ADD/ADHD

Question 1

ADHD Risk Factors

Answer 1

Family Hx 
mom: young, unhealthy, smoker, EtoH, pre-eclampsia
pre-mature, post-mature
extended labour
hypoxia
high forceps
infant malnutrition / deprivation

conditions:
FAS, PKU, G6PD def, fragile X, TBI

Question 2

ADD Diagnostic Criteria

Answer 2

A) At least 6 months of either:

1) 6+ attention sx OR
2) 6+ hyperactive/impulsive sx

B) Onset before age 12
C) Present in 2+ settings
D) Interferes with QOL/function
E) Not accounted for by mood or psychotic disorder

Attention sx not due to defiance or not understanding

Can be combined, predominately inattentive or hyperactive-impulsive

Question 3

ADD Attention Symptoms

Answer 3

• fail to give attention to details
• can’t sustain attention
• does not listen
• does not finish instructions
• can’t organize tasks
• avoid tasks requiring concentration
• loses things
• easily distracted
• often forgetful

Question 4

ADHD Hyperactive-Impulsive Symptoms

Answer 4

• fidgets
• leaves seat
• run/climb excessively
• difficulty playing quietly
• often “on the go”
• talks excessively
• blurts out answers
• difficulty waiting turns
• interrupts/intrudes on others

Question 5

Assessment / Diagnosis of ADD/ADHD

Answer 5

Get info from parents, teachers, patient

Psycho=educational testing can r/o LD (can present similar)

Assess for comorbid: anxiety, OCD, tic, depression, ODD, conduct, substance use

Medical: hearing/vision, physical exam

Question 6

Self Rating Scales

Answer 6

SNAP-IV
SWAN
Conners
behaviour checklists

Question 7

Treatment

Answer 7

Meds 
Psychoeducation
Behaviour Management
- reinforcement, structure, written instructions, break down tasks, breaks, timers, organizational aids, time out, consistency, ?social skills training
- first line for preschoolers

Question 8

Medications

Answer 8

1st line Stimulants:
- methylphenidate
- amphetamine
Try both classes before 2nd line

Others

• atomoxetine
• guanfacine