Monday, June 20, 2011
Reminder: KidsBC has moved
Posts normally found on the blog are now located at: http://www.relatedmindsbc.com/blog
Saturday, May 7, 2011
Medical News: Family Therapy Can Combat Conduct Disorders (if done right)
Medical News: Family Therapy Can Combat Conduct Disorders - in Pediatrics, Parenting from MedPage Today
Conduct problems? Drug abuse? What to do, who can help? Many people aren't sure who to turn to, A psychologist, counsellor, therapist, psychiatrist? Which profession? Research has shown that family therapy can help quell substance abuse and conduct disorders in children and adolescents, but is not as effective when the diagnosis is attention deficit hyperactivity disorder (ADHD), researchers said here today. Simply put, yes, a family therapist can be effective, but when there is underlying Attention Deficit Hyperactivity disorder, family therapy might not be the way to go. (although parent training, education and support are necessary).
This study (click above) is a 10-year review of published research and it found that two types of family therapy, parent management training and behavioral family therapy, are especially effective for conduct disorders. Many parents want to have family meetings, or have their child seen alone for therapy. That may simply not be the effective way to deal with these particular problems. Dr. Josephson, one of the co-authors of the review, which will be published in the September issue of the Journal of Child and Adolescent Psychiatry, presented these findings at a back-to-school health briefing sponsored by the American Medical Association and the National PTA.
Parent-management training teaches parents techniques such as positive reinforcement and working with children to develop problem-solving skills. Studies suggests that parent-management training can be an effective for conduct disorders for up to 14 years -- long enough for a child to complete elementary and high school. (In my office I often suggest some specific books by Dr. Russell Barkley on both ADHD and conduct disorder). Behavioural family therapy, practiced in my office, is a similar technique but it also incorporates "into treatment a variety of family, parent, and child factors that have been implicated as leading to disruptive disorders (e.g. parental stress, cognitions about the child, child temperament)." What the literature presented review suggested is that "ADHD core symptoms are better controlled by a combination of pharmacotherapy and board based intervention"s that include psychosocial interventions and may include family therapy.
Finally, Dr. Josephson said that family-based therapy may help in some of the current concerns about the side effects of pharmacotherapy, such as suicidal ideation. "When physicians and parents are partners in monitoring patients' safety, the family serves as a safety net that can facilitate several treatment goals." To sum up: Conduct Disorder (a specific diagnosis only your medical doctor of psychologist can determine) which is associated with ADHD is best treated first medically, then behaviourally, and last by family therapy. Parenting skills, education and coaching are critical components to success.
For more information on ADHD (Attention Deficit Hyperactivity Disorder, parenting, child behaviour, academic problems and relationship issues, please feel free to visit my website at www.relatedminds.com I also have specific information on ADHD available at www.adhdhelp.ca and information on my counselling and assessment services can be found at either the British Columbia Psychological Association (click here), Psychology Today (click here) or my AAMFT Family Therapist website (Click here). I am a registered Psychologist here in British Columbia, along with being a Registered Marriage and Family Therapist and teacher of special education. There is also some specific information on treatment for aggression and anger in children on my webpage called "The Angry Child," (Click here)
I look forward to hearing from you.
Dr. Jim Roche
Registered Psychologist
778.998-7975
Offices in Burnaby and Vancouver, British Columbia
Conduct problems? Drug abuse? What to do, who can help? Many people aren't sure who to turn to, A psychologist, counsellor, therapist, psychiatrist? Which profession? Research has shown that family therapy can help quell substance abuse and conduct disorders in children and adolescents, but is not as effective when the diagnosis is attention deficit hyperactivity disorder (ADHD), researchers said here today. Simply put, yes, a family therapist can be effective, but when there is underlying Attention Deficit Hyperactivity disorder, family therapy might not be the way to go. (although parent training, education and support are necessary).
