Cow Patty Bingo I

Nonprofits are always exploring new and perfecting old fundraisers.

We love what may be Oklahoma's first Cow Patty Bingo, executed by El Reno's Students Striving for Success at the county fair. From its inception, this mentoring program board has beaten its own path in creativity, fun, and results.

Photos below are from El Reno's event, and links are to the cow/chicken/goat/dog or whatever poop fundraisers elsewhere. 

Dana Gibson, chairman of Students Striving for Success, said, "Curtis Blanc and I [are] selling chances, and the goats getting ready to poop!  We alternated using cows and goats.  Goats are much quicker!!"

The judges, definitely a fun group!

Wrangling the poopers!

Getting ready to poop!

This fundraiser might require extraordinary patience!

Links (or Google "cow patty bingo,")

• http://www.fundraising-ideas.org/DIY/cowpie.htm 

• http://www.pinterest.com/calebsmca/cow-patty-bingo/ (more photo examples)

• http://www.better-fundraising-ideas.com/cow-patty-bingo.html (also Cock-a-Doodle Poo)

• Google "cow patty bingo images." 

• http://www.ehow.com/list_6710788_rules-cow-patty-bingo.html

• http://www.evlt.org/cow/, features multiple activities for three hours

• Video, https://www.youtube.com/watch?v=os-Lx-eew44, multiple cows at one time, $20 a square (The winner presumably is the first one upon whose square is pooped.) 

You get the idea. Just do it!

After-school Program for Middle Schoolers

After-school program builds character, teaches leadership

Posted: Sunday, October 12, 2014 12:00 am

By Andy Rieger

It’s still an hour before sunrise on the first day of Norman schools’ Fall Break and a gaggle of teenagers are hanging out around an old tire and automobile repair shop in downtown Norman.

They are friendly, well-groomed and well-dressed. Not one is checking texts as we speak. They are cheerfully wrangling members of the Norman Downtowners into the headquarters of Loveworks, a leadership program designed to help middle-school students discover their potential and live into their dreams.

About 150 kids in sixth through eighth grade participate in the program which was developed by Journey Church three years ago. There's a waiting list of kids wanting in.

Dozens of adult volunteers work with the students from 4 to 6 p.m. four afternoons a week. It's the precise time period some of the kids might be tempted into engaging in risky behavior.

Students team up on projects that teach character, leadership, experiential learning and giving back to their community.

Food is a big part of the experience. They have snacks upon arrival in Norman school buses. Dinner is served at the end of the evening before parents pick them up.

Rusty Loeffler, of Interurban Restaurants, is a regular cook on Thursday nights.

“I think if you want to strengthen our society, you start locally and take kids that may not have any leadership at home and give them some leadership,” Loeffler said. “Show them how to get better, gain confidence, self esteem, encourage them.”

Coordinator Michael Hirsch says students come two afternoons a week. Clark Mitchell, pastor at Journey Church, and others had the vision to reach middle school students who are most at-risk behaviorally and academically of all children. They started at Irving Middle School, then moved to a former bowling alley on East Lindsey.

Their home at 127 W. Main is cut up into classrooms, a kitchen, performing stage, offices and a winter wonderland next door. (The iceberg theme teaches about a person’s character. Hint: Much of it is below the surface).

Teenage years can be tough. (My late father once told me teenagers are why some species eat their young).

There’s peer pressure to try new things, challenge parents and find some independence. Loveworks taps into students’ creativity and lets them pursue their ideas and dreams in a safe, nurturing and non-judgmental environment. One class explained their plan for a video studio.

“We want at the end of the day to feel like the day was too short and they can’t wait to come back,” says Daniel Smith, one of the group’s leaders and a former volunteer there.

The transformation is often impressive.

Says Loeffler, “It’s amazing to see some of the results of some of those kids that come in as sixth graders, head down, no eye contact and when they leave they’re beaming with confidence.”

http://www.normantranscript.com/opinion/after-school-program-builds-character-teaches-leadership/article_3385ef7c-4fc8-11e4-ba29-d7385ef51cee.html

Ret. 10-30-14

Coaches' Mentoring Challenge, OKC Rotary 29

Often online, the newsletters of various clubs, fraternities, sororities, and other organizations around the state are useful tools to publicize your mentoring program. Use every vehicle to spread the word. Perhaps assist a member of an organization in writing the article to post under his or her byline.

