Is characterized by persistent inattention or by hyperactivity / impulsivity for at least 6 months affecting about 3 to 5 percent of children globally and diagnosed

d in about 2 to 16 percent of school aged children.

continuation..
ADHD is diagnosed two to four times more frequently in boys than in girls It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.

 ADHD has three subtypes:

Predominantly hyperactiveimpulsive
Most symptoms (six or more) are in the hyperactivity-impulsivity categories. Fewer than six symptoms of inattention are present, although inattention may still be present to some degree

Continuation.

Predominantly inattentive
The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.

Continuation.
Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice symptoms of ADHD.

 Combined hyperactiveimpulsive and inattentive

Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present. Most children with ADHD have the combined type.

ADHD possible causes: Genetics Biochemical (possible neurochemical deficits [dopamine norepinephrine]) Intrauterine exposure to substances such as alcohol or smoking; exposure to lead Dyes additives in food Stressful home environments

Inattention includes: Carelessness and inattention to detail Cannot sustain attention and does not appear to be listening Does not follow through on instructions and unable to finish task, chores, homework Difficulty with organization and dislikes activities that require concentration and sustained effort Loses things; distracted by extraneous stimuli Forgetful

Hyper activity impulsivity includes: Hyperactivity Fidgeting, moving feet, squirming Leaves seat before excused Runs about/ climbs excessively Difficulty playing quietly on the go and driven by motor Excessive talking Impulsivity Blurts out answers without thinking Problems waiting for his turn Interrupts or intrudes

Methylphenidate
Brand Names: Ritalin, Metadate, Concerta Type: Stimulant How it works: Increases the release of dopamine and norepinephrine Side Effects: fast, pounding, or uneven heartbeats; feeling like passing out, fever, aggression, restlessness, hallucinations, unusual behavior, motor tics, easy bruising, dangerously high blood pressure

Dextroamphetamine
Brand Names: Dexedrine Type: Stimulant How it works: is to stimulate the release of several biogenic amines from storage sites in the nerve terminal. Each molecule of amphetamine that is taken up by the nerve terminal displaces one molecule of neurotransmitter. At typical doses, amphetamines stimulate the release of norepinephrine. Increases brain activity and the ability to focus Side Effects: fast or pounding heartbeats; fainting; dangerously high blood pressure tremor, restlessness, hallucinations, unusual behavior, or motor tics

Amphetamine
Brand Names: Adderall Type: Stimulant How it works: works by blocking the reuptake of dopamine and norepinephrine into the presynaptic neuron and increasing their release from the presynaptic neuron into the extraneuronal space. In other words, Adderall "reverses" the reuptake mechanism, turning it into a pump instead of a vacuum. Side Effects: fast, pounding, or uneven heartbeats, fainting, increased blood pressure, tremor, restlessness, hallucinations, unusual behavior, or motor tics

Atomoxetine
Brand Names: Strattera Type: Anti depressant How it works: to inhibit the reuptake of the neurotransmitter norepinephrine. Consequently, it is called a selective norepinephrine reuptake inhibitor Side Effects: include upset stomach, decreased appetite, nausea or vomiting, dizziness, tiredness, and mood swings.

 individual/family theraphy Behavior modification Support desired behaviors and immediately respond to undesired behaviors with consequences Roleplaying: helpful in teaching friend friend interactions; helps child prepare for interactions and understand how intrusive behavior annoy and drive friends away

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Seek out special education Classroom: seat near teacher, one assignment at a time, untimed test, tutoring

Short-term or Long-term Counseling

(CHADD, 2010, Treatment, para.

17

Parent Training

(CHADD, 2010, Treatment,

18

Special Education/Occupation Therapy

(CHADD, 2010, Treatment, para. 3)

19

Risk for injury Impaired social interaction Ineffective role performance Compromised family coping

 Set realistic expectations and limits because the patient with attention deficit hyperactivity disorder is easily frustrated Always remain calm and consistent with the child. Keep all your instructions to the child short and simple. Provide praise and rewards whenever possible.

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Provide the patient with diversional activities suited to his short attention span. Help the parents and other family members develop planning and organizing systems to help them cope more effectively with the child's short attention span.