Transcript Attention Deficit /Hyperactivity Disorder

Attention Deficit /Hyperactivity
Disorder
Diagnosis and Treatment
ADHD Overview
• -3-10% of school age children
• -Male to female ratio 3:1
• -Known genetic and environmental
contributions
• -Co-occurs or masquerades as mood,anxiety
,conduct disorders
• -80% ADHD children grow into ADHD adults
• -Untreated have higher risk for school /work
problems and underachievement
• -ADHD adolescents more likely to use
substances and drop out of school
ADHD Diagnosis
• -No specific biological marker/test
• -Purely behaviorally defined
• -Get patient/family/teacher
history(Vanderbilt Rating Scales)
• -Interview and exam
• -Psychological testing may be needed
Diagnostic Criteria
• -6 or more symptoms of inattention
and/or hyperactivity-impulsivity
• -Persistence for at least 6 months to a
degree that performance at home or
school adversely effected
• -Symptoms usually begin before 7 yo
Symptoms of Inattention
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-Frequent or careless mistakes
-Difficulty sustaining attention
-Difficulty following instructions
-Difficulty completing tasks
-Poor organizational skills
-Distraction by minimal extraneous stimuli
-Forgetfulness
Symptoms of Hyperactivity
and Impulsivity
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-Restlessness and fidgeting
-Difficulty sitting still
Extreme degree of motor activity
-Excessive talking
-Interrupting
-Intrusiveness
-Difficulty in working quietly
Associated symptoms
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-Overemotionality
-Academic underachievement
-Low self esteem
-Interpersonal Difficulties
Comorbid Conditions
• -Behavioral disorders:oppositional
defiant/conduct disorders 30-50%
• -Depression 30%
• -Bipolar disorder 20%
• -Anxiety disorder 25%
• -Learning disorder 25%
• -Tic disorder 20%
Management of
ADHD/Educational
-Identify learning disorders
-Appropriate academic placement
-Diagnosis of ADHD confers eligibility for
special education services
-Goal is for more on task behavior and
less disruption in the classroom
Management of
ADHD/Behavioral
• -Identify any comorbid psychiatric conditions
• -Investigate psychosocial factors-home
situation
• -School psychologist may contribute with
further testing
• -Work with students on
organizational/planning skills
Management of
ADHD/Medical
• -Reserve medication for those who
have not succeeded with behavioral
interventions and have functional
impairment
• -Stimulants and Non stimulants
• -Usually see response in 1-2 weeks
Treatment Goals
• Improved attention:
Task completion
Accuracy
Memory
Organizational skills
Following through on directions
Treatment Goals
-Decreased impulsivity/hyperactivity
Decreased aggression/defiance
Improved compliance/rule following
Decreased fidgeting and restlessness
Decreased talking out of turn
Results
• -Improved behavior and productivity
• -Improved academic performance
• -Improved peer status and social
relations