Talking About ADHD Language Guide

AADPA is excited to release the newly developed ‘Talking about ADHD’ guide. The guide was developed in conjunction with Neurodevelopment Australia and has been endorsed by the ADHD Foundation, ADHD Australia, and Parents for ADHD Australia.

The aim of the guide is to encourage people to think about and stop using words/rhetoric (including words that elicit negative narratives and stereotypes) that tend to feed into the stigma surrounding ADHD and cause psychological harm to those living with the disorder, and instead, use language that fosters understanding and awareness of ADHD and aligns with the recovery paradigm i.e. hope for the future, acceptance of disability, personal empowerment, etc.(as outlined in the National Health and Medical Council Recovery-focused language guide).

Developmental Language Disorder and Mental Health

Will every person diagnosed with Developmental Language Disorder (DLD) struggle with their mental health?

How do you support a loved one with mental health challenges?

What do health professionals and educators need to know about working with people with DLD who also have mental health issues?

In this very practical episode of The Talking DLD Podcast we are talking Developmental Language Disorder and mental health with Melanie Cross, speech and language therapist.

Melanie Cross is a speech and language therapist. She has worked with children and young people with mental health needs for many years. She is the author of ‘Children with Social, Emotional and Behavioural Difficulties and Communication Problems’ , 2nd edition. She is also an Advisor on child mental health, and she was lead author of the Royal College of Speech and Language Therapist’s Clinical Guidelines on Social Emotional and Mental Health. Melanie graduated from Reading University in 1984 and gained an MPhil in undetected communication problems in children looked after by the local authority in 2001. In 2017 she became a Fellow of the Higher Education Teaching Academy. She is also a trainer, supervisor and a Video Interaction Guider.

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Can Your Home Affect Your Child’s ADHD?

Researchers at the University of NSW are seeking volunteer research participants to identify home features impacting children and adolescents with ADHD. By participating in this research you can help us better understand how to make homes more suitable for people living with ADHD.

Who Can Participate

Be over the age of eighteen, and

Be a parent guardian or carer of a child or adolescent diagnosed with ADHD

Benefits To You

Once you submit your response you can access a factsheet about built environment and ADHD. The factsheet gives information about some elements that can trigger ADHD symptoms and suggests some ways of space design to improve physical surroundings to be ADHD friendlier.

The Survey Is Anonymous and Online

For more information please contact Professor Catherine Bridge at c.bridge@unsw.edu.au

Drug Turns Back the Clock on Cognitive Decline

Could this be the proverbial silver bullet necessary to enhance cognitive function amongst an XXY community and more, early signs certainly seem to point that way. Bring on the human trials, our community is more than ready for this.

When faced with stressful stimuli — anything from oxygen or nutrient deprivation to viral infections — cells have in-built safety mechanisms to ensure their survival. This elaborate series of biochemical events is known as the integrated stress response. Once initiated, a cell in this state shuts down its protein production machinery. 

The integrated stress response is of particular interest to neuroscientists as these physiological safety switches have been found to be turned on in neural cells affected by traumatic brain injury, aging, and neurodegenerative disease. The question is — what if they could reset these safety switches, turning them back off again? Does this mean the cognitive impairment associated with these conditions is not as permanent as we once thought?

Scientists have made the exciting discovery that a recently-discovered drug is indeed capable of kickstarting neural cells in standby mode, getting their protein synthesis systems back online, and most promisingly, restoring cognitive function. 

The drug, called ISRIB (integrated stress response inhibitor), is a product of studies by investigators at UCSF. Earlier experiments that involved administering ISRIB treatment to mice with traumatic brain injuries showed spectacular results: normal brain function was restored in a matter of hours.

“We’ve seen how ISRIB restores cognition in animals with traumatic brain injury, which in many ways is like a sped-up version of age-related cognitive decline,” commented study lead Susanna Rosi, professor of Neurological Surgery at UCSF. “It may seem like a crazy idea, but asking whether the drug could reverse symptoms of aging itself was just a logical next step.”

UCSF

In their latest study, Rosi and colleagues were interested in ISRIB’s potential to reverse cognitive impairment associated with aging. Two cohorts of mice (one aged and one young) were trained to navigate a maze — a cognitive task much easier for the younger mice to handle. When given a daily dose of ISRIB, however, the older mice were able to keep up with their youthful counterparts, outperforming other elderly mice who did not receive the medication. All this with no observable side effects.

