I need someone to take my weekly short online quiz

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ATTENTION-DEFICIT/ HYPERACTIVITY DISORDER

(ADHD)

https://www.youtube.com/watch?v=z2hLa5kDRCA

BRAD’S STORY

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A BIT OF HISTORY

Symptoms of ADHD first described in 1885 in Dr. Heinrich Hoffman’s story Fidgety Phil

Dr. Hoffman also wrote Johnny Look-in-the-Air

ADHD is characterized by persistent age-inappropriate symptoms of inattention, hyperactivity, and/or impulsivity that are sufficient to cause impairment in major life activities

ADHD is considered a Neurodevelopmental Disorder in the DSM-5

DESCRIPTION

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• Inability to sustain attention, particularly for repetitive, structured, and less interesting tasks

• Behaviors indicative of inattention may include:

• Problems with concentration, easily distracted

• Appearing as if the child is not listening

• Disorganization and forgetfulness

• Failure to finish assignments, frequent change in activities

• Difficulty persevering on a task even when child tries

• Making lots of minor mistakes

INATTENTION

• Hyperactive-impulsive behavior: excessively energetic, intense, inappropriate, and not goal directed

• Single dimension

• Both part of a more fundamental deficit in behavior regulation

• Hyperactive behaviors include:

• Fidgeting and difficulty staying seated

• Moving, running, climbing, touching everything in sight, excessive talking, and pencil tapping

• Excessively energetic, intense, “driven by a motor”

HYPERACTIVITY-IMPULSIVITY

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• Impulsivity

• Inability to control immediate reactions or to think before acting

• Typical impulsive behaviors:

• Difficulty stopping on-going behavior

• Difficulty awaiting turn

• Inability to resist immediate gratification

• Interrupting others’ conversations

• Blurting out thoughts

HYPERACTIVITY-IMPULSIVITY

DSM-5 DIAGNOSTIC CRITERIA FOR ADHD

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• Predominantly inattentive presentation (ADHD-PI)

• Predominantly hyperactive–impulsive presentation (ADHD-HI)

• Combined presentation (ADHD-C)

ADHD PRESENTATION TYPES IN DSM-5

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• Most common presentation, especially in girls

• But least referred. Why?

• May have comorbid learning disability, process information slowly, have trouble remembering things, and display low academic achievement

• Often anxious, socially withdrawn or immature, and can develop depression

• Cluster of symptoms known as “sluggish cognitive tempo”

PREDOMINANTLY INATTENTIVE TYPE (ADHD-PI)

EXAMPLE OF INATTENTIVE SUBTYPE

At age 17, Lisa struggles to pay attention and act appropriately. But this has always been hard for her. She still gets embarrassed thinking about the time that her parents took her to a restaurant to celebrate her 10th birthday. She was so distracted by the waitress’s bright red hair that her father had to call her name three times before she remembered to order. Then, before she could stop herself, she blurted “your hair dye looks awful.”

In school, Lisa was quiet and cooperative but often seemed to be daydreaming. She was smart, yet couldn’t’ improve her grades no matter how hard she tried. Several times she failed exams. She knew the answers, but couldn’t keep her mind on the test. Lisa found it agonizing to do homework. Often, she forgot to plan ahead by writing down the assignment or bringing home the right book. And when trying to work, every few minutes she found her mind drifting to something else. As a result, she rarely finished and her work was full of errors.

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• Requires six symptoms of inattention AND six symptoms of hyperactivity- impulsivity

• Type most often referred for treatment

COMBINED TYPE (ADHD-C)

• Primarily symptoms of hyperactivity-impulsivity (rarest group)

• Primarily includes preschoolers and may have limited validity for older children

• May actually be a distinct subtype of ADHD-C where inattentive symptoms don’t become apparent until demands of school increase

PREDOMINANTLY HYPERACTIVE-IMPULSIVE TYPE (ADHD-HI)

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EXAMPLE OF HYPERACTIVE-IMPULSIVE SUBTYPE

Mark, age 14, has more energy than most boys his age. But then, he’s always been overactive. At age 3, he was a human tornado, dashing around and disruptive everything in his path. At home, he darted from one activity to the next, leaving a trail of toys behind him. At meals, he upset dishes and talked non-stop. He was reckless and impulsive, running into the street despite oncoming cars., no matter how often his mother explained the danger or scolded him. At the playground, his tendency to overreact – like socking playmates simply for bumping into him – had already gotten him into trouble several times.

• Developmentally insensitive

• Same symptoms at all ages, even though some more likely in younger children

• Number symptoms not adjusted for age or maturity level (except: reduced symptom count to 5 for individuals over 17)

• Categorical view of ADHD

• Both statistical and neurobiological research support the idea that ADHD is a dimensional rather than a categorical disorder

• Can wax in and out of diagnosis

• Presentation types are unstable over time

LIMITATIONS OF DSM-5 CRITERIA FOR ADHD

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DEMOGRAPHICS

• 6-7% in children/adolescents in North America vs. 5% worldwide

• ADHD occurs more frequently in boys

• 2% to 4% of all school aged girls and 6% to 9% for all school aged boys

• ADHD in girls may go unrecognized and unreported

• DSM criteria (cutoffs and symptoms) may be more appropriate for boys than girls

• Girls with ADHD are more likely to display inattentive symptoms and to have trouble during adolescence (e.g., anxiety, depression, peer rejection; difficulties with romantic relationships)

• ADHD found in all social classes

• Slightly more prevalent among lower SES groups

• ADHD is found in all countries and cultures

• Rates vary

• But diagnosed more often in boys than girls in all cultures

SOCIOECONOMIC STATUS AND CULTURE

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Infancy

• Signs of ADHD may be present at birth - no reliable or valid methods exist to identify it

Preschool

• Hyperactivity-impulsivity symptoms become more visible and significant at ages 3 to 4

Symptoms are especially evident when the child starts school • Deficits in attention became more apparent as school demands increase

ADHD OVER DEVELOPMENT

• Many children with ADHD do not outgrow problems and some can get much worse

• 50% of clinic-referred children continue experience problems in adolescence

• Adult challenges

• Some individuals either outgrow symptoms or learn to compensate by adulthood

ADHD OVER DEVELOPMENT