ADHD

HOLY NAME UNIVERSITY
THE PREMIER CATHOLIC UNIVERSITY IN THE PROVINCE OF BOHOL

College of Health Sciences – Nursing Department
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Trailblazing Excellence in Educating Servant Leaders

Copyright © 2020 dcasquejo@hnu.edu.ph
ATTENTION DEFICIT
HYPERACTIVITY
DISORDER (ADHD)
 ADHD is one of the most common

neurobiologic conditions in
childhood that can also persist into
adulthood.
 Sometimes also called Attention
Deficit Disorder, ADD when there is
less hyperactivity
 It is a significant impairment in
functioning in at least 2 settings
(usually in the home & at school)
due to impulsivity, inattention,
and /or hyperactivity.
 Boys are affected more frequently

than girls
 The cause of ADHD is unknown
but several factors contribute to
ADHD such as:
 Environment
 Low socio-economic status
 Foster care
 Very Low Birth Weight
 Genetic (family history)
 Physiologic
 The disorder is characterized by
three major behaviors --- and can
present differently depending on
the age at presentation:
1. Inattention
2. Impulsiveness
3. Hyperactivity
1. Inattention
Inattention can include symptoms
such as:
 Difficulty organizing tasks
 Reluctance to do tasks that
require mental effort over time
 A child who easily gets bored of a
task
 A child who jumps from one task
to another without completing the
first task
 A child who is easily distracted or
does not follow tasks carefully
2. Impulsiveness
Impulsiveness includes:
 A child acting before thinking and
therefore having difficulty with
such tasks like waiting for his/her
turn
 A child blurting answers before a
question is completed
 A child interrupting or intruding on
others’ conversations

3. Hyperactivity
Hyperactivity includes:
 A child may shift excessively from
one activity to another
 A child can be described as “on
the go” or “acts as if driven by
a motor”
 A child who can’t seem to sit still
and who is constantly moving,
roaming, touching things,
squirming or fidgeting.
ASSESSMENT
Preschool Elementary Adolescence
Age School
Hyperactive Struggles with Academic demands
listening in class become
(Inattention) overwhelming
Impulsive Poor Struggles with
organizational attention, learning,
skills & executive
functioning
Not flexible Struggles with

social interaction
May be Difficulty
aggressive functioning
with peers independently

DIAGNOSING ADHD
A child who is inattentive, impulsive,
or hyperactive does not necessarily
have ADHD.
Many normal children have some of
these symptoms especially young
children…and the symptoms could be
caused by another disorder entirely.
The criteria for diagnosis of ADHD

includes a thorough initial history,
physical examination, and completion
of evidenced-based rating scales by an
individual who is familiar with the child
such as:
 Parents & Teachers
 Primary care providers
 other caretakers
A complete H&P (History & Physical

exam) is designed:
 To look into other causes of
behavior problems such as
neurologic & genetic problems

 To rule out conditions with similar

symptoms or which may coexist
with ADHD such as:
 Anxiety
 Depression
 Sleep disturbances (e.g. apnea)
 Substance abuse
 Oppositional defiant disorder
 Conduct disorder
 Learning disorder
For example, a child with visual

impairment who is unable to see the
board may not have ADHD but gets
“off task” because he/she cannot
see assignments or instructions
clearly.
As a rule, children with ADHD do not
have a deficit in intelligence,
although they may seem to because
of their impulsive behavior and an
unawareness that their behavior is
upsetting to family, friends, and
teachers.

THERAPEUTIC
MANAGEMENT
A variety of treatment methods are
used , often in combination, in the
management of ADHD.
Environmental Modification
 Stable learning environment – is
crucial for children with ADHD so
that instruction can be free from
distractions
 Educational accommodations which
may include:
 Preferential seating - placing a
student's seat in a location that is
most beneficial for their learning in
the classroom)
 Extended time for test taking,
 Written list of assignments & due
dates, &
 Note-taking support
 Provide a structured and predictable
environment at home & in school –
children with ADHD respond best in

an environment with clear and

consistent rules & expectations.
The main goal of behavior
management is to increase
appropriate behavior and decrease
negative behavior.
Ways to help manage a child’s

behavior:
 Encourage parents to be fair but
firm and to set limits to reduce
arguments.
 Teach parents to give instructions
slowly and make certain that they
have the child’s attention before
beginning instructions
 Remind parents to break down a
chore in several steps to help child
follow easily
 Encourage parents to understand
that anger is normal (when they
correct a child’s behavior) and
should be directed at the child’s
disruptive behavior, and not on
the child.

Family Support
Parents of a child with ADHD may
have more frequent healthcare visits
because of unintentional injuries, such
as lacerations or simple burns. Ask
parents during these encounters if they
are having difficulty raising a child with
hyperactivity. Help them to understand
that because of a very complex and ill-
understood syndrome, the behavior is
the best their child can achieve.
Organizations of ADHD children may
be available online & can be of great
help to parents.
Although hyperactivity fades with late
adolescence, some children with
ADHD continue to experience
problems with impulsivity & inattention
into adulthood. These children may
need counselling to find a career that
fits with these behaviors and allows
them to succeed as adults.

Medications
Medication management is a proven
treatment for many individuals with
ADHD, but not all children and teens
with ADHD need to take medication.
Those with milder forms may be

successful with structured environment
and firm, but fair types of discipline &
reward.
Most frequently prescribed stimulant
medications for ADHD:
 methylphenidate and amphetamines
Stimulants work by stimulating
dopamine receptors so there is regular
nerve transmission, which results in
increased attention span.
Side-effects:
1. Insomnia - to relieve the insomnia,
the drug must be taken during the
day
2. Anorexia – administer medication
before breakfast and offering nutri-
tious snacks between meals.

CAUTION:
Parents must be cautioned that this
drug offers a “high” effect to children
who do not have ADHD, so their child
must be conscientious that the
medication is not stolen by other
children to use for euphoria effect.
Other meds for ADHD:

Nonstimulant drugs such as
 atomoxetine (Strattera) – first-line
medication for children with ADHD
who cannot tolerate stimulants.
Must be used cautiously with
children because of a black box
warning about increased risk of
suicidal thoughts
 guanfacine (Intuniv)
 guanfacine hydrochloride (Tenex)

END OF
PRESENTATION


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HOLY NAME UNIVERSITY

THE PREMIER CATHOLIC UNIVERSITY IN THE PROVINCE OF BOHOL

FAIR USE NOTICE AND

This PowerPoint presentation

Trailblazing Excellence in Educating Servant Leaders

 ADHD is one of the most common

 Boys are affected more frequently

Trailblazing Excellence in Educating Servant Leaders

Not flexible Struggles with

Trailblazing Excellence in Educating Servant Leaders

The criteria for diagnosis of ADHD

A complete H&P (History & Physical

Trailblazing Excellence in Educating Servant Leaders

 To rule out conditions with similar

For example, a child with visual

Trailblazing Excellence in Educating Servant Leaders

Trailblazing Excellence in Educating Servant Leaders

an environment with clear and

Ways to help manage a child’s

Trailblazing Excellence in Educating Servant Leaders

Trailblazing Excellence in Educating Servant Leaders

Those with milder forms may be

Trailblazing Excellence in Educating Servant Leaders

Other meds for ADHD:

Trailblazing Excellence in Educating Servant Leaders

Trailblazing Excellence in Educating Servant Leaders

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