NAMI is the National Alliance on Mental Illness, the nation’s largest grassroots mental health. They work to raise awareness and provide essential and free referral, support, education, and outreach surrounding mental illness.
Call 211 to locate appropriate treatment and agencies. There’s also a website if you want to search for yourself. ADHD, Learning Disabilities or Parenting classes yield good results.
Washington State ADHD Treatment Providers – Note: ADD freeSources does not endorse or recommend any provider or services listed. Nor should not being on the list affect your choice of provider. Most of these were chosen because they were associated with ADD Resources or local CHADD groups at some time.
Ark Institute of Learning in Tacoma assists students with a variety of learning challenges including; dyslexia, language disorder, nonverbal learning disorder/visual-spatial processing disorder, dyscalculia, dysgraphia, specific learning disorder or disability, and attention issues. Provides assessments, training, and support – – Nonprofit, but services are billed at a regular rate.
Puget Sound ParentingCalendar → http://www.psasadler.org/calendar.pdf from the Puget Sound Adlerian Society (Give it a minute to load) Copy and paste URL
Conducts workshops for parents and others on laws governing special education, testing and assessment, IEP’s, communication, 504 plans and other topics as needed.
Staff assists parents individually to increase skills in working with their children’s teachers, therapists, and other team members to obtain appropriate educational services.
Provides information about resources and specialists in your community.
Has information about resources and laws in Washington and other states.
Office of the Education Ombudsman is an agency within the Governor’s Office created to help elementary and secondary public school students and families in Washington understand how the public school system works, how to find education-related resources and how to resolve conflict with schools. This organization is independent and neutral and not a part of the state public education system.
StaffSeattle office-Toll-free: 1-866-297-2597 Phone interpreter services available
Fax: 206-729-3251 OEOinfo@gov.wa.gov
Low-Income Help
Diagnosis and Treatment for Children
Catholic Community Services in Whatcom and Skagit Counties offers specialized ADHD assessment, counseling, and care coordination for children of families with low income. Treatment includes collaboration regarding medication evaluation and management with primary care physicians, psychiatrists, and community clinicians. The clinic also provides parent education, behavior management classes, school consultation, and parent/teacher education.
Child Development Clinic – the University of Washington has been operating since 1965 and serves approximately 200 children each year. Each child visits the clinic one to three times during the year and is served by multiple clinicians at each visit. About 80% of clients seen at this clinic are less than nine years of age. Over 50% of children served are insured by Medicaid.
Clients are diagnosed with an array of developmental disabilities including intellectual disability, autism spectrum disorders, motor disabilities, learning disabilities, behavioral disorders, communication disorders, and attention-deficit hyperactivity disorder.
Offers core behavioral health programs – Counseling, parent education and family support
Please help complete these resources. These are what I had saved in my files from 3 years ago with updated links. Leave a comment if you know of other organizations and services that pertain to ADHD.
Disclaimer: ADD freeSources does not endorse or recommend any of the providers or services listed. Nor should not being included on the list affect your choice of provider. We have not investigated those listed and do not have the ability to evaluate their competence in providing services to families and individuals living with ADHD.
Psychiatrists can diagnose and prescribe medications. Other MDs may or may not diagnose, but all can prescribe. Psychologists can diagnose and refer to a prescribing provider. Many Nurse Practitioners have experience adjusting ADHD medications but may not feel comfortable diagnosing.
Treatment combines medication, supplements, and lifestyle changes. SPECT Scans are expensive and may not be covered by insurance. Will diagnose and treat without using a SPECT scan- but hourly rates are quite high and they do not accept insurance. However, if it’s a case that has been difficult to diagnose or treat, it may be worth the price.
Independent Practitioners – Eastside and greater Seattle area. Offices in Issaquah, Snoqualmie, and Woodinville. Everett Clinic – Search under behavioral health brought up over 25 providers north of Seattle. The referral line is 425-458-5048. info@eastsidepsychologicalassociates.com
Tacoma
Rainier Associates
George F. Jackson III, MD –
James Dale Howard, MD
(Fletcher Taylor, MD is very experienced, but seldom has an opening)
Steve Parkinson, PhD also does ADHD Assessments
Trust the front desk, but be clear about what you need.
