Week 1 - ADHD Flashcards
What is the male to female ratio of hyperkinetic disorders?
3-4:1
What are the core features of ADHD?
Inattention and lack of persistence in activities requiring concentration.
Excessive activity
Impulsivity.
What are the clinical features of ADHD?
Apparent before the child is age 7 years.
Excessive for the child’s age and development.
Pervasive i.e. evident in more than 1 environment e.g. at home and in school.
Symptoms may worsen in the afternoon.
Which genes are related to susceptibility of ADHD?
DRD4 SLC6A3/DAT1 DRD5 SLC6A4/5HTT HTR1B
What are the changes in the brain in people with ADHD?
Smaller brain volume - frontal and parietal cortex.
Smaller basal ganglia.
Right dorso-lateral prefrontal lobe reduced.
Smaller cerebellar vermis.
Attentional systems involve - anterior fronto-striatal networks
Posterior parieto-cerebellar circuits.
Which executive difficulties are associated with ADHD?
Organisation Planning Working memory Attention Response inhibition Impulse control.
Which comorbid disorders are associated with ADHD?
Sleep disorders Behavioural difficulties Specific learning disabilities Development co-ordination disorders Social communication difficulties Anxiety symptoms Tic disorders Mood difficulties Increased psychosocial factors.
What does assessment for ADHD include?
Direct observations in >1 setting. Psychoeducational assessment. Structured questionnaires. Identifying co-morbid (mental) health problem Developmental history Develop a formulation
What kind of information should be asked of parents?
Current behaviours Ability to sustain interest Eating and sleep habits What is the impact? Responses to interactions with others Parental management strategies Structured questionnaires
Which additional assessments should be taken when diagnosing ADHD?
Hearing and vision screening checks.
If appropriate to previous health problems, e.g. cardiac or epilepsy.
Screening for neurlogical signs and physical anomalies.
Baseline height and weight
Baseline blood pressure and heart sounds.
What is the non-pharmacological management of ADHD?
Provide a calm environment.
Avoid too many distracting stimuli when you want the child to concentrate.
Initially, avoid situations that require quiet, still behaviour for long periods.
Maintain structure and supervision longer than you think should be necessary.
What kind of information should be given at behaviour training programmes?
Encourage consistency in managing less desirable behaviour.
Do not personalise the behaviour problems.
Positively reinforce appropriate and acceptable behaviour.
Assist parents tob e firm and in control without being coercive.
Provide feedback using direct observation of interactions between child and parents.
What are the main pointers for behavioural management?
Do not give instructions without first gaining the child’s attention
Give clear direct instructions
Ask the child to repeat the instructions back to ensure they have heard & understood them
Improve concentration skills with activities the child already enjoys
Try and plan ahead for problem situations
What is meant by pharmacokinetics?
What your body does to the drug.
What is meant by pharmacodynamics?
What the drug does to your body.
What is meant by bioavailability?
Fraction of the administerd dose of drug that reaches the systemic circulation. expressed as letter F. Affected by many factors.
What is meant by clearance?
Volume of plasma cleared of drug per unit time.