ADHD

Attention Deficit Hyperactivity Disorder

 Overview

The three different types of ADHD What are the treatments?

Symptoms/Di History/Medical
Different Types Treatment
agnosis Advancements

What are the symptoms and how is What is the history of

it diagnosed? ADHD(documentation), and what
is the future?
The 3 Different
Types of ADHD
◦ Predominantly Inattentive Presentation:
This type makes it hard to organize/finish
tasks, pay attention to detail, and gets easily
distracted/forgets details of daily routines
◦ Predominantly Hyperactive-Impulsive
Presentation: This type usually fidgets and
talks a lot, it’s hard to sit still/feels restless
and has trouble with impulsivity
◦ Combined Presentation: This type is a
combined representation of the first 2 types,
where symptoms of the other 2 types are also
equally present
 CAUSES/FALSE
CAUSES
There are no clear causes for ADHD, but genetics are a heavy variable. Probable causes are brain injury,
exposure to environment (like lead) during pregnancy/at young age, alcohol/tobacco use during pregnancy,
premature delivery, and low birth weight. There are false causes(stereotypes) that are not true: eating too
much sugar, watching too much TV, parenting, social/environmental factors(poverty/family chaos).
Symptoms/Diagnosis
Symptoms Process
◦ There is no single test for diagnosing ADHD
◦ The first step: talk with a healthcare provider
to find out if the symptoms fit the diagnosis
◦ The American Academy of Pediatrics(AAP)
recommends that healthcare providers ask
parents/teachers/other adults who care for the
child about the child’s behavior in different
settings-> home, school, peers
How to diagnosis ADHD?
◦ Healthcare providers use the guidelines given in
the American Association’s Diagnostic and
Statistical Manual, Fifth Edition (DSM-5) to help
them with diagnosis
◦ This standard helps to ensure that people are
properly diagnosed/treated for ADHD
◦ When using this standard across different
communities it can help determine how many
children have ADHD and how public health is
impacted by this condition
Symptoms/Diagnosis Continued
◦ DSM-5 Criteria for ADHD Summary:
◦ People with ADHD present a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with
function/development:
◦ 1) Inattention- 6/more symptoms of inattention for children up to age 16 and five or more for adolescents for age 17/older and
adults; symptoms of inattention have been present for at least 6 months and they are inappropriate for developmental level
◦ These symptoms often present themselves when: they often fail to give close attention to details and make carless mistakes in
schoolwork/at work, or with other activities; they often have trouble holding their attention on task/play activities; they often do
not seem to listen when spoken to directly; they often do not follow through on instruction/fail to finish schoolwork, chores, and
duties in the workplace (lose focus, sidetracked); they often avoid, dislike, or are reluctant to do tasks that require mental effort
over a long period of time (such as schoolwork/HW); they often lose things necessary for tasks/activities (school materials,
pencils, books, tools, wallets, keys, paper work, etc.); they often are easily distracted and are forgetful in daily routines
◦ 2) Hyperactivity/Impulsivity: 6/more symptoms of hyperactivity-impulsivity for children up to age 16 and 5 more for
adolescents age 17/older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent
that it is disruptive/inappropriate for the person’s developmental level:
Symptoms/Diagnosis Continued
◦ These symptoms often present themselves when: they often fidget with or taps hands/feet or squirms in seat; they often leave
seat in situations when remaining seated is expected; they often run around/climb in situations where it is not appropriate
(adolescents/adults may be limited to feeling restless); they often are unable to play or take part in leisure activities quietly;
they often are “on the go” acting as if they are “driven by a motor”; they often blurt out an answer before a question has been
completed; they often have trouble waiting their turn and interrupt/intrude on others (butts into conversations/games)
◦ In addition to the following, these must also be met: several inattentive/hyperactive-impulsive symptoms were present before
age 12; several symptoms are present in 2/more settings (school, home, work; with friends, relatives in other activities); there
is clear evidence that the symptoms interfere with or reduce the quality of social, school/work functioning; the symptoms are
not better explained by another mental disorder (mood disorder, anxiety disorder, dissociative disorder, personality disorder);
the symptoms do not happen only during the course of schizophrenia/another psychotic disorder
◦ Based on the types of symptoms, 3 kinds of presentation can occur (the three that were forementioned). Because symptoms
can change over time, the presentation may change over time as well
 DIAGNOSING ADHD
IN ADULTS
ADHD often lasts into adulthood. To diagnose ADHD in adults/adolescents age 17/older, only 5 symptoms are
needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For
example, in adults, hyperactivity may appear as extreme restlessness and wearing others out with their activity.
What to do After
Diagnosis?
◦ Now that the child has been diagnosed parents wonder what
treatments are available to their child.
◦ ADHD can be managed with the right treatment. There are
many treatment options, and it is recommended that parents
work closely with others involved in the child’s life; healthcare
providers, therapists, teachers, coaches/other family members
◦ Types of treatment: behavior therapy (including training for
parents)/medications
Treatment Recommendations/Medications
Recommendations
◦ For children who are younger than 6, the
American Academy of Pediatrics(AAP)
recommends parent training in behavior
management as the first line of treatment
before medication is tried
◦ For children 6/older, the recommendation
includes medication/ behavior therapy together
and parent training in behavior management for
children up to 12, along with other types of
behavior therapy/training for adolescents
Medications
◦ Medications can help children manage their
ADHD symptoms in their everyday life and
can help them control the behaviors that cause
difficulties with family, friends, and at school
◦ Several different types of medications are
FDA approved to treat ADHD in children as
young as 6
◦ The 2 most commonly used, are
stimulants/nonstimulants
Treatment Recommendations/Medication
Continued
Recommended
◦ Schools can be part of the treatment plan:
AAP recommends adding behavioral
classroom interventional/school supports
◦ Good treatment plans include: Close
monitoring of whether and how much the
treatment helps the child’s behavior, as well as
making changes along the way
Medication
◦ Stimulants: are the best-known and most
likely used ADHD medication. Between 70-
80% of children with ADHD have fewer
symptoms when taking these fast-acting
medications
◦ Nonstimulants: were approved for the
treatment of ADHD in 2002. They don’t work
as quickly as stimulants, but their effect can
last up to 24 hours
 TREATING ADHD IN
ADULTS
ADHD lasts into adulthood for at least 1/3 of children with ADHD. Treatments for adults can
include medication, psychotherapy, education/training, and a combination of treatments
 • ADHD was originally called
Hyperkinetic Impulse
Disorder
HISTORY OF ADHD • It wasn’t until the late
1960’s that the American
Psychiatric Association
(APA) recognized ADHD as
a mental disorder