5909 Orchard St W
University Place, WA 98467
(253) 475-6021
Robert Sands, MD (& Associates)
Child Psychiatrists- will work with adults)
Bellmore Center
3609 S 19th St
Tacoma, WA 98408
253-752-6056
Dr. Stephen Schilt, MD- (Child Psychiatrist)
7609 6th Ave
Tacoma, WA 98405
Union Ave. Neurobehavioral Clinic–
Child Psychiatrists- Will also diagnose and treat parents of the children they treat)
Carl Plonsky and Associates
Dr. Heather Daniels and others
1530 S. Union Suite 13
Tacoma, WA 98405
(253)759-5340
Lance A. Harris, PhD – Neuropsychologist
3001 East J Street
Tacoma, WA 98404
Phone: 253) 274-9733
Edwin Lawrence Hill, PhD – Neuropsychologist
2013 South 19th Street
Tacoma, WA 98405
Phone: (253) 383-3355
Daniel Wanwig, MD – Adult psychiatrist
1901 South Union Avenue Suite A305
Tacoma, WA 98405
Phone: (253) 272-3031
Patrick Joseph Donnely. MD – Adult psychiatrist
3609 South 19th Street
Tacoma, WA 98405
Phone: (253) 381-3071
Robert Grumer, DO, Ann Marie Branchard, MD and Todd Clemens, MD
Individual and family counseling, Case management, Group Therapy, Psychiatric services and medication management. Partners with Tacoma schools to offer counseling at schools, Services also available in Gig Harbor.
Must call for information 253-396-5800
1305 Tacoma Ave S Ste 305
Tacoma, WA 98402
(253) 396-5000
Olympia
John Holtum. MD – Behavioral Health Research
4422 6th Ave SE
Lacy, WA 98503
360-403-4437
David Penner MD PLLC
324 West Bay Dr NW
STE 214
Olympia, Washington 98502 (360) 339-8759
Laura Wagner, ARNP
Sound Psychiatric Solutions, LLC
1800 Cooper Point Road SW
Building 12
Olympia, Washington 98502 (360) 633-2819
Edward Case, MD
200 Lilly Road NE, Suite B-3
Olympia, Washington 98506
Gig Harbor
Michael R. Pearson, MD Psychiatrist
5801 Soundview Dr # 251, Gig Harbor, WA 98335
(253) 858-3464
Dr. Vanraj C. Varu – Psychiatrist
7191 Wagner Way NW – Gig Harbor, WA 98335
(253) 514-8076
Munn, Helen, ARNP
4700 Point Fosdick Dr NW Ste 302
Gig Harbor, WA 98335
(253) 851-3808
Brace, Melanie, ARNP
6401 Kimball Dr. Ste. 104
Gig Harbor, WA 98335
(253) 853-3888
Tutor, researcher, and teacher of teachers. She advocates for children and parents in and out of the school system. She teaches all ages all aspects of literacy and specializes in Dyslexia and ADD. http://www.readingwritingthinking.net/
The Learning Disability Association of Washington online directory helps those affected by learning disabilities find resources within the greater Puget Sound region. The directory lists over 800 resources organized into categories ranging from diagnostic testing, consultants, therapists and support groups to optometrists, ADHD resources, physicians, and psychiatrists.
Washington State ADHD Treatment Providers – Note: ADD freeSources does not endorse or recommend any provider or services listed. Nor should exclusion from the listing affect your choice of provider. Many of these were chosen because they were associated with ADD Resources or local CHADD groups at some time.
ADHD Professional Services, Parent to Parent Teachers, Tutors, Schools and Support groups
Psychology TodayLook for Find a Therapist page on Menu – Find Therapists, Psychiatrists, and therapy groups.
OurFind ADHD Treatment and Support pagehas a fine collection of Directories to help you find a myriad of services you may need to treat ADHD – It includes:
Money Matters – The Affordable Health Care Act and Mental Health – Find Health Insurance – Low-Income Help – Social Security Income and Social Security Disability
The Cost of Not Treating ADHD by Steven Kurtz – “We’re already paying the cost, and our kids are too.” “Many kids with ADHD, and other conditions, just find their problems compounding as they get older. And they are less and less responsive to treatment. Kids with untreated ADHD often become adults with untreated ADHD, and with that comes a whole host of adult-sized problems.”
