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    Post  mfnierra on Sun 06 Sep 2009, 12:02 am

    yogi, please take note of the relevant researches contributed by the class to enrich your work. Make an effort to incorporate them in your final paper. what you initially uploaded is a work in progress. the final output is the clincher.
    Althea Perez

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    Post  Althea Perez on Fri 04 Sep 2009, 8:02 pm

    In addition to the multimodal approach. PARENTS INVOLVEMENT plays a vital role for treating the child with ADHD.

    I have come across an article regarding parents involvement with the treatment. In the United States, the American Academy of Pediatrics together with associations supporting ADHD came up with a PARENT STARTER KIT, a 14-page guide for parents whose child is undergoing medication treatment for ADHD.

    The Parent Starter Kit Contains Four Sections:

    1. Guidelines to Effectively Communicate With Your Child’s Doctor

    This section provides discussion topics and questions to bring to thechild’s doctor related to choosing the right medicine, taking the medicine properly, determining the right dose, making sure the medicine works, and understanding side effects and safety issues.

    2. Reporting Your Child’s Medical History

    A detailed medication history.

    3. Understanding the Medication Guides

    Better explanation of the medical terminology.

    4. Monitoring Your Child’s Progress on Medication: A Weekly Diary
    This section provides an outline/checklist of the physical, emotional and behavioral changes that may be seen in children taking ADHD medication. Once the child starts taking the medication, the diary may be completed on a daily or weekly basis.

    You can preview the PARENT STARTER KIT HERE:


    I haven't found one in the Philippines, I think it would be better that here in our country, we could be able to produce one like this, and even a Filipino translation of it so that mother's or parents from different walks of life would be able to guide their children as well as be informed of the treatments to be done. Smile


    Greenburg, Sally. "New Parent Starter Kit for Parents of Children with ADHD." Email Responses to Keath Low through Debbie Harvey. 16, Jan. 2008.

    Harvey, Debbie. “New Parent Starter Kit for Parents of Children with ADHD.” Emails to Keath Low. 26, Dec. 2007 and 16, Jan. 2008.

    Parent Starter Kit. National Consumers League. 2006.
    Althea Perez

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    Join date : 2009-08-11

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    Post  Althea Perez on Fri 04 Sep 2009, 7:39 pm

    I agree that the multimodal approach are used as a treatment for ADHD.
    But the thing is the disorder is being overlooked and that the doctor's and even other health care providers resort to a greater percent adherence to the PHARMACOLOGIC INTERVENTIONS.

    There are other Non Pharmacologic Management for ADHD.

    According to Two ADHD experts, Peter Jensen, Ph.D., and Patricia Quinn, M.D.,who are both physicians and professors respectively, states that Behavior Therapy is effective in helping manage symptoms of ADHD in children. A reward system is implemented with input from the child and new behaviors are taught to replace the old, maladaptive ones.

    They've also stated the importance of the THREE C's that the health care providers and the parents must remember when setting up a behavioral program for children with ADHD.

    1. Clarity of Expectations
    Keep rules and expectations simple, concise and clear. Make sure they are easily understood by the child.

    2. Consistency
    Follow through with consequences in a consistent manner.

    3. Calmness
    Approach situations calmly. Take a deep breath and make sure you are in control. Take a brief “time-out” if you need to get a better hold over your emotions. Children are especially sensitive if we lose our temper. A calm approach is most effective and won’t overstimulate the child or escalate the situation.


    Behavior Therapy for ADHD Children
    By Keath Low, http://add.about.com/od/childrenandteens/a/behaviortherapy.htm

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    Post  mfnierra on Fri 04 Sep 2009, 2:08 am

    Yogi, your clarification on the issues raised are well taken but you need to reflect your sources properly. As it is it would be difficult to cross check information you have given.

    I would like to see a more indepth analysis of the effects of adhd on the developmental tasks or milestones of the child and its implications to the care of the child by parents and health care professional, like nurses.

