Written by Heidi Bernhardt R.N.
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What exactly is this new “quadmester” system?
Instead of two semesters there will be four semesters in this 2020/2021 school year in Ontario. Two subjects will be taken per semester with each semester lasting approximately ten weeks. Students may choose in school learning or remote learning before each quadmester. If students choose in- class learning versus complete remote learning, they will be in school for approximately 2.5 hours per day, two days out of five one week and three out of five the next week. After their in-class sessions they will be expected to complete their day learning online. The days of the week that they are not in school will be spent in online learning.
How might these changes impact our students with ADHD?
There may be a slight benefit for students with ADHD in this quadmester system because they will only need to focus on two courses at a time, rather than four. This means less juggling of multiple assignments, which is a challenge for many students with ADHD and executive functioning impairments. A more concentrated learning schedule will require a faster moving curriculum which depending on the student may be a benefit or drawback. Some students will find it difficult to keep pace requiring additional time to process and integrate new concepts. Others with ADHD who find classes too slow and boring may actually do better when classes move at a quicker pace. However, this faster pace will mean that if a student misses a day or two due to illness, they will most likely become overwhelmed fearing that they will never be able to catch up.
For most students with ADHD the expectation that they sit and listen to lecture style teaching for extended periods of time with minimal breaks will cause a problem. In addition, many of our students need to move frequently which will undoubtedly be even more restricted than usual. This will further reduce their attentional capabilities and may lead to more shifting of position, tapping, squirming etc., causing them to be unintentionally more disruptive. Also, the new schedule of moving from in-class learning to online learning at the end of the day and through the week will be difficult for students with ADHD. Consistency of routine is a necessity for those with ADHD.
Tips for students with ADHD and their parents on navigating this new quadmester system.
Having raised three boys with a variety of ADHD presentations, I continue to find it fascinating how ADHD can be similar yet so different in girls and women. Unfortunately ADHD continues to be underdiagnosed in girls, resulting in many young women growing up with a significant dent in their self- esteem and wondering why things that seem simple for others can be such a struggle for them.
I just came across a wonderful article in the New York Times magazine, What It’s Like to have ADHD As a Grown Women, written by Rae Jacobson, a young woman with ADHD who grew up undiagnosed until the age of 21. The way other people treated her, their misperceptions and judgements are certainly disturbing, but the toll all of this took on her self- concept and confidence is the most heartbreaking. As she states:
“Repeated failure is destructive. It chips away at your self-confidence and eats at your resolve. It makes you hate yourself.”
Rae cites Dr. Patricia Quinn in her article. Dr. Quinn and Dr. Nadeau jointly host the ADDvance web site, http://www.addvance.com/, where they answer questions about ADHD with a focus on female ADHD. This is a wonderful resource for anyone interested in finding out more about ADHD in girls and women. Another great resource is a newly released up-dated version of Dr. Nadeau book, Understanding Girls with ADHD.
If you are a young woman, or know a young woman who has or thinks she may have ADHD, I strongly suggest that you read this article and access some of the numerous resources now available to assist girls and women with ADHD.
CADDAC presents ADHD PREP, a 2-day program on Saturday April 25 from 9AM - 4PM and Sunday April 26 9AM - 4PM
Visit the ADHD Prep Outline for an overview of the course content.
ADHD PREP is a comprehensive 12-hour program geared to parents of newly diagnosed children and adolescents with ADHD, and to parents wishing to upgrade their knowledge on the more complex aspects of ADHD including ADHD and learning, executive functioning and self and mood regulation.
Treatment options, parenting strategies and advocacy skills will also be covered. The program will occur over a weekend allowing parents from outside the local area to drive in for the weekend. Pricing includes workshop materials and light refreshments each morning and afternoon.
A post published by Mark Bertin M.D recently caught my eye for several reasons – one being the fact that Dr. Bertin will be one of our featured 2015 conference speakers, and another being his well-balanced multimodal approach to addressing ADHD, and his realization that the high levels of stress this disorder causes often drives the way families deal with ADHD.
