By sex materials we mean magazines and books, regarded as pornographic by the respondent, wall calendars featuring nudes, sex magazines, sex movies in the cinema and video versions of these, and other sex films or programs on TV. In 1971 only books and magazines regarded as pornographic by the respondent were studied. The above were designated sex materials, because any classification into e.g. pornography and erotica is subjective, telling more about the personal attitude of the respondent towards their acceptability than about their contents.

The only possibility to measure changes in the use of sexual products is offered by the question on the use of magazines and books, classified as pornographic by the respondent him/herself. This comparison does, however, run into some problems. Firstly, the very idea of pornography has changed during the last 20 years. Many magazines regarded as pornographic 20 years ago are no longer generally regarded as such.

Another, and perhaps more serious problem is that the porn market has changed radically during that same period. The circulation figures of sex magazines have declined since the 1970s, these magazines being replaced by sex videos. A case in point is the magazine Jallu, the circulation of which was very large in 1971, 111,694 copies, but only 13,645 in 1991. However, the total circulation of all sex magazines was 150,000 in 1991. Estimated readership of each copy is five. To measure changes in the use of pornography, all magazines, books and sex videos in the 1992 material must be counted as one batch.

The proportion of those having read or browsed a magazine or book that they regarded as pornographic during the last year was considerably less in 1992 than it was in 1971. Among men, the proportion of users dropped from 82% to 64%, among women from 59% to 30%. When the watching of sex videos during the last year is added, the use of sexual products still decreased, but not as dramatically as the above comparison shows. In 1992, 75% of men under 55 had used a pornographic magazine or book or a sex video or both during the last year. The corresponding figure for women was 41%.

The total use of pornographic products has decreased during the last 20 years also on the basis of this comparison. This might follow from the fact that 20 years ago these products were novelties for the majority of the population, and it was fashionable to test them. Along with their wider availability the market has become saturated, and interest in them has declined slightly.

Young people are significantly heavier consumers of sexual products than older people are. People seem to get fed up with pornographic products when growing older. The percentage of aging people using these products is only one third of that of younger groups. Part continue their consumption through life. From 1971 to 1992 the use of pornography declined in all age groups.

When comparing the use of magazines and books by men and women with the use of sex videos by men and women, both product groups have an approximately equal number of users. Almost as many men and women watch sex videos as read pornographic magazines or books. The number of men using these products is the larger by far in all age groups. According to the 1992 study, 53% of men and 22% of women had watched sex videos, approximately half of these at least a few times.

According to the MC analysis, male gender, young age and the use of alcohol explain reading and browsing of pornographic magazines and books. Marital status, education and religiosity were not related, when allowing for the impact of the first-mentioned. When none of the other variables is controlled, it can be seen that religious people use less pornography than do people that are estranged from religion.

What kind of people, from a sexual standpoint, are the users of pornography? As pornography splits the opinions of especially women, it is interesting to find out what kind of women do use pornography. Pornography is regarded as arousing and not arousing by approximately equal amounts of people.

The first observation is, that women who have read pornographic material during the year support women's right to make sexual initiatives more often than do other women; 70% of these women do so unconditionally. They have taken the initiative to sexual intercourse with their partner more frequently than other women. Of the women who have watched pornographic videos during the last year, 61% regard them as arousing, while this view is shared by only 27% of other women (corresponding figures for men: 80% and 55%). Women watching sex videos had orgasms more frequently than others, they had intercourse with significantly greater regularity, they had had more sex partners during their life, they satisfied their partner manually twice as often as other women and they were versatile users of coital positions.

Of the women that had watched several sex videos during the last year, 89% had an orgasm during their most recent intercourse. Women that watched sex videos found their sex life satisfactory also for this reason. These women regard themselves as more skilful in sexual matters, more active and sexually more attractive than other women. All in all, sex life is important for women who consume pornography, and they have enjoyed it in many ways. Women's attitudes towards pornography may be formed on the basis of their general attitude towards sex in their own life.

Of other sexual products the following were studied in 1992: sex films of cinemas, sex films and other sex programs shown on TV, sex magazines and wall calendars featuring nudes. Of these, sex films and other sex programs shown on TV were the most popular. They had been seen at least once or twice by 82% of men and 59% of women, at least a few times by 51% of men and 26% of women. This was the only product group consumed by women to any greater extent. In the youngest age groups the percentage of women (75%) was even quite close to the corresponding percentage of men. However, men followed sex programs on TV more regularly than did women.

Sex magazines had been looked at by 61% of men and 16% of women during the last year. Half of them had looked at them at least a few times. Approximately as many, i.e. 66% of men and 20% of women had looked at wall calendars featuring nudes. Two thirds of these men had watched them at least a few times, one third of women. Men had looked at wall calendars more regularly than women.

It is significantly more usual among younger age groups to look at sex magazines and at wall calendars featuring nudes than among older ones. Some 70-75% of men under 30 and 20-25% of women had looked at sex magazines during the last year. For wall calendars the corresponding figures were 75% of men and 30% of women. Slightly less than 10% of women and 60% of men of 50 and over had looked at them. The male interest in nudes does seem to remain at a high level in spite of an advancing age.

Only 13% of men and 4% of women had seen sex movies at cinemas. TV and video have thus largely replaced cinemas as venues for watching sex films. The remaining spectators are fairly evenly distributed among the various age groups. Six per cent of men and 1% of women had watched these sex films at least a few times.

In 1992 questions were also asked on other sexual products and accessories: sexy undergarments, vibrators or dildos, lubricating cream, artificial vaginas, sex dolls, pills or other preparations increasing potency, erection rings and pump-actuated penis builders. Respondents were asked whether they at any time had used these implements alone or with their partner for masturbation or for intercourse.

The most widely used item on the list was sexy undergarments. Approximately one fifth of both men and women had used such garments. Most frequently they were used by people under 35, one third of these were users. Just a few per cent of older age groups had used them. Young people do not look for inspiration only in versatile positions and techniques, but also from sexy attire.

Number two in popularity was lubricating cream, used by 17% of men and 15% of women. Use of this product increases with age; lubrication cream is usually applied when a dry vagina is a problem. A vibrator or a dildo had been used by 7% of men and 6% of women during intercourse. It is most frequently used by people around 30 years of age, approximately 10%. Only 2% of older age groups have ever used a vibrator. The use of vibrators might become very popular in the future, based on the present interest of the younger age groups.

Very few respondents had ever tried the other products studied, artificial vaginas, sex dolls, pills or other preparations increasing potency, erection rings and pump-actuated penis builders. Potency- building substances had been used by 1.5% of men and 1% of women. Slightly less than 1% had used rings maintaining an erection. A mere 0.2-0.3% of women and men had used pump-actuated penis builders and sex dolls, while 0.7% of men and 0.2% of women had tried artificial vaginas.

next: Pornography Use

Parents may notice their teenager picking at his or her food or that their child has begun to exercise more frequently and intensely. Parents may also notice their child talking constantly and almost obsessively about body size of their peers or slender people they idolize on television. Although parents may want to pass these occurrences off as a normal stage of adolescence, some parents are right to be concerned.

