With Instructor:

Janice R. Morabeto M.Ed. L.S.W. C.H.T.

Enjoy the fact that you will not have to be traveling today to get your C.E.U. hours met!

Get prepared to learn! If you normally take notes during lecture, do that as you take this On demand class. It will help you to remember what you learned better, longer and be able to apply that knowledge when you need it most!

Take advantage of downloading and printing the PowerPoint presentations before class begins.

Email me at info@mindlegacy.com if you have questions regarding the content of this material, or if you are interested in future C.E.U. Opportunities.

ADHD is the most common psychiatric disorder diagnosed in children in America. It remains, as well, one of the most controversial in terms of diagnosis and treatment approaches. Recently, the fields of neuroanatomy, molecular genetics and neurochemistry are beginning to shed some real light as to the complexities, and actualities of this important disorder.

Take this 5 question pre-test to review and learn!

Spend only 2-3 minutes on it

Answers will be reviewed before I continue with the presentation.

Many people feel manipulated by the ADHD individual due to the inconsistencies of their behaviors.

Knowing the biology behind the behavior will help you to realize that those who suffer from ADHD have not mastered developmentally appropriate skills; ie, communication, study skills and at times are lagging in maturity

True? False?

Hyperactive-Impulsive Type Hyperactivity In children

Inability to modulate locomotion; squirming , fidgeting, excessive climbing

Hyperactivity in Adults Restlessness, irritability, difficulty relaxing

Impulsivity in children Inability to moderate behaviors i.e. excessive

talking, butting into conversations, invading others’ personal boundaries, low frustration tolerance

Impulsivity in Adults Continue to be consistent talkers who have not

learned to listen to others in a genuine way, tend to change jobs more frequently, have more divorces, traffic violations and substance abuse problems including nicotine, caffeine and overeating

In children: Difficulties in memory, listening, following

directions, lack of follow through, persistence, transitioning between tasks, daydreaming.

In adults Difficulty in memory, planning, organization,

follow through in work and in family lives. Less likely to finish high school or college and tend to advance slower than their peers.

If they can channel their energy, enthusiasm and love of novelty, they can become very successful in the workplace.

Studies show that about 1/3 of adults with ADHD can become entrepreneurs by their 30’s.

First Things First: A look at a healthy brain and nervous system.

The human brain is the most complex structure on earth.

Comprised of 100 billion neurons Connection with cells

near and far Can include up to 100

trillion connections 3.5 lb of gray and

white matter the size of a grapefruit

Dynamic nature – changes constantly in response to environmental stimuli

Major Job – to reach and maintain Homeostasis, the regularity of the internal environment, and to integrate and modulate incoming information from our senses

Modulates incoming information to ascertain the bodies need for and level of response

Smaller anatomic areas and/or volumes in the following regions of the brain. Some studies suggest as much as 7-10% below the healthy control samples:

Corpus Callosum Prefrontal Cortex Basal Ganglia Cerebellum

Locus Coeruleus Reticular Activating System

Total White Matter Volume

Corpus Callosum the large bundle of axons which connect the two

cerebral hemispheres. It disseminates information from the cerebral cortex on one side of the brain to the same region on the other side.

Prefrontal Cortex Area of the brain that is devoted to many

aspects of mature adult functioning such as judgment, reasoning, planning, rational thought, organization goal setting and follow through.

Basal Ganglia group of structures which coordinate movement;

located in the forebrain (telencephalon)

Cerebellum structure located in the back of the brain involved

in central regulation of movement, such as basic movement, balance, and posture; comes from the latin word meaning "little brain"; is divided into two hemispheres and has a cortex

Locus Coeruleus Noradrenergic system supplies Norepinephrine

(NA) throughout the central nervous system. Involved in processing of relevant or salient information as well as highly involved in startle reactions, stress and panic.

Reticular Activating System The RAS acts as the executive secretary

conscious awareness. It is the chief gatekeeper that screens or filters the type of information that will be allowed to get through.

WELLNESS = BALANCE

The three major categories of substances that act as neurotransmitters are Amino Acids Peptides Monamines

 Amino Acids Glutamic acid or Glutamate

Workhorses GABA of the

Brain Aspartic acid Glycine

Peptides Vasopressin Somatostatin Neurotensin, etc. The peptides perform specialized functions

in the hypothalamus or act as co-factors elsewhere in the brain.

 Monoamines Norepinephrine, Dopamine Serotonin Acetylcholine

The monoamines & acetylcholine perform specialized modulating functions and are often confined to specific structures.

Dopamine “Gusto” Neurotransmitter Implications in motivation, reward and risk taking

Predictive of locomotive activity

Norepinephrine Responsible for sustained attention Fight and Flight Reaction (Little Brain) Prepares the body for action increase the heart rate as well as blood

pressure

Serotonin Has been called the “Master

neurotransmitter” Has regulatory effects on other

neurotrasmitters Mood, appetite, concentration, memory,

sexual function and arousal

Inattentive Type Norepinephrine Daydreaming

Dopamine Memory Impairment

Serotonin Difficulty concentrating

Hyperactive-Impulsive TypeNorepinephrine Hyperactivity

Dopamine ImpulsivitySerontonin Restlessness

Are those people related??

Several genes have been consistently found to be a associated with ADHD Dopamine D4 (DRD4) Dopamine Transporter Gene (DAT)

Found to be also impaired in Tourettes Conduct Disorder Obsessive-Compulsive Disorder

Dopamine D5 receptor gene (DRD5) Dopamine beta-hydoxylase gene (DBH)

Implicated in Decreased concentrations of dopamine Upregulated postsynaptic dopamine

(decreased amount available in the synapse) Extracellular concentrations of dopamine Brain’s inability to modulate dopamine levels to

control behaviors and mental processes

New advances in molecular genetics have enabled science to selectively “knock out” one gene in a sample of mice. By observing and contrasting generations of mice with and without a particular genetic influence behaviors can be observed, compared and contrasted.

Serotonin Transporter Gene (5HTTT) Serotonn Receptor Gene (HTR1B)

Decreased concentrations of serotonin Upregulated postsynaptic serotonin

(decreased amount available in the synapse) Extracellular concentrations of serotonin Brain’s inability to modulate serotonin levels to

control behaviors and mental processes

The genetic contribution to ADHD has been shown to be as high as 75% in some families, but! Other possible causes can be:

Other psychiatric disorders in parents and first degree biological relatives

Substance use, abuse and dependency in mother, father and alcoholism and substance related disorders in families

Other medical problems that could have caused damage to the brain

Review Flash Cards under Java Games These will highlight the important aspects

of the class and prepare you for the quiz. Complete at least one more game, so that

you can enjoy the review of this important information. You will also greatly increase the chances of passing the quiz the first time!

You can also review this presentation as many times as you’d like.