Attention Deficit Disorder, Learning Disabilities & Neuroscience "Perhaps somewhat oversimplified, a practical way to comprehend learning disabilities is to view it as very large differences that exist between a person's underlying learning strengths and weaknesses, so that the weaknesses may seem to constantly get in the way, and prevent the individual from demonstrating his/her strengths." This is so true!!!!! Attention Deficit Disorder NOS (not otherwise specified) is an apparent cause of many of the "cognitive problems" I shared on this site. Apparently the hashimoto's or hypothyroidism aggravated it, causing a worsening of the symptoms. However for the most part the symptoms have improved yet some areas remain and some of the ADD symptoms have always been an annoying problem especially socially. Cognitive functioning of ADHD and non-ADHD boys on the WISC-III and WRAML: An analysis within a memory model. This study examined differences in patterns of cognitive functioning, as assessed by the Wechsler Intelligence Scale for Children-Third Revision (WISC-III) and Wide Range Assessment of Memory and Learning (WRAML), in 20 boys with ADHD and 20 boys referred for other psychological problems. The two groups were comparable in age (6 to 13 years) and WISC-III Full-Scale IQ. The ADHD group showed significantly lower scores on the WISC-III Freedom from Distractibility Index and the WRAML General Memory Index, Learning Index, and Visual Memory Index. Patterns of index scores and subtest scores, interpreted with relation to Atkinson and Shiffrin's Store Model of Memory, indicated that ADHD children show special problems on tasks requiring attention and processing through initial stages of memory. However, once material gets beyond initial stages to the long-term store, ADHD children tend to retain and apply the information as well as other children. Types of Attention Vigilance and focussed attention. Attention comprises at least two related functions: the ability to focus limited attentional capacity upon some stimuli to the exclusion of others, called focussed attention, and the ability to be distracted by significant stimuli outside of focussed attention, called vigilance. During focussed attention, the brain continues to process all incoming stimuli; stimuli that activate a sufficiently large network of neurons capture attention. For example, when you are at a social gathering and you are attending to a conversation (focussed attention), you will probably be distracted if someone outside your group mentions your name. Maintaining an appropriate balance among many competing stimuli and response alternatives requires exquisite coordination among many regions of the brain, most importantly brain stem and basal forebrain arousal systems, thalamic relay and gating systems, and higher-order cortical association systems capable of determining stimulus significance. Metabolic disorders that partially compromise neuronal function are usually first manifested by disorders of attention. The converse is an important clinical rule: patients presenting with general disorders of attention (called delirium or confusional states should first be suspected of having a metabolic disorder such as drug intoxication, electrolyte imbalance, or a systemic infection. Such attentional disorders are usually entirely reversible with correction of the metabolic disorder. Spatial attention Attention has an important spatial component. The left and right hemispheres appear to have different attentional capacities. The left hemisphere is adept at focussing attention, particularly to the contralateral (right) hemispace. The right hemisphere, in contrast, is better at maintaining vigilance in both right and left hemispace. Right hemisphere lesions will therefore often result in a very abnormal distribution of attention, since the remaining intact left hemisphere will focus attention in right hemispace, and left hemispace will be neglected. Left hemisphere lesions, on the other hand, will produce much less of an attentional bias, since the right hemisphere can attend to stimuli in both halves of space. Patients with unilateral neglect from right hemisphere lesions may fail to respond to visual, auditory, or tactile stimuli in left hemispace, and they may direct gaze preferentially to the right. They may neglect to cancel lines (or letters) on the left side of the page, and this deficit will be greater if the page is placed in left hemispace. They may also bisect lines far to the right of midline. Intentional attention: the frontal lobes We become aware of stimuli that are able to activate strong neuronal networks by virtue of previous inborn or learned associations. Thus, our nervous system is wired to respond rapidly to moving stimuli in the periphery of the visual field, loud noises, or signs of aggression in others. We learn to respond selectively to other stimuli, such as the sound of our names. Brainstem, collicular, and parietal systems are important in mediating these "automatic" attentional responses. But we can also will ourselves ("intend") to attend to stimuli of less obvious salience, for example, to reading about brain mechanisms of attention. Frontal cortical networks contribute importantly to setting goals, and directing attention to stimuli that are goal-relevant. They help suppress responses to stimuli that are not relevant to the task. Executive functioning of children with ADHD on neuropsychological tests and real-world experiences "The performance of children with ADHD on neuropsychological testing and real-world activities was studied by a group of researchers (Lawrence et al., 2004) who reported their findings in the Journal of Attention Disorders (Vol. 7, No. 3). Neuropsychological testing conducted in laboratory settings provides information to help us better understand executive function deficits associated with ADHD. The performance of 22 unmedicated boys with ADHD matched on age and IQ with 22 normally developing control boys was compared on neuropsychological tests (the Stroop and the Wisconsin Card Sorting Task) and on two real-life measures (performance during videogame play and staying on a prescribed route while going through a zoo). While no group differences in executive function on the Stroop or zoo tasks were found, the ADHD group exhibited deficits in set-shifting as assessed