ADD/ADHD

1. ADD/ADHD Duygu Kanat Mehmet Şahin GPC 126 29.04.2014

2. Outline What is ADD/ADHD History of ADD/ADHD Case of brain Diagnose Who can diagnose ADD/ADHD Causes Treatment Coexisting conditions Adult ADHD

4. What is ADD/ADHD Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder that mainly affects children, but can also affect adults.

5. History • ADHD was first recognized as a disorder in 1902 • In 1956, Ritalin came on the market • In 1998, the American Medical Association stated that ADHD was one of the most researched disorders.

6. What is happening in theirbrain?

7. Thefrontalcortex of ADHD personappearsthinner. • Motor cortexgrow much faster than normal • The brains of boys and girls with ADHD were 3% to 4% smaller than normal one.

8. https://www.youtube.com/watch?v=u82nzTzL7To

9. Diagnose The contemporary concept of ADHD as defined in the DSM-IV-TR (APA2000) is relatively new.

10. Diagnostic criteria for ADHD To be diagnosed with ADHD, child must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders published by the APA.

11. Diagnostic criteria for ADHD Inattention • Often fails to give close attention to details or makes careless mistakes in schoolwork and other activities • Often has difficulty sustaining attention in tasks or play activities • Often doesn't follow through on instructions and fails to finish school work or chores • Often avoids, dislikes tasks that require sustained mental effort, such as schoolwork or homework • Often loses items necessary for tasks or activities such as toys, school assignments, pencils • Is often forgetfull in daily activities

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14. TYPES OF ADHD • 1)Predominantly Inattentive Presentation

15. This is what is typically referred to when someone uses the term ADD. This means a person shows enough symptoms of inattention, but doesn’t meet the full criteria for hyperactivity and impulsivity

16. Example

17. TYPES OF ADHD 2)Predominantly Hyperactive-Impulsive Presentation

18. Inversely, this type occurs when a person has enough symptoms of hyperactivity and impulsivity but not enough for inattention.

19. Example

20. TYPES OF ADHD 3)Combined Presentation

21. This type is when a person meets the criteria of both inattention and hyperactivity and impulsivity.

22. Example

24. Who can diagnose ADD/ADHD? .

25. The Psychiatrist • A psychiatrist, an M.D. who treats the brain, may prescribe medication or other treatment

26. The Psychologist A psychologist understands how the mind works, but is not an M.D. and cannot prescribe medications. If the psychologist feels that medications are called for, he or she will have to refer the patient to either a medical doctor or a psychiatrist.

27. Family’s Doctor Most family doctors know of ADD/ADHD but may lack the extensive knowledge of more specialized professionals.

28. The Neurologist A neurologist is a doctor who specializes in treatment of the brain and central nervous system.

29. The Master Level Counselor A Master level counselor has a master's degree in either psychology or counseling. They may be able to do an initial assessment if they have the appropriate training.

30. Causes While the exact cause of ADHD is not clear, research efforts continue.

31. Risk Factors • Blood relatives • Exposure to environmental toxins • Maternal drug use, alcohol use or smoking during pregnancy • Maternal exposure to environmental poisons • Premature birth

32. Although sugar is a popular suspect in causing hyperactivity, there's no reliable proof of this. Many things in childhood can lead to difficulty sustaining attention, but that is not the same as ADHD.

33. Children with ADHD • They often struggle in the classroom • They tend to have more accidents and injuries • They have poor self-esteem • They are more likely to have trouble interacting with and being accepted by peers and adults • They are at increased risk of alcohol and drug abuse and other delinquent behavior

34. Treatment is it working? may be(!)

35. Standard treatments for ADHD in children include medications, education, training and counseling

36. Medication Currently, stimulant drugs (psychostimulants) are the most commonly prescribed medications for ADHD.

37. Stimulants Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters.

38. Stimulants Examples include methylphenidate (Concerta, Metadate, Ritalin, others), dextroamphetamine (Dexedrine), dextroamphetamine-amphetamine (Adderall XR) and lisdexamfetamine (Vyvanse).

39. Methylphenidate is a short acting drug, and in older forms, had to be taken multiple times a day. Longer-acting versions of the drug are now available for once-daily use.

40. Other Drugs Other medications used to treat ADHD include atomoxetine (Strattera) and antidepressants such as bupropion (Wellbutrin, others) and desipramine (Norpramin). Clonidine (Catapres) and guanfacine (Intuniv, Tenex) have also been shown to be effective.

41. Non Stimulants Atomoxetine and antidepressants work slower than stimulants and may take several weeks before they take full effect. These may be good options if the child can't take stimulants because of health problems or if stimulants cause severe side effects.

42. Most Common Side effects of Stimulants • Loss of appetite • Weight loss • Sleep problems

43. Rare Side Effects of Stimulants Although rare, several heart-related deaths occurred in children and teenagers taking stimulant medications.

44. The possibility of increased risk of sudden death is still unproved, but if it exists, it's believed to be in people who already have underlying heart disease or a heart defect.

45. Suicide Risk Although it remains unproved, concerns have been raised that there may be a slightly increased risk of suicidal thinking in children and teenagers taking nonstimulant ADHD medication or antidepressants.

46. ADHD Behavior Therapy and Counseling Behavior therapy: Teachers and parentscan learn behavior-changing strategies for dealing with difficult situations. These strategies may include token reward systems and timeouts.

47. Psychotherapy: This allows older children with ADHD to talk about issues that bother them, explore negative behavioral patterns and learn ways to deal with their symptoms.

48. Parenting skills training: This can help parents develop ways to understand and guide their child's behavior

49. Family therapy: Family therapy can help parents and siblings deal with the stress of living with someone who has ADHD.

50. Social skills training: This can help children learn appropriate social behaviors.