ADHD Flashcards
What are the two categories of ADHD?
- inattention
- hyperactivity/impulsivity
How do we frame ADHD? Flu or Diabetes?
- like diabetes
- neurodevelopmental difference that on the level of our psychology leads to differences in executive functioning
Diagnostic criteria for ADHD (the 3 types)
- combined presentation: at least 6 symptoms in each category
- predominantly inattentive presentation: at least 6 of the inattention symptoms
- predominantly hyperactive/impulsive presentation: at least 6 of the hyp/imp symptoms
What is the underlying construct of ADHD diagnoses?
- challenges in executive functioning
- when u have a strong feeling it is associated with action urges that can be adaptive
what is executive control?
- 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
Why does the diagnostic criteria for ADHD not really capture it properly? Relating to inattention
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
What is liekly to happen for kids as they get older, regarding the symptoms they have?
- 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
what are things we must see regarding the symptoms and timeline?
- 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)
give some examples of executive dysfunction
- focusing too much on one thing
- easily distractible
- trouble starting a difficult/boring task
-daydreaming - struggling to balance tasks
Executive function: inhibitory control
- 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.
Executive function: working memory
- 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.
Executive function: cognitive flexibility
- 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.
Prevalence of ADHD
- 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
Etiology of ADHD
High heritability - the coefficient is estimated to be high, similar to learning disabilities
Development of ADHD
- 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
ADHD assessment: Questionnaire - Conners
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
KSADS for ADHD - interview
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
What other document can psychologists look at when assessing ADHD?
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
What is important to look at on report cards?
teachers comments
ex: forgets to hand in work, doesn’t stay organized, never writes homework in his/her agenda
- evidence of problematic executive functioning
Why should we also look at WISC and WIAT scores when assessing ADHD?
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)
What has been found through a meta-analysis regarding medication and ADHD
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
What can parent management training be useful for, for ADHD?
can help with behaviors, not executive functioning
