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1. ADHD
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ADHD |
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Attention-Deficit/ Hyperactivity Disorder (ADHD) ADHD Considered a severe disorder with biological underpinnings Symptoms: age-inappropriate inattention, hyperactivity, and impulsivity Associated with problems in social, cognitive, academic, familial, and emotional domains of development and adjustment History of ADHD Early 1900s- considered to be due to poor inhibitory volition and defective moral control Great encephalitis epidemic of 1917-1918 gave rise to the concept of a brain-injured child syndrome, which was often associated with mental retardation History of ADHD (cont.) In 1950s- referred to as hyperkinetic impulse disorder, motor overactivity seen as primary feature By 1970s, deficits in attention and impulse control, in addition to hyperactivity, seen as the primary symptoms Most recently, more focus on childs impulsivity ADHD: Importance to Professionals Children referred to: Pediatricians Family physicians Educators Child and adolescent psychiatrists Psychologists Neurologists Other health/mental health care professionals Most common behavioral referral to health care professionals Can be diagnosed and treated The Individuals with Disabilities Education Act mandates special education services Core Characteristics Inattention inability to sustain attention, particularly for repetitive, structured, and less enjoyable tasks inattentive behaviors may include: problems with concentration, easily distracted often seems as if child not listening disorganization, forgetfulness failure to finish assignments, frequent change in activities difficulty persisting even when child wants to Core Characteristics (cont.) Hyperactivity-Impulsivity hyperactivity and impulsivity may be thought of as a single dimension and/or as part of a more fundamental deficit in behavioral inhibition hyperactive-impulsive behavior is excessively energetic, intense, inappropriate, and not goal-directed hyperactivity-impulsivity is a specific marker for ADHD (inattention is not) Core Characteristics (cont.) Hyperactivity-Impulsivity cont hyperactive behaviors include: fidgeting, difficulty staying seated when required moving, running, climbing about excessive talking appearing as if driven by a motor impulsive behaviors include: difficulty stopping on-going behavior inability to resist immediate gratification responding too quickly interrupting others Additional Dx Criteria Excessive, long-term, and persistent behaviors (at least 6 months) Behaviors appear prior to age 7 Age-inappropriate Behaviors occur in several settings Impairment in at least 2 areas Behaviors not due to another disorder Domains of Impairment Relationships with peers & siblings Relationships with parents & teachers Academic & behavioral functioning at school Family functioning at home Leisure activities DSM-IV Subtypes Predominantly Inattentive Type Often identified later than other types Associated with academic impairment Predominantly Hyperactive-Impulsive Type More common in younger children Inattention often becomes problematic as academic demands increase Combined Type Most common subtype Limitations of DSM Criteria Developmentally Insensitive Categorical view of ADHD Requirement of an onset before age 7 uncertain (esp. ... ) Interpersonal Difficulties family problems, including negative interactions, child noncompliance, high parental control, maternal depression, paternal antisocial behavior, marital conflict problems with peers Associated with ODD, CD, anxiety, depression, and Tic disorders Why are Peer Relationships Important in ADHD? |
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Title: ADHD
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