How much does it cost to test for ADHD? Consumer Reports – $700 to $1600 was the average assessment cost. – “About one-third of the parents in the survey reported that the costs of treating their child for ADHD were covered completely by their child’s health plan, with two-thirds of respondents reporting half to all treatment costs were covered by insurance.”
Managing the Costs of ADHD – by Chris Taylor – “Many parents are caught in a financial vise. They want to spend whatever it takes to ensure a successful future for their child but don’t want to bankrupt the family. Some tips: Work the public school system, be an insurance Ninja, and plan your budget early.”
The Affordable Care Act has new regulations to make sure that mental health treatment is covered to the same extent as physical care. Therapies for depression, anxiety, and substance abuse — which often come along with ADHD — are among a core set of 10 services called “essential health benefits” that must be covered with no out-of-pocket limit. Included in these are prescription medications, which are usually a major component of ADHD treatment. Knowing that a pre-existing condition won’t exclude you from getting affordable insurance is also a bonus. So is the option of keeping children on their parents’ policies until they’re 26. (1)
Before health reform, one out of five people who bought their own insurance had no mental health benefits. This change is long overdue. One drawback may be that by placing the primary care physician is at the center of treatment, Doctors may decide to treat ADHD themselves by just prescribing medication, rather than referring to a specialist. With the high rate of mental health issues and Learning Disabilities so commonly associated with ADHD, however, a complete diagnosis and a holistic treatment plan may be beyond the expertise of primary providers. (2) They may not appreciate the value of parent training to managing behavior or family therapy to educate and help all members of the family.
The news for low-income families is not as good. “In 2012, the Supreme Court gave states the choice of whether to join the Medicaid expansion or not. Unfortunately, almost half of the states have decided not to do so. That means that 6 to 7 million Americans won’t enjoy this enhanced access.”(3) Even with Medicaid, finding a physician will be difficult. “Under the present Medicaid reimbursement rates, physicians are paid only about $45.00 for a basic visit, while $75 per visit is the break-even point for most private practices. So the physician has to take a $30 loss for every Medicaid patient that he or she sees and has increased paperwork to even get the reimbursement.” (4)
Find Health Insurance
Alternatively, let your fingers do the walking. Check the Community Pages in your local phone book under Mental Health for local federally funded clinics. They accept Medicaid, Medicare, most insurances and will adjust their rate according to your income. (Note: Some areas do not consider adults with ADHD (alone) as qualified for treatment. Others will treat if it’s in combination with another mental disease or disorder). Children’s clinics, however, deal with ADHD concerns on a regular basis.
Or, use Google. I had good results using the words community mental health with city, county, and/or state
The Department of Vocational Rehabilitation is another possible way to go. You do, however, have to prove you are not employable or under-employed due to your ADHD or combination of disabilities. I know quite a few people who got a lot of help through DVR a number of years ago (including paying for a diagnosis for ADHD,) but their funding has been hit. – Find your state’s Voc-Rehab services
Clinical trials don’t cost a thing and you may even be reimbursed for your time.
(There’s no guarantee you’ll get the drug being tested, but you can often get a free evaluation for ADHD.) For a listing of current studies, see the National Institute of Mental Health.
2-1-1 is an Information and Referral service to help people connect with important community services and help them find help in their community more easily. Call 2-1-1 or Search for a 2-1-1 Call Center. Available in many states, 2-1-1 can help you find organizations that may assist with a broad range of needs. You may find help paying for medications or financial assistance with other essential needs such as food, clothing, rent and utility assistance, child care, employment supports, services for older adults, etc.
Social Security Income and Social Security Disability Income
Supplemental Security Income, or SSI, provides monthly income for those who cannot work due to a disability such as depression, bipolar disorder or other mental disorders. You must meet strict eligibility criteria to qualify.
The basics of SSDI – “Social Security Disability Insurance (SSDI) is available to any worker who has a “disability” as defined by the federal government and who has paid into the Social Security system for a specified amount of time, depending on their age. In order to qualify as “disabled,” an SSDI applicant must show that he is almost completely unable to work at any job whatsoever.”