by the WCST (perseverative errors and responses) and videogame play (fewer challenges completed). The ADHD group also showed slowed processing speed on the Stroop (slower color naming) and in the zoo activity (longer time to complete task), as well as a slower rate of acquisition of the sorting rule on the WCST (more trials to complete first category). Problems in goal-directed behavior at the zoo (number of deviations from designated route) were related to problems in set-shifting on the WCST (perseverative responding). The investigators concluded that children with ADHD exhibit impairments in executive function and processing speed in real-world activities as well as in neuropsychological testing. Cognitive deficits detected by standardized neuropsychological testing are related to performance difficulties in real-world activities." ADULTS SUFFER FROM LEARNING DIFFICULTIES, TOO. "Although learning disabilities and attention-related problems are not being diagnosed more effectively in children, many people don't realize that adults can suffer from these problems, too. In fact, for many adults, the diagnosis and treatment of learning issues was not readily available when they were in school. So it is likely that many people with learning and attentional issues passed through the education system undetected. Now they are facing adult responsibilities and demands with the same processing problems that may have limited them in school." Brain Basics: Know Your Brain "The Geography of Thought Each cerebral hemisphere can be divided into sections, or lobes, each of which specializes in different functions. To understand each lobe and its specialty we will take a tour of the cerebral hemispheres, starting with the two frontal lobes (3), which lie directly behind the forehead. When you plan a schedule, imagine the future, or use reasoned arguments, these two lobes do much of the work. One of the ways the frontal lobes seem to do these things is by acting as short-term storage sites, allowing one idea to be kept in mind while other ideas are considered. In the rearmost portion of each frontal lobe is a motor area (4), which helps control voluntary movement. A nearby place on the left frontal lobe called Broca’s area (5) allows thoughts to be transformed into words. When you enjoy a good meal—the taste, aroma, and texture of the food—two sections behind the frontal lobes called the parietal lobes (6) are at work. The forward parts of these lobes, just behind the motor areas, are the primary sensory areas (7). These areas receive information about temperature, taste, touch, and movement from the rest of the body. Reading and arithmetic are also functions in the repertoire of each parietal lobe. As you look at the words and pictures on this page, two areas at the back of the brain are at work. These lobes, called the occipital lobes (8), process images from the eyes and link that information with images stored in memory. Damage to the occipital lobes can cause blindness. The last lobes on our tour of the cerebral hemispheres are the temporal lobes (9), which lie in front of the visual areas and nest under the parietal and frontal lobes. Whether you appreciate symphonies or rock music, your brain responds through the activity of these lobes. At the top of each temporal lobe is an area responsible for receiving information from the ears. The underside of each temporal lobe plays a crucial role in forming and retrieving memories, including those associated with music. Other parts of this lobe seem to integrate memories and sensations of taste, sound, sight, and touch." Frontal lobe function "Anatomy and function: an overview The cortex of the frontal lobes is bounded posteriorly by the central sulcus and inferiorly by the Sylvian fissure and insular cortex. The primary motor cortex (Brodmann's area 4) premotor and supplementary motor cortex (area 6) and the frontal eye fields (area 8) are directly involved with motor programming. The cortex anterior to these motor cortices is called "pre-frontal" cortex. Pre-frontal cortex can be conceived as being at the top of a sensory hierarchy ascending from primary sensory to sensory association to high-order association cortex in parietal and temporal lobes, as well as being at the top of a motor hierarchy descending from pre-frontal to pre-motor to motor cortex. Pre-frontal cortex is in a position to influence processing at lower levels of this hierarchy. These anatomic relationships correspond to the role of prefrontal cortex in "executive" function. Frontal cortex is important for setting goals for the organism, and directing behavior to achieve these goals. In order to achieve long-range goals, it is sometimes necessary to inhibit lower-level "automatic" responses to stimuli, and it is sometimes necessary to initiate behavior that is not prompted by immediate contingencies. Patients with frontal lobe deficits may therefore fail to inhibit inappropriate responses to stimuli (they exhibit "stimulus-bound" behavior), and they may act only when prodded (akinesia). Regional specialization of function Prefrontal cortex comprises many anatomic regions with different cytoarchitecture and different connectivity, but we are only beginning to be able to specify specific functions for these regions. The dorsolateral frontal lobes appear to be associated with cognitive functions (setting goals, working memory), and lesions result in stimulus-bound behavior, difficulty shifting sets, and difficulty generating ideas. The prefrontal cortex on the medial aspect of the hemisphere surrounds the cingulate and supplementary motor regions, and appears to be important for the initiation of motor programs. Lesions in this area result in profound akinesia. The orbitofrontal cortex is intimately connected with limbic cortex in anterior temporal lobes, and appears to be critical for emotional and motivational associations. Patients with orbitofrontal lesions may demonstrate lack of inhibition of socially inappropriate emotional behavior, and have difficulty making decisions based upon emotional or motivational value. Tests of frontal lobe function Observation and careful questioning of persons who have observed the patient's behavior are critical, since many deficits are not assessable by bedside testing. Inappropriate social behavior, and poor decision-making may disrupt