This study (click above) is a 10-year review of published research and it found that two types of family therapy, parent management training and behavioral family therapy, are especially effective for conduct disorders. Many parents want to have family meetings, or have their child seen alone for therapy. That may simply not be the effective way to deal with these particular problems. Dr. Josephson, one of the co-authors of the review, which will be published in the September issue of the Journal of Child and Adolescent Psychiatry, presented these findings at a back-to-school health briefing sponsored by the American Medical Association and the National PTA.
Parent-management training teaches parents techniques such as positive reinforcement and working with children to develop problem-solving skills. Studies suggests that parent-management training can be an effective for conduct disorders for up to 14 years -- long enough for a child to complete elementary and high school. (In my office I often suggest some specific books by Dr. Russell Barkley on both ADHD and conduct disorder). Behavioural family therapy, practiced in my office, is a similar technique but it also incorporates "into treatment a variety of family, parent, and child factors that have been implicated as leading to disruptive disorders (e.g. parental stress, cognitions about the child, child temperament)." What the literature presented review suggested is that "ADHD core symptoms are better controlled by a combination of pharmacotherapy and board based intervention"s that include psychosocial interventions and may include family therapy.
Finally, Dr. Josephson said that family-based therapy may help in some of the current concerns about the side effects of pharmacotherapy, such as suicidal ideation. "When physicians and parents are partners in monitoring patients' safety, the family serves as a safety net that can facilitate several treatment goals." To sum up: Conduct Disorder (a specific diagnosis only your medical doctor of psychologist can determine) which is associated with ADHD is best treated first medically, then behaviourally, and last by family therapy. Parenting skills, education and coaching are critical components to success.
For more information on ADHD (Attention Deficit Hyperactivity Disorder, parenting, child behaviour, academic problems and relationship issues, please feel free to visit my website at www.relatedminds.com I also have specific information on ADHD available at www.adhdhelp.ca and information on my counselling and assessment services can be found at either the British Columbia Psychological Association (click here), Psychology Today (click here) or my AAMFT Family Therapist website (Click here). I am a registered Psychologist here in British Columbia, along with being a Registered Marriage and Family Therapist and teacher of special education. There is also some specific information on treatment for aggression and anger in children on my webpage called "The Angry Child," (Click here)
I look forward to hearing from you.
Dr. Jim Roche
Registered Psychologist
778.998-7975
Offices in Burnaby and Vancouver, British Columbia
Sunday, May 1, 2011
Child Behaviour Problems? Parenting books, Where to Start?
Problems with child behaviour? And wondering where to start? Often parents come to my office with very specific problems: toileting, talking back, non-compliance (NO!) and difficulty with home work. I usually have specific behavioural interventions that we talk about and work on, but beyound the specifics there is always the more general question in parent's minds, "What's a parent suppose to do to avoid these issues and problems?" Generally, "What's a great parent look like?" Well, that's a good question, and I have a good answer too. One that doesn't overwhelm and can set you on a path to feeling good about yourself as a parent. The first recommended reading I make is usually: Raising an Emotionally Intelligent Child, by John Gottman (Simon and Schuster, 1997 ISBN: 0684838656). You can find a link to this book on my web page at www.relatedminds.com. Just go to the suggested readings page and you can order this book from Amazon.ca, the cheapest way to obtain it. And yes, for those who find reading just can't fit into your schedule, there is also a CD or the book, and a DVD. You can also download a copy from Audible.com if you use an iPhone or other device, and it loads directly to your music player. There are no excuses!
I find this is one of the most useful, research-based, and insightful books on parenting around, and it is research based. This is important, as there are many, many parenting books for behaviour issues out there that are simply made up theories from what the author thinks would work, but doesn't know will work. John Gottman is a professor of psychology at the University of Washington, and author of Why Marriages Succeed or Fail. His extensive work with parents and children based on his deep understanding of the emotions offers a guide throughout the years of parenting. He suggests that "emotion coaching" is they key to raising emotionally intelligent children, and helps parents to understand their parenting style and how to make the most of it.