The signs of an eating disorder

According to the American Academy of Child and Adolescent Psychiatry, all of the activities mentioned above may be signs of an eating disorder. Anorexia nervosa and bulimia nervosa are eating disorders that are increasing among teens and children, especially young women but not excluding young men.

"Generally, eating disorders involve self-critical, negative thoughts and feelings about personal appearance and food," says Becky Burnett, Clinical Dietitian at East Tennessee Children's Hospital. "Eating disorders are thought to be caused by underlying psychological problems, with the visible symptom being disordered eating and thinking about food."

A person with anorexia nervosa is hungry, but he or she denies the hunger because of an irrational fear of becoming fat. It is often characterized by self-starvation, food preoccupation and rituals, compulsive exercising, and in women, the absence of menstrual cycles.

Bulimia nervosa is characterized by reoccurring periods of binge eating, during which large amounts of food are consumed in a short period of time. Frequently, the binges are followed by purging, through self-induced vomiting, abuse of laxatives and/or diuretics, or periods of fasting. The bulimic's weight is usually normal or somewhat above normal range; it may fluctuate more than 10 pounds due to alternating binges and fasts.

The National Association of Anorexia Nervosa and Associated Disorders estimates that there are 8 million people in this country suffering from eating disorders, and there are more cases being reported in the eight-to- eleven-year-old bracket every day. The American Anorexia/Bulimia Association estimates that 1 percent of teenage girls in the United States develop anorexia nervosa, and approximately 5 percent of college women in the United States have bulimia.

The staff at East Tennessee Children's Hospital offers the following warning signs for helping to detect both anorexia nervosa and bulimia nervosa.

Anorexia danger signs include significant weight loss; continual dieting (even though the child is already thin); feelings of fatness by the child even after weight loss; fear of weight gain; lack of menstrual periods; preoccupation with food, calories, nutrition, and/or cooking; a preference to eat in isolation; compulsive exercise; insomnia; brittle hair or nails; and social withdrawal.

Bulimia nervosa danger signs include uncontrollable eating (binge eating), purging by self-induced vomiting; vigorous exercise; abuse of laxatives or diuretics (water pills) to lose weight; frequent use of the bathroom after meals; reddened fingers (from inducing vomiting); swollen cheeks or glands (from induced vomiting); preoccupation with body weight; depression or mood swings; irregular menstrual periods; dental problems, such as tooth decay caused by induced vomiting; and heartburn and/or bloating.

It won't go away on its own

Eating disorders are not associated with an "adolescent stage" in life or something that will merely fade away. Once a parent suspects a child or adolescent has an eating disorder, they should talk with the child about visiting a doctor or a dietitian. A medical professional can help the child with an eating disorder to take steps toward healthier eating and nutrition.

The focus of treatment is helping children and teens cope with emotional problems which are the cause of their disordered eating behaviors.

Treatment includes medical supervision, nutritional restoration and behavioral therapy, which addresses beliefs about body size, shape, eating, and foods. "Whatever the reason for the eating disorder, if parents and children can work together to understand the problem, the results will be much more favorable," says Burnett.

next: Reviewing the Literature on Children and Eating Disorders
~ eating disorders library
~ all articles on eating disorders

Studies and articles on the safety and effects of psychiatric medications on women during pregnancy and nursing

Psychiatric Drugs and Pregnancy and Breastfeeding

1. Alternative Psychiatric Treatments During Pregnancy
   September 1, 2002
2. Determining Safety of Psychiatric Drugs During Pregnancy Difficult
   March 1, 2001

Antidepressant Medications During Pregnancy and Breastfeeding

1. The FDA Advisory on Paroxetine (Paxil) During Pregnancy
   January 15, 2006
2. Safety of SSRIs During Pregnancy and Nursing
   October 15, 2005
3. Neonatal Withdrawal Syndrome and SSRI's
   March 15, 2005
4. Recent Antidepressant Label Changes and Pregnancy
   September 15, 2004
5. Is Prozac Safe During Pregnancy and Nursing?
   June 15, 2004
6. Impact of SSRIs During Pregnancy on the Baby
   March 15, 2004
7. Impact of Antidepressants on Unborn Children
   December 1, 2003
8. Risks of Antidepressants During Pregnancy
   May 1, 2003
9. Effects of Antidepressants in Pregnancy
   May 1, 2000

Antipsychotic Medications During Pregnancy and Breastfeeding

1. Taking Atypical Antipsychotics While Pregnant
   June 15, 2005
2. Effects of Bipolar Drugs During Pregnancy
   December 15, 2004
3. Anticonvulsants for Bipolar During Pregnancy
   September 1, 2003
4. Bipolar Medications During Pregnancy
   June 1, 2002
5. Older Antipsychotics Safer During Pregnancy
   July 1, 2000

ADHD (Stimulant) Medications During Pregnancy and Breastfeeding

1. Are ADHD Drugs Safe During Pregnancy?
   September 1, 2001

(read this HealthyPlace.com article on the Effects of Psychiatric Medications During Pregnancy)

Persistent or recurrent delay or absence of orgasm after a normal excitement phase of sexual activity that is assessed as adequate in focus, intensity, and duration.

Most patients have a disturbance of both sexual excitement and orgasm; in such cases, the diagnosis is not orgasmic disorder. Orgasmic disorder is diagnosed only when there is no or slight difficulty with arousal (excitement).

Orgasmic disorder may be lifelong or acquired, general or situational. About 10% of women never attain orgasm regardless of stimulation or situation. Most women can attain orgasm with clitoral stimulation, but only about 50% of women regularly attain orgasm during coitus. When a woman responds to noncoital clitoral stimulation but cannot attain coital orgasm, a thorough sexual examination, sometimes with a trial of psychotherapy (individual or couple), is required to judge whether the inability to attain coital orgasm is a normal variation of response or is due to individual or interpersonal psychopathology.

Once a woman learns how to reach orgasm, she generally does not lose that capacity unless poor sexual communication, conflict in a relationship, a traumatic experience, a mood disorder, or a physical disorder intervenes.

Etiology

Etiology is similar to that of sexual arousal disorder (see above). In addition, lovemaking that consistently ends before the aroused woman reaches climax (eg, due to inadequate foreplay, ignorance of clitoral/vaginal anatomy and function, or premature ejaculation) and produces frustration may result in resentment and dysfunction or even sexual aversion. Some women who develop adequate vasocongestion may fear "letting go," especially during intercourse. This fear may be due to guilt after a pleasurable experience, fear of abandoning oneself to pleasure that depends on the partner, or fear of losing control.