function at work and home long before the physician can find specific deficits, particularly in patients with orbitofrontal pathology. With more severe deficits, inappropriate jocularity ("Witzelsucht") and impaired social behavior may be observed. Akinesia and abulia may be prominent in patients with medial frontal lesions. Although this profoundly affects social and intellectual function, it may be confused with non-cooperation or depression. Bedside tests are helpful for dorsolateral and medial dysfunction. Stimulus-bound behavior, difficulty shifting set, and impairments of intentional attention can be assessed by contrasting programs, go-no-go, and antisaccade testing, respectively. Motor impersistence may be observed. Decreased generativity of ideas often results in profound deficits on word fluency testing in patients without other language deficits. Frontal lesions may also disinhibit certain primitive reflexes, including the suck, root, and grasp, so-called frontal release signs." Frontal lobe function neurological examination Objectives: Frontal lobe lesions may result in changes in behavior that can only be assessed in real-life situations. It is therefore crucial to ask the patient's close contacts about social and occupational behavior. Stimulus-bound behavior, difficulty shifting set, and impairments of intentional attention can be assessed by contrasting programs, go-no-go, and antisaccade testing, respectively. Motor impersistence may be observed. Decreased generativity of ideas can result in profound deficits on word fluency testing in patients without other language deficits. Frontal lesions may also disinhibit certain primitive reflexes, including the suck, root, and grasp, so-called frontal release signs. Test: Contrasting programs Instruct the patient: "Hold up one hand opposite mine. As soon as I raise one finger, you raise two fingers. When I put my finger down, you put yours down. Whenever I raise two fingers, you raise only one finger. Respond as quickly as possible, and put your finger down each time as soon as you have responded." Use a quasi-random pattern, such as 1,1,1,2,1,2,2,1,1,2 Record: "Normal" or "impaired" or, better, Number correct out of 10 trials. Interpretation Patients with frontal damage will usually understand the commands, but will nevertheless have a tendency to revert to mirroring the examiner's fingers. This tendency to copy movements is called echopraxia. Normals may make one or two errors, but will improve rapidly with practice. Test: Go/no-go After completing contrasting programs, instruct the patient: "Now I am going to change the rules. When I hold up one finger, you still hold up two, but now when I hold up two fingers, you don't hold up any." Begin with the sequence, 1, 1, 1, 1, 2... Use a quasi-random pattern, as in contrasting programs. Start with several 1's. Record: As for contrasting programs. Interpretation: Frontal patients have difficulty inhibiting a response when you raise 2 fingers. Normals may one or two errors, but rapidly improve. Test Antisaccade test Hold both hands up, one in each of the patient's visual hemifields. The patient is instructed to look at the examiner's eyes, and as soon as the examiner wiggles a finger on one hand, to look to the opposite hand. Repeat using a quasi-random sequence, as for contrasting programs. Record: as for contrasting programs. Interpretation: Frontal-damaged patients will tend to look at the fingers that move (stimulus-bound; failure to suppress collicular or parietal attentional mechanisms. Test: Word fluency (In elderly) Instruct the patient: "I want you to give me as many words as you can in one minute that begin with the letter that I will give you. You may not use proper names (words that begin with a capital letter), and you may not use the same word in different forms. For example, if I give you the letter "G," you could say good, great, gruff, or giraffe, but not George or Georgia, and, having said great, you could not say greater, greatest. Do you understand?... Remember you will have a minute: keep going until I tell you to stop. The letter is "S"; go." You may use the letters F, A or S (these have been standardized). Count the words. Stop the patient after a minute. If the patient stops before the minute is over, give one brief reminder ("Keep going until I tell you to stop"). DO NOT keep encouraging the patient: you do not want to act as the patient's frontal lobes. Do not count repetitions, proper nouns, or words beginning with the wrong letter. Record: The number of words given in 1 minute ("Word fluency: 12 with the letter 'S' in 1 minute". Interpretation: Well-educated patients should get at least 9 words in one minute; poorly educated patients should get more than 6. Patients with frontal lobe dysfunction typically give two or three words during the first few seconds, and then are silent for the remainder of the minute. Some persist in giving proper names or derivations of words despite repeated instructions not to. Some will perseverate. Patients with amnesia may repeat words toward the end of the minute. Patients with anomia or other varieties of aphasia may fail the task because of primary problems with language, rather than because of frontal dysfunction. Thus abnormal performance on this test indicates frontal lobe dysfunction only if there is not an associated aphasia or anomia. Test: Abstractions Ask the patient, how are an apple and orange alike?...or a poem and a statue? ...or a tree and a dog? Record "Abstract," "limited abstraction," "Concrete." Interpretation: Judge the response for level of abstraction (fruit, works of art, living = most abstract; round, there are poems about statues, dog urinates on tree = more concrete). Memory Objectives To detect memory deficits of localizing significance. Deficits in memory that are not explained by other mental status abnormalities (such as inattentiveness or language dysfunction) occur as a result of damage to the medial temporal lobes, medial thalamus, or basal forebrain. Test: Orientation to time and place are tests of recent memory. Orientation to person (included here) is not a test of memory. To time: Ask the patient the day of the week, date, month, and year. To place: Ask the patient where he or she is (name of the hospital or clinic, what floor they are on). To person: Patients should know the