By Dana G. Smith Do you: Cut the tags out of your clothes? Relive (and regret) past conversations? Have episodes of burnout and fatigue? Zone out while someone is talking? Become hyper-focused while working on a project? Take on dozens of hobbies? Daydream? Forget things? According to TikTok, you might have attention deficit hyperactivity disorder. Videos about the psychiatric condition are all over the social media app, with the #adhd hashtag receiving more than 17 billion views to date. Many feature young people describing their specific (and sometimes surprising) symptoms, like sensitivity to small sensory annoyances (such as clothing tags) or A.D.H.D. paralysis, a type of extreme procrastination. After viewing these videos, many people who were not diagnosed with A.D.H.D. as children may question whether they would qualify as adults. As with most psychiatric conditions, A.D.H.D. symptoms can range in type and severity. And many of them “are behaviors everyone experiences at some point or another,” said Joel Nigg, a professor of psychiatry at Oregon Health & Science University. The key to diagnosing the condition, however, requires “determining that it’s serious, it’s extreme” and it’s interfering with people’s lives, he said. It’s also critical that the symptoms have been present since childhood. Those nuances can be lost on social media, experts say. In fact, one study published earlier this year found that more than half of the A.D.H.D. videos on TikTok were misleading. If a video (or article) has you thinking you may have undiagnosed A.D.H.D., here’s what to consider. Approximately 4 percent of adults in the United States have enough symptoms to qualify for A.D.H.D., but only an estimated one in 10 of them is diagnosed and treated. For comparison, roughly 9 percent of children in the United States have been diagnosed with the condition, and three-quarters have received medication or behavioral therapy for it. One reason for the lack of diagnoses in adults is that when people think of A.D.H.D., they often imagine a boy who can’t sit still and is disruptive in class, said Dr. Deepti Anbarasan, a clinical associate professor of psychiatry at the NYU Grossman School of Medicine. But those stereotypical hyperactive symptoms are present in just 5 percent of adult cases, she said. © 2023 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28646 - Posted: 01.27.2023

Researchers at the National Institutes of Health have successfully identified differences in gene activity in the brains of people with attention deficit hyperactivity disorder (ADHD). The study, led by scientists at the National Human Genome Research Institute (NHGRI), part of NIH, found that individuals diagnosed with ADHD had differences in genes that code for known chemicals that brain cells use to communicate. The results of the findings, published in Molecular Psychiatry(link is external), show how genomic differences might contribute to symptoms. To date, this is the first study to use postmortem human brain tissue to investigate ADHD. Other approaches to studying mental health conditions include non-invasively scanning the brain, which allows researchers to examine the structure and activation of brain areas. However, these studies lack information at the level of genes and how they might influence cell function and give rise to symptoms. The researchers used a genomic technique called RNA sequencing to probe how specific genes are turned on or off, also known as gene expression. They studied two connected brain regions associated with ADHD: the caudate and the frontal cortex. These regions are known to be critical in controlling a person’s attention. Previous research found differences in the structure and activity of these brain regions in individuals with ADHD. As one of the most common mental health conditions, ADHD affects about 1 in 10 children in the United States. Diagnosis often occurs during childhood, and symptoms may persist into adulthood. Individuals with ADHD may be hyperactive and have difficulty concentrating and controlling impulses, which may affect their ability to complete daily tasks and their ability to focus at school or work. With technological advances, researchers have been able to identify genes associated with ADHD, but they had not been able to determine how genomic differences in these genes act in the brain to contribute to symptoms until now.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28559 - Posted: 11.19.2022

