{"version":"1.0.0","segments":[{"speaker":"Simon Currigan","startTime":87.35,"endTime":93.28999999999999,"body":"Look. The truth is deciding whether to medicate your child for ADHD is hard for any parent."},{"speaker":"Simon Currigan","startTime":93.50999999999999,"endTime":95.53,"body":"How can you be sure it's the right call?"},{"speaker":"Simon Currigan","startTime":95.905,"endTime":104.485,"body":"This week on the School Behaviour Secrets podcast, we tackle this critical question with developmental pediatrician and author, Dr Walt Karniski."},{"speaker":"Simon Currigan","startTime":105.33999999999999,"endTime":112.24,"body":"Don't miss this insightful conversation that could help you make a more informed choice for your child and your students'"},{"speaker":"Simon Currigan","startTime":112.63499999999999,"endTime":118.25399999999999,"body":"well-being as we sweep aside the myths and misconceptions around medication and ADHD."},{"speaker":"Simon Currigan","startTime":119.27499999999999,"endTime":124.03999999999999,"body":"Welcome to the School Behaviour Secrets podcast. I'm your host, Simon Currigan."},{"speaker":"Simon Currigan","startTime":124.1,"endTime":129.915,"body":"My co host is Emma Shackleton, and we're obsessed with helping teachers, school leaders, whole"},{"speaker":"Simon Currigan","startTime":137.89499999999998,"endTime":141.31,"body":"school strategy, and more, all with the aim of helping your students whole school strategy, and more, all with the aim of"},{"speaker":"Simon Currigan","startTime":141.31,"endTime":144.05,"body":"helping your students reach their true potential."},{"speaker":"Simon Currigan","startTime":144.35,"endTime":150.185,"body":"Plus, we'll be letting you eavesdrop on our conversations with thought leaders from around the world."},{"speaker":"Simon Currigan","startTime":150.245,"endTime":157.53,"body":"So you'll get to hear the latest evidence based strategies before anyone else. This is the School Behaviour Secrets podcast."},{"speaker":"Simon Currigan","startTime":161.03,"endTime":166.58499999999998,"body":"And this is one thing I that tallies with my experience of working with lots and lots of kids with ADHD is they often engage"},{"speaker":"Simon Currigan","startTime":166.58499999999998,"endTime":170.685,"body":"in behaviours in the moment and then really regret it afterwards."},{"speaker":"Simon Currigan","startTime":170.95999999999998,"endTime":177.06,"body":"And they almost get into a shame spiral sometimes about their behaviour in school because it's something that's kind of beyond their control."},{"speaker":"Dr. Walt Karniski","startTime":177.28,"endTime":184.095,"body":"Exactly. It is beyond their control, and yet they're continued able to do all of the functions that you would expect them to do."},{"speaker":"Dr. Walt Karniski","startTime":184.095,"endTime":188.915,"body":"They can listen and attend and focus on something as highly interesting like a video game."},{"speaker":"Dr. Walt Karniski","startTime":189.04,"endTime":195.62,"body":"And parents say, well, that's a sign that this is not medically related because they can focus on the video game."},{"speaker":"Dr. Walt Karniski","startTime":195.68,"endTime":204.185,"body":"But the video game is giving them constant feedback or the book that they have in front of them is just sitting there waiting for them to process the information."},{"speaker":"Dr. Walt Karniski","startTime":204.405,"endTime":206.344,"body":"It takes a different way of thinking."},{"speaker":"Dr. Walt Karniski","startTime":206.35,"endTime":213.81,"body":"The other thing I should mention is that how the brain communicates is by sending messages from one nerve cell to another."},{"speaker":"Dr. Walt Karniski","startTime":213.87,"endTime":217.64499999999998,"body":"And at the end of those nerve cells are chemicals called neurotransmitters."},{"speaker":"Dr. Walt Karniski","startTime":218.585,"endTime":225.85999999999999,"body":"And there are 2 neurotransmitters in the three areas of the brain that we talked about that predominant, norepinephrine and dopamine."