function of persons around them: nurses, doctors, etc. Knowing their own name does not qualify as being oriented to person. Interpretation Orientation to time and place are effectively tests of recent memory; orientation to person is not. Test: Recall of three words: (in the elderly) Instruct the patient: "I'm going to give you three words to remember. I'll ask you for them later, so please try to remember them. The words are, 'rose, umbrella and fear.'" You may use other words, but avoid words that can be easily associated, like "big, deep, lake," since they can be stored as a single item. Have the patient repeat the words immediately. This ensures that the patient has attended. Failure may indicate a deficit of attention, which may preclude reliable testing of memory. Distract the patient by having them count backwards from 100 by 7's (serial 7's), or, if the patient cannot do 7's, by 3's. This prevents the patient from rehearsing the words. It also tests the patient' ability to calculate (see below, under Gerstmann syndrome. Have them do at least 4 subtractions. Immediately after the distraction, ask: "What did I ask you to remember?" Do not use hints or multiple choice. [Optional] You may also ask the patient to recall the words after the entire mental status examination. Interpretation: Normals can recall at least 2 of the three words after distraction; and most will then also recall at least two of the three after a longer delay (at the end of the exam). Test Remote memory Public information Have the patient name the last 5 presidents in reverse order. Interpretation: Most patients will know at least 3 of the past 5 presidents. Expectations depend in part on level of education. Even patients with considerable memory loss will know the name of the current president. Personal memory Can the patient give an accurate history of present illness and past medical history? If not, ask the patient to "tell me something about your work"... or "about what you did last summer". Interpretation Even if you cannot verify the information, patients with memory deficits tend to provide only sketchy and general information, whereas normals typically give a lot of detail. ADHD Support Company "Here's a wide range of information about ADHD: You can learn the facts about ADHD or about legal issues that may impact your child." Brain Anatomy, Physiology and Neuropsychology Research Links Informational sites to learn more about what the parts of the brain does and what may be the key to being "specialized" (not working). Current Brain Research "Scientists apply the term neuroplasticity to the action of brain growth and adaptation in response to challenge. Provided the correct challenge and environment, children and adults frequently compensate (shift brain function from one area to another) when a certain area of the brain cannot function correctly. It is documented in many medical and neurological journals that the brain will increase activity in another region to overcome loss of another region. UCLA pediatric neurologist Dr. Donald Shields states, "if there's a way to compensate, the developing brain will find it." There is no question that the brain can compensate even if it has problems focusing attention. However, it has to be provided the correct environment prompting challenge." Neuroanatomy & Neuropathology on the Internet "A searchable Directory compiled for Medical Students, Residents, and other Health Professionals" Excellent site to spend hours searching & learning about the brain. Excellent for the scientifically & medically detailed academic type mind. NeuroNames & the Template Atlas More brain structure and illustrations. BrainInfo Search for structures of the brain and learn more about the structures. Online neuropathology Atlas "A searchable database containing gross, microscopic, and electron microscopic images, CT and MRI scans." Internet Handbook of Neurology Toxicology, Vitamin Toxicity, Drugs, Metabolic Disorders, Maldigestion and Malabsorption, Journal of Neural Transmission The role of diet in cognitive decline V. Solfrizzi, F. Panza, A. Capurso Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Policlinico, Bari, Italy Received March 7, 2002; accepted June 12, 2002 Published online August 22, 2002 Summary. Recent findings suggest a possible role of diet in age-related cognitive decline, and cognitive impairment of both degenerative (Alzheimer's disease, AD) or vascular origin. In particular, in an older population of Southern Italy with a typical Mediterranean diet, high monounsaturated fatty acids energy intake appeared to be associated with a high protection against cognitive decline. In addition, dietary fat and energy in older people seem to be risk factors, while fish consumption and cereals are found to reduce the prevalence of AD in the European and North American countries. Moreover, foods with large amounts of aluminium-containing additives or aluminium from drinking water may affect the risk of developing AD. Vitamin deficiencies, especially vitamin B6, B12 and folates, and antioxidant deficiencies (vitamins E and C) could also influence the memory capabilities and have an effect on cognitive decline. Dietary anti-oxidants and supplements and specific macronutrients of the diet may act synergistically with other protective factors opening new possibilities of intervention for cognitive decline. Learning Disabilities and Related Links Informational sites to learn more about various types of learning disabilities, communication problems and other related disorders. Attention Deficit Disorder AssociationServing the needs of people with ADD/ADHD since 1989 K12 Academics - ADD/HD My name is Chris. I run a website devoted to providing resourceful information for a number of topics in education and disorders. I have created a wonderful page on Attention Deficit Disorder with in depth information on the disorder. Please take a moment out of your day to visit the page. If you would like to help in any way please do not hesitate to contact me. I am always looking for individuals interested in providing articles and resources for Autism. If you have time, please visit the rest of my website. It is a labor of love. National Resource Center on AD/HD: A Program of CHADD "has been established with funding from the U.S. Centers for Disease Control and Prevention (CDC) to be