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Attention Deficit Hyperactivity Disorder

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Attention Deficit Hyperactivity Disorder

ADHD (attention deficit hyperactivity disorder) is a prevalent pediatric psychiatric illness marked by age-inappropriate characteristics of attention deficit, restlessness, and aggression. Before the age of 12, a child must exhibit a minimum six of the nine characteristics of attention deficit and/or hyperactivity/impulsivity to be identified with ADHD.

ADHD I - NeuroDiverCityS

· Its clinical display changes over time, and the effect of the disorder on a person’s daily performance is primarily determined by his or her maturational phase.

Signs and Symptom

Individuals may manifest with symptoms of hyperactivity, and attention deficit which include;

Hyperactivity symptoms

attention deficit symptoms

· Flinches in seat and fidgets with or taps hands or feet.

· Feels restless 

· they have a hard time participating in peaceful, relaxing activities.

· Is “on the move” or seems to be “powered by a motor”

· talks a lot.

· Answers in a jumble

· they have a hard time waiting their turn

· Interrupts or intrudes other people

· Makes thoughtless errors/doesn’t pay attention to details

· Makes thoughtless errors/doesn’t pay attention to details

· When addressed to directly, he does not appear to listen.

· Failure to complete duties and instructions

· Shows a lack of organization.

· Tasks demanding persistent mental effort are avoided or disliked.

· Is prone to misplacing items that are required for chores or activities.

· Distracted easily (including unrelated thoughts)

· Is prone to forgetfulness in everyday tasks

Incidence and prevalence

· According to CDC researchers, 6.1 million children aged 2 to 17 years in the United States were diagnosed with attention deficit hyperactivity disorder (ADHD) in 2016, which is consistent to prior figures.

· In comparison to children in urban or suburban regions, researchers discovered that children in rural areas were more likely to be diagnosed with ADHD and less likely to get behavioral therapy in the previous year.

· 62%, 20 youngsters in the United States, were on ADHD medication.

· In the previous year, 47 percent) of people with ADHD got behavioral therapy for 5-7 years patients. The figure grew to nearly half (60 percent) among the youngest children (2-5 years old).

· 64% of the DHD patients have other mental illnesses

Considerations related to culture, gender, age

· Men are more often affected by ADHD, compared to females with a male to female ratio of around 4:1.

· Hispanic Americans re more likely to be affected

· European Americans re less likely to be affected

· Symptoms appear to diminish with age.

· Symptoms of hyperactivity dimmish almost completely

· Attention deficit persists to adulthood, with patients remining inattentive and disorganized

Diagnostics and labs

· There are usually no diagnostic tests for ADHD.

· Diagnosis is usually made based on clinical presentation and evaluation.

· Laboratory tests like liver function tests re often carried out to assess for liver function before initiating treatment

Differential diagnoses

Disorder

Differentiating Features from ADHD

Oppositional Defiant and

Conduct Disorders

Although he resists adult guidance at first, once involved in a task, he is able to persevere (sustain attention).

Has no hyperactive or impulsive tendencies. Behavioral issues are particularly severe at residence (defiance often directed primarily toward parents)

Learning disorders

The symptoms are related to the academic environment and/or courses (e.g., reading groups).

Lacks a historical origin of hyperactivity and impulsivity-related difficulties (e.g., no violence or disruption).

Anxiety and mood disorders

Problems with continuous (but not focused) attention. a history of these illnesses in the family (vs. a history of ADHD).

‘Overrestricted’ (not impulsive).

Symptoms appear after the age of seven (lacks preschool history of hyperactivity).

Disruptive conduct or instructor worries about restlessness, impulsivity, or attention problems are usually not included in school performance.

Autism

Internal (rather than exterior) stimuli cause distractible inattention. Worsening in concentration and alertness over time is not as apparent.

Pharmacological treatments, including any side effects

ADHD can be treated using antidepressants, or stimulants

Methylphenidate

· Methylphenidate (MPH), sometimes known as Ritalin or Concerta, is an FDA-approved medicine that is recommended for treatment of ADHD.

Side effects

· Appetite inhibition, stomach pain, sleeplessness, and migraine are some of the most prevalent side effects of stimulants, but they are normally endurable enough to proceed taking the drug (Shier et al., 2012).

· As a stimulant, there is an increased threat of misuse, particularly among those who already have a trouble with substance abuse.

· As a result, it is critical to keep an eye on the risk of misuse both before and throughout treatment.

· Assessing development variables in infants and teenagers prior to any psychoactive therapy with continuous surveillance through repetitive assessments of bodyweight and their shifts over time, and pretreatment reviewing and monitoring of heartbeat and blood pressure is important, holding the risks and advantages in mind (Inglis et al., 2016).

Bupropion

· Bupropion is an off-label dopamine and norepinephrine reuptake inhibitor (NDRI) that has been demonstrated to be a viable non-stimulant option for the management of ADHD in teenagers, with multiple reports of excellent results.

Side effects

· Drowsiness, constipation, vomiting, loss of weight, myalgia, migraine, nervousness, sweating, anorexia, tinnitus, and high blood pressure are all frequent Bupropion side effects, but most of them go away on their own.

· Because of the lack of evidence of effectiveness and safety, as with any antidepressant, it is critical to evaluate for suicidal thoughts and educate caregivers of the danger so they can keep an eye on their children.

· Suicide is a significant concern for teenagers using antidepressants (Kweon & Kim, 2019).

Nonpharmacological treatments

· Parent training in behavior management (PTBM), which fosters parent-child psychotherapy and assists parents improve their parental practices and create a better connection with their kids, is one of the most prevalent behavioral therapies.