Drugs, particularly selective serotonin reuptake inhibitors, may inhibit orgasm. Depression is a leading cause of decreased sexual arousal and orgasm, so the patient's mood must be evaluated.

Treatment

Physical disorders should be treated. When psychologic factors predominate, counseling to remove or reduce the causes helps; usually both partners should attend.

The Masters and Johnson 3-stage sensate focus exercises, in which the couple moves stepwise from nongenital pleasuring to genital pleasuring to nondemanding coitus, generally benefit women regardless of the level of sexual inhibition. Individual psychotherapy or group therapy is sometimes useful.

A woman should understand the function of her sexual organs and her responses, including the best methods of stimulating the clitoris and enhancing vaginal sensations. Kegel's exercises strengthen voluntary control of the pubococcygeus muscle. The muscle is contracted 10 to 15 times tid. In 2 to 3 mo, perivaginal muscle tone improves, as does the woman's sense of control and the quality of orgasm.

Women with lifelong orgasmic disorder should be referred to a psychiatrist. With any patient, the nonspecialist should limit the number of counseling sessions to about six, referring complex cases to a sex therapist or a psychiatrist.

next: Female Orgasmic Disorder: "I'm Not Able to Climax"

The following is a brief overview of the most common medications used in the UK for the treatment of ADHD. We do not endorse any of the following but do recognise the need for a description of these medications to enable those who have been diagnosed to make informed choices in the treatment they or their child receives.

For more information and also for details on other medications available outside the UK we recommend the Medication List on Taming The Triad by Margie Sweeney M.D. Also, check out the ADD/ADHD section on the popular Remedyfind website where real users have rated many of the medications and treatments available.

Please note that the following is not intended to be a substitute for professional medical advice. It is only intended as a guide, purely for information only. Any medication or alteration of current medications should be discussed fully with your physician or other medical professional.

Methylphenidate

This is the generic name for one of the most common medications for ADHD - there are a number of brand names which are detailed below.

Cautions: mild hypertension (contra-indicated if moderate or severe)-monitor blood pressure; history of epilepsy (discontinue if convulsions occur); tics and Tourette syndrome (use with caution)-discontinue if tics occur; monitor growth in children (see also below); avoid abrupt withdrawal; data on safety and efficacy of long-term use not complete.

SPECIAL CAUTIONS IN CHILDREN: Monitor height and weight as growth retardation may occur during prolonged therapy (drug free periods may allow catch-up in growth but withdraw slowly to avoid inducing depression or renewed hyperactivity). In psychotic children may exacerbate behavioural disturbances and thought disorder.

Contra-indications: cardiovascular disease including moderate to severe hypertension, hyperexcitability or agitated states, hyperthyroidism, history of drug or alcohol abuse, glaucoma, pregnancy and breast-feeding - DRIVING. May affect performance of skilled tasks (e.g. driving); effects of alcohol unpredictable.

EVENING DOSE. If effect wears off in evening (with rebound hyperactivity) a dose at bedtime may be appropriate (establish need with trial bedtime dose)

Over the years I have been asked a number of questions as to how the fast acting forms of Methylphenidate and the slow release forms work and roughly what is equal to what.

I am certainly not medically qualifed so please remember that these are very rough ideas which I have learnt and how I view things over the years!!

Ritalin - Methylphenidate

This is licensed in the UK for the treatment of children - however Ritalin can be prescribed for adults, as it does not have a licence for adults it can only be prescribed through the individual doctors clinical judgement.

Ritalin is one of the stimulant drugs and is a derivative of amphetamine - when used correctly it is safe and effective.

Ritalin reduces hyperactivity and impulsiveness and increases the attention span.

It is a fast absorbing medication and is usually absorbed within ½ hour reaching maximum effectiveness within 1 - 2 hours after 4 - 5 hours it has passed through the system.

There is no evidence that Ritalin can become addictive or the patient become dependant.

Side effects can include:

Insomnia, loss of appetite

Both of which usually return to normal within a short time but proper monitoring by a qualified ADHD aware doctor is essential

Less common side effects can include:-

Tics, irritability, depression, tummy aches, headaches, nausea, dizziness, dry mouth and constipation.

These are mainly seen at higher doses and are not always attributed to the Ritalin. They should therefore be discussed with the doctor.

There is no evidence to suggest that Ritalin free holidays are necessary and certainly the idea of only using in school time is unnecessary.

Ritalin releases dopamine from the storage vessels.

Equasym - Methylphenidate

This is a new generic form of Methylphenidate which has just been brought out in the UK by UCB Pharma.

This medication is available in not only the 10mg tablet form but also in 5mg and 20mg tablets. This will eliminate the need for halving tablets.

The Effects and Side Effects are the same as Methylphenidate above.

The Slow Release form of Equasym, Equasym XL known as Metadate CD in the USA is available off licence in the UK. The Pharmacist would have to get in touch with Celltech who fax them a form which they can then fax back with the details and the medication is sent down the following day.

Equasym XL - Methylphenidate

This is a new generic form of Methylphenidate which has just been brought out in the UK by UCB Pharma.

This medication is available in 10mg, 20mg or 30mg capsules.

The Effects and Side Effects are the same as Methylphenidate above.

The Slow Release form of Equasym XL is known as Metadate CD in the USA.

Concerta

Concerta™ is an extended-release formulation of methylphenidate tablets for ADHD treatment which is designed to last throughout the day with just one dose. Methylphenidate is the most commonly prescribed medication for treating and managing ADHD. It has been used safely and successfully among children and adults for more than 25 years.

Concerta™ is now licensed and available in the UK.

Concerta™ is an integral part of a total treatment program that typically includes behavior modification and medication.

How does Concerta™ work? Concerta™ is designed to be taken just once a day in the morning, before a child leaves for school. The drug over-coat dissolves within one hour providing an initial dose of methylphenidate. The medication is then released gradually in a smooth pattern, improving attention and behavior throughout the day. The advanced system was designed to help a child maintain focus without in-school and after-school dosing. Due to its controlled release, Concerta™ minimizes the peaks and valleys-the fluctuating levels of medicine in the blood-associated with other medications when they are taken more than once per day.

Concerta™ is available in 18 mg and 36 mg tablets. It should be taken in the morning, with or without breakfast. Concerta™ tablets must be swallowed whole with the aid of liquid, such as water, milk, or juice. Concerta™ must not be chewed, divided, or crushed.