Emily Stratton, the executive director of the Oklahoma Foundation for Excellence, is a loyal member of Rotary Club 29, the largest Rotary Club in world in 2013. She wrote a column about the Coaches' Mentoring Challenge for the October 21st issue. We are so proud of Emily, our fundraiser-in-chief among many other job descriptions that accompany being the leader of the foundation!

http://www.okcrotary.com/portals/0/programs/RotNews_17-15.pdf

Ret. 10-23-14

Five Skills toward Adulthood

From the Chronicle of Evidence-based Mentoring, University of Massachusetts, Boston

Purpose, Planning and Perspective, Adaptability, Resource Recruitment, Optimism

Five skills for navigating the transition to adulthood

by Jean Rhodes

I’m sometimes alarmed that so many of my undergraduates seem adrift and unclear about their futures. I find myself wondering how they can bring themselves to pay tuition, go to class, study for tests, and go about their daily lives without a detailed, ambitious plan for their future careers. But, I’ve come to realize that times have changed dramatically since I was a college student in the 1980′s. Indeed, coming of age has never been more confusing. Traditional economic and social markers of adulthood have all but vanished, leaving a generation of youth in limbo. And our collective notions of the transition to adulthood — young people finishing high school or college and marching lockstep into lifelong jobs, marriages, and mortgages — seem as quaint as our parents’ wedding photos.

Economic, demographic, technological, and social changes have conspired to both lengthen and complicate the road to adulthood. By the time my generation had reached our mid to late twenties, many of us were occupied with marriage, young families, jobs, military service, or other full-time pursuits.  A “quarter-life identity crisis,” as this new period of prolonged transition to adulthood has been described, implies setback and confusion. But is this really the case? Might not the current delays in forming lasting job commitments and partnerships be an adaptive response to economic and social turmoil. Maybe this longer period of identity and relationship exploration has some upsides?

Classic developmental theories would suggest otherwise. Much of our current understanding of identity formation in adult development stems from early seminal work by Erik Erikson, a developmental psychologist who conceived of a life-stage theory of development that is tied to confronting and mastering the challenges of each stage. Challenges not fully resolved at one stage often carry over into the next stage, resurfacing as problems arise.  Although the key challenges of young adulthood involve establishing intimate partnerships and commitments (intimacy vs. isolation),some have argued that today’s young adults are, in many ways, still grappling with the crisis of adolescence, identity vs. role confusion. Changing economic and social conditions have prolonged this adolescent identity challenge and, in many ways, complicated the resolution of the subsequent stage tasks of finding an intimate partner. As other scholars wrangle with the socio-demographic and policy implications, there is a pressing need to explore the underlying psychological processes that both drive and are necessitated by these shifts. What might have facilitated the transition to adulthood in the past, including conformity, loyalty, steady commitment, is shifting. Instead, selection biases of these uncertain times may favor those who can blend tenacity with flexibility in responding to setbacks and rapid change. From this perspective, the social and economic climate may favor those who can tolerate ambiguity and adapt their skills to the rapidly changing global economy. As Rudyard Kipling opined, you are truly an adult, ”If you can dream—and not make dreams your master; If you can think—and not make thoughts your aim; If you can meet with Triumph and Disaster and treat those two impostors just the same.”

In other (less elegant) words, today’s economic and social climate requires a different set of adaptive capacities than those of previous generations. Much has been written lately about self-regulation but other skills are needed in a world of dwindling supports, rapid transitions, and uncertainty. Here’s a few:

• Purpose: As individuals work toward goals, those youth with a sense of purpose are better able to adapt to the challenges of the transition to adult roles.  Particularly when wages are low and a sense of economic despair is pervasive, it is important to feel one’s actions have some greater purpose.

• Planning and perspective: Likewise, those who are more planful are better able to establish priorities, assess which tasks are most important to long-term goals, and generate options in response to obstacles. Masten and colleagues (2004) found that this resource discriminated between vulnerable adolescents who went on to achieve academically and in their careers and those who did not. Likewise, individuals with stronger perspective-taking abilities are better able to self-reflect and to read and tailor their goals to changing conditions.

