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Attention Deficit Disorder

Attention Deficit Disorder. December 8, 2004. Attention Deficit Hyperactivity Disorder: DSM-IV-TR . ADHD: combined type ADHD: predominantly inattentive type ADHD: predominantly hyperactive-impulsive type. Prevalence Data. Approximately 3-7% of school-aged children have ADHD.

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Attention Deficit Disorder

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  1. Attention Deficit Disorder December 8, 2004

  2. Attention Deficit Hyperactivity Disorder: DSM-IV-TR • ADHD: combined type • ADHD: predominantly inattentive type • ADHD: predominantly hyperactive-impulsive type

  3. Prevalence Data • Approximately 3-7% of school-aged children have ADHD. • Estimates that 23-50% of children receiving clinical services have ADHD. • Occurs more frequently in males than females • 3:1 non-clinic samples • 6:1 clinic samples

  4. Etiology • Genetic Component • Twin studies: 51% concordance for monozygotic twins; 33% in dizygotic twins. • Brain Functioning • Decreased activity of inhibitory areas of the brain (e.g., prefrontal cortex). • Impairments on executive function tasks.

  5. ADHD Comorbidity • Learning Disorders: 25-50% • Oppositional Defiant Disorder: 35% • Conduct Disorder: 26% • Depressive Disorder: 18% • Anxiety Disorder: 26%

  6. ADHD Diagnostic Evaluation • Parent Interview • Parent & Teacher Ratings (broad and narrow) • Intellectual Assessment • Achievement Testing

  7. Issues in Diagnosing ADHD • Age of onset – must be prior to 7 years • Developmental level – must be inconsistent with child’s mental age • Symptoms must be present in two or more settings • Medical confounds – must not be due to side effects associated with medical conditions or medications • Family/environmental confounds – rule out family stress, anxiety, depression as cause of symptoms

  8. Performance-Based Assessment of ADHD (Rapport et al., 2000) • Continuous Performance Test • X only – discriminated between ADHD and non-ADHD on 18/21 studies (86%) • AX – 28/31 studies (93%) • Stop Signal (7/9 studies, 78%) • WISC-R Arithmetic (3/4 studies, 75%) • WISC-R Coding (3/4 studies, 75%) • Argue that all of these tasks involve working memory.

  9. Behavioral Assessment Scale for Children (BASC) • 3 informant versions provide comparisons across multiple informants: • Parent • Teacher • Self-report • 3 age versions: • preschool (4 to 5 years) • child (6 to 11 years) • Adolescents (12 to 18 years)

  10. ADHD ProfileMean T-Values on BASC

  11. University Medical CenterADHD Clinic Assessment Battery: • Parent interview • School questionnaire • Parent and teacher rating scales: • BASC • CSI-4 • IQ screener: WASI • Achievement screener: WRAT-3 • Physical Examination Case Study

  12. Interventions • Educational Accommodations • Behavior Management • Positive reinforcement • Token economy • Medication Management • 60-90% respond to medication • See medication handout

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