Attention deficit hyperactive disorder

Sudhir GuptaMsc(Psychiatry)

ADHD

What is ADHD? ADHD ,(attention deficit hyperactive

disorder), is a common behavioral condition that affects children and adolescents and it can also continue on into adulthood.

Causes Most scientists are not sure what really causes

ADHD, but they do know that it results from a combination of factors, especially genes. Most scientists suggests that it derives from environmental factors or nutrition that effects ADHD.

Genes: We inherit them from our parents. Which shows that ADHD can run in the family. Studies show that some children with ADHD carry a very specific gene that has thinner brain tissue where areas of the brain are associated with attention.

Causes Environmental Factors: Studies show that

cigarette smoking and alcohol drinking during pregnancy can cause development of ADHD.

  Brain Injury: Some children who have brain

injury might suffer from ADHD symptoms afterwards.

Sugar: Studies show that when children are given sugar additives, it can cause ADHD or make the symptoms worse.

Types

Predominantly hyperactive-impulsive

Predominantly inattentive Combined hyperactive-

impulsive and inattentive

Symptoms Inattentive Type:

› Inability to pay attention, especially in class or when given instructions.

› Carless mistakes while doing work› Having difficulty following directions› Difficulty with keeping things organized› Refusal or dislike of doing tasks that require mental effort› Loses or misplaces things frequently and easily like toys, or work› Easily distracted › Forgetfulness with taskHyperactive-Impulsive Type:› Excessive talking› Excessive fidgeting and squirming › Having a hard time staying in your seat› Blurting out answers before the question is fully given› Problems with interrupting people’s conversations

Age Ranges for On-set ADHD

ADHD usually appears early in a child’s life from ages 3 to 6 but because each child will have different symptoms and different personalities, it is hard to diagnose the disorder.

Diagnostic criteria DSM-IV-TR Diagnostic Criteria for

Attention-Deficit/Hyperactivity Disorder Either (1) or (2):

› six (or more) of the following symptoms of inattention have persisted for at least 6 months

Inattention often fails to give close attention to schoolwork, or other

activities often has difficulty sustaining attention in tasks or play

activities often does not seem to listen when spoken to directly failure to understand instructions often has difficulty organizing tasks and activities

Diagnostic criteria

often loses things necessary for tasks or activities (e.g., toys, pencils, books, or tools)

is often easily distracted by extraneous stimuli is often forgetful in daily activities

2six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months

Hyperactivity often fidgets with hands or feet or squirms in seat often leaves seat in classroom or in other situations in

which remaining seated is expected often runs about or climbs excessively in situations in which

it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

Diagnostic criteria

often has difficulty playing or engaging in leisure activities quietly

is often achieving the goal often talks excessively

Impulsivity often blurts out answers before questions have been

completed often has difficulty awaiting turn

often interrupts or intrudes on others Some hyperactive-impulsive or inattentive symptoms that

caused impairment were present before age 7 years. Some impairment from the symptoms is present in two or

more settings (e.g., at school [or work] and at home).

Treatment

Treatments: Behavioral Therapy

Research shows that behavior therapy can help a great deal with the children’s outlook on their disorder. It helps them cope with it, making it easier to handle. Therapy also can help the relationship between the child and their family.

Treatments: Behavior Therapy

This list might help your child’s behavior therapy be successful: › Create a routine: try not to w=switch things up so

much, make your daily schedule easy for your child to manage.

› Get organized: Keep your child’s bags, toys and other materials in the same spot every time , so it will be easy for your child to access them.

› Avoid distractions: Turn off all distracting things like TVs, radios, etc , especially if your child is doing homework.

› Limit choices: Giving your child a lot to choose from can overwhelm your child. Minimize them so that it will be easier for your child to make up their mind.

Treatments: Behavior Therapy

This list might help your child’s behavior therapy be successful:› Change your interactions with your child: Instead of

having long lectures, briefly discuss with your child their responsibilities.

› Bribe them with rewards or goals: Use charts to track their good behavior, this will make them excited to behave because they know that they will be rewarded for it.

› Discipline: Be careful on how you discipline your child. You can easily and mentally mess them up if done wrong. Try not to do excessive yelling or spanking.

› Help them find a talent: Helping them reach their dreams can help their confidence in life.

Tips for Adults with ADHD Create an organized space: Make a storage or space that

specifically accommodates all of your work or important items like bills, letters, keys, etc.

Buy a day planning calendar: Keeping up with certain dates is very important. Using a planner or a calendar App for your phone can give you easy access to the information that you need to know.

Use Lists: Create lists that show upcoming dates of important events. It is easier to check them off as you complete the tasks rather than to keep up with them mentally. This is good for groceries, doctors appointments, projects, upcoming tests, and other things.

Don’t put things off for later: Instead of waiting till the last minute to complete a task, go ahead and do it now while its fresh in your mind. It is very common for people with ADHD to forget about their responsibilities.

Commonly used medication for ADHD Patients

Adderall: Adderall (amphetamine) is a prescribed medication used to decrease the symptoms of ADHD. It is a central nervous stimulant which increases the level of the brain dopamine. It creates a calm and focusing effect on people who take the pill.

Focalin (oral): Dexmethylphenidate is a mild stimulant which alters the amounts of natural substances in the brain. This medication helps increase your ability to pay attention, stay focus, and control behavioral problems. It also helps you to organize tasks and improve listening skills.

Ritalin LA (oral): Methylphenidate can also be used to help increase your ability to pay attention, complete tasks, control behavior, and stay focus.

Parents, Calm Your Temper as Well!

Children at ADHD have trouble communicating to their parents already, don’t make it worse by excessively yelling and doing long lectures. This can also make a child sad and confused because they cannot understand why they are in trouble. On the other hand, most children that take these punishments try to tune their parents out so most of these methods are a waste of time.

Communicate Have a family meal together, ask about

how your child's’ day went and what did he/she learn. Studies show that families that communicate more throughout the day have a healthier relationship.

Have Fun Have fun with your children, the better

experiences you have with your child, the more positive they will be about life. Anything that has to do with being positively active will suffice.

Help them Cope with Anger Teach your child various methods to cope

with their anger. It is very easy for a child with ADHD to lose their temper when something doesn’t go right. Sit down and have a face-to-face reasonable conversation with your child. NO YELLING!

Make Sure they are Learning in Class

Constantly keep in touch with their teachers, and make sure that their hard work in class reflects their grades.

Put them in Tutorials If your child is still struggling in class,

put them in tutorials or enroll them in a learning center such as Sylvan or Huntington Learning facility.

Put Your Child in Extracurricular Activities

Since your child is already energetic, put that into good use by letting he/she play sports! Studies also show that this is a great stress reliever.

Most of All, Give them Confidence!

Make them believe that they have the ability to accomplish anything they put their minds to. Giving them confidence helps with most children with ADHD low self-esteem

Nursing intervention Accept the child or individual as what

he is. Approach the child at his current

level of functioning. Encourage him to express his

thought  Use simple and direct instructions. Implement scheduled routine every

day. Involve the child in Play Therapy. Give positive reinforcements.  Administer medications as ordered.

Thank you