    Ladies, your contributions on contemporary/alternative interventions are appreciated. Ara's comment about current interventions being physician dependent is significant. With the new alternative approaches, what will its implcation/s be on nursing practice?

    Keep it up!

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    Post  railibo- on Thu 03 Sep 2009, 1:50 am

    Hi Yogi.

    I would also like to suggest that you also include in your intervention the health teaching about medications to parents as well as how they should manage the side effects. ^_^

    I also read about this study done by the Researchers at the University of Illinois at Urbana-Champaign about letting children with ADHD spend more time outdoors and they have found that "green outdoor settings appear to reduce ADHD symptoms in children across a wide range of individual, residential, and case characteristics. " They suggested that daily doses of “green time” can supplement medications and other traditional treatments of ADHD since it is an affordable, healthy method of controlling symptoms. Unlike medications for ADHS that are expensive and can have serious side effects, including loss of appetite and trouble sleeping. They suggested that increasing “green time” can be done by:

    * Choosing a greener route for the walk to school
    * Doing classwork or homework outside or at a window with a relatively green view
    * Playing in a green yard or ball field at recess and after school



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    Post  arch_ang on Wed 02 Sep 2009, 11:15 pm


    For the effects oF adhd to the parents and siblings:

    Difficulties at home or on outings with carers (for example, when shopping, out in the park, or visiting other family members) also become more apparent at primary school age. Parents may find that family members refuse to care for the child, and that other children do not invite them to parties or out to play. Many children with ADHD have very poor sleep patterns, and although they appear not to need much sleep, daytime behaviour is often worse when sleep is badly affected. As a result, parents have little time to themselves; whenever the child is awake they have to be watching them. Not surprisingly, family relationships may be severely strained, and in some cases break down, bringing additional social and financial difficulties. This may cause children to feel sad or even show oppositional or aggressive behaviour.

    Johnston and Mash reviewed the evidence of the effect of having a child with ADHD on family functioning. They concluded that the presence of a child with ADHD results in increased likelihood of disturbances to family and marital functioning, disrupted parent-child relationships, reduced
    parenting efficacy, and increased levels of parent stress, particularly when ADHD is comorbid with conduct problems.

    Limited attention has been given to sibling relationships in families with ADHD children. While it has been reported that siblings of children with ADHD are at increased risk for conduct and emotional disorders,20 a more recent study presenting sibling accounts of ADHD identified disruption caused by symptoms and behavioural manifestations of
    ADHD as the most significant problem. This disruption was experienced by siblings in three primary ways: victimisation, caretaking, and sorrow and loss. Siblings reported feeling victimised by aggressive acts from their ADHD brothers through overt acts of physical violence, verbal aggression, and manipulation and control. In addition, siblings reported that parents expected them to care for and protect their ADHD brothers because of the social and emotional immaturity associated with ADHD. Furthermore,
    as a result of the ADHD symptoms and consequent disruption, many siblings described feeling anxious, worried, and sad.

    **V A Harpin (2005).The effect of ADHD on the life of an individual, their family, and community from preschool to adult life.

    **Johnston C, Mash EJ. Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child and Fam Psychol Rev 2001;4:183–207.

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    Post  arch_ang on Wed 02 Sep 2009, 11:02 pm

    Guys, there's a new management on how to reduce ADHD symptoms among students:

    The Transcendental Meditation technique may be an effective and safe non-pharmaceutical aid for treating ADHD, according to a promising new study published this month in the peer-reviewed online journal Current Issues in Education.

    The pilot study followed a group of middle school students with ADHD who were meditating twice a day in school. After three months, researchers found over 50 percent reduction in stress and anxiety and improvements in ADHD symptoms.

    The study was conducted in a private K-12 school for children with language-based learning disabilities. Participation was restricted to 10 students, ages 11-14, who had pre-existing diagnoses of ADHD. About half of the students were on medication. The students meditated at school in a group for 10 minutes, morning and afternoon.
    To determine the influence of the TM technique, at the beginning and end of the three-month period, parents, teachers and students completed standard ADHD assessment inventories measuring stress and anxiety, behavior and social competency, and executive function. Students were also given a battery of performance tests to measure cognitive functioning.