Social Security Disability and ADHD (link works) – This article focuses primarily on children. – They need to show a MARKED inability to succeed in school and strong documentation is required. For adults: Adults must be unable to earn more than $960 per month gross (with that inability also caused by MARKED impairments. Most importantly, to win disability benefits from the Social Security Administration based on attention deficit, or ADHD, a person must have measurable functional deficits, in the context of school or work performance. (URL: https://www.disabilitysecrets.com/adhd-attention-deficit-social-security-disability.html)
SSI / SSDI Outreach, Access and Recovery – SOAR
Help for the homeless with mental illnesses, a process where eligible individuals can have their disability case expedited. SOAR’s online training course (Link works – Or copy and paste) https://soarworks.prainc.com/course/ssissdi-outreach-access-and-recovery-soar-online-training) is about 16 hours long, but it leads you through all the steps to help clients apply for SSI or SSDI. – To be eligible you must be at least 18, diagnosed with a serious mental illness, and homeless or at risk of becoming homeless. The SOAR process is designed to have a decision for disability claims within 90 days.
• “Image courtesy of Luigi/FreeDigitalPhotos.net” Modified on Canva.com
References
(1) “The Affordable Care Act: Good for ADHDers”
by Katherine Ellison – www.additudemag.com/adhdblogs/19/10545.html
(2) “An Update on How the U.S. Affordable Care Act Impacts Mental Health Care”
By John M. Grohol, PSY.D. – http://psychcentral.com/blog/archives/2013/11/01/an-update-on-how-the-u-s-affordable-care-act-impacts-mental-health-care/
(3) “Affordable Care Act : Will It Impact Your ADHD Child’s Treatment?” http://newideas.net/adhd-affordable-care-act-impact
(4) “One of the Best Things to Happen to People With ADHD? Obamacare” by Dennis Thompson Jr. http://www.everydayhealth.com/news/obamacare-best-thing-happen-people-with-adhd/
Finding a doctor for diagnosis is only the initial step in managing your ADHD symptoms. The list of additional resources below can help you move forward in your understanding of yourself and the challenges of ADHD. For optimal treatment for ADHD, you may find a need for a variety of professionals from different fields.
See Find Treatment for diagnosis, medical or psychological providers. These include:
Child Psychiatrists, Psychiatrists, Child Psychologists, Clinical Psychologists, Psychologists, General Practitioners, Pediatricians, Neurologists, Behavioral Neurologists, Therapists, Marriage and Family Therapists, Clinical Social Workers, Social Workers and Counselors.
Other types of professionals/services may include ADHD Coaches, Professional Organizers, Support groups, Lawyers, Educational Consultants, Advocates, Information and Parent support organizations, Private Schools, Tutors, and Residential Treatment Facilities. Professionals with an interest in or specialize in treating ADHD will often list their services in ADHD Directories as well.
Find Support – Make in person or online connections
You may find advocates, tutors, a few coaches, legal help and more here:
Wright’s Law – Yellow Pages for Kids with Disabilities Listings for educational consultants, advocates, advisors, psychologists, diagnosticians, health care specialists, academic tutors, speech/language therapists, and attorneys. You’ll also find government programs, grassroots organizations, disability organizations, legal and advocacy resources, special education schools, and parent support groups. A good resource for finding help for kids, but there’s no sort for ADHD specific providers
Find a Lawyer/ Advocates for IDEA or 504’s – Council of Parent Attorneys and Advocates The Council of Parent Attorneys and Advocates (COPAA) can provide a list of lawyers who specialize in disability rights. Visit their Web site or call in Washington DC 202-544-2210.
National Disability Rights Network – (Link works) Every state and territory of the United Sates has an organization designated to provide independent protection and advocacy services to eligible people with developmental and other disabilities and/or mental illness. Cover both school and workplace rights. Services include: Information and Referral, Training and Publications, Legal Representation, System Impact Litigation and Abuse or Neglect Intervention.
Center for Parent Information – Every State has at least one Parent Center that provides information and training to parents of children with disabilities, birth to 26. Find your State’s Parent Center and connect with a world of expertise and resources
LAW HELP – helps low and moderate income people find free legal aid programs in their communities, and answers to questions about their legal rights.