Here are Gottman's five key steps to what he calls "emotion coaching" (1) becoming aware of the child's emotion, (2) recognizing the emotion as an opportunity for intimacy and teaching; (3) listening empathetically, validating the child's feelings; (4) helping the child find words to label the emotion he is having; and (5) setting limits while exploring strategies to solve the problem at hand.
Dr. Gottman's book is filled with practical examples of how to deal with different kinds of challenges in healthy ways. In addition to discussing the role of mothers, it also includes discussion of the critical role that fathers play and the importance of a healthy marriage in creating the environment that can help children to develop their potential as fully as possible. what we know from Dr. Gottman's research is that a child who learns to be happy in relationships, who is social, understands and can cope with his or her emotions, is more likely to graduate from high school, live longer, live healthier and be generally more successful in life. In many ways emotional knowledge is more important than academic knowledge (but, yes, we need both).
I suggest Dr. Gottman's book as a starting point for any parent. It shows you in a non-threatening way, how things ought to be going. Once we know that we can start to work on particular difficulties that you and your child may be having. In my clinical setting we will quickly get involved in behaviour therapy, cognitive therapy, behaviour management techniques and so on, but it's always good to have a firm grounding and some idea of where we are going. Dr. Gottman's book is a quick read (listen or view) and from there we can get into the nitty gritty details of improving your child's behaviour and academic outcomes.
Below you will find a link to an introductory talk by Dr. Gottman:
For more information on parenting, child behaviour, academic problems and relationship issues, please feel free to visit my website at www.relatedminds.com I also have specific information on ADHD available at www.adhdhelp.ca and information on my counselling and assessment services can be found at either the British Columbia Psychological Association (click here), Psychology Today (click here) or my AAMFT Family Therapist website (Click here). I am a registered Psychologist here in British Columbia, along with being a Registered Marriage and Family Therapist and teacher of special education. There is also some specific information on treatment for aggression and anger in children on my webpage called "The Angry Child," (Click here)
I look forward to hearing from you.
Dr. Jim Roche
Registered Psychologist
Offices in Burnaby and Vancouver, British Columbia
I find this is one of the most useful, research-based, and insightful books on parenting around, and it is research based. This is important, as there are many, many parenting books for behaviour issues out there that are simply made up theories from what the author thinks would work, but doesn't know will work. John Gottman is a professor of psychology at the University of Washington, and author of Why Marriages Succeed or Fail. His extensive work with parents and children based on his deep understanding of the emotions offers a guide throughout the years of parenting. He suggests that "emotion coaching" is they key to raising emotionally intelligent children, and helps parents to understand their parenting style and how to make the most of it.
Here are Gottman's five key steps to what he calls "emotion coaching" (1) becoming aware of the child's emotion, (2) recognizing the emotion as an opportunity for intimacy and teaching; (3) listening empathetically, validating the child's feelings; (4) helping the child find words to label the emotion he is having; and (5) setting limits while exploring strategies to solve the problem at hand.
Dr. Gottman's book is filled with practical examples of how to deal with different kinds of challenges in healthy ways. In addition to discussing the role of mothers, it also includes discussion of the critical role that fathers play and the importance of a healthy marriage in creating the environment that can help children to develop their potential as fully as possible. what we know from Dr. Gottman's research is that a child who learns to be happy in relationships, who is social, understands and can cope with his or her emotions, is more likely to graduate from high school, live longer, live healthier and be generally more successful in life. In many ways emotional knowledge is more important than academic knowledge (but, yes, we need both).
I suggest Dr. Gottman's book as a starting point for any parent. It shows you in a non-threatening way, how things ought to be going. Once we know that we can start to work on particular difficulties that you and your child may be having. In my clinical setting we will quickly get involved in behaviour therapy, cognitive therapy, behaviour management techniques and so on, but it's always good to have a firm grounding and some idea of where we are going. Dr. Gottman's book is a quick read (listen or view) and from there we can get into the nitty gritty details of improving your child's behaviour and academic outcomes.
