Lecture 8

ADHD 2

birth, reliable

Symptoms of ADHD should be present at ______ but there are no ______ and valide measures to assess symptoms below 3 years old

challenges

In preschool, if ADHD symptoms last for about a year, the child is likely to continue to have _______

decline

After elementary school, outward hyperactivity might _____ slightly but it will still remain higher than most people without ADHD

higher

→ resolve

Many studies have shown that pre-adolescents who meet criteria for a diagnosis of ADHD have ______ rates of ADHD symptoms in early adulthood (ages 21-27) compared to youth who do not have ADHD

→ Demonstrates that symptoms of ADHD don’t ______ in adolescence

large

In many outcomes such as finishing school, salary, divorce, death..., there were _______ differences between people who had ADHD and those who didn’t

80%

How many (%) of children with ADHD have a co-occurring psychological disorder?

• Oppositional, conduct

  → Early

• Anxiety

• Depression

• Tic

Types of psychological disorders associated to ADHD:

• ______ defiant disorder and _______ disorder

  → _____-onset ADHD is a strong predictor of these disorders later

• ______ disorders

• _______

• _____ disorders

intellectual, impaired

→ language

ADHD is not associated with decreased ______ ability BUT academic functioning is _______

→ Impacts on _____ abilities (ex: speech production errors)

75%

Heritability estimates for inattentive and hyperactive/impulsivity are around ___%

development

Environmental influences and factors that compromise _______ of the nervous system may be related to ADHD (ex: cigarettes, alcohol in pregnant mothers…)

genetics, environmental

Overall, ADHD symptoms are mostly caused by _______, and are then maintained, mitigated, and exacerbated by ______ influences

Prefrontal cortex

Medication such as dextroamphetamine and methylphenidate given for ADHD increases activity in which part of brain?

fast, effects

Medication given for ADHD acts ______ and has many side ______ such as loss of appetite, weight loss, slowing of growth, and difficulty falling asleep

• 20

• all

• time

• efficacy

Problems with medication for ADHD:

• ___% of children may not improve

• It may not help academic performance, peer relationships, or family functioning in _____ kids

• Its beneficial effects may not be maintained over _____ and will stop once medication is stopped

• Tolerance may also occur, in large % of cases leading to reduced _____ over time at the same dosage

managing, positive

Parent training’s goal is to support caregivers _____ challenging child behaviour and promoting ______ behaviours

• Psychoeducation

  • education

• Improving parent-child relationship

  • attention

  • time

  • monitoring

• Behavioural strategies

  • rewards

  • routine

  • removal

• Communication strategies

  • assertive

Structure of parent-focused programs:

• Psychoeducation

  • Provides parents ______ about ADHD in children

• Improving parent-child relationship

  • Emphasis on providing children with positive ______ and affirmation to increase wanted behaviours

  • Special ______

  • Parent thought and mood ______ through a record

• Behavioural strategies

  • Introducing behaviour charts & _____ for positive behaviour

  • Building a ______ and structure

  • Using time-outs and privilege _______

• Communication strategies

  • Encouraging firm and _______ communication when necessary (ex: child is misbehaving)

Periods of 10 minutes a day where parents:

• Provide the child with positive attention

• Praise the child for positive behaviours

• Ignore minor misbehaviours

What is special time?

children, parents

→ long

Parent-training programs have benefits for _______ by reducing their ADHD symptoms and ______ by improving parent-child relationship quality, mental health, and sense of competence

→ BUT these effects may not be sustained in the _____ term

• control

• impairment

Other interventions:

• Cognitive interventions can be useful by providing techniques that children can use to ______ their attention and behaviour

• Organizational skills training can help with ______ associated with ADHD, especially in the academic domain

1. medication, behavioural

2. combined

3. community

The multimodal treatment of ADHD study had 3 objectives:

1. Compare long-term _______ and ______ treatments for ADHD

2. Determine if there are additional benefits if meds and behavioral treatment are _______

3. Compare systematic administration of treatment to treatment as delivered in ______ settings

• 5, 7

• 80

• C

Participants of the multimodal treatment of ADHD study:

• Ages ___ to ___

• ___% male

• ADHD-___ diagnosis

1. • symptoms

     • outcomes

   • improved

   • behavioural

2. • differ

   • conflict

3. • outperformed

Multimodal treatment of ADHD study results:

1. Medication vs. behavioural treatment?

   • Medication outperformed behavioural treatment for improving ADHD ______

     • BUT not true for many other ______

   • Children who got behavioural treatments still ______ on symptoms

   • Parents preferred ______ treatments

2. Additional benefits of combining meds and behavioural treatment?

   • Combined treatment didn’t _____ for any outcome

   • For parent-child ______, combined treatment (and behavioural treatment) was better than community treatment (and medication)

3. Community treatment?

   • Combined treatment and meds _______ community treatment for most ADHD outcomes

   • Behavioral treatment did _____ outperform community treatment

• increased

• fluctuated

• norm

Study examining the long-term patterns of remission following the MTA study:

• Over time, symptoms ______ and most still showed clinical symptoms

• Many people ______ in symptoms and impairment

• Having some symptoms and/or impairment through emerging adulthood is the ______

• depressive, parenting, behaviour, functioning

  → sustained

• better

Study comparing a standard parent training to an integrated intervention among mothers of children with ADHD:

• The integrated intervention produced small to moderate impacts on maternal _____ symptoms, negative ______, child disruptive _____, and family ______ compared to standard parent training

  → BUT this effect of the integrated intervention wasn’t ______ over time

• At later follow ups, the standard parent training group had ______ positive parenting compared to the integrated intervention group