Legal Services Corporation – Government site – Legal Aid programs – Look for Find Legal Aid in the upper right corner of the page
Private Schools and Treatment Facilities
National Association of Private Schools for Exceptional Children (NAPSEC) (Link works)
NAPSEC is a nonprofit association of private special education schools that serve both privately and publicly placed individuals with disabilities. Free referral service.
Note: Many private schools and treatment centers advertise in ADDitude Magazine (Bound version or in their ADHD Directory) as well as in CHADD’s Provider Directory or their Attention 2.0 on-line magazine.
Educational Consultants – Struggling Teens – Directory of educational consultants who specialize in helping parents find appropriate places for children with behavioral and/or emotional problems. When you have a need for specialized placement, they know what’s available and for how much.
In need of intensive care? Oppositional Defiant Disorder or the more severe Conduct Disorder are common comorbidities. Later in life, addictions can be a problem.
Psychology Today’s Facilities Guide – Detailed listings for residential treatment facilities, treatment programs, wilderness programs, therapeutic services and young adult programs
Treatment 4 Addiction – (Link works) Drug Rehab Resource Page contains the SAMHSA (Substance Abuse and Mental Health Services Administration) database, as well as many private treatment centers, therapists, and addiction professionals.
Tutors/ Advocates
You may find tutors and/or advocates listed in an ADHD Directory, but chances are you’ll need to ask for referrals from local groups, do a computer search and or try the phone directories. Again, ask questions about their general experience and specific knowledge of ADHD. (I don’t know of any professional directories for these fields. If you do, please let us know.)
American Academy of Child and Adolescent Psychiatry – Link works. Extensive information for Families relevant to many disorders: Anxiety, ADHD, Autism, Bipolar disorder, Conduct disorder, Depression, Oppositional Defiant Disorder, and more. Includes a Child and Adolescent Psychiatrist Finder
Locate Affordable Healthcare in Your Area
HRSA (Health Resources and Services Administration) health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide:
• checkups when you’re well
• treatment when you’re sick
• complete care when you’re pregnant
• immunizations and checkups for your children
• dental care and prescription drugs for your family
• mental health and substance abuse care if you need it
Local Searches
Use Google. I had good results using the words community mental health with your county and or state.
Let your fingers do the walking. Check the Community Pages in your local phone book under Mental Health for local federally funded clinics. They accept Medicaid, Medicare, most insurances and they should adjust their rate according to your income. How to qualify for Medicaid or Children’s Health Insurance Program (CHIP). (Link works — Just click through or https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/)
If you qualify for Medicaid, you’re covered in full. (Note: most clinics will diagnose and treat children with ADHD, but many will not treat adults. Some areas do not consider ADHD in adults to be serious enough to qualify for treatment, but will treat if it’s in combination with another mental disorder.)
Note: Make sure to Look for hospitals with Mental Health or Behavioral Health treatment as well. They’re not just for emergencies.
The Medicare Participating Physician Directory can assist you in finding a psychiatrist who accepts Medicare. Copy and paste: https://www.medicare.gov/physiciancompare/
Non-profits for Help and Support
Mental Health America.net (Copy and paste: http://www.mentalhealthamerica.net/) is the country’s leading nonprofit dedicated to helping ALL people live mentally healthier lives. Provides information, advocacy and direct help to consumers in many states. Although they don’t cover all states, there are 320 affiliates nationwide. – Especially see their Get Help section – Many of the resources don’t apply directly to ADHD, but out of such a great selection- you should find something. – The site’s Get Info section is extensive!
The National Alliance on Mental Illness (NAMI), is the nation’s largest grassroots mental health organization dedicated to improving the lives of persons living with serious mental illness and their families. NAMI has organizations in all 50 states, as well as in Puerto Rico and the District of Columbia. There are also more than 1,200 local affiliates spanning all 50 states, D.C. and Puerto Rico. Provides information, support, and advocacy. www.nami.org
Parent Training and Information Centers – Parent Centers serve families of all ages (birth to 26) and all disabilities (physical, cognitive, behavioral, and emotional). They provide a variety of services including one-on-one support and assistance, workshops, publications, and Web sites. Find the Parent Centers in your area
For more information, see our Board below: Mental Health and Comorbidities Web sites.
