ODD

Oppositional Defiant Disorder (ODD)

According to the American Academy of Child & Adolescent Psychiatry; All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family and academic life.
In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning. Symptoms of ODD may include:

• Frequent temper tantrums
• Excessive arguing with adults
• Often questioning rules
• Active defiance and refusal to comply with adult requests and rules
• Deliberate attempts to annoy or upset people
• Blaming others for his or her mistakes or misbehavior
• Often being touchy or easily annoyed by others
• Frequent anger and resentment
• Mean and hateful talking when upset
• Spiteful attitude and revenge seeking

The symptoms are usually seen in multiple settings, but may be more noticeable at home or at school. One to sixteen percent of all school-age children and adolescents have ODD. The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding that the child’s siblings from an early age. Biological, psychological and social factors may have a role.

Implications for Home and School

-Difficulty getting along with others

-Trouble complying with authority figures

-Easily annoyed by others

-Difficulty relaxing

-Engages in power struggles

What to do



According to the American Academy of Child and Adolescent Psychiatry; A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present; such as, attention-deficit hyperactivity disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to develop conduct disorder.
Treatment of ODD may include: Parent Management Training Programs to help parents and others manage the child’s behavior. Individual Psychotherapy to develop more effective anger management. Family Psychotherapy to improve communication and mutual understanding. Cognitive Problem-Solving Skills Training and Therapies to assist with problem solving and decrease negativity. Social Skills Training to increase flexibility and improve social skills and frustration tolerance with peers.
Medication may be helpful in controlling some of the more distressing symptoms of ODD as well as the symptoms related to coexistent conditions such as ADHD, anxiety and mood disorders.
A child with ODD can be very difficult for parents. These parents need support and understanding. Parents can help their child with ODD in the following ways:

• Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.
• Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if he decides to take a time-out to prevent overreacting.
• Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don’t add time for arguing. Say “your time will start when you go to your room.”
• Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
• Maintain interests other than your child with ODD, so that managing your child doesn’t take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.
• Manage your own stress with healthy life choices such as exercise and relaxation. Use respite care and other breaks as needed

Many children with ODD will respond to the positive parenting techniques. Parents may ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist or qualified mental health professional who can diagnose and treat ODD and any coexisting psychiatric condition.

(Source: http://aacap.org/)

Online Resources

http://www.aacap.org/cs/ODD.ResourceCenter

http://aacap.org/

http://www.minddisorders.com/Ob-Ps/Oppositional-defiant-disorder.html

http://studentsfirstproject.org/wp-content/uploads/ODD-Quick-Fact-Sheet-for-parents-guardians-and-child-serving-professionals.pdf

