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Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder. Features Classification Predominantly Inattentive Predominantly Hyperactive-Impulsive Combined. ADHD. Gender Differences Boys outnumber girls 4 to 1 Cultural Factors Probability of diagnosis is greatest in the United States Toxins as Cause?

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Attention Deficit Hyperactivity Disorder

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  1. Attention Deficit Hyperactivity Disorder Features Classification Predominantly Inattentive Predominantly Hyperactive-Impulsive Combined

  2. ADHD Gender Differences Boys outnumber girls 4 to 1 Cultural Factors Probability of diagnosis is greatest in the United States Toxins as Cause? Allergens and food additives NOT related Maternal smoking increases risk

  3. ADHD: Biological Factors • Genetic Factors • ADHD seems to run in families • Three specific genes have been implicated • Neurobiological Factors • Smaller brain volume • Inactivity of the frontal cortex and basal ganglia • Abnormal frontal lobe development and functioning

  4. Biological Treatment of ADHD Stimulant Medications Ritalin, Dexedrine, Adderall, others Paradoxical Effect Reduce the core symptoms of ADHD in 70% of cases Improve compliance and decrease negative behaviors Do not affect learning and academic performance Relapse following discontinuation

  5. Behavioral Treatment of ADHD • Behavioral Treatment • Increase appropriate behaviors and decrease inappropriate behaviors • May also involve parent training • Combined Biopsychosocial Treatments • Highly recommended • Generally superior to either tx alone

  6. Other Disruptive Behavior Disorders Conduct Disorder Oppositional Defiant Disorder

  7. Learning Disorders • Academic Performance Lower than IQ Predicts • Reading Disorder • Arithmetic Disorder • Disorder of Written Expression • Disorder vs. Disability?

  8. Autism Spectrum Disorders Autistic Disorder Social and Communication Impairment Restricted Behavior Asperger’s Disorder Similar to Austism without Communication Impairment

  9. Additional Pervasive Developmental Disorders • Rett’s Disorder • Initial Normal Development • Increasing Mental Retardation • Childhood Disintegrative Disorder • Regression in language and motor skills at 2 to 4 years

  10. Treatment of Autism Spectrum Disorders • Biological and medical treatments are unavailable • Behavioral treatments • Skill building • Reduction of problem behaviors • Target communication and language problems • Address socialization deficits • Early intervention is critical • Integrated treatments: The preferred model • Focus on children, their families, schools, and home

  11. Mental Retardation Mild IQ from 50-55 to 70 ~85% Moderate IQ from 35-40 to 50-55 ~10% Severe IQ from 20-25 to 35-40 ~3-4% Profound IQ below 20-25 ~1-2%

  12. Other Classification Systems • American Association of Mental Retardation • Levels of assistance required • Intermittent, limited, extensive, pervasive • Classification of MR in educational systems • Educable (IQ of 50 to 70-75) • Trainable (IQ of 30 to 50) • Severe (IQ below 30)

  13. Mental Retardation Biological Factors Chromosomal Down Syndrome, Fragile X Syndrome Neurological Injury Prenatal – exposure to disease or a drug/toxin Perinatal – difficulties during labor Postnatal – head injury Cultural-Familial Environmental Deprivation, Abuse Considered to be about 75% of Cases

  14. Treatment of Mental Retardation • Parallels treatment of pervasive developmental disorders • Teach needed skills • To foster productivity and independence • Educational and behavioral management • Living and self-care skills via task analysis • Communication training • Community and supportive interventions

  15. Other Childhood Disorders Tic Disorders Tourette’s Syndrome Elimination Disorders Separation Anxiety Selective Mutism Others

  16. Cognitive Disorders • Nature of Cognitive Disorders • Broad impairments in memory, attention, perception, and thinking • Profound changes in behavior and personality • Three Classes • Delirium • Dementia • Amnesia

  17. Dementia Gradual deterioration of brain functioning Affects judgment, memory, language, and advanced cognitive processes Dementia has many causes and may be reversible or irreversible Impairments have a marked negative impact on social and occupational functioning

  18. DSM-IV Classes of Dementia • Dementia of the Alzheimer’s type • Vascular Dementia • Dementia Due to Other General Medical Conditions • Parkinson’s Disease • Huntington’s Disease • Pick’s Disease • Creutzfeldt-Jakob Disease • Substance-Induced Persisting Dementia • Dementia Due to Multiple Etiologies • Dementia Not Otherwise Specified

  19. Range of Cognitive Deficits • Aphasia • Speech and word usage deficits • Apraxia • Task and coordination deficits • Agnosia/Facial Agnosia • Recognition deficits • Executive Function • Deficits in planning, organizing, sequencing, or abstracting information

  20. Treatment of Dementia • Medical Treatment: Best If Enacted Early • Few medical treatments exist for most types of dementia • Attempt to slow deterioration • Do not actually stop progression of dementia • Psychosocial Treatments • Focus on enhancing the lives of dementia patients and their families/caregivers • Teach adaptive skills • Use memory enhancement devices (e.g., memory notebook) • Main emphasis of psychosocial interventions is on the caregivers (help caregivers cope and help them help the patient)

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