Center for ADHD Connection

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Center for ADHD Connection

INSIDE

From the director 2

Center for ADHD

clinical services 3

Improving academic skills for middle and high school

students with ADHD 3

My child has been diagnosed with ADHD… when is it time

to consider medication? 4

Join an ADHD

research study 5 & 8

2016 Center for ADHD

group program schedules 6 & 7

A newsletter for parents of children with ADHD,

our collaborators and community partners

Fall 2015 www.cincinnatichildrens.org/adhd

ADHD Summer Treatment Program (STP)

a success in Cincinnati

Aaron Vaughn, PhD

The first Summer Treatment Program (STP) in Cincinnati was a resounding success. Twenty one children 7 to 13 years old diagnosed with ADHD came from around the Cincinnati area (and as far away as Dayton) to participate in the 7-week program held on the Xavier University campus. The STP offers a comprehensive treatment program for children with behavioral, emotional, and learning problems proven to help them develop better problem-solving and social skills, ability to follow directions/complete tasks, and to manage their frustration.

Each STP day was filled with sports, classroom-based learning, and computer-based activities. In addition, children swam every day, earned fun activities (water balloons, capture the flag, Olympics day) each week, while making significant daily improvements in their ability to manage their things, actively participate and follow the rules of games and sports, and learn in our classroom and computer lab. Parents expressed how their children improved in their ability to participate and play multiple sports, develop friendships, and manage their STP materials completely independently. This is no small accomplishment with children having to keep track of their homework, towel, baseball glove, swimsuit, water bottles, and lunch!

All parents reported significant, noticeable improvements in how their child became more independent during the STP and improved not only in their behavior, but in their social relationships as well. Most importantly, parents expressed how positive and engaging the counselors and staff were each day and how motivated their children were to come every day during the summer. Although the STP is highly structured and emphasizes treatment, children also enjoy the STP tremendously and this was evident every single day.

A parent of one of the boys in the Cincinnati program said, “We have struggled for almost ten years to help our son learn. We have read countless books, seen a myriad of therapists and doctors, and tried almost every strategy and program you can imagine. Some did not work at all. In others, we saw modest gains followed by regressions. This program is the only one that’s sustained a consistent change. We were shocked the first week to see immediate positive behavior. We were thrilled our son enjoyed himself so much. If there were a school like this, we’d switch immediately!”

The STP will be held next summer at Xavier University from June 13 through July 29. For more information or to reserve a spot for your child, please go to cincinnatichildrens.org/adhd.

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Julia Anixt, MD Stephen Becker, PhD Bill Brinkman, MD Heather Ciesielski, PhD Jessica Cyran, PhD Tanya Froehlich, MD Josh Langberg, PhD Phil Lichtenstein, MD Nicholas Newman, DO S. Rachelle Plummer, PsyD Leanne Tamm, PhD Aaron Vaughn, PhD

Contact Information

For more information about Cincinnati Children’s Center for ADHD, please contact the Division of Behavioral Medicine and Clinical Psychology Intake Line at 513-636-4336, and press #. The center is located on our Oak Campus at:

2800 Winslow Avenue Fifth Floor, Suite 5200 MLC 10006

Cincinnati, OH 45206

www.cincinnatichildrens.org/adhd

About this Newsletter

The Center for ADHD Connection newsletter is published two times each year. To be added or removed from the mailing list for this newsletter, email us at [email protected].

To give feedback about the newsletter or if you have a story idea, email us at [email protected].

To see previous newsletters, please go to our website

www.cincinnatichildrens.org/adhd.

The past 6 months have been a busy and productive time for our Center. Regarding our clinical services, we successfully ran our first Summer Treatment Program (STP) for children 7 to 12 years old with ADHD. This 7-week program was conducted on the Xavier University campus from mid-June through early August. We enrolled 21 children, and the response from parents and children was phenomenal (see the article on the front page of this newsletter). We plan on not only offering an STP again next summer, but doubling our capacity. Look for information about signing up for next summer’s program in the next issue of the Center for ADHD Connection.

