Chapter 6: Attention deficit hyperactivity disorder

Define and describe ADHD

ADHD is a neurobiological disorder. Characterized by persistent and maladaptive symptoms of inattention (inability to pay attention), hyperactivity (excess of activity, unable to sit still, non-stop talking, etc.), and impulsivity (doing things without thinking first). Average age of onset is 7 years old.

Etiology of ADHD

Combination of genetic, environmental factors with prematurity, brain injury, coexisting conditions. Specific underlying causes remains largely unknown

Hypothesized low levels of dopamine, brain abnormalities, reduced gray matter volume

List and define the subtypes/clinical presentations of ADHD

1. Combined: Exhibits both attention (children 6 symptoms) and hyperactive-impulse (children 6 symptoms) symptoms

2. Predominantly inattentive: Exhibits at least 6 inattentive symptoms but inadequate hyperactive impulse symptoms

3. Predominantly hyperactive: Exhibits at least 6 hyperactive-impulse symptoms, and inadequate inattentive symptoms

4. Other specified or unspecified: For individuals who have some symptoms but do not meet diagnostic criteria

Describe executive functions

Executive function refers to skills that you use to manage everyday tasks like making plans, solving problems and adapting to new situations. Executive dysfunction could include things like inattention, disorganization, poor awareness, and poor problem solving.

What is the course and prognosis of ADHD?

Considered lifelong, although the clinical presentation changes over time. Impulsivity and hyperactivity generally subside with age, while inattention remains

Describe non pharmacological physiological and behavioral interventions.

Cognitive behavioral therapy

Mindfulness

Coaching

Parent education and training programs

Educational and classroom interventions

Differentiate between the issues younger vs older children have with occupational performance.

All areas may be affected

Younger children: Ability to learn ADLS is hindered, learning and executing IADLs may be more difficult, medication management for health management, fatigue and difficulty sleeping, for education children often struggle in school, participation in play and leisure activities are often compromised in children

Older children: Older children and adults may have trouble staying in the routine of doing ADLs, in adolescents and adults the IADL of driving is often affected, medication management for health management, fatigue and difficulty sleeping, for education college students have more difficulty and are less likely to finish their degree, adolescents and adults may have more difficulty in the workplace, social participation and leisure activities may be affected for adolescents and adults