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Is characterized by
persistent inattention or by
hyperactivity / impulsivityfor at least 6 months
affecting about 3 to 5
percent of children globallyand diagnosed in about 2 to
16 percent of school aged
children.
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ADHD is diagnosed two to fourtimes more frequently in boys
than in girls
It is primarily characterized by"the co-existence of attentional
problems and hyperactivity, with
each behavior occurringinfrequently alone" and
symptoms starting before seven
years of age.
continuation..
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ADHD has three subtypes:
Predominantly hyperactive-
impulsive Most symptoms (six or more) are in the
hyperactivity-impulsivity categories.
Fewer than six symptoms of inattention
are present, although inattention may
still be present to some degree
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Continuation.
Predominantly inattentive
The majority of symptoms (six or more)
are in the inattention category and
fewer than six symptoms of
hyperactivity-impulsivity are present,although hyperactivity-impulsivity may
still be present to some degree.
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Children with this subtype are less
likely to act out or have difficultiesgetting along with other children. They
may sit quietly, but they are not paying
attention to what they are doing.Therefore, the child may be
overlooked, and parents and teachers
may not notice symptoms of ADHD.
Continuation.
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Combined hyperactive-
impulsive and inattentive Six or more symptoms of inattention
and six or more symptoms of
hyperactivity-impulsivity are present.
Most children with ADHD have the
combined type.
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ADHD possible causes:
Genetics
Biochemical (possible neurochemical deficits
[dopamine norepinephrine])
Intrauterine exposure to substances such as
alcohol or smoking;
exposure to lead
Dyes
additives in food
Stressful home environments
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Inattention includes: Carelessness and inattention to detail
Cannot sustain attention and does not appear
to be listening
Does not follow through on instructions and
unable to finish task, chores, homework
Difficulty with organization and dislikes
activities that require concentration andsustained effort
Loses things; distracted by extraneous stimuli
Forgetful
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Hyper activity impulsivity includes:
Hyperactivity
Fidgeting, moving feet, squirming Leaves seat before excused
Runs about/ climbs excessively
Difficulty playing quietly on the go and driven by motor
Excessive talking
Impulsivity
Blurts out answers without thinking
Problems waiting for his turn
Interrupts or intrudes
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MethylphenidateBrand Names: Ritalin, Metadate, Concerta
Type: Stimulant
How it works: Increases the release of dopamineand norepinephrine
Side Effects: fast, pounding, or uneven
heartbeats; feeling like passing out, fever,aggression, restlessness, hallucinations,unusual behavior, motor tics, easy bruising,dangerously high blood pressure
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DextroamphetamineBrand Names: DexedrineType: StimulantHow it works:is to stimulate the release of several biogenicamines from storage sites in the nerve terminal.Each molecule of amphetamine that is taken up bythe nerve terminal displaces one molecule ofneurotransmitter. At typical doses, amphetamines
stimulate the release of norepinephrine.Increases brain activity and the ability to focusSide Effects: fast or pounding heartbeats; fainting;dangerously high blood pressure tremor,restlessness, hallucinations, unusual behavior, ormotor tics
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AmphetamineBrand Names: AdderallType: StimulantHow it works: works by blocking the reuptake of
dopamine and norepinephrine into the presynapticneuron and increasing their release from thepresynaptic neuron into the extraneuronal space. Inother words, Adderall "reverses" the reuptakemechanism, turning it into a pump instead of a
vacuum.Side Effects: fast, pounding, or uneven heartbeats,fainting, increased blood pressure, tremor,restlessness, hallucinations, unusual behavior, ormotor tics
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AtomoxetineBrand Names: Strattera
Type: Anti depressant
How it works: to inhibit the reuptake of theneurotransmitter norepinephrine. Consequently,it is called a selective norepinephrine reuptakeinhibitor
Side Effects: include upset stomach,decreased appetite, nausea or vomiting,dizziness, tiredness, and mood swings.
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individual/family theraphy
Behavior modification
Support desired behaviors and immediatelyrespond to undesired behaviors with
consequences
Roleplaying: helpful in teaching friend friend
interactions; helps child prepare for
interactions and understand how intrusive
behavior annoy and drive friends away
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Continuation.
Seek out special education Classroom: seat near teacher, one assignment
at a time, untimed test, tutoring
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Short-term or Long-term Counseling
(CHADD, 2010, Treatment, para. 17
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Parent Training
(CHADD, 2010, Treatment, 18
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Special Education/Occupation Therapy
(CHADD, 2010, Treatment, para. 3) 19
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Risk for injury
Impaired social interaction
Ineffective role performance
Compromised family coping
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Set realistic expectations and limitsbecause the patient with attention deficit
hyperactivity disorder is easily frustrated
Always remain calm and consistent withthe child.
Keep all your instructions to the child
short and simple. Provide praise and rewards whenever
possible.
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Continuation.
Provide the patient with diversional activities
suited to his short attention span.
Help the parents and other family members
develop planning and organizing systems to
help them cope more effectively with the
child's short attention span.
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