Research update

As you are likely aware, a primary mission of our Center for ADHD is to conduct research that will advance the knowledge base concerning ADHD. Most of our research is funded by the National Institutes of Health (NIH). Many of our research studies occur over 5 year periods. Coincidentally, several of our ongoing research studies ended in the past 6 months. These include several studies examining non-pharmacological ADHD interventions, a study examining various treatment strategies for children with ADHD and reading difficulties, a study examining genetic predictors of ADHD medication response, a study examining predictors of medication adherence, and a large clinical trial examining whether we can improve the quality of ADHD care delivered by community-based pediatricians.

With data collection on these studies complete, we are working diligently on analyzing the collected data. We want to present the results of these studies to fellow researchers and clinical providers, in order to advance our understanding of ADHD and hopefully advance the clinical care that children with ADHD receive. We look forward to reporting the results of these studies in future Center for ADHD Connection newsletters.

Ideas for future newsletters and the Center

We would like to hear from you. If you have suggestions for features that you’d like to see in future newsletters, or if you have suggestions for our Center, please email us at [email protected].

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Cincinnati Children’s Hospital Medical Center – Center for ADHD

Center for ADHD

clinical services

The Center for ADHD currently provides the following evidence-based services for the families of children and adolescents with ADHD:

n ADHD Evaluations

n Individual/Family Therapy Services

n Parent Training Groups (schedule on page 6) n Managing Frustration Groups (schedule on page 7) n Academic Success Groups for Teens (schedule on page 7)

Improving academic skills for middle and high school students with ADHD

Heather Ciesielski, PhD and Richard Loren, PhD

Along with the new supplies, teachers, clothes and books, the start of the school year also often brings on conflict between children with ADHD and their parents. For adolescents with ADHD, the demands are even greater and many of these arguments are due to the teens forgetting to write down assignments and turn in work, and procrastinating in completing homework, papers, and projects, missing deadlines. Statements such as, “I got it done at school”, or “That’s not really due” are often heard by parents. Academic skills,

including homework and taking tests, are challenging for teens with ADHD, as they struggle with starting tasks, completing tasks, managing time, and rushing through assignments without checking their work.

The Center for ADHD offers group sessions that teach teens

and their parents academic skills and how to use these skills

with less arguments. Each group begins with an explanation of ADHD to adolescents (often for the first time), and then focuses on using a contract to improve time management skills, organizational skills, study skills, and note-taking/written assignment skills. Teens often bring work from their classes to

is also used to help parents and teens identify school behaviors to prioritize (for example, writing in their planner, completing homework by a certain time, turning assignments in, studying for tests, etc).

In a study that will be published in the Journal of Attention Disorders, we looked at the effectiveness of our Academic

Success for Young Adolescents group. The results of this study showed that the information taught in the group sessions led to improvements in homework completion and homework organization and management. In addition, parents reported less academic impairment for the teens, and improvements in their confidence in working with and getting along with their teens.

Please see the schedule of upcoming groups at the Center for ADHD, for further information about the dates and times of this group (pages 6 and 7). The Academic Success for Young Adolescents group (sixth through eighth grade) is offered two or three times each fall and each spring, and the Academic Success for High Schoolers (ninth and tenth grade) is offered

To learn more, visit www.cincinnatichildrens.org/adhd, or call the Division of Behavioral Medicine and Clinical Psychology Intake Line at 513-636-4336, and press #.

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Tanya Froehlich, MD

Please see other research studies on page 5.

As the school year gets underway, many parents of children with ADHD ask themselves the same question, “Should we try medication?” This decision is often difficult, and every family and child is different. If you are considering medication for your child, here are some questions to ask yourself:

Does my child have other problems besides ADHD?

For children, there are other problems that can cause behaviors that look like ADHD, such as sleep difficulties (sleep apnea), thyroid problems, or even seizures. Other developmental and behavioral issues, including learning disorders, anxiety, depression and adjustment difficulties to family stressors or bullying can lead to problems paying attention and/ or overactivity, so they must also be considered during any evaluation for ADHD. These problems also can co-occur with ADHD, so for best results, make sure that the treatment plan is addressing all of the issues that your child is facing.

