This first news segment focuses on Dr. Jaffe’s explanation of what the Quotient is and it benefits his patients:

This second news segment features an interview with the mother of one of Dr. Jaffe’s patients. She gives a lot of valuable information for parents who think their child may have ADHD:

For about a year now, I’ve been meeting quarterly with these Letter People. My daughter’s principal leads the group, and her teacher is there with me as an additional advocate for her. The six other people in the room are school and district psychiatrists, counselors and social workers. The meetings usually start with an introduction in which each of the Letter People make sure to add the letters that signify their credentials after their name. I’ve been tempted myself to include the letters….M…O…M after my own name, but I’m not sure they would appreciate the humor. After we’ve all been re-acquainted, the Letter People go around the room and discuss my daughter’s successes and failures since the last meeting. It is all quite clinical and, to be honest, intimidating. BUT, seeing as I am truly the main advocate for my daughter, I never hesitate to stop and ask them what they are talking about when they start spewing their letters at each other. Without fail, they will stop and answer my questions to fill me in with language I can understand.

When my first meeting with the letter people for the year was scheduled before school one morning, I was hesitant to bring my daughter. She’s always been invited to the meetings, but seeing as I have a hard time keeping up myself, I really didn’t see much value in having her there. For this meeting though, I really didn’t have much choice. I entered the meeting room with trepidation, we were welcomed and quickly took our spot at the head of the table. I could sense my daughter was nervous, why wouldn’t she be? Here she was sitting in front of all the important people in her school, and some people she didn’t even know. I’m sure it felt like a nightmarish parent teacher conference. Her principal also sensed her uneasiness and instantly put her at ease. “I’m so glad you could make it this morning Paige,” he said, “yours is a real success story and you should be very proud of yourself.”

I looked at my daughter and I could see the relief cross over her face in an instant. He continued on to praise her, all of her hard work, and the strides she had taken to improve not only as a student, but also as a young lady. At this point, my daughter was beaming. He carried on with the meeting. We all re-introduced ourselves, letters and all. Her teacher spoke first telling the group what a joy she was to have in class. As the principal went around the room asking all of the Letter People for their status updates they each gave their typical clinical lettered response, but then each of them who knew her personally praised her in some way. They weren’t just giving off-handed “atta girl’s” either. They were giving specific examples for my daughter to take stock in and feel proud of, and she did feel proud. Her eyes danced with joy as these lettered administrators helped boost her confidence.

The meeting ended on a high note. Her principal suggested that we no longer schedule any meetings for her because she was currently doing so well in school. If she starts to slip we can regroup. To me that was a great accomplishment, but it was not the most important part. The most important part was the sense of pride my daughter was feeling knowing that all of her hard work wasn’t just paying off, but also getting noticed. Dr. Jim Loehr said, “with confidence you can reach truly amazing heights; without confidence even the simplest accomplishments are beyond your grasp.” It’s so true. Although my daughter still struggles daily with school, her new found sense of confidence is helping her tackle each obstacle with her head held high. I’m so proud of her.

-Kathy Hull, ADHD Parent

I am a neuropsychiatrist with a full time clinical practice specializing in ADHD. My job description includes cooking, cleaning, maintaining household organization, keeping track of birthdays, bills, occasions, dental appointments, kids’ activities, and changing toilet paper. Oh yes, I forgot about the dog.

I don’t have ADHD, but I often imagine what life would be like it I did. Here is the bad news: as a female, chances are I would not be properly diagnosed with ADHD even if I did have it. Perhaps my teachers described me as a daydreamer, not trying hard enough in school. My friends might say I’m chatty, disorganized, or frequently late. Even my psychiatrist may not recognize the problem, diagnosing me with depression or anxiety – which unfortunately resulted from my underlying ADHD that nobody noticed! At this point I may be taking the wrong medication, feeling rather negative about myself, overwhelmed, and wondering why the many balls I’m juggling keep hitting me in the head.

The reality is that ADHD is still significantly underdiagnosed in girls and women compared to males. In fact research shows we may be missing the diagnosis in up to 75% of girls with ADHD. Why are we falling so short in identifying females with this condition?