    Comment: "The children also showed improvements in attention, working memory, organization, and behavior regulation."
    After the in-school meditation routine began, "teachers reported they were able to teach more, and students were able to learn more because they were less stressed and anxious."

    Maharishi University of Management
    Journal on Current Issues in Education.
    Transcendental Meditation reduces ADHD symptoms among students: New study
    Published: Tuesday, December 30, 2008 - 12:08 in Health & Medicine

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    Post  arch_ang on Wed 02 Sep 2009, 10:49 pm

    Tina =)

    For your concern:

    • Write contracts for specific behavioral change[b]

    It is basically acknowledging the positive attitude of an individual with ADHD especially kids. Teachers or mothers should take note of any positive behavior and may provide rewards. By having a positive attitude, let them know that it is better to continue that kind of attitude.

    Research has shown that children with ADHD do not tend to benefit from punishment in the same manner as other children. Therefore, an effort should be made to utilize a system based on rewards for positive behavior. Rewards should be based on behavior, not given without objective cause, and occur immediately, or as soon as possible, following the desired behavior.

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    Post  arch_ang on Wed 02 Sep 2009, 10:44 pm

    guys, thanks for your output or comments in ADHD. I'll try my best to accommodate your questions.

    I would like to elaborate the environmental approach as an alternative treatment.

    Environmental Behavior Modification techniques involve changing the environment to reinforce (increase) desirable behaviors while punishing (diminishing) undesirable behaviors. These techniques can be used at home or in school settings. Reinforcements or rewards must be considered positive by the child (not the just the adult!) in order to be effective. Token reward systems, a behavioral system that provides tokens as a reinforcer for desirable behavior that can be exchanged for desired goods, can be an effective technique with children and teens. In contrast, timeouts (i.e., removing the child from a social environment in order to sit quietly alone and consider their behavior) can be used as a punishing consequence for undesirable behaviors, so long as the child experiences the timeout as unpleasant or undesirable.
    Children with ADHD require clear structure and incentives in order to focus on behavioral change. This type of plan should be presented as a loving, positive, and focused approach rather than a way to continually "catch" the child misbehaving.

    Margaret Austin, Ph.D., Natalie Staats Reiss, Ph.D., and Laura Burgdorf, Ph.D.
    Althea Perez

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    Post  Althea Perez on Wed 02 Sep 2009, 10:04 pm

    Good evening classmates Smile

    Hi yogi Smile i have read your report regarding ADHD.

    I just want to add, besides the multi-modal approach for ADHD (which was mentioned by ara) other treatment for ADHD varies.

    Doctors recommend the GFCF diet or Gluten-Free Casein-Free Diet as a nutritional management.

    Gluten and casein are getting a lot of attention in the autism community and from doctors in the "Defeat Autism Now!" biomedical movement. Some parents, doctors and researchers say that children have shown mild to dramatic improvements in speech and/or behavior after these substances were removed from their diet. Some also report that their children have experienced fewer bouts of diarrhea and loose stools since starting a gluten-free, casein-free (GFCF) diet.

    Gluten and gluten-like proteins are found in wheat and other grains, including oats, rye, barley, bulgar, durum, kamut and spelt, and foods made from those grains. They are also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, flavorings, artificial colors and hydrolyzed vegetable proteins.

    According to one theory, some people with autism, ADHD and PDD cannot properly digest gluten and casein, which form peptides, or substances that act like opiates in their bodies. The peptides then alter the person's behavior, perceptions, and responses to his environment. Some scientists now believe that peptides trigger an unusual immune system response in certain people. Research in the U.S. and Europe has found peptides in the urine of a significant number of children with autism. A doctor can order a urinary peptide test to see if proteins are being digested properly.

    Nursing Interventions:
    1. Before changing the child's diet, consult with a physician and nutritionist to make sure you are providing a healthy diet and, if necessary, nutritional supplements.

