ADHD

1
ADHD

• Fatima Al-Haidar
• Professor, Child Adolescent Psychiatrist
• KSU

2
Development of Normal Attention

• Newborn pay attention to certain kinds of
  stimuli.
• Moving objects
• Intermittent tones
• Pictures of human face
• Developmental dimensions
• Exploration
• Search
• Distraction
• Span of attention
• Links with other cognitive skills.

3
ADHD

• Definition
• Combination of over activity, poorly modulated
  behavior with marked inattention, lack of
  persistent task involvement, restlessness,
  impulsive tendencies and a high degree of
  distractibility with an early onset and duration
  of more than 6 months.

4
Background Information

• UK 0.5 1.0
• US 3 5
• Boys Girls
• 3 4 1
• No social class variations
• KSA !!!

5
Clinical features

• Onset
• Duration
• Hyperactivity
• Impulsivity
• Inattention
• Sleep

• School
• Learning
• Play
• Friendship
• Sociability

6
Comorbidity

• Over 50 of ADHD have comorbidity
• Oppositional/defiant disorder 40
• Conduct disorder 25
• Depressive disorder 15
• Anxiety disorder 25
• Learning disability 15-40
• Language impairment 15-75
• Other

7
Etiology

• Genetic factors
• Brain dysfunction
• Neurochemical factors
• Diet
• Lead
• Temperament

• Psychological factors
• Social factors
• Parental behavior
• Early childhood experience
• Interactional effects

8
Assessment

• What ?
• When ?
• Where ?
• For how long ?
• Family issues !!!
• Chart .

9
Treatment

• Counseling of parents
• Environmental manipulations
• Formal behavioral modification programs
• Medication
• Dietary treatment.

10
Outcome

• Mild and pure forms have reasonably good outcome
• Severe forms show poor scholastic achievement,
  antisocial
• Behavior, increased risk for substance abuse,
  poor work
• Records, and relationship difficulties.
• Prolongation of ADHD into adulthood is well
  described.