Below you will find a link to an introductory talk by Dr. Gottman:
For more information on parenting, child behaviour, academic problems and relationship issues, please feel free to visit my website at www.relatedminds.com I also have specific information on ADHD available at www.adhdhelp.ca and information on my counselling and assessment services can be found at either the British Columbia Psychological Association (click here), Psychology Today (click here) or my AAMFT Family Therapist website (Click here). I am a registered Psychologist here in British Columbia, along with being a Registered Marriage and Family Therapist and teacher of special education. There is also some specific information on treatment for aggression and anger in children on my webpage called "The Angry Child," (Click here)
I look forward to hearing from you.
Dr. Jim Roche
Registered Psychologist
Offices in Burnaby and Vancouver, British Columbia
Monday, December 13, 2010
Educational Appeals: What to do when your school does nothing.
http://wrightslaw.com/
OK, I know Canadian education law is different from US law. And here in Canada we are often shocked by how quickly people in the US go to court. "Sue em!" is often a first answer. But knowing your rights is important. But often I see Individual Education Plans (IEPs) that are silly, blame the student and parents and never once mention what supports the school will be offering. Often students are "coded" (labelled) by the schools when they have not written an IEP, haven't completed an FBA (Functional Behaviour analysis) and sometime students are even designated dangerous with a "safety plan" before the school has attempted to figure out what the problem is! I've seen 5 year olds with "safety plans" to protect staff and the student hasn't been assessed, no testing has been completed, and the student has been designated to be severely behaviourally disturbed before anyone understands what is wrong. Too many of our children end up being "home schooled" or in alternative placements, or on three year wait lists for assessments, because no seems accountable. There are ways to make schools accountable.
The Ministry of Education here in BC, however is a source of help when you feel you are not being served well by your school. Click here to go to their website. Since 1992, the School Act has included a provision for a student or parent to appeal a decision of an employee of a board of education. Section 11 of the School Act provides that “if a decision of an employee of a board significantly affects the education, health or safety of a student, the parent or the student may, within a reasonable time from the date that the parent or student was informed of the decision, appeal to the board.”
What do they provide"
Dispute Resolution
When disputes occur between parents or students and the school, the best way to resolve those disputes is through an informal resolution at the local level.This includes problem-solving, negotiation and discussions with those most directly involved in the dispute.
Appeal to a Board of Education
Every school district is required to establish an appeal process – this allows students and parents to file a section 11 appeal with their local board of education. A board of education is empowered to make any decision that it considers appropriate to the case before it as long as the decision is within the board’s authority under the School Act.
Appeal to a Superintendent of Achievement
A section 11.1 appeal to a superintendent of achievement is the final level of appeal for students and parents in the K–12 public education system. In order to appeal to a superintendent of achievement, the student or parent must have first appealed the matter to their board of education.
Every school district should have a free pamphlet about Educational Appeals. Ask for a copy. Ask for a copy of your child's education file. ALL OF IT. Put all of your requests in writing and get the school office to sign a copy that it was received.
And then takie a look at WrightsLaw. One of the reasons I recommend this American sight is it will at least give you an idea of what an IEP should look like. And give you an idea of what interventions your school should be able to offer.
Too often children in BC with ADHD, depression, anxiety and other similar disorders are relegated to home or on-line education because schools don't want to take on the task of learning what to do to support the student. Don't let this happen to you. Get professional help from a psychologist or other licensed pr5ofessional who is familiar with the schools and how they work. Join parent groups, join your school's parent group and find a support community.
Good luck. Don't give up, there is a process already there designed to help you.
..............................................................
This blog is not offered as medical advice or as a means of diagnosing or treating ADHD, learning disabilities or any other disorder. Don't go on line and take an ADHD "test." The diagnosis is complex, and it involves not just looking for symptoms of ADHD, but also ruling out other disorders that might look just like ADHD. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you.
My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.
Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
OK, I know Canadian education law is different from US law. And here in Canada we are often shocked by how quickly people in the US go to court. "Sue em!" is often a first answer. But knowing your rights is important. But often I see Individual Education Plans (IEPs) that are silly, blame the student and parents and never once mention what supports the school will be offering. Often students are "coded" (labelled) by the schools when they have not written an IEP, haven't completed an FBA (Functional Behaviour analysis) and sometime students are even designated dangerous with a "safety plan" before the school has attempted to figure out what the problem is! I've seen 5 year olds with "safety plans" to protect staff and the student hasn't been assessed, no testing has been completed, and the student has been designated to be severely behaviourally disturbed before anyone understands what is wrong. Too many of our children end up being "home schooled" or in alternative placements, or on three year wait lists for assessments, because no seems accountable. There are ways to make schools accountable.
The Ministry of Education here in BC, however is a source of help when you feel you are not being served well by your school. Click here to go to their website. Since 1992, the School Act has included a provision for a student or parent to appeal a decision of an employee of a board of education. Section 11 of the School Act provides that “if a decision of an employee of a board significantly affects the education, health or safety of a student, the parent or the student may, within a reasonable time from the date that the parent or student was informed of the decision, appeal to the board.”
What do they provide"
Dispute Resolution
When disputes occur between parents or students and the school, the best way to resolve those disputes is through an informal resolution at the local level.This includes problem-solving, negotiation and discussions with those most directly involved in the dispute.
Appeal to a Board of Education
Every school district is required to establish an appeal process – this allows students and parents to file a section 11 appeal with their local board of education. A board of education is empowered to make any decision that it considers appropriate to the case before it as long as the decision is within the board’s authority under the School Act.
Appeal to a Superintendent of Achievement
A section 11.1 appeal to a superintendent of achievement is the final level of appeal for students and parents in the K–12 public education system. In order to appeal to a superintendent of achievement, the student or parent must have first appealed the matter to their board of education.
Every school district should have a free pamphlet about Educational Appeals. Ask for a copy. Ask for a copy of your child's education file. ALL OF IT. Put all of your requests in writing and get the school office to sign a copy that it was received.
And then takie a look at WrightsLaw. One of the reasons I recommend this American sight is it will at least give you an idea of what an IEP should look like. And give you an idea of what interventions your school should be able to offer.
Too often children in BC with ADHD, depression, anxiety and other similar disorders are relegated to home or on-line education because schools don't want to take on the task of learning what to do to support the student. Don't let this happen to you. Get professional help from a psychologist or other licensed pr5ofessional who is familiar with the schools and how they work. Join parent groups, join your school's parent group and find a support community.
Good luck. Don't give up, there is a process already there designed to help you.
..............................................................
This blog is not offered as medical advice or as a means of diagnosing or treating ADHD, learning disabilities or any other disorder. Don't go on line and take an ADHD "test." The diagnosis is complex, and it involves not just looking for symptoms of ADHD, but also ruling out other disorders that might look just like ADHD. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you.
My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.
Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
Saturday, December 4, 2010
Raising an Emotionally Intelligent Child
This is my favourite video about parenting, and I can't recommend it enough. IT's available from the Gottman Institute, or Amazon, or go to my website and get it. You'll find a lot of good books and videos there. Dr. Gottman speaks about the research that clearly shows that how successful you are in life is more dependent on how you get along with others as a child than how smart you were, or how you did academically.
More about the book/DVD: In Raising an Emotionally Intelligent Child, (both the book and the DVD) Dr. John Gottman explores the emotional relationship between parents and children. It's not enough to simply reject an authoritarian model of parenting, he says. A parent needs to be concerned with the quality of emotional interactions in the family. Gottman provides a series of exercises to assess parenting styles and emotional self-awareness. He identifies a five-step "emotion coaching" process to help teach children how to recognize and address their feelings, which includes becoming aware of the child's emotions; recognizing that dealing with these emotions is an opportunity for intimacy; listening empathetically; helping the child label emotions; setting limits; and problem-solving. Chapters on divorce, fathering, and age-based differences in emotional development help make Gottman's teachings detailed and useful.