Dr. Bertin begins with a genius analogy describing the fundamentals; the need for a strong foundation consisting of three pillars that has been proven to have significant impact on ADHD symptoms; school accommodations that recognize executive functioning impairments and; family supports and medical interventions.
Next steps would involve looking for ways to better things such as sleep, nutrition, exercise, communication, time management, safe driving and the excess time spent with electronic technology and media. Dr. Bertin concludes his analogy by talking the focus of his upcoming book, the use of mindfulness as a tool to help in “holding it all together”. If you have a child with ADHD who is struggling, or you are having difficulty functioning as a family with ADHD, this article may assist you in assessing where to start and how to build upon the successful management of ADHD as a family. Unfortunately while reading this article what came to my mind is the fact that in many parts of Canada it still remains difficult to access two of the supports that Dr. Bertin identifies as crucial: school accommodations and family support.
To view the Dr. Bertin’s entire post: https://www.psychologytoday.com/blog/child-development-central/201501/the-house-we-build-adhd
A new study researching how individuals with low birth weights were impacted found that they had decreased chances of developing alcohol and substance use disorders later in life but an increased chance of developing other psychiatric problems. Funded by the Canadian Institute of Health Research (CIHR), the study followed children into their 30s and found that they were 3 times less likely to develop alcohol or substance abuse issues, but 2.5 times more likely to develop psychiatric disorders such as anxiety, depression, and ADHD. Those born at an extremely low birth weight who received a full course of life saving steroids were nearly 4.5 times more likely to experience psychiatric problems.
Researchers feel that this information will increase awareness amongst parents and medical professionals and allow them to screen and assess for these disorders earlier. Of course it has been known for some time that premature babies have a higher incidence of ADHD, the new information about anxiety and depression is interesting. It would be interesting to find out how many of these adults who were diagnosed with ADHD also had comorbid anxiety and depression since these disorders frequently coexist in the adult ADHD population.
Because only 84 adults were followed all the way into their thirties, this is considered a small study; additionally, factors such as DNA and environment were not controlled and so a larger scale study would need to be completed before any definitive results could be reported.
For more information visit the original article at http://www.sciencedaily.com/releases/2015/02/150209083008.htm.
Don't forget to register for CADDAC's upcoming workshop on Adult ADHD, less than two weeks away!
Date: Saturday October 4th, 2014.
Location: Centennial College Culinary Arts Centre, 940 Progress Avenue, Toronto Ontario M1G 3T5.
Time: Registration and Breakfast from 8:00AM to 9:00AM. Presentations from 9:00AM to 3:30PM, followed by a Q & A Discussion session.
CADDAC is hosting a full day workshop on Understanding Adult ADHD. Presentations will be geared to adults and their families dealing with adult ADHD. This workshop will also be of interest to health professionals who wish to gain an understanding of adult ADHD and potential treatments.
The morning sessions will cover the medical science of adult ADHD, how it presents itself, how it differs from childhood ADHD, medication and psychosocial treatment options. These sessions will be followed by a unique presentation by adults with ADHD speaking about their own experiences and insights.
The afternoon will include a presentation on emotional dysregulation in adult ADHD and a presentation on ADHD in the workplace, discussing potential strategies and accommodations. An open question and answer and discussion period will follow where attendees can ask questions and share their insights.
Featured presenters include:
Dr. Flood, is a graduate of McGill University and the University of Manitoba. She is a family physician with a focused practice in Child and Adolescent Psychiatry at the Shoniker Clinic. She has considerable experience working in the field of ADHD, Learning Disorders and Autism. She is a member of CADDRA and on the Advisory Board of CADDAC.
