Attention Deficit-Hyperactivity Disorders

Condition Description

Poor sustained attention

Hyperactivity-impulsivity

Subtypes

Predominantly inattentive (ADHD-I) – main symptom is attention deficit
Predominantly hyperactivity-impulsive (ADHD-HI) – main symptom is excessive motor activity
• Includes fidgeting, restlessness, and difficulty remaining seated. Often manifests in impulsivity such as interrupting and not waiting for a turn.
Combined types (ADHD-C) – most prevalent

All types appear with varied degrees of severity.

ADHD Across the Lifespan

Difficult to identify in very young children and adults

Often first diagnosed when symptoms interfere with school performanced

During adolescence, it may be observed in difficulties managing their
schedule/routine, missing appointments or other obligations

Greater risk for social deficits because of impulsiveness and inability to react appropriately to required information during social events

Genetics and Biologic Factors

Parents with ADHD have an 80% chance of having a child with ADHD,
which impacts the parent-child relationship.
The current neuroanatomical view of ADHD relates to the dopaminergic
system, frontal and prefrontal lobe function, and the cerebellum, as well
as multisystem perspectives
Evidence for disruptions in the connectivity between anatomical structures in the brain–both at rest and during task completion

Impact on Occupational Performance

Family interactions

Academic functions

Social and leisure participation

Work

Executive functions

Sensory motor abilities

ADLs, IADLs, and daily routines

Sensory Motor Abilities

Tendency for over responsiveness to sensory stimuli

Difficulties with both gross and fine motor skills

High comorbidity of ADHD and developmental coordination disorder

Executive Functions

Individuals with ADHD may have difficulty

• Making simple choices

• Choosing what is most important to pay attention to their surroundings

• Deciding what they wish to do and how they will react in order to achieve a certain goal

ADLs/IADLs, and Daily Routines

Studies have shown ADL/IADL performance is a strong indicator for children and adolescents with and without ADHD

Children between ages 4 to 15 with ADHD performed significantly lower on the Assessment of Motor and Process Skills

Family Interactions

Varying degrees of disturbances in family and marital function, disrupted parent child relationships. increased levels of stress

Academic Functions

Organizational deficits

Miss important information

Respond too quickly

Low rates of on task behavior, task completion, and positive exchanges with teachers

Social and Leisure Participation

Deficient interpersonal interaction abilities among children, adolescents, and adults with ADHD influence social participation

Work

Social participation and executive functioning deficits contribute to difficulties in work environment

practitioners can contribute by eval what job may suit the individual with ADHD and assist in job maintenance

Medications

• stimulants

• nonstimulants

• compliance with medication protocol is low

• drug treatment alone is insufficient for symptom management of ADHD

Evidence Based Approaches and Interventions

Goal setting and visualizations

Break large goals into smaller, manageable tasks

Visual aids

Encourage clients to vividly imagine achieving their goals

Cognitive Behavior Based Treatment

Use a reward system//token economy for completing tasks for reaching milestones

Frequent, specific praise and feedback for efforts

Environmental Modifications

Assist clients in creating a workspace that minimizes distraction

Suggest using timers or apps

Body Double

Doing a task with someone helps initiate and complete tasks