    2. Remove one food at a time so as to know what food is causing the problem.

    3. It's often suggested to remove milk first because the body will clear itself of milk/casein the quickest. Gluten may be removed a month after the elimination of milk. It may take up to six months on a gluten-free diet for the body to rid itself of all gluten. That is why most advocates suggest giving the diet a trial of six months.

    4. Foods that CAN be eaten on a gluten-free, casein-free diet include rice, quinoa, amaranth, potato, buckwheat flour, soy, corn, fruits, oil, vegetables, beans, tapioca, meat, poultry, fish, shellfish, teff, nuts, eggs, and sorghum, among others.

    Paul Shattock and Dr. Paul Whiteley of the British Autism Research Unit at the University of Sunderland


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    Post  ara_portillo on Wed 02 Sep 2009, 8:36 pm

    yogi.. just want to add.. i've read the medical management that you have on the report... And I came across a good research article about ADHD in children, in this report, the current management being done for ADHD is termed as "multimodal" approach. Wherein, it encompasses some that you have mentioned on the report : individual and family education, counseling, behavioral therapy, school remediation, and medication.
    If this is the approach, for the treatment to be successful, a big factor will affect it would be the close coordination between the client, family, nurse,and the school system (just like in other childhood diseases). And from this point, I would like to add the a possible gap that i can see from the data and other articles that I have read about the ADHD in children - the focus of the pediatric practice today is that of the pharmacological aspect of managing ADHD. Even in your report (which I think you based it from the resources available, the discussion of management is started with the meds {just an opinion Smile }). According to the research that I found, the integrative approach of managing ADHD in children has been overshadowed by the pharmaceutics.
    Looking it in that way, the management of the case is really dependent on the health care provider (esp. the physician).

    >>Kidd P., 2000. Attention Deficit/Hyperactivity Disorder In Children: The Rationale For Integrative Management. Alternative Medicine Review, Vol 5. No. 5. Electronic Version available at www.thorne.com/media/attention_deficit.pdf. Retrieved on September 1, 2009
    Angel Ve

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    Post  Angel Ve on Wed 02 Sep 2009, 8:29 pm

    Hello Yogi,

    I just want to add some information on your report. I think it is also important if we look into the factors that may cause the child to have ADHD.. Here are some of the risk factors..

    Environmental Agents

    • Studies have shown a possible correlation between the use of cigarettes and alcohol during pregnancy and risk for ADHD.
    • High levels of lead in the bodies of young preschool children are another possible environmental cause of ADHD.

    Traumatic Brain Injury

    • Children who have been in accidents that resulted in brain injury occasionally show some signs of behavior similar to that of ADHD, but only a small percentage of children with ADHD have been found to have suffered a traumatic brain injury.

    Food Additives and Sugar

    • Some research suggests that attention disorders are caused by refined sugar or food additives, or that symptoms of ADHD are exacerbated by sugar or food additives.
    • In 1982, the National Institutes of Health held a scientific consensus conference to discuss this issue. It was found that diet restrictions helped about 5 percent of children with ADHD.

    Genetics and Hereditary Factors

    • Around 25 percent of close relatives in the families of ADHD children also have ADHD.
    • Twin studies show there is a strong genetic influence to ADHD.

    Brain abnormalities

    • Some ADHD studies have shown structural differences in the brains of ADHD patients.

    Boyer S. 2009. What is Attention Deficit Disorder? Patient Guide. ADHD Issues.com
    Available at: http://www.adhdissues.com/ms/guides/what_is_adhd/main.html
    ma. cristina arroyo

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    Post  ma. cristina arroyo on Wed 02 Sep 2009, 8:00 pm

    Can you elaborate more on this intervention:

    "Write contracts for specific behavioral change."

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

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    Post  ma. cristina arroyo on Wed 02 Sep 2009, 7:57 pm

    yogi, i've read the report and i appreciate the effects on the child of ADHD. but in one of your data, you mentioned about the effect on the parents and families of these children,. can you give us a scenario of a parent or a family which has a child/sibling who has ADHD?

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