“Image courtesy of SalvatoreVuomo/FreeDigitalPhotos.net” Modified on Canva.com
This collection of Directories is part of the series: Find Treatment and Support. You may want to start there.
Live and Work Well – An extensive listing of ADHD physicians and therapists Lists service providers in the United Behavioral Health system, but they could provide care to others not in this system. Sorts for Medicaid or Medicare providers, Area of Expertise (Attention Deficit Disorder) and clinician type- Psychiatrists (MD), Master’s-Level Clinicians (e.g., MFT, LCSW), Psychologists (LP, PhD) and Nurse Practitioners (e.g., NP, MHNP)
Psychology Today – Find a Therapist, Psychologist, counselor or social worker – Under I’m looking for help with… Try ADHD, but I had better luck with Learning Disabilities, Life Coaching and don’t forget Child and Adolescent Issues.
Social Worker Finder– Can choose ADHD as specialty- also has an insurance option. If you live a major metropolitan area, you could try their advanced search for even more specific needs.
Find a Therapist -Network Therapy – Counselors, psychologists, therapists…Can choose ADHD as a specialty- also has an insurance option.
The following assume expertise with ADHD based on their professions.
American Psychological Association (APA)- Psychologist Locator-
Sorts for ADHD, but not many names come up. Assume experience with ADHD, but ask anyway.
This collection of Directories is part of the series: Find Treatment and Support. You may want to start there.
Find a Psychiatrist – Web MD – Copy and paste – http://doctor.webmd.com/find-a-doctor/psychiatry – A list of physicians in the United States. – Does not sort for ADHD, but you may choose a specialist who is likely to have the requisite knowledge to diagnose and treat ADD. For example: Pediatrician, Psychiatrist, Development Behavioral Pediatrician, or Neurologist. To see if they accept your Insurance, click on Specialized Options (near the Find a provider button)
From CHADD, the National ADHD Resources Center – Can you find me a doctor or mental health professional?- Links to every national organization of Professionals who treat ADHD, but there are glitches. Some contain no provider finder, a few have ADHD as a specialty, while with others, Developmental and Behavioral is the closest specialty option. Most of the Directories are reviewed elsewhere on this site.
Yellow Pages for Kids with Disabilities – Find listings for educational consultants, advocates, psychologists, diagnosticians, health care specialists, academic tutors, speech language therapists, and attorneys. You’ll also find government programs, grassroots organizations, disability organizations, legal and advocacy resources, special education schools, and parent support groups. Good resource for finding help for kids with ADHD, but there’s no sort for ADHD specific providers- you need to know what type of help you need.
Marriage and Family Therapists – American Association of Marriage and Family Therapists Extensive listings- most with plenty of information about their specialties
In the real world, finding a provider well versed in ADHD can be a challenge. Well known diagnosticians don’t have to advertise, while others claim experience, but lack the expertise in treating all the aspects of the disorder. A missed or incorrect diagnosis delays getting the help you need. It may also be difficult to identify other disorders that so often accompany ADHD. Many physical or mental disorders have similar symptoms and make a correct and complete diagnosis challenging. Emotional difficulties, as well as the family problems, or a poor school or work environment may also create similar behaviors.
Basic symptoms of ADHD include: Making careless mistakes, failing to pay attention and keep on task, not listening, talking excessively and fidgeting. Symptoms are rated as to how often they occur and whether they create impairment in at least two areas – social, school, in the workplace or at home. (1) Many of these symptoms are common is other disorders as well, which means patients may be incorrectly labeled as having ADHD, or just as often, that ADHD will be missed. In general practice, therefore, ADHD is both over-diagnosed and under-diagnosed.
Physical disorders that may be confused with ADHD include thyroid problems, poor hearing, celiac disease, sleeping disorders or even food allergies. (2) (3) Other psychiatric disorders may be “comorbid” with ADHD or a different disorder altogether. They may be missed at first glance as they may not surface until later in a child’s development, in adolescence or adulthood. The most common comorbidities include Learning Disabilities, Oppositional Defiant Disorder, anxiety, and depression. (4) Aspergers Syndrome, now categorized as high functioning autism, or bipolar disorder are also something to be considered. (5)
Due to the serious nature of ADHD deficits, finding the best treatment at the price you can afford is important. Just how much you need to stretch your budget is a personal matter and should be based on the severity of symptoms of ADHD and their negative impact. (See: How much does it cost to test for ADHD? from Consumer Reports) If finances are a concern, please see ADHD Treatment: Money Matters.
