Attention Deficit Hyperactive Disorder

Question 1

Differential for ADHD

Answer 1

• Autism Spectrum Disorder
• Oppositional Defiant Disorder
• Foetal Alcohol Syndrome
• Child abuse
• Global developmental Delay
• Heraing impairment
• Obstructive Sleep apnoea
• Anxiety disorder
• Post-traumatic Stress Disorder
• Thyroid disease (hyperthyroidism)
• Diabetes Mellitus

Question 2

Risk Factors for ADHD

Answer 2

• In Foster care
• Existing diagnosis of intellectual disability (ODD< ASD, Learning disorder, anxiety
• Pre-term birth
• Family history of ADHD
• Prenatal exposure to alcohol or recreational drugs
• Low birth weight

Question 3

Baseline investigations for ADHD

Answer 3

• Audiology
• FBC
• TFT

Question 4

Non-pharmacological Management of ADHD

Answer 4

• Implement positive behaviour system
• Set clear consistent rules for whole family
• Ignore minor attention-seeking behaviour
• Use consequences on same day of poor behaviour
• Set apart regular one-on-one time
• Keep instructions brief and clear
• Maintain consistent routine
• Build rest breaks into activities
• Make eye contact when giving instructions
• Tap on shoulder of person to get attention.

Question 5

Pharmacological Management of ADHD

Answer 5

Stimulants increasing noradrenaline and dopamine at the synapse
- Avoid use below 4yo

• Methylphenidate
• Dexamphetamine
• Atomoxetine

SE: Poor weight gain, decreased appetite, headache, stomach aches, insomnia, irritability, Growth stunting

Fish oil sometimes suggested for ADHD but unclear evidence of benefit.