ADHD Flashcards
(44 cards)
How common is ADHD?
1-5% prevalence
What are the core features of ADHD?
Inattention
Excessive activity
Impulsivity
Before which age must the symptoms of ADHD be present?
Before seven years old
What does it mean that the symptoms of ADHD are pervasive?
They must be present in more than one environment
ADHD is more common in females. T/F?
False
How do the symptoms of impulsivity present in a child with ADHD?
Poor awareness of danger Social disinhibition Excessively talkative Poor peer relationships Emotional dysregulation
Describe how attention develops over the first five years of life.
0-12 months fleeting attention 1-2 years rigid attention 2-3 years single Chanelled attention 3-4 years single focused attention 4-5 years dual challenged attention More than 5years integrated attention
What genetic syndromes are associated with ADHD?
Fragile x syndrome
Klinefelters syndrome
Williams syndrome
Children affected with ADHD are often exposed to years of negative feedback. T/F?
True
How is brain structure affected by ADHD?
Smaller brain volume mainly affected frontal and parietal cortex
Smaller basal ganglia
Right dorsolateral prefrontal lobe reduced
Smaller cerebellum vermis
What are the comorbid disorders associated with ADHD?
Sleep disorders Behavioural difficulties Specific learning disabilities Social communication difficulties Anxiety symptoms Tic disorders Mood difficulties Increase psychosocial factors
There is no specific diagnostic test for ADHD. What is involved in assessment?
Direct observations Psycho educational assessment Structured questionnaires Identifying comorbid health problems Developmental history
What factors need to be asked about in previous history with suspected ADHD?
Pregnancy Patterns of feeding, sleeping and play Activity levels Impulsivity Emotional reactivity Ability to sustain interest
Once a thorough history of ADHD is established what additional checks are required?
Hearing and vision screening tests
Examination of neurological signs and physical anomalies
Baseline height and weight
Baseline blood pressure, pulse and heart sounds
What measures can be put in place to manage the environment of children with ADHD?
Provide a calm environment without background noise
Avoid too many distracting stimuli
Initially avoid situations that require quiet, still behaviour for long periods
Maintain structure and supervision
What behavioural management strategies can be used for children for ADHD?
Waiting to get the child’s attention before giving instructions
Give clear, short direct instructions
Providing support when needed
Ask the child to repeat the instructions back to ensure they have heard and understood them
Improve concentration skills with activities the child already enjoys
Plan ahead for problem situations
Model good listening skills
Which two psychostimulants are used in the treatment of ADHD?
Methylphenidate and dexamphetamine
What second line anti ADHD drug acts on noradrenaline transporters?
Atomoxetine
What is the mechanism of action of guanfacine?
Acts as an alpha 2a adrenergic receptor agonist
What is the mechanism of action of methylphenidate?
Blocks dopamine and noradrenaline reuptake
What is the mechanism of action of dexamphetamine?
Releases dopamine stored in presynaptic vacuoles
What is the prodrug form of dexamphetamine which can be used inADHD?
Elvanse
What is the disadvantage of use of prolonged release tablet formations in ADHD?
Tablet cannot be crushed, chewed or broken before swallowing
What factors are associated with persistence of ADHD to adulthood?
Progressive reduction in cerebellum and hippocampal volumes Maternal depression Marital discord Negative parent child interaction Family socioeconomic disadvantage Familial ADHD