By Fenit Nirappil A national shortage of Adderall has left patients who rely on the pills for attention-deficit/hyperactivity disorder scrambling to find alternative treatments and uncertain whether they will be able to refill their medication. The Food and Drug Administration announced the shortage last week, saying that one of the largest producers is experiencing “intermittent manufacturing delays” and that other makers cannot keep up with demand. Some patients say the announcement was a belated acknowledgment of a reality they have faced for months — pharmacies unable to fill their orders and anxiety about whether they will run out of a medication needed to manage their daily lives. Experts say it is often difficult for patients to access Adderall, a stimulant that is tightly regulated as a controlled substance because of high potential for abuse. Medication management generally requires monthly doctor visits. There have been other shortages in recent years. “This one is more sustained,” said Timothy Wilens, an ADHD expert and chief of child and adolescent psychiatry at Massachusetts General Hospital who said access issues stretch back to spring. “It’s putting pressure on patients, and it’s putting pressure on institutions that support the patients.” Erik Gude, a 28-year-old chef who lives in Atlanta, experiences regular challenges filling his Adderall prescription, whether it’s pharmacies not carrying generic versions or disputes with insurers. He has been off the medication for a month after his local pharmacy ran out.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 28520 - Posted: 10.22.2022

By Greg Miller If you’re lucky enough to live to 80, you’ll take up to a billion breaths in the course of your life, inhaling and exhaling enough air to fill about 50 Goodyear blimps or more. We take about 20,000 breaths a day, sucking in oxygen to fuel our cells and tissues, and ridding the body of carbon dioxide that builds up as a result of cellular metabolism. Breathing is so essential to life that people generally die within minutes if it stops. It’s a behavior so automatic that we tend to take it for granted. But breathing is a physiological marvel — both extremely reliable and incredibly flexible. Our breathing rate can change almost instantaneously in response to stress or arousal and even before an increase in physical activity. And breathing is so seamlessly coordinated with other behaviors like eating, talking, laughing and sighing that you may have never even noticed how your breathing changes to accommodate them. Breathing can also influence your state of mind, as evidenced by the controlled breathing practices of yoga and other ancient meditative traditions. In recent years, researchers have begun to unravel some of the underlying neural mechanisms of breathing and its many influences on body and mind. In the late 1980s, neuroscientists identified a network of neurons in the brainstem that sets the rhythm for respiration. That discovery has been a springboard for investigations into how the brain integrates breathing with other behaviors. At the same time, researchers have been finding evidence that breathing may influence activity across wide swaths of the brain, including ones with important roles in emotion and cognition. “Breathing has a lot of jobs,” says Jack L. Feldman, a neuroscientist at the University of California, Los Angeles, and coauthor of a recent article on the interplay of breathing and emotion in the Annual Review of Neuroscience. “It’s very complicated because we’re constantly changing our posture and our metabolism, and it has to be coordinated with all these other behaviors.” © 2022 Annual Reviews

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 2: Functional Neuroanatomy: The Cells and Structure of the Nervous System
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 2: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Link ID: 28508 - Posted: 10.08.2022

William E. Pelham, Jr. For decades, many physicians, parents and teachers have believed that stimulant medications help children with ADHD learn because they are able to focus and behave better when medicated. After all, an estimated 6.1 million children in the U.S. are diagnosed with attention-deficit/hyperactivity disorder, and more than 90% are prescribed stimulant medication as the main form of treatment in school settings. However, in a peer-reviewed study that several colleagues and I published in the Journal of Consulting and Clinical Psychology, we found medication has no detectable effect on how much children with ADHD learn in the classroom. At least that’s the case when learning – defined as the acquisition of performable skills or knowledge through instruction – is measured in terms of tests meant to assess improvements in a student’s current academic knowledge or skills over time. Compared to their peers, children with ADHD exhibit more off-task, disruptive classroom behavior, earn lower grades and score lower on tests. They are more likely to receive special education services and be retained for a grade, and less likely to finish high school and enter college – two educational milestones that are associated with significant increases in earnings. In this study, funded by the National Institute of Mental Health, we evaluated 173 children between the ages of 7 and 12. They were all participants in our Summer Treatment Program, a comprehensive eight-week summer camp for children with ADHD and related behavioral, emotional and learning challenges. Children got grade-level instruction in vocabulary, science and social studies. The classes were led by certified teachers. The children received medication the first half of summer and a placebo during the other half. They were tested at the start of each academic instruction block, which lasted approximately three weeks. They then took the same test at the end to determine how much they learned. © 2010–2022, The Conversation US, Inc.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 28366 - Posted: 06.11.2022

