Cooley: Neurodev. Disorders and ADHD Flashcards
Females with ADHD present more commonly with which subtype; why is this a problem?
- Inattentive subtype
- Less disruptive behavior in females may contribute to referral bias causing under identification and lack of tx
What is the tourette’s syndrome triad?
How is gender assc?
- Tics
- ADHD
- Obsesseive compuslive sx’s (OCS)
Girls: more likely to have tics and OCS
Boys: more likely to have tics and ADHD
Which other disorder needs to be considered in both the initial assessment and ongoing management of children with ADHD?
Chronic Tic Disorder
ADHD is an information processing dysfunction in what 2 brain locations?
Primarily due to deficinecy of which 2 NT’s?
- Within prefrontal cortex: executive functioning impairment
- Dorsal anterior midcingulate cortex
- Deficiency of dopamine and norepinephrine
According to the DSM-5 how many sx’s should a child vs. patient >17 y/o have for making dx of ADHD?
- Children: should have 6 or more
- Adults: should have at least 5 sx’s
According to the DSM-5 what are 9 sx’s of the inattentive type of ADHD?
- Fails to give close attention to details or make careless mistakes
- Difficulty sustaining attention
- Does not appear to listen
- Struggles to follow through on instructions
- Difficult with organization + loses things + easily distracted
- Avoids or dislikes tasks requiring a lot of thinking
- Is forgetful in daily activities
According to the DSM-5 what are the sx’s that fit the hyperactive type of of ADHD?
- Fidgets in chair
- Hard time staying seated
- Runs excessively
- Talks excessively
- Blurts out answers
- Hard taking turns
What are the clinical practice guidelines for treating preschool-aged children (4-5 years of age) with ADHD?
- Prescribe evidence-based parent- and/or teacher-administered behavior therapy as the 1st line tx
- Prescribe methylphenidate if the child continues to have moderate to severe sx’s
What are the clinical practice guidelines for treating elementary school-aged children (6-11 years of age) with ADHD?
- Preferably both medication and behavior therapy should be used together
- Evidnce is particularly strong for stimulant medications
What is a potential AE associated with Bupropion?
↑ risk of seizure
Which stimulant used for ADHD is a re-uptake inhibitor of catecholamines AND also releases catecholamines?
Amphetamines
Dx for pt unable to undergo systematic assesments of intellectual fxn
Global developmental delay
Dx of disturbances in nml fluency and motor production of speech. Might have marked recurrences of syllable repetitions.
Childhood-onset fluency (stuttering)
Dx for difficulties in the use of language across all modalities: spoken, written, etc.
Language disorder
Dx for difficulty with speech sound production that interferes with speech intelligibility
Speech sound disorder
Dx for difficulties in social use of communication
Social (pragmatic) communication disorder
Most autistic kids have this
What are the 2 FDA approved meds for irritability and aggitation assc w ASD?
- Risperidone
- Aripiprazole
Which ADHD med binds to DA transporter, inh DA reuptake? For adults only
Modafinil
Dx when coordinated motor skills are substantially below pt’s age. Manifests as clumsiness.
Developmental Coordination Disorder
Dx for purposeless motor behavior (head banging) that interfers with life activities. Not explained by another neurodevelopmental disorder.
Stereotypic Movement Disorder
Tourette’s syndrome meds
- Antidopaminergic drugs: only approved drugs in USA (haloperidol)
- DA depleters: inh VMAT2
- Antipsychotics: fluphenazine and risperidone
- Alpha agonists: clonidine
- Botulinum injection
- Anticonvulsants
Dx for vocal OR motor tics (not both) that have lasted for >1yr. Onset before age 18.
Persistent Motor/Vocal Tic Disorder
