ADHD

Question 1

What are the two categories of ADHD?

Answer 1

1. inattention
2. hyperactivity/impulsivity

Question 2

How do we frame ADHD? Flu or Diabetes?

Answer 2

• like diabetes
• neurodevelopmental difference that on the level of our psychology leads to differences in executive functioning

Question 3

Diagnostic criteria for ADHD (the 3 types)

Answer 3

1. combined presentation: at least 6 symptoms in each category
2. predominantly inattentive presentation: at least 6 of the inattention symptoms
3. predominantly hyperactive/impulsive presentation: at least 6 of the hyp/imp symptoms

Question 4

What is the underlying construct of ADHD diagnoses?

Answer 4

• challenges in executive functioning
• when u have a strong feeling it is associated with action urges that can be adaptive

Question 5

what is executive control?

Answer 5

• Executive control is what allows you to not act on that action urge
• ex: knowing not to touch someone’s hair if it looks soft

Question 6

Why does the diagnostic criteria for ADHD not really capture it properly? Relating to inattention

Answer 6

Because it’s not a general inability to sustain attention, but an inability to sustain attention in activities that are not intrinsically interesting to you

Question 7

What is liekly to happen for kids as they get older, regarding the symptoms they have?

Answer 7

• it is not uncommon for younger kids to meet more symptoms in both categories and then have more on the inattentive side as they age
• kids executive functions improve within themselves as they age even if they are diagnosed with ADHD at a young age
• Inattention gets worse with age

Question 8

what are things we must see regarding the symptoms and timeline?

Answer 8

• persistent experience (more than 6 months)
• need to see history back to childhood (before age 12)
• had to be impairing (getting in the way of functioning well)

Question 9

give some examples of executive dysfunction

Answer 9

• focusing too much on one thing
• easily distractible
• trouble starting a difficult/boring task
  -daydreaming
• struggling to balance tasks

Question 10

Executive function: inhibitory control

Answer 10

• the ability to control one’s attention, behavior, thoughts, and emotions to override a strong internal predisposition or external lure, allowing one to act appropriately according to the situation
• individuals with ADHD often struggle with impulse control, making it difficult to resist distractions, interrupting tasks, or acting on impulse without considering the consequences.

Question 11

Executive function: working memory

Answer 11

• the capacity to hold and manipulate information in mind over short periods
• many people with ADHD have difficulty holding and processing information in their minds, which can affect their ability to follow multi-step instructions, organize tasks, or remember details, especially over short periods.

Question 12

Executive function: cognitive flexibility

Answer 12

• the ability to switch between thinking about two different concepts, or to adjust to changing demands, rules, or perspectives
• ADHD can also impair the ability to switch between tasks or adapt to new situations or changing rules. This inflexibility can result in challenges with adjusting plans or managing transitions smoothly.

Question 13

Prevalence of ADHD

Answer 13

• More frequent in males than females (thought to be missed in girls)
  ○ 2:1 in children
  ○ 6:1 in adults
• 7.3% of children worldwide

Question 14

Etiology of ADHD

Answer 14

High heritability - the coefficient is estimated to be high, similar to learning disabilities

Question 15

Development of ADHD

Answer 15

• difficult to distinguish before age 4
• starts with H/I symptoms and often progresses to have more inattention symptoms
• wait until age 6-7-8 and then it becomes more clear

Question 16

ADHD assessment: Questionnaire - Conners

Answer 16

Questionnaire similar to ASEBA: a bunch of items, circling different answers and end up with raw scores for subscales and compare them to a norm group

There is one for the parent one for the child and teachers
- good to see scores across different settings

Question 17

KSADS for ADHD - interview

Answer 17

structured diagnostic interview, the psychologist uses this to guide questioning
- get some more information from this
- Not compared to a norm group, just want to know if criteria are met

Question 18

What other document can psychologists look at when assessing ADHD?

Answer 18

report cards
- one report card per year back to grade 1
- The grades themselves can give us some data
- Grades are not standardized test scores - based on what the tests were that the teacher designed, based on raw scores
- A B in one school can mean a different thing than a B in another school

Question 19

What is important to look at on report cards?

Answer 19

teachers comments

ex: forgets to hand in work, doesn’t stay organized, never writes homework in his/her agenda

• evidence of problematic executive functioning

Question 20

Why should we also look at WISC and WIAT scores when assessing ADHD?

Answer 20

can give us an indication of if the child has a cognitive disability or an academic disability

…and comparing that with other tests we can see if it’s just a performance vs. knowledge thing
(knowing how to do something but not doing it)

Question 21

What has been found through a meta-analysis regarding medication and ADHD

Answer 21

medication can help compensate for those executive functioning challenges
There are large effect sizes (.8+) favoring the drug vs. placebo

• it is like putting glasses on and taking them off, no withdrawals
• dose often changes over time
  these drugs are associated with few risks

Question 22

What can parent management training be useful for, for ADHD?

Answer 22

can help with behaviors, not executive functioning