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Children Adolescents
What is ADHD?The Current Clinical View
  • A disorder featuring age-inappropriate
  • Inattention
  • Poor persistence of responding
  • Impaired resistance to distraction,
  • Deficient task re-engagement following disruption
  • Hyperactivity-Impulsivity (Disinhibition)
  • Impaired motor inhibition,
  • Poor sustained inhibition
  • Excessive and often task-irrelevant motor and
    verbal behavior
  • Restlessness decreases with age, becoming more
    internal, subjective by adulthood
  • Most cases are developmental and involve delays
    in the rate at which these two traits are
  • Some cases are acquired (20 mainly males)
  • These may represent pathology and may differ in
    severity, recovery, possibly treatment response

Essential Features
  • ADHD presents as impairment in
  • Persistence
  • Resistance to distraction
  • Working memory

  • ADHD Individuals do not have problems with such
    perceptual aspects of attention as
  • arousal or alertness
  • focus or selective attention
  • span of apprehension or divided attention
  • Rather have an inability to sustain action toward
    a goal for an adequate period of time which is a
    motor problem
  • Persistence is on the motor side of attention, it
    is an output disorder.
  • Output is the problem
  • Most people think of attention as an input
    problem how you perceive, select filter and
    process information

Resistance to Distraction
  • Related to persistence opposite sides of the
    same coin.
  • If you can persist it is because you can resist
    distraction If you can resist distraction you
    can persist One requires the other
  • Not a perception problem, ADHD kids are not
    overly perceptive they do not perceive
    distractions any better the difference is that
    they respond to the distracting events
  • Most of us are able to inhibit our responses to
    distracting events, ignore them even though we
    detect them.
  • ADHD is not a problem of perception but inhibition

Working Memory
  • Once distracted ADHD individuals are far less
    likely to return to the original goal or task
  • task re-engagement is a major problem for this
  • This is modulated by working memory information
    held in mind that guides us toward a goal.
  • People with ADHD are likely to have serious
    difficulties with working memory.
  • Once distracted they are gone, off on another task

Inattention Symptoms (DSM-IV)
  • Failure to give close attention to details
  • Difficulty sustaining attention
  • Does not seem to listen
  • Does not follow through on instructions
  • Difficulty organizing tasks or activities
  • Avoids tasks requiring sustained mental effort
  • Loses things necessary for tasks
  • Easily distracted
  • Forgetful in daily activities
  • Symptoms must occur Often or more frequently

Hyperactive-Impulsive Symptoms
  • Fidgets with hands or feet or squirms in seat
  • Leaves seat in classroom inappropriately
  • Runs about or climbs excessively
  • Has difficulty playing quietly
  • Is on the go or driven by a motor
  • Talks excessively
  • Blurts out answers before questions are completed
  • Has difficulty awaiting turn
  • Interrupts or intrudes on others
  • Symptoms must occur Often or more frequently

DSM-IV Criteria for ADHD
  • Manifests 6 symptoms of either inattention or
    hyperactive-impulsive behavior
  • Symptoms are developmentally inappropriate
  • Have existed for at least 6 months
  • Occur across settings (2 or more)
  • Result in impairment in major life activities
  • Developed by age 7 years
  • Are not better explained by another disorder,
    e.g. Severe MR, PDD, Psychosis
  • 3 Types Inattentive, Hyperactive, or Combined

ADHD Varies by Setting
  • Better Here Worse Here
  • Fun Boring
  • Immediate Delayed Consequences
  • Frequent Infrequent Feedback
  • High Low Salience
  • Early Late in the Day
  • Supervised Unsupervised
  • One-to-one Group Situations
  • Novelty Familiarity
  • Fathers Mothers
  • Strangers Parents
  • Clinic Exam Room Waiting Room

Prevalence (United States)
  • 7-8 of children (using DSM-IV) (3-4 million)
  • Varies by sex, age, social class, urban-rural
  • 31 Males to females in children (51 in clinical
  • Somewhat more common in middle to lower-middle
  • More common in population dense areas
  • No evidence for ethnic differences to date that
    are independent of social class and urban-rural

Co-Occurring DSM-IV Disorders
  • More than 80 have one additional disorder
  • More than 60 have two additional disorders
  • Oppositional Defiant Disorder (Average of 55)
  • Conduct Disorder (Average of 45)
  • Anxiety Disorders (20-35)
  • Major Depression (25-35)
  • Bipolar Disorder (0-27 likely 6-10 max.)
  • (97 of those Diagnosed w/ Bipolar also have ADHD)