},{"speaker":"Dr. Walt Karniski","startTime":226.07999999999998,"endTime":233.89499999999998,"body":"And it's been found in the children with ADHD, those areas of the brain have a decreased activity of those two substances."},{"speaker":"Dr. Walt Karniski","startTime":234.435,"endTime":236.355,"body":"Now they don't have the same amount."},{"speaker":"Dr. Walt Karniski","startTime":236.355,"endTime":238.275,"body":"They don't seem to be working as well."},{"speaker":"Dr. Walt Karniski","startTime":238.275,"endTime":246.82999999999998,"body":"The medications that are used today look almost exactly like those 2 neurotransmitters that are normally functioning in the brain."},{"speaker":"Dr. Walt Karniski","startTime":246.82999999999998,"endTime":254.57399999999998,"body":"So when you take the medication, all that is happening is that that area of the brain is getting an increase in those chemical"},{"speaker":"Dr. Walt Karniski","startTime":254.634,"endTime":261.61,"body":"substances back to the level that you would expect them to occur so that the child can focus and attend."},{"speaker":"Dr. Walt Karniski","startTime":261.75,"endTime":268.125,"body":"These medications are not suppressing a child. They're not sedating a child. They're not changing the brain activity."},{"speaker":"Dr. Walt Karniski","startTime":268.185,"endTime":274.28999999999996,"body":"As a matter of fact, what they're really doing is bringing the brain back to a more average, normal functioning state."},{"speaker":"Dr. Walt Karniski","startTime":274.37,"endTime":281.33500000000004,"body":"Medication doesn't teach a child anything, but it gives the child the ability to learn from normal teaching methods."},{"speaker":"Simon Currigan","startTime":281.895,"endTime":284.455,"body":"And if you're listening in the UK, I think you used the term epinephrine now."},{"speaker":"Simon Currigan","startTime":284.455,"endTime":286.71500000000003,"body":"I think we use adrenaline and I think norepinephrine."},{"speaker":"Simon Currigan","startTime":287.015,"endTime":288.775,"body":"We call that noradrenaline in the UK."},{"speaker":"Dr. Walt Karniski","startTime":288.775,"endTime":293.02,"body":"There's actually about 200 different neurotransmitters in the brain."},{"speaker":"Dr. Walt Karniski","startTime":293.02,"endTime":300.4,"body":"And the way that medication affects just certain functions in the brain is by targeting certain neurotransmitter."},{"speaker":"Dr. Walt Karniski","startTime":300.875,"endTime":305.695,"body":"So we know that those 2 neurotransmitters are dysfunctional in the brain."},{"speaker":"Dr. Walt Karniski","startTime":305.995,"endTime":314.789,"body":"And when medication corrects it, it only only changes the activity of those 2 neurotransmitters, not the other 199."},{"speaker":"Dr. Walt Karniski","startTime":315.685,"endTime":320.825,"body":"As a result, you can use the medication to focus on just specific brain activity."},{"speaker":"Simon Currigan","startTime":320.96500000000003,"endTime":325.99,"body":"So you've touched on this already. You've you've talked about sedatives and I think there is sort of popular belief out there"},{"speaker":"Simon Currigan","startTime":325.99,"endTime":332.57,"body":"that medications are for ADHD are like sedatives and sometimes parents talk about their kids, you know, becoming like zombies."},{"speaker":"Simon Currigan","startTime":332.655,"endTime":334.17499999999995,"body":"But you've touched on that that's not the truth."},{"speaker":"Simon Currigan","startTime":334.17499999999995,"endTime":338.355,"body":"So what are these substances that are used to, medicate ADHD?"},{"speaker":"Dr. Walt Karniski","startTime":338.575,"endTime":347.53,"body":"When we treat children with ADHD with medication, we have 2 major choices of medication, either the stimulants or the non stimulants."},{"speaker":"Dr. Walt Karniski","startTime":347.90999999999997,"endTime":351.53,"body":"The stimulants are more effective than the non stimulants."