What are the baseic DSM5 Qualifications for ADHD?
Several symptoms evident by age 12
Impairment in functioning in >1 setting
6 symptoms over 6 months per category
What are the "Inatettentive Symptoms"?
Difficulty sustained attention in tasks or play
doesn't listen when spoken to directly
doesn't follow through on instructions
forgetful in daily activity
What are "Hyperactive-Impulsive symptoms"?
Fidgets or squirs in seat
leaves sit when expected to stay in it
runs or climbs in inappropriate situations
unable to play quietly
Often "on the go" as if "driven byt a motor"
blurts out answers
can't wait their turn
what things do you NOT want to miss when evaluating someone for ADHD?
ADHD is NON-EPISODIC
What is the "clinical presentation" most commonly presented for ADHD?
underperforms to his/her potential - seen as Lazy or Unmotivated
Trouble prioritizing, organizing and sequencing tasks
Can have concerns about high risk behaviors or aggression
Who is more likely to continue to have ADHD as an adult?
50% will continue it and predictors include:
- combined symptoms of hyperactive and inattentive (Hyperactive symptoms tend to get better with age)
- higher symptom severity
- comorbid depression
- Paternal anxiety mood disorder or antisocial personality disorder
What does the Pre-frontal cortex do with regards to ADHD?
Region of Cognitive control - achieving a task in the face of distractions
Executive functioing - organizing, prioritizing, and sequencing tasks
ADHD kids have difficulty with spresspression of normal activity once the task gets harder in this area
What is the Dimensional view on the cortex and ADHD and development vs the normal brain maturation process?
Normal brain maturation process has Cortical Thinning that occurs over late childhood and early adolescence
Rate of Cortical Thinning:
Slowest ADHD< ADHD Symptoms < No symptoms
What is the pattern of reward on ADHD?
ADHD kids have hypoactivity during reward anticipation and Hyper-responsiveness to rewards
They prefer smaller, immediate rewards over delayed larger rewwards
Impairments in working memory and reduced ability to inhibit responses
How to pts with ADHD Time perception differ?
ADHD affects the ability to wait/delay response and to make predictions about environment
ex. They have greater discrepancy errors when replicating a flishing light time sequence
How do symptoms change over time in ADHD?
As kids brains mature, hyperactive symptoms get better but inattentive do not.
What are the treatments for ADHD?
2) parenting skills training/behavior management (ex. smaller more frequent rewards etc)
3) Stimulants of 2 general classes: Methylphenidate or Amphetamine based