Medical Risks
  • Sleep problems (39-56) mainly delayed onset and
    greater night waking leading to shorter sleep
  • Developmental Coordination Disorder (50)
  • Reduced Physical Fitness, Strength, Stamina
    (using physical fitness tests)
  • Accident Proneness 57
  • 1.5 to 4x risk of injuries (greater in ODD)
  • 3x risk for accidental poisonings
  • Due to Impulsivity, risk-taking, impaired
    coordination, oppositionality, and poor parental

Causes of ADHD
  • Disorder arises from multiple causes
  • All currently recognized causes fall in the realm
    of biology (neurology, genetics)
  • Causes may compound each other
  • Common neurological pathway for ADHD appears to
    be the areas of the brain controlling Executive
    Functions and Physical Activity (Smaller / Less
  • Social causes have poor evidence

Acquired Cases Prenatal
  • Maternal smoking in pregnancy (odds 2.5)
  • Maternal alcohol drinking in pregnancy (same)
  • Prematurity of birth, especially if brain bleeds
    (45 have ADHD)
  • Total increased pregnancy complications
  • Maternal high phenylalanine levels in blood (?)
  • High maternal anxiety in second trimester (?)
  • Cocaine/crack exposure not a risk factor after
    controlling for the above factors

Acquired Cases Post-Natal (7-10)
  • Head trauma, brain hypoxia, tumors, or infection
  • Lead poisoning in preschool years (0-3 yrs.)
  • Survival from acute leukemia (ALL)
  • Treatments for ALL cause brain damage
  • Post-natal Streptococcal Bacterial Infection
  • triggers auto-immune antibody attack of basal
  • Post-natal elevated phenylalanine (dietary amino
    acid related to PKU)
  • Prenatal hyperactivity
  • Post-natal inattention

Heredity Family Studies
  • Familial Expression of ADHD
  • - 25-35 of siblings
  • - 78-92 of identical twins
  • - 15-20 of mothers
  • - 25-30 of fathers
  • - If parent is ADHD, 20-54 of offspring
  • (odds 8)

Heredity Twin Studies
  • Heritability (Genetic contribution)
  • 57-97 of individual differences (Mean 80)
  • (91-95 using DSM criteria)
  • Shared Environment (common to all siblings)
  • 0-6 (Not significant in any study to date)
  • Unique Environment (events that happen only to
    one person in a family)
  • 15-20 of individual differences
  • (but includes unreliability of measure used to
    assess ADHD)

Etiologies of ADHDFrom Joel Nigg (2006), What
Causes ADHD?
Heritable (Genetics)
ADHD Evaluation Core Considerations
  • Are the symptoms of inattention, impulsiveness,
    and overactivity, present. MOST Importantly Is
    there clear evidence of an impulsive style?
  • Is there evidence that these symptoms
    significantly interfere with the childs
    functioning both at school and at home?
  • Did these symptoms have a reasonably early onset?
    (If not, is there a good explanation?).
  • Have these symptoms been an enduring and
    consistent feature of the childs behavior
    throughout their development and in the majority
    of contexts?
  • Is there evidence that the child wishes to
    perform well but cannot?
  • Are there better explanations for the
  • Is there a pattern or specific triggers to the
    problem behaviors?

6 Step Diagnostic Process
  • Review of Home Behavior
  • Review of School Bx and Collateral Information
  • Review of Developmental History
  • Review of Family/Marital Situation
  • School / Natural Environment Observation
  • Interview of Child

Psychodiagnostic Evaluation
  • A psychodiagnostic Evaluation may be necessary if
    the assessment produces mixed/inconsistent
    results or has uncovered possible evidence of any
    of the following
  • Suicidality
  • Significant Developmental Delays
  • Intellectual limitations
  • Learning disabilities
  • Serious Psychiatric disturbance
  • Significant family problems
  • Other reasons to refer for testing
  • Child was moderately to severely premature
  • Prenatal exposure to toxins especially ETOH
  • Low birth weight
  • Complicated pregnancy and/or birth
  • Reports that child had trouble grasping
    concepts/acquiring new skills
  • Reports that child has trouble with major
    academic subjects even when attentive.