• Adaptability: Of course, different settings will offer youth different resources, information and supports, and youth must be attuned to the particulars of the contexts they occupy. Adaptability, or the capacity to flexibly respond to various social, educational and career settings, is vital. Adaptability entails deploying new strategies in the face of problems, particularly when the usual way of doing things is no longer as effective.  Rather than stubbornly persist in the face of rejection or roadblocks, adaptable young adults formulate,  reset, and try new, innovative strategies to accomplish their goals (e.g., maker spaces, Kickstart). This might require seeking out new resources, additional education, specialized information, and appropriate mentors and role models.

• Resource recruitment: Another capacity–the ability to identify resources, opportunities, information, and social supports–is also critical to young people as they identify their goals and the means to attain them.

• Optimism: Finally, a sense of optimism, maintaining a positive outlook for the future, tempered by an awareness of the real challenges of this stage, is critical to managing the inevitable uncertainty and frustrations of the transition to adulthood.

http://chronicle.umbmentoring.org/coming-of-age-in-uncertain-times/ 
Ret. 10-20-14

28 Things You Should Never Say...

houseofbeck.com

Although this is intended for employees, these communication tidbits really show who we are and who we can become in the larger world. We have probably used or heard some of these without even considering what they really suggest to others. 'Good to learn these lessons early in life!

The list precedes the first part of the article.

28 Things You Should Never Say To Your Boss

Business Insider

jsmith@businessinsider.com 

by Jacquelyn Smith

Aside from the obvious — like profanity and insults — here are 28 phrases you should avoid:

"I can't."  

A "can-do" attitude is always a valued trait. "I can't" shows both a lack of confidence and unwillingness to take chances — neither of which will endear you to management, says Taylor.

"That's not my area." Or, "That's not part of my job."

No job description is ever set in stone. "As cross-functional teams remain the order of the day, you're expected to be flexible and make your boss' life easier," Taylor explains. "As a side note, the more skillsets you accumulate, the more indispensable you are."

Saying that you're not willing to go beyond your role shows that you are also not willing to pitch in for the success of the company, Kahn adds.

"I don't know."

You may not have the answers to every question, but your best guess and a promise to find out is much better than a shrug of the shoulders, she says. "Anytime your boss would need to do the work for you, assume that's not a path you should take."

"No."

Your cooperation is expected, and so is a polite tone. "Telling your boss 'no' is a challenge, and is sometimes necessary — but it can be inappropriate if you don't phrase it well with an explanation," Taylor says. "For example, if your boss says, 'Do you have time to work on the Smith project today?' you shouldn't just say, 'No.' Instead try something like, 'Today will be a challenge if you still want me to focus on that company presentation. Would you prefer I work on this today instead?'"

"I'll try."

Some people think that this is an acceptable response, as we all "try" to get things done to our best ability. But it leaves a manager feeling unsure, and when assignments are given, your boss is counting on you, usually with specific deadlines, says Taylor. "Imagine yourself asking, 'Will you be signing off on my paycheck on the 15^th?' and your boss responding, 'I will try.'"

"That's not what I heard."

Avoiding gossip and conjecture is a good idea, as it can backfire. If you're not sure about something, wait, or you risk appearing unprofessional. 

"How do I benefit from this?"

Sometimes your work involves helping others and other departments. Bosses have little tolerance for those who aren't team players, Taylor says.

"I'm sorry, but…" 

"The caveat essentially cancels any genuine apologetic sentiment," Taylor says. "A straight, 'I'm sorry…I'll be much more aware of this next time' is the expected response when you mess up."

"Well, I did my best."

This is a cop-out. If you made a mistake, and that was your best, that doesn't speak highly of your abilities. The better response is that you'll get it right next time.

"I'll leave."

Don't threaten to leave the company, says Kahn. It's unprofessional and they'll consider you a flight risk.

"I just assumed that…"

That phrase causes frustration for many bosses, as they'd rather hear that you made an error in judgment and learned from it, versus excuses. "To err is human, but to defer blame is a career killer," Taylor says.

"I've tried that before."  

