What is the epidemiology of ADHD?
- Hx of parents with ADHD
- Hx of siblings with ADHD
- More prevalent in boys than girls
- Sxs usually present by age 3
What is the etiology of ADHD?
- Genetic
- Prenatal toxic exposures
- Prematurity
- Prenatal mechanical insult to the fetal nervous system
- Food additives, coloring, preservatives and sugar contribute to hyperactive behavior
What are the core sxs/specifiers of ADHD?
- Inattention
- Hyperactivity/Impulsivity
What is the criteria of the combined specifier of ADHD?
If enough sxs are both criteria inattention and hyperactivity-impulsivity were present for the past 6 mos
What is the criteria of the predominantly inattentive presentation specifier of ADHD?
If enough sxs of inattention, but not hyperactivity-impulsivity, were present for the past 6 mos
What is the criteria of the predominantly hyperactive/impulsive presentation specifier of ADHD?
If enough sxs of hyperactivity-impulsivity but no inattention were present for the past 6 mos
What is the DSM-5 diagnostic criteria for ADHD?
A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
What is the diagnostic criteria for inattention?
- Six (or more) symptoms
- Persisted for at least 6 months to a degree that is inconsistent with developmental level and that it negatively impacts social and academic/occupational activities
What are some sxs of inattention?
- Fails to give close attention to details or makes careless mistakes
- Difficulty sustaining attention in tasks or play activities
- Does not seem to listen when spoken to directly
- Difficulty organizing tasks and activities
- Avoids to engage in tasks that require sustained mental effort
- Loses things necessary for tasks or activities
- Easily distracted by extraneous stimuli
- Forgetful in daily activities
What is the diagnostic criteria for hyperactivity and impulsivity?
Six (or more) symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/ occupational activities
- For older adolescents and adults (age 1 7 and older), at least five symptoms are required.
What are some sxs of hyperactivity and impulsivity?
- Fidgets w/ or taps hands or feet, squirms in seat.
- Leaves seat in situations when remaining seated is expected.
- Runs or climbs in things where it is inappropriate.
- Unable to play or engage in leisure activities quietly.
- Talks excessively.
- Blurts out an answer before finishing a question
- Difficulty waiting his/her turn
- Interrupts or intrudes on others
Several inattentive or hyperactive-impulsive symptoms are said to be present prior to what age and in how many settings?
- Prior to 12 years of age
- In two or more settings (ie, home, school, work)
Clear evidence of what is needed to diagnose ADHD?
Clear evidence that the symptoms interfere with/or reduce the quality of:
- Social functioning
- Academic functioning
- Occupational functioning
Why is non-pharmacological tx recommended prior to medications for ADHD?
Prevents effecting the development of the child
What are some non-pharmacological tx options for ADHD?
- CBT
- Parent education
- Group therapy: aimed at both refining social skills, increasing self-esteem, and sense of success.
What is the first line pharmacological tx for ADHD?
Stimulants
- Amphetamine (Adderall) or methylphenidate (Ritaline)
What are the non-stimulant tx options for ADHD?
- Strattera
- Vyvanse
- Guanfacine