Ruling out Depression
  • Later onset than ADHD
  • Usually preceded by excessive anxiety
  • Not uncommon to have both as a result of the
    negative outcomes due to ADHD behaviors.
  • Must treat both
  • When comorbid, associated with a 4x increase in
    suicidal ideation and 2x increase in attempts
  • Appears to be connected to same genes associated
    with ADHD.
  • Best differential EARLY HISTORY

Ruling Out Anxiety
  • Onset later than ADHD
  • Associated with a particular event or in
    accordance with a time pattern (anniversary).
  • Restlessness is not a primary manifestation of
    Anxiety (usually a habit, style, or boredom)
  • Usually characterized by panic or dread along
    with worry.
  • Best measure for presence of anxiety is childs
    report (parents and teachers under report).

Ruling Out PTSD
  • Must look closely at developmental and early
    school history.
  • PTSD will stem from a specific event
  • Children with ADHD are at greater risk for PTSD
    from abuse and risky behaviors.

Ruling Out Bipolar Disorder
  • Childhood BPD manifests as severe and chronic
    irritability (rather than episodic mania)
  • Also characterized by Disjointed thinking,
    capricious mood, destructiveness, and dysphoria.
  • BPD usually starts as ADHD in childhood
  • ADHD itself does not develop into BPD
  • One-way Comorbidity
  • 3-6 of ADHD have BPD
  • 80-97 of BPD have ADHD

Ruling Out ODD
  • In many cases ADHD is at the root of ODD
  • There is a high degree of co-occurrence
  • Early onset of ADHD symptoms is the differential

DISORDERIn Children Adolescents
Current Perspective
  • ADHD creates a kind of Myopia for future events
    or Time Blindness.
  • ADHD individuals live in the Moment
  • ADHD is a Disorder of
  • Performance, not skill
  • Doing what is known, not knowing what to do
  • The when where, not the how or what
  • Using representations of the past at the
    appropriate place time (Point of Performance)
  • ADHD is better characterized as an Intention

ADHD Executive Functioning
  • Executive Functioning is responsible for two
    types of sustained attention (SA)
  • Contingency-shaped (Externally maintained)
  • Video Games
  • Goal-directed (Internally guided motivated)
  • Homework
  • Goal-directed (SA) is impaired in ADHD
    individuals which creates problems with
  • Delayed responding intrinsic motivation
  • Doing the opposite of what is suggested in
    sensory fields
  • Time, waiting, delays, and future orientation
  • Problem solving, strategy development,
  • Increases in complexity with age development

Treatment Implications
  • Teaching skills is ineffective (As is insight)
  • Treatment must occur at the point of performance.
  • Medications are likely to be essential for most
    but not all cases.
  • Diminished capacity does not excuse
    accountability (The problem is time and timing
    not consequences).
  • Behavioral treatment is essential but does
    generalize or endure after removal.
  • Treatment success depends on the compassion and
    willingness of others to make accommodations.
  • Maintaining a Chronic Disability perspective is
    most effective.

Unproven / Disproved Therapies
  • Elimination Diets Sugar, Additives, etc. (Weak
  • Megavitamins, Anti-oxidants, Minerals (No strong
    evidence or disproved)
  • Sensory Integration Training (Disproved)
  • Chiropractic Skull Manipulation (No Evidence)
  • Play / Psychotherapy (Disproved)
  • Neurofeedback (Experimental)
  • Cognitive Self-Control Therapies (Effective in
  • Social Skills Training (Effective in Clinic
  • Better for Inattentive (SCT) Type and anxious

Empirically Proven Treatments
  • Parent Education
  • Psychopharmacology
  • Parent Training in Child Management
  • 65-75 of Children under 11 respond
  • 25-30 of Adolescents show reliable changes
  • Family Therapy for Adolescents
  • Problem-Solving and Communication Training
  • 30 show change (best combined with BMT)
  • Teacher Education
  • Train Teachers in Classroom Bx Management
  • Special Ed (IDEA, 504)
  • Regular Physical Exercise
  • Residential Treatment (5-8)
  • Parent Family Services (25)
  • Parent/Patient Support Groups

Managing ADHD
  • Time is critical reduce delays
  • Externalize a many processes as possible
  • Time (Clocks, Timers, Calendars, PDAs etc.)
  • Important information (Lists, reminders,
    instruction cards, etc.)
  • Motivation (Token economy, tangible rewards)
  • Problem Solving (use paper and pencil or dry
    erase board)
  • Give immediate feedback
  • Increase frequency of consequences
  • Increase accountability to others
  • Use salient artificial rewards