Taking a closer look at the mechanism behind this boost of cognitive power, the investigators identified two key pathways that ISRIB improved: neurological activity in the hippocampus and reducing the activity of inflammatory immune cells in the brain. T cells are particularly susceptible to dysfunction as a result of aging, which has been linked to the brain’s elevated inflammatory state in conditions such as Alzheimer’s. 

“This was very exciting to me because we know that aging has a profound and persistent effect on T cells and that these changes can affect brain function in the hippocampus,” said Rosi. 

“At the moment, this is just an interesting observation, but it gives us a very exciting set of biological puzzles to solve.”

Source

Children with ADHD can now be prescribed a video game

The American Food and Drug Administration (FDA) permitted marketing of the first game-based digital therapeutic device to improve attention function in children with attention deficit hyperactivity disorder (ADHD). The prescription-only game-based device, called EndeavorRx, is indicated for paediatric patients ages 8 to 12 years old with primarily inattentive or combined-type ADHD who have demonstrated an attention issue.

EndeavorRx is indicated to improve attention function as measured by computer-based testing and is the first digital therapeutic intended to improve symptoms associated with ADHD, as well as the first game-based therapeutic granted marketing authorisation by the FDA for any type of condition. The device is intended for use as part of a therapeutic program that may include clinician-directed therapy, medication, and/or educational programs, which further address symptoms of the disorder.

The EndeavorRx device offers a non-drug option for improving symptoms associated with ADHD in children and is an important example of the growing field of digital therapy and digital therapeutics. The FDA is committed to providing regulatory pathways that enable patients timely access to safe and effective innovative digital therapeutics.”

Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health

ADHD is a common disorder that begins in childhood, affecting approximately 4 million children ages 6-11. Symptoms include difficulty staying focused and paying attention, difficulty controlling behaviour, and very high levels of activity. According to the Centers for Disease Control and Prevention, diagnosis of ADHD should be conducted by a trained health care professional and follow an evaluation of symptoms or pattern of symptoms, such as inattention, hyperactivity, and impulsivity that interfere with functioning or development.

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Connection Between Hubs Responsible for ADHD & ASD

Between 14-30% of children and adolescents worldwide have learning difficulties severe enough to require additional support. These difficulties are often associated with cognitive and/or behavioural problems. In some cases, children who are struggling at school receive a formal diagnosis of a specific learning difficulty or disability, such as dyslexia, dyscalculia or developmental language disorder, or of a developmental disorder such as attention deficit and hyperactivity disorder (ADHD), dyspraxia, or autism spectrum disorder.

Scientists have struggled to identify specific areas of the brain that might give rise to these difficulties, with studies implicating myriad brain regions. ADHD, for example, has been linked to the anterior cingulate cortex, caudate nucleus, pallidum, striatum, cerebellum, prefrontal cortex, the premotor cortex and most parts of the parietal lobe.

One potential explanation is that each diagnosis differs so much between one individual and the next, that each involves different combinations of brain regions. However, a more provocative explanation has been proposed by a team of scientists at the MRC Cognition and Brain Sciences Unit, University of Cambridge: there are, in fact, no specific brain areas that cause these difficulties.

To test their hypothesis, the researchers used machine learning to map the brain differences across a group of almost 479 children, 337 of whom had been referred with learning-related cognitive problems and 142 from a comparison sample. The algorithm interpreted data taken from a large battery of cognitive, learning, and behavioural measures, as well as from brain scans taken using magnetic resonance imaging (MRI). The results are published today in Current Biology.

The researchers found that the brain differences did not map onto any labels the children had been given — in other words, there were no brain regions that predicted having ASD or ADHD. More surprisingly, they found that the different brain regions did not even predict specific cognitive difficulties — there was no specific brain deficit for language problems or memory difficulties.

Instead, the team found that the children’s brains were organised around hubs, like an efficient traffic system or social network. Children who had well-connected brain hubs had either very specific cognitive difficulties, such as poor listening skills, or had no cognitive difficulties at all. By contrast, children with poorly connected hubs — like a train station with few or poor connections — had widespread and severe cognitive problems.

