Introduction

CME Credit: 0.5
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In this twenty-five minute course, Lenard Adler, MD, covers the broad steps for diagnosis of ADHD and the in-office use of two highly reliable patient self-report surveys: the ASRS V1.1 6-Question ADHD Screener, and the 18 Point ADHD Symptom Checklist.

Learning Objectives
After completing this activity, the learner should be better able to:

1. Recognize symptoms of ADHD in adult patients in primary care to trigger screening and diagnosis.
2. Discuss up-to-date information on the criteria of an ADHD diagnosis as published in the new 2013 DSM V.
3. Ask prospective adult ADHD patients about the presence of both ADHD symptoms and functional life impairments.
4. Use other diagnosed patient disorders and comorbidities to trigger screens and diagnosis for underlying ADHD.
5. Conduct a complete screening and subsequent diagnosis to determine if a patient has ADHD as an adult.

CME Credit: 1.0
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In this first of a two-part series, primary care clinicians will learn the appropriate prompts for ADHD screening, how to make a complete ADHD diagnosis, and how to schedule and monitor the prescription of medications for ADHD symptom relief. Presented by a family physician, Oren Mason, MD, who diagnoses and treats ADHD full-time, learners will walk away with a confidence in handling ADHD as we currently do anxiety, depression, and associated medications.

Learning Objectives:
After completing this activity, the reader should be better able to:

1. Use the 6-question ASRS screener for your office patients, and know what next steps to take when someone screens positive for ADHD.
2. Use the ADHD 18 symptom checklist and other prescribed methods for making a complete and thorough diagnosis of ADHD.
3. Identify comorbid conditions patients might have that can trigger a screen for underlying ADHD.
4. Prescribe medications for an ADHD trial treatment with confidence, and how to titrate those medications up to effective dosing.
5. Set up an effective patient visit schedule to diagnose, treat, and monitor ADHD in patients.

CME Credit: 1.0
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In this second of a two-part series, primary care clinicians will learn to choose and dose ADHD medications appropriately for symptom improvement, determine improvement levels through Measurement-Based Care, recognize side effects that would warrant medication change or adjustment, and refer patients appropriately for psycho-social support. Presented by a family physician, Oren Mason, MD, who diagnoses and treats ADHD full-time, learners will walk away with a confidence in handling ADHD as we currently do anxiety, depression, and associated medications.

Learning Objectives
After completing this activity, the learner should be better able to:

1. Choose confidently between stimulant and non-stimulant medication for a particular patient.
2. Titrate medication dosage up to an optimal level in each patient over an appropriate time period.
3. Refer to a third party for adjunctive and appropriate psycho-social support.
4. Follow an ADHD patient’s improvement with Measurement-Based Care.
5. Identify adverse side effects of medication that would warrant a change to a different medication.

CME Credit: 1.5
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In this 90 minute presentation with Anthony Rostain, MD provides a thorough review of medications available for ADHD treatment, and protocols for managing medication adherence and safe use. Viewers will understand the vital role primary care physicians play in the treatment of ADHD.

Learning Objectives
After completing this activity, the reader should be better able to:

1. Discuss strategies for follow-up care of adults with ADHD
2. Monitor clinical outcomes and adverse effects
3. Titrate medications to achieve optimal improvement
4. Improve patient adherence
5. Address common misconceptions about medications

CME Credit: 1.0
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This 56 minute presentation with Anthony Rostain, MD answers questions regarding the safety of stimulant medications for use in ADHD patients. Viewers become familiar with the extensive research showing the overall safety and efficacy of stimulant medications, and the “at risk” factors which warrant a provider’s attention and follow-through.

Learning Objectives
After completing this activity, the learner should be better able to:

1. Screen for cardiovascular risk before prescribing ADHD medications
2. Discuss with your patients the medication alternatives in treating ADHD
3. Monitor your patients safely when prescribing ADHD medications
4. Refer ADHD patients out to cardiology when cardiovascular risk is identified

CME Credit: 1.0
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In this one-hour session, Anthony L. Rostain, MD MA reviews the numerous medical conditions which are most commonly present with adult ADHD and can in fact be triggers for diagnosing ADHD – smoking, eating disorders, substance abuse, and others. Dr. Rostain reviews the list of ADHD medications and their appropriate use with comorbid conditions, as well as discussing ADHD and pregnancy, ADHD and lifestyle management, and side effects of ADHD medications.

Learning Objectives
After completing this activity, the reader should be better able to:

1. Choose to screen for ADHD based upon known and existing patient medical conditions.
2. Select appropriate ADHD medications.
3. Monitor and managing common medical side effects of stimulant medications.
4. Screen for cardiovascular conditions to increase medication safety.
5. Discuss with patients the management of health and well being.

