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ADHD || Attention Deficit Hyperactivity Dissorder
ADHD – Attention Deficit Hyperactivity Disorder Presented by: Anurag Joseph Course: M.Sc. Final Year (Mental Health Nursing) Institution: SMT RD GARDI Nurses Training Centre Case Study 1 – Inattentive Type (Raju) 5th standard student Trouble focusing in class; often daydreams Misses deadlines; delays homework Slow information processing; indecisive Case Study 2 – Hyperactive-Impulsive Type (Rahul) 3rd standard student Cannot sit still; loud and aggressive Talks fast; interrupts; impatient Disruptive, energetic when unsupervised Behavioral Problems in School Inattention + Hyperactivity Impacts learning, peer interaction, discipline Introduction ADHD is a developmental disorder marked by co-existing attention problems and hyperactivity, rarely found alone. Definition (DSM-5 Inspired) A neurodevelopmental disorder with persistent inattention and/or hyperactivity-impulsivity, interfering with functioning or development, starting in childhood. Prevalence 5.1 million children diagnosed in the U.S. 6.8% (ages 4–10), 11.4% (ages 11–14), 10.2% (ages 15–17) Symptoms may appear by age 4; diagnosable by 7 68% of affected children carry symptoms into adulthood Causes of ADHD Genetic Causes Strong hereditary link Runs in families Biological Factors Brain and neurotransmitter dysfunction Abnormal brain region volumes Environmental Factors Exposure to toxins (e.g., microplastics) Prenatal and perinatal risks Unstable home or school environment Psychological Contributions Negative feedback from peers/teachers Low self-esteem, peer rejection, isolation Symptoms of ADHD 1. Inattention Easily distracted, forgetful, daydreams Avoids long tasks, misses details Trouble completing homework and following instructions Difficulty processing information 2. Hyperactivity Fidgeting, inability to sit still Excessive talking and movement Constantly in motion, impulsive behavior 3. Impulsiveness Acts without thinking, interrupts frequently Instant gratification, inappropriate outbursts Anxiety about future events Why ADHD Children Are Different Issues in executive functions, working memory, motor inhibition, time management, and emotional regulation Problems with decision making, reward system, and risky behavior Diagnosis of ADHD Requires ≥6 symptoms (children) or ≥5 symptoms (adolescents/adults) over 6+ months in 2+ settings Tools include: Medical, neurological, vision, hearing exams Psychiatric evaluation (IQ, academics) Teacher/parent observations Brain imaging (MRI), prenatal history DSM-5 Key Diagnostic Points Persistent inattention/hyperactivity Symptoms must interfere with daily function Inattention signs include careless mistakes, trouble focusing, forgetfulness, etc. Management Goals & Strategies 1. Prevent Trauma Provide structured environments Maintain routine for predictability 2. Improve Thought Process Use Cognitive Behavioral Therapy (CBT) Consider medication if necessary 3. Boost Self-Esteem Encourage positive
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ADHD || Attention Deficit Hyperactivity Dissorder
- 1. ADHD Attention deficit hyperactivitydisorder Presented By- Anurag Joseph MSc. Final year (Mental health nursing) SMT RD GARDI NURSES TRAINING CENTRE
- 2. • Raju isa student in 5th standard and he has hard time focussing in class. • Teacher often complains about him of daydreaming and being distracted. • He never turns the homework on time and fails to complete project and school work before deadline. • He also takes time processing information and is often indecisive in his actions CASE STUDY 1
- 3. • Rahul isa student in 3rd standard and he never sits quietly in class. • Teacher often complains that he cant sit still for more than 5 minutes • He is loud, aggressive and doesn’t listen to instruction. • He also speaks fast, is impatient and interrupts other, sometimes even saying inappropriate words. • He runs in the class and is full of energy when the teacher is not present. CASE STUDY 2
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- 6. Attention Deficit HyperactivityDisorder (ADHD) is a developmental disorder it is primarily characterized by “the co-existence of attention problems and hyperactivity, with each behavior infrequently alone.” INTRODUCTION
- 7. DEFINITION:- Attention-Deficit/Hyperactivity Disorder (ADHD)is a neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interfereswith an individual'sdaily functioning or development. It is typically diagnosed in childhood but can persist into adolescence and adulthood.
- 8. PREVALENCE OF ADHD •5.1 million children have a current diagnosis of ADHD: 6.8% of children ages 4–10 (1 in 15) 11.4% of children ages 11–14 (1 in 9) 10.2% of children ages 15–17 (1 in 10) • Symptoms usually arise at the age of 4 (diagnosable average age 7) • 68% of children with ADHD have problem as adults • ADHD is one of the most commonly diagnosed in children and adolescents. • It is often identified during the school years due to its impact on academic performance and classroom behavior. • While ADHD is not the only school-related problem, but it can affect a student's ability to succeed in an educational setting.
- 9. CAUSES OF ADHD Genetic s Runsin Family Heredity
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- 16. Psychological contributions Negative Feedbackfrom teachers, parents, and peers.
