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Dr. David W. Goodman invited to speak at Regional CHADD conference February 22, 2014 at West Chester University, PA


Anticipating over 300 attendees, the 13th Annual ADHD Conference for parents, teachers, professionals and adults with ADHD on Saturday, February 22, 2014 from 8:00am to 1:00pm will feature several expert speakers. West Chester University is just outside Philadelphia. Below is the program of speakers and topics.

Marie Paxon, program coordinator, invited me to present on the science of diagnosis and treatment of ADHD in adolescents and adults. If you reside in the area, please consider attending because it is a great way to learn a great deal about ADHD quickly and network with people with ADHD and those who offer guidance and treatment. See you there.

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ADHD and the Brain: Knowledge Matters Speakers

Marilyn B. Benoit, M.D. is a child and adolescent psychiatrist. She is senior vice president of Clinical and Professional Affairs and chief clinical officer at Devereux. She is a past president of the American Academy of Child and Adolescent Psychiatry. Dr. Benoit has served on the faculties of Howard and George Washington Universities and is a clinical associate professor of psychiatry at Georgetown University Medical Center, from which she received the Vicennial Silver Medal of Honor for 20 years of distinguished service.

David W. Goodman, M.D. is assistant professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. He is also director of the Adult Attention Deficit Disorder Center of Maryland in Lutherville and medical director of Suburban Psychiatric Associates, LLC. Dr. Goodman is the author of The Black Book of ADHD.

Marjorie Johnson, LCSW, PCC is a licensed clinical social worker and certified coach who provides leadership and career coaching, training, and counseling. She specializes in helping students and professionals with ADHD. Ms. Johnson serves on Chester County/Main Line CHADD’s Professional Advisory Board and is a professional member of ADDA (Attention Deficit Disorder Association.). She is past president of the International Coaching Federation-Philadelphia chapter and was named the 2011 Small Business Person of the Year by the Exton Chamber of Commerce (PA).

Jesse D. Matthews, Psy.D. is a licensed psychologist and has worked with individuals with ADHD for a number of years. He is in private practice at The Center for Psychological Services in Paoli and Ardmore and also works at Holcomb Behavioral Health Systems, a community mental health organization. He evaluates adolescents for substance abuse at the Chester County Youth Center in West Chester and does substance abuse evaluations and treatment in an outpatient program in Kennett Square. Dr. Matthews is an adjunct professor at Immaculata University. Previously, Dr. Matthews worked for six years as a counselor at Hill Top Preparatory School, and he facilitated the Chester County/Main Line CHADD teen ADHD support group for two years.

Joan M. Polka, Ph.D. is a psychologist in the Counseling Center at West Chester University assigned full time to the Act 101 portion of the Academic Development Program (a developmental education opportunity for underprepared first-time college students). She is also co-chair of Chester County/Main Line CHADD’s Adult Program and was the 2011 CHADD Educator of the Year.

Martin Patwell, Ed.D. is director of the Office of Special Services for Students with Disabilities at West Chester University. He has also been the director of evaluation clinic at Landmark School. He has presented “Trends and Issues in Disabilities in Higher Education” at Jiangxi University, Nanchung, China. He is also a consultant to The College Board, Inc.

Preeti Singh, M.S. is the associate director of the Twardowski Career Development Center at West Chester University.

Sharon Watson, M.S. is assistant director of West Chester University’s Office of Services for Students with Disabilities. She has over 20 years of experience working with students with learning differences, mental health, and physical disabilities.

8:30 a.m. Welcome

Chester County/Main Line CHADD and West Chester University

West Chester University

Earl F. Sykes Student Union

110 West Rosedale Avenue

West Chester, PA 19383

8:45 –9:15 a.m.

ADHD Across the Lifespan

Marilyn Benoit, M.D.

Research has proven that ADHD does not end with childhood. Over the course of a lifetime, the scenarios change, but the struggles might not. What does ADHD look like at each stage of life and what is the impact? This fast-paced-but-thorough presentation will help attendees learn more about this complex disorder and will provide a summary of current treatment and management options. Don’t miss this valuable session to gain a better understanding of childhood, teen, and adult ADHD.

9:15 –10:30 a.m.

ADHD and the Brain – What You Need to Know About Treatment and Management

David W. Goodman, M.D.

Those with ADHD express frustration with the disorder’s symptoms: trouble focusing, procrastination, forgetfulness, and difficulty filtering out distractions. Some people have a slower processing speed and others struggle with impulsivity. To make things even more complex, many people with ADHD will have a co-occurring condition like learning disabilities, anxiety, depression, or autism. The good news is that treatment is available, and there are strategies to counteract these challenges. Dr. Goodman will provide an overview of medications and pro-social treatments for ADHD and discuss common co-occurring conditions in this valuable presentation. Children and adults report that they receive unhelpful advice like “try harder,” “start applying yourself,” and “pull yourself up by your bootstraps.” Attend this session to learn about evidence-based treatments for ADHD and how they make a difference.

10:45 –11:30 a.m.