Bosses have little tolerance for laziness. "Examine whether you really gave the option a shot before you shoot it down," she suggests. "Your boss may have something else in mind." Alternatively, explain that you appreciate the suggestion, and tried XYZ, with such and such a result — but would be glad to try something more effective.

"At my last job we did it this way."

No manager likes a know-it-all, so you must tread lightly if you think you have a better way. "You're better off phrasing sensitive or challenging responses by turning them into questions versus being confrontational," Taylor says.

"It's really not my fault; it's John's fault."

The blame game is a treacherous path. If you're innocent, then explain why. Don't implicate others if you bear the primary responsibility, Taylor says.

"Taking responsibility is key," adds Kahn. "If your always seen as someone pointing the finger, eventually your boss is going to question who is really to blame."

"[Your predecessor] did this differently/better."

"Bosses usually feel that their methods are preferred over their predecessors because they now hold the position," Taylor explains. "Unless a method is clearly a mistake, don't challenge your boss with the 'old ways of doing things' just because they made things easier for you."

"I'm bored."

"You may have a weak moment and share your boredom with the wrong person: your boss," says Taylor. "You're being paid to be productive and remain enthusiastic; it's your responsibility to find ways to make your job interesting." 

"I can't work with him/her."

"Not playing well with others" isn't good in elementary school, nor is it in the workplace. It's assumed that you are capable of getting beyond personality conflicts in the interest of delivering excellent results.

"He's a jerk."

"The golden rule is something your boss expects you to observe, and casting aspersions on others has no redeeming value. It just reflects badly on you," she says.

"If I don't hear from you, I'll just do X."

This has a threatening tone. Better to wait than be admonished later.

"Why does Jane always…?"

Whining is annoying. "If you have a gripe, better to ask how you can attain a certain privilege, and leave others out of the discussion," she suggests.

"Can I/we speak with your boss about this?" Or, "I want to speak with HR about this."

"Going over your boss' head challenges authority — a usually no-win situation, unless you're about to quit (or be terminated) and have no other recourse," says Taylor.

If you're going to HR, don't threaten in advance, she adds. "And you should avoid it unless you've exhausted all the options with your boss."

"I don't have a solution."

Don't tell the boss about problems without presenting potential solutions, says Kahn. "Leaders talk about solutions; followers talk about the problems."

"Why does John have X and I don't?"

Focus on your own career, not others' salary or promotions — unless you're witnessing blatant favoritism. "If that's the case, you can opt for a more professional discussion once you've collected your thoughts about the facts," Taylor says.

"I'm pretty busy. Can it wait?"

It's your responsibility to ask your boss if priorities have changed, as your objectives must stay aligned with your manager's. "Priorities are rarely stagnant, so as in most cases, your better option is to ask if you should reshuffle them," she recommends.

"Can I leave early today since things are slow?"

It's fine if you have to leave early. But don't say it's because "things are slow" or you have "nothing to do." "There are always more projects in the pipeline. Bosses want you to show initiative," she says.

"That's impossible."

Your manager doesn't want to hear negativity or a lack of conviction. If you have concerns, state what they are, and ask for input.

One of the best approaches in deciding whether to share your thoughts with your boss or ask sensitive questions is to put yourself in their shoes, Taylor suggests. "Do your comments and questions reflect a positive, can-do, and confident demeanor? Remember loose lips sink ships ­— so choose your words carefully when you feel challenged at work if you want to thrive in your career."

The introduction of the article

Honesty is the best policy in the workplace — with a few exceptions.

"It's important to be cautious with what you say to your boss, as even the slightest slip up could make or break your career," says Ryan Kahn, a career coach, founder of The Hired Group, and author of "Hired! The Guide for the Recent Grad." "There are the obvious things to hold back from saying to your boss, but the key is to dissect the little things in your interactions." 

Lynn Taylor, a national workplace expert and the author of " Tame Your Terrible Office Tyrant: How to Manage Childish Boss Behavior and Thrive in Your Job," agrees. "There are certain comments and questions based on negative perspectives that can set you back with your boss," she says. "If they continue unabated, these phrases can sabotage an otherwise great job." 

A good practice is to first pause before blurting out something you might regret and examine what you're trying to achieve, and the likely reaction you'll get from your boss.