a national clearinghouse of information and resources concerning this important public health concern. Attention-deficit/hyperactivity disorder (AD/HD) is a neurobehavioral disorder that impairs the functioning of millions of American children and adults each and every day. This Website will answer many of your questions about AD/HD, and will direct you to other reliable sources online." ADD/ADHD: New Perspectives on Attentional Priority Disorders "Dr. Wynn Knowling, who provided reports and articles for this page, suggests that a better term for Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder might be Attentional Priority Disorders, a phrase used by the Handle Institute, founded by Judith Bluestone, to describe the children they have helped. Over the years of her professional career in the field of education, she has investigated the use of medication, biofeedback, diets and behavior-modification to mention only a few of the many treatment approaches. She and other researchers have come to the conclusion that we should take a closer look at a child's temperament and environment, including hidden allergies and sensitivities, before prescribing medication as the only and final solution. Research supports the benefits of eliminating physical and emotional irritants and distractions, and the importance of good nutrition and sleep habits." What Is Strattera? "The U.S. Food and Drug Administration (FDA) has approved Strattera, judging it safe and effective for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children, adolescents, and adults. • Strattera is a selective norepinephrine reuptake inhibitor, a new class of treatment that works differently from the other ADHD medications available. • Strattera is the only FDA-approved ADHD medication clinically proven effective for adults. • Strattera is the first non-stimulant medication approved for the treatment of ADHD in children, adolescents, and adults." Neurology Channel:ADHD "Computer imaging of the brains of people with ADHD sometimes reveals smaller basal ganglia and reduced frontal lobe activity. Basal ganglia, or nerve clusters, are involved in routine behaviors, and the frontal lobes in planning and organizing, attention, impulse control, and inhibition of responses to sensory stimulation. The neurotransmitter dopamine is involved in controlling emotions and reactions, concentrating, reasoning, and coordinating movement. An abnormally low level of dopamine can cause the three primary symptoms of ADHD: inattention, impulsivity, and hyperactivity." ADD / ADHD Resources "Attention Deficit Disorder - ADD - Attention Deficit Hyperactivity Disorder - ADHD - is a difference in brain functioning that can have disastrous consequences in our society if undiagnosed and untreated. It can also be a blessing when recognized. This site is intended to be a source of information about this difference." Attention Deficit Disorder (ADD) (Hyperactivity) Not an excuse, but a biological difference that makes a difference. Artical by Charles K. Kenyon 1, Assistant State Public Defender, Marinette, "Unfortunately, the harder people with ADD try, the worse it gets. Instead of harder, they have to try doing something different, i.e. different friends, anger management to rehearse and plan reactions to common triggers, multiple reminders and artificial deadlines. Unless they know about and understand the ADD, they will keep trying harder, and often failing because their brain is shutting down on them. The ADD person will not be able to stop because they won’t know why they are doing what they are doing. This does not mean that the ADD is an excuse for antisocial behavior. They won’t be able to stop because their brains have been conditioned since early childhood to seek out or create stimulation as a survival mechanism. This is something which is not at the conscious level but rather a conditioned response." Surviving Social Situations With Help From An Expert "Michele Novotni, Ph.D. is an Associate Professor in the Graduate Counseling Department of Eastern College in Saint Davids, Pennsylvania and has a private practice. She is the author of What Does Everybody Else Know That I Don't?: Social Skills for Adults with AD/HD, and The Novotni Social Skills Checklists. She co-authored Adult ADD: A Reader-Friendly Guide to Identifying, Understanding and Treating Adult Attention Deficit Disorder. Michele lectures extensively throughout the country on a variety of topics related to AD/HD. Michele offers her expert advice on relationships, conversational skills and survival in other social situations." A Distracted Healer Crosses the Road by Linda Wellner MD "The Plus in the Minus: Perhaps it was synchronicity that combined some of my personal traits. The parts normally considered "not normal" -- such as ADHD, reading and word retrieval dyslexia, social latency -- have had fortuitous consequences for which I am thankful. All of it combined to create this mesomorphic, ambidextrous, androgynous female MD, born in Jan.1950 as the middle child of two ADD parents, the me I am meant to be in this lifetime at least." As many folks say "I can relate." A light bulb just turned on. I'll have to check more into this "reading and word retrieval dyslexia, social latency"! National Institute of Mental Health ADHD information National Attention Deficit Disorder Association Provides information & some research trends in ADHD. CHADD Children and Adults with Attention-Deficit/Hyperactivity Disorder website. National support & educational group for adults and children with ADHD. ADHDInfo.com ADHD information for Parents, Patients, Teachers and Healthcare Professionals. About.com ADHD General Characteristics of the Adult With ADD/ADHD. ATTENTION RESEARCH UPDATE Sign up below for a FREE subscription and receive immediate access to detailed reviews of over 150 recently published studies such as: "The MTA Study is the largest treatment study of ADHD every conducted. Participants were 579 8-12-year-old children diagnosed with the combined type of ADHD who were randomly assigned to receive 1 of 4 different treatments: intensive medication management alone (MM); intensive behavior therapy alone (BT), the combination of medication management and behavior therapy (Comb), or community care (CC; children assigned to community care received whatever community-based treatments