ADHDFatima Al-Haidar

Professor, Child & Adolescent Psychiatrist

KSU

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.

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.

Background Information:

UK 0.5 – 1.0 %

US 3 – 5%

Boys : Girls

3 – 4 : 1

No social class variations

KSA !!!

Clinical features:

Onset

Duration

Hyperactivity

Impulsivity

Inattention

Sleep

School

Learning

Play

Friendship

Sociability

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………

Etiology:

Genetic factors

Brain dysfunction

Neurochemical factors

Diet

Lead

Temperament

Psychological factors

Social factors

Parental behavior

Early childhood experience

Interactional effects

Assessment:

What?

When?

Where?

For how long?

Family issues !!!

Chart.

Treatment:

Counseling of parents

Environmental manipulations

Formal behavioral modification programs

Medication

Dietary treatment.

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.