Concerta™ was developed by ALZA for Crescendo Pharmaceuticals. On August 1, 2000, the U.S. Food and Drug Administration approved the new drug application for Concerta™ for the treatment of ADHD. The product will be manufactured and marketed by ALZA. McNeil Consumer Healthcare will co-promote Concerta™ in the U.S. For more information see concerta.net

Side Effects In a controlled clinical study with patients using Concerta™, the most common side effects reported were headache(14%), upper respiratory tract infection (8%), stomachache (7%), vomiting (4%), loss of appetite (4%), sleeplessness (4%), increased cough (4%), sore throat (4%), sinusitis (3%), and dizziness (2%).

Who shouldn't use Concerta™ ? Concerta™ should not be taken by patients who: have significant anxiety, tension, or agitation, since Concerta™ may make these conditions worse; are allergic to methylphenidate or any of the other ingredients in Concerta™; have glaucoma, an eye disease; have tics or Tourette's syndrome, or a family history of Tourette's syndrome; are taking a prescription monoamine oxidase inhibitor (MAOI). Ordinarily, Concerta™ should not be administered to patients with preexisting severe gastrointestinal narrowing. Concerta™ should not be used in children under six years, since safety and efficacy in this age group have not been established.

Concerta™ should be given cautiously to patients with a history of drug dependence or alcoholism. Chronic abusive use can lead to marked tolerance and psychological dependence. (See Boxed Warning).

Q. Can I crush the fast acting tablet if my child won't swallow it?

A. Crushing is not a good idea as the Ritalin/Equasym is bitter and swollowing is quicker as a tablet, than a powder or pieces. Try giving a quarter which is easier to swallow, placed far back on his tongue, where the bitterness is less obvious with his favourite drink. It should just wash down. When used to a quarter, try a two quarters (half) and eventually a full half and if required a whole eventually. Also compliment him when he manages to succeed. A sip of the drink before you start also helps. However crushed and mixed with something they like may be alright providing the bitter taste does not come through!

The Slow Release tablets such as Concerta XL and Equasym XL should not be crushed or opened in any way as this will make them ineffective.

^a From a question posted on adders.org forum and answered by Dr Billy Levin from South Africa

Strattera

Strattera, developed by Eli Lilly and Company (NYSE:LLY & UK), is the first licensed treatment for ADHD that is not a stimulant medication.

Strattera, a selective norepinephrine reuptake inhibitor, has a different pharmacologic mechanism than other currently approved ADHD treatments. It's not known precisely how atomoxetine reduces ADHD symptoms. Scientists believe it works by blocking or slowing reabsorption of norepinephrine, a brain chemical considered important in regulating attention, impulsivity and activity levels. This keeps more norepinephrine at work in the tiny spaces between neurons in the brain.

Side effects can include: Most people in clinical studies who experienced side effects were not bothered enough to stop using atomoxetine. The most common side effects in children and adolescents were decreased appetite, nausea, vomiting, tiredness and upset stomach. In adults, the most common side effects were problems sleeping, dry mouth, decreased appetite, upset stomach, nausea or vomiting, dizziness, problems urinating, and sexual side effects.

Ritalin S.R.

Slow Release Ritalin is now available in the UK, the only problem is that to obtain this means that you need to take a prescription to your pharmacist who then has to fax it to BR Pharma on the following number (UK Only), 020 8207 5557 (Tel:020 8238 6770). BR Pharma then deliver to the pharmacist the next day. They can only provide this service for prescriptions for 3 months supply, (approx 120 tablets). The advantage of SR is it could remove the need for a mid-day dose at school, by allowing a slow released stream of medication into the system for about 6 hours, it does however take longer to get into the system to start with.

Be aware that Ritalin SR may not work for all.

Dexedrine (Dextroamphetamine Sulfate)

Dexedrine affects the neurotransmitter Norepinephrine primarily, and secondarily Dopamine, which is significantly different than Ritalin, and can produce very different results for patients. Dexedrine is only similar to Ritalin in that the same type of side effects can occasionally be seen. Dexedrine also appears to stay in the blood longer than Ritalin reducing the frequency of the dose.

Dexedrine inhibits re-uptake of dopamine.

Indications: narcolepsy, adjunct in the management of refractory hyperkinetic states in children (under specialist supervision)

Cautions: mild hypertension (contra-indicated if moderate or severe)-monitor blood pressure; history of epilepsy (discontinue if convulsions occur); tics and Tourette syndrome (use with caution)-discontinue if tics occur; monitor growth in children (see also below); avoid abrupt withdrawal; data on safety and efficacy of long-term use not complete.

SPECIAL CAUTIONS IN CHILDREN. Monitor height and weight as growth retardation may occur during prolonged therapy (drug free periods may allow catch-up in growth but withdraw slowly to avoid inducing depression or renewed hyperactivity).

In psychotic children may exacerbate behavioural disturbances and thought disorder.

Contra-indications: cardiovascular disease including moderate to severe hypertension, hyperexcitability or agitated states, hyperthyroidism, history of drug or alcohol abuse, glaucoma, pregnancy and breast-feeding.

DRIVING. May affect performance of skilled tasks (e.g. driving); effects of alcohol unpredictable.

Side-effects: insomnia, restlessness, irritability and excitability, nervousness, night terrors, euphoria, tremor, dizziness, headache; convulsions; dependence and tolerance, sometimes psychosis; anorexia, gastro-intestinal symptoms, growth retardation in children; dry mouth, sweating, tachycardia (and anginal pain), palpitations, increased blood pressure; visual disturbances; cardiomyopathy reported with chronic use; central stimulants have provoked choreoathetoid movements, tics and Tourette syndrome in predisposed individuals (see also Cautions above); overdosage: Stimulants AMPHETAMINES - These cause wakefulness, excessive activity, paranoia, hallucinations, and hypertension followed by exhaustion, convulsions, hyperthermia, and coma. The early stages can be controlled by diazepam or lorazepam; advice should be sought from a poisons information centre on the management of hypertension. Later, tepid sponging, anticonvulsants, and artificial respiration may be needed.

Dose: Hyperkinesia, CHILD over 6 years 5-10 mg daily, increased if necessary by 5 mg at intervals of 1 week to usual max. 20 mg daily (older children have received max. 40 mg daily); under 6 years not recommended

Adderall

A single entity amphetamine product combining the neutral sulfate salts of dextroamphetamine and amphetamine, with the dextro isomer of amphetamine saccharate and d, l-amphetamine aspartate.

A recent study in the U.S. which was published in the Journal of the American Academy of Child and Adolescent Psychiatry in May 2000, said: "Adderall(R) (mixed salts of a single-entity amphetamine product) is significantly more effective at reducing inattention, oppositional behaviour, and other symptoms of attention deficit/hyperactivity disorder (ADHD) than methylphenidate, an older ADHD treatment.