OCD

Obsessive-Compulsive Disorder

According to the 2005 National Comorbidity Survey-Replication study, about 2.2 million American adults have obsessive-compulsive disorder (OCD), a brain disorder that often begins in childhood. The persistent, unwanted thoughts and rituals of OCD sometimes take over people’s lives to the point that they can’t work or maintain relationships or engage in everyday tasks and social interactions. YESTERDAY The standard treatment for OCD was a type of long-term psychotherapy aimed at overcoming psychological defenses. There was no evidence that this treatment was effective. Clinicians lacked objective measurements that could help them accurately diagnose OCD – a crucial prerequisite for appropriate treatment. There were no proven medications for OCD. OCD was thought of primarily as a psychoanalytic issue, not a brain disorder. TODAY Effective treatments are now available. Among them are antidepressant medications that act on serotonin, one of several neurotransmitters (brain chemicals) through which brain cells communicate with each other. These medications also act on brain systems and circuits involved in OCD. Recently developed antipsychotic medications may become another option when prescribed alongside standard medications for hard-to-treat patients with OCD. A type of psychotherapy called “exposure and response prevention,” which breaks the cycle of repetitive behavior, is an effective treatment for many patients. Clinicians now have objective tools for identifying OCD subtypes and measuring their severity, allowing treatment to be personalized. Imaging studies show that people with OCD have differences in specific brain areas, compared with other people. Successfully treated patients have brain-activity patterns like those of healthy people. Traditionally, OCD was thought to “run in families.” Genetic studies now suggest that variations in certain genes are involved and that risk is higher when certain variations occur together. Researchers are following up on early evidence that infection from the Streptococcus bacterium might lead to some cases of OCD. Using genetic engineering, NIH-funded researchers created an OCD-like set of behaviors in mice. They then reversed these behaviors with antidepressants and genetic targeting of a key brain circuit. The study suggests new strategies for treating the disorder. TOMORROW Researchers are studying the potential of deep-brain stimulation, a surgical technique that stimulates cells in specific brain areas, for patients who don’t respond to other treatments. Genetics research may help clinicians decide what treatments are likely to work for each patient. Whether a treatment works may be partly due to variations in certain genes. Imaging, molecular biology, and genetics research are pointing the way to brain mechanisms involved in OCD. Features of these mechanisms are potential biomarkers that could identify people at risk – a key to early intervention. Research to identify brain mechanisms involved in OCD also holds the potential to reveal targets for better medications with fewer side effects. (Source: http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=54&key=O#O) According to the helpguide.org; Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting. Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. Most people with obsessive-compulsive disorder (OCD) fall into one of the following categories: Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions. Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger. Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen or they will be punished. Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements. Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use. (Source: http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm)   Implications for Home and School  -Unable to shift thoughts -Difficulty focusing/concentrating on work -Intense feelings of fear/anxiety -Difficulty with social adjustment -Repeated negative thoughts/actions that impact relationships What to do The most effective treatment for obsessive-compulsive disorder is often cognitive-behavioral therapy. Antidepressants are sometimes used in conjunction with therapy, although medication alone is rarely effective in relieving the symptoms of OCD. (Source: http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm) If you are concerned that you may be experiencing symptoms of OCD, talk with your family physician.  Your family doctor can refer you to the most suitable treatment in your area. Online Resources http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm  http://www.nimh.nih.gov http://www.ocfoundation.org/ http://www.theocdcloset.com/

BPD

Bipolar Disorder

According to the National Institute on Mental Health; Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Bipolar disorder often develops in a person's late teens or early adult years. At least half of all cases start before age 25.  Some people have their first symptoms during childhood, while others may develop symptoms late in life.

Bipolar disorder is not easy to spot when it starts. The symptoms may seem like separate problems, not recognized as parts of a larger problem. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.

People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.

A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.
Symptoms of bipolar disorder are described below.

Symptoms of mania or a manic episode include:

Mood Changes

• A long period of feeling "high," or an overly happy or outgoing mood
• Extremely irritable mood, agitation, feeling "jumpy" or "wired."

Behavioral Changes

• Talking very fast, jumping from one idea to another, having racing thoughts
• Being easily distracted
• Increasing goal-directed activities, such as taking on new projects
• Being restless
• Sleeping little
• Having an unrealistic belief in one's abilities
• Behaving impulsively and taking part in a lot of pleasurable,
  high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.

Symptoms of depression or a depressive episode include:

Mood Changes

• A long period of feeling worried or empty
• Loss of interest in activities once enjoyed, including sex.

Behavioral Changes

• Feeling tired or "slowed down"
• Having problems concentrating, remembering, and making decisions
• Being restless or irritable
• Changing eating, sleeping, or other habits
• Thinking of death or suicide, or attempting suicide.

In addition to mania and depression, bipolar disorder can cause a range of moods, as shown on the scale. Implications for School and Home - Feelings of agitation -Trouble sleeping -Changes in appetite -Suicidal thoughts -Feelings of hopelessness -Behavioral problems -Abuse drugs/alcohol -Trouble maintaining relationships -Difficulty completing school work -Trouble with concentration What to do According to the National Institute on Mental Health; The first step in getting a proper diagnosis is to talk to a doctor, who may conduct a physical examination, an interview, and lab tests. Bipolar disorder cannot currently be identified through a blood test or a brain scan, but these tests can help rule out other contributing factors, such as a stroke or brain tumor. If the problems are not caused by other illnesses, the doctor may conduct a mental health evaluation. The doctor may also provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder. The doctor or mental health professional should conduct a complete diagnostic evaluation. He or she should discuss any family history of bipolar disorder or other mental illnesses and get a complete history of symptoms. The doctor or mental health professionals should also talk to the person's close relatives or spouse and note how they describe the person's symptoms and family medical history. To date, there is no cure for bipolar disorder. But proper treatment helps most people with bipolar disorder gain better control of their mood swings and related symptoms. This is also true for people with the most severe forms of the illness. Because bipolar disorder is a lifelong and recurrent illness, people with the disorder need long-term treatment to maintain control of bipolar symptoms. An effective maintenance treatment plan includes medication and psychotherapy for preventing relapse and reducing symptom severity. Online Resources http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml http://www.childadvocate.net http://psychcentral.com/resources/Bipolar/Support_Groups/ Information obtained at the National Institute of Mental Health website.