How much impact is ADHD having on my child?

When considering ADHD medication, it is important to reflect on the balance between possible risks and benefits. For children with milder cases who are not experiencing marked problems in daily life due to their ADHD, the benefits due to the medication may not outweigh the possible side effects, and behavioral treatments alone may provide enough relief. For other children, the impairment caused by ADHD is such that parents are willing to accept the possibility of medication side effects. Scenarios that signal significant impairment due to ADHD can include:

• Academic underachievement (grades that are significantly below a child’s potential)

• Difficulty making and keeping friends due to overactive, impulsive, and/or disorganized behaviors

• Inability to participate successfully in age-appropriate activities due to ADHD symptoms (examples include significant problems on sports teams and in other extracurricular activities, little “free” time due to hours spent attempting unsuccessfully to complete homework) • Pronounced family stress due to a child’s ADHD-related problems

• Weakened self-esteem due to negative feedback from frustrated parents, teachers, and peers

• Safety concerns related to hyperactivity and impulsivity Once you feel comfortable that ADHD is the correct diagnosis and that the detrimental impact of ADHD on your child tips the potential benefit/risk balance toward trying medication, talk to your doctor about the medication choices and possible

side effects. In general, the most effective treatment for ADHD is stimulant medication (generic names: methylphenidate, dexmethylphenidate, dextroamphetamine and amphetamine-dextroamphetamine). However, response does vary by individual, and non-stimulant medications, including

atomoxetine, extended-release clonidine, and extended-release guanfacine are also FDA-approved for the treatment of ADHD. Here are some important things to remember when trying ADHD medications:

• One size does not fit all, and most children need to try a range of medication doses and/or different medications, before finding the most effective and best tolerated treatment. This takes time, so be patient.

• Research studies have shown that ADHD medication is most effective when doctors closely monitor response, gather information from both parents and teachers about response using behavior rating forms, and make

adjustments accordingly. This takes effort, but the payoff is better control of ADHD symptoms.

• Not all children respond well to ADHD medications, so remember that behavioral treatments for ADHD are also available and effective. And, even if your child’s ADHD symptoms do improve with medications, research has shown that use of BOTH behavioral interventions and medication leads to the best results for many important issues that affect children with ADHD, such as child conflict, social functioning, academic difficulties, anxiety symptoms, and oppositional/aggressive symptoms.

If you are interested in participating in a research study that involves diagnostic assessment for ADHD (and its possible mimicking or co-occurring conditions), a trial of a range of stimulant medication doses, and careful monitoring of response using parent and teacher input, you can contact the TEAM Study at [email protected] or 513-636-1344.

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Adolescents With ADHD and a Parent

with Bipolar Disorder Needed

What

The purpose of this research study is to investigate brain changes in adolescents who are currently experiencing Attention Deficit Hyperactivity Disorder (ADHD) symptoms and have a family history of bipolar disorder. Participants will be randomized to mixed amphetamine salts or placebo for 12-week treatment.

Who

Adolescents 13 to 17 years of age who are experiencing ADHD symptoms or have been diagnosed with ADHD and have a biological parent with bipolar I disorder may be eligible to participate.

Pay

Participants will receive compensation for their transportation and/or time for the study visits. All study visits, tests,

procedures and medication will be provided at no cost to participants.

Contact

Participants will have MRI scans. For more information, contact Kaitlyn Bruns at [email protected] or call

Join an ADHD research study

Our researchers conduct studies to learn more about and work to find treatments for ADHD. Parents and children can help by joining a research study. Current research studies include:

Needed: Children 8 to 12 Years Old

With ADHD and/or Attention

Problems

Children’s Attention Problems Study

What

This is a research study to learn more about how children with ADHD differ from children without ADHD, in their cognitive and sleep functioning.

Who

Children 8 to 12 years old with ADHD and/or who have problems with attention

Pay

Families may receive up to $100 for time and effort.