Dr. David Teplin, is an adult clinical psychologist in private practice in Richmond Hill, Ontario. His primary focus is diagnostic assessment, clinical consultation, adult ADHD, and substance use disorders. Dr. Teplin is adjunct faculty in the Doctor of Clinical Psychology program at Medaille College in Buffalo, New York, and is on the editorial review boards of several clinical journals. He is also on the Advisory Board of CADDAC.
Heidi Bernhardt RN, is the mother of three young men with ADHD. She has a background in psychiatric nursing, was the Executive Director of the (CADDRA), a national not-for-profit organization of the leading clinicians and researchers in ADHD in Canada, and a founder of CADDAC and the ADRN. Heidi is presently the President and Executive Director of the Centre for ADHD Awareness Canada (CADDAC).
I received a call today regarding our post entitled “Vancouver’s Battle Against Adult ADHD Stigma” alerting me that clarification on CADDAC’s position is required.
I sincerely thank the caller for taking the time to speak to me about their concerns.
Our comment was in no way intended to be political or favour one councillor over another.
Our intention was to highlight the message that could be taken from statements made. If an employee requests assistance for their disability, especially adult ADHD, they are seen as not being capable of the job, or playing the “poor me I have a disability card”.
I hope that this is not Ms. DeGenova's position; unfortunately it could be interpreted (or misinterpreted) in that way. As stated in the blog, questioning the expense, or any expense, is not the issue. Our concern was that additional statements made could send the wrong message.
At this time many employees are fearful of disclosing their ADHD. They are reluctant to ask for simple accommodations in the workplace that would make them a more productive employee. They fear the stigma and being viewed as incompetent or making excuses. They worry that coworkers may resent them for receiving special treatment.
A recent Ontario Human Rights Commission (OHRC) report, “Minds that matter: Report on the consultation on human rights, mental health and addictions”, http://www.ohrc.on.ca/en/minds-matter-report-consultation-human-rights-mental-health-and-addictions
helped to clarify the duty of employer to accommodate individuals with mental health conditions. It is however also important to note that the commission states, “The accommodation process usually begins when someone identifies they need accommodation due to a disability-related need.”, http://www.ohrc.on.ca/en/minds-matter-report-consultation-human-rights-mental-health-and-addictions/10-duty-accommodate, and that it is the responsibility of the person with the disability is to ”inform their employers of their needs”, http://www.ohrc.on.ca/en/disability-workplace-roles-and-responsibilities-fact-sheet.
Hopefully this report is a first step in helping to clarify everyone’s role in assisting those with a disability in the workplace, but we still have a long way to go. If comments, unfortunate or misinterpreted as they may be are left unchallenged it furthers the stigma or the disorder.
Recent studies out of the Karolinska Institute in Stockholm, Sweden found that people with ADHD have an increased risk of suicide. In addition, they also found an increased risk of suicide in the parents and siblings of people with ADHD.
This study is the first large scale study to show that ADHD and suicidal behaviour could share genetic risk factors. Researchers felt that the findings suggest that genetics may link ADHD and suicidal behaviour.
The study looked at national data for 52,000 patients with ADHD, about a third of whom also had another psychiatric disorder, as well as about 260,000 people without ADHD. The researchers found that, of the study participants without ADHD, 1.3 percent attempted suicide and 0.02 percent completed suicide. People with ADHD had a risk of 9.4 percent attempted suicide and 0.2 percent committed suicide. Parents and siblings of people with ADHD also had an increased risk of suicide, according to the study. The researchers found that 6.6 percent of the parents of people with ADHD attempted suicide, and 0.7 percent completed suicide. Among the siblings, 3.4 percent attempted suicide.
Even when researchers excluded data of people with multiple psychiatric disorders numbers remained well above the norm for people without ADHD.
An additional study found that medication to treat ADHD did not increase suicide attempts or completed suicides and may actually be protective.
In this study 38,000 people in Sweden diagnosed with ADHD between 1960 and 1996.
Experts in the field stated that this was a very well designed study because it was very large and because it tracked suicidal behaviours when individuals were either on or off the medications.
