1 ADHD (Attention Deficit/Hyperactivity Disorder) Youth Justice Project 2010/2011

2 Aims Give some straightforward information about a very complex condition. ADHD Attention Deficit/Hyperactivity Disorder

3 What is ADHD? (Dr Likierman) A range of problem behaviours associated with poor attention span. These may include :- impulsiveness restlessness hyperactivity inattentiveness, The above prevent children from learning and socializing well. Divided into Inattention and Hyperactivity

4 ADHD – A Definition: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), Either 1 or 2 1- Inattention: Often fails to give close attention to details or makes careless mistakes in work, or other activities Often has difficulty sustaining attention in tasks. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish schoolwork chores, or duties in the workplace (not due to oppositional behaviour or failure to understand instructions)

5 Often has difficulty organizing tasks and activities Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort. Often loses things necessary for tasks or activities. Is often easily distracted by extraneous stimuli. Is often forgetful in daily activities.

6 Definition continued 2 - Hyperactivity –Often fidgets with hands or feet or squirms in seat –Often leaves seat in classroom or in other situations in which remaining seated is expected –Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) –Often has difficulty playing or engaging in leisure activities quietly

7 –Is often "on the go" or often acts as if "driven by a motor" –Often talks excessively - Impulsivity –Often blurts out answers before questions have been completed –Often has difficulty awaiting turn –Often interrupts or intrudes on others (e.g. butts into conversations or games)

8 For the condition to be confirmed: Some hyperactive, impulsive or inattentive symptoms were present before 7 years of age Some difficulty from the symptoms is present in two or more settings (e.g., at school or work and at home) Clear evidence of significant difficulty socially, academically, or affecting work Symptoms are not part of something else e.g. mental health condition or other disorder

9 Incidence of ADHD Approx. 3-7% of the UK population, have ADHD. In America it is reported as being as high as 10% Boys are more likely to be affected than girls.

10 The future? You cannot grow out of ADHD, but hyperactive movements and impulsiveness may not be as apparent. Some research shows that children with hyperactive-impulsive symptoms tend to have more behavioral problems and conduct disorder, while children with the inattention symptoms have a higher risk of depression or anxiety disorders.

11 Richard Branson Founder & CEO of the multi-billion dollar Virgin empire, has ADHD and is Dyslexic, but he found a way to make his ADHD work for him. He could have struggled his whole life trying to "fit in" by suppressing his ADHD. Instead he "broke-out" into fame, fortune & wild success, because he discovered the genius behind his ADHD

12 Charlotte Fisher on living with adult ADHD (Horizon programme on ADHD 2009) ‘I still have a problem with my moods which can, at times, still explode to the surface. Sometimes when I am standing and waiting to be served in a check-out queue I can literally feel the anger welling up inside me, like a volcano. I'm thinking, 'Why are others so slow?' They irritate me so much that I blow up and start shouting at people. Five seconds later it's blown over for me and I'm absolutely fine. I just can't understand why no one else around me wants to talk to me - what more can I say?’

13 Charlotte Fisher on living with adult ADHD (Horizon programme on ADHD 2009) ‘Before my diagnosis my life consisted of daily drug taking. The only way I can explain it is that I knew from a very early age I was different. I didn't know why, I just knew that I was. I felt like I had a void inside me, and one day I discovered drugs - and that void was filled. The numbing effect of the illicit substances was the only thing that helped to relieve my whirring mind that never switched off, and restless body that never kept still.’

14 Occipital lobe Temporal lobe Parietal lobe Frontal lobe

15 Prefrontal Cortex Planning Decision making Attentional control Inhibition of inappropriate behaviour

16 Executive functioning Executive functioning skills Not needed for routine well practised actions (e.g. walking and eating) Needed when a routine behaviour is not sufficient Crucial for doing several tasks at once and switching between tasks From Frith (2003)

17 Problems in this area can lead to: Poor executive control Inability to disengage Inability to inhibit inappropriate responses Inability to plan tasks and organise ahead Inability to switch task set (perseveration) Inability to generate novel responses Russell (1997) Also thought to be related to autistic disorders (e.g. rigid routines and resistance to change)

18 TEENAGERS?

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22 Impact in Adulthood Untreated, ADHD affects all aspects of life. Employment prospects are poor. There is an increased risk of substance misuse. A driver with ADHD is at substantially increased risk of driving offences and accidents. Relationships may be unstable. It may lead to depression or anxiety.

23 ADHD Strengths Creative Energetic. Quick learners Rapid fire minds Risk takers Constantly scanning the environment..

24 Charlotte Fisher on living with adult ADHD (Horizon programme on ADHD 2009) es/horizon/adhd_living_with.shtml

25 Useful contacts The National Autistic Society Dyspraxia Foundation ADHD