ADHD in pediatric population commom problems.ppt
- 1. ATTENTION ATTENTION DEFICIT HYPER- DEFICIT HYPER- ACTIVITY ACTIVITY DISORDER DISORDER DR.KAMILA IFTIKHAR DR.KAMILA IFTIKHAR
- 2. What is ADHD What is ADHD • It is a behavioral syndrome which cause significant dysfunction in important aspects of child's experience • Have Challenging relationships with parents ,teachers & peers • Have behavior & discipline problems in multiple settings in home,& school
- 3. ACCORDING TO DSM-IV ACCORDING TO DSM-IV • Six or more of following symptoms of inattention have persisted for at least 06 months • INATTENTION often fails to give close attention to details or make careless mistakes in school work, work or other activities. • has difficulty sustaining attention in tasks or play activities
- 4. • Does not seem to listen when spoken to directly does not follow through instructions & fails to finish school work chores or duties in the work place. • Has difficulty organizing tasks & activities • Often avoids, dislikes, or is reluctant to engage in tasks which require sustained mental effort
- 5. • Often loses things necessary for tasks (toys, school assignment, pencils books ) • Is easily distracted by extraneous stimuli • Is often forgetful in daily activities
- 6. HYPERACTIVITY- HYPERACTIVITY- IMPULSIVITY IMPULSIVITY • Six or more of following symptoms persistent for six months • HYPERACTIVITY : • Often fidgets with hands & feet or squirms in seat • Often leaves seat in classroom or othe situation in which remaining seated is expected
- 7. • Often “on the go” or if driven by motor • Often talks excessively • IMPULSIVITY: • Often blurts out answers before question is completed • Often has difficulty awaiting turns • Often interrupts or intrudes in others conversation
- 8. Classification of ADHD Classification of ADHD • ATTENTION DEFICIT/ HYPERACTIVITYDISORDER(COMBINE D TYPE) • ATTENTION DEFICIT/HYPERACTIVITY DISORDER PREDOMINANTLY INATTENTION TYPE • ATTENTION DEFICIT/HYPERACTIVITY DISORDER,PREDOMINANTLY HYPERACTIVE-IMPULSIVE TYPE
- 9. CO-MORBID DISORDERS CO-MORBID DISORDERS • SPECIFIC DEVELOPMENTAL DISORDERS • MILD MENTAL DISORDERS • OPPOSITIONAL DEFIANT DISORDER • CONDUCT DISORDER • ANXIETY DISORDERS • BIPOLAR DISORDERS • TIC DISORDERS
- 10. ETIOLOGY ETIOLOGY • Genetic factors • Medical risks (premature & LBW babies, increased lead levels,). • PET scan studies showed under activity in parts of cerebral cortex especially frontal lobe • Environmental factors are not causal factors but exacerbate symptoms of ADHD
- 11. MAKING THE DIGNOSIS MAKING THE DIGNOSIS • Careful & detailed history • Behavioral concerns • Who else is concerned • Attention span • Activity level • Is he impulsive (to act without thinking) • How he express his emotions • Does he get along with other kids
- 12. • Clinical observations • Diagnostic tests • Educational tests • Specific tests (Connors parents & teachers parents rating scale)
- 13. MANAGEMENT MANAGEMENT • Primary goals • To enhance child's functioning in academics, family, peer- relationship &self esteem • Information for the family • Medication treatment mostly stimulant medication
- 14. MULTI-MODAL TREATMENT MULTI-MODAL TREATMENT • Parent training in behavioral management, also involve teachers for training in schools • Additional therapies (individualized psychotherapy) improves Childs ability to pay attention & reduce impulsiveness • Family therapy • Social skills training.