For practical reasons, diagnosis and treatment is often left to Family Practice doctors or general pediatricians. An exploration of two opposing viewpoints on the struggle to receive appropriate treatment highlight the dichotomy between an ideal situation and the care you are able to find. One is a personal opinion of a Psychiatric Nurse Practitioner with many years of experience assessing ADHD while the other comes from an article on improving care for ADHD in primary care practices.
“AD/HD is real. It is neurological/biochemical in origin and is NOT a behavioral disorder or an excuse for failure. It is a disorder that requires that every aspect of the person’s life be explored because AD/HD affects ALL aspects of life and is almost always associated with other disorders.
Because of its complexity, ADHD is NOT a disorder that can, or should, be diagnosed in a busy family or pediatric practice. It requires extensive history taking, a lot of time, and knowing the subtleties of the disorder. Treatment requires first and foremost a COMPLETE diagnosis of all comorbid conditions.
Preliminary treatment will usually include the use of medications in proper sequencing for the best symptom coverage for all presenting conditions. In addition, self-care needs, such as a healthy diet, moderate exercise, and making sure of adequate sleep should receive attention. Further treatment will likely include psychological counseling; school and workplace accommodations; peer interaction and social skills training as well as coaching to develop time management and organizational skills.”
Adapted from the words of Ted Ritter, ARNP, CAPMHNP, board certified as both a Family Nurse Practitioner and as a Psychiatric-Mental Health Nurse Practitioner. (Harvested 9/20/2010 Northwest ADHD and Behavioral Clinic)
On the other hand….
“Attention-Deficit/Hyperactivity Disorder (ADHD) has a prevalence rate of 8.6 percent among children, which translates into approximately five million children in the United States who require ADHD-related mental health services (Froehlich et al., 2007).
ADHD, as one of the most prevalent pediatric chronic conditions in childhood, is certainly a part of daily practice for virtually every pediatric provider.
The mental health system and specialty mental health providers in the United States do not have the capacity to accommodate this number of children. As a result, the majority of children with ADHD receive diagnosis and treatment services from their primary care physicians….”
Jeff N. Epstein, Ph.D., and Joshua M. Langberg, Ph.D
Source: Improving ADHD Care with Community-based Interventions in Primary Care From National Alliance on Mental Illness – www.nami.org – Harvested 9-20-2010
A 2015 research study reviewed by David Rabiner, Ph.D, points out the failings of “community care.”
Guidelines from the American Academy of Pediatrics on the evaluation and treatment of ADHD are frequently not followed.
The careful monitoring of medication often does not happen to the degree that it should.
The commonly co-existing conditions are routinely not identified. (6)
Vigilance and patience are needed to ensure the best care. Whoever your provider, specialist or not, keep a journal to track responses to medication and any behavioral intervention. You can use any of these ADHD Screening Tools. Try documenting any behavior that seems different from others at that age. If ADHD alone doesn’t account for all the symptoms you see, look for the ADDitude Mag.com series, “Is it ADHD or is it…? — Possible disorders include Anxiety, Learning Disabilities, Bipolar Disorder, Sensory Processing Disorder and more. (7) (Look below the footnotes for a few statistics from a large 2011 study- Survey)
“Consult a specialist if traditional treatment isn’t working, or if you suspect your child has a complex form of ADHD,” says Brock Eide, M.D., “Your pediatrician or family doctor may not be up-to-date on the latest and greatest cutting-edge diagnostic and treatment approaches.” (8) Specialists will vary according to your concerns. For instance, with anxiety, depression or bipolar disorder, see a psychiatrist. For Tic or Autism Spectrum disorders, see a neurologist. Assessing learning disabilities is a job for any number of specialists, including psychologists. (9) See Find ADHD Treatment and Support to find a provider near you. Early detection offers the best prognosis, but remember, all disorders don’t present at the same age. And, as children move into adulthood, it cannot be assumed that an individual will grow out of the disorder. Studies have shown that 30 to 65% will continue to have problems. (10, 11.12)
Expect results from getting treatment, but not immediate changes. As Rae Jacobson writes, “Getting diagnosed wasn’t a cure, it was a key” that opened a gate to getting treatment, implementing appropriate strategies, and accepting that ADHD is not a character flaw.” (13) ADHD is a chronic condition that can be managed with medication, routines and structure and other personalized techniques. It may require some exploration to find the right type of medication and to find the right dosage, a process called titration. It will also take time to change behavior rooted in biology, regulate emotions and support weak executive functions.