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PTSD

Post-Traumatic Stress Disorder (PTSD)

PTSD, or post-traumatic stress disorder, is an anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident or natural disaster.
People with PTSD may relive the event via intrusive memories, flashbacks and nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before that are so intense their lives are disrupted.  (Adapted from the Encyclopedia of Psychology)

Researchers from the Minneapolis VA Medical Center say composite brain scans of PTSD patients show unusual activity in the part of the brain responsible for memory.

(source: http://minnesota.publicradio.org/display/web/2010/10/28/ptsd-brain-scans/)

DSM-IV diagnostic criteria for Post Traumatic Stress Disorder (PTSD)

The diagnostic criteria for Post Traumatic Stress Disorder (PTSD) are defined in DSM-IV as follows:

A. The person experiences a traumatic event in which both of the following were present:

1. the person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others;
2. the person's response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently re-experienced in any of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions;
2. recurrent distressing dreams of the event;
3. acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated);
4. intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event;
5. physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of:

1. efforts to avoid thoughts, feelings or conversations associated with the trauma;
2. efforts to avoid activities, places or people that arouse recollections of this trauma;
3. inability to recall an important aspect of the trauma;
4. markedly diminished interest or participation in significant activities;
5. feeling of detachment or estrangement from others;
6. restricted range of affect (eg unable to have loving feelings);
7. sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following:

1. difficulty falling or staying asleep;
2. irritability or outbursts of anger;
3. difficulty concentrating;
4. hypervigilance;
5. exaggerated startle response.

E. The symptoms on Criteria B, C and D last for more than one month.
F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

Implications for Home and School

- Students may have difficulty concentrating due to intrusive thoughts. 

- Work completion may become a problem area.

-Students may be withdrawn or avoid social situations.

-PTSD can impact sleep and the ability to relax.

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Online Resources

http://www.apa.org/monitor/jan08/helping.aspx

http://www.ptsdinfo.org/
http://kidshealth.org/parent/positive/talk/ptsd.html

http://www.giftfromwithin.org/

Anxiety

ANXIETY

Definition

According to the American Psychiatric Association;
Generalized Anxiety Disorder (Includes Overanxious Disorder of Childhood)
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
B. The person finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children.

1. Restlessness or feeling keyed up or on edge
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

D. The focus of the anxiety and worry is not confined to features of an Axis I disorder, e.g., the anxiety or worry is not about having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder.
E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
F. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.

Implications for School and Home

Some anxiety can help us to be productive. 

However, when anxiety levels are too high and last for too long, they may cause;

     -Feelings of being overwhelmed.

     -Getting "tongue-tied".

     -An inability to get jobs/projects/school work done.

     -Feeling preoccupied and distracted or unable to concentrate.

     -Strong physical reactions, like chest pain, tight muscles, sweating, stomachaches and tiredness.

     -Decreased ability to socialize normally.

     -A decreased ability to participate in normal daily living activities.

     -Trouble sleeping at night.

What to Do

If you feel that anxiety is impacting your life in a negative way, talk to your parents and family doctor.  Your family doctor should be able to determine if your symptoms are being caused by an Anxiety Disorder.  Also, seek out assistance at school through your school counselor or school social worker for tailored ideas that may help you combat anxiety in the school setting. 

