Attention%20Deficit%20Hyperactivity%20Disorder

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Attention Deficit Hyperactivity Disorder

• A Review of An Overview of ADHD
• Past and Present
• Presented by Dr. Chris Babbitt
• Compiled by Patrice Edgar
• 1/22/07

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ADHD Facts

• ADHD is a brain based disorder. It is not
  primarily behavioral.
• 3-5 of school age children have ADHD.
• ADHD is under diagnosed most often in girls.
• 80 of children with ADHD continue to have
  symptoms into adulthood.
• Ritilin has been used to treat ADHD since the
  1950s.

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• ADHD is a disability, a handicapping condition
  that is treated, but not cured.

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• Children with ADHD need stimulation to keep
  going.
• They act out to gain that stimulation.

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Causes of ADHD

• Although there is no one proven cause of ADHD,
  there is a strong genetic component. 50 of
  children with the disorder have a parent with
  ADHD.
• Head injury.
• Environmental issues such as lead exposure are
  another area of concern.

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Children with ADHD may have multiple symptoms.

• Conduct disorders 24
• Oppositional Defiant Disorder 50
• Learning Disabilities 30
• Depression 15-20
• Aspergers
• Sensitivity/skin allergies

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Official New Labels

• Attention Deficit Hyperactivity
• Disorder Primarily Inattentive.
• Attention Deficit Hyperactivity
  Disorder-Primarily Hyperactive and Impulsive.
• Attention Deficit Hyperactivity Disorder-Combined

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Diagnostic Criteria

• Six or more symptoms of inattention,
  hyperactivity-impulsivity must have persisted for
  at least 6 months to a degree that is maladaptive
  and inconsistent with developmental level.
• Diagnostic Systems Manual (DSMIV)

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Research by Daniel Amen

• Amen used SPECT Scans to look at blood flow in
  the brain. The scans showed that the frontal
  lobes of the brain of children with ADHD are
  poorly infused with blood.
• An increase of blood and a decrease in symptoms
  occurred with medication and diet.

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• Amen identified six types of ADHD based on the
  scans.

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Type 1

• Classic ADHD-over active, poorly attentive,
  fidgety, impulsive, poor judgment, and
  organization.
• Scans showed frontal lobe issues in the
  Prefrontal Cortex.
• Stimulant medication was appropriate when used at
  the right dose. It showed blood getting into the
  frontal lobe efficiently. Adderal and Concerta
  were the medicines of choice.
• A high protein-low carbohydrate diet was helpful
  along with aerobic exercise.

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Type 2

• Inattentive ADHD-disorganization, poor follow
  through, and under activity.
• The areas of poor blood infusion were more spread
  over the brain.
• Stimulant medications such as Adderal and
  Concerta were appropriate.
• A high protein-low carbohydrate diet and aerobic
  exercise was recommended.

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Type 3

• Over focused ADHD-rigid thought process,
  stubborn, difficulty shifting tasks, rule
  governed, not a flexible thinker, addictive
  personality.
• Stimulants will not work. An antidepressant such
  as Effexor is recommended.
• Add more carbohydrates to diet and aerobic
  exercise is appropriate.

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Type 4

• Lymbic- The lymbic system is in the middle of the
  brain and deals with emotion and expression.
• This person is distractible, poorly organized,
  etc, but also very moody.
• Amen treated this type with Welbutrin.
• A well balanced diet is recommended.

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Type 5

• Temperal ADHD-occurs in the temperal lobe of the
  brain.
• All the classic ADHD symptoms in addition to
  memory problems. These children are poor
  predictors and cant place themselves in time.
• Anticonvulsive medicines such as Depacote and
  Tegratal are recommended.
• A high protein diet along with simple
  carbohydrates was recommended.

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Type 6

• Ring of Fire ADHD
• The child appears behaviorally disordered,
  defiant, unable to sit still and attend. May look
  Bipolar.
• Problems with infusion all around the brain which
  interferes with regulation of behavior, emotion,
  and judgment.
• An antipsychotic medication such as Risperdal and
  Zyprexa are recommended.
• Diet should include high protein and simple
  carbohydrates.

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Long Term Study of Treatment for ADHD By the MTA
Cooperative Group

• Four types of treatment were studied.
• 1. Medication alone
• 2. Intensive behavioral therapy alone
• 3. Combination of medication and
• behavior
• 4. Routine community care

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Study Results

• Medication alone and the combination treatment
  were more effective than behavioral therapy and
  routine community care.
• The combination of medication and therapy was not
  proven to be better than medication alone.
• Combined treatment outcomes were achieved with
  significantly lower medication doses than used in
  medication management.

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Study Results

• In the study, children generally tolerated their
  medication well, including a third dose given in
  the afternoon.
• 36 no side effects
• 50 mild side effects
• 11 moderate side effects
• 3 severe side effects

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Using Medication With an ADHD ChildTaken From
Northwest Counseling Services, S.C.

• Myth Using medication to treat ADHD will lead
  to other problems down the road.
• Fact Untreated ADHD has far greater consequences
  than an ADHD that is treated with appropriate
  medication.

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Using Medication With an ADHD Child continued

• Children whose ADHD is not treated with medicine
  are far more likely to develop problems with drug
  and alcohol abuse in their teens and early
  twenties.
• By some estimates as many as 35 of untreated
  ADHD children never finish High School.
• Almost twice as many untreated ADHD children will
  choose to smoke cigarettes (19) as opposed to
  their treated peers (10).

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Using Medication With an ADHD Child continued

• Research indicates that 43 of untreated ADHD
  boys who are hyperactive will be arrested for a
• felony by age 16.
• Parents of untreated ADHD children divorce at a
  much higher rate that those of treated ADHD
  children.
• Adolescent adult drivers with untreated ADHD
  take more risks and have more accidents.

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Myths About ADHD

• Myth Stimulants such as Ritilin agitate children
  with ADHD.
• Fact Stimulants slow them down and help them to
  be calm.

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Myths About ADHD

• Antidepressants are a suicide risk.
• False The risk is not caused by the pill. A
  depressed person may lack the energy to harm
  him/herself. When the person starts to get better
  they gain energy to complete the act.

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Myths About ADHD

• Stimulants cause cardiac problems.
• False A pre-existing condition is the cause.
• Watching television causes ADHD. False The
  problem is having a TV in the childs bedroom.
  It increases issues like social isolation, not
  ADHD.