Daniel Lavelle With ADHD, thoughts and impulses intrude on my focus like burglars trying to break into a house. Sometimes these crooks carefully pick the backdoor lock before they silently enter and pilfer all the silverware. At other times, stealth goes out of the window; they’re kicking through the front door and taking whatever they like. Either way, I was supposed to be reading a book just now, but all I can think about is how great it would be if I waded into a river to save a litter of kittens from tumbling down a waterfall just in the nick of time. I’ve got the kittens in my hand, and the crowd has gone wild; the spectres of Gandhi, Churchill and Obi-Wan Kenobi hover over the riverbank, nodding their approval while fireworks crackle overhead … I snap back and realise I’ve read three pages, only I don’t remember a single line. I reread the same pages, but the same thing happens, only now I’m so hung up on concentrating that another fantasy has hijacked my attention. This time I’m imagining that I’m super-focused, so focused that Manchester United have called and told me they want me to be their special penalty taker. These Walter Mitty, borderline narcissistic episodes persist for a while until I give up and go and be distracted somewhere else. Advertisement Unfortunately, I don’t take Ritalin, a stimulant prescribed to daydreamers like me, so when it comes to focusing I need all the help I can get. Enter Swiss developer and typographic designer Renato Casutt, who has spent six years trying to develop a typographical trick that helps people read more quickly and efficiently. “Bionic reading” is a font people can use on their devices via apps for iPhone and other Apple products. It works by highlighting a limited number of letters in a word in bold, and allowing your brain – or, more specifically, your memory – to fill in the rest. © 2022 Guardian News & Media Limited

Related chapters from BN: Chapter 17: Learning and Memory; Chapter 19: Language and Lateralization
Related chapters from MM:Chapter 13: Memory and Learning; Chapter 15: Language and Lateralization
Link ID: 28358 - Posted: 06.07.2022

By Christina Caron When Chris Lawson began dating Alexandra Salamis, the woman who would eventually become his partner, he was “Mr. Super Attentive Dude,” he said, the type of guy who enjoyed buying cards and flowers for no reason other than to show how much he loved her. But after they moved in together in 2015, things changed. He became more distracted and forgetful. Whether it was chores, planning social events or anything deadline-driven — like renewing a driver’s license — Ms. Salamis, 60, had to continually prod Mr. Lawson to get things done. Invariably, she just ended up doing them herself. “I was responsible for nothing,” Mr. Lawson, 55, admitted. Ms. Salamis, who is not one to mince words, described that period of their relationship as “like living with a child,” later adding, “I hated him, frankly.” But when she brought up her frustrations, Mr. Lawson would become defensive. And as she continued to nag, she started to feel more like a parent than a partner, something they both resented. Then in 2019, at a friend’s suggestion, the pair read an article about how attention deficit hyperactivity disorder, or A.D.H.D., can affect romantic relationships. “We both kind of looked at each other and our jaws dropped,” Ms. Salamis said. The couple, who live in Ottawa, had discovered something millions of others have realized, often after years of conflict: One of them — in this case, Mr. Lawson — most likely had A.D.H.D., a neurodevelopmental disorder often characterized by inattention, disorganization, hyperactivity and impulsivity. When one or both members of a couple have A.D.H.D., the relationship typically has unique challenges, which are usually exacerbated when the disorder goes undiagnosed, experts say. Studies suggest that people with A.D.H.D. have higher levels of interpersonal problems than their peers do, and marriages that include adults with A.D.H.D. are more likely to be unsatisfying. Forums like the one found on the popular website A.D.H.D. and Marriage are often filled with stories of frazzled, emotionally spent spouses stuck in unhealthy, yearslong patterns. But if a couple makes a strong effort to learn more about the disorder, manage its symptoms and find more effective ways to communicate, they can revitalize their relationship. © 2022 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 28209 - Posted: 02.19.2022

