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Title: Attention%20Deficit%20Hyperactivity%20Disorder


1
Attention Deficit Hyperactivity Disorder
  • A Review of An Overview of ADHD
  • Past and Present
  • Presented by Dr. Chris Babbitt
  • Compiled by Patrice Edgar
  • 1/22/07

2
ADHD Facts
  • ADHD is a brain based disorder. It is not
    primarily behavioral.
  • 3-5 of school age children have ADHD.
  • ADHD is under diagnosed most often in girls.
  • 80 of children with ADHD continue to have
    symptoms into adulthood.
  • Ritilin has been used to treat ADHD since the
    1950s.

3
  • ADHD is a disability, a handicapping condition
    that is treated, but not cured.

4
  • Children with ADHD need stimulation to keep
    going.
  • They act out to gain that stimulation.

5
Causes of ADHD
  • Although there is no one proven cause of ADHD,
    there is a strong genetic component. 50 of
    children with the disorder have a parent with
    ADHD.
  • Head injury.
  • Environmental issues such as lead exposure are
    another area of concern.

6
Children with ADHD may have multiple symptoms.
  • Conduct disorders 24
  • Oppositional Defiant Disorder 50
  • Learning Disabilities 30
  • Depression 15-20
  • Aspergers
  • Sensitivity/skin allergies

7
Official New Labels
  • Attention Deficit Hyperactivity
  • Disorder Primarily Inattentive.
  • Attention Deficit Hyperactivity
    Disorder-Primarily Hyperactive and Impulsive.
  • Attention Deficit Hyperactivity Disorder-Combined

8
Diagnostic Criteria
  • Six or more symptoms of inattention,
    hyperactivity-impulsivity must have persisted for
    at least 6 months to a degree that is maladaptive
    and inconsistent with developmental level.
  • Diagnostic Systems Manual (DSMIV)

9
Research by Daniel Amen
  • Amen used SPECT Scans to look at blood flow in
    the brain. The scans showed that the frontal
    lobes of the brain of children with ADHD are
    poorly infused with blood.
  • An increase of blood and a decrease in symptoms
    occurred with medication and diet.

10
  • Amen identified six types of ADHD based on the
    scans.

11
Type 1
  • Classic ADHD-over active, poorly attentive,
    fidgety, impulsive, poor judgment, and
    organization.
  • Scans showed frontal lobe issues in the
    Prefrontal Cortex.
  • Stimulant medication was appropriate when used at
    the right dose. It showed blood getting into the
    frontal lobe efficiently. Adderal and Concerta
    were the medicines of choice.
  • A high protein-low carbohydrate diet was helpful
    along with aerobic exercise.

12
Type 2
  • Inattentive ADHD-disorganization, poor follow
    through, and under activity.
  • The areas of poor blood infusion were more spread
    over the brain.
  • Stimulant medications such as Adderal and
    Concerta were appropriate.
  • A high protein-low carbohydrate diet and aerobic
    exercise was recommended.

13
Type 3
  • Over focused ADHD-rigid thought process,
    stubborn, difficulty shifting tasks, rule
    governed, not a flexible thinker, addictive
    personality.
  • Stimulants will not work. An antidepressant such
    as Effexor is recommended.
  • Add more carbohydrates to diet and aerobic
    exercise is appropriate.

14
Type 4
  • Lymbic- The lymbic system is in the middle of the
    brain and deals with emotion and expression.
  • This person is distractible, poorly organized,
    etc, but also very moody.
  • Amen treated this type with Welbutrin.
  • A well balanced diet is recommended.

15
Type 5
  • Temperal ADHD-occurs in the temperal lobe of the
    brain.
  • All the classic ADHD symptoms in addition to
    memory problems. These children are poor
    predictors and cant place themselves in time.
  • Anticonvulsive medicines such as Depacote and
    Tegratal are recommended.
  • A high protein diet along with simple
    carbohydrates was recommended.

16
Type 6
  • Ring of Fire ADHD
  • The child appears behaviorally disordered,
    defiant, unable to sit still and attend. May look
    Bipolar.
  • Problems with infusion all around the brain which
    interferes with regulation of behavior, emotion,
    and judgment.
  • An antipsychotic medication such as Risperdal and
    Zyprexa are recommended.
  • Diet should include high protein and simple
    carbohydrates.

17
Long Term Study of Treatment for ADHD By the MTA
Cooperative Group
  • Four types of treatment were studied.
  • 1. Medication alone
  • 2. Intensive behavioral therapy alone
  • 3. Combination of medication and
  • behavior
  • 4. Routine community care

18
Study Results
  • Medication alone and the combination treatment
    were more effective than behavioral therapy and
    routine community care.
  • The combination of medication and therapy was not
    proven to be better than medication alone.
  • Combined treatment outcomes were achieved with
    significantly lower medication doses than used in
    medication management.

19
Study Results
  • In the study, children generally tolerated their
    medication well, including a third dose given in
    the afternoon.
  • 36 no side effects
  • 50 mild side effects
  • 11 moderate side effects
  • 3 severe side effects

20
Using Medication With an ADHD ChildTaken From
Northwest Counseling Services, S.C.
  • Myth Using medication to treat ADHD will lead
    to other problems down the road.
  • Fact Untreated ADHD has far greater consequences
    than an ADHD that is treated with appropriate
    medication.

21
Using Medication With an ADHD Child continued
  • Children whose ADHD is not treated with medicine
    are far more likely to develop problems with drug
    and alcohol abuse in their teens and early
    twenties.
  • By some estimates as many as 35 of untreated
    ADHD children never finish High School.
  • Almost twice as many untreated ADHD children will
    choose to smoke cigarettes (19) as opposed to
    their treated peers (10).

22
Using Medication With an ADHD Child continued
  • Research indicates that 43 of untreated ADHD
    boys who are hyperactive will be arrested for a
  • felony by age 16.
  • Parents of untreated ADHD children divorce at a
    much higher rate that those of treated ADHD
    children.
  • Adolescent adult drivers with untreated ADHD
    take more risks and have more accidents.

23
Myths About ADHD
  • Myth Stimulants such as Ritilin agitate children
    with ADHD.
  • Fact Stimulants slow them down and help them to
    be calm.

24
Myths About ADHD
  • Antidepressants are a suicide risk.
  • False The risk is not caused by the pill. A
    depressed person may lack the energy to harm
    him/herself. When the person starts to get better
    they gain energy to complete the act.

25
Myths About ADHD
  • Stimulants cause cardiac problems.
  • False A pre-existing condition is the cause.
  • Watching television causes ADHD. False The
    problem is having a TV in the childs bedroom.
    It increases issues like social isolation, not
    ADHD.
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