This Photo by Unknown Author is licensed under CC BY-NC

ADHD was first The APA issued the first The APA released a revised
mentioned in 1902. “Diagnostic and Statistical version of the DSM-III in
British pediatrician Sir Manual of Mental Disorders” 1987. They removed the
1980
George Still described 1936 (DSM) in 1952. This manual hyperactivity distinction and
“an abnormal defect of listed all the recognized changed the name to attention
mortal control in mental disorders. It also deficit hyperactivity disorder
children”. He found that included known causes, risk (ADHD). The APA combined
some children couldn’t factors/treatments for each The APA released a the 3 symptoms
control their behavior the condition. Doctors still use third edition of the (inattentiveness,
The FDA approved Benzidine the updated version today. DSM (DSM-III)in impulsivity/hyperactivity) into
way a typical child
as a medication in 1936. Dr. The APA did not recognize 1980. They changed the a single type and did not
would, but they were
Charles Bradley stumbled ADHD in the first edition. A name of the disorder identify subtypes of the
still intelligent. ADHD
across some unexpected side second DSM was published from hyperkinetic disorder. The APA released the
cases began to climb
effects of this medicine. 1968. This edition included impulse disorder 4th edition of the DSM in 2000.
significantly in the
Young patients’ hyperkinetic impulse disorder (ADD). Scientists the 4th edition established the 3
1990’s.
behavior/performance in for the fist time believed hyperactivity subtypes of ADHD used by
school improved when he was not a common healthcare professionals today
gave it to them. Bradley’s symptom of the
contemporaries largely disorder. This listing
ignored his findings. created 2 subtypes of
Doctors/researchers began to ADD: ADD with
recognize the benefit of what hyperactivity/ADD
Bradley had discovered years without hyperactivity
later
Early 1990’s 1952/1968 1987/2000
 ◦ Scientists are trying to identify the causes of ADHD as well as possible
treatments.

Where ADHD is ◦ Research paints a very strong genetic link. Children who have
parent/siblings with the disorder are more likely to have it.

Today ◦ It’s not currently known what role environment plays in determining
how develops ADHD. Researchers are dedicated to finding the
underlying cause of the disorder.
◦ They’re aiming to make treatments more effective and to help find cures
Medical Advancements
◦ eTNS-> Monarch External Trigemenial Nerve Stimulation System
◦ Delivers low level electrical pulses to parts of the brain associated with ADHD. These pulses increase activity in areas of the brain that
regulate emotion, attention, and behavior. It is about the size of a phone and is connected to an adhesive patch placed on the forehead. The
device is meant to be used by people 7-12 who don’t take prescription for their ADHD. It should be used at home and during sleep while
under supervision of a caregiver. Needs further research for long-term effects.

◦ InterStim II/ Micro Systems

◦ Similar device to the eTNS, just different company

This Photo by Unknown Author is licensed under CC BY-SA-NC

How Does ADHD Affect
Others?
(family/friends/community)
◦ When a child and other
family members has
ADHD it can shift
routines/relationships in
ways that affect the whole
family, not just the person
who has the condition.
Helping the person who
has ADHD can be stressful
◦ Studies show that when 1
person in the family has
ADHD, it can affect how
satisfied parents, siblings,
and others feel in their
everyday life. This can lead
to relationship problems This Photo by Unknown Author is licensed under CC BY-SA

and conflict in the family

How Does ADHD Effect Others?
(family/friends/community) Continued
◦ Research shows higher divorce rates and depression among parents of a child with ADHD, compared to other families
◦ When a parent has a child with ADHD, they must keep track of their child’s treatment, school, and self-esteem.
◦ Parenting a child with ADHD adds to the challenges that already exist with raising any child.
◦ Brothers/sisters often feel the added stress if they have a sibling with ADHD. They may feel neglected when a parent pays
more attention to the child with ADHD. They might feel guilty because they’re well or wonder if they did something to cause
the other child’s ADHD. They also might: make themselves sick with anxiety, or worry they might get an illness, try to take
attention for themselves, get angry because they have to help out more around the house, feel embarrassed when nonfamily
members see them with their family, They might feel neglected
HERE’S A LINK TO A
VIDEO IF YOU WANT
TO KNOW MORE
https://youtu.be/YeamHE6Kank