Attention Deficit Hyperactivity Disorder

1. Attention Deficit Hyperactivity Disorder Ricci, pp. 1901-1903

2. Manifestations of ADHD • One of most common mental health disorders in children • Developmentally inappropriate degrees of • Inattention • Impulsiveness • Distractibility • Hyperactivity

3. Manifestations • Frequently associated with learning disabilities in reading, writing, reasoning, or math skills • Causes problems with socialization and relationships. • Child frequently is noncompliant causing disruption with rules and demands by others • Many have comorbidities such as hearing problems, depression, anxiety, and defiant disorder • Child may also have feelings of low self-worth

4. Diagnostics • History must reveal manifestations before age 7 years and persist longer than 6 mo • Must be present in at least 2 settings • Other causes must be ruled out such as head trauma, lead intoxication, or MR • Manifestations may be numerous or few or mild or severe (Box 52.3)

5. Diagnostics • Testing may be done in intelligence (IQ), hand-eye coordination, vision and hearing, comprehension, and memory • Restless behaviors may be noted during diagnostic exams. • Behavioral checklists should be completed by parent and teacher and compared by HCP

6. Pharmacological Management • Stimulants: take in the morning with or after meal • Ritalin, Dexedrine, Adderall, Vyvanse • Non-stimulants: • Strattera • May need pharm treatment for depression and anxiety as well.

7. Management • Behavioral therapy—time-out, + reinforcement, reward/withdrawal system, tokens • Decrease stimulation and distraction • Limit-setting • Increase consistency and establish routines in school and at home—need parent training with professional therapist • Individualized Education Plan (IEP) for improving school success