By Emma Yasinski By the time kids diagnosed with attention deficit hyperactivity disorder meet with clinical psychologist Mary O’Connor, they have often been taking multiple medications or unusually high doses of stimulants like Ritalin. “They may have had a trial of stimulants that worked initially,” she says, but when the effect waned, their physicians prescribed higher doses, sometimes to the point of toxicity. O’Connor researches fetal alcohol spectrum disorders at the University of California, Los Angeles, where she has provided both diagnosis and treatment to children exposed to alcohol in the womb. At one end of the spectrum sits fetal alcohol syndrome, characterized by facial abnormalities, growth problems, and intellectual disabilities. The other end of the spectrum is characterized by subtler symptoms, including poor judgement and impulsivity — in other words, what looks to many like ADHD. But experts say standard ADHD treatments often don’t work as well for children exposed to alcohol in-utero. And lack of awareness, a shortage of specialists, and social stigma have combined to limit families’ ability to receive an accurate diagnosis and support for FASD, a condition that is underdiagnosed in the United States and could affect between 1 and 5 percent of this country’s children. The lack of diagnoses, scientists say, stifles research on treatments and may even cloud data on therapies for other disorders.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 14: Attention and Higher Cognition
Link ID: 28206 - Posted: 02.16.2022

By Emily Willingham As with most decision points around pregnancy, cannabis use is a fraught subject. Researchers can’t assess it in randomized trials because dosing pregnant people with the psychoactive substance is unethical. The next best thing is studies with enough participants who use cannabis on their own, allowing for comparisons with those who do not. The findings of one such study, published on November 15 in the Proceedings of the National Academy of Sciences USA, highlight symptoms of increased anxiety, hyperactivity and aggression in children whose parents used cannabis during pregnancy. And its analysis of placental tissue points to changes in the activity of immunity-related genes. Today pregnant people “are being bombarded with a lot of ads to treat nausea and anxiety during pregnancy” with cannabis, says the paper’s senior author Yasmin Hurd, director of the Addiction Institute at Mount Sinai. “Our studies are about empowering them with knowledge and education so that they can make decisions.” The results are “very striking, very much a first,” says Daniele Piomelli, a professor and director of the Center for the Study of Cannabis at the University of California, Irvine, who was not involved in the work. Pregnancy studies in rodents and even in sheep, which have a placenta more like ours, have required cautious interpretations of findings that show effects on offspring behavior and function, he says. The new study is one of the first to tackle the question in people “in a systematic way,” Piomelli adds. © 2021 Scientific American

Related chapters from BN: Chapter 7: Life-Span Development of the Brain and Behavior; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 13: Memory and Learning; Chapter 4: Development of the Brain
Link ID: 28078 - Posted: 11.17.2021

By Katherine Ellison Jessica McCabe crashed and burned at 30, when she got divorced, dropped out of community college and moved in with her mother. Eric Tivers had 21 jobs before age 21. Both have been diagnosed with attention-deficit/hyperactivity disorder, and both today are entrepreneurs who wear their diagnoses — and rare resilience — on their sleeves. With YouTube videos, podcasts and tweets, they’ve built online communities aimed at ending the shame that so often makes having ADHD so much harder. Now they’re going even further, asking: Why not demand more than mere compassion? Why not seek deeper changes to create a more ADHD-friendly world? “I’ve spent the last five or six years trying to understand how my brain works so that I could conform, but now I’m starting to evolve,” says McCabe, 38, whose chipper, NASCAR-speed delivery has garnered 742,000 subscribers — and counting — to her YouTube channel, “How to ADHD.” “I think we no longer have to accept that we live in a world that is not built for our brains.” With Tivers, she is planning a virtual summit on the topic for next May. As a first step, with the help of Canadian cognitive scientist Deirdre Kelly, she says she’ll soon release new guidelines to assess products and services for their ADHD friendliness. Computer programs that help restless users meditate and a chair that accommodates a variety of seated positions are high on the list to promote, while error-prone apps or devices will be flagged. Kelly also envisions redesigning refrigerator vegetable drawers, so that the most nutritious food will no longer be out of sight and mind. In the past two decades, the world has become much kinder to the estimated 6.1 million children and approximately 10 million adults with ADHD, whose hallmark symptoms are distraction, forgetfulness and impulsivity. Social media has made all the difference.