Contact

The study coordinator at [email protected] or 513-803-0771

Teens 16 to 19 Years Old

With ADD or ADHD Needed

Simulated Driving Study for Teens with ADD/ADHD

What

A research study to learn more about how teens with ADD or ADHD drive

Who

Teenagers 16 to 19 years old with a history of ADD or ADHD and who have a driver’s license may be eligible to participate. One parent will also be asked to participate.

Pay

Families will receive up to $50 for this 2-visit study (lasting up to 2 hours each).

Contact

[email protected]

Needed: Children With Attention/

Hyperactivity Problems and are

Seeking Alternatives to Medication

What

This research study is aimed at looking at how omega-3 fatty acid supplements affect brain function in children with ADHD. This 10-week study includes a psychiatric interview and two MRI scans.

Who

Children 6 to 15 years old who are diagnosed with ADHD and have not received psychostimulants in the past 30 days may be eligible for participation.

Pay

Participants may receive up to $160 for their time and travel.

Contact

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a_{Skips 07/04 (Independence Day)}b_{Skips 09/05 (Labor Day)}c_{Skips 11/23 (Thanksgiving Wed.)}

Day/Dates Time CCHMC Location Therapist

Thu 01/28/16 to 03/17/16 5:00 pm – 6:30 pm Oak Campus Heather A. Ciesielski, Ph.D. Thu 2/11/16 to 03/31/16 12:00 pm – 1:30 pm Liberty Campus Beverly H. Smolyansky, Ph.D. Thu 05/19/16 to 07/07/16 4:30 pm – 6:00 pm Oak Campus Heather A. Ciesielski, Ph.D. Mon 06/06/16 to 08/01/16a _{12:00 pm – 1:30 pm} _{Liberty Campus} _{Beverly H. Smolyansky, Ph.D.}

Mon 08/15/16 to 10/10/16b _{5:00 pm – 6:30 pm} _{Oak Campus} _{Heather A. Ciesielski, Ph.D.}

Wed 10/12/16 to 12/07/16c _{12:00 pm – 1:30 pm} _{Liberty Campus} _{Beverly H. Smolyansky, Ph.D.}

Day/Dates (Start-End) Time (Start-End) CCHMC Location Therapist

Wed 02/03/16 to 03/23/16 5:00 pm – 6:30 pm Oak Campus Richard E. A. Loren, Ph.D. Mon 02/22/16 to 04/11/16 6:00 pm – 7:30 pm Mason Campus Sanford L. Chertock, Ph.D. Wed 02/24/16 to 04/20/16a _{12:00 pm – 1:30 pm} _{Oak Campus} _{Richard E. A. Loren, Ph.D.}

Mon 03/07/16 to 05/02/16b _{5:30 pm – 7:00 pm} _{Green Township} _{F. Lynne Merk, PhD}

Wed 03/09/16 to 04/27/16 4:00 pm – 5:30 pm Fairfield Kristine A. Huiet, Ph.D. Tue 03/15/16 to 05/03/16 4:30 pm – 6:00 pm Oak Campus Jessica E. M. Cyran, Ph.D. Wed 03/16/15 to 05/04/16 12:00 pm – 1:30 pm Mason Campus S. Rachelle Plummer, Psy.D. Mon 04/04/16 to 05/23/16 4:30 pm – 6:00 pm Eastgate Rebecca J. Apseloff, Psy.D. Mon 04/18/16 to 06/13/16c _{4:30 pm – 6:00 pm} _{Liberty Campus} _{Richard E. A. Loren, Ph.D.}

Mon 05/02/16 to 06/27/16c _{5:00 pm – 6:30 pm} _{Oak Campus} _{Heather A. Ciesielski, Ph.D.}