their parents selected). Initial results from this landmark study were published in 1999 and suggested that children who received careful medication management (i.e. those in the MM and Comb conditions) did better than those who did not (i.e. those in the BT and CC conditions), and differed only slightly from each other. This was not true for all the different treatment outcomes considered individually, but was evident when outcomes were combined into a single overall indicator of treatment response. And, when the investigators defined an "excellent response" as one where the child had parent and teacher ratings of core ADHD symptoms plus oppositional behavior that fell in the average range, the following percentage of children in each group were found to be excellent responders: Combined - 68%; MM - 56%; BR - 34%; CC - 25% Resources for Women With ADD "Resources, Web Sites and Information for the unique challenges faced by Women with ADD." ADHDinfo "You can also sign up for e-mail alerts when new info is available." myADHD.com "Research has shown that frequent communication between parents and doctors improves outcomes for children with ADHD. Now, myADHD.com makes communication easier with our online rating scales and treatment tools." National Resource Center on AD/HD "The National Resource Center on AD/HD: A Program of CHADD has been established with funding from the U.S. Centers for Disease Control and Prevention (CDC) to be a national clearinghouse of information and resources concerning this important public health concern. Attention-deficit/hyperactivity disorder (AD/HD) is a neurobehavioral disorder that impairs the functioning of millions of American children and adults each and every day. This Website answers many of your questions about AD/HD, and directs you to other reliable sources online. New material is reguarly being added, so please bookmark this page and come back often." The Arc of the United States "The Arc of the United States works to include all children and adults with cognitive, intellectual, and developmental disabilities in every community." Play Attention Site focuses on the product that helps ADHD & ADD folks improve attention but also has various interesting articals thoughout the site, especially under Educators & Research. Fibromyalgia and attention deficit disorder Patricia shares what she has learned about a potential link between FM and ADHD. It's an interesting link & possible the cognitive problems associated with hypothyroidism is connected. I think maybe there might be an underlying ADD which the hypothyroidism has made worse due to slight hormonal changes which apparently thyroid replacement hormones do not correct. Chronic Fatigue Syndrome and its Connection to ADD/ADHD "What is the origin of this illness? We may find thirty or forty different factors can be involved. This writer wonders if CFIDS is not an actual virus, but rather an altered response to a changing environment or agents, which are probably acting as cofactors. Are we reacting to ozone layer depletion? Is there some other environmental condition creating or bringing out a genetic disposition for this phenomenon in an increasing percentage of the population? There certainly appears to be reason for great concern. Why are we experiencing such high levels of this syndrome? Why did we start with an epidemic some time in the late '70s, early '80s that, unlike past epidemics, has never stopped?" (Interesting idea from the artical.) (This is the only portion of the artical that discusses ADHD or it's similar symptoms with CFS.) "Cognitive problems may be a primary symptom of CFS, particularly in children. Affected children frequently experience difficulties in the school environment. They are typically unable to concentrate and demonstrate lack of memory skills. A common presentation is a child who is able to read a book, but cannot recall what was read, or a child who cannot remember what was said immediately after the teacher has delivered a lesson. One can appreciate what this has done to a child's self-image when applying the descriptions of this syndrome we have heard from its adult victims. Imagine a child who knows he is doing poorly in school, but has no basis for understanding why. It is a very frustrating situation because CFS/CFIDS children truly want to succeed. They want to go out and play and do all of the things they see their peers doing. Eventually, they lose hope in doing well and may even become behavior problems. As Dr. Hyde has noted, they become difficult kids and may eventually turn to drugs, and evesuicide (Perhaps we will come to learn that this syndrome partly underlies the increased adolescent drug use and suicide we are experiencing today). If their physiologic dysfunction remains undetected and untreated, it is unlikely counseling or therapy alone will be very successful. One must always be suspicious regarding any change in physical or behavioral patterns that fall outside the range of what we accept as "normal". These children tend be very anxious and clinging. They typically have poor self-esteem and have an understandable reluctance to attend school as a result of the constant failure they have suffered there. These children will often adopt an attitude of lassitude as a facade. They frequently have a disturbed sleep pattern and experience nightmares, restless sleep, and/or a "non-restorative" sleep. Sometimes a change in body weight is observed. They have, in the past, been diagnosed as depressed, lazy, or under-achievers. Often parental "over-involvement" has been blamed. As noted ove, how many of the cases being referred to in the Pediatric literature as Munchausen Syndrome (or Munchausen Syndrome by proxy), may truly be undiagnosed or unrecognized CFS/CFIDS? A medical history may suggest signs of cognitive dysfunction, particularly lack of focus, inability to concentrate on school work, perhaps the label of "quiet" ADD/ADHD (Attention Deficit Disorder). Almost all recent academic pediatric articles have focused on the high incidence of school dysfunction, school absenteeism, and need for home tutoring; often defining these problems as secondary to the physical dysfunction, rather than arising from a primary cognitive dysfunction. Fortunately, the majority of recent articles, while they do not understand this phenomenon in children, have generally