},{"speaker":"Dr. Walt Karniski","startTime":351.905,"endTime":357.92499999999995,"body":"They're highly effective in treating the symptoms of ADHD, whereas the non stimulants are moderately effective."},{"speaker":"Dr. Walt Karniski","startTime":358.06499999999994,"endTime":367.22,"body":"The difference is that all of the side effects that occur with the stimulants, and we we can go into what those side effects are, are minimized by the"},{"speaker":"Dr. Walt Karniski","startTime":367.67999999999995,"endTime":374.78499999999997,"body":"non stimulants. So if a child develops significant side effects on a stimulant, then we can switch to a non stimulant to minimize the side effects."},{"speaker":"Dr. Walt Karniski","startTime":374.78499999999997,"endTime":381.64,"body":"If we go back to the stimulants versus the nonstimulants, there are two main stimulants, methylphenidate and amphetamine."},{"speaker":"Dr. Walt Karniski","startTime":382.02,"endTime":388.03999999999996,"body":"Methylphenidate is the main ingredient in Ritalin, Concerta, Medidate, and a number of different medications."},{"speaker":"Dr. Walt Karniski","startTime":388.475,"endTime":395.595,"body":"Amphetamine is the main medication involved in Adderall, Vyvanse, and many other medications as well."},{"speaker":"Simon Currigan","startTime":395.595,"endTime":402.05999999999995,"body":"When you say amphetamine, to me as a layperson, a nonmedical person, the first thing I'm thinking of is street drugs."},{"speaker":"Dr. Walt Karniski","startTime":402.20000000000005,"endTime":407.56499999999994,"body":"Well, street drugs are similar in structure to these medications. They do work on the brain."},{"speaker":"Dr. Walt Karniski","startTime":407.56499999999994,"endTime":414.66999999999996,"body":"But what you call speed, amphetamine on the street is really metamphetamine, which is a different chemical substance."},{"speaker":"Dr. Walt Karniski","startTime":414.66999999999996,"endTime":423.93499999999995,"body":"And, yes, it shares the same basic molecular structure, but it has something to added on to it and change the activity of those neurotransmitters in the brain."},{"speaker":"Dr. Walt Karniski","startTime":423.93499999999995,"endTime":425.93499999999995,"body":"So they're not acting in a normal way."},{"speaker":"Dr. Walt Karniski","startTime":425.93499999999995,"endTime":434.34000000000003,"body":"So amphetamines that are used in treating ADHD are bringing the brain back to an average type of neural functioning, where"},{"speaker":"Dr. Walt Karniski","startTime":434.34000000000003,"endTime":441.355,"body":"if somebody who takes a a street drug are getting an enhanced effect on pleasure areas, the brain, and so on."},{"speaker":"Dr. Walt Karniski","startTime":441.355,"endTime":448.71000000000004,"body":"And of course, that leads to addiction and other problems. These medications are not addictive. They do not give highs."},{"speaker":"Dr. Walt Karniski","startTime":449.01,"endTime":455.764,"body":"As a matter of fact, one of the biggest problems I have in treating adolescents with ADHD is keeping them on their medication."},{"speaker":"Dr. Walt Karniski","startTime":455.82500000000005,"endTime":459.18499999999995,"body":"The medications we're giving them a high, they would be glad to take it."},{"speaker":"Dr. Walt Karniski","startTime":459.18499999999995,"endTime":463.49,"body":"In reality, when they're on their medication, they just feel normal."},{"speaker":"Simon Currigan","startTime":463.49,"endTime":469.255,"body":"So these are safe, researched chemicals that don't have sort of adverse impacts on the brain?"},{"speaker":"Simon Currigan","startTime":469.255,"endTime":474.135,"body":"We're not putting anything particularly foreign to the body, and side effects can be well managed?"},{"speaker":"Dr. Walt Karniski","startTime":474.135,"endTime":479.83000000000004,"body":"Yes. There's actually no serious long term side effects of these medications."