Chapter 5 AttentionDeficitHyperactivity Disorder ADHD

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Chapter 5Attention-Deficit/Hyperactivity
Disorder (ADHD)
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Attention-Deficit/Hyperactivity Disorder

• Symptoms
• age-inappropriate inattention
• hyperactivity
• impulsivity
• Associated with problems in social, cognitive,
  academic, familial, and emotional domains of
  development and adjustment

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History of ADHD

• Early 1900s-
• inhibitory volition and defective moral
  control
• 1917-1918
• encephalitis epidemic
• brain-injured child syndrome
• 1940s and 1950s
• minimal brain damage and minimal brain
  dysfunction
• hyperkinetic impulse disorder
• 1970 on
• attention and impulse control, in addition to
  hyperactivity
• problems in self-regulation and behavioral
  inhibition

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Core Characteristics

• Inattention
• inability to sustain attention, particularly for
  repetitive, structured, and less enjoyable tasks
• inattentive behaviors may include
• problems with concentration, easily distracted
• often seems as if child not listening
• disorganization, forgetfulness
• failure to finish assignments, frequent change in
  activities
• difficulty persisting even when child wants to

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Core Characteristics (cont.)

• Hyperactivity-Impulsivity (cont.)
• hyperactive behaviors include
• fidgeting, difficulty staying seated when
  required
• moving, running, climbing about
• excessive talking
• appearing as if driven by a motor
• impulsive behaviors include
• difficulty stopping on-going behavior
• inability to resist immediate gratification
• difficulty waiting for turn, interrupting others

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DSM-IV Subtypes

• Predominantly Inattentive Type (ADHD-PI)
• less common, may be co-morbid with learning
  disorders, slow processing speed, difficulties
  with information retrieval, and anxiety/mood
  disorders
• Predominantly Hyperactive-Impulsive Type
  (ADHD-HI) and Combined Type (ADHD-C)
• associated with aggressiveness, defiance, peer
  rejection, suspension, and placement in special
  education classes

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Additional Diagnostic Criteria

• At least 6 months)
• Behaviors appear prior to age 7
• Age-inappropriate
• Behaviors occur in several settings with
  impairment in at least 2
• Behaviors not due to another disorder or serious
  life stressor

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Associated Characteristics

• Cognitive Deficits
• Speech and Language Impairments
• Health Problems
• Social Problems
• High Co-morbidity

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Theories of ADHD

• Motivation Deficits
• Deficits in Arousal Level
• Deficits in Self-regulation
• Deficits in Behavioral Inhibition

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Figure 5.2 A possible developmental pathway for
ADHD.
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Treatment

• Medication
• Parent Management Training (PMT)
• Educational Intervention
• Family counseling
• Support groups
• Individual counseling
• Multimodal Tx
• Medication, PMT, Educational Intervention