This document summarizes evidence-based psychosocial treatments for ADHD in children. It describes the core symptoms of ADHD including hyperactivity, impulsivity, and inattention. Pharmacological treatments like stimulants and non-stimulants are discussed. The document focuses on clinical behavior therapy, using principles of applied behavior analysis to modify a child's behavior through reinforcement of positive behaviors. Specific interventions taught to parents like praise, commands, and time outs are covered. The importance of psychoeducation and parent training are emphasized. Alternative treatments for ADHD are also reviewed.

1. Evidence Based Psychosocial
Treatment for ADHD in Children
G.Aasritha William
Pharm-D

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.

4. The Changing Face of ADHD
CHILDHOOD ADULTHOOD
Hyperactivity May
Become
Restlessness
Physical
Impulsivity
May
Become
Verbal
Impulsivity
Inattention Often
Remains
Inattention

5. 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.

6. STATISTICS IN INDIA IN 2013
STUDY
CONDUCTED
RESULTS

7. REFERENCE:Venkata JA, Panicker AS. Prevalence of attention deficit hyperactivity
disorder in primary school children . Indian J Psychiatry 2013;55:338-42

8. 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

9. 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

10. 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

11. 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.

12. ABC model( Antecedent
Behavior Consequence )
Behavior
Consequences
Antecedents
Contingencies

13. 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

14. 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.”

15. Specific interventions to help the
student with ADHD
• Psycho-education with parent
• Parent praise
• Commands/limit setting
• Response cost
• Parent monitoring
• Time out
• Ignoring

16. 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.

17. 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

18. “Never give up on someone with a mental illness.
When "I" is replaced by "We", illness becomes
wellness.”

19. THANK
YOU
G.Aasritha William