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CPS mental health/psych statements > ADHD > Flashcards

ADHD Flashcards

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1
Q

Definition of adhd

A

a persistent pattern of inattention and/or hyperactivity that interferes with functioning or development and negatively impacts directly on social and academic/occupational activities.

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2
Q

estimated world wide prevalence of ADHD

A

3.4%

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3
Q

number of children who’s ADHD symptoms persist into adulthood

A

50%

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4
Q

is ADHD genetic

A

highly! gene variants predicting risk fo ADHD are important for brain development, cell migration and catecholmine recepto/transporter genes.

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5
Q

name the non-inheriteded neurological factors associated with ADHD development

A 
pregnancy and birth complications
use of marijuana in pregnancy
prematurity
alcohol/tobacco exposure in utero
low birth weight
HIE
epilepsy
traumatic brain injury
exposure to environmental toxins (lead, pesticides)
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6
Q

Differences in structure of brain of children with ADHD

A

structural development and functional activation of prefrontal cortex, basal ganglia, anterior cingulate cortex and cerebellum
delay in cortical maturation has been documented, (peak thickness occurs in children with ADHD at 10 years and thos without at 7 years)

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7
Q

ADHD screening tools validated for preschool children

A

Conner’s

ADHD rating scale IV

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8
Q

before diagnosing ADHD in preschoolers, the following is recommended

A

parents enroll in parent training program. can help parents develop age appropriate developmental expectations and management skills for problem behaviours

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9
Q

List 5 rating scales that can be used to screen ADHD in children and adolescents

A

Snap IV 26
Weiss functional impairment rating - parent
weiss symptom record
Caddra teacher assessment form (there is also a self rating one for adolescents)
Caddra patient adhd medication form

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10
Q

List DSM 5 criteria for ADHD diagnosis

A
  1. symptoms severe, persistent (onset before age 12 > 6 months), inappropriate for age and development
  2. Symptoms associated with impairment in academic achievement, peer and family relations and adaptive skills
  3. symptoms occur in 2 or more settings
  4. specify type of ADHD (need 5 or more)
    i) comorbid (i.e. combined)
    i) inattentive
    iii) hyperactive-impulsive
  5. current severity (mild, moderate, severe)
  6. not due to GMC or other psychotic disorder and are not explained better by other mental disorder)
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11
Q

List 8 conditions commonly misdiagnosed as ADHD

A 
Learning disorder
Sleep disorder
Oppositional defiant disorder
intellectual disability
language disorder, conduct disorder, mood disorder
anxiety disorder
ASD
Developmental coordination disorder
Epilepsy (2-3 higher risk in this population to have comorbid ADHD)
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12
Q

rate of comorbidity with ADHD for disruptive behaviour disorders

A

this includes conduct and ODD which can have ADHD comorbidity in 90% of cases

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13
Q

anxiety and ocd disorder comorbid rate with ADHD

A

present in about 30% of patients with ADHD

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14
Q

List common comorbidities with ADHD

A 
ODD /conduct
Anxiety/OCD
Bipolar disorder
substance use disorder
Tic disorder
Developmental coordination disorder
learning disorder
eating disorders
ASD
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15
Q

most common area of delay for children with ADHD and developmental coordination disorder?

A

Fine motor delays often most impaired area of motor performance

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16
Q

Rate of comorbidity for learning disorders in ADHD

A

30%

17
Q

recommendations for non pharmacologic care for children with ADHD that are evidence based

A
  1. organizational skills training
  2. psychoeducation (improvement in parent reported symptoms and prosocial behaviour)
  3. parent behaviour training
    (improvement in conduct problems)
  4. classroom management (teachers set rules/expectations, individual praise and attention)
  5. daily report card (psychological consult improved compliance with classroom behaviours)
18
Q

recommendations for providing non-pharmacologic options

A

should be individualized
have specific goals
follow thorough evaluatoin of comorbid conditions and be appropriate for age

19
Q

first line treatment for preschool aged children with ADHD (i.e. younger than age 6)

A

parent behaviourd/skills training, since overall evidence for effectiveness of stimulants in this age group is weak and thus not health canada approved

CPS mental health/psych statements (6 decks)

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