Concept and Practice in

ADHD 5
CORE SYMPTOMS
ADHD brief definition

Level of inattention and/or

Hyperactivity-impulsivity present
Before the age of seven years
CORE SYMPTOMS
ADHD brief definition

– Must be more severe than those seen in other

children of same age.
– Must be present in several settings.
– Must create severe problems in everyday life
– Will change with age and can be life long
ADHD in preschool children
(3-6 years)

 Comorbid symptoms and problems

 Hard to manage preschoolers
 Temper tantrum
 Oppositional Defiant Disorder
 Specific developmental disorders of
 Speech and language
 Motor function
 Attachment disorder
 Disturbed parent-child relationship
 Exhausted parents
 Delayed school readiness
COMORBIDITY
ADHD
11% tic
 40%
14% conduct disorder  Oppositional defiant
disorder
4%mood

34% anxiety
COMORBIDITY

 Anxiety / depressions overlaps of symptoms

 Tics – start later in life and improve earlier
than ADHD
 Stimulants might increase tics
 Stimulants may be use in combination with
drugs reduction ( eg resperidone)
COMORBIDITY
anxiety / depression & ADHD

 Symptom overlap of poor concentration/

motor restlessness in anxiety( general
anxiety) or depression (major depression/
dysthymia)
 Less situational pervasiveness of these
symptoms in anxiety and depression
 Up to 40% of children with ADHD can have
comorbid anxiety/ depression and vice versa
COMORBIDITY
Tics disorders

 Tic start later in childhood and improve

earlier than ADHD
 Stimulants might increase tics
 Stimulants may be used in combination with
drugs for tic reduction i.e resperidone
COMORBIDITY
Developmental Coordination Disorder

 Overlap in about 50% of cases

 Poor drawing and handwriting
 Often additional developmental problems
 Higher risk for difficulties in social group
interaction
COMORBIDITY
Dyscalculia (DC)

 The association of children with dyscalculia

having dyslexia is 17% and ADHD 26%
 20% of boys with ADHD have dyscalculia
 Children with the dual diagnosis of DC and
dyslexia have more profound impairment of
arithmetic skills and poorer performance on
neuropsychological test than children with
DC alone or DC with ADHD
CLINICAL PICTURE
Course of the disorder
Increasing complications with age
Low
Family Poor
self esteem
disruption social skills
Disruptive
Learning
behaviour
problems
Complex
Learning Oppositional
difficulties ADHD only defiant disorder
Lack of Mood
motivation disorder
Conduct Provocative
disorder
Substance Antisocial behaviour
abuse School behaviour
exclusion
THANK YOU