Prepared by, Yap Cheng Yee Dietetics 3 GTN301 Community Nutrition & Dietetics Services Practicum - Developmental Disabilities

Causes  The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role.  Other possible causes and risk factors including: Brain injury Environmental exposures (e.g., lead) Alcohol & tobacco use during pregnancy Premature delivery Low birth weight

The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA) is the guide that lays out the criteria to be used by doctors, mental health professionals, and other qualified clinicians when making a diagnosis of ADHD. There are 3 types of ADHD

ADHD—Primarily Inattentive Type ADHD—Primarily Hyperactive/Impulsive Type: Fails to give close attention to details or makes careless mistakes Has difficulty sustaining attention Does not appear to listen Struggles to follow through on instructions Has difficulty with organization Avoids or dislikes tasks requiring sustained mental effort Is easily distracted Is forgetful in daily activities Fidgets with hands or feet or squirms in chair Has difficulty remaining seated Runs around or climbs excessively Has difficulty engaging in activities quietly Acts as if driven by a motor Talks excessively Blurts out answers before questions have been completed Has difficulty waiting or taking turns Interrupts or intrudes upon others ADHD—Combined Type: Meets both inattentive and hyperactive/impulsive criteria

 To be diagnosed with ADHD, children must have 6 or more out of the 9 characteristics and older teens or adults must have at least 5 of the 9 characteristics in either or both DSM-5 categories listed.  In children and teenagers, the symptoms must be more frequent or severe compared to other children the same age. In adults, the symptoms must affect the ability to function in daily life and persist from adolescence.  Symptoms must be present for at least 6 months. Moderate: Symptoms /impairment between "mild" and "severe" are present. Mild: Few symptoms beyond the required number for diagnosis are present and symptoms result in minor impairment at home, school, work and/or in social settings. Severe: Many symptoms are present beyond the number needed to make a diagnosis, or multiple symptoms are particularly severe, or symptoms extremely impair an individual at home, school, work and/or in social settings.

There is no cure for attention deficit hyperactivity disorder (ADHD), but treatment can alleviate the symptoms and make the condition much less of a problem in day-to-day life. ADHD can be treated using medication or therapy, but it is widely agreed a combination of both is the best way to treat it. Types: Methylphenidate; Dexamfetamine; Atomoxetine Concentrate better Be less impulsive Feel calmer Learn & practise new skills With the help of Counsellors Psychiatrists Psychologists social workers

Psychotherapy A type of therapy that can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help them to cope and live with the condition. Behaviour therapy It provides support for carers of children with ADHD, and may involve teachers as well as parents. This therapy usually involves behaviour management, which uses a system of rewards and penalties to encourage children to try and control their ADHD. Parent training and education programmes They aim to teach parents and carers about behaviour management, while increasing confidence in the ability to look after the child and improving the relationship between parents and the child.

Social skills training It involves the children taking part in role-play situations, and aims to teach them how to behave in social situations by learning how their behaviour affects others. Cognitive behavioural therapy (CBT) A talking therapy that intends to change how the children feels about a situation, which would in turn potentially change their behaviour.

Diet People with ADHD should eat a healthy balanced diet. Do not cut out foods without medical advice. Some people may notice a link between types of food and worsening ADHD symptoms. For example, sugar and caffeine are often blamed for aggravating hyperactivity, and some people feel they have intolerances to wheat or dairy products that may add to their symptoms. If this is the case, keep a diary of what the child eat and drink and what behaviour this causes. Discuss this with GP, who may refer patient to a dietitian. Exercise People with ADHD is advised to take regular exercise. that might help

Reference  Attention-deficit/hyperactivity disorder. [Internet] [Updated 2013 Nov 18; cited 2013 Nov 28]. Available from:  Attention deficit hyperactivity disorder. [Internet] [Cited 2013 Nov 28]. Available from: hyperactivity-disorder/index.shtml  Symptoms and Diagnostic Criteria. [Internet] [Cited 2013 Nov 28]. Available from:  Treating ADHD. [Internet] [Updated 2012 May 29; cited 2013 Nov 28]. Available from: disorder/Pages/Treatment.aspx