What is the history of ADHD assessing?
- Minimal brain damage (20th century thoughts) - encephalitis
- 80s changed to ADD from research in the 70s
- After more research they realized it was a combination ADHD - Inattention/Hyper/Combined
What is the problem of activity in ADHD kids?
- It is not the type of activity that is the problem, it is the intensity of it
- show the reverse of the situation calls for (out of sync with environment)
What are the categories of ADHD?
A) Pervasive
B) Situational
What are some situational variables that come into play with ADHD children?
i. The more structure there is, the worse they do
ii. Perform better with Fathers because they are more authoritative
iii. Trouble with tasks that require sustained attention
iv. Novelty kids do worse – doesn’t allow them to focus
What is ADHD like in early childhood?
- sometimes in infancy -Difficult temperament, Trouble sleeping, crying when changing
Problems toilet training
50% identified by 3 years and most by 12 y.o.
What problems do ADHD children have in school?
- problems with peer relations
2. listening to rules
What is ADHD like in middle childhood?
A) school achievement becomes a bigger problem
B) Usually around 4th grade because things ratchet up
C) Learning disabilities
D) Don’t take responsibility
What is ADHD like in adolescence?
A) 50-80% of kids continue to have problems
B) Peer relationships continues to be a problem
C) Problems with authority
What are the influences of ADHD?
i. Genetic
ii. Neurological/Neurophysiological
iii. Family
iv. Environment
What are the genetic influences of ADHD?
A) Identical Twin studies so the concordance much more than frat twins
B) Siblings more than, relatives
C) Relatives more than strangers
What are the Neurological/Neurophysiological influences of ADHD?
A) Brain imaging doesn’t show any gross difference between ADHD kids and regular kids
c) Basically they are under-aroused in the neurological area
d) Smaller right prefrontal cortex
e) Smaller left caudate nucleus
f) Decreased blood flow to cerebellum
What are the family influences of ADHD?
- More common in families with high levels of discord
2. Parenting Practices
What are the environmental influences of ADHD?
Elevated levels of lead have been found in 25-30% of ADHD kids, but the data is uncertain
How do neurotransmitters affect ADHD?
- dopamine:
- Most related to the reward centers of the brain that respond to attentional responses and positive reward
- Attention deficit
- norepinephrine:
- regulates behavioral inhibition
- Hyperactivity
What are parenting practices that exacerbate ADHD effects?
a) Permissiveness
b) Lack of attention to child/Neglect
c) Child temperament and parenting interactions
What did the Hyperactive/Defiant study find?
A) suggests that hyperactivity can lead to defiance
B) But defiance does not lead to hyperactive
What are the long term outcomes of ADHD?
i. Developmental Delay
ii. Developmental Decay
iii. Continuous Display