"If you think you may regret it, you probably will," she says. "Better to err on the side of waiting until you can crystallize your thoughts into a more palatable and professional dialogue."

In honor of National Boss Day, which is celebrated in the US on October 16 each year, we've compiled a list of the words and phrases you should never say to your manager.

http://www.msn.com/en-us/money/careerandeducation/28-things-you-should-never-say-to-your-boss/ar-BB9tH1f

Ret. 10-16-14

ADHD and Crime

The entire article may not be helpful to mentoring or juvenile justice practitioners; however, the connection between ADHD and the prison population is worthy of note. That connection action, if and when possible in a variety of ways.

From Medscape Education Psychiatry & Mental Health

ADHD and Crime: Considering the Connections

Joel L. Young, MD

CME Released: 04/12/2010 ; Valid for credit through 04/12/2011

INTRODUCTION

Jim, age 18, was just hanging out in the neighborhood with his younger cousin, when he happened upon a very hot-looking red sports car a few blocks from home. Amazingly, the keys were in the ignition, seemingly just waiting for someone to come along. Without much thought, the adolescents jumped in the car and drove off. Several hours later, the very chagrined Jim was apprehended by the police, who were entirely unsympathetic to his explanation that he had just wanted to experience the ride; he didn't think it counted as stealing. The Court was also unconvinced, and although he had no prior criminal convictions, Jim was sentenced to 9 months in jail and 2 years probation.

As part of his sentence, the court demanded that Jim obtain a full mental health evaluation. The psychiatrist learned of Jim's chronic struggles, including poor school performance, intermittent marijuana use, and regular conflicts with authorities. After a thorough examination, the psychiatrist diagnosed attention-deficit/hyperactivity disorder (ADHD), predominantly hyperactive-impulsive type, and prescribed treatment. Within weeks, Jim noted improvements in his focus and concentration. Jim's family reported that he was decidedly less moody and impulsive. After a few months on treatment, Jim's gains solidified, and the family was convinced the intervention had averted further encounters with the criminal justice system. This case highlights the complicated relationship that individuals with ADHD have with their impulsivity and the criminal and societal implications of this disorder.

People with ADHD commit crimes for many of the same reasons as those without ADHD: Some want money or property that belongs to others and have little motivation to acquire the loot honestly. Those with ADHD also have other triggers for crimes; adolescents and adults with untreated ADHD are often bored, sensation seeking, or simply impulsive, and this combination of attributes leads them to react with poor judgment. A desired item appears, they want it, so they take it.^[1] It also appears that when individuals with ADHD commit violent crimes, these acts are more likely to be crimes of spontaneous and "reactive" aggression rather than carefully plotted out offenses. Such crimes are generally impulsive acts driven by a provocation or conflict that triggers an outburst. Research with adult male offenders seems to bear out this hypothesis.^[2]

Studies show that at least 25% of prisoners in the United States have ADHD. The recidivism rate among all felons is high, and an estimated two thirds are rearrested within about 3 years.^[3] These statistics have important implications for society at large.

WHY SHOULD WE CARE ABOUT UNTREATED CRIMINALS WITH ADHD?

ADHD among prisoners is a problem, not only for the offenders with ADHD but also for their victims who were misused violently and nonviolently. Evidence suggests that the diagnosis and treatment of ADHD could have an impact on crime rates. In 2009, the National Bureau of Economic Research^[4] sought an explanation for a decline in violent crimes starting in the 1990s; they hypothesized that there was a relationship between the increase in prescribing of newer-generation antidepressants for depression (such as bupropion) and also in the prescribing of stimulants for ADHD.

The researchers compared the rates of prescriptions for these psychiatric medications to rates of violent crimes in the United States from 1997-2004 with a statistical regression analysis.^[4] They found a significant inverse correlation; that is, as prescriptions went up, violent crimes came down. As a comparison, the authors also looked at the prescription rate of statins for cholesterol treatment and found no relationship between the number of prescriptions for statins and the crime rate.