General Recommendations
  • Change rewards periodically
  • Minimize talking, maximize communicative touch
  • Corollary Act dont Yak
  • Maintain a sense of humor
  • Emphasize rewards over punishments (reward first)
  • Anticipate problem situations and make a plan
  • Keep a sense of priorities (pick your battles)
  • Hold to the perspective of ADHD as a Disability
  • Be forgiving (of child, self, and others)

Give Effective Commands
  • Initially give heavy praise to high compliance
  • Dont use questions, use Imperatives
  • Use eye contact and touch
  • Have child recite request
  • Break complex tasks into simpler ones
  • Make chore cards for Multi-Step tasks
  • List all steps involved on a 3x5 card
  • Stipulate the time period on the card
  • Reduce time delays for consequences
  • Make use of Timers at the Point of Performance
  • Avoid assignment of multiple tasks all at once
  • Praise initiation of compliance
  • Provide rewards throughout the task
  • Have child evaluate their performance at the end

  • Target time-out to focus on one problem
  • Act quickly after infractions
  • Violations of household rules get instant time
  • Immediate commands
  • Give Command ( count backwards from 5)
  • Give Warning with raised voice (repeat count of
  • Initiate time-out
  • Release from time-out contingent on
  • Completion of minimum time period (1-2
    minutes/year of age)
  • Becoming quiet
  • Consenting to command
  • Reward next good behavior
  • Best to use Bedroom for Time-out
  • Remove all major play activities (Sanitize)

Stimulant Medications
  • These are the most well studied drugs in
  • In use for over 40 years
  • Over 350 studies
  • Thousands of cases

StimulantsBehavioral Effects
  • Increased concentration and persistence
  • Decreased Impulsivity hyperactivity
  • Increased work productivity
  • Better emotional control
  • Decreased aggression and defiance
  • Improved compliance
  • Better working memory internalized language
  • Improved handwriting and motor coordination
  • Improved self-esteem
  • Decreased punishment
  • Improved peer acceptance and interactions
  • Better awareness in sports
  • Improved driving performance

Stimulants Side Effects
  • Most tolerate well
  • 5 discontinue due to negative effects
  • Side effects are dose dependent
  • Most common side effects
  • Insomnia (50 )
  • Loss of Appetite (50 )
  • Headaches (20-40)
  • Stomach Aches (20-40)
  • Irritability, tearfulness (lt10)
  • Nervous Habits Mannerisms (lt10)
  • Tics (lt3) and Tourettes (Rare)
  • Mild Weight Loss (Average 1-4 pounds transient)
  • Small effect on height during 1st year (Approx
    1cm) Increased heart rate (3-10 bpm)
  • Increased blood pressure (1.5-14 mmHg)
  • Psychosis (lt3)

StimulantsCommon Myths
  • Addictive when used as prescribed
  • No, Must be inhaled or injected
  • Over Prescribed
  • 7.8 prevalence rate, only 4.3 on stimulants
  • Creates Aggressive, Assaultive Behavior
  • No, decreases aggression and antisocial actions
  • Increases the likelihood of Seizures
  • Only at very very high doses
  • Causes Tourettes Syndrome
  • Can increase tics in 30 decreases it in 35
  • Increases risk of later substance abuse
  • No, 14 studies have found no such result, some
    found that it decreased risk if continued
    throughout teens

  • Selective Norepinepherine reuptake inhibitor
  • Not Schedule II no abuse potential
  • Effective for children, adolescents, and adults
  • Equal efficacy with Methylphenidate with
    previously unmedicated cases (75 positive
  • Slightly lower efficacy with those previously on
    stimulants (55 positive response)
  • Sustained response for up to 3 years
  • Increasing improvement over time
  • Can be given once daily (morning) or split (am/pm)

Benefits of Strattera
  • Reduces ADHD, ODD, aggression
  • Reduces internalizing symptoms
  • Increases school productivity
  • Improved peer social behavior
  • Improved self-esteem
  • Improved parent-child relations
  • Improved dry nights among bed-wetters
  • Better morning after behavior
  • Less insomnia and faster onset of sleep than
  • No emotional blunting

Academic and Occupational Interventions for the
Treatment of ADHD
Classroom ManagementBasic Considerations
  • One of the major impairments of children with
    ADHD is functioning in the educational setting.
  • More children with ADHD are receiving services in
    public schools now than at any other time in
  • Despite the success of medication management and
    parent training, psychoeducational interventions
    are needed to ensure academic success and
    maintain positive behavior in children with ADHD.

