1. ATTENTION DEFICITY AND HYPERACTIVITY DISORDER

2. ADHD ACCORDING TO DSM IV
“Persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals.”

3. 3 Dimensions of ADHD: Inattention
Fails to give close attention to details
Has difficulty sustaining attention in tasks
Does not seem to listen
Does not follow through on instructions
Has difficulty organizing task
Avoids, dislike or is reluctant to engage in tasks that require sustained mental effort
Loses things
Easily distracted by extraneous stimulu
Forgetful in daily activities.

4. Hyperactivity Fidgets with hands Leaves seat in classroom Runs about
Has difficulty playing
Is often “on the go”

5. Impulsivity Blurts out answers before questions have been completed
Has difficulty awaiting turn
Interrupts or intrudes on others

6. Demographic Information
Date of birth:
School: Barış İlköğretim Okulu, 4th grade
Has a sister (7 years old)
Mother & Father : Faculty members
First visit to the clinic :

7. The History of the Present Disorder
Referral to another psychiatrist during the 2nd semester of the 2nd grade.
> Three nervous breakdowns, night fears since the age of 4. Therapy + medicine (Concerta).
Stopped therapy thinking that it wasn’t effective, continued with Concerta.

8. The History of the Present Disorder
Came to Koza Danışmanlık, still using the medicine.
SYMPTOMS:
Sleep disturbance
Learning disabilities
Failure to attend to in-class activities & forgetting his stuff at school
Forgetful in daily activities

9. In his daily life… In his school life… Easy-going child
Sociability-> not possitive effect, not adaptable
Attention span (not strong)
In his school life…
Cannot solve long mathematical problems
Cannot read fast, skips words
Forgets words when writing
Doesn’t pay attention to what the teacher says, gets lost in daydreaming.
Grades are not consistent

10. In his home life… Cannot sit still and do his homework
Have sleep disturbance
Begins playing with toys but gets bored easily
Forgets his books at home

11. FAMILY and PEER RELATIONS
Perfectionism of the parents
Happy family
Likes going to school
Not engage in group activities
Weekends -> Playstation days

12. DEVELOPMENTAL & SOCIAL HISTORY
Pregnancy
Planned, cesarean, no complications
MEDICAL HISTORY
Allergies (polens, especially in times of seasonal changes).
No surgery
Concerta

13. MEDICAL HISTORY OF THE FAMILY
MOTHER:
Diagnosed with Depression, using Prozac
UNCLE (mother side):
Diagnosed with OCD, still in treatment
GRANDFATHER (mother side):
- Diagnosed with Bipolar Disorder and have Diabetes, uses Paxil & Seroxate

14. DIAGNOSTIC & ASSESMENT TOOLS
STRESS FACTORS
- Biological tendency
- Birth of the sister (2002) -> night fears
DIAGNOSTIC & ASSESMENT TOOLS
DSM-IV
WISC-R:There are two parts in WISC-R:
1). Verbal Part
General information, comparison, arithmetic, vocabulary, judgment, set of numbers
2