The study of 58 children with ADHD also found that the benefits of Adderall last longer than those of methylphenidate (which is sold under the brand name Ritalin(R)). In fact, 70 percent of patients taking a single morning dose of Adderall found significant improvement in ADHD symptoms, while just 15 percent of patients taking methylphenidate improved significantly with only one dose."

Side effects can include:

• Cardiovascular: Palpitations, tachycardia, elevation of blood pressure. There have been isolated reports of cardiomyopathy associated with chronic amphetamine use.
• Central Nervous System: Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, exacerbation of motor and phonic tics and Tourette's syndrome.
• Gastrointestinal: Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Anorexia and weight loss may occur as undesirable effects when amphetamines are used for other than the anorectic effect.
• Allergic: Urticaria.
• Endocrine: Impotence, changes in libido.

See Shire Pharmaceuticals for more information.

Adderall is now available off licence in the UK though only on the same basis as Ritalin SR i.e. your pharmacist has to fax your prescription to BR Pharma on the following number (UK Only), (Tel:020 8238 6770). BR Pharma then deliver to the pharmacist the next day. Also, only packs of 100 tablets are available in both 5 and 10 mg doses. ADDerall XR is now also available in 10, 20 and 30mg doses. This formulation provides an all day treatment with one morning dose. There is an immediate 50% release of the active ingredient followed by a further 50% being released at midday.

Focalin

Dexmethylphenidate Hydrochloride

NOTE: This preparation may contain one or more substances that are restricted in certain sports competitors should check with the appropriate sports authorities

Drug Profile

Dexmethylphenidate hydrochloride is the d-threo-enantiomer of racemic methylphenidate hydrochloride. It is used as a central stimulant in the treatment of hyperactivity disorders in children.

For patients new to methylphenidate the starting dose of dexmethylphenidate hydrochloride is 2.5 mg twice daily. Each dose should be given at least four hours apart. Dosage may be adjusted in 2.5 to 5 mg increments weekly to a maximum of 10 mg twice daily.

For patients currently using methylphenidate the starting dose of dexmethylphenidate hydrochloride is half the dose of the racemic substance. The maximum recommended dose is 10 mg twice daily. Dexmethylphenidate should be stopped if there is no improvement in symptoms after appropriate adjustments in dosage over one month. It also needs to be stopped from time to time in those who do respond to assess the patient's condition.

As this medication is a preperation of both dexmethylphenidate hydrochloride and methylphenidate hydrochloride :-

Uses and Administration, Adverse Effects, Treatment, and Precautions, Pharmacokinetics and Preparations please check out:- Martindale: The Complete Drug Reference and should be taken as to being appropriate to majority of the medications on this page that have either of the ingredients above - Ed.

Focalin is now available off licence in the UK though only on the same basis as Ritalin SR i.e. your pharmacist has to fax your prescription to BR Pharma on the following number (UK Only), (Tel:020 8238 6770). BR Pharma then deliver to the pharmacist the next day.

The following are sometimes used with the stimulant medications to help with sleep problems or other associated conditions so the information we have here is not that extensive so always speak to the doctor to find out more information about these and ask how these medications will be monitored:

Imipramine - Tofranil

This is one of the tricylic antidepressants.

Imipramine helps with anxiety and depression and is used when stimulant medication fails to get a response or it not appropriate to be given. It is not as effective with the core ADHD symptoms.

Side effects can include:

dry mouth, constipation, rash, raised blood pressure, confusion, seizures, abnormal heart rhythms.

Only the first two are usually seen however this medication should be carefully monitored by the doctor and regular blood pressure and pulse checks should be made. Also if there is a concern EEG recordings can be taken.

Imipramine inhibits re-uptake of norepinephrine.

Clonidine - Catapres - Dixirit

Clonidine is an antihypertensive medication and is often used later in the day to help combat insomnia which can be caused by stimulant medication. Clonidine can help symptoms by: -

Decreasing impulsivity and hyperactivity, decreasing aggression, improving sleep.

Clonidine is usually given in conjunction with Ritalin or Dexedrine,

Side effects can include: -

• Sedation, dry mouth, nausea, dizziness, rash
• There is a very slight concern of heart deaths and Clonidine must be withdrawn gradually.
• Overdose is very dangerous.
• Clonidine blocks norepinephrine auto-receptors.

Clonidine / Catapres Patches are also available, these appear to last for about 5 days in children compared to 7 days in adults. The patch may be cut to adjust doseage. It can take up to 2 - 4 weeks to see any effect and maximum effect can take several months. This can also be the case in tablet form.

Clonidine should only be discontinued under proper guidence for gradual withdrawal to avoid any withdrawal symptoms.

Drug Combinations

If certain medications help only some of the symptoms a combination of medications may be tried, but only in consultation with your physician or medical practitioner.

For example Tricylic Antidepressiants can help with depression but ADHD symptoms remain, Ritalin or Dexedrine can be used in conjunction to enable relief of all symptoms. Likewise Clonidine can be used to combat aggressive behaviour along with Ritalin or Dexedrine for the other ADHD symptoms.

next: ADHD Treatment Overview: Psychotherapy
~ back to adders.org homepage
~ adhd library articles
~ all add/adhd articles

A Sound Portrait of Words of Wisdom

Collected & Spoken
by Larry James

THIS IS A LIMITED OFFER!Audio cassette program with two cassettes featuring
333 timeless quotations!

Words have a magical impact on your life! Words inspire, encourage, motivate, stimulate your thinking and create a future vision that can change your life!

"LifeWords for Success" can put the wind in your sails!

Listen to the words spoken by the Masters, past and present, set to the sounds of nature and th egentle spray of waves of the ocean.

You will hear quotations by. . .

• Sir Winston Churchill ~ We make a living by what we get, but we making a life by what we give.
• Wayne Dyer ~ Only a ghost wallows around in the past, explaining himself with self-descriptors based on a life lived through. You are what you choose today, not what you've chosen before.
• Earl Nightingale ~ Is success worth the trouble, the effort, the commitment, the dedication, the perseverance? Yes. Yes, of course it is worth it. The time will pass anyway; why not put it to constructive, productive use? Everybody benefits, nobody loses.
• Malcom Forbes ~ To stick with a mistake is worse than making one.
• Jim Rohn ~ All things, even adversity, have their worthy purpose.
• Aldous Huxley ~ Experience is not what happens to a man; it is what a man does with what happens to him.
• The Bible ~ As we have therefore opportunity, let us do good unto all men. ~ Galatians 6:10.
• Kahil Gibran ~ You give but little when you give of your possessions. It is when you give of yourself that you truly give.

