6: Treatment of ADHD Flashcards
(16 cards)
What is Evidence based treatment?
The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
How does a therapist know which treatment is gucci?
Guidelines: show what type of treatment is recommended for specific disorders
Zorgstandaard & National Institute for Health and Care Excellence (NICE)
What is effectiveness?
The extent to which a treatment achieves its intended effect in the usual clinical setting.
Pros of medication use?
- Effective in 70%
- Direct effect on symptoms and functioning
- Choice between short- and long acting formula
- Less sensitive to addiction later in life
Cons of medication use?
- Not effective in 30%
- Does not cure ADHD, when it wears out, effects stop
- Suboptimal delivery of dose and monitoring
- Effects might wear of in time: tolerance
- Long term effects not known
- Reduction of height
- Side-effects
- Forgetting to take medication
What are the criteria of NJI of levels of efficacy?
- Well reasoned: clear description of the treatment that makes effectiveness plausible
- First indications of effectiveness: two studies using pre- to postmeasurements (1 in NL)
- Good indications of effectiveness:
- Strong indications of effectiveness: two studies with strong evidence
What does medication do?
- Reduce overactivity, impulsivity and inattention
- Improve associated behaviors, including on-task behavior, academic performance and social functioning
Where does treatment start?
Psycho-education!
What’s recommended for kids?
Combi between behavioral and medication therapy
When are behavior interventions most effective?
- Psycho-education in 2 sessions (not more)
- Individual instead of grouptraining
- When CD, single parent or severe ADHD, child symptoms worsen without BI
Why study adolescents with ADHD separately?
In the adolescence there is more independence, which creates a greater demand on EF, Motivation and Timing, which can bring more problems (school, parents, friends, comorbidity)
Guidelines on treatment of adolescents with ADHD
Advise:
- CBT/skills training
- Parent/teacher training
- Medication
What can you say about motivation for treatment?
45-60% of adolescents drop out of treatment
ADHD is important predictor for dropout
What can you say about motivation for treatment?
45-60% of adolescents drop out of treatment
ADHD is important predictor for dropout
What can you say about Zelf Plannen?
Invention gericht op planning
- In high school effective, less effective in university
What are new developments?
- Planning problems in secondary school
- Treatment of planning skills at schools
- Sleep interventions for adolescents with ADHD