},{"speaker":"Dr. Walt Karniski","startTime":480.37,"endTime":485.57000000000005,"body":"All of the side effects that do occur occur while the medications in the body."},{"speaker":"Dr. Walt Karniski","startTime":485.57000000000005,"endTime":489.505,"body":"So for instance, Ritalin only lasts about 3 and a half hours."},{"speaker":"Dr. Walt Karniski","startTime":490.125,"endTime":494.75,"body":"So if there are side effects to Ritalin, it's gonna occur during those 3 and a half hours."},{"speaker":"Dr. Walt Karniski","startTime":494.82899999999995,"endTime":501.40999999999997,"body":"And once the Ritalin has worn off, it no longer has a positive effect and no longer has a side effect either."},{"speaker":"Dr. Walt Karniski","startTime":501.47,"endTime":503.975,"body":"So there are no long term side effects."},{"speaker":"Dr. Walt Karniski","startTime":504.21500000000003,"endTime":508.775,"body":"Let me give you an example of I had a mother child who I diagnosed with ADHD."},{"speaker":"Dr. Walt Karniski","startTime":508.775,"endTime":512.555,"body":"He was about 9 or 10 years of age, and, we started him on medication."},{"speaker":"Dr. Walt Karniski","startTime":513.08,"endTime":516.6,"body":"Mother brought him back in 2 weeks for the 1st follow-up visit."},{"speaker":"Dr. Walt Karniski","startTime":516.6,"endTime":518.62,"body":"And I asked her, well, how are the things going?"},{"speaker":"Dr. Walt Karniski","startTime":518.84,"endTime":528.855,"body":"And she said, well, the teacher thinks that he is doing fabulous. He's focusing better in school. He's not hitting other children. He's learning better. His grades have improved better."},{"speaker":"Dr. Walt Karniski","startTime":528.855,"endTime":532.45,"body":"But at home, I said, well, that sounds great. What's the problem?"},{"speaker":"Dr. Walt Karniski","startTime":532.59,"endTime":535.71,"body":"And she said, well, at home, he's depressed. Oh, really?"},{"speaker":"Dr. Walt Karniski","startTime":535.71,"endTime":537.41,"body":"What why do you think he's depressed?"},{"speaker":"Dr. Walt Karniski","startTime":537.79,"endTime":542.395,"body":"And she said, well, he comes home from school every day. He goes to his room."},{"speaker":"Dr. Walt Karniski","startTime":542.455,"endTime":547.799,"body":"He opens up a book and he reads for 2 hours. And I said, yes. And what's wrong with that?"},{"speaker":"Dr. Walt Karniski","startTime":547.799,"endTime":550.46,"body":"And she said, well, he's never been that way before."},{"speaker":"Dr. Walt Karniski","startTime":550.6,"endTime":559.805,"body":"He's usually running around the house, pulling the cat's tail, knocking over the lamp, yelling at me, running out the door when he's not supposed to be. Now he's just sitting."},{"speaker":"Dr. Walt Karniski","startTime":559.805,"endTime":564.465,"body":"And I said to her, I said, if he had been born that way, would you have been concerned?"},{"speaker":"Dr. Walt Karniski","startTime":564.75,"endTime":567.89,"body":"She looked at me like I was crazy. She said, well, of course not."},{"speaker":"Dr. Walt Karniski","startTime":568.11,"endTime":575.485,"body":"I said, then what you're seeing when your child is on medication is what he would have been like if he had been born with ADHD."},{"speaker":"Dr. Walt Karniski","startTime":575.785,"endTime":581.01,"body":"And so the fact that he sits and reads for 2 hours is not an abnormality. It's not a sign of pressure."},{"speaker":"Dr. Walt Karniski","startTime":581.09,"endTime":585.01,"body":"It's a sign of that the medication is working and doing what it's supposed to be doing."},{"speaker":"Simon Currigan","startTime":585.01,"endTime":588.77,"body":"Just how effective are these medications in general? That's one sort of anecdotal story."},{"speaker":"Simon Currigan","startTime":588.77,"endTime":594.605,"body":"But when we look at the statistics, what's the impact kind of on a wider scale when we look at 100 or 1000 of children?"