Classroom ManagementBasic Considerations
  • The first goal of school-based interventions is
    to improve basic knowledge among educators about
    the nature, causes, course and treatment of ADHD.
  • The second goal is to increase home and school
    collaboration to ensure that the treatment plan
    is consistent, and effective across settings.
  • Third, effective interventions should include
    strategies to improve academic and social
    functioning in children and adolescents and
    occupational functioning in adults.

ADHD BasicsTraining for Educators
  • ADHD is biologically based and is treatable but
    not curable. Goal is to manage symptoms and
    reduce secondary harm (e.g., grade retention,
    peer rejection, disciplinary actions).
  • ADHD is not due to a lack of skill or knowledge,
    but is a problem of sustaining attention, effort,
    and motivation and of inhibiting behavior. It is
    a disorder of performing what one knows, not of
    knowing what to do.
  • Treatment is most effective when applied
    consistently at the place and time where a
    behavior is expected to be performed (e.g., at

ADHD BasicsTraining for Educators
  • It is harder for students with ADHD to do the
    same academic work and exhibit the social
    behavior expected of other students. Thus, these
    students need more structure, frequent positive
    consequences, consistent negative consequences,
    and accommodations to assigned work.
  • To maximize behavior change proactive
    interventions involve manipulating antecedent
    events to prevent challenging behaviors from
    occurring reactive interventions involve
    implementing consequences following a target

Classroom Interventions 9 Key Principles
  • Rules and instructions provided to children with
    ADHD must be clear, brief and often delivered
    through more visible and external modes of
    presentation than required for the management of
    their peers.
  • Consequences used to manage the behavior of those
    with ADHD must be delivered more swiftly
    (ideally, immediately) than with their peers.
  • Consequences must also be applied more frequently.

Classroom Interventions 9 Key Principles
  • Consequences must often be of a higher magnitude,
    or more powerful, than that needed to manage the
    behavior of typical children.
  • An appropriate degree of incentives must be
    provided within a setting or task to reinforce
    appropriate behavior before punishment can be
  • Reinforcers/rewards that are employed must be
    changed or rotated more frequently than typical
    to avoid habituation or satiation.

Classroom Interventions 9 Key Principles
  • Anticipation is key. Thus, teachers must plan
    ahead and ensure that children with ADHD are
    cognizant of an upcoming transition or change in
    rules or routine before it occurs. Think aloud,
    think ahead.
  • Children with ADHD must be held more publicly
    accountable for their behavior and goal
    attainment than typical children.
  • Behavioral interventions only work while they are
    being implemented and require modification over
    time for effectiveness.

Classroom ManagementAccommodations
  • 10 core areas of intervention
  • Decrease workload to fit the childs attentional
  • Alter teaching style and curriculum
  • Make rules external
  • Increase frequency of rewards and fines
  • Increase immediacy of consequences
  • Increase the magnitude/power of rewards
  • Set time limits for work completion
  • Develop a hierarchy of classroom punishments
  • Coordinate home and school consequences
  • Modifications for teens adults

Classroom ManagementAccommodations
  • Decreasing the workload
  • Give smaller quotas of work
  • Allow frequent, shorter work periods
  • Target productivity and effort first accuracy
    and completion of assignments later
  • Post work instructions on the board provide a
    schedule of assignments weekly and send home to
  • Reduce the amount of homework to 10 mins. per
    grade level (e.g., 1st grade 10 mins.)

Classroom ManagementAccommodations
  • Modifying the classroom and curriculum
  • Be animated, flexible and responsive
  • Reward incentive systems and clear consequences
    for misbehavior are crucial
  • Use participatory teaching strategies have child
    write on board, point, use counters
  • Sit child close to the teachers area
  • Allow for restlessness, short stretching and/or
    exercise breaks
  • Intersperse low interest with high interest tasks

Classroom ManagementAccommodations
  • Make rules external
  • Post schedule and rules
  • Use color-coded materials for instructions and
  • Have child re-state the instruction to ensure
  • Use verbal prompts such as stay in seat, keep
    on working, etc.