Here are the facts:

1) ADHD girls tend to present more with the inattentive symptoms rather the hyperactive/impulsive symptoms typically seen in the boys.

2) The inattentive symptoms (difficulty sustaining attention in tasks, forgetfulness, distractibility, poor attention to detail) are less visible, which means the teachers and parents cannot “see” the warning signs.

3) Even when girls have hyperactive/impulsive ADHD symptoms they present differently than boys. Girls are more likely to show excessive talking/chattiness or fidgetiness (i.e. hair twirling, skin picking) rather than frank behavioral issues.

4) If the ADHD girl is not having behavioral problems, chances are no one has suggested an evaluation.

5) Cultural pressures encourage girls to be more socially conscious, “people pleasers”. They may suffer silently, working hard to mask their symptoms and even developing a perfectionist style to compensate. These girls may make great grades but at the cost of extreme effort and emotional turmoil.

6) Females with ADHD tend to present more with mood disorders, depression, anxiety, and low self esteem than the males. These co-exisiting diagnoses become evident and get treated, but the underlying ADHD frequently remains unknown.

Interestingly statistics show the ratio of boys to girls with ADHD is 3:1, yet the ratio of adult men to women with ADHD is 1:1. Does that mean more of the boys outgrow their ADHD? Probably not. I suspect we are just better at diagnosing boys at a younger age, so it simply appears that more boys have the condition. By adulthood, most of the hyperactive/impulsive symptoms of ADHD subside in both males and females so we are equally good (or bad!) at diagnosing adult men and women. Studies show we still significantly underdiagnosing male and female adults with ADHD.

So what is the good news? Well, we are getting much better at creating awareness about ADHD in both genders. We are also finding more objective evaluation tools such as the Quotient ADHD system to enhance diagnosis and treatment. Thankfully more clinicians are learning to screen patients for ADHD symptoms in their practice. There is hope.

As for my “job description” above, perhaps there are other gender gaps. But I’ll leave that for another blog!

My name is Daniel Hartman, MD and I am a practicing Psychiatrist in Flourtown, Huntingdon Valley and Doylestown, PA. For ADHD Awareness Week I wanted to share a story of two of my patients. One of them I have seen for most of his life. One, for just over a year.

I started seeing Mike when he was six years old or so. Brought in by his mother, he was having all the classic problems that a child with ADHD has. He was inattentive and distracted. He was disorganized and was losing things. He couldn’t sit still and would get in trouble for talking and playing when he was supposed to be sitting still and doing his work. He was described as “lazy” when, in reality, that “lazy” was the standard disengaged and distracted we here in mental health land can easily diagnose as Attention Deficit Hyperactivity Disorder (ADHD). Mike was started on stimulant medicine and did great. Over the years, he would come to see me every two or three months. Medicine would be tweaked to ensure adequate coverage of his symptoms. The occasional typical adolescent issues would surface and recede, but, by and large, he did very well. He applied to colleges and got in, and has gone on to successfully complete a rigorous academic program in the field of his choosing.

Paul is relatively new to me as a patient. He was the sort of “getting by ok” student that often runs under the radar. His tendency toward inattention and difficulty with task completion was evident for years, but he always did “well enough”. Well enough, anyway, to avoid seeking treatment. But the standard comments of his being “a bit lazy” and “not living up to his potential” were always there and always haunting him, contributing to his sense of not-being-good-enough. Still, he did do well-enough to get by, and he, too, went to college. But that is where he hit the brick wall. Even though he was intellectually capable of performing adequately in college, the pace of the work was too much. Old insecurities from years of struggling to succeed surfaced as his performance lagged and his grades plummeted. Eventually his mood symptoms reached the point of Major Depression. He had to return home and seek a medical withdrawal and… finally… ended up seeking treatment. Initial treatments for his mood disorder were not well tolerated. It was only after an astute colleague suggested that we send him for a Quotient-ADHD Test that we stumbled upon the root of the problem. Paul, after all these years of struggle and failure, was diagnosed with ADHD. With this information in hand, appropriate medication and therapy interventions were developed… and Paul has thrived.

