Easter Seals and the Brain Plasticity Institute: Working Together

Attention Deficit Disorders & Attention Deficit Hyperactivity Disorders

The Issue

• The American Psychiatric Association states in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 2000, that 3 to 7 percent of school-aged children have ADD & ADHD.
• Parents report that approximately 9.5 percent, or 5.4 million children 4-17 years of age, have ever been diagnosed with ADHD, as of 2007.
• The percentage of children with a parent-reported ADHD diagnosis increased by 22 percent between 2003 and 2007.
• Rates of ADHD diagnosis increased an average of 3 percent a year from 1997 to 2006 and an average of 5.5 percent a year from 2003 to 2007.
• Boys (13.2 percent) were more likely than girls (5.6 percent) to have ever been diagnosed with ADHD.
• Rates of ADHD diagnosis increased at a greater rate among older teens as compared to younger children.
• Using a prevalence rate of 5 percent, the annual societal “cost of illness” for ADHD is estimated to be between $36 and $52 billion in 2005 dollars, or $12,000 to $17,458 for each person with ADD/ADHD. (Centers for Disease Control and Prevention, 2012)

Taking on Attention Deficit Disorders & Attention Deficit Hyperactivity Disorders

Easter Seals is partnering with the Brain Plasticity Institute (BPI) to develop and rigorously validate innovative treatment strategies designed to help school-aged children and young adults manage attention deficit (ADD) and attention deficit disorders hyperactivity disorders (ADHD). BPI’s approach is to apply a combination of brain plasticity-based training strategies that have already been shown to re-normalize different key aspects of neurological attention-control abilities. This Internet-delivered training program can be expected to organically restore the functionality of the brain machinery that accounts for the deficits that limit the performance abilities of individuals with ADD and ADHD. Treatments are inexpensive to produce Attention Deficit Disorders & Attention Deficit Hyperactivity Disorders and scientifically validated and, because they are delivered via the Internet, can be immediately available to millions of children and adults in need of help throughout the world. Using this approach, we believe that more complete and reliably sustained improvements can be achieved without applying the prescribed stimulants that are now the medical standard of care for this large patient population.

Our goal is to help the many millions of children and young adults limited by ADD and ADHD and other related disorders to avoid a long-term dependence on drug therapy and, more importantly, achieve a more productive, stable, and secure life.

The Brain Plasticity Center: Project Scope

More than 9 percent of American children and more than 13 percent of American boys now formally acquire the ADHD label before their 18th birthday.¹ Approximately half of these children, now nearly 3 million in the US, are prescribed stimulant drugs to address their problem. This represents an almost 20-fold increase in the number of drug-treated children with ADHD recorded over the past 25 years.

Put another way, 25 years ago we formally identified a handful of children in every American school with an attention disorder who justified drug treatment. A generation later, we identify one or two children with ADHD in almost every American classroom.

According to the Centers for Disease Control, reported in 2011, the population of children with ADD and ADHD is growing 3 to 5 percent each year. While there is no question that we now have a greater and more refined sensitivity for recognizing children who have attention issues, there also is a substantial body of evidence that suggests the number of affected children is rapidly growing in modern societies.³

ADD and ADHD put a child at risk for limited success and, often, failure in and dropping out of school.⁴ There also is a strong co-morbidity with disruptive behavioral disorder,⁵ specific language and reading impairments,⁶ and cognitive, executive control and social control impairments.⁷ Children with ADHD have less regular and often-disruptive sleep patterns.⁸ They are at much higher risk for the development of addictions.⁹ They are more prone to having a driving accident.¹⁰ They are also more likely to commit a felony in later life.¹¹ Families of children with ADD/ADHD are more prone to conflict and increased levels of stress.¹² While there are many outstanding exceptions, someone living with an ADD or an ADHD diagnosis often faces difficulty in school, in finding employment, and in developing positive peer relationships.

It should be noted that when we calculate the human and social costs of any given childhood condition, this calculation is usually couched in terms of direct, condition-related medical and educational burdens. ADHD alters the performance abilities of a child in many ways that can powerfully and negatively impact society, and that collectively add up to enormous costs. The CDC reported in 2011 that the annual societal “cost of illness” is between $32 and $52 billion. The aggregate personal, social and monetary toll in modern America is great and, almost certainly, still growing.

Easter Seals is trying to find a path to a real solution for addressing this serious life-spanning neurological issue by creating a new form of therapy that holds the promise of normalizing the performance abilities for individuals living with ADHD. The services will be delivered through Easter Seals centers and more broadly through outreach to millions of individuals in need of help.

Help us help scientists and researchers at the Brain Plasticity Institute meet this great human challenge.

1. Vital and Health Statistics, CDC, Series 10, Number 237
2.  ‘Best practice’ advice by the American Academy of Pediatrics recommends treatment with methylphenidate (Ritalin, and several other slowerrelease forms of the same compound) or amphetamine (Adderall) or related compounds, supplemented by poorly defined/non-specified ‘behavioral therapies’. Even though a number of drugs targeting ADHD are off-patent, total US expenditures for ADHD-targeted drugs were about $5 billion in 2011.
3. For example, a widely cited CDC Report (Morb Mortal Wkly Rep 59:1439-1443) documented a 22% parent-reported increase over a recent 4-year period (2003-2007); a slow drumbeat of studies indicate that increased screen time and video game play add to ADHD symptomology in studied child populations (average media exposure times are now >7 hours/day for an American child; with multi-tasking, the average US kid now consumes more than 10 hours of media content/day). Many studies have also shown that other still-growing environmental factors contribute to increased risks of ADHD, and to frequently-comorbid clinical diagnoses.
4. Daley & Birchwood, Child Care Health Dev 36:455-64, 2010; Polderman et al., Acta Psychiatr Scand 122:261-84, 2010; http://www.kpbs.org/news/2010/aug/02/adhd-linked-high-school-dropouts/
5. Hofvander et al., Int J Law Psychiat 32;224-34, 2009; Psychiat Res 185:280-5, 2011; note that disruptive behavioral disorder is often called ‘oppositional defiance disorder’.
6. Dawes & Bishop, Int J Lang Commun Disord 44:440-65, 2009; Shaywitz & Shaywitz, dev Psychopathol 20:1329-49; Shanahan et al., J Abnorm Child Psychol 34:585-602
7. Schoemaker et al., J Child Psychol Psychiatry Oct 2011 (epub ahead of print); Uekermann et al., Neurosci Biobehav Rev 34:734-43, 2010
8. Jan et al, Psychol Res Behav Manag 4:139-50, 2011; Walters et al., J Clin Sleep Med 4:591-600
9. Lee et al., Clin Psychol Rev 31:328-41, 2011. It might be noted that about 20% of ADHD patients taking stimulants are abusive users (over-medicate to achieve stronger stimulant effects), and about 3% of non-medicated college students regularly take these (for them, illegal) stimulants.
10. Barkley et al., Pediatrics 92:212-8, 1993; Pediatrics 98:1089-95.
11. Mannuzza et al., Psychiat Res 160:237-46, 2008; Erne, J Correct Health Care 15:5-18, 2009; Westmorland et al., Int J Offender Ther Comp Criminol 54:361-77; Ginsberg et al., BMC Psychiatry 10:112
12. Bernardi et al., Psychol Med, Aug 16 2011 (epub ahead of print); Limbers et al., J Atten Disord 15:32-402, 2010; Klassen et al., Pediatrics 114:541-7.