Wed 05/04/16 to 06/22/16 4:30 pm – 6:00 pm Fairfield Richard E. A. Loren, Ph.D. Thu 06/09/16 to 07/28/16 4:00 pm – 5:30 pm Mason Campus Teri L. Caudill, Psy.D Tue 07/12/16 to 08/30/16 4:30 pm – 6:00 pm Green Township Grace D. Shelby, Ph.D. Wed 07/13/16 to 08/31/16 12:30 pm – 2:00 pm Oak Campus Richard E. A. Loren, Ph.D. Wed 08/31/16 to 10/19/16 4:00 pm – 5:30 pm Fairfield Kristine A. Huiet, Ph.D. Mon 09/12/16 to 11/07/16d _{5:30 pm – 7:00 pm} _{Green Township} _{Grace D. Shelby, Ph.D.}

Wed 09/14/16 to 11/02/16 5:00 pm – 6:30 pm Oak Campus Richard E. A. Loren, Ph.D. Thu 09/22/16 to 11/10/16 5:00 pm – 6:30 pm Eastgate James H. Brewer, Ed.D. Wed 09/28/16 to 11/16/16 12:00 pm – 1:30 pm Oak Campus Jessica E. M. Cyran, Ph.D. Mon 10/03/16 to 11/28/16d _{4:00 pm – 5:30 pm} _{Mason Campus} _{S. Rachelle Plummer, Psy.D.}

Thu 10/13/16 to 12/08/16e _{4:30 pm – 6:00 pm} _{Green Township} _{F. Lynne Merk, Ph.D.}

Mon 10/17/16 to 12/12/16d _{4:30 pm – 6:00 pm} _{Liberty Campus} _{Richard E. A. Loren, Ph.D.}

Tue 10/18/16 to 12/06/16 5:00 pm – 6:30 pm Fairfield TBA

Thu 10/27/16 to 12/22/16e _{5:00 pm – 6:30 pm} _{Oak Campus} _{Heather A. Ciesielski, Ph.D.}

To enroll in any of our behavior therapy group programs, please call the Cincinnati Children’s Behavioral Medicine & Clinical Psychology Intake Office at (513) 636-4336, option # (hash key)

This program is for parents of children ages 3.5 to 5 years who have been or are at risk for being diagnosed with ADHD. In addition to up-to-date information about ADHD and how it affects their child’s behavior, parents learn specific evidence-based techniques for providing the structure and guidance that a preschool-aged child with ADHD needs in order to succeed both at home and at preschool/kindergarten. Sessions are held on the same day each week for a total of 8 sessions, each lasting 90 minutes. The material in each session builds on that covered in prior sessions, so it is important that parents attend all 8 sessions in order to get the greatest benefit from the program. A pre-group interview with the parent(s) is typically required.

Understanding and Managing ADHD in Children ages 6-12 Parent Group Program*

This program is for parents of children ages 6 to 12 years with a primary diagnosis of ADHD. Parents obtain an up-to-date understanding of ADHD and how it affects their child’s behavior, as well as training in the use of specific evidence-based techniques for providing the structure and guidance that a child with ADHD needs to succeed behaviorally, academically, and socially. Sessions are held on the same day each week for a total of 8 sessions. Each session is 90 minutes, except for the first session which may run up to 2 hours. The material in each session builds on that covered in prior sessions, so it is important that parents plan to attend all 8 sessions in order to get the greatest benefit from the program.

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Managing Frustration for Children with ADHD Group Program*

This program is designed to address the problems some children with ADHD have with managing their frustration. It is not an alternative treatment

for the core problems with attention regulation and/or impulse control associated with ADHD. The program is most effective for children whose core symptoms of ADHD are under reasonably good control via ongoing medication and environmental management. To participate in this group, a child must be between the ages of 9 and 11 and be in third through fifth grades at the time of the group. This group is only offered at the Center for ADHD

on Cincinnati Children’s Oak Campus (off Exit 3, I-71S). There is a required pre-group interview with the parent(s) and child that will be scheduled in the weeks preceding the start of a new group that lasts 75-90 minutes. There are a total of 12 group sessions, each lasting approximately 90 minutes. Children will attend all sessions except for the 1st and 7th sessions which are attended by parents without their children. As the material in each session

builds on what is covered in earlier sessions, it is important that participants plan to attend all 12 sessions.