Symptoms Treatments

CME Credit: 1.0
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In this first of a two part series on ADHD and Women, Ellen Littman, PhD describes the significant difference in symptoms of ADHD in women vs men. Because diagnostic criteria for ADHD were developed in the early 1900’s based upon the symptoms of hyperactive boys, many young females and even older women have been missed in diagnosis. We now know what to look for in women with ADHD, and Part 1 provides that clarity for screening and diagnosis.

Learning Objectives
After completing this activity, the learner should be better able to:

1. Interview women patients for chronic health complaints that can signal underlying ADHD.
2. Differentiate ADHD symptoms to look for in female vs male patients.
3. Reduce misdiagnosis of anxiety and depression in women, and query further about underlying ADHD.
4. Recognize hormonal and emotional dysregulation cycles, isolated social life, and CNS hyper-sensitivities as potentials for ADHD screening.

CME Credit: 1.0
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In this second of a two part series on ADHD and Women, Ellen Littman, PhD discusses the unique situations of ADHD women with high IQ’s and those with hyperactive/impulsive presentation. The majority of the session focuses on the variety of successful therapeutic options for all women with ADHD.

Learning Objectives
After completing this activity, the reader should be better able to:

1. Successfully identify ADHD women with high IQ’s and hyperactive/impulsive type for diagnosis and care.
2. Support ADHD women in the primary care setting to communicate directly and self-advocate for optimal medical care.
3. Recommend psychotherapeutic treatments and make referrals to qualified local professionals.
4. Identify comorbid disorders that are common to ADHD women, and take steps to treat the disorder along with the underlying ADHD.

CME Credit: 1.0
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In this 66 minute presentation, Anthony Rostain, MD MA clearly describes the neural correlates that ADHD patients share with proclivity toward substance abuse. He reviews the risks of Substance Use Disorder (SUD) in teenagers, college students and adults, discusses appropriate medication usage and describes multiple treatment approaches (both pharmaceutical and cognitive therapies) that clinicians can use to treat both ADHD and SUD. A trusting clinician-patient relationship is an important key to treatment success.

Learning Objectives
After participating in this activity, you will be able to describe:

1. The prevalence, phenomenology and impact of Substance Use Disorders in youth and adults with ADHD
2. Current theories regarding the links between ADHD and SUD
3. Key studies documenting the occurrence of stimulant misuse and abuse among college and university students
4. Clinical strategies for managing ADHD in the presence of SUD and for reducing the misuse / abuse of stimulant medications in at-risk patients

CME Credit: 1.0
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In this one-hour presentation, Joseph Biederman, MD describes the symptoms of working memory deficits as one of a set of Executive Function Deficits (EFDs) that can accompany ADHD and in fact have similar neural correlates in the brain. Dr. Biederman describes these phenomena throughout the lifespan, with research data in children, young adults, and adults.

Learning Objectives
At the conclusion of this CME activity, you will be able to:

1. Describe working memory deficits and distinguish them from ADHD symptoms
2. Identify working memory deficits in patients based on your new understanding of prevalence
3. Successfully refer ADHD patients with suspected working memory deficits to outside professionals for assessment
4. Teach your patients and their families about working memory deficits in association with ADHD and raise their awareness and consideration of options

CME Credit: 1.0
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ADHD is often comorbid with one or more other psychological disorders. In this one hour CME session, primary care professionals will learn the list of psychological disorders that frequently occur with ADHD, the order of treatment of co-occurring conditions, and the available medications for multiple conditions, and side effects which need to be balanced in dosing and polypharmacy.  Presented by Joseph Biederman, MD.

Learning Objectives
After completing this activity, the learner should be better able to:

1. Begin screening for ADHD in adult patients, prompted by the more obvious diagnosis of comorbid disorders such as depression, anxiety, substance abuse, and more.
2. Treat ADHD effectively with medications, when present with comorbid disorders, and in a preferred order of treatment.
3. Cite the important benefits of treating ADHD as early as possible in a patient’s life, to prevent complications of untreated ADHD down the road.
4. Refer patients for adjunct treatments who suffer from identifiable dysfunctions that are not improved with ADHD medications.

CME Credit: 0.5
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This 30 minute presentation with Lenard Adler, MD clarifies how the primary care practitioner can identify Executive Function Deficits in ADHD patients which are separate from symptoms of ADHD. Both the symptoms and deficits can be ameliorated with effective and very different kinds of therapy.

Learning Objectives
After completing this activity, the learner should be better able to:

1. Identify potential Executive Function Deficits in patients
2. Know what symptom relief to look for in using stimulant and non-stimulant medications for ADHD patients with Executive Function Deficits
3. Refer ADHD patients with Executive Function Deficits out to appropriate types of therapy

CME Credit: 0.5
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This 27 minute presentation with Lenard Adler, MD explains the components of a complete diagnosis of ADHD in adults and how to distinguish the symptoms of ADHD from frequently comorbid executive function deficits.