Classroom ManagementAccommodations
  • Use a reward incentive system
  • Combine positive consequences (praise, rewards,
    token economies) and negative consequences
    (response cost, time out), with positive
    consequences tending to make the most impact
  • Use strategic teacher attention smiles, nods,
    pats on the back, active ignoring

Classroom ManagementAccommodations
  • Consequences must be immediate
  • Avoid lengthy reasoning over misbehavior. Simply
    state the misbehavior and the consequence (should
    be posted as a rule)
  • Use a daily report card or sticker chart.
  • Variations of time out go to the chill area of
    classroom complete a given number of worksheets
    (drills) depending on the severity of the
  • Use mild, private, specific reprimands although
    punishment should be used sparingly

Classroom ManagementAccommodations
  • Rewards must be tangible and desirable
  • Vary rewards to keep interest high
  • A videogame (especially, educational type) or
    computer program can be used as an incentive
  • Have parents donate preferred toys and games
  • Try group rewards
  • Use a home-school based reward program (e.g. good
    behavior points from school transfer to rewards
    at home)

Classroom ManagementAccommodations
  • Set time limits for work completion
  • Use timers or a bell to signify the end of a work
    period use a signal about five minutes before
    the end as well
  • Generally, extra time is not beneficial. Focus
    on developing a distraction-free work setting and
    provide breaks after short work periods.

Classroom ManagementAccommodations
  • Use a punishment hierarchy
  • Head down on desk quiet time
  • Response cost (loss of tokens)
  • Time out in a corner/chill location
  • Time out at school office where childs behavior
    can be monitored
  • Suspension to the office (in school, not at
    home)--punishment is immediate and brief and does
    not include rewarding activities

Classroom ManagementAccommodations
  • Coordinate home and school consequences
  • Daily school behavior report card/rating form and
    point system
  • Daily home-school journal to communicate with
    parents and/or provide a reminder to child when
    completing homework
  • Gradually, move to weekly monitoring

Classroom ManagementAccommodations
  • Specifically, for teens with ADHD
  • Use a daily assignment notebook/planner with
    teacher verification and cross-checking
  • Create a private, in-class cueing system for
    off-task behavior and disruption
  • Use a daily or weekly school report card
    coordinate w/ home rewards (e.g. for grades)
  • Assign a daily case manager or organizational
    coach to help monitor, organize and motivate
  • Permit music during homework
  • Require note-taking to pay attention
  • Keep an extra set of books/materials at home

Classroom ManagementAccommodations
  • More tips for teens
  • Learn SQ4R for reading comprehension
  • Survey material, draft Questions, Read, Recite,
  • Write, Review
  • -- Study with buddy after school
  • -- Swap phone numbers and email addresses with
    classmates to call in the event of lost or
    missing assignment sheets and instructions
  • -- Attend after school help/tutoring sessions
  • -- Schedule parent-teacher review meetings every
    6 weeks

  • College-bound teens and young adults may require
    assistance with
  • Employment
  • Independent Living
  • Managing money
  • Organization
  • Time management
  • Accommodations/resources for college and
    occupational success

  • CHADD (Children and Adults with
    Attention-Deficit/Hyperactivity Disorder) offers
    several resources to assist adults in handling
    these and other important issues. Please visit for more information.

  • Education of teachers and other professionals
    working with children and adults with ADHD is
    crucial to helping these individuals receive the
    accommodations needed to ensure success
    academically and occupationally.
  • Interventions are effective as long as they are
    being implemented and must be maintained over
    extended time periods.
  • Collaboration between school and home appears to
    ensure greater success in the classroom.
  • There are many resources available offering a
    wealth of advice to professionals who help those
    with ADHD.

  • offers scientifically reliable
    information in English and Spanish about ADD in
    children, adolescents, and adults. Sponsored by
    Children and Adults with ADHD (CHADD), the
    largest ADHD support and advocacy organization in
    the United States, it has downloadable fact
    sheets of science-based information for parents,
    educators, professionals, the media, and the
    general public. The site also includes contact
    information for two hundred local chapters of
    CHADD throughout the United States.
  • presents evidence-based
    information in English and Spanish about ADD in
    children, adolescents, and adults. This national
    clearing house of downloadable information and
    resources concerning many aspects of ADHD is
    funded by the U.S. government's Centers for
    Disease Control and Prevention and operated by
    CHADD. New material is added frequently, and
    questions directed to the site are responded to
    by knowledgeable health-information specialists.
  • is a resource in English for adults
    with ADD. Sponsored by Attention Deficit Disorder
    Association (ADDA), the world's largest
    organization for adults with ADHD, it provides
    information, resources, and networking
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