ADHD Flashcards
What is the core diagnostic criteria for ADHD?
Impulsivity, inattention and hyperactivity
Careful history, collateral and observations from school and clinic
Rating scales e.g. Conner’s
Screen for comorbidity and organic causes
What are the features of inattention?
Carelessness
Inability to follow instruction
Struggle to finish tasks
Loses/forgets things
What are the features of hyperactivity?
Squirming/fidgeting On the go all the time Talks incessantly Restless No quiet hobbies
What are the features of impulsivity?
Blurts out answers Interrupts others Cannot take turns Intrudes on others Poor road safety
Why is the diagnosis of ADHD delayed until school entry age or later?
Locomotor hyperactivity at an early stage abates with time
What are the differentials for ADHD?
Age-appropriate behaviour
Low (or high) IQ
Hearing impairment
Behavioural disorders
What is ADHD associated with?
Conduct disorder and other disruptive behaviour disorders
Victims of assault
Suicide/self-harm
What is the prognosis for children diagnosed with ADHD?
Signs often attenuate during adolescence, but may persist to mid-adulthood
By age 18
- 1/3 have no symptoms
- 1/3 have symptoms, but don’e need medication
- 1/3 still need medication
What are the non-pharmacological treatments for ADHD?
Booklet to parents on positive parenting and behavioural techniques
Moderate ADHD - parent training/education programmes
Older children may benefit from CBT
Describe the pharmacological treatment of ADHD.
1st line: methylphenidate
2nd line: atomoxetine
(Both first line in severe ADHD in school-age children)
In what forms is methylphenidate available? Which one might be better?
Immediate release (lasts 4 hours) Modified release (lasts 12 hours)
The modified release is better tolerated and allows the child to last an entire school day
Why is it recommended that ADHD medication is not given over the weekends/holidays?
The medication reduces appetite and therefore, suppresses growth. Drug holidays allow time for growth.
Why should caution be taken when prescribing methylphenidate?
It is a controlled drug due to its street value as a drug of misuse (continue amphetamine). Need to check for substance misuse before prescribing.
How long does atomoxetine take to reach full efficacy?
6 weeks
And has lasting effects even on withdrawal