Here’s where cultivating patience comes in. Your job is to do the best with what you have to work with today. Structure and routine help automate everyday actions, lead to greater productivity as well as build self-esteem and awareness. Progress inspires a change in attitude as well as lessening the unfortunate shame and doubt in one’s abilities that so often accompany the disorder.
Don’t just address deficits. Work to identify areas of strength, or “islands of competence,” and create a toolkit of strategies with different ways to get around problem areas more naturally. (14) Parents, advocate for your children to get the help they need. Both children and adults with ADHD must learn to speak up for themselves. It’s empowering and can be life-changing. Don’t try to hurry the process. Treating ADHD is not a sprint, it’s a journey of a thousand steps. One step at a time is enough.
“Photo courtesy of Luigi/FreeDigitalPhoto.net” Modified on Canva.com
(2) Meta-Analysis of Attention-Deficit/Hyperactivity Disorder or Attention-Deficit/Hyperactivity Disorder Symptoms Joel T. Nigg, Ph.D., Kara Lewis, Ph.D., Tracy Edinger, N.D., Michael Falk, Ph.D. – Journal of the American Academy of Child & Adolescent Psychiatry. Volume 51, Issue 1, Pages 86-97 .e8, January 2012.- Harvested 10/20/2014 – Link works – http//www.jaacap.com/article/S0890-8567(11)00953-1/abstract
(4) Patterns of Comorbidity, Functioning, and Service Use for US Children With ADHD, 2007, Kandyce Larson, PhDa, Shirley A. Russ, MD, Robert S. Kahn, MD, MPHc, Neal Halfon, MD, MPH http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065146/ – Harvested 10/17/2014
(10) Not Just for Kids by Ronnie Rochman – Time – ADHD Often Continues into Adulthood Harvested 3-6-2016 http://healthland.time.com/2013/03/04/why-adhd-is-not-just-a-problem-for-kids/ “In the largest study of its kind, researchers at Boston Children’s Hospital and Mayo Clinic found that close to a third of children with ADHD — 29.3% — still have the disorder as adults, along with an increased rate of other psychiatric problems.”
(12) Can Children Recover from ADHD by Adulthood? Russell Barkley’s Facebook pageMarch 1 at 8:57am – Harvested March 4, 2016 “Follow-up studies published over the past decade, which are more rigorous than those done 20-40 years ago, indicate that up to 35% of children may no longer qualify for the diagnosis of the disorder or be impaired from it in any major life activities.
(13) What it’s Like to have ADHD as a Grown Woman by Rae Jacobson – Harvested 9-7-2015 – http://nymag.com/thecut/2015/08/what-its-like-to-have-adhd-as-a-grown-woman.html (Copy and paste URL)
The survey published by National Survey of Children Health, which involved over 60,000 children ages 6-17 years including over 5,000 with ADHD, showed that psychiatric and physical comorbidities were very common in children with ADHD. (Larson 2011) Overall, 67% of ADHD children had at least one other mental health or neurodevelopmental disorder compared to 11% of children without ADHD. 33% had one comorbidity disorder, 16% had two, and 18% had three or more. ADHD was associated with elevated prevalence of the following (Phend): 1. Learning disorders (46% vs 5%) 2. Conduct disorder (27% vs 2%) 3. Anxiety (18% vs 2%) 4. Depression (14% vs 1%) 5. Speech problems 12% vs3%) 6. Autism Spectrum Disorder (6% vs0.6%) 7. Epilepsy/Seizures (2.6% vs0.6%)
ADHD and Comorbidity by Mintin Patel, Mita Patel and Harsha Patel – Harvested 9-7-2015 – Copy and paste – http://cdn.intechopen.com/pdfs-wm/28240.pdf
