week 3 lecture review

how do adhd symptoms change over time over the course of a person’s life

• younger = hyper active

• older = inattentive

what is the range in severity of adhd

• mild

• moderate

• severe

what are some symptoms of inattention

• fails to give attention to details, makes careless mistakes

• has trouble holding attention on tasks or play

• does not seem to listen when spoken to directly

• does not follow through or finish instructions

• has trouble organizing

• dislikes tasks that require mental effort for a long period

• often loses things

• easily distracted

• forgetful in daily activities

symptoms of hyperactivity/impulsivity

• fidgets with or taps hands or feet

• leaves seat when expected to stay seated

• runs or climbs when inappropriate

• unable to play/leisure quietly

• “driven by a motor”

• talks excessively

• blurts out an answer before a question is completed

• has trouble waiting turn

• interrupts or intrudes others

what is the criteria of the symptoms to be diagnosed with adhd

• 6+ symptoms of inattention

  • ADHD-predominantly inattentive

• 6+ symptoms of hyperactivity

  • ADHD-predominantly hyperactive

• 6+ symptoms of both

  • ADHD-combined presentation

(5+ symptoms for 17 years+; symptoms must be present for 6+ months)

what are some additional criteria for diagnosing adhd

• several symptoms present before age 12

• symptoms present in 2+ settings

• symptoms interfere with or reduce quality of social, school, work functioning

• symptoms not better explained by other disorder

how do you diagnose adhd?

• clinical interviewing with history gathering

  • structured interviews

• questionnaires (parent or teacher)

• neuropsychological testing

• behavioral observations

what are the major risk factors for ADHD

• genetics

  • heritability in parents

• neurotoxin exposure

  • lead, air pollutants, alcohol/tobacco exposure in utero

• other health conditions

  • low birth weight

  • type 1 diabetes

  • congenital heart disease

  • epilepsy

what are the brain behavior relationships for those with adhd

• slower wave form activity

• differences in neural activity at rest and while completing tasks

• smaller total brain volume

• slower rate of cortical brain maturation

what are common co-occurring conditions with adhd

• odd (32%)

• conduct disorder (7%)

• autism spectrum disorder (14-50%)

• anxiety (40%)

• specific learning disorder (~40%)

what is the prevalence of adhd

11.7% of US children 3-17

• 13% male

• 7% female

what is the persistence of adhd in adults

• around 43% of individuals with adhd continue having it into adulthood

• many people grow out of adhd bc their brain catches up in maturity

what are the types of medication treatment for adhd

• stimulant

  • only work while in your body

• non-stimulant

  • less effective than stimulant

what are some behavioral treatments for adhd

• parent management training

• parent child interaction therapy

• behavior therapy

• social skills interventions

what are the 4 causes of defiance

• child negative temperament and psychopathology

• parent negative temperament and psychopathology

• ineffective child management by parents

• parent and family stress events

what is the diagnostic criteria for odd

4+ symptoms in past 6 months

• angry/irritable mood

• argumentative/defiant behavior

• vindictiveness

what is the severity levels of odd

• mild

  • symptoms confined to only 1 setting

• moderate

  • some symptoms are present in 2+ settings

• severe

  • some symptoms are present in 3+ settings

what is the diagnostic criteria of conduct disorder

3 criteria in past 12 months, 1 criteria in past 6 months

• aggression to people and animals

• destruction of property

• deceitfulness or theft

• serious violations of rules

what is the limited prosocial emotions specifier to conduct disorder

2 criteria in past 12 months in multiple relationships and settings

• lack of remorse or guilt

• lack of empathy

• unconcerned about performance

• shallow or deficient affect

what are the levels of severity in conduct disorder

• mild

  • few excess problems, relatively minor harm to others

• moderate

  • some excess problems, some harm to others

• severe

  • many excess problems, considerable harm to others

what are the genetic factors of conduct disorder

more likely to have CD if first degree relative has CD, alcohol use disorder, depressive/bipolar, schizophrenia, ADHD

what are environmental factors of odd

• harsh inconsistent, neglectful parenting

• frequent changes in caregiving

what are environmental factors in conduct disorder

• parental rejection and neglect

• inconsistent parenting

• harsh discipline

• abuse

• lack of supervision

• early institutional living

• peer rejection

• delinquent peer group

• exposure to violence

what are gender differences for odd and cd

odd

• somewhat more prevalent in male children than female

• no difference by adolescence

cd

• males (12%) > females (7%)

what is the difference between IEP and 504

IEP

• outside of classroom support

  • speech therapy

  • special ed

  • classroom mentor

504

• inside of classroom support (minimal)

  • accommodations

  • extra time on tests

  • fidgets

  • line leader

what is parent child interaction therapy (pcit)

behavior based intervention with the goal of altering parent-child communication and discipline strategies to reduce unwanted behaviors

• bug in the ear intervention

• praise, reflect, imitate, describe, enthusiasm

what is parent management training

includes self-regulating skills, boundary setting, and rewards to master behaviors

parents have to be willing and emotionally available to work through this together

• short term (daily)

• medium-term (weekly)

• long-term (monthly)

  • use sticker calendar system for reward if 3/7 days

• adjust goals based on compliance

• teaches delayed gratification, planning