noted the probable legitimacy of many of the patients followed, and ruled out other diagnoses (including psychological) over time. It is worth noting that over time, very few of these patients go on to "another" diagnosis or explanation." Hyperthought.net "site for several related endeavors, including Hyperthinkpress.com, the archives of Bouncingbrains.com, and writings of Carla Berg Nelson regarding thinking styles and attention differences. Supporting the wellbeing of leaping minds of all kinds by reflecting on how we think and why we do what we do." National Center for Learning Disabilities "Learning disabilities are neurological disorders that interfere with a person's ability to store, process, or produce information, and create a "gap" between one's ability and performance. Individuals with learning disabilities are generally of average or above average intelligence. Learning disabilities can affect one's ability to read, write, speak, or compute math, and can impede social skills. Learning disabilities can affect one or more areas of development. Individuals with learning disabilities can have marked difficulties on certain types of tasks while excelling at others. Sometimes overlooked as "hidden handicaps", learning disabilities are often not easily recognized, accepted or considered serious once detected. Learning disabilities affect children and adults. The impact of the disability ranges from relatively mild to severe. Learning disabilities often run in families. Learning disabilities are not cured and do not go away, but individuals can learn to compensate for and even overcome areas of weakness." Learning Disabilities: The Impact on Social Competencies of Adults "The relative "newness" of the field is apparent when one considers the fact that the term "learning disability" was not formally introduced until 1963. The next two decades of research were focussed almost exclusively on children with learning disabilities and the difficulties that they experienced with academic skills (Smith, 1989). In the 1980's, there was a greater awareness of the fact that social skills were also an area of difficulty for many of these children. Given the fact that a learning disability influences how a person might take in (perceive), process or interpret, and/or express information, it seems only logical that such difficulties would extend to information (both verbal and nonverbal) in other areas of a person's life, not just in school. Lower self esteem (Wright & Stimmel, 1984), fewer friends, and difficulties relating to others were all identified as existing with much greater frequency among children with learning disabilities as compared to those without (La Greca, 1987). This understanding was further reflected with a recommendation to extend the definition of learning disabilities to include possible difficulties with social competence and social skill attainment (I.C.L.D., 1987)." International Dyslexia Association "Dyslexia is one of several distinct learning disabilities. It is a specific language-based disorder of constitutional origin characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing abilities. These difficulties in single word decoding are often unexpected in relation to age and other cognitive and academic abilities; they are not the result of generalized developmental disability or sensory impairment. Dyslexia is manifest by variable difficulty with different forms of language, often including, in addition to problems reading, a conspicuous problem with acquiring proficiency in writing and spelling. The Definition of Dyslexia as adopted by the Research Committee of IDA, May 11, 1994 and by the National Institutes of Health, 1994. Studies show that individuals with dyslexia process information in a different area of the brain than do non-dyslexics." Common Signs of Dyslexia: Adults The difficulties noted below are often associated with dyslexia if they are unexpected for the individual's age, educational level, or cognitive abilities. A qualified diagnostician can test a person to determine if he or she is truly dyslexic. May hide reading problems. May spell poorly; relies on others to correct spelling. Avoids writing; may not be able to write. Often very competent in oral language. Relies on memory; may have an excellent memory. (unless they have ADD/ADHD) Often has good "people" skills. Often is spatially talented; professions include, but are not limited, to engineers, architects, designers, artists and craftspeople, mathematicians, physicists, physicians (esp. surgeons and orthopedists), and dentists. May be very good at "reading" people (intuitive). In jobs is often working well below their intellectual capacity. May have difficulty with planning, organization and management of time, materials and tasks. Often entrepreneurs. The Strategic Spelling Skills of Students with Learning Disabilities: The Results of Two Studies. "Each experiment has important implications regarding students with learning disabilities and instructional programs designed to teach spelling. Moreover, the findings of the first experiment, which suggests that students with disabilities do not use appropriate strategy (i.e., rule-based strategy), offer support to the second study which favors using rule-based programs to teach students with learning disabilities. These results suggest that students with learning disabilities who frequently experience problems with spelling, benefit from programs that incorporate rule-based strategies that are intensive and skill-directed, and provide specified correction and practice procedures. School administrators and teachers can use the results when planning instruction for students with learning disabilities. Students with learning disabilities often experience difficulty in spelling and often times use inappropriate strategies when engaging in spelling tasks. These studies suggest that rule-based curricula provide teachers with strategies to teach students who experience difficulty in spelling." NLDLine "Nonverbal learning disorders (NLD) is a neurological syndrome consisting of specific assets and deficits. The assets include early speech and vocabulary development, remarkable rote memory skills, attention to detail, early reading skills development and excellent spelling skills. In addition, these individuals have the verbal ability to