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27960 - Posted: 08.25.2021

By Katherine Ellison ADHD — the most common psychiatric disorder of childhood —  lasts longer for more people than has been widely assumed, according to new research. “Only 10 percent of people really appear to grow out of ADHD,” says the lead author, psychologist Margaret Sibley, associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. “Ninety percent still struggle with at least mild symptoms as adults — even if they have periods when they are symptom free.” The study challenges a widely persistent perception of a time-limited condition occurring mostly in childhood. Indeed, one of the earliest names for attention deficit/hyperactivity disorder was “a hyperkinetic disease of infancy,” while its most common poster child has long been a young, White, disruptive male. Previous research has suggested the condition essentially vanishes in about half of those who receive diagnoses. But in recent years, increasing numbers of women, people of color and especially adults have been seeking help in managing the hallmark symptoms of distraction, forgetfulness and impulsivity. By the most recent estimates, 9.6 percent of children ages 3 to 17 have been diagnosed with ADHD. Yet researchers report that only 4.4 percent of young adults ages 18 to 44 have the disorder, suggesting that if the new estimates are valid, there may be some catching up to do. Sibley’s paper paints a picture of an on-again, off-again condition, with symptoms fluctuating depending on life circumstances. © 1996-2021 The Washington Post

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27946 - Posted: 08.14.2021

By Christina Caron Q: How common is adult A.D.H.D.? What are the symptoms and is it possible for someone who was not diagnosed with it as a child to be diagnosed as an adult? A: Attention deficit hyperactivity disorder, or A.D.H.D., is a neurodevelopmental disorder often characterized by inattention, disorganization, hyperactivity and impulsivity. It is one of the most common mental health disorders. According to the World Federation of A.D.H.D., it is thought to occur in nearly 6 percent of children and 2.5 percent of adults. In the United States, 5.4 million children, or about 8 percent of all U.S. children ages 3 to 17, were estimated to have A.D.H.D. in 2016, the Centers for Disease Control and Prevention reported. For decades, experts believed that A.D.H.D. occurred only among children and ended after adolescence. But a number of studies in the ’90s showed that A.D.H.D. can continue into adulthood. Experts now say that at least 60 percent of children with A.D.H.D. will also have symptoms as adults. It’s not surprising that so many people are now wondering whether they might have the disorder, especially if their symptoms were exacerbated by the pandemic. The Attention Deficit Disorder Association, an organization founded in 1990 for adults with A.D.H.D, saw its membership nearly double between 2019 and 2021. In addition, Children and Adults With Attention-Deficit/Hyperactivity Disorder, or CHADD, reported that the highest proportion of people who call their A.D.H.D. help line are adults seeking guidance and resources for themselves. © 2021 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27933 - Posted: 08.07.2021

By Branko van Hulst, Sander Werkhoven, Sarah Dursto “A rose by any other name would smell as sweet.” It is an often-used quote, and for good reason. Juliet tragically underestimated the impact of the Montague surname. She was not the first, nor the last, to underestimate the power of the names we give. In psychiatry, handbooks determine which names (or classifications) we give to the difficulties that people face. We use them so that when we say ADHD, schizophrenia or depression, people have a more or less consistent idea of what we mean. Moreover, it enables us to study groups of people with the same classification and learn about treatments and prognostics. However, a severe and often overlooked side effect of this practice is that these names implicitly suggest causality. The classificatory terms we use all refer to disorders that cause symptoms, and therefore suggest that we understand the causes of the problems. Which we do not. At the very least, the term disorder suggests a common causal structure, which goes against all our current knowledge on causal heterogeneity in psychiatry. Moreover, these classifications are applied to individuals and therefore suggest that causes lie mainly with the affected individual. The most common psychiatric handbooks (DSM-5 and ICD-11) are clear on the status of their classifications: they are purely descriptive and are not based on underlying causes. Still, in practice, we say things like “he is inattentive at school because he has ADHD.” It is a circular statement: a child is inattentive because of his inattentiveness. When we say that someone has an attention deficit, we are inclined to look for the cause of the problem. But when we say someone has an attention deficit disorder, we might wrongly assume we have already found the cause. Or, in a milder version, assume the cause to be located somewhere in the (brain of the) individual. © 2021 Scientific American,

