ADHD

Question 1

What is ADHD?

Answer 1

A co-occurring cluster of impairing symptoms relating to self regulation (executive functioning)
Triad of inattention, hyperactivity and impulsivity

Question 2

How can the symptoms of ADHD impact home/community?

Answer 2

Complicated to parent
Raised family stress levels
Increased anger and upset
Increased risk of harm (e.g. impulsive behaviour)

Question 3

How can the symptoms of ADHD impact school?

Answer 3

Barrier to learning
Frequently in trouble
Disorganisation, forgetting, losing things

Question 4

What are some co-morbid difficulties with ADHD?

Answer 4

Social communication difficulties
LD
Attachment difficulties
Mood and anxiety problems
Behavioural disorders (ODD/CD)
Substance use

Question 5

What does ADHD increase the rates of?

Answer 5

Crime
Substance misuse
Psychiatric disorder

Question 6

What is the worldwide prevalence of ADHD?

Answer 6

5.3%

Question 7

What is the sex ratio of ADHD?

Answer 7

M:F 2.5:1

Question 8

What causes ADHD?

Answer 8

Environmental Factors
Genes
Brain Structure and Function
Cognition

Question 9

What Hx is required in ADHD?

Answer 9

Parent and school reports
Screening questionnaires (SDQ, DAWBA)
Structured diagnostic questionnaires (Conners Rating Scale, ADHD rating scale)
Background information regarding risk: Family history, male gender, socioeconomic status
Careful review of differentials/comorbidities

Question 10

What examination is needed in ADHD?

Answer 10

School observation
Observation in clinic room- no other tools used clinically
Cognitive assessment possibly

Question 11

What aspects of memory is ADHD associated with?

Answer 11

Significant deficits in both executive and non-executive aspects of working memory

Question 12

What is the 1st line psychological therapy for ADHD?

Answer 12

Parent training (New forest parenting programme)
Behavioural classroom management strategies

Question 13

What is the 2nd line psychological therapy for ADHD?

Answer 13

Social skills training

Sleep and diet: eliminations and supplements

Question 14

What is the 1st line pharmacological therapy for ADHD?

Answer 14

Stimulants:
Methylphenidate (Ritalin)
Dexamfetamine
Lisdexamfetamine

Question 15

What is the 2nd line pharmacological therapy for ADHD?

Answer 15

Atomoxetine

Question 16

What is the 3rd line pharmacological therapy for ADHD?

Answer 16

Antidepressants
Antihypertensives
Antipsychotics

Question 17

What is the new forest parenting programme?

Answer 17

Week 1: (parent only) The practitioner discusses the nature of ADHD with the parent and introduces simple strategies, such as the use of praise and eye contact, to manage the child’s behaviour and attention
• Week 2: (parent only) The practitioner reviews the weekly diary with the parent and discusses the child’s behaviour. Parents learn how to develop routines, communicate clear messages, set limits and avoid confrontation
Week 3: (parent and child) Parents learn how to manage their child’s temper
tantrums and difficult behaviour through the use of firm limits and distraction
strategies
Week 4: (parent and child) Parents learn how to use time out and quiet time
effectively
Week 5: (parent only) The practitioner and parent assess the success of the new strategies
Weeks 6&7: (parent and child) The practitioner observes the parent and child interacting for 15 minutes. The practitioner then provides feedback about the quality of the interaction
Week 8: (parent only) The practitioner reviews the key messages from the
previous weeks and discusses strategies for managing behaviours that may still be
challenging

Question 18

What are some S/Es of ADHD pharmacological therapy?

Answer 18

Minor appetite and sleep reduction
Dysphoria
Anxiety
Tics

Question 19

Is medication usually effective in ADHD?

Answer 19

No