ADHD and Social Interactions

Jesse Matthews, Psy.D.

Social interactions can consist of anything from a casual conversation with an acquaintance to daily communication with loved ones. This can present challenges for both children and adults with ADHD. Those with ADHD may feel isolated and disconnected from others. They may find that executive function challenges can cause them to misinterpret social cues, which are usually unspoken or vague. The invisible challenges of impulsivity, forgetfulness, and an inability to regulate emotions can have a negative effect on forming and maintaining friendships. Fortunately, new information and strategies are available through the field of social learning and social cognition. Attend this session to learn more about this exciting topic and how to apply it to everyday life.

• Facilitated activity: Mindfulness Meditation and ADHD

Marjorie Johnson, LCSW

Mindfulness meditation is a way to calm the mind and relax the body while increasing the ability to sustain attention and manage distractibility. Hear about compelling research and daily applications of mindfulness meditation. Practice it to experience the deep relaxation it generates.

11:45 a.m. –1:00 p.m.

Becoming Successful in College and Early Career

ADHD and Career Success

Preeti Singh

Career development is a life-long process, involving decision making, self-awareness, exploration, preparation, and experience. What tools are available to help students successfully navigate this territory? This brief presentation will provide an overview of resources and strategies.

WCU Student Panel

Sharon Watson, facilitator

Current students at West Chester University who have “been there, done that” tell it like it is. Their transitions, challenges, and routes to where they are today provide a look at what real students face in college.

• Facilitated activity: ADD and Loving It?!

This video blends humor, hope, and science to dispel the myths about adult ADHD. Comedian Patrick McKenna seeks a diagnosis for adult ADHD and learns the facts from an impressive array of experts. Funny, moving, and transformative, this fascinating documentary will hold you spellbound!

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ADHD in People Age 50 and older


In the September issue 2013 of Attention Magazine, published by the national organization CHADD (Children and Adults with ADHD), my article was published on ADHD in people age 50 and older. There is remarkably little research looking at this population of patients. Clinical medication trials that seek the FDA approval for the treatment of ADHD include subjects up to 65 years old. However, the number of subjects over 50 in these studies is relatively small and often the mean age is 34.

Unfortunately, ADHD may not be a diagnostic consideration when older people complain of cognitive difficulties. A study looking at memory clinics in the U.S. found only 1 in 5 centers screen for ADHD. Therefore, it is possible that ADHD symptoms may be misdiagnosed as something else (Fischer BL 2012). Given that ADHD is a cognitive impairment, people wonder if ADHD is a risk factor for developing dementia. A recently published study looking at the question concluded that ADHD is not a risk factor for dementia (Ivanchak N, 2011). We’ll await further research.

Myths about ADHD over age 50:

Can’t diagnose ADHD in the presence of older age.

Can’t diagnose ADHD in the presence of medical disorders and medications.

Why bother treating it, they lived their whole life this way.

The ADHD medications aren’t safe in older adults.

Diagnosing ADHD in a person this age presents unique challenges because there are specific medical and psychiatric considerations in someone over age 50. If we just focus on the cognitive symptoms, the first issue is how much of the cognitive symptoms are age related. As we age we will notice some forgetfulness, difficulty in recalling information quickly, losing a train of thought, and getting distracted. What distinguishes this from ADHD is the fact that the symptoms started much later in life and not in childhood. Second possibility is a new diagnostic category in the DSM-5 called Mild Cognitive Impairment. This is a degree of cognitive change accompanied by impairment but not rising to the level of Alzheimer’s disease. Third are the effects of medication on cognition. As we age we will develop medical illnesses treated with medication that may have subtle effects on cognition (i.e. statins, antidepressants, chemotherapy).  The more medications we are on, the more likely they will affect our thinking ability. Fourth, medical illnesses themselves may affect our thinking ability (i.e. hypothyroidism, post cardiac surgery). Fifth, women in peri- or post-menopause often notice clear changes in memory and cognition. Sixth, a long history of alcohol and/or substance abuse may cause lasting cognitive symptoms. Seventh, head trauma/concussion/neurological disorders may leave persistent changes on memory and processing speed for information (i.e. multiple concussions from sports injury).  What distinguishes all of the above diagnostic consideration is the age of onset of these symptoms. Except for the possibility of head trauma in childhood, all the other diagnostic considerations occur later in life. The hallmark of ADHD is the presence of symptoms in childhood.

I will continue my blog on this subject in the future. Thank you for your interest. Hope it is helpful to you.

Finding ADHD Experts Around the World


Because my patients travel from the U.S. or come to consult me from other countries, the question of locating experts in ADHD, especially for adults, comes up often. Here is my suggestion to locate such an expert.

Go to www.pubmed.com.   This is the National Institute of Health website on medical publications.

In the search box, enter “ADHD” and the city and/or country in which you seek an expert.

Several publications will come up with authors in your designated location. Find one that is relevant, Open the link and you will see a summary of the publication.

The first author will often have an academic affiliation whose geography you can check. The first author often has his/her email address listed. You can email the author and ask if he/she sees patients or to whom he/she would refer someone for evaluation and treatment of ADHD.