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 13: Memory and Learning
Link ID: 27725 - Posted: 03.11.2021

By Cheryl Maguire When my 15-year-old son was given a diagnosis of attention deficit hyperactivity disorder at age 7, I was told that it was a lifelong chronic condition. So I felt a little bit hopeful when a study published last winter in the Journal of Developmental and Behavioral Pediatrics said that “an estimated 30 percent to 60 percent of children diagnosed with A.D.H.D. no longer meet diagnostic criteria for this disorder by late adolescence.” Does that mean they outgrew it? There is no simple answer, said Thomas Power, director of the center for management of A.D.H.D. at Children’s Hospital of Philadelphia, and the senior author of the study. He was one of eight experts I consulted, and while they fell into different camps on whether someone can outgrow A.D.H.D., they all agreed that the answer is complicated. Some said there could be a genetic component to outgrowing A.D.H.D., while others told me that certain coping skills and job choices play a prominent role in lessening symptoms, which could make it seem that the person no longer has it. Russell Barkley, a clinical professor of psychiatry at the Virginia Commonwealth University Medical Center, clarified that ceasing to meet the definition of A.D.H.D. in the Diagnostic and Statistical Manual of Mental Disorders, the main resource that clinicians use to make a diagnosis, does not mean that the person no longer has the issues of A.D.H.D. “People are outgrowing the D.S.M. criteria but not outgrowing their disorder for the most part,” Dr. Barkley said. “Diagnosing A.D.H.D. is not like leukemia, where you do a blood test and you know definitively you have leukemia,” said Dr. William Barbaresi, a developmental behavioral pediatrician at Children’s Hospital in Boston, and professor of pediatrics at Harvard Medical School. When a young child is given an A.D.H.D. diagnosis, doctors and clinicians rely on patient, parent and teacher feedback. But when a late adolescent or adult is assessed, it is normally based on self-reports only. “There are a lot of reasons to wonder how accurate that report is since it is difficult to evaluate yourself,” said Dr. Barbaresi. And Dr. Power noted, “Individuals with A.D.H.D. tend to underreport their symptoms.” © 2020 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27578 - Posted: 11.14.2020

Can a video game help children struggling with ADHD? That question inspired hopeful headlines last month after the Food and Drug Administration permitted marketing of the first digital game that may be prescribed to treat children ages 8 to 12 who have been diagnosed with attention-deficit/hyperactivity disorder. In EndeavorRx, designed for iPhones and iPads, children guide an avatar surfing through molten lava and an icy river, dodging fires and icebergs while grabbing flying objects. The game is not yet available for purchase, nor has a price been released, but its Boston-based developer, Akili Interactive Labs, may now feature its unique status in ads and pursue coverage by insurance plans. No trip to the pharmacy is needed: Doctors and nurses will be able to prescribe the game by giving parents a code to download an app. Akili’s website touts its digital approach as “the future of medicine.” But some critics say: Not so fast. “It’s a marketing ploy,” said clinical psychologist and researcher Russell Barkley, author of several books on ADHD. Barkley and three other ADHD experts who reviewed Akili’s research said the firm was overpromising by implying that EndeavorRx can provide meaningful help for children struggling in school and at home with the sometimes-debilitating neurodevelopmental disorder, whose symptoms include distraction, forgetfulness and impulsivity. “I’m a little shocked and more perplexed about why the FDA would approve this and allow it to be paid for by insurance,” said Mark Rapport, head of the Children’s Learning Clinic at the University of Central Florida, who has published extensive research on other brain-training programs making similar claims. “I abhor seeing desperate parents spend money based on empty promises. . . . On moral grounds, I think it’s wrong to tell people to get their doctors to prescribe this when it does nothing of real-world importance.”