continue story below

• Ernest Holmes ~ Faith is a mental attitude which is so convinced of its own idea, which so completely accepts it, that any contradiction is unthinkable and impossible.
• Ralph Waldo Emerson ~ Unless you try to do something beyond what you have already mastered, you will never grow.
• Lucille Ball ~ One of the things I learned the hard way was that it doesn't pay to get discouraged. Keeping busy and making optimism a way of life can restore your faith in yourself.
• Robert Kennedy ~ Only those who dare to fail greatly can ever achieve greatly.
• Dorothea Brande ~ All that is necessary to break the spell of inertia and frustration is this: Act as if it were impossible to fail. That is the talisman, the formula, the command of right-about-face which turns us from failure toward success.
• Seneca ~ Whan a man does not know what harbor he is making for, no wind is the right wind.
• Thomas Jefferson ~ The most valuable of all talents is that of never using two words when one will do.
• Larry James ~ Between the thought and the thing, we have the power to choose.
• Zig Ziglar ~ You can have everything in life you want if you will just help enough other people get what they want!
• Albert Einstein ~ A successful man is he who receives a great deal from his fellow men, usually incomparably more than corresponds to his service to them. The value of a man, however, should be seen in what he gives and not in what he is able to receive.
• Og Mandino ~ When you have finished your day, be done with it. Never save any of your load to carry on the morrow. You have done your best, and if some blunders and errors have crept in, forget them. Live this day, and everyday, as if it all may end at sunset, and when your head hits the pillow, rest, knowing that you have done your best.
• Helen Keller ~ Many people have a wrong idea of what constitutes true happiness. It is not attained through self-gratification, but through fidelity to a worthy purpose.
• Mae West ~ He who hesitates is last!
• Brian Tracy ~ Those who do not have goals are doomed forever to work for those who do.
• Napoleon Hill ~ Until you have learned to be tolerant with those who do not always agree with you, until you have cultivated the habit of saying some kind word of those whom you do not admire, until you have formed the habit of looking for the good instead of the bad there is in others, you will be neither successful nor happy.
• Anthony Robbins ~ It is in your moment of decision that your destiny is shaped.
• Werner Erhard ~ When you honor your commitments over your preference of the moment, when you choose to do what you said solely because you said so, in that moment you are expressing yourself as action, rather than as a collection of mere ideas, wishes or dreams. In such moments, you find yourself producing results that seem discontinuous and unpredictable from the spectator's point of view.
• . . . and many more!

Special Bonus: Each audio program contains a 46-page, pocket-sized "LifeWords for Success" booklet featuring all of the 333 quotes on these audio cassettes with author acknowledgement.

On one cassette you will hear the gentle sounds of the ocean as Larry James reads a quotation, gives you time to think about it, then reads another quotation. The second cassette has the sounds of the birds of spring in the background as you listen to more quotations selected to focus your attention on success. There are no subliminal messages and each cassette can safely be listened to as you drive to and from your office or in the privacy of your home.

"Some of the best pick-me-ups available are quotations. I love quotes! They motivate! They inspire! As a professional speaker, I have often developed a complete presentation around a single quote or used the wisdom of others to make a point. The quoted word makes you think (even when you would rather be doing something else). In quotations rests the wisdom of the ages. Many times they are what you need to hear when you need to hear them."
Larry James

There is something in this audio cassette program for everyone, whether you are in sales or management, network marketing, a mother, a father, in school, out of school, or a household executive. Everyone ocassionally needs that little "kick in the pants" to keep them up! "LifeWords for Success" will do just that!

This is a CLOSEOUT Special. Offer is good while supply lasts!

Each audio cassette album was $39.95.
CLOSEOUT Price: $20 plus $6.00 postage and handling.
Telephone orders only. Call our "toll-free" number! 800-725-9223

This audio cassette program is only offered on our website for our online friends! Order today!

continue story below

next: LoveNotes for Lovers

HealthyPlace.com is divided into various communities representing major psychological interests. The various sites within each community and extensive information on the issue are listed on the front page of the community or you can click on one of the links below and go directly to that site.

Caps Commas, and Other Things

If you are looking for a flexible program to teach writing skills to your child, this book is for you. Activities are appropriate for regular, remedial and ESL students in grades 3 through 12. While the material is arranged sequentially, you can begin wherever the needs of your child dictate. Concentration is on: Capitalization and Punctuation (6 levels) and Written Expressions (4 levels). An Overview section for each level gives specific suggestions for developing individual lessons.

Buy the Caps Commas and Other Thinks book, when you click here.

Cues and Comprehension (Reading)

This series of 4 workbooks aids in developing visual skills needed for increased fluency and reading comprehension. Adaptable for group or independent study, the tests promote visual recognition, memory for words and word sequence and attention to word variations and punctuation. The books increase in difficulty and begin at approximately third grade reading level.

Buy the Cues and Comprehension Workbooks when you click here.

Letter Tracking

This program serves a dual purpose effectively teaching the alphabet sequence and the visual discrimination of letters while correcting reversals and rotations and instilling the habit of left-to-right progression that is so essential to the skill of reading.

Buy the Letter Tracking Workbook when you click here.

Junior Phonics

• Has Children Reading as Early as Three Years Old.
• Starts with prereading skills and moves right on to full reading ability.
• It's Fun, Easy and Effective.
• Prepare your child to enter preschool, kindergarten or first grade ahead of the rest of the class! Give your children a head start in school with Junior Phonics. Studies and common sense show that children who develop early reading skills are often more successful in school and beyond! Plus they feel great about themselves! A delightful puppet character name "Ed" leads your child on a lively learning excursion through three entertaining videos that teach everything needed to be a superior reader. A colorful board game, cards, charts, reward stickers and more motivate your children to learn as they play.

The Phonics Game

• It's Fast, Fun and Effective!

• Children, Teens & Adults are up to or above grade level in no time!

• Perfect for Children and Teens with ADD or Learning Disabilities

The Phonics Game is an incredible learning tool. In a matter of hours, your children will be reading and spelling better than you ever imagined. Fun, yes! But The Phonics Game is also a complete, systematic, and explicit phonics teaching program for people of all ages! The card games cover all the rules of phonics and when to use them. In no time, your children will be sounding out words easily and fluently. In as little as 18 hours your child can be reading at or above grade level. Young children like it because it's a fun game. Older children and teenagers like it because it makes school easier! Excellent for children and teens with ADD or Learning Disabilities including Dyslexia.

The complete program includes:

• 6 Progressive Double Deck Card Games
• 3 Video Tapes
• Play Book
• 2 CD Rom: Fun Zone & Phonetic Readers
• Sounds & Spelling Audio CD

The Phonics Fun Zone

Turn your computer in a Phonics Game tutor! The Phonics Fun Zone CD-ROM is a learning breakthrough, because it allows your children to practice their Phonics Game skills independently. Just pop it in and watch with pride as your children become reading "MegaStars!" (This is only sold as a supplement to the Phonic Game. It is not a stand alone phonics program.)

