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Unformatted text preview: ADHD= ADHD=
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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
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Difficulty focusing on tasks Unable to follow instructions Makes mistakes Difficulty with organization Loses things, is forgetful Easily distractible Impulsivity Impulsivity
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Interrupts or intrudes Blurts out answers Difficulty waiting in lines and taking turns Acts before thinking Hyperactivity Hyperactivity
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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!
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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!
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Treatments for balance problems Pet/art therapy Dietary supplements Vision treatments Effective treatments: Behavioral Effective treatments: Behavioral modification
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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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- Fall '09