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Expert flies in to address the AD/HD issues

INTERNATIONALLY renowned Attention Deficit Hyperactivity Disorder (AD/HD) expert John J. Ratey, MD will arrive in Bermuda next week to hold various sessions aimed at attacking the crucial issues associated with this often-misunderstood neurological disorder.

Dr. Ratey, an acclaimed practitioner in the field of child psychiatry, is Director of Research at Medfield State Hospital and an Assistant Professor of Psychiatry at Harvard Medical School.

On July 13, under the auspices of the Learning Disabilities Association of Bermuda and its parent support group Bermuda Overcoming Learning Disabilities, Dr. Ratey will speak first to professionals in the medical field, education, counselling and support services concerning strategies for coping with anxiety and depression in AD/HD children.

In the afternoon, Dr. Ratey will address young adults with AD/HD in order to encourage structure and accountability, helping these teens to manage life in high school and eventually on a college campus.

In the evening, Dr. Ratey will deliver a layman's version of his medical presentation to families coping with AD/HD. This will be followed by a short question-and-answer period moderated by local paediatrician Dr. Bent? Lundh

Dr. Lundh hopes that Dr. Ratey's visit will inform the general public of the validity of this misunderstood condition.

"Attention Deficit Hyperactivity Disorder has been controversial in recent media portrayals," Dr. Lundh said. "Scientists and clinicians have had to convince the public that it is a bona fide diagnosis. Two-thirds of children with AD/HD don't outgrow it, and continue to have difficulties through adulthood. It isn't simply an 'excuse'."

Dr. Lundh has long been interested in AD/HD, and is currently busy setting up a new practice focused on helping children and families deal with AD/HD and its repercussions. She believes Dr. Ratey's lectures could help eliminate the misconception that AD/HD children are simply 'slow' or lazy'.

"There's this old-fashioned notion that this is a matter of will or a lack of will power, as if there is a moral failing with this particular person or that they're not trying," Dr. Lundh explained.

"These are very harmful and unhelpful labels. It's important to start from a standpoint of understanding what you are dealing with. I'd rather everyone knows that my child has a brain-based neurological disorder than be labelled lazy or slow or that I'm a bad parent."

Dr. Lundh encourages parents who suspect their child may have AD/HD to seek help from a physician familiar with AD/HD or a psychologist in order to establish a diagnosis.

She explained that while there has been controversy regarding the over-prescription of Ritalin over recent years, medication can help children with AD/HD, but only if used in conjunction with other treatments.

"Medication is usually the last step; it's treated as a last resort," Dr. Lundh said. "To put that into perspective, it's a common misconception that Ritalin is over-prescribed. Three to seven per cent of children and two to four per cent of adults have AD/HD.

"There is the knowledge that 70-80 per cent of these people who have AD/HD are going to respond very well to the medication. Then you look at the number of prescriptions written, and it's far fewer.

"Medication is not the treatment of choice," she continued. "The treatment of choice is multi-modal ? a comprehensive approach that includes medical, psychological and behavioral components. It's individualized for each person."

Dr. Lundh explained that the most important step in the treatment of AD/HD is the establishment of a diagnosis. From there, with the help of a physician or psychologist, a family can decide how best to school their child.

"You need to know what you're dealing with," Dr. Lundh said. "The vast majority of children with AD/HD stay in regular schools, but with modifications in the classroom that help them."

"A small percentage will need to be taken out for some extra help but the vast majority can stay in a regular classroom. Between 40 and 60 per cent of children with AD/HD also have learning disabilities, often language-based. It could be writing, reading, or math."

Dr. Lundh spoke of local frustrations concerning AD/HD, including the difficult, often expensive process of educational testing.

"One of the problems because of the overlap with learning difficulties is getting children to have cognitive and educational testing," she explained.

"In private schools, kids must get tested privately as insurance companies won't pay. It's viewed as an educational expense and the Department of Education won't test private school students."

"On the Government school side, even though you have the educational psychologist on site and free to the family, it's difficult to get a child tested. I think they're understaffed and under-resourced, and there are so many children that need help."

Although there are no definitive symptoms of AD/HD set in stone, Dr. Lundh advised parents to watch out for certain warning signs.

"All children and adults have traits of hyperactivity, impulsivity and inattention. In people with AD/HD, it's a pervasive and persistent problem," she said.

"When a young child with AD/HD grows up their peers are passing them and they're still having trouble sitting still and focusing," she continued. "They may appear not to listen. They may be fidgety or have problems waiting in line.

"In class they might blurt out answers to questions. The child should see a physician familiar with AD/HD or a psychologist to establish a diagnosis."

q Dr. Ratey's sessions will all be held at ACE Global Headquarters on Tuesday, July 13. Tickets can be purchased at the Bermuda Bookstore, Queen Street, Hamilton.