VOLUME 9, NO.7&8                                                            July & August, 2004

 

NJ ADD/ADHD ADULT NEWSLETTER

ADD ADULT SELF HELP SUPPORT GROUP

FOR ADD/ADHD ADULTS

AND THEIR SIGNIFICANT OTHERS

 

MEETING: THE NEXT MEETING OF THE ADD ADULT SELF HELP SUPPORT GROUP WILL BE ON JULY 22, 2004 AT 7:30 PM AT MONMOUTH MEDICAL CENTER, COMMUNITY MEETING ROOM , LONG BRANCH, NJ.  GO TO THE RECEPTION DESK IN THE MAIN LOBBY AND GET DIRECTIONS.  THE TOPIC WILL BE:  WHAT SHOULD WE EXPECT FROM STIMULANT MEDICATIONS? 

 

NOTICE:  REMEMBER THERE WILL BE NO MEETING IN AUGUST.

 

RESEARCH: In the July issue of J.Am.Acad.Child Adolesc.Psychiartry, 2004, 43(7):792-838, several well known ADHD researchers completed a two year study on the effects of three treatments for ADHD: 1) methylphenidate (Ritalin) alone; 2) methylphenidate combined with parent training, counseling, academic assistance, psychotherapy, and social skills training; and, 3) methylphenidate plus attention comparable to that received by the subjects in the second treatment.  The conclusions from the various studies were similar: nothing seemed to equal the treatment effects of Ritalin alone.  There appeared to be no added benefit from adding any of the following to the methylphenidate: social skills training, psychotherapy, academic assistance, parent training.   There was just as much improvement in all these psychosocial areas with methylphenidate alone.  Even the parental self-rating improved as much when the child was on the medication as when the parent had parent training and the child was on medication.  Adding the social supports of treatment 2 above did not enable the children to discontinue the Ritalin.  Interestingly the Ritalin plus attention group did just as well as the Ritalin plus intensive psychosocial support (treatment 2).   Ritalin seemed to be as effective for social skills as the social skills training.  All the children in these studies were free of learning disabilities, conduct disorders, and showed an initial positive response to Ritalin or they were not included in the study.  All children maintained the gains expected and the gains lasted for the duration of the study, two years.  Many children with ADHD were excluded from the study due to various criteria.

COMMENTS: We are going to hear a lot more about this study in the future, since it advocates treating ADHD with medication alone, or medication plus added attention.  There are several concerns about the validity of this study: 1) Many of the researchers got funding from the drug companies and we do not know how many “demand characteristics” influenced the research; 2) The children, ages 7-9, were free of conduct and learning disorders.  ADHD becomes a learning disorder in many if not most children, so one wonders whether this research sample and findings can be generalized to other children with ADHD; many of us have learning disabilities; 3) The social skills training offered under treatment 2 may not have generalized to real life because children need real life social skills training not artificial trainings; 4)  This study only included “all white” children, so it cannot be generalized to other groups; 5) and others.

                On the positive side, the study showed how very beneficial Ritalin can be with certain children.  It also demonstrated that the social gains made under the stimulant, seem to remain for the two years.

 

COMMENTARY:  For years I have been recommending that ADDers with impulsivity, restlessness, or hyperactivity engage in meditation.  And, for years the responses has been uniformly negative.  Let me try again.  One purpose of practicing meditation would be to teach the brain that low stimulation, lack of chatter in our minds, quietness, thoughtfulness, sitting, reading can gradually teach our brains through habit and desensitization that quietness can be pleasant; the ADD mind won’t explode with quietness, stillness, focus, on low intensity sensory input.  We sleep each night with low stimulation.  The practice of daily meditation when it has been adopted by ADDers has been dramatically helpful.  Eventually the ADD mind learns that it is “OK” to just “BE” without doing. 

Peace!!!  

               Bob

This newsletter is available as an email at www.DrLoPresti.com.  It is offered to readers only for informational and educational purposes and does not constitute medical or psychological advice; always consult your doctor.