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Every writer faces a moment in her career when she realizes that a good part of success has nothing to do with skill or planning, and everything to do with pure, dumb luck. For me, that moment arrived at a party at the Romance Writers of America conference in St.
But my colleague seemed so sure and, worse, so amused, that I rushed to the conference bookstore and checked the cover. It was true. What do you do when your cover artist has a bad day, forgets to erase that extra hand, and no one in the art department spots the mistake before your book goes to press? I tottered over to my editor and told her the good news, and caught a glimpse of the expression that must have been contorting my own face — a cross between deer caught in the headlights and shrieking amusement.
Or was that hysteria? Scans show that those brain regions in children with ADHD are smaller than they are in children in the general population. In one study done jointly by the Child Psychiatry Branch of the National Institute of Mental Health and McGill University in Montreal, brain scans of children with ADHD showed that the thickening of cortical tissue was delayed by about three years compared to scans of a control group of equal numbers of normally developing youngsters.
The ultimate source of these brain differences is likely genes—perhaps thousands of them. The heritability of ADHD is striking. But this chemical that carries information between nerve cells plays a far more important function in human life than providing us with a cocaine or cupcake high. It uses reward—the pleasurable feelings it supplies—to motivate us to pay attention, avoid distraction, to pick out the most relevant information circulating in short-term memory when solving a problem or completing a task.
It also governs motion. There are dopamine receptors on certain neurons nerve cells to which dopamine delivers its various messages, such as pay attention, control yourself, feel good, and do that thing that made you feel good again, the latter reflecting its role in promoting both addiction and learning.
Dopamine transporters also protrude from the neurons that produce dopamine. One particular gene, DAT-1, has been implicated in both ADHD and bi-polar disorder and is very active in the basal ganglia and pre-frontal cortex, the brain regions that are smaller in people with ADHD. Other genes recently linked to the disorder strengthen the idea that ADHD is a fundamental communication system gone awry, a short-circuiting of the transmission between cells. There are some non-genetic risk factors for ADHD: premature birth, maternal smoking and alcohol use, lead exposure, frequent maternal infections during pregnancy, and brain injuries.
A German study found a significant link between having eczema, a rash caused by allergies, and developing ADHD symptoms, giving more credence to a controversial theory that at least some ADHD is the result of allergies or sensitivities to certain foods, food additives, or other environmental chemicals. Organophosphate pesticides—the kind used on most of the U. The takeaway: eat organic produce or at least wash your veggies. See other approaches to try. He made it to the front office before he was stopped. He recently graduated from Penn with a degree in physics.
One of the clues that lead researchers to look at the dopamine genes as possible markers of ADHD is the effect of methylphenidate—the drug known as Ritalin, a central nervous system stimulant and one of the early drugs used to treat ADHD. But the drugs work so well on symptoms that sales barely slowed in when the FDA—briefly—required them to carry a black box warning because of a small number less than 50 over 10 years of reported deaths, mostly related to heart damage.
Another FDA panel withdrew the black box warning within a month.
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So why does stimulant medication given to high-energy kids calm them down? Today we know that stimulants such as Ritalin, Adderall and Vyvanse, like other drugs, have the opposite effect on children than the one they have on adults. Diet, exercise, parenting techniques and therapy are extremely important as well. Yet the majority of children with ADHD are getting only medication.
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Drug Guide: Choosing the Right Medication. Parents turn to drugs alone for a number of reasons. Experts such as Pelham, Koplewicz, Hallowell, and Barkley are all proponents of medication, but not necessarily as a first-line treatment.
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He laments that the takeaway from the MTA research has been that pills alone work. Research has produced evidence that good parenting can even trump bad genes. They also learn how to give instructions to a child whose short-term working memory is impaired and who finds it tougher than normal to keep distractions at bay. Parents practice ways to minimize their responses to minor annoyances—like a year-old who repeatedly puts her feet on the dining room table.
This does not help.
Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College, drew on the Kenya study, to suggest that many children with the genetic version of ADHD might benefit from education plans tailored to their needs for hands-on, fast-paced experiences high in novelty that, while unlikely to reduce their need for medication, could turn their disability into an asset. Kerri Meenagh was fortunate. That, she said, changed some of the expectations she and her husband have for their daughter—and themselves. While most kids can find something to occupy them for 45 minutes at Mass, Saorla has to go to the bathroom at least three times.
So we go to Mass and Saorla has to go to the bathroom three times. If I know that happens because she has a brain disorder, why would I get upset? And Saorla seems to gravitate towards activities that channel some of her risk taking and her copious energy, particularly performing. And she was a hit. When it comes to Irish dancing or performing, Saorla is an audience magnet. Her energy and expression make her a delight to watch.
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Performing makes her feel proud of herself and very confident. Scheffler PhD, to drill down into the statistics.
For one thing, a diagnosis can lead to treatment that could help underachieving students do better in the classroom and, as a result, increase mean test scores. Having a lot of students diagnosed with ADHD allows the districts to simply drop the scores of their lowest achievers and not lose any funding. However, Medicaid covers ADHD assessments and medication, but not other therapies which may also explain why rates of drug treatment are also on the rise. Wikisource has original works written by or about: Ernest Hemingway.
Wikimedia Commons has media related to: Ernest Hemingway. Namespaces Page Discussion. Views Read Edit View history. In other projects Wikimedia Commons Wikipedia Wikisource. This page was last edited on 14 August , at
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