· Parents are trained to notice troublesome activities in their kids and to use nonphysical tactics such as commercial breaks to prevent undesired behaviors while rewarding good actions with good focus and appreciation (Shrestha et al., 2020).

Pertinent patient education considerations

· Parents whose children suffer from ADHD are educated on how to support the child as well as foster their development by;

· Keeping in touch with the child’s teacher on a frequent basis.

· Maintaining a daily plan that includes schoolwork, food, and outside activities at regular intervals.

· Making schedule alterations ahead of time rather than at the last minute.

· Reducing the number of distractions in the child’s surroundings.

· Ensuring the youngster eats a balanced, healthful diet that includes lots of fiber and other minerals.

· Ascertain that the youngster receives adequate rest.

· Good conduct should be praised and rewarded.

· Provide the youngster with clear and consistent rules.

Legal and ethical considerations

· The process of establishing restrictions for children’s consent to treatment, particularly mental health care, is in disarray.

· Confidentiality is a challenge since, in certain situations, data may be disclosed without agreement due to worries regarding child safety, lawbreaking, or danger to others.

· Hyperactivity often causes ethical difficulties between beneficence/nonmaleficence and fairness for professionals. Before a diagnosis, instructors may inform therapists that the kid will not be permitted to return to school until treated, or that a diagnosis is necessary before special schooling services are made accessible. Victims with hyperactive impulsivity may seek vengeance privately or officially via the courts.

· Limited evidence on some of the treatment’s methods, the risks my be way too much that the benefits

Comorbidities

Several mental health disorders coexist with ADHD

ADHD and comorbidities - but the thing is

References

Inglis, S. K., Carucci, S., Garas, P., Häge, A., Banaschewski, T., Buitelaar, J. K., … & Coghill, D. C. (2016). Prospective observational study protocol to investigate long-term adverse effects of methylphenidate in children and adolescents with ADHD: the Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) study. BMJ open, 6(4), e010433.

Kweon, K., & Kim, H. W. (2019). Effectiveness and Safety of Bupropion in Children and Adolescents with Depressive Disorders: A Retrospective Chart Review. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 17(4), 537–541. https://doi.org/10.9758/cpn.2019.17.4.537

Shier, A. C., Reichenbacher, T., Ghuman, H. S., & Ghuman, J. K. (2013). Pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: clinical strategies. Journal of central nervous system disease, 5, JCNSD-S6691.

Shrestha, M., Lautenschleger, J., & Soares, N. (2020). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: a review. Translational pediatrics, 9(Suppl 1), S114–S124. https://doi.org/10.21037/tp.2019.10.01

L8

The Assignment

Create a study guide for ADHD disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.

Areas of importance you should address, but are not limited to, are:

· Signs and symptoms according to the DSM-5

· Differential diagnoses

· Incidence

· Development and course

· Prognosis

· Considerations related to culture, gender, age

· Pharmacological treatments, including any side effects

· Nonpharmacological treatments

· Diagnostics and labs

· Comorbidities

· Legal and ethical considerations

· Pertinent patient education considerations

Create a study guide, in outline form with references, for your assigned disorder. Incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards.

27 (27%) – 30 (30%)

The response is in a well-organized and detailed outline form. Informative and well-designed visual elements are incorporated.

Followed directions correctly by uploading assignment to Gradebook and submitted to the discussion forum area.

24 (24%) – 26 (26%)

The response is in an organized and detailed outline form. Appropriate visual elements are incorporated.

Partially followed directions by uploading assignment to Gradebook but did not submit to the discussion forum area.

21 (21%) – 23 (23%)

The response is in outline form, with some inaccuracies or details missing. Visual elements are somewhat vague or inaccurate.

Partially followed directions by submitting to the discussion forum area but did not upload assignment to Gradebook.

0 (0%) – 20 (20%)

The response is unorganized, not in outline form, or is missing. Visual elements are inaccurate or missing.

Did not follow directions as did not submit to discussion forum area and did not upload assignment to gradebook per late policy.

Content areas of importance you should address, but are not limited to, are:

• Signs and symptoms according to the DSM-5

• Differential diagnoses

• Incidence

• Development and course

• Prognosis

• Considerations related to culture, gender, age

• Pharmacological treatments, including any side effects

• Nonpharmacological treatments

• Diagnostics and labs

• Comorbidities

• Legal and ethical considerations

• Pertinent patient education considerations

45 (45%) – 50 (50%)

The response throughly addresses all required content areas.

40 (40%) – 44 (44%)

The response adequately addresses all required content areas. Minor details may be missing.

35 (35%) – 39 (39%)

The response addresses all required content areas, with some inaccuracies or vagueness. No more than one or two content areas are missing.

0 (0%) – 34 (34%)

The response vaguely or inaccurately addresses the required content areas. Or, three or more content areas are missing.

Support your guide with references to the DSM-5 and at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines. Be sure they are current (no more than 5 years old).

9 (9%) – 10 (10%)

The response is supported by the DSM-5 and at least three current, evidence-based resources from the literature.

8 (8%) – 8 (8%)

The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study.

7 (7%) – 7 (7%)

Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.

0 (0%) – 6 (6%)

Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.

Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors

4 (4%) – 4 (4%)

Contains one or two grammar, spelling, and punctuation errors

3.5 (3.5%) – 3.5 (3.5%)

Contains several (three or four) grammar, spelling, and punctuation errors

0 (0%) – 3 (3%)

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

Written Expression and Formatting – The guide follows correct APA format for parenthetical/narrative in-text citations and reference list.

5 (5%) – 5 (5%)

Uses correct APA format with no errors