“Scientists have argued for decades that there are specific brain regions that predict having a particular learning disorder or difficulty, but we’ve shown that this isn’t the case,” said Dr Duncan Astle, senior author on the study. “In fact, it’s much more important to consider how these brain areas are connected — specifically, whether they are connected via hubs. The severity of learning difficulties was strongly associated with the connectedness of these hubs, we think because these hubs play a key role in sharing information between brain areas.”

Dr Astle said that one implication of their work is that it suggests that interventions should be less reliant on diagnostic labels.

“Receiving a diagnosis is important for families. It can give professional recognition for a child’s difficulties and open the door to specialist support. But in terms of specific interventions from the child’s teachers, they can be a distraction.

The findings may explain why drugs treatments have not proven effective for developmental disorders. Methylphenidate (Ritalin), for example, which is used to treat ADHD, appears to reduce hyperactivity, but does not remediate cognitive difficulties or improve educational progress. Drugs tend to target specific types of nerve cells, but would have little impact on a ‘hub-based’ organisation that has emerged over many years.

“It’s better to look at their areas of cognitive difficulties and how these can be supported, for example using specific interventions to improve listening skills or language competencies, or at interventions that would be good for the whole class, like how to reduce working memory demands during learning.”

The findings may explain why drugs treatments have not proven effective for developmental disorders. Methylphenidate (Ritalin), for example, which is used to treat ADHD, appears to reduce hyperactivity, but does not remediate cognitive difficulties or improve educational progress. Drugs tend to target specific types of nerve cells, but would have little impact on a ‘hub-based’ organisation that has emerged over many years.

While this is the first time that hubs and their connections have been shown to play a key role in learning difficulties and developmental disorders, their importance in brain disorders is becoming increasingly clear in recent years. Cambridge researchers have previously shown that they also play an important role in mental health disorders that begin to emerge during adolescence, such as schizophrenia.

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What are the Differences Between Developmental Language Disorder (DLD) and Autism Spectrum Disorder (ASD)

Neurodevelopmental conditions is a name doctors and scientists give to differences from the expected brain and behaviour development during childhood.  There are many ways that brain development can be different. One of the most well known neurodevelopmental conditions is autism, which has some similarities with Developmental Language Disorder (DLD), but also some important differences.

Autism is a broad term that includes a wide variety of challenges, but people with this neurodevelopmental condition all share the following two traits:

Challenges with Social Communication can range from being unable to speak and/or understand language, to difficulty reading body language and facial expressions and understanding what others are thinking and feeling.

Repetitive Behaviours and Restricted Interests can range from self-harm such as banging one’s head or biting one’s hands to less severe behaviours like hand flapping or rocking back and forth.  Restricted interests in autism often look like obsessions or fixations on certain kinds of objects or themes. It can be difficult for individuals to change from one activity to another.

DLD Awareness Day 18 October 2019

Individuals with DLD, like individuals with autism, struggle with social communication. In DLD, these challenges relate mostly to expressing one’s thoughts and comprehending what others are saying, while in autism the problems tend to go beyond just language and extend to difficulty understanding the meaning behind a person’s facial expression or body language.

Patterns of restricted interests and repetitive behaviours, as described above, are specific to autism and are not a characteristic of DLD.

​Children with autism often have other serious medical conditions, such as seizures, digestive system problems, or sleep disorders.  These additional medical problems make it more likely for children with ASD to see a medical provider, which in turn makes diagnosis more likely.  In contrast, children with DLD might not have any other obvious medical conditions that would make diagnosis by a professional more likely, which is part of the reason that DLD can often go unrecognised.​

​Finally, although autism receives more attention in the public consciousness, DLD is far more common than autism.  The latest studies show that almost 2% of children have autism, while more than three times as many (about 7%) have DLD.​

Additional resources from around the world, if your country is not listed and you are aware of an organisation that should be included, then please bring it to our attention and we will add it.

American Speech-Language-Hearing Association

Speech-Language & Audiology Canada (SAC) | Orthophonie et Audiologie Canada (OAC)

Irish Association of Speech and Language Therapists

New Zealand Speech-language Therapists’ Association

Royal College of Speech and Language Therapists

Speech Pathology Australia

The St. John Aphasia Support Group

American Academy of Private Practice in Speech Pathology and Audiology

Federazione Logopedisti Italiani

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