One of the reasons I use this book and DVD in my practice all the time is that it's one of the very few that is based on any research. Most parenting books are written by individuals who basically had a good idea...they thought....and wrote a book of ways to make that idea happen. But often there isn't any science behind what your reading, just someone else's idea of how things should be. Gottman has science. And it's easy to understand!
Finally, this is a fun book or DVD. It's a pleasure to listen to or read, and unlike other books that have one after another technique about child raising this one sets out five basic goals and you finish feeling "I can do that!" I could be a parent like that.
Now I know there are problems between what is and what we would like. Often times I need to present specific parent skills, teach behaviour management and work out intervention details with schools. But behind all of that there needs to be a basic parenting philosophy, and a clear goal of how you wish it would be. Gottman provides that.
There are more Gottman videos on youtube and elsewhere I'll be suggesting, but if your looking for a basic parenting book, this is a place to start.
...................................
This blog is not offered as medical advice or as a means of diagnosing or treating ADHD, learning disabilities, autism, relationship issues or any other disorder. Don't go on line and take an autism, ADHD, intelligence or relationship "test." Diagnosis is complex, and it involves not just looking for symptoms of a disorder, but also ruling out other disorders that might look just like what your worried about. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you to help you with these matters, or if you are in another province or state contact their psychological association.
My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD) as well as other learning and social disorders. Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.
Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
Should teen drivers with ADHD need medical approval before getting a permit to drive?
Study urges doctor's OK before teen with ADHD can drive
9I warned you about my cross posting!)
When patients visit my office I have to go over an informed consent form. One item that might seem odd is that I have to inform patients that I am required by law to report impaired driving. That doesn't mean driving while intoxicated ...well, it does, but it means more. It means if you have a head injury, a stroke or other disability that makes your driving dangerous to others, I need to file a report with the proper authorities. Your medical doctor needs to do this too, he or she just doesn't inform every patient that comes through the door. As a matter of fact, medical doctors never do any informed consent until a major treatment intervention is at hand ....but that's another story. Bt impaired driving is one of those critical issues for mental health providers here in BC. Research is clear that ADHD can and often does impair driving. People with untreated ADHD (attention deficit hyperactivity disorder) are more likely to get in accidents, more likely to be injured and when injured spend more time and money in the hospital. Those are the simple facts.
This interesting little article points our thatthe opinion of many that behaviour disorders should be listed among official conditions that force young drivers to get doctors' approval before earning and maintaining their licence. This new study that finds behaviour issues are behind a significant portion of vehicle crashes among teen boys.
The study led by Dr. Donald Redelmeier at the University of Toronto said conditions such as attention deficit hyperactivity disorder (ADHD) could reasonably be added to an existing list of conditions that require medical clearance before driving.
"Maybe ADHD ought to be considered just like diabetes, epilepsy . . . or narcolepsy — that is the patient must show they are in good medical condition if they wish to maintain their driver's licence," said Redelmeier, who is also a physician at Sunnybrook Hospital in Toronto. "I don't think it should be a prohibition, but think it should be on the list of notifiable medical conditions.
He said, however, that the prominence of crashes involving teens between the ages of 16 and 19 aren't limited to when the teens are behind the wheel. "The risks don't end when you stop driving. We find teenagers with ADHD are also predisposed to be pedestrians involved in motor vehicle crashes." Now think about that! Not only are teenage boys in more accidents, its both as the driver and the victim! OFten parents with children on ADHD medication want to just give the medication to their child when they are at school, "It's for learning, right?" they say to me. I tell them it's for life, not just learning. The medication and behavioural treatments are designed to reduce impulsive and RISKY behaviour, something teens are already doing too much of, and teens with ADHD increase the frequency and severity of risk taking behaviour (that includes drugs, sex, and jumping from places you just shouldn't jump from! - wathc youtube for examples of this behaviour).
