ADHD in pediatric population commom problems.ppt

Attention Deficit hyperactive disorder

1. ATTENTION ATTENTION
DEFICIT HYPER-DEFICIT HYPER-
ACTIVITY ACTIVITY
DISORDERDISORDER
DR.KAMILA IFTIKHARDR.KAMILA IFTIKHAR

2. What is ADHDWhat 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-IVACCORDING 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-
IMPULSIVITYIMPULSIVITY
•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 ADHDClassification 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 DISORDERSCO-MORBID DISORDERS
•SPECIFIC DEVELOPMENTAL
DISORDERS
•MILD MENTAL DISORDERS
•OPPOSITIONAL DEFIANT DISORDER
•CONDUCT DISORDER
•ANXIETY DISORDERS
•BIPOLAR DISORDERS
•TIC DISORDERS

10. ETIOLOGYETIOLOGY
•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 DIGNOSISMAKING 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. MANAGEMENTMANAGEMENT
•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 TREATMENTMULTI-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.