express themselves eloquently. Moreover, persons with NLD have strong auditory retention. Four major categories of deficits and dysfunction also present themselves: •motoric (lack of coordination, severe balance problems, and difficulties with graphomotor skills). •visual-spatial-organizational (lack of image, poor visual recall, faulty spatial perceptions, difficulties with executive functioning and problems with spatial relations). •social (lack of ability to comprehend nonverbal communication, difficulties adjusting to transitions and novel situations, and deficits in social judgment and social interaction). •sensory (sensitivity in any of the sensory modes: visual, auditory, tactile, taste or olfactory)" Prosopagnosia (Face Blindness) "Will you easily recognize your family members if they would change their hairstyle? Would you easily recognize a friend if you accidently met her in the post office? Some people will not. These individuals find the task of recognizing other people just by looking at their face extremely difficult. Thus, in order to recognize familiar people, they will rely on such features as the voice, hairstyle, and clothing items, or on contextual information. How good is my face recognition? It stinks!I only got 22% right. Take the Old-New Face Test, it's easier, I got 76% right on that one. Neurologists call this face blindness PROSOPAGNOSIA (Greek: prosop = face, agnosia = lack of knowledge). Prosopagnosia is a relatively rare condition and may result from stroke or brain injury. Nevertheless, in some cases, prosopagnosia can occur with no apparent neural damage and be present from early childhood (just as in the case of dyslexia). We refer to this condition as congenital prosopagnosia or developmental prosopagnosia." Welcome to my pages about prosopagnosia "My name is Cecilia Burman, and I am 'face-blind' in the sense that I can not recognize people by their faces. The medical term for this condition is prosopagnosia. I have written these pages to try to give you who read them a better understanding for what it can be like to live with prosopagnosia." Interactive section of this site about Prosopagnosia ( Face Blindness ) How do you compare with recognizing faces to people whose brain has problems recognizing faces? Take the tests & see. Prosopagnosia: Seeing the World through Fog-Colored Glasses "While the exact mechanism of the disorder is still somewhat debated, it is abundantly clear that those afflicted suffer greatly. Though their suffering may not register as physical pain, and prosopagnosia in no ways hinders their ability to make their way through daily obstacles, significant emotional damage can be done stemming from forgotten or missed encounters with people as close as family members. While there are very few recorded cases of prosopagnosia, and it was only named in 1947, the reports of daily trials provided by sufferers are consistent in their degree of frustration and annoyance and despondency. One particularly poignant anecdote describes an incident in which a man who endures the burden of prosopagnosia met his own mother walking down the sidewalk of their neighborhood and did not recognize her. He reports that he only became aware of this encounter when she later told him about it. This may represent an extreme example of the hardships caused by face blindness, but similarly awkward and embarrassing events occur frequently. Just as people who are blind in the more conventionally thought of sense learn to rely on the compensatory strength of their other sensory modalities to inform them about their surroundings, an individual who lives with prosopagnosia must adapt to other distinguishing markers, such as a distinctive walk or voice. However, these are not always enough to ensure a complete reprieve from what are perceived as being humiliating social blunders, despite their being a function of a neurological impairment. And while a face blind person may develop a fairly consistent accuracy in recognizing people without the benefit of a familiar face, it is difficult to do so without acuity and speed being compromised to some degree." MSN SearchResults 1-15 of about 2398 containing 'prosopagnosia' National Stuttering Association information about stuttering." I was a stutterer as a child & young adult. I very rarely stutter now, but stuttering seems to be caused when there is something that prevents the person from communicating their thoughts immediately. The thoughts then get "caught" in the part of the brain responsible for speech and communicating ideas. This thoughts are then difficult to innitiate and results in stammering the innitial part of the first word or first several words. Once the speech process is innitiated and the thoughts are flowing then the words come out without stuttering. Emotions, interuptions and distractions can inhibit the communication process resulting in stuttering. Telling a person who's stuttering to "slow down and think about what you want to say" only causes the thoughts to "gum up" and increases stuttering. Anxiety may be a contributing emotion. If you have time to "think" about a speech you have to make, you may experience "stage fright". Most people speak fluently and the "thinking" is concurrent with the "speaking" (at least with me & appears to be with others). Thinking of the exact words to speak seems to inhibit fluent speech. Just a tid bit from a former stutterer, who seldom stutters now. Aerobics of the Mind: Brain Exercises Series 1 "Just like our bodies need exercise to help us stay physically fit, so stimulating our brains through these exercises can be an important way to stay mentally sharp." National Institute of Neurological Disorders and Stroke List of neurological disorders. THE HARVARD BRAIN Spring 1996 (Text Version) Several articals on various aspects of the brain. Early Menopause.com "The average age for women to have completed menopause is age 51 -- which means that most women go through this change between the ages of 47 and 53. So if you go through menopause before this -- for whatever reason -- you're usually said to have experienced premature or early menopause. So (here we go again!) the key factor is age." I just had to add this. Women who suffer from PMS (emotional & physical), cramps, mood swings, etc. It's a good thing when you reach the period at the end of the periods.