant medication2prescribed for children and teenagers with ADHD.2To keep your child's medications safe and to make sure your child is getting the right2dose at the right time:2* Give medications carefully.2Children and teens shouldn't be in charge of their own ADHD medication without proper2supervision.2* At home, keep medication locked in a childproof container.2And store medication away from the reach of children.2An overdose of stimulant drugs is serious and potentially fatal.2* Don't send supplies of medication to school with your child.2Deliver any medication yourself to the school nurse or health office.2--- Should children stop taking ADHD medication2during holidays and the summer?2Since children with ADHD don’t need to perform academically during the summer or on extended2holidays, parents sometimes seize the opportunity to take kids off their regular medication2regimen, especially if they are experiencing side effects.2Other parents avoid an interruption, fearing that their children’s behavioral problems2will rebound.2One reason to stay with treatment year-round is that ADHD doesn’t only affect a child’s3performance in school.3During the summer, children still have to get along with family and friends and function3effectively in group activities like sports and camp.3However, if you are concerned that taking a stimulant medication may be slowing your3child’s growth, a summer break can allow him to catch up.3And if you are concerned that he is underweight due to suppressed appetite, a summer without3medication can help him put on some pounds.3I’ve linked to another article in the description below, by the Child Mind Institute, that covers3more of the pros and cons of stopping medication during holidays and over the summer.3Otherwise known as “a drug holiday”.3https://childmind.org/article/adhd-pros-cons-drug-holiday/3--- Now, you know what to expect from specialists3in regards to ADHD treatment with ADHD medications, but remember that there are many other ways3of treating ADHD.3To make sure you’re as prepared as you can be I want you to hit the notification bell3below, because in the next video we’ll cover different behavioral therapies suggested by:3* the Mayo Clinic * The National Institute of Mental Health3or (NIMH) * The Child Mind Institute3* Children and Adults with Attention-Deficit/Hyperactivity Disorder (or CHADD)3* WebMD * and the American Psychiatric Association3Again, I am not a doctor so I will not give you any medical advice, but still, it helps3to hear what the experts suggest.3---3So, again, hit the notification bell and the subscribe button under this video if you want3to be notified when we publish that video.3In the meantime, while you wait for that video, I’ve got some special offers for you.3But first, if you liked this video please don’t forget to like it, and let us know3what you liked or what you’d like to see more of in the comments below.3The more people like, subscribe, click the bell, and comment, the more people will see3this kind of content on YouTube, and we know some people could really use the help.3---3Now, if you’re looking for extra help, I’d also really recommend joining our expert-vetted3newsletter.3It’ll be free until October 3rd, so don’t wait up.3Our resources will help you:3* find answers to your basic questions about ADHD3* understand why Middle School is so challenging for students with ADHD​3* and introduce you to ADHD support groups and other sites to help you meet your child’s3needs at school and at home.3Visit the links in the description and on your screen.3---3You can also join our own expert-moderated ADHD Education & Support Group for Parents,3where you can get direct help from other parents with shared experiences.3Now while you’re waiting for our next video, make sure to check out these two videos right3here *point left*:3We share tons of expert-vetted resources on parenting and education for differently-abled3kids, just like kids with ADHD, so make sure to check out these two videos as well.3As always, I appreciate you taking the time, thank you for watching and see you next week!

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