The researchers stated, "Our evidence suggests that, in particular, sales of new-generation antidepressants and stimulants used to treat ADHD are negatively associated with rates of violent crime." They added, "To put this in perspective, doubling the prescription rate [of antidepressants] would reduce violent crimes by 6%, or by 27 crimes per 100,000, at the average rate of 446.5 crimes per 100,000 population. A similar calculation with stimulants would decrease crimes by a range of 30-38 crimes per 100,000. While doubling the prescription rates seems like a large change, it has been estimated that 28% of the US adult population in any year has a diagnosable mental or addictive disorder, yet only 8% seeks treatment."^[4]

The researchers noted that the crime rate in Canada also fell during the same time period.^[4] As in the United States, Canada was among the world leaders in treatment with new psychiatric medications. This finding asserts that identifying and treating ADHD is a win-win situation: Individuals with the condition experience the benefit of treatment, and the public is less likely to become their victims.

STUDIES ON ADHD AND CRIMINAL BEHAVIOR

In ADHD in Adults: What the Science Says,^[5] Russell Barkley and colleagues report on the Milwaukee Study, a longitudinal outcome assessment of crime and other activities of hyperactive children through the life cycle. According to Barkley, there were too many medication variations to account for treatment, but the majority had not received medication treatment for their ADHD (Barkley RA, personal communication, 2008). The authors reported on 2 separate groups of adults with hyperactivity: those diagnosed with ADHD with hyperactivity as children (H+ADHD; n=55) and those not diagnosed with ADHD until adulthood (H-ADHD; n=80). These groups were compared with a community control group (n=73). In most cases, the 2 groups of adults with ADHD had significantly higher rates of crime than the community control group, although the H+ADHD group fared worse than both other groups in terms of stealing property, selling drugs, assaulting others, and several other categories. For example, 40% of the H+ADHD group had carried a weapon illegally, compared with 20% of the H-ADHD group and 8% of the control group. Among the H+ADHD group, 58% had ever been jailed, compared with 46% of the H-ADHD group and 24% of the control group (Table 1).^[5] Clearly, ADHD is a factor in the commission of crimes.

Table 1. Crime Categories for Each Group in the Milwaukee Study

	H+ADHD (%) (n=55)	H-ADHD (%) (n=80)	Community (%) (n=73)	P Value
Stole others' property	74	58	45	.004
Stole others' money	47	42	28	NS
Robbed someone of money	7	2	1	NS
Breaking and entering	14	15	3	.021
Assaulted with fists	42	33	16	.004
Assaulted with a weapon	29	6	3	< .001
Set fires intentionally	11	9	5	NS
Carried a weapon illegally	40	20	8	< .001
Forced sexual activity	2	0	0	NS
Possessed illegal drugs	67	61	48	NS
Sold drugs illegally	40	27	19	.026
Engaged in disorderly conduct	47	34	24	.022
Arrested	73	52	33	< .001
Jailed	58	46	24	< .001

H+ADHD = adults diagnosed with ADHD with hyperactivity as children; H-ADHD = adults not diagnosed with ADHD until adulthood; NS = not significant
Adapted from Barkley RA, Murphy KR, Fischer M. ADHD in Adults: What the Science Says. New York, NY: Guilford Press; 2008:313.

In a study of 198 prisoners in a Scottish prison,^[6] Young and colleagues found that 48 subjects (24%) met the criteria for childhood ADHD. Of these 48 prisoners, 11 (23%) still exhibited fully active ADHD symptoms as adults, while 16 (33%) had partial symptoms. Thus, 55% (27 inmates) had identifiable symptoms of ADHD that persisted from their childhood into adulthood. The researchers found that these 27 prisoners with continued ADHD symptoms had perpetrated significantly more aggressive incidents than the other prisoners.^[6] Nonsymptomatic prisoners averaged 0.46 acts of physical aggression compared with 2.48 incidents among those with ADHD symptoms. The symptomatic group was also more verbally aggressive and was responsible for more incidents of property damage (Table 2). The researchers noted that the severity of aggression was nearly 12 times greater for the ADHD group.^[6]

Of interest, adults in the ADHD group appeared to externalize their anger and were less likely to be self-injurious than their non-ADHD cohorts. The study did not control for treatment, and it is unknown if appropriate intervention could have altered the findings.

