ADD/ADHD Flashcards
How is the brain involved in ADD/ADHD
- right hemisphere dysfunction in the behavioral and attention areas
- anterior and superior frontal regions
- may be some posterior region involvement as well
- basal ganglia including the caudate nucleus and globus pallidus
What is ADD
- originally names minimal brain dysfunction
- a neurodevlopment disorder that includes immaturity of emotions, control of activity, and behavior
Academic picture of someone with ADD
disabilities related to:
- communication skills needed for reading, math, and writing
- inability to maintain attention and concentration
- inability to blend auditory and visual cues necessary for language development
- simply attention problems without hyperactivity
what are the subgroups of ADD
- attention deficit with hyperexcitability (ADHD)
- ADHD and austism (ADHD-ASD)
- ADHD and aggressivity (ADHD-A)
- ADHD and seizures (ADHD-S)
What are some co-morbidities assoicated ith ADHD
- oppositional defiant behavior
- ASD
- anxiety with agressive behaviors towards self or others
- hearing or visual neurosensory learning differences assoicated with dyslexia, dysgraphia, cognitive deficits
- anorexia or hyperphagia
- social isolation
- pulmonary disease
- genuinely valgus
- pes planus
factors assoicated with ADHD
- prematurity/low birth weight
- perinatal hypoxia
- maternal hx of placenta previa
- diabetes
- stress
- HTN
- anxiety
- depression
- poverty
DSM-V criteria for ADHD
- inattention: 6+ symmptoms of inattention children up to age 16 or 5+ >17 years old
- hyperactivity and impulsivity: same criteria as above
Who makes the ADHD diagnosis
- psychologist or psychiatrist
- primary care physician (pediatrician)
who contributes to the diagnosis of ADHD
- parents
- teachers
- daycare staff
- private babysitters
- etc
how does the moro reflex relate to ADHD
- should be inhibited at 4 months and replaced by startle
- if it persists can be assoiated with hypersensitivity, hyperreactivity, poor impluse control etc
How does symmetric tonic neck reflex relate to ADHD
- if not integrated can cause a poor ability to sit still and concentrate
How does spinal galant reflex related to ADHD
- should be inhibited between 3-9 months
- ability to sit still, pay attention can be caused by this reflex persisting
categories of Medications used in the treatment of ADD and ADHD and what drugs are commonly prescribed
- stimulants: methylphenidate, amphetamine
- non-stimulants: norepinephrine reuptake inhibitor, alpha agonist
drugs common prescribed: adderall, strattera, ritalin, concerta
Considerations in the use of medications for ADD/ADHD
- 6 years old is conisdered the youngest age at which medication should be used
- long acting or sustained release medications eliminate need to administer additional medication during the day
- LA and SR medications less likely to cause obvious behavioral changes during the school day
- stimulants are generally prescribed; therefore the childs weight must be monitored carefully
- potential for abuse of stimulants if dosing and access are not carefully monitored
Considerations for medication use in ADD/ADHA in adults
- potential for abuse of stimulants
- problems sleeping and headaches
- cardiac issues: tachycardia, palpitations, increase BP
- neurological issues: hallucinations, psychosis, tics, seizures
what are some issues with adults taking strattera for ADD/ADHD
- GI: dry mouth, nausea, vomiting, significant liver problems
- suicidal thoughts
- headahces
- changes in libido
- sexual dysfucntion
- menstrual changes
- irritability
treatment strategies for children ith ADHD
- praise the child
- express your displeasure with child’s behavior not the child
- develop and maintain a schedule
- a place for everything and everything in its place
- specific place for homework with necessary supplies organized and available
- length of time to focus and length of rest between sessions
Treatments for the adult with ADHD
- daily schedules/routines
- TO DO list
- calendars
- reminder notes
- keys, wallet, backpack, bills, and important papers in same place and labelled
- schedule large tasks in small steps