I strongly disagree with the recent article in Today’s parent magazine “What’s in a Label?” http://www.todaysparent.com/family/parenting/kids-health-labelling-behaviour/, which states that labeling a child with a disorder, be it ADHD, ODD, anxiety or OCD, imprisons a child and gives them the feeling of a life sentence. Liza Finlay, a psychotherapist, goes on to say that these labels allow a child to sidestep any effort to improve. My experiences are far different. From a personal family perspective as well as the perspective of someone who has spoken to thousands of families over the past twenty years, it is the lack of early diagnosis and therefore lack of treatment and access of resources that have imprisoned many children into a life of dealing with the consequences of these disorders. Left untreated, ADHD can lead to additional mental health disorders, increased rates of high school dropout, less years of education, self-medication leading to substance abuse, involvement with the justice system, as well as increased socioeconomic costs.
A psychologist who believes that the earlier mentioned disorders are nothing but behaviours, and that children can simply choose to adopt different behaviours, is an affront to decades of medical research. Does therapy combined with other treatments for these conditions prove helpful? Sometimes, but that does not mean that ADHD is simply a set of behaviours that can be unlearned.
The notion that "once a child is diagnosed with ADHD, parents stop expecting them to behave" is not only ludicrous, it is insulting. Once a diagnosis happens, parents are able to put the child’s behaviour into perspective. They are then able to focus on appropriate parenting strategies to assist that child with their behaviours and access other appropriate treatments.
I certainly agree that additionally focusing on a child’s strengths and working to increase their capacities is essential, but the best way to do this is within the understanding of a child’s overall profile. The lack of understanding of a child with ADHD can lead to all of the above mentioned consequences as well as increased childhood and family stress, family breakup, and, in extreme cases, abuse and children leaving home.
Do we need increased tolerance for those who do not fit into society’s definition of normal? Do we need to expand society’s definition of normal? The answer to both of these questions, of course, is yes. But we need to make sure that while we work on this goal, we don’t neglect the children who are labeling themselves as stupid, lazy and bad because no one has let them know why they might be finding it more difficult to succeed than their peers.
*** You can comment on the original article or click here to leave a letter for the editor. ***
I was notified about an incident that occurred during a Vancouver City Park Board meeting which highlighted the continued misunderstanding and stigma which still remains about adult ADHD. Vancouver Park Board Commissioner Melissa DeGenova shamed and stigmatized Vancouver Park Board Commissioner Sarah Blyth, who is the first politician in Canada to go public with ADHD.
Asking a question about Vancouver paying for the cost of business coaching is of course acceptable, making someone with a medical condition feel ashamed for asking for assistance is not.
About a year ago Sarah Blyth asked park board staff for help as she would be chairing some upcoming contentious meetings. She was offered business coaching. At this park board meeting questions were asked with regard to expenses surrounding the ADHD coaching she received. Commissioner Jasper asked staff to bring to the board any related information; and added that chairing the park board is at times a difficult job, and that if a commissioner needed help that he thought the request was reasonable. He also stated that Sarah Blyth was open about being diagnosed with ADHD.
Following this discussion, Melissa DeGenova asked why the governing party would not elect someone capable of doing the job, and further stated that she had disabilities, too. Melissa has two diagnosed Learning Disabilities: dyslexia and written output disorder, and is on the City of Vancouver Disability Advisory Committee. Ms. Blyth and others reported that, as she was leaving the meeting, Commissioner DeGenova proceeded to follow her out the door asking why she was playing the, "Poor me, I have a disability card."
To access Sarah Blyth’s description of the stigma she felt, please click on the following link or copy and paste it into your browser: https://www.facebook.com/notes/sarah-blyth/stigma/10152386409495210
To access Jamie Lee Hamilton’s account of the incident and request for an apology, please click on the following link or copy and paste it into your browser: https://www.facebook.com/jamie.hamilton.9480/posts/461977273945834