The test group in this study included 3,421 Ontario teens who were hospitalized following a car crash over a seven-year period. Of those, some 767 were diagnosed with a behaviour issue within the last decade, including 402 cases of ADHD. The researcher said the test group's demographic are the riskiest for vehicle crashes, citing that teen boys between 16 and 19 represent roughly three per cent of all drivers, but about six per cent of all crashes.
"(Teen boys) are so overrepresented in serious crashes, despite their low amounts of driving and despite excellent physical health otherwise," said Redelmeier. "(They have) wonderful reaction times, great visual acuity and a relative freedom from cognitive decline or alcoholism or heart attacks or many other conditions that can impair adults behind the wheel." Redelmeier said the main limitation of the study, which was published this week in PLoS Medicine, is the rate of incorrect diagnosis or diagnosis by someone other than a medical professional. That is no suprise (see my MANY posts on the need to get a proper and comprehensive diagnosis for ADHD). Another problem with the study is that although it accounted for thousands of crashes, the study did not record whether the teen males involved were at fault for the crashes. But, lack of attention doesn't only CAUSE accidents, it keeps you from AVOIDING accidents. We all know this from experience.
So should we add ADHD (attention deficit hyperactivity disorder) to the list of disorders for which you need clearance before getting your driver's permit? Some point out this will just keep parents and teens away from doctors, an incentive NOT to be diagnosed and not to be noticed. And would this make teens even more reluctant to accept the diagnosis of ADHD? And what effect would it have on medication compliance? Regretfully ADHD (attention deficit hyperactivity disorder) still has a stigma that you don't find with other disorders. We have a long way to go in dealing with ADHD (attention deficit hyperactivity disorder) including dealing with the stigma of both the diagnosis itself and the treatment (medication and cognitive behaviour therapy).
Read more: http://www.canada.com/health/Study+urges+doctor+before+teen+with+ADHD+drive/3836160/story.html#ixzz17DGCCKUe
................................
This blog is not offered as medical advice or as a means of diagnosing or treating ADHD or any other disorder. Don't go on line and take an ADHD "test." The diagnosis is complex, and it involves not just looking for symptoms of ADHD, but also ruling out other disorders that might look just like ADHD. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you.
My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.
Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
9I warned you about my cross posting!)
When patients visit my office I have to go over an informed consent form. One item that might seem odd is that I have to inform patients that I am required by law to report impaired driving. That doesn't mean driving while intoxicated ...well, it does, but it means more. It means if you have a head injury, a stroke or other disability that makes your driving dangerous to others, I need to file a report with the proper authorities. Your medical doctor needs to do this too, he or she just doesn't inform every patient that comes through the door. As a matter of fact, medical doctors never do any informed consent until a major treatment intervention is at hand ....but that's another story. Bt impaired driving is one of those critical issues for mental health providers here in BC. Research is clear that ADHD can and often does impair driving. People with untreated ADHD (attention deficit hyperactivity disorder) are more likely to get in accidents, more likely to be injured and when injured spend more time and money in the hospital. Those are the simple facts.
This interesting little article points our thatthe opinion of many that behaviour disorders should be listed among official conditions that force young drivers to get doctors' approval before earning and maintaining their licence. This new study that finds behaviour issues are behind a significant portion of vehicle crashes among teen boys.
The study led by Dr. Donald Redelmeier at the University of Toronto said conditions such as attention deficit hyperactivity disorder (ADHD) could reasonably be added to an existing list of conditions that require medical clearance before driving.
"Maybe ADHD ought to be considered just like diabetes, epilepsy . . . or narcolepsy — that is the patient must show they are in good medical condition if they wish to maintain their driver's licence," said Redelmeier, who is also a physician at Sunnybrook Hospital in Toronto. "I don't think it should be a prohibition, but think it should be on the list of notifiable medical conditions.