Phonetic Readers

Our new Phonetic Readers work so well..it's almost like outfitting your child's first books with training wheels! The Phonetic Readers were written expressly to follow the progress a child makes playing The Phonics Game. All 10 Phonetic Readers are entertaining, beautifully illustrated and just the right length to guarantee success! Your child's face will light up as he or she travels on a big tan van, rides along with Mat's bike, eats out a Joe's and dances with Celia, the turtle.

Additional Resources Available From Our Associates

ADD Focus in association with amazon.com provides the following list of recommended books from their catalog. You can order any book on the list directly from amazon.com at 10% to 30% off the list price by clicking on the "Buy Now" button next to each selection. (A new page will open).

The Read Aloud Handbook (All Ages)

Since its initial publication in 1979, this highly acclaimed reference has informed parents and teachers across the nation and around the world of the importance of reading aloud to their children.

This updated edition features lists of more than 12,000 titles, from picture books to novels, that are great for reading aloud.

[Buy Now]

Building Blocks for Teaching Preschoolers With Special Needs (All Ages)

This book is designed specifically to help students improve their Reading, Comprehension, and Vocabulary Skills. Students using this book will achieve higher scores on state and national competency tests. The Building Blocks for Reading Proficiency Level B is designed for elementary students that are in second through sixth grade BUT reading at the first, second, or third grade level. There are four instructional sections contained in this book: Vocabulary, Comprehension, Read A Book, and Story Frames. Each section contains: Pre tests, Instructional Lessons, Practice Lessons, Extra Practice Lessons, and Post Tests

[Buy Now]

Princeton Review: Reading Smart Junior: Becoming a Star Reader (All Ages)

In READING SMART JUNIOR, our fearless young crew tries to outsmart an evil tycoon bent on ridding the world of books. Along the way, they are introduced to such literary fixtures as Huck Finn, Oliver Twist, and the March sisters from LITTLE WOMEN. The SMART JUNIOR series won the prestigious Parents' Choice Award in 1995 and again in 1997.

[Buy Now]

99 Ways to Get Kids to Love Writing: And 10 Easy Tips for Teaching Them Grammar (All Ages)

Strong writing skills are essential for success in school, college, and on the job. In 99 Ways to Get Kids to Love Writing, educator Mary Leonhardt provides parents with practical, easy-to-follow tips on how to teach their children the fundamentals of writing and make it fun for them at the same time.

[Buy Now]

Encourage Reading

Subscribe to Magazines of interest appropriate to kids' age

next: Helping Your Child Overcome Spatial Problems
~ back to ADD Focus homepage
~ adhd library articles
~ all add/adhd articles

This department contains information and self-help materials related to mathematics and arithmetic skill building. These materials are excellent for introducing children and teens to math topics to give them a head start or as remedial instruction for kids with learning disabilities or ADD or for use in home schooling.

Teach Your Child Math (All Ages)

This book will teach your child how to solve problems, a skill that will help him or her get ahead in all situation. Of course, it's a little tough to get children to understand the importance of problem solving, but don's they love to play? Teach Your Child Math is full of games and show you how to present math as a fun thing for your child to do. The book will introduce your preschooler to concepts using visuals. As the book progresses, so do the concepts learned, allowing your fourth or fifth grader to enjoy the games in later chapters.

Buy Teach Your Child Math book when you click here.

Online Math Help

• All Math.com
• A+ Math
• Ask Dr Math
• Math.com
• Newton's Window
• Convert- me.com (Measures and Measure Conversion

next: ADD - ADHD Support Organizations
~ back to ADD Focus homepage
~ adhd library articles
~ all add/adhd articles

Welcome to the internet parent education workshop. A place to build parenting skills that help parents to discipline kids from toddlers to teens as well as to encourage children and adolescents to feel positive about themselves and to become the winners they were meant to be. Lots of practical solutions for parents as well as tips for improving communication, building positive relationships and other useful parenting skills. The goal of parenting is to teach kids to develop self-discipline. Many parents feel spanking is necessary for effective discipline. When parents learn and apply the three Fs of Effective using the parenting techniques on this page and others, they find that yelling, screaming and spanking disappear and a positive relationship is established.

Guidelines For Parent Child Relationships

• Try to set a side time on a regular basis to do something fun with your child.
• Never disagree about discipline in front of the children.
• Never give an order, request, or command without being able to enforce it at the time.
• Be consistent, that is, reward or punish the same behavior in the same manner as much as possible.
• Agree on what behavior is desirable and not desirable.
• Agree on how to respond to undesirable behavior.
• Make it as clear as possible what the child is to expect if he or she performs the undesirable behavior.
• Make it very clear what the undesirable behavior is. It is not enough to say, "Your room is messy." Messy should be specified in terms of exactly what is meant: "You've left dirty clothes on the floor, dirty plates on your desk, and your bed is not made."
• Once you have stated your position and the child attacks that position, do not keep defending yourself. Just restate the position once more and then stop responding to the attacks.
• Look for gradual changes in behavior. Don't expect too much. Praise behavior that is coming closer to the desired goal.
• Remember that your behavior serves as a model for your children's behavior.
• If one of you is disciplining a child and the other enters the room, that other person should not step in on the argument in progress.
• Reward desirable behavior as much as possible by verbal praise, touch or something tangible such as a toy, food or money.
• Both of you should have an equal share in the responsibility of discipline as much as possible.

The "3 Fs" of Effective Parenting

Discipline should be:

• Firm: Consequences should be clearly stated and then adhered to when the inappropriate behavior occurs.

• Fair: The punishment should fit the crime. Also in the case of recurring behavior, consequences should be stated in advance so the child knows what to expect. Harsh punishment is not necessary. Using a simple Time Out can be effective when it is used consistently every time the behavior occurs. Also, use of reward for a period of time like part of a day or a whole day when no Time Outs or maybe only one Time Out is received.

• Friendly: Use a friendly but firm communication style when letting a children know they have behaved inappropriately and let them know they will receive the "agreed upon" consequence. Encourage them to try to remember what they should do instead to avoid future consequences. Work at "catching them being good" and praise them for appropriate behavior.

The Parent As Teacher/Coach

See your role as that of a teacher or coach to your children. Demonstrate in detail how you would like them to behave. Have them practice the behavior. Give them encouragement along with constructive criticism.

• Try to set aside time on a regular basis to do something fun with your children.
• Rather than tell them what not to do, teach and show them what they should do.
• Use descriptive praise when they do something well. Say, "I like how you ____ when you ____." Be specific.
• Help your child learn to express how he feels. Say: "You seem frustrated." "How are you feeling?" "Are you up set?" "You look like you are angry about that." "It's O.K. to feel that way."
• Try to see a situation the way your children do. Listen carefully to them. Try to form a mental picture of how it would look to them.
• Use a soft, confident tone of voice to redirect them when they are upset.
• Be a good listener: Use good eye contact. Physically get down to the level of smaller children. Don't interrupt. Ask open ended questions rather than questions that can be answered with a yes or no. Repeat back to them what you heard.
• Make sure they understand directions. Have them repeat them back.
• When possible give them choices of when and how to comply with a request.
• Look for gradual changes in behavior. Don't expect too much. Praise behavior that is coming closer to the desired goal.
• Develop a nonverbal sign (gesture) that your children will accept as a signal that they are being inappropriate and need to change their behavior. This helps them to respond to your prompt without getting upset.

The Use of Reward In Positive Parenting

1. When ever possible try to use reward and praise to motivate your child to improve their behavior.
2. For younger children you can use "grandma's rule." Say, "When you have picked up all your clothes, you may go out and play." Be sure you use "when" rather than "if."
3. Combine reward with time out for serious disruptive or defiant behaviors. Say, "Every time you ____, you will have a ____ time out. If you can go the whole (day, afternoon, etc.) without getting a time-out, you will earn ____.

The First Time Club

If you are having trouble getting your child to do something when you ask, have him become a member of "The First Time Club."

1. Make up a chart with 30 squares.
2. Tell the child that each time he does something the first time he is asked, a happy face will be placed in a square. When all the squares are completed, he will earn a reward.
3. Mutually agree on the reward. For younger children, you can place a picture of the reward on the chart or for older children you can write it on the chart.
4. Then practice with the child how he is to behave. "Each time I ask you to do something, I want you to: (1) Use good eye contact, (2) Listen quietly, (3) Say OK I will ____. then (4) Do it." Practice this, making a number of requests.
5. Then start the program.
6. Be sure to praise him for each success during practice as well as when the program starts. By the time the squares are filled, he will have developed a new habit. When he completes the program, provide the reward immediately. Take the chart down and let him have it as part of the reward. Continue to use praise and encouragement to make sure this new habit remains and becomes even stronger.

The Family Chip System

If your child is having a lot of difficulty getting along at home consider using the "Family Chip System." This is a very powerful tool. When used consistently, most children will show great improvement within just a few weeks. The program provides immediate reward for appropriate behavior and immediate consequences for inappropriate behavior. By the way, if you have other children around the same age as the child for whom you are designing this program, put them on the program as well. Children really like this system. Parents love the system. Here are the steps to follow to use this program with your child:

1. Purchase a box of poker chips from the drug store.
2. Hold a family meeting to discuss the need for the program. Tell the children that it will help them to learn to be in charge of themselves. You can tell older children that this system is similar to what adults experience: (1) Adults earn money for working; (2) Adults have to pay fines for breaking rules like speeding or make a late payment; (3) Adults spend their money on things they need as well as a few things they want.
3. Develop a list of behaviors they will earn chips for. Start with the morning and then go throughout the day looking for behaviors to reward. These can include positive attitude, self-help behaviors and chores. If you are using a behavior modification program for school you can give them chips for each point earned on that system. Some possibilities are: getting up on time, brushing teeth, getting ready for school on time, playing nicely with brother or sister, completing chores such as feeding a pet or taking out the trash, saying please and thank you, doing things the first time they are asked, doing homework without a fuss, getting ready for bed on time, going to bed on time, cleaning bedroom.
4. Agree on a list of behaviors that result in a loss of chips. These can include behaviors that are oppositional, defiant or disruptive. Some examples are: tantrums, yelling, screaming, fighting, arguing, throwing things, jumping on the furniture, getting up after bed time, swearing, putting others down. (Some more serious behaviors will receive a Time Out as well as a fine).
5. Agree on a list of privileges they will earn and pay for with chips. Some privileges will be bought for the day, others will be bought for a period of time (usually 1/2 hour). These can include: watching TV, playing outside, computer time, renting their bike or other large toy, playing a game with a parent, etc.

Assign point values to each item on the list. See the sample below:

Earn Chips For

Lose Chips For

Privileges To Spend Chips For

Rules for Parents When Giving Chips

1. Be near your child and able to touch him (not 20 feet or two rooms away).
2. Look at your child and smile.
3. Use a pleasant voice tone.
4. Make sure your child is facing you and looking at you.
5. Praise your child "Hey that's great. You're really doing a nice job. That's really helping me." Reward you child with chips "Here's 2 chips for doing a great job."
6. Describe the appropriate behavior for your child so he know exactly what behavior he is being praised and rewarded for.
7. Hug your child occasionally or use some other form of positive touch.
8. Have your child acknowledge you such as, "Thanks Mom" or "O.K."

Rules for Parents When Taking Away Chips

1. Be near you child and able to touch him.
2. Look at your child and smile.
3. Use a pleasant voice tone.
4. Make sure your child is facing you and looking at you.
5. Explain what was inappropriate such as "Remember you are not allowed to run in the house because it is not safe." "You need to learn not to yell and scream so we can enjoy being together at home."
6. Be sympathetic. "I know it's hard to lose chips but that's the rule."
7. Give your child the chip fine.
8. Make sure your child gets the chip appropriately.
9. Prompting the appropriate responses will sometimes be necessary. For example, "Come on, give me a smile--That's right."
10. If a chip loss is taken very well by your child, it is a good idea to give him back a chip or two.
11. If your child is too mad or upset to give you the chips, don't force the issue. Place your child in time out (to cool off) and then get the chips.

Rules For Children When Getting Chips

1. You should be facing your parents, looking at them and smiling.
2. You should acknowledge the chips by saying "O.K.," "Thanks," or something else pleasant.
3. The chips should be put in a specified container. (Any chips left lying around are lost.)

Rules For Children When Losing Chips

1. You should face your parents, look at them and smile (not frown.)
2. You should acknowledge the chip loss with "O.K." or "All right," "I'll get the chips," etc. (You must keep looking at them and be pleasant).
3. You should give the chips to your parents pleasantly

Post the list of behaviors and chips earned in a convenient place.

Let your child decorate a paper cup in which to keep their chips. Place the "bank's" chips is a jar or bowl and put it in a place that is out of reach of children.

Start using the program. Feel free to modify the program at any time by holding a meeting. Sometimes point values need to be raised or lowered to achieve a goal. You may add or remove items from the list as well.

After about 6 weeks, you may be able to start short trials off the system. Say, "Today we are going to try not using the chip system. If things go well we will try it again the next day." If the trial is successful continue for about a week. If things continue to go well, hold a meeting and celebrate all that you and your child have both gained from the system. If your child is not ready, continue with the program.

Note: If your child runs out of chips, have a list of extra chores they can do to earn chips so that they remain on the system.

next: Handling Sibling Rivalry
~ back to ADD Focus homepage
~ adhd library articles
~ all add/adhd articles