Table 2. Means, Standard Deviations, Medians, and Range of Scores for Critical Incidents Within the Prison for the Nonsymptomatic and the ADHD Symptomatic Group

Critical Incidents	Nonsymptomatic Group (n=171)				Symptomatic Group (n=27)
	Mean No. of Incidents	SD	Median No. of Incidents	Range	Mean No. of Incidents	SD	Median No. of Incidents	Range
Verbal aggression	5.05	13.2	1.00	0-90	18.26	28.1	4.00	0-100
Physical aggression	0.46	0.95	0.00	0-6	2.48	5.8	1.00	0-30
Damage to property	0.39	1.2	0.00	0-7	1.59	4.7	0.00	0-20
Self-injury	0.09	0.55	0.00	0-5	0.15	0.4	0.00	0-1
Total critical incidents	6.41	13.9	2.00	0-95	23.5	33.8	8.00	0-120
Severity of aggression	0.68	1.5	0.00	0-10	4.7	12.1	1.00	0-62

SD = standard deviation
Adapted with permission from Young S, et al. Personality Individual Differences. 2009;46:267.^[6]

Adolescents and Children and Criminal Acts

Children and adolescents derive their self-esteem through succeeding in school and pleasing the adults around them. Children with ADHD are struggling with chronic symptoms of inattention, distractibility, hyperactivity, and impulsivity and frequently do not realize this satisfaction. They can become alienated or friendless, and to avoid this outcome, they learn that outlandish behavior can earn them the respect of their peers. To them, negative attention is more desirable than no attention whatsoever, and befriending "bad kids" is preferable to having no friends.

Punishment for impulsive and criminal actions can begin a cascade of decline. A young offender's introduction to the juvenile justice system exposes them to increasingly troubled adolescents who can readily offer further education about wayward activities. Preventing this destructive cycle is the fundamental reason for early identification and treatment of this population.

ADHD That Persists Into Adulthood

Until recently, ADHD was thought to be "outgrown" by the time children reached adulthood; we now know that for many, ADHD symptoms persist. Indeed, the National Comorbidity Survey Replication found that 4.4% of American adults have ADHD.^[7]

In a longitudinal study, Mannuzza and colleagues^[8] studied 207 white boys (ages 6-12 years) with ADHD.^[8] Follow-up visits were obtained at ages 18, 25, and 38 years. The analysis compared subjects with ADHD vs non-ADHD probands, revealing trouble for the afflicted group. Men with ADHD were nearly twice as likely to have been arrested (47% for the ADHD subjects vs 24% for the probands) and more than 3 times more likely to be convicted for crimes (42% for the men with ADHD vs 14% for the probands). Their rates of incarceration (15% vs 1%) were also pronounced.^[8]

Mannuzza reported other disturbing trends. Seventeen percent of the men with ADHD had committed aggressive violent offenses such as murder, rape, robbery, and arson whereas none of the probands had committed any violent acts. Given the long duration of the study, the researchers were unable to control for treatment exposure.

In a retrospective study of more than 14,000 subjects with ADHD,^[9] Fletcher and Wolfe analyzed the relationship between childhood ADHD and the commission of crimes in adulthood. The previous treatment status of the subjects, now young adults ages 18-28, was not known. Subjects were separated into the 3 subtypes of ADHD: hyperactive, inattentive, and combined. The findings were clear: compared with the general non-ADHD population, the likelihood of committing any crime was 11 points higher for those with hyperactive ADHD, 6.5 points higher for those with inattentive ADHD, and 5 points higher for those with the combined subtype.^[9]

ADHD symptoms presenting early in life carry an ominous prognosis. Individuals with ADHD symptoms evident between ages 5 and 12 years, regardless of subtype, were significantly more likely to engage in criminal activities as adults compared with those without ADHD.^[9] Individuals with the hyperactive subtype were the most likely to be arrested and convicted of a crime.^[9] Robbery and theft were associated with this subtype. By contrast, those with the inattentive subtype of ADHD were more likely than those without ADHD to commit crimes that required planning, such as burglary or selling drugs. For unknown reasons, individuals with the combined subtype had the weakest links to adult criminal behavior.^[9]

Female Criminals With ADHD

The prevalence of ADHD among incarcerated men and women far exceeds the rates among men and women in the general population. A study of 320 prisoners in Iowa found that 14.3% of the female prisoners and 23.1% of the male prisoners met the diagnostic criteria for ADHD.^[10]