},{"speaker":"Dr. Walt Karniski","startTime":594.605,"endTime":601.65,"body":"Okay. Well, first place I should mention that for every year for the last 20 years, there have been approximately 350 research"},{"speaker":"Dr. Walt Karniski","startTime":601.7900000000001,"endTime":604.9300000000001,"body":"studies published in the world concerning these medications."},{"speaker":"Dr. Walt Karniski","startTime":605.39,"endTime":611.602,"body":"Most of those studies are looking at the effect of the medication on children's behaviour."},{"speaker":"Dr. Walt Karniski","startTime":611.635,"endTime":619.1700000000001,"body":"And those 350 studies overwhelmingly show every year that the medications are safe and effective."},{"speaker":"Dr. Walt Karniski","startTime":619.71,"endTime":621.71,"body":"So that's the first thing that's important."},{"speaker":"Dr. Walt Karniski","startTime":621.71,"endTime":627.875,"body":"The second thing that's important to remember is what happens if you do not treat somebody with ADHD."},{"speaker":"Dr. Walt Karniski","startTime":628.4150000000001,"endTime":633.989,"body":"And I could probably spend the next hour talking about some of the problems that occurred."},{"speaker":"Dr. Walt Karniski","startTime":633.989,"endTime":642.934,"body":"But in just about every area, adults with ADHD who were not treated with medication as children have more likely to be in a car accident."},{"speaker":"Dr. Walt Karniski","startTime":642.994,"endTime":645.955,"body":"They're more likely to have been fired from a job."},{"speaker":"Dr. Walt Karniski","startTime":645.955,"endTime":648.2950000000001,"body":"They're more likely to have been arrested."},{"speaker":"Dr. Walt Karniski","startTime":648.61,"endTime":650.39,"body":"They're more likely to have gone bankrupt."},{"speaker":"Dr. Walt Karniski","startTime":650.6890000000001,"endTime":652.85,"body":"They're more likely to have abused drugs."},{"speaker":"Dr. Walt Karniski","startTime":652.85,"endTime":655.35,"body":"They're more likely to smoke or drink excessively."},{"speaker":"Dr. Walt Karniski","startTime":655.65,"endTime":662.785,"body":"And the amazing thing is that in the studies that have looked at the differences in adults is that those adults that were"},{"speaker":"Dr. Walt Karniski","startTime":662.785,"endTime":669.02,"body":"treated with medication have about the same problems in those areas as people who don't have ADHD."},{"speaker":"Simon Currigan","startTime":671.985,"endTime":676.004,"body":"So, obviously, that was just a small section of my interview with doctor Walt Karniski."},{"speaker":"Simon Currigan","startTime":676.225,"endTime":684.52,"body":"If you'd like to know more about how ADHD affects the brain, the outcomes of research projects into the effects of ADHD medication,"},{"speaker":"Simon Currigan","startTime":685.14,"endTime":692.265,"body":"or more key questions you should consider before deciding to use medication, then click the link at the bottom of the episode"},{"speaker":"Simon Currigan","startTime":692.265,"endTime":698.124,"body":"description to head back to the full interview. I definitely recommend you do. It's well worth a listen."},{"speaker":"Simon Currigan","startTime":698.23,"endTime":701.61,"body":"Thanks for joining us for another enlightening episode of School Behaviour Secrets."},{"speaker":"Simon Currigan","startTime":701.99,"endTime":704.5500000000001,"body":"Your feedback fuels our journey and helps us grow."},{"speaker":"Simon Currigan","startTime":704.5500000000001,"endTime":706.905,"body":"So please take a moment to rate and review us."},{"speaker":"Simon Currigan","startTime":706.905,"endTime":710.345,"body":"It only takes 30 seconds, but it means the world to us."},{"speaker":"Simon Currigan","startTime":710.345,"endTime":715.5880000000001,"body":"It lets us know how we're doing, and, also, it helps prompt the algorithm to share School Behaviour Secrets with other podcast listeners."},{"speaker":"Simon Currigan","startTime":721.34,"endTime":722.5550000000001,"body":"Thanks for listening today and I'll see you next time on School Behaviour Secrets."}]}