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- 18. SYMPTOMS OF ADHD INATTENTION HYPERACTIVITYIMPULSIVENESS
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- 20. Be easilydistracted, missdetails, forget things, and frequently switch from one activity to another.
- 21. Have difficulty focusingon one things
- 22. Become bored witha task
- 23. Not seem tolisten when spoken to
- 24. Daydreaming Trouble followingupwith homework and project submission
- 25. Have difficulty processing information asquicklyand accurate as other Struggle to follow instruction
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- 27. Fidgeting and troublesitting for longtime, will switch positions frequently
- 28. Talkingvery fast andnonstop.
- 29. Dasharound, trouble sittingand doinga task for prolonged time, constantly in motion.
- 30. Cannot stay quitefor long time
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- 32. Very impatient, Instantgratification
- 33. Blurt out inappropriatecomments, show their emotions without restraint
- 34. Difficulty waiting. Futureevent can increase anxiety, inattention, impulsivity and hyperactivity
- 35. Often interrupt conversationsor others activities
- 36. Why ADHD children'sare not like other normal children?
- 37. Executive functions Cool Working memory Visio-spatial Verbal Inhibition Motor inhibition Interference inhibition cognitiveswitching Attention Sustained and Selective Temporal processing Motor timing Temporal discounting Time anticipation Hot Reward related decision making Risky behavior, Gambling reinforcements
- 38. How is ADHDdiagnosed?
- 39. ADHDdiagnosed in childrenafter a child has shows six or more specific symptoms of inattention or hyperactivity on a regular basisfor more than 6 months in at least two settings.
- 40. Complete medical evaluation,with emphasis on a neurologic examination, hearing& vision.
- 41. Apsychiatric evaluation toassessintellectual ability, academic achievement, & potential learningdisorder problem
- 42. Direct observation, teacher’sschool report, parent’s report. Analysis of home and/or school environment
- 43. MRI studies reported decreasedvolume of brain regions Detailed prenatal and maternal history
- 44. What symptoms andsigns to look for DSM-5 ( diagnostic & statistical manual of mental disorders) 1. Pattern of inattention and /or hyperactivity-impulsivity that interferes with functioning or development 2. Inattention: sixor more symptoms of inattention for children up to age 16, or five or more adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months. 3. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activity. 4. Often has trouble holding attention on tasks or playactivity. 5. Often does not seem to listen when spoken to directly. 6. Often does not follow through on instructions and failsto finish schoolwork, chores, or duties in the workplace 7. Often avoid, dislikes,or reluctant to do tasks that require mental effort over a long period of time) 8. Is often easilydistracted. Often loses things necessaryfor tasks and activities(e.g. school materials, pencils, books, tools, wallets, keys 9. Is often forgetful in dailyactivity.
- 45. MANAGEMENT Goal- Avoid riskfor trauma (impairments in cognitive and psychomotor functioning) •Structured Environment: Create a structured and predictable environmentat home and school to reduce stress and help the child feel safe. •Regular Routines: Establish daily routines to provide a sense of consistency, which can help manage ADHD symptoms and reduce the risk of
- 46. •Cognitive-Behavioral Therapy(CBT): ConsiderCBT to help the child develop better thought processes, self-awareness, and emotional regulation. •Medication: In some cases, medication may be prescribed by a healthcare professional to improve cognitive function and manage symptoms. Goal- Improving though process
- 47. Goal- Improving selfesteem •Positive Reinforcement: Encourage and praise the child for their efforts and accomplishments, no matter how small. Positive feedback can boost self-esteem. •Therapeutic Support: Consider therapy or counseling to address self-esteem issues and help the child develop a more positive self-image. Goal- Improving self esteem
- 49. Goal- Teaching parentsand the child coping skills
- 50. Goal- Teaching parentsto support their child and find the right socialgroup •Parent Training: Participate in parent training programs that specifically address ADHD management, parenting techniques, and strategies for supporting the child. •Communication: Maintain open and honest communication with the child to understand their needs and provide emotional support.
- 51. Goal-Buildingstrong familysystem •Family Therapy:Consider family therapy to address family dynamics, improve communication, and develop strategies for maintaining a healthy family system. •Establish Boundaries: Define clear boundaries and rules within the family to provide structure and consistency.
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- 53. RED FLAGS INADHD
- 54. When child becomesdull and irresponsive
- 55. When child talksto themselves often.
- 56. Frequent complains fromteachers regardingacademic performance, discipline and behavioral problems.
- 57. Continuous poor performancein school
- 58. Participation in violentactivities
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- 60. Inform parents abouttheir child behavioral and academic problems
- 61. Suggest parents totake counsellingor expert help
- 62. "A classroom ismeant to be a sanctuary of growth” "एक कक्षा विकास का आश्रय होती ह
- 63. “not a battlegroundof broken spirits." टू ट ीहुई आ त्म ा ओ ं क ीज ं ग भू श्र ि न हीं ।
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