In an analysis of 110 female offenders with ADHD in a German prison,^[11] Rösler and colleagues found a 24.5% lifetime prevalence of ADHD and a 10% prevalence of persistent ADHD. The inmates with ADHD were significantly younger at their first conviction (19.2 years, compared with 27 years for the non-ADHD women). In addition, the rate of diagnosis of ADHD was higher with younger age; for example, the prevalence of ADHD was 17.9% among the female inmates ages 25 and below and fell to just 10% among inmates ages 26-45 years.^[11] Why the older inmates were less symptomatic is unclear. Perhaps they were more experienced at dealing with their symptoms.

IMPLICATIONS FOR MENTAL HEALTH PROFESSIONALS

The presumption that treatment for ADHD will positively affect outcomes drives clinicians to address this population. In a meta-analysis of studies of adolescents followed for 4 years,^[12] Wilens and colleagues showed that treating adolescents with ADHD with methylphenidate significantly reduced their risk of developing a substance use disorder. Similar data regarding risk reduction are sparse in the ADHD/crime literature, but some preliminary findings are encouraging.

A Norwegian study of adults with ADHD determined the subjects' "index of burden" (IOB).^[13] The IOB is a composite of scores evaluating alcohol abuse, substance abuse, criminality, and other items. Stimulant treatment in childhood and adolescence was found to contribute significantly to a higher level of psychological and social functioning in adulthood. For example, 48% of the group that had received treatment had a 0 score on the IOB (lower scores are better). This compares favorably with the 18% of the untreated group that scored 0. This trend continues if criminality is assessed alone. Two out of 14 of the treatment group (14%) had criminal records, compared with 14 out of 59 of the nontreatment group (24%).^[13]

The Need for Continued Treatment of ADHD

While the need for chronic treatment is apparent, many factors contribute to the fall off in treatment rates as patients age. Adolescents often lack the ability to assess the positive impact that treatment offers, and they tend to devalue parental input. Adolescents and young adults have less contact with their pediatricians and suffer from this professional void. As the individual transitions into the third and fourth decades of life, Medicaid and private insurance benefits are less well-protected, and cost becomes an obstacle to access to ADHD medications and treatment. All evidence suggests that the absence of treatment is correlated with increased rates of criminal behavior.^[5,6,8-10]These findings have clear implications for public policy makers interested in criminality.

Our collective ambivalence extends to the issue of how to treat incarcerated individuals with ADHD. Prison officials may find it logically inconsistent that, on one hand, some prisoners are incarcerated for their misuse of addictive or illicit substances while, on the other hand, controlled agents are indicated for ADHD treatment. Despite this inherent paradox, more prison officials are recognizing the importance of treatment, if for no other reason than maintaining calm among closely quartered, impulsive inmates. The introduction of the nonstimulant atomoxetine, a US Food and Drug Administration-approved agent for treating adult ADHD,^[14] has also been helpful. The long-acting OROS (osmotic-release oral system) methylphenidate also has a low risk for abuse.^[15] Most recently, the introduction of the pro-drug lisdexamfetamine offers an effective, long-acting amphetamine that is activated after absorption in the gastrointestinal tract and has little potential for nasal or intravenous abuse.^[16] These novel agents and delivery systems significantly reduce the risk for stimulant misuse.

CONCLUSION

ADHD is a significant factor relating to both crime and punishment. The condition increases the risk of committing a crime, and once the individual is incarcerated, the conundrum develops regarding appropriate treatment. Evidence suggests that proper treatment may reduce the risk for criminal behavior and the rate of recidivism among afflicted criminals.

Coherent approaches to treating youth with ADHD both in and out of the criminal justice system need to be developed. Additional study will further enlighten these difficult issues. For the present, it is important for psychiatrists to consider ADHD as a valid factor in crime and the treatment of ADHD as a potentially preventive measure against the commission of violent and nonviolent criminal acts. Resolving or improving ADHD symptoms can bring relief to the individual as well as to society at large.

Supported by an independent educational grant from Shire.

http://www.medscape.org/viewarticle/719862   Ret. 7-1-14


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