ADHD Flashcards
Atypical development
There is a delay in the emergence of a particular behaviour
A child presents differently
Developmental disorder
Begins in the early years Can affect one single developmental area (specific disorder) Or several areas (pervasive disorder) Can continue to adulthood Can decline with age
ADHD
Those who are hyperactive or impulsive
Attention Deficit Hyperactivity Disorder
ADHD prevalence in UK
- 62% boys
0. 85% girls
Worldwide prevalence
5%
Individuals diagnosed with ADHD as children found that by age _____ only _____ retained full ADHD diagnosis
25
15%
_____ fulfilled criteria for ADHD or ADHD in partial remission
65%
Prevalence of ADHD in adults
3 - 4%
DSM-V classification of ADHD
Classified as being either inattentive, hyperactive or both
Several symptoms before age 12
Symptoms present in more than one location
Symptoms interfere with quality of functioning
Symptoms not exclusive to ADHD but not explained in a better way than any other disorder
Inattention symptoms
Often fails to give close attention to details or makes careless mistakes
Often has difficulty sustaining attention in tasks or play
Often does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish things
Often has difficulty organising tasks and activities
Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort
Often loses things necessary for tasks and activities
Is often easily distracted by extraneous stimuli
Is often forgetful in daily activities
Hyperactivity symptoms
Often fidgets with or taps hands or feet or squirms in seat
Often leaves seat in situations when remaining seated is expected
Often runs about or climbs in situations where it is inappropriate
Often unable to play or engage in leisure activities quietly
Is often on the go, acting as if driven by a motor
Often talks excessively
Often blurts out an answer before a question has been completed
Has difficulty waiting their turn
Interrupts or intrudes on others
How many symptoms are required for classification
6 or more for at least 6 months
ICD-10
European equivalent of DSM
International Classification of Diseases and Related Health Problems, 10th Revision
Co-morbidity in ADHD
Motor coordination - less coordinated
IQ - perform less well on IQ tests
Academic attainment - perform less well as they are less ready for school
Sleep - may have more sleep disturbances but need less sleep (anecdotal)
Social issues - less likely to make friends, struggle with play and waiting, more aggressive
Causes of ADHD
Genes Environment Parents Diet Neuropsychology
Genes
Highly heritable disorder
Parents and siblings of children with ADHD have a 2 to 8-fold increased risk for ADHD
Environment
Growning up in deprived institutional care may increase rates of ADHD
Children with ADHD have an atypical cortisol response to stress, cortisol decreases after stressor - could be linked to poor response inhibition in HPA
Parents
Chaotic and disorganised parenting can allow development of ADHD in predisposed individuals
Diet
No definitive link to consumption of sugar or additives
Neuropsychology - Cognitive dysregulation
ADHD child’s behaviour stems from a lack of planning, forethought and control
(Nigg, 2001)
Neuropsychology - Delay Aversion
When child has control over environment they can minimise delay by acting impulsively
When they do not have control or there are behavioural expectations on them, they can pass time by daydreaming (inattention) or fidgeting (hyperactivity)
(Song-Burke et al (1996))
Treatment of ADHD
Psychosocial or behavioural
Drugs
Psychosocial interventions
Parent training
Teacher training
Cognitive behavioural
New Forest Parent Training
Address 4 key symptoms of ADHD - Psycho-education - Parent child relationship - Behaviour training and limit setting - Attention training (Sonuga-Burke et al (2001))
Triple-P Positive Parenting Programme
17 core child management strategies
- 10 competence and development
- 7 limit setting and managing disruptive behaviour
Teacher training
Work with child and parents to set structure
Set tone of behavioural expectations
Positive reinforcement of god behaviour
Keep focus with concrete learning techniques building on creativity
Ways to speak to child in teacher training
Address child by name
Make eye contact
Saying what not why
Clear step-by-step instructions
Cognitive Behavioural
Setting rules
Clear commands
Set reasonable expectations
Using when/then to encourage good behaviour
Reward system
Change disciplinary techniques as the child gets older
Dopamine levels in ADHD
May be an imbalance of dopamine in the brain
Also may be a lack of Norepinephrine (noradrenaline)
These are related to rewards and control (dopamine) and stress (norepinephrine) and happiness
What drug is used to treat ADHD?
Methamphetamine (Ritalin)
Stimulates CNS
Increases dopamine levels - reduces hyperactivity
Difference between Ritalin and Amphetamine
Slower release
Sustained levels of stimulation
Control over dopamine levels for a long period of time
ADHD in adult life
Structure - function better in jobs with function and guidance
Jobs - artists and musicians due to increases creativity
Creativity in work - work better when allowed to develop creative approaches to work