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 27384 - Posted: 07.27.2020

By Katherine Ellison After a lifetime of arriving late, missing deadlines and having friends call her a ditz, Leslie Crawford wanted to know whether her chronic distraction meant she had attention-deficit/hyperactivity disorder, ADHD. And, if that were true, could medication help? Over three visits with her managed-care plan doctor in San Francisco, Crawford, 57, a busy mother of two and professional editor, complied with urine and blood tests some doctors require to rule out drug abuse, and was checked for any preexisting heart condition that might make stimulants too risky. Then came the last step: a telephone interview. “What kind of student were you in elementary school?” she remembers the psychiatrist asking. “I was an A student,” Crawford answered. “I’m sorry,” he said, as Crawford recalled. “You don’t meet the qualification for ADHD and we can’t give you medication.” AD “I couldn’t believe it,” Crawford said later. Two private therapists had already told her she had ADHD, she said. But her plan’s psychiatrist said it was company policy to deny diagnosis and medication if a patient had done well in school as a child. This left Crawford with the option of paying several hundred dollars for a private psychiatrist’s evaluation, plus recurring costs for new prescriptions over time. For now, she’s not pursuing that. After her three appointments, “I just felt exhausted,” she said. ADHD affects more than 16 million U.S. children and adults. Despite decades of research involving thousands of studies, it remains one of the most perplexing of mental health diagnoses, susceptible to confusion and controversy even among doctors who treat it. The muddle can be particularly damaging to girls and women, who like Crawford may miss early treatment that could have spared them years of shame, anxiety, depression, self-harm and even suicide attempts.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 12: Sex: Evolutionary, Hormonal, and Neural Bases
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 8: Hormones and Sex
Link ID: 27252 - Posted: 05.18.2020

Differences associated with learning difficulties are found less in specific areas of the brain and more in the connections between them, experts say. After scanning 479 children's brains, Cambridge University researchers found they were organised in multiple "hubs". Those with no difficulties - or very specific ones, such as poor listening skills - had well connected hubs. But those with widespread and severe difficulties - 14-30% of all children - were found to have poor connections. It was recently suggested schools were failing to spot ADHD and autism, which could be contributing to a rise in exclusions. Dr Duncan Astle told BBC News: "We have spent decades searching for the brain areas for different types of developmental difficulty such as ADHD and dyslexia. "Our findings show that something which is far more important is the way a child's brain is organised. "In particular, the role that highly connected 'hub' regions play. "This has not been shown before and its implications for our scientific understanding of developmental difficulties is big. "How do these hubs emerge over developmental time? "What environmental and genetic factors can influence this emergence?" "Another key finding is that the diagnostic labels children had been given were not closely related to their cognitive difficulties - for example, two children with ADHD [attention deficit hyperactivity disorder] could be very different from each other. "This has been well known in practice for a long time but poorly documented in the scientific literature." Mental-health disorders © 2020 BBC

Related chapters from BN: Chapter 19: Language and Lateralization; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 15: Language and Lateralization; Chapter 14: Attention and Higher Cognition
Link ID: 27080 - Posted: 02.28.2020

