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A comprehensive overview of adhd, exploring its different types, diagnostic criteria, and associated characteristics. It delves into the biological and family systems influences on adhd, examines various assessment methods, and discusses medication and non-medication interventions. The document also includes exercises and questions that can be used for study purposes.
Typology: Exams
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ADHD can have three main types -Predominantly Inattentive (PI)
-Hyperactivity-impulsivity (HI)
-Combined type
Diagnostic criteria for ADHD
Also why is ADHD referred to as the rule of 6's 6 or more of each symptoms for each type (Combined 6 or more in each categori)
For at least 6 months
Present before age 12
INconsistent with peer behavior
Occurs in two settings
PI type ADHD
Inattention
-doesn't pay close attention; careless mistakes -difficulty sustaining attention -does not seem to be listening -doesn't follow through on instructions -difficulty organizing tasks -avoids tasks that require sustains mental effort -loses things -easily distracted -forgetful
HI type Hyperactivity-Impulsivity
-fidgets, taps, squirms -leaves seat -runs about -on the go -talks excessively -blurts out -interrupts or intrudes
Dimensional vs Categorical Diagnosis for AD/HD
- If a child has 5 characteristics but not 6, they are still experiencing problems but do AA
Filtering distractions Revising plans
ADHD: Response Inhibition/Inhibitory Control Ability to stop automatic responses to allow us to make strategic actions towards long term goals
ADHD: Types of Impulivity Cognitive - uncontrolled, rapid thoughts
Behavioral - act without control
Emotional - cannot control emotions
ADHD: Attention Attention helps students to regulate behavior, emotions, and impulses
Distractibility selective attention to salient and appealing stimuli
Sustained attention most problematic during boring or repetitive tasks or when fatigued
Alerting Initial reaction
ADHD: Rewards and Motivation Sensitivity to reward
Difficulty with delayed reward
Children with ADHD need reinforcement with every behavior and do best with consistent reinforcement
ADHD: Self talk and internal language We control ourselves through language
After class I need to...
You can teach kids this to say it out loud and then they internalize it
ADHD: Working memory Holding facts in mind while manipulating information, flexible thinking, mental computation
Assessment of ADHD Testing, subtests on intelligence testing
ADHD shows lower working memory scores and weakened processing speed HOWEVER they usually have avg to above avg IQ
Kids with ADHD often do better with what kind of tests Verbal
Assessment of ADHD: Conners Continuous Performance Test X followed by O press space bar If not followed by o, don't puish
Erros of omission
tests PI
Errors of comissions, testing for impulsivity HI
Assessment of ADHD: Checklists and rating scales Conners Teacher Rating scale/Conners Parent rating scale
Child behavior checklist
They are cost and time efficient
Vulnerable to bias (parents just dont see it) and immediacy effects (kid gets referred for evaluation when the symptoms are extreme not avg)
Assessment of ADHD: Behavioral observations observe in natural environment operationalize definitions like ontask, callin out, disruptive
- What steps are taken to diagnose ADHD? Testing Checklists and Rating Scales Behavioral Observational
Associated characteristics with ADHD: Intelligence IQ Scores -most people with ADHD have average to above average IQ
Interest level and ability to focus can be difficult, motivation that could cause them to appear lower
Also, if you dislike school you start hanging out with others that dislike school, this increases risk of substance abuse
Associated characteristics with ADHD: Co-occuring disorders -learning disabilities -anxiety disorders -mood disorders -tic disorders -oppositional defiant disorders -conduct disorders -autism spectrum disorder
ADHD: Prevalence 5-9% of school children in North America Approx. 1-3 students per classroom
Boys:Girls: 2.5:
ADHD: Race and Ethnicity By Kindergarten, black children are 70% less likely to be diagnosed with ADHD than white children that show the same behaviors
The bulk of research on ADHD indicates that ___________________________________ play a
centralrole
genetics and beurobiological factors
ADHD is a biological disorder
Biological causes of ADHD: Family members 1/3 biological family members also have ADHD
If a parent has ADHD, the risk of the child having ADHD is 60%
Rates are 3x higher in biological vs adoptive parents
Biological causes of ADHDL Dopamine genes involved in dopamine regulation
Biological causes of ADHD: Gene x Environment interactions Children with genetic risk factors with ADHD
who are also exposed to environmental risks (maternal smoking, psuchosocial adversity, )
are more likely to develop ADHD symptoms
otehr substance use during pregnancy
lead expsure
Family systems causes of ADHD: -no clear causal relationships -family conflict may increase the SYMPTOMS of HI and CD symptoms. Can increase the severity of the disorder
Barkley did research on family factors: -they put moms and sons in a room with a one way mirror -a half hour before the session the child recevied ritalin or placebo
-the childs behavior determined the mom's behavior
What is the primary cause of ADHD? Biological, brain differences, dopamine
How do families influence ADHD? High conflict can increase the severity of the symptoms of HI and CD
Medication treatment for ADHD stimulant medications most effective treatment for attention , impulsivity, and activity level
the most effective treatment for attention, impulsivity, and activity level stimulants
stimulants alter activity in what region of the brain by increasing the availability of
frontostriatal
Dopamine
○ Organize, make good decisions, be less impulsive, behavioral inhibition
Children with ADHD who receive medication often show initial _________________ in academics
Medication has little ___________________________ effect on academic performance. Why not? improvement
Pros and cons of medications for ADHD Improvements:
Side effects:
3 types of Non-stimulant interventions that are effective Behavioral Parent Training Behavioral Classroom Management Behavioral Peer Interventions - Summer Treatment Programs
Group based social skills training: traditional, office based social skills training programs produce minimal effects. No group bases SST
What do the effective non-stimulant interventions involve? -increase rewards and reinforcements -decrease in nattering -increase use of effective punishment strategies -increase in positive interactions in general
Overall, is medication recommended for kids with AD/HD? Yes, stimulants are effective but best paired with therapy
How does medication impact academic performance? short term impact but does not address deficits
Discuss the pros and cons of medication most effective increase availability of dopamine
side effects: poor appetite, weight loss, growth reduction, sleep problems, etc. tics
What types of non-medication interventions are useful for ADHD? Behavioral PT Behavioral CM Behavioral PI
What do the non-medication interventions involve? increase in reward increase in positive interactions decrease in nattering increase use of effective punishment strategies
