ADHD Flashcards

1
Q

ADHD is a persistent pattern of

A

inattention and or hyperactivity - impulsivity

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2
Q

how long must symptoms perist for?

A

at least 6 months

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3
Q

criteria

A

interfers with function or development, several symptoms noted prior to age 12
present in 2 or more settings

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4
Q

criteria for Inattention

A
  • lack of attention to detail
  • difficulty staying on task
  • trouble listening
  • problem with follow through
  • poor organization
  • avoids/dislikes tasks that require sustained mental effort
  • trouble keeping track of things necessary for tasks/activities
  • easily distracted
  • forgetful in daily activities
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5
Q

hyperactivity-impulsivity criteria

A
  • fidgets/squirms
  • leaves seat when you should be seated
  • runs/climbs when inappropriate
  • unable to play quietly
  • “on the go”
  • talks excessivley
  • blurts out answeres
  • difficulty waiting turn
  • interrupts or intrudes on others
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6
Q

diagnosis - innattentive

A

6/9 symptoms (5/9) if 17 or older

fewer than 6 hyperactivity

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7
Q

diagnosis - hyperactive/impulsive

A

6/9 symptoms (5/9) if 17 or older
fewer than 6 inattention
mostly preschoolers

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8
Q

contemporary model of ADHD

A

problem of executive functions of the brain

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9
Q

executive functions

A

higher cognitive process

involves communication and organization across multiple brain regions/pathways

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10
Q

executive function ROLE

A

plan and complete a task, multitask
keep track of time, differentiate among conflicting thoughts, filter out unimportant information, anticipate future consequences of current behavior/activities, work toward a defined goal, make mid-course corrections when thinking, reading, writing, inhibit impulses that could lead to socially unacceptable problems

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11
Q

problems when executive function isn’t working

A

significant problems learnign
cant get tasks done
difficulty controlling emotions
struggles with social functioning

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12
Q

what can cause executive function to be impaired

A

prenatal exposure to drugs, pregnancy complications, frontal lobe injury, stroke, Alzheimers, dementia, many medical conditions

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13
Q

ADHD represents and EXTREME in

A

inefficiency in executive function

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14
Q

common comorbitd contiditions in children

A
oppositional definat disorder
conduct disorder
anxiety
depression
autism
learnign disabilites
bipolar
speech/languae
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15
Q

genetic factors

A

elevated risk of ADHD among biological relatives
twin studies suggest 60-80% heritability
abnormality with the DRD4 dopamine receptor gene

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16
Q

neurological factors

A

cerebral blood flow reduced in frontal lobes, striatum, cerebellum, reduced brain volumes of anterior frontal lobes, deficits in DA and NE

17
Q

dopamine is predominately present in

A

hyperactive/impulsive
changes in DAT
reduces DA in brain
treatment? stimulant medications to block DAT and increase DA

18
Q

NE is predominately present in

A

inattentive
changes in NET
reduces NE levels in brain
treatment? nonstimulant to block NE transporter so increases NE

19
Q

Neuropsychological deficits

A
behavioral inhibition
sustained attention
resistance to distraction
working memory
internalization of language
planning
emotional self-regulation
20
Q

comprehensive assessment

A

collect info from multiple settings (parent, teacher, child care)
assess for comorbid conditions
assess impact on family, social and academic functioning
rule out other causes

21
Q

assessment should include

A

parent, child interviews, bio-psycho-social assessment interview including family history, parent and teacher rating scales and self-report

22
Q

multidisciplinary assessment

A

rule out any unusual medical conditions that might produce ADHD like symptoms (standard pediatric exam, neurodevelopmental screening) + vision, hearing, speech and language assessment

23
Q

psychological assessment tools - intelligence testing

A

Wechsler intelligence scale for children

24
Q

psychological assessment tools - achievement testing

A

Wechsler individual achievement test

25
Q

psychological assessment tools - some tests of executive functionings

A

wisconsin card sorting test, category test, trail making test

26
Q

structure of assessment

A
  1. prior to meeting mail rating scales to parents and teachers
  2. session 1 test the child
  3. session 2 interview parent
  4. decision making, feedback, recommendations
27
Q

questions to ask yourself

A

are there enough ADHD symptoms, do they cause impairment? present to age 12, any other explanation? comorbid conditions?

28
Q

gender differences

A

gender differences

29
Q

girls diagnosed later than boys

A

,silently suffer, more likely to have inattentive presentation and puberty is catastrophic because DA covaries with estrogen