By Richard Klasco, M.D. A. The theory of the “sugar high” has been debunked, yet the myth persists. The notion that sugar might make children behave badly first appeared in the medical literature in 1922. But the idea did not capture the public’s imagination until Dr. Ben Feingold’s best-selling book, “Why Your Child Is Hyperactive,” was published in 1975. In his book, Dr. Feingold describes the case of a boy who might well be “patient zero” for the putative connection between sugar and hyperactivity: [The mother’s] fair-haired, wiry son loved soft drinks, candy and cake — not exactly abnormal for any healthy child. He also seemed to go completely wild after birthday parties and during family gatherings around holidays. In the mid-’70s, stimulant drugs such as Ritalin and amphetamine were becoming popular for the treatment of attention deficit hyperactivity disorder. For parents who were concerned about drug side effects, the possibility of controlling hyperactivity by eliminating sugar proved to be an enticing, almost irresistible, prospect. Some studies supported the theory. They suggested that high sugar diets caused spikes in insulin secretion, which triggered adrenaline production and hyperactivity. But the data were weak and were soon questioned by other scientists. An extraordinarily rigorous study settled the question in 1994. Writing in the New England Journal of Medicine, a group of scientists tested normal preschoolers and children whose parents described them as being sensitive to sugar. Neither the parents, the children nor the research staff knew which of the children were getting sugary foods and which were getting a diet sweetened with aspartame and other artificial sweeteners. Urine was tested to verify compliance with the diets. Nine different measures of cognitive and behavioral performance were assessed, with measurements taken at five-second intervals. © 2020 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27060 - Posted: 02.21.2020

Maternal obesity may increase a child’s risk for attention-deficit hyperactivity disorder (ADHD), according to an analysis by researchers from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health. The researchers found that mothers — but not fathers — who were overweight or obese before pregnancy were more likely to report that their children had been diagnosed with attention-deficit hyperactivity disorder (ADHD) or to have symptoms of hyperactivity, inattentiveness or impulsiveness at ages 7 to 8 years old. Their study appears in The Journal of Pediatrics. The study team analyzed the NICHD Upstate KIDS Study, which recruited mothers of young infants and followed the children through age 8 years. In this analysis of nearly 2,000 children, the study team found that women who were obese before pregnancy were approximately twice as likely to report that their child had ADHD or symptoms of hyperactivity, inattention or impulsiveness, compared to children of women of normal weight before pregnancy. The authors suggest that, if their findings are confirmed by additional studies, healthcare providers may want to screen children of obese mothers for ADHD so that they could be offered earlier interventions. The authors also note that healthcare providers could use evidence-based strategies to counsel women considering pregnancy on diet and lifestyle. Resources for plus-size pregnant women and their healthcare providers are available as part of NICHD’s Pregnancy for Every Body initiative.

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 27055 - Posted: 02.20.2020

By Perri Klass, M.D. Whenever I write about attention deficit hyperactivity disorder — whether I’m writing generally about the struggles facing these children and their families or dealing more specifically with medications — I know that some readers will write in to say that A.D.H.D. is not a real disorder. They say that the rising numbers of children taking stimulant medication to treat attentional problems are all victims, sometimes of modern society and its unfair expectations, sometimes of doctors, and most often of the rapacious pharmaceutical industry. I do believe that A.D.H.D. is a valid diagnosis, though a diagnosis that has to be made with care, and I believe that some children struggle with it mightily. Although medication should be neither the first nor the only treatment used, some children find that the stimulants significantly change their educational experiences, and their lives, for the better. Dr. Mark Bertin, a developmental pediatrician in Pleasantville, N.Y., who is the author of “Mindful Parenting for A.D.H.D.,” said, “On a practical level, we know that correctly diagnosed A.D.H.D. is real, and we know that when they’re used properly, medications can be both safe and effective.” The choice to use medications can be a difficult one for families, he said, and is made even more difficult by “the public perception that they’re not safe, or that they fundamentally change kids.” He worries, he says, that marketing is really effective, and wants to keep it “at arm’s length,” far away from his own clinical decisions, not allowing drug reps in the office, not accepting gifts — but acknowledging, all the same, that it’s probably not possible to avoid the effects of marketing entirely. Still, he said, when it comes to stimulants, “the idea that we’re only using them because of the pharmaceutical industry is totally off base,” and can make it much harder to talk with parents about the potential benefits — and the potential problems — of treating a particular child with a particular medication. “When it comes to A.D.H.D. in particular, it’s a hard enough thing for families to be dealing with without all the fear and judgment added on.” © 2020 The New York Times Company

Related chapters from BN: Chapter 7: Life-Span Development of the Brain and Behavior; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 27030 - Posted: 02.10.2020