Learning disabilities 2 - ASD and ADHD Flashcards
What is ADHD (attention deficit hyperactivity disorder) ?
A problem charactersied by a traid of 3 things demonstrated across 2 or more settings (such as home and school).:
- Inattention
- Hyperactivity
- Impulsivity
ADHD can limit academic, interpersonal, and occupational success and can also lead to greater risk-taking and accidents.
When does ADHD usually present ?
- Most children are diagnosed between the ages of 3 and 7
- Signs of ADHD often reduce in adolescence but may persist into mid-adulthood
Is there a family tendency to ADHD ?
Yes - genetic and environmental factors are all risks
What other psychiatric problems are patients with ADHD more at risk for ?
- Learning difficulties
- Mood disorders such as depression and mania
- Anxiety
- Substance abuse
- Conduct disorder (disruptive and violent behaviour and have problems following rules)
- Oppositional defiant disorder (hostile, disobedient, and defiant behaviors)
- Suicide and self-harm
- Higher rates of crime in adulthood
How is ADHD diagnosed ?
ADHD is considered a behavioural disorder and is diagnosed by clinical history
Clinical history includes:
- Parent and school reports
- Screening questionnaires (SDQ, DAWBA)
- Structured diagnostic questionnaires (Conners Rating Scale, ADHD rating scale. SNAP IV)
- Background information regarding risk: Family history, male gender, socioeconomic status*
- Careful review of differentials/comorbidities
May include some examination factors such as:
- School observation
- Observation in clinic room
What are the attention deficit signs seen in ADHD ?
Unable to:
- Listen/attend closely to detail (carelessness) - makes easy mistakes
- Difficulty sustaning attention in play activities
- Follow instructions
- Finish homework (when there not doing it due to defiancy)
- Organise tasks needing sustained application
- Ignore extraneous stimuli such as noises or activity
- Remember simple tasks
What are the symptoms of hyperactivity someone with ADHD may experience
- Squiriming/fidgeting
- Always ‘on the go’ acts like driven by a motor - runs about or climbs excessively in situations which it is not appropriate
- Talks excessively
- Restless - often leaves seat in situations in which remaining seated is required
- Often has difficultly playing or engaging in lesiure activities quietly
What are the symptoms of impulsivity someone with ADHD may experience ?
- Blurts out answers before questions have been completed
- Interrupts others
- Too impatient to wait their turn or to queue
- Reckless behaviour and accident prone
- Makes important decisions without considering the long-term consequences
What is ADD (attention deficit disorder) and how does it differ from ADHD ?
Attention Deficit Disorder (ADD) is a term used for people who have excessive difficulties with concentration without the presence of other ADHD symptoms such as excessive impulsiveness or hyperactivity. The official term from the Diagnostic and Statistical Manual IV is “ADHD of the predominantly inattentive type.”
more common in girls
What is the diagnostic criteria for ADD?
- Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
- Often has trouble keeping attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often has trouble organizing activities.
- Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
- Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
- Often does not follow instructions and fails to finish schoolwork,
- Is often easily distracted.
- Is often forgetful in daily activities.
What is the treatment of ADHD ?
Pharmacological + psychological therapies
Pharmacological:
- 1st line = Methylphenidate (‘Ritalin’) or Dexamfetamine
- 2nd line = Atomoxetine
Psychological therapies:
- 1st line = Parent training (New forest parenting programme) + Behavioural classroom management strategies
What are Autism spectrum disorders (ASD) characterised by?
Now criteria is just 2 core areas of difficulties:
- Persistent deficits in social communication and social interaction
- Restricted, repetitive patterns of behaviour, interests, or activities
What are the clinical features of someone with ASD in terms of Persistent deficits in social communication and social interaction?
- Children frequently play alone and maybe relatively uninterested in being with other children. Happy with their own company.
- They may fail to regulate social interaction with nonverbal cues like eye gaze, facial expression, and gestures. Appear cool and distant and problems reading and reacting to social cues , only interested in people to meet their needs
- Fail to form and maintain appropriate relationships and become socially isolated.
What are the clincial features of ASD in relation to Restricted, repetitive patterns of behaviour, interests, or activities
- Stereotyped and repetitive motor mannerisms, inflexible adherence to nonfunctional routines or rituals are often seen.
- Children are noted to have particular ways of going about everyday activities.
What other conditions is ASD strongly associated with ?
- Intellectual/language impairment
- ADHD
- Epilepsy
