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ADHD in Children

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Evidence based psychosocial treatment for ADHD in children

Published in: Health & Medicine
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ADHD in Children

  1. 1. Evidence Based Psychosocial Treatment for ADHD in Children G.Aasritha William Pharm-D
  2. 2. ADHD(Attention Deficit Hyperactivity Disorder) • “Attention Deficit Hyperactivity Disorder(ADHD) is a chronic condition that affects millions of children and often persists into adulthood.” • Children with ADHD are often hyperactive (overactive) and have difficulty paying attention and staying focused on tasks. • They may interrupt other people's conversations or be impulsive and impatient.
  3. 3. The Changing Face of ADHD CHILDHOOD ADULTHOOD Hyperactivity May Become Restlessness Physical Impulsivity May Become Verbal Impulsivity Inattention Often Remains Inattention
  4. 4. PATHOPHYSIOLOGY -Brain studies on individuals with ADHD suggest a defect in the dopamine receptor D4 (DRD4) receptor gene and overexpression of dopamine transporter-1 (DAT1) -The DRD4 receptor uses DA and NE to modulate attention and responses to one's environment. The DAT1 or dopamine transporter protein takes DA/NE into the presynaptic nerve terminal so it may not have sufficient interaction with the postsynaptic receptor. The neurotransmitters dopamine (DA) and norepinephrine (NE) are implicated in the pathophysiology of ADHD.
  5. 5. STATISTICS IN INDIA IN 2013 STUDY CONDUCTED RESULTS
  6. 6. REFERENCE:Venkata JA, Panicker AS. Prevalence of attention deficit hyperactivity disorder in primary school children . Indian J Psychiatry 2013;55:338-42
  7. 7. PHARMACOLOGICAL TREATMENT STIMULANTS • methylphenidate hydrochloride • dextroamphetam ine sulfate • dextroamphetam ine/amphetamin e formulation • methylphenidate NON- STIMULANT atomoxetine ANTI DEPRESSANTS • buproprion hydrochloride • imipramine ANTI HYPERTENSIVES • clonidine hydrochloride • guanfacine
  8. 8. What works for ADHD? • All of the evidence-based practice elements for use in ADHD have their basis in Clinical Behavior Therapy (Psychosocial Therapy) REFERENCE:From the National Institute of Mental Health and Project # U45 MC00174 from the Office of Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services
  9. 9. What doesn’t work for ADHD? • Treatments with little or no evidence of effectiveness include – Special elimination diets – Vitamins or other health food remedies – Psychoanalysis – Biofeedback – Play therapy – Sensory integration training – Social skills training – Self-control training
  10. 10. Clinical Behavior Therapy: ‘Theory’ Proposed Mechanism: Individuals with ADHD have difficulty understanding the consequences of their actions. Approach:Application of principles of social learning theory to modify children’s behavior by training parents and teachers to manipulate environmental antecedents, consequences and contingencies.
  11. 11. ABC model( Antecedent Behavior Consequence ) Behavior Consequences Antecedents Contingencies
  12. 12. An example: The ABC Model Behavior Student ignores bell while rest of class takes out math books Consequences Teacher yells at student Antecedent 9:30 bell signals beginning of math period
  13. 13. The ABC Model Behavior Student takes out math book Consequence Teacher smiles at student Antecedent 9:30 bell signals beginning of math period Contingencies Teacher makes eye contact with student, says, “Take out your math books.”
  14. 14. Specific interventions to help the student with ADHD • Psycho-education with parent • Parent praise • Commands/limit setting • Response cost • Parent monitoring • Time out • Ignoring
  15. 15. Does acupuncture have a positive effect on school success in children? • OBJECTIVE: • To evaluate school success in pediatric patients undergoing acupuncture treatment for various indications including ADHD. • CONCLUSION: • Acupuncture contributed to the academic success of the children who underwent treatment for their primary symptoms. Reference:Tas D, Acar HVJ; Tradit Chin Med. 2014 Aug;34(4):450-4.
  16. 16. A review of ADHD in girls: • OBJECTIVE: To describe the clinical presentation of attention deficit/hyperactivity disorder (ADHD) in girls and factors influencing proper diagnosis and treatment. • RESULTS: The ADHD prevalence rates are higher among boys than girls. A low index of clinical suspicion exists for girls; their presentation is considered "subthreshold" because inattentiveness is more prominent than hyperactivity/impulsivity. Females with ADHD may develop better coping strategies than males to mask their symptoms. REFERENCE:Venkata JA, Panicker AS. Prevalence of attention deficit hyperactivity disorder in primary school children . Indian J Psychiatry 2013;55:338-42
  17. 17. “Never give up on someone with a mental illness. When "I" is replaced by "We", illness becomes wellness.”
  18. 18. THANK YOU G.Aasritha William

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