He said, however, that the prominence of crashes involving teens between the ages of 16 and 19 aren't limited to when the teens are behind the wheel. "The risks don't end when you stop driving. We find teenagers with ADHD are also predisposed to be pedestrians involved in motor vehicle crashes." Now think about that! Not only are teenage boys in more accidents, its both as the driver and the victim! OFten parents with children on ADHD medication want to just give the medication to their child when they are at school, "It's for learning, right?" they say to me. I tell them it's for life, not just learning. The medication and behavioural treatments are designed to reduce impulsive and RISKY behaviour, something teens are already doing too much of, and teens with ADHD increase the frequency and severity of risk taking behaviour (that includes drugs, sex, and jumping from places you just shouldn't jump from! - wathc youtube for examples of this behaviour).
The test group in this study included 3,421 Ontario teens who were hospitalized following a car crash over a seven-year period. Of those, some 767 were diagnosed with a behaviour issue within the last decade, including 402 cases of ADHD. The researcher said the test group's demographic are the riskiest for vehicle crashes, citing that teen boys between 16 and 19 represent roughly three per cent of all drivers, but about six per cent of all crashes.
"(Teen boys) are so overrepresented in serious crashes, despite their low amounts of driving and despite excellent physical health otherwise," said Redelmeier. "(They have) wonderful reaction times, great visual acuity and a relative freedom from cognitive decline or alcoholism or heart attacks or many other conditions that can impair adults behind the wheel." Redelmeier said the main limitation of the study, which was published this week in PLoS Medicine, is the rate of incorrect diagnosis or diagnosis by someone other than a medical professional. That is no suprise (see my MANY posts on the need to get a proper and comprehensive diagnosis for ADHD). Another problem with the study is that although it accounted for thousands of crashes, the study did not record whether the teen males involved were at fault for the crashes. But, lack of attention doesn't only CAUSE accidents, it keeps you from AVOIDING accidents. We all know this from experience.
So should we add ADHD (attention deficit hyperactivity disorder) to the list of disorders for which you need clearance before getting your driver's permit? Some point out this will just keep parents and teens away from doctors, an incentive NOT to be diagnosed and not to be noticed. And would this make teens even more reluctant to accept the diagnosis of ADHD? And what effect would it have on medication compliance? Regretfully ADHD (attention deficit hyperactivity disorder) still has a stigma that you don't find with other disorders. We have a long way to go in dealing with ADHD (attention deficit hyperactivity disorder) including dealing with the stigma of both the diagnosis itself and the treatment (medication and cognitive behaviour therapy).
Read more: http://www.canada.com/health/Study+urges+doctor+before+teen+with+ADHD+drive/3836160/story.html#ixzz17DGCCKUe
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This blog is not offered as medical advice or as a means of diagnosing or treating ADHD or any other disorder. Don't go on line and take an ADHD "test." The diagnosis is complex, and it involves not just looking for symptoms of ADHD, but also ruling out other disorders that might look just like ADHD. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you.
My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.
Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
KidsBC: A new blog about raising children and adolescents in the lower mainland
Hi! I'm Jim roche, a Registered Psychologist and Registered Marriage and Family Therapist here in British Columbia. I currently have three other blogs about mental heal, one about autism, another about ADHD and a third one about family therapy. But many people talk to me about more general issues of raising kids. I've been a parent, teacher of special education, director of behaviour services for school districts and a psychologist/therapist for over twenty years. Occasionally I find materials or write things myself that just don't fit these other categories and at the urging of several folk thought I needed to find a place to deposit these things.
This blog will be about raising kids and it will talk about everything from basic childrearing to vaccines, parent books, diets, you name it. Counter to all rules of blogging I'll also be cross posting a number of blogs here from my other blog sites. I know google hates this, but it s the internet and rumour has it there are very few rules.
I hope you enjoy what I write, sign up and follow. Check out my other blogs if you like. and make comments, I will answer.
This blog will be about raising kids and it will talk about everything from basic childrearing to vaccines, parent books, diets, you name it. Counter to all rules of blogging I'll also be cross posting a number of blogs here from my other blog sites. I know google hates this, but it s the internet and rumour has it there are very few rules.
I hope you enjoy what I write, sign up and follow. Check out my other blogs if you like. and make comments, I will answer.
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