To enroll in any of our behavior therapy group programs, please call the Cincinnati Children’s Behavioral Medicine & Clinical Psychology Intake Office at (513) 636-4336, option # (hash key) Academic Success for Young Adolescents with ADHD Group Program*

This program is designed for young adolescents in sixth through eighth grades who are experiencing academic difficulties as a result of ADHD. It teaches adolescents and their parents proven strategies to improve organization, time management, and study skills. This program is held only at the Center for ADHD. There are a total of 7 group sessions, each lasting 90 minutes, which the adolescent and their parent attend together. As the material in each session builds on what is covered in earlier sessions, it is important that participants plan to attend all 7 sessions. In addition, a pre-group interview with the parent(s) is also required.

Academic Success for High Schoolers with ADHD Group Program*

This program is designed for freshman and sophomores in high school who are experiencing academic difficulties as a result of ADHD. It teaches adolescents and their parents proven strategies that improve organization, study skills, and academic performance with fewer arguments, less frustration, and reduced conflict between parents and their high school student who has ADHD. This program is held only at the Center for ADHD. There are a total of 8 group sessions, each lasting 90 minutes, which the parent and their adolescent attend together. As the material in each session builds on what is covered in earlier sessions, it is important that participants attend all 8 sessions. In addition, a pre-group interview with the parent(s) is also required.

Tue 03/01/16 to 05/24/16a _{4:30 pm – 6:00 pm} _{Oak Campus} _{Richard E. A. Loren, PhD}

Tue 06/07/16 to 08/30/16b _{4:00 pm – 5:30 pm} _{Oak Campus} _{Richard E. A. Loren, PhD}

Tue 10/04/16 to 12/20/16 4:30 pm – 6:00 pm Oak Campus Richard E. A. Loren, PhD

Tue 01/19/16 to 03/01/16 4:30 pm – 6:00 pm Oak Campus Jessica E. M. Cyran, PhD Mon 02/01/16 to 03/14/16 5:00 pm – 6:30 pm Oak Campus Heather A. Ciesielski, PhD Thu 03/24/16 to 05/05/16 5:00 pm – 6:30 pm Oak Campus Heather A. Ciesielski, Ph.D. Tue 08/16/16 to 09/27/16 4:30 pm – 6:00 pm Oak Campus Jessica E. M. Cyran, Ph.D. Thu 09/01/16 to 10/13/16 5:00 pm – 6:30 pm Oak Campus Heather A. Ciesielski, Ph.D. Tue 10/04/16 to 11/15/16 4:30 pm – 6:00 pm Oak Campus Jessica E. M. Cyran, Ph.D.

Thu 02/04/16 to 03/24/16 4:00 pm – 5:30 pm Oak Campus Aaron J. Vaughn, PhD Wed 02/10/16 to 03/30/16 4:00 pm – 5:30 pm Oak Campus Aaron J. Vaughn, PhD Thu 09/01/16 to 10/20/16 4:00 pm – 5:30 pm Oak Campus Aaron J. Vaughn, PhD Wed 09/14/16 to 11/09/16 4:00 pm – 5:30 pm Oak Campus Aaron J. Vaughn, PhD

* These behavior therapy group programs are covered by most insurance policies which provide coverage for group psychotherapy and multifamily group therapy services, with families responsible for any deductibles and co-pays.

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MLC 10006 3333 Burnet Avenue Cincinnati, OH 45229-3039 www.cincinnatichildrens.org/adhd

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Make a Donation to the Center for ADHD

A Study for Children 7 to 11 Years Old

Who Have or May Have ADHD

The Effects of ADHD Medication (TEAM) Study

What

This research study will look at how children with attention deficit hyperactivity disorder (ADHD) respond to medication.

Children will have a full diagnostic evaluation for ADHD, as part of this study. Who

Children 7 to 11 years old who:

• Have been diagnosed with ADHD and have not previously taken medication for ADHD

OR

• Have ADHD symptoms including: short attention span for age, difficulty listening to others, easily distracted, excessive fidgeting and/or talking, or often interrupting others

Pay

Families may receive up to $310 for time and effort. Contact

Study staff at [email protected] or 513-803-1344