Online Resources

http://kidshealth.org/

http://www.helpguide.org/mental/anxiety_self_help.htm

http://www.anxietycoach.com/

www.nasponline.org/resources/intonline/anxiety_huberty.pdf

Depression

Depression

 

Definition

According to the National Institue of Mental Health, "there are several forms of depressive disorders.

Major depressive disorder, or major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major depression is disabling and prevents a person from functioning normally. Some people may experience only a single episode within their lifetime, but more often a person may have multiple episodes.  Depression is a common but serious illness. Most who experience depression need treatment to get better.

Dysthymic disorder, or dysthymia, is characterized by long-term (2 years or longer) symptoms that may not be severe enough to disable a person but can prevent normal functioning or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Minor depression is characterized by having symptoms for 2 weeks or longer that do not meet full criteria for major depression. Without treatment, people with minor depression are at high risk for developing major depressive disorder.

Some forms of depression are slightly different, or they may develop under unique circumstances. However, not everyone agrees on how to characterize and define these forms of depression. They include:

• Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
• Postpartum depression, which is much more serious than the "baby blues" that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.¹
• Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.²

Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression). More information about bipolar disorder is available.

Implications for School and Home

Negative Thoughts

Low Energy

Difficulty Concentrating

Lacks Motivation

Difficulty Organizing

Physical Discomfort

Difficulty Sleeping

Isolation From Peers

What To Do

If you believe that you are suffering from Depression, talk with your doctor.  If you or someone you know is feeling suicidal call 1-800-273-8255 for the National Suicide Prevention Lifeline. 

If there is an emergency call 911.

Online Resources

http://suicidehotlines.com/

http://www.nami.org/

http://www.ndmda.org/



Attention Deficit Hyperactivity Disorder - ADHD

ADHD

Definition

As explained by the Centers for Disease Control and Prevention.

DSM-IV Criteria for ADHD
I. Either A or B:
According to chadd.org, around 2/3 of children that have been diagnosed with ADHD also have other co-existing disorders like; behavior disorders, mood disorders, anxiety disorders, tics and tourettes syndrome, and learning disabilities.

1. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level:
   
   Inattention

1. 1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
   2. Often has trouble keeping attention on tasks or play activities.
   3. Often does not seem to listen when spoken to directly.
   4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
   5. Often has trouble organizing activities.
   6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
   7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
   8. Is often easily distracted.
   9. Is often forgetful in daily activities.

 

2. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
   
   
    Hyperactivity

1. 1. Often fidgets with hands or feet or squirms in seat when sitting still is expected.
   2. Often gets up from seat when remaining in seat is expected.
   3. Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
   4. Often has trouble playing or doing leisure activities quietly.
   5. Is often "on the go" or often acts as if "driven by a motor".
   6. Often talks excessively.

           Impulsivity

2. 7. Often blurts out answers before questions have been finished.
   8. Often has trouble waiting one's turn.
   9. Often interrupts or intrudes on others (e.g., butts into conversations or games).

II. Some symptoms that cause impairment were present before age 7 years.
III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).
IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.
V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Based on these criteria, three types of ADHD are identified:

IA. ADHD, Combined Type: if both criteria IA and IB are met for the past 6 months

IB. ADHD, Predominantly Inattentive Type: if criterion IA is met but criterion IB is not met for the past six months 

IC. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion IB is met but Criterion IA is not met for the past six months.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

Some Implications for School

• Poor Gades
• Delayed Social Skills
• Impulsive Decision Making
• Careless Mistakes
• Misses Details
• Unfinished School Work
• Poor Organization
• Avoids Tasks
• Discipline Problems
• Disrupts the Classroom Environment

Some Implications for Home

• Difficulty Initiating and Completing Tasks
• Poor Organization
• Difficulties with Social Interaction
• Trouble with Emotional Regulation
• Difficulty Maintaining Focus
• Frustration with Homework
• Forgetful
• Loses Possessions
• Interrupts
• Difficulty Waiting for Turn

What To Do

If you have concerns that you or your child may have ADHD talk with your family physician or mental health professional.

Online Resources

http://www.chadd.org/

ADDinschool.com

LDonline.com