You may have to go through emailing a few people to get to someone with the expertise you seek and is currently seeing patients.

Simple and effective. Hope this helps those who stumble across this blog.

David W. Goodman, M.D.

ADHD Treatment in New Zealand


On January 16, 2013, I had the opportunity to meet with 20 child and adolescents psychiatrists at the University Hospital, Auckland, New Zealand for the purpose of exchanging perspectives on diagnosis and treatment of ADHD across the life span. Many of the physicians had been to U.S. conferences that covered this topic so they were familiar with U.S. perspective. 

Although we all agree on the validity of ADHD as a psychiatric disorder, there were some clear differences in approach. First, it is important to know that the only stimulant medications available in New Zealand are methylphenidate compounds (Ritalin, Ritalin LA, Concerta). They do not have any amphetamine preparations (Dexedrine, Adderall, Adderall XR, Vyvanse). Without clinical experience with amphetamines, there were a bias against them believing that they represented a “stronger and potentially more addictive”. 

Although 50-60% of ADHD patients will respond to either stimulant compound (methylphenidate or amphetamine), about 25% of patients will respond better to one vs the other. Without amphetamine, there are a group of patients that won’t be optimally treated.

When physicians lack experience in using some medications, there is a bias that develops against the medication. This phenomenon develops beyond just ADHD into the rest of medical treatments.

Another issue in New Zealand is the rare physician who will treat ADHD in adults. Not only are adults unlikely to get newly diagnosed as adults, but children diagnosed with ADHD who grow to adulthood will find it difficult to obtain ongoing medication treatment. Apparently there is a special license needed to prescribe stimulant medications and very few adult physicians have such a license.  Physician pursuit of such a license is not high. The perception is that adults with ADHD are quite rare. This belief is in contrast to numerous studies showing world-wide prevalence rates between 2-6% in adults. 

What will usually drive an increase in treatment of medical disorders is the increasing number of effective treatments. One can see this in the history of depression treatment. As more antidepressants came on the market after Prozac, the rate of depression treatment increased over time. Now most depression is treated, not by psychiatrists, but by primary care providers.  In fact, 80% of all psychotropic medications in the U.S. are prescribed by primary care providers

So, for my patients treated with amphetamine preparations that may be traveling in New Zealand for periods of time (eg student study abroad), we advise that a family member in the U.S. obtain an adequate supply of medication (usually 90 days though insurance plans) and ship the medication to the individual. If treatment is needed by a psychiatrist in New Zealand, there are several excellent and experienced doctors in Auckland and Christchurch.

When looking for expert physicians for adult ADHD, see my blog that offers instructions on locating such doctors around the world.

As always, thank you for your interest.

David W. Goodman, M.D. Read more…

Unmasking ADHD in Adults-Medscape article Jan 2013


As an advocate for patient education, I direct my patients to credible sources of information on ADHD and associated disorders. Medscape is a highly reputable site for medical professionals and a great site for patients who wish to read about research and the state-of-the-art medicine.

I was invited to write a continuing medical education for medical professional on the presentation and treatment of adults with ADHD. The article was recently posted. I encourage those of you interested in this subject to read the article. It is written with patient cases to help professionals “think through” such a patient’s case. 

The article will give you insight into how the diagnosis is determined and how treatment options are considered. You may have to register for the site, however, this is a worthwhile site.

 

 

Adult ADHD on Sirius XM Doctors Radio October 16 Tues 8:00 am


Doctors Radio on Sirius XM satellite radio will feature me in a one hour live interview with Dr. Carol Burnstein, past president for the American Psychiatric Association. The topic, “Updating physicians on diagnosis and treatment of ADHD, especially in adults”. I apologize for the late notice but the time was only confirmed today.

With a full hour, I hope to cover a broad range of physicians concerns about identifying, diagnosing and effectively treating ADHD. In adults the complexity increases because of co-existing psychiatric and medical conditions. As physicians, we can consider the implication of neurodevelopment in assisting diagnostic evaluation. Also, medical illnesses need to be considered as some medical conditions may mimic attention problems (ie sleep apnea, hypothyroidism, medication effects). Since medications are often prescribed, a medical assessment of safety risk (cardiac, drug interactions, over-the-counter medications, daily caffeine intake, substance abuse history) is an important component of the initial evaluation. The complement of individualized psychotherapies expands the new skills needed by people with ADHD and their families.

I am pleased and honored that the producer has invited me, now the second time, to review the state of new research and its clinical applicability.

David W. Goodman, M.D.

ADHD and Olympians


Michael Phelps is universally known as the most medaled olympian in the history of the games. He is also very public about his ADHD.

Yet the 2008 Beijing Olympics  had another gold metal winnerwith ADHD, Adam Kreek from Canada. He won his medal in rowing.

So, for those of you who see ADHD as a life-long handicap, take inspiration from those whose determination led them to success. Go to our website and see famous people with ADHD in all walks of life.  All identified and capitalized on their strengths. What are your strengths that can make you a success?