He is now taking a full roster of classes at the local community college (and getting all “A’s”) and getting ready to apply to local 4-year colleges. He can attend to the tasks necessary to make this successful and can utilize his strong work ethic to work independently and proactively in his classes. And he has no symptoms of a mood disorder… without the need for antidepressant medicines.

These two cases bring so many thoughts and questions to mind.

How would Mike have faired if he had not started in treatment at an early age… and how would Paul have done if he had?

How would Paul be today if he had not serendipitously come to my practice for treatment. What if he had not had the benefit of the Quotient-ADHD Testing System that can look below the presenting mood symptoms for those core neuropsychiatric symptoms of ADHD? Would he still be muddling through with unpleasant trials of antidepressants?
What if?… What if?… What if???

These two scenarios highlight the importance of early diagnosis and treatment for ADHD. Both of these young men are fortunate to have had their conditions identified and treated. So many others are not so fortunate. Untreated ADHD increases the risk that a child or adult will experience clinically significant Major Depression, anxiety and substance abuse issues. Untreated ADHD increases the chances that you and your child’s life will be one of unfulfilled dreams.

If you have any suspicion that you or your child (or some other family member) might have ADHD symptoms… get them tested… and get them treated.

“It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to, than I have ever known.”

Dan Hartman, MD
Medical Director, Philmont Guidance Center

Host of The Sidewalk Psychiatrist
www.thesidewalkpsychiatrist.com
www.philmontguidance.com

I was “officially” diagnosed at the age of 31. Looking back at my life, I was able to see all the problems I had. On the first day of first grade, I “got paddled” for “talking in class”. Of course, it was not my fault. If that darn kid had not talked to me first, I would not have received my paddling. I could recount numerous other stories, but I will spare everyone. For several years after my diagnosis, I will admit that it bothered me when someone would tell me that there is no way I could have AD/HD because I was “too smart to have AD/HD”. My response was, “I guess only ‘stupid’ people have AD/HD”. Eventually, my retort softened as the stigma of having AD/HD was no longer a stigma. I was never embarrassed about having AD/HD. You are what you are. Patients have thanked me just for admitting that I have AD/HD because they feel they have someone they can talk to, who understands them, and realizes that they are “not stupid”. In fact, I find most of my AD/HD patients to be bright and creative.

About 5 to 6 years into my journey of understanding how my AD/HD affects me, I started to look at how others see patients with AD/HD. While I find these tools helpful, I was always troubled that the diagnosis was based on someone else’s opinion of the affected child. In other words, the basis for the diagnosis is someone’s observations. Imagine a young married couple going to a physician’s office but their significant other answers all the questions for the person affected with an illness. I can only image the backlash after that appointment. Yet, this is how AD/HD is diagnosed in a child. I realize that a child cannot self-exam, but what about an adult? Current rating scales for children are based on parental and teacher observations. It is all too common for one of the parents to believe that the child does not have a problem. It is very common to hear from one parent that “all children are hyper”.

On my website’s FAQ, I post the following question and response:

How do I know if my child or I have Attention Deficit/Hyperactivity Disorder (AD/HD)?

A. AD/HD is not what most people think it is. Since I suffer from AD/HD (most of my patients know this and I am not embarrassed to state it), I view it from a different perspective. AD/HD is not the inability to concentrate or “focus”, but a person becoming so hyperfocused on something (including daydreaming) that they are “not paying attention” to what their parents, teachers, significant others want them to pay attention to. I use two questions to determine if someone has AD/HD: 1) Do you become so hyperfocused on something that you lose track of time. It does not have to be hours of time but enough time that you are then hurrying or late to something. 2) Do you literally scan your environment or as you are reading, you start thinking of something but continue to scan the pages in the book unaware that you are not paying attention; therefore, you have to go back and read it again. If you answered yes to both questions and you do this frequently enough, there is evidence of AD/HD. However, these symptoms must have been present by the age of seven and cannot be explained by either a mood disorder or anxiety.

