OUTSIDE THE BOX NON-TRADITIONAL APPROACHES TO TREATING ADHD DIANE M. DANIS, M.D.,M.P.H. DEVELOPMENTAL & BEHAVIORAL PEDIATRICIAN HELP GROUP SUMMIT OCTOBER, 2016 IS ADHD A NEW PHENOMENON? — Johnny Look-in-air DSM V ADHD Diagnostic Criteria — People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development: — Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level: — Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities. — Often has trouble holding attention on tasks or play activities. — Often does not seem to listen when spoken to directly. — Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked). — Often has trouble organizing tasks and activities. — Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework). — Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). — Is often easily distracted — Is often forgetful in daily activities. — Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level: — Often fidgets with or taps hands or feet, or squirms in seat. — Often leaves seat in situations when remaining seated is expected. — Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless). — Often unable to play or take part in leisure activities quietly. — Is often "on the go" acting as if "driven by a motor". — Often talks excessively. — Often blurts out an answer before a question has been completed. — Often has trouble waiting his/her turn. — Often interrupts or intrudes on others (e.g., butts into conversations or games) CURRENT STATISTICS U.S.A. PREVALENCE STATISTICS 2011 INTERNATIONAL STATISTICS WHAT WE KNOW WORKS — BEHAVIORAL STRATEGIES PARENT TRAINING PROGRAMS ¡ PARENT COACHING ¡ EXECUTIVE FUNCTION TRAINING ¡ BEHAVIORAL INTERVENTIONS ¡ — MEDICATION STIMULANT MEDICATIONS ¡ NON-STIMULANT MEDICATIONS ¡ WHEN MEDICATION DOESN’T WORK — PROBLEMS WITH DURATION OF ACTION — PROBLEMS WITH EFFICACY — PROBLEMS WITH SIDE EFFECTS APPETITE ¡ SLEEP ¡ INCREASED ANXIETY ¡ TICS ¡ PERSONALITY CHANGES ¡ IRRITABILITY ¡