ADHD Flashcards
ADHD is a dysfunction of neurotransmitters which ones 2
1 Noradrenaline and dopamine are the 2 key NT
Pre frontal cortex regulation attention /emotions/ behavior
Epidemiology
Common 5-12% of all children Most common psychiatric diagnosis in childhood Chronic condition Co morbidities is 80% of kids have them Overlap with ASD and ID common Males : females 2;1 Strong genetic link Children don’t grow out of ADHD ‘present in 2.5-5% of adults Disorder often recognized in parents when the child is diagnosed Co morbitidy common Antisocial behavior Substance abuse/ gambling Mood disorders depression/ anxiety/ BPD
Risk factors for ADHD
1 preterm
2 family history eg parents of first degree relative
3 in uterine alcohol exposure
Executive functioning in ADHD is impaired
Problems with / impairment in Organizing prioritize and activiativing work Focus. Sustaining and shifting focus Regulating alertness Managing emotions / modulating emotions Memory recall and working memory Monitoring and self regulation
How do children present with ADHD
Behavior problems Externalising hyperactive /impulsive Internalizing. Inattention disorder ( these kids get missed) Academic failure Learning difficulties Social difficulties
Diagnosis of ADHD
1Symptoms must be present >6/12
2Persistent pattern of inattention/ hyperactivity impulsivity interfering with functioning and development
3 negative impacts of social/academic /occupational
4 symptoms of impulsivity /inattention/ hyperactivity must be present <12years of age
5 clinically significant impairment in social /accademic / occupation
6 symptoms must not be accounted for by another MH diagnosis
Describe the different types of ADHD
1 combined
2 predom inattention
3 predominantly hyperactivity /impulsivity
Mild/ moderate/severe
History
Snapshot of the day
Get the history of behavioral difficulties from school parents and grandparents
Strengths and weaknesses
Overview of the inattention /hyperactivity/impulsivity
ADHD and prematurity
Born <32 weeks 4 x more likely to have inattention
7x more likely to need educational support
Examination in ADHD
Ht wt and BMI HC Dysmorphisim HEARING AND VISION Skin NEUROCUTANEIOUS CHANGES EG NF1 cafe au Kait
ADHD and neurological disorders
Epilepsy CP Hydrocephalus Brain injury eg Chemo/ trauma/ infection tic disorder 70% ADHD OCD
Dd of ADHD
Hearing and vision problems Mental health problem Neurological problem Endocrine Sleep problems ID or learning problems Chronic illness Pschological problems family stressors
Fetal alcohol syndrome
ADHD/ ODD/ID/ASD
Small head flat midline Thin upper lip Short nose Large nasal bridge
Fragile x
1/2000 ID . ASD/ADHD and epilepsy Bulk billed chromosome study Developmental delay /ID ADHD Speech language problem Long face/ prominent ears Prominent jaw
Down’s syndrome
ID language delay