Now, I have a new, wonderful tool to test AD/HD that provides me an objective result that I can share with the patient and their parents, the Quotient. I have found it useful to diagnosis AD/HD but also to demonstrate the benefit of continuing medication or fine-tuning a medication. Most of all, I can truly inform patients how severe their child suffers from AD/HD. I found it troubling that AD/HD was based on the number of symptoms someone suffered from. In other words, the more symptoms someone has, the more “severe” their AD/HD is. The problem with rating severity in this manner is that how severe the symptom is, is in not being taken into account. Let me explain. If a child has all nine symptoms of inattention and nine symptoms of hyperactivity and impulsivity, that person would be diagnosed with a “severe” case of AD/HD. What if all the symptoms this patient experienced were only one standard deviation from normal? Another patient might only have six or seven symptoms but their symptoms are 3 to 4 standard deviations from normal. Using conventional rating scales, their symptoms would by mild to moderate. In my opinion, those patients would be classified as having severe to profound AD/HD symptoms.

I finally feel I can convince even the doubters. I do not want this blog to be an advertisement for Quotient. I want everyone that reads this to think about how they could possibly use this wonderful tool.

I welcome your comments.

Carlos Guerra, Jr., M.D.
www.cbtxi.com

Whether you’re a child or an adult, if your brain works differently and it is harder to focus, to achieve and to interact smoothly with others, your internal assessment of yourself is usually to the downside.

If we are bright, watch others achieve and can’t figure out why we don’t get better results, we chew ourselves up with thoughts like, “I must be really stupid,” “People don’t like me,” “Why should I even try.” The consequences of not being able to perform to meet academic, work and social expectations takes its toll on self-esteem and self-image. I believe this is the most damaging consequence of untreated ADHD/ADD. The social emotional torture that ensues from hyperactivity, distractibility, impulsivity and disorganization can never be underestimated. That is why treatment recommendations must include BOTH medication and either family, couples or individual psychotherapy.

It follows that those who relate to ADHD/ADDers also suffer the effects of trying to manage and interact with someone who, through no fault of their own, can be annoying, exhausting, and unruly. Their frustration quotient can sky rocket and everyone feels bad. Understanding what it means to have ADHD/ADD, and that many of the ADHD/ADD behaviors are not intended to hurt or frustrate, can go a long way to short circuit self- defeating behavior all around. What everyone needs is affirmation and encouragement for positive behavior and results. Today an 8th grader told me that he is beginning to see he isn’t stupid. Why? Because on his medication he can focus and do his math, bring home A papers and begin to create a positive cycle of accomplishment!

Maggie Baker, Ph. D.
http://www.maggiebakerphd.com/
Wynnewood, PA

Have you read about the Quotient ADHD System but you’re still not sure exactly how it works? Check out this great video interview with Dr. Howard Schub where he explains the different features of the Quotient ADHD System and how the test is helping children, adolescents and adults around the country.

Not long ago, I wrote an article for HubPages titled “Struggling with ADHD: Getting an Objective Diagnosis.” Like any good hubber, I spammed the article on my Facebook page. You know what I found out? That I am not alone. Friends of mine that I have known for years were dealing with the same issues I was having with my daughter. Some offered suggestions, while others asked for help.

So when the folks at BioBDx offered me the opportunity to become a patient advocate for them, I was really excited. It was not only a chance for me to connect with other parents like myself, but also to help educate people on the Quotient ADHD system.

I don’t profess to be an expert on ADHD, but I am an expert on one thing…my daughter. Since she was diagnosed with ADHD a few months ago, I’ve made it my mission to educate myself as much as I can on ADHD. Like any parent, I want to help her as much as I can so she can be successful in school and in life.

Personally, I’m a stay at home mom. I’m the mother of two, a wife, a writer, a gardener, a gamer and a closet Facebook addict. When I’m not scouring the internet for ways to help my daughter with her ADHD or writing a Hub for HubPages, do I find myself quite frequently tending to my farm on Farmville.

I hope that we can take advantage of the opportunity here to form a community of support. I’ll share with you my successes and failures with my daughter. I hope you will do the same. You can feel free to contact me directly at (insert e-mail here – not sure which one I will use yet) or post your comments.

So remember, you are not alone…

Yes, my name is Kathy and my daughter has ADHD