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Lecture Slides - ADHD= ADHD= • • • • • Minimal...

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Unformatted text preview: ADHD= ADHD= • • • • • Minimal brain damage Minimal brain dysfunction Hyperkinetic reaction of childhood ADD (with and without hyperactivity) ADHD – Predominately inattentive type – Combined type – Predominately hyperactive­impulsive type “Sean” video clip Core symptoms: Attention Core symptoms: Attention problems • • • • • • Difficulty focusing on tasks Unable to follow instructions Makes mistakes Difficulty with organization Loses things, is forgetful Easily distractible Impulsivity Impulsivity • • • • Interrupts or intrudes Blurts out answers Difficulty waiting in lines and taking turns Acts before thinking Hyperactivity Hyperactivity • • • • Fidgety Leaves seat, climbs Overly talkative Acts as if “driven by a motor” Diagnostic criteria: Diagnostic criteria: • At least 6 symptoms of inattention or • • • • hyperactivity/impulsivity Before age 7 A persistent problem (at least 6 months) Problems evident in several settings Produces significant impairments Associated features: Associated features: • Learning problems • Peer problems – 25% of children with ADHD have a significant delay in one or more areas relative to IQ – Impaired peer relations – Association with deviant peers – Up to 50% of children with ADHD have significant conduct problems • Aggression/noncompliance Prevalence: Prevalence: • 3­5% of the general population • Much more common in boys than in girls • Boys more likely to have aggression and defiance, girls to be inattentive Diagnosis: Diagnosis: • Based on the history of the disorder • Methods used: – Rating scales (parent and teacher) – Interviews (what is developmentally appropriate?) • No medical test or lab measure to diagnose ADHD • Need to understand daily functioning Prognosis: Prognosis: • 1/3 ­> tolerable outcome­have only mild problems, but still must work hard • 1/3 ­> moderately poor outcome­will continue to have moderate to serious problems, like school or work problems, underachievement, interpersonal problems • 1/3 ­> bad outcome­severe psychopathology, criminal activity and incarceration, alcoholism Causes: Causes: • Genetic and neurobiological factors play a large role • Vulnerabilities can interact with the – ADHD runs in families environment (e.g., parenting) • Not caused by sugar or food preservatives Treatments that don’t work! Treatments that don’t work! • • • • • • • Traditional 1:1 therapy Play therapy Elimination diets (sugar, red dye) Biofeedback/attention training Allergy treatments Chiropractics Sensory integration training Treatments that don’t work! Treatments that don’t work! • • • • Treatments for balance problems Pet/art therapy Dietary supplements Vision treatments Effective treatments: Behavioral Effective treatments: Behavioral modification • • • • • • • Home or school Target behaviors are specifically defined System in place for rewards and punishments Consistent follow­through Immediate consequences Teaches skills for the future Highly effective, but difficult to do Effective treatments: Stimulant Effective treatments: Stimulant medications • Examples: Ritalin, Concerta, Adderall • Effective for about 80% of children with ADHD • Some mild and temporary side effects, like weight loss, reduced appetite, temporary growth suppression, decreased sleep • Effective just when in system Effective treatments: Combined Effective treatments: Combined treatment • Combination of meds and behavioral therapy usually has better short­term effects; hopefully long­term effects too • Need lower doses of meds; thus, fewer side effects • Important to get parents and teachers involved ...
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