Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder often first diagnosed in childhood. Children with ADHD may have trouble paying attention, difficulty getting along with others or a tendency to squirm or fidget. Once a child has a diagnosis of ADHD, they can be treated with behavior therapy, now available through UofL, and medication prescribed by a physician.

UofL faculty member and ADHD specialist Paul Rosen, associate professor in the UofL Department of Psychological and Brain Sciences, and his colleagues are providing behavioral therapy based on an affordable sliding-scale fee thanks to $20,500 in funding received from the .

 “The need for ADHD services usually increases substantially a few months into the school year as teachers get to know the students and recognize when they are having problems,” Rosen said. “The first months often are when they fall behind their classmates and once they fall behind, untreated ADHD makes it much harder for them to catch up. The sooner we can get kids evaluated and treated for ADHD, the sooner we can help them and the better they will do.”

The behavioral treatment will help children and adolescents age 6-17 with ADHD learn to manage frustration and emotions and improve organization skills, as well as provide counseling and therapy.

The UofL ADHD Evaluation Service was launched earlier this year, offering affordable ADHD evaluations that can be started immediately and completed in one to two weeks. Families can access either service via the . Services are available both in-person and fully online, making it possible for the team to work with families anywhere in the Kentuckiana region.

A parenting support group also is planned for launch in the next few weeks.

Attention-deficit/hyperactivity disorder is a common neurodevelopmental disorder often first diagnosed in childhood. Children with ADHD may have trouble paying attention, difficulty getting along with others or a tendency to squirm or fidget. Once a child has a diagnosis of ADHD, they can be treated with behavior therapy and medication, but evaluations can be costly and it may take months to get an appointment.

UofL faculty member and ADHD specialist Paul Rosen, associate professor in the UofL Department of Psychological and Brain Sciences, has launched the UofL ADHD Evaluation Service which provides children ages 6 through 17 with ADHD evaluations in just a few weeks. The evaluations are conducted by Rosen and his colleagues. With support from the , evaluations are available to any family based on a sliding scale, with fees for most families ranging from $10 to $100.

“There clearly is a demand for this service. Traditional evaluations can take much longer and be cost prohibitive for some parents if they are uninsured or have high-deductible policies,” Rosen said. “If a child needs help, parents can contact us and within two to three weeks have a report in hand to take to their doctor or school and get the intervention process started.”

The evaluations can be conducted entirely online. The family completes an initial questionnaire, then participates in a single two-hour virtual or in-person visit with the psychologists. Using research-based templates, a customized report is provided to the family with recommendations tailored to the child’s individual needs.

“We specialize in ADHD and are aware of certain issues that are associated with ADHD – behavioral issues, trouble dealing with emotions, trouble focusing on schoolwork or other factors,” Rosen said. “We provide detailed recommendations for school accommodations. The parents can take this report to the school to get services for their child. School accommodations can be very effective at helping kids with ADHD succeed.”

Fully virtual evaluations are available for those with transportation concerns or who live outside Louisville, making travel difficult.

This fall, the group also will begin a tailored treatment program for children and adolescents with ADHD offering frustration and emotion management training, organization skills training, counseling and therapy for children and adolescents and a parenting support group.

To learn more about the ADHD Evaluation Service or to request an evaluation, visit the .

UofL School of Public Health and Information Sciences researcher Kristina Zierold, PhD, associate professor in the Department of Epidemiology and Population Health, is one of just a few scholars in the United States investigating the health impacts from exposure to coal ash.

Coal ash is generated when power plants burn coal for energy. It includes many elements, but fly ash, which is comprised of small, spherical particles, is the greatest component. The composition of fly ash varies, but it frequently contains toxic metals such as arsenic, cadmium, chromium, copper, lead, manganese, mercury; polycyclic aromatic hydrocarbons (PAHs); and radioactive elements.

Most coal ash is stored in open landfills or ponds, and because it is not classified as a hazardous waste, there are limited federal regulations that govern its use, storage or disposal.

“Children are exposed to fly ash through inhalation and ingestion from fugitive dust emissions that come from power plant emissions, landfills and sludge ponds, putting these children at risk of developing emotional and behavioral issues such as attention-deficit/hyperactivity disorder (ADHD), and neurobehavioral performance problems like the ability to concentrate,” Zierold said.  

An estimated 1.54 million children in the United States are exposed to coal ash. Kentucky ranks in the top five states for the amount of ash generated and ash storage, according to a .

Study details

Zierold is recruiting 300 children ages 6-14 who live in neighborhoods located between 150 feet and a 10-mile radius of coal ash landfills and ponds in Louisville. Specific zip codes include: 40109, 40118, 40177, 40211, 40214, 40215, 40216, 40258, 40272.

The research team will conduct in-home air sampling to determine the presence of fly ash and metals. Parents will be asked to fill out questionnaires that will help characterize environmental exposure history and health history of the children.

In addition, researchers will collect toenail and fingernail clippings of children to test the level of metals such as manganese, chromium, and lead found within the children’s bodies. Children also will be asked to take tests on a computer to evaluate neurobehavioral performance.

All testing will be completed within the homes of those who take part in the study, which allows for one child per household. Parents will receive a $100 Visa gift card and the participating child will receive a $25 Visa gift card.

As the study progresses, Zierold plans to provide community members with the findings, both through direct contact and through community meetings. Upon completion of the study, Zierold will evaluate the relationships between coal ash and emotional and behavioral disorders and neurobehavioral performance.

More information also can be found on the .