Learning Objectives
After completing this activity, the reader should be better able to:

1. Explain the components of a complete diagnosis of ADHD in adults
2. Recognize the symptoms of ADHD and executive function impairments in your patients
3. Use quality of life indicators to screen for ADHD in adults
4. Be prompted to screen your patients for ADHD from comorbid disorders

CME Credit: 1.0
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In this 50 minute presentation, Stephen V. Faraone, PhD presents atypical cases of ADHD which can confound diagnosis in the clinical setting. Clinical guidance is given in clarifying how to diagnose ADHD with late onset beyond the DSM-5 age of 12, as well as individuals with both low and high IQ who may also have ADHD.

Learning Objectives
After completing this activity, the reader should be better able to:

1. Separate the symptoms of intellectual disability and low IQ from symptoms of ADHD in order to make an ADHD diagnosis.
2. Identify significant impairments in high IQ that may lead to an ADHD diagnosis despite intelligence.
3. Diagnose young adults with ADHD whose symptoms may have developed or become more severe at ages older than the DSM-5 criterion of age 12.

Non Pharma

CME Credit: 1.0
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In this 40 minute presentation, Dr. Stephen Faraone, PhD presents the appropriate use of both pharmacologic and non-pharmacologic treatments for ADHD individuals. Non-pharmacologic treatments include cognitive training, meditation, diet inclusions and restrictions, and more. Dr. Faraone uses an evidence-based approach which evaluates the quality of evidence and magnitude of treatment effect (effect size) for each therapy. Further, he presents a helpful algorithm on how to integrate therapies.

Learning Objectives
At the conclusion of this activity, you will be able to:

1. Describe the multiplicity of treatment options for ADHD symptoms and related impairments frequently comorbid with ADHD
2. Choose treatment options based upon their quality of evidence and effect size and the interests of your patient
3. Use an algorithm described in the session to plot a course of treatment for ADHD patients based upon reported and observed symptoms
4. Access further ADHD CME resources on the http://adhdinadults.com website to learn further detail about both medication and non-pharmacologic interventions

CME Credit: 1.5
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This 80 minute presentation with Mary Solanto, PhD describes the benefits and efficacy of the non-pharmacologic treatment of Cognitive Behavioral Therapy, which assists patients with core deficits in executive functioning. The primary care practitioner who refers out to a trained therapist benefits his/her patients greatly.

Learning Objectives
After completing this activity, you should be better able to:

1. Discuss the benefits of Cognitive Behavioral Therapy (CBT) with your patients
2. Know how to recommend CBT for your patients, and choose between individual or group options
3. Recognize impairments you are treating in the office as part of a potential ADHD diagnosis
4. Check in with patients on the benefits they are receiving from CBT and prescribed ADHD medication as part of a regular checkup

CME Credit: 1.0
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In this 65 minute presentation by John Mitchell, PhD, you will learn the history of overall Behavior Therapy and the more specific development of Mindfulness Based Therapy (MBT) for ADHD and other conditions. You will learn the evidence basis for the efficacy of MBT as a legitimate treatment choice in your toolkit for ADHD, derived from previous research. You will be exposed to the overall approach in introducing MBT to your ADHD patients, whether you choose to refer them to third-party programs, or begin to deliver all or portions of this program yourself.

Learning Objectives
At the conclusion of this activity, you will be able to:

1. Describe the evolution of Mindfulness Based Therapy (MBT) in waves of development in overall Behavior Therapy
2. Share the evidence-basis and efficacy of MBT with fellow clinicians and patients
3. Describe an MBT program to your ADHD patients, how it can help them, and refer them to outside programs as an adjunct to therapies used in your practice.

CME Credit: 1.0
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In this continued 50 minute presentation by John Mitchell, PhD, we go through the learning modules (3-8) of a sample Mindfulness program for ADHD, with modules focusing on: breath, body and sound, body sensations, thoughts, judgments, emotions, and interactions with others. (Modules 1-2 are covered in Part 1.)

Learning Objectives
At the conclusion of this activity, you will be able to:

1. Describe the components of an evidence-based Mindfulness program for ADHD patients
2. Discuss Mindfulness with your ADHD patients as an option for care, and refer them to effective programs
3. Choose to begin your own mindfulness practice from available resources to assist ADHD patients via direct training or referral

CME Credit: 1.0
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In this 51 minute presentation, Jeffrey Halperin, PhD describes the development of ADHD symptoms throughout the lifespan, what we know about the interplay between environment and genetics, and how the environment can be used to alter long-term trajectory of ADHD, evidenced by reduced symptomatology.

Learning Objectives
At the conclusion of this activity, you will know and be able to describe:

1. The best time to detect and treat ADHD
2. The inter-play between genetics and the environment in the development of ADHD symptoms
3. Brain development and its relationship to ADHD
4. The role of games and exercises in improving ADHD symptomatology

Evidence-based, fair and balanced, non-commercial, in accordance with standards from the ACCME.

If you want to learn more about CME (Continuing Medical Education) in general,  visit here.
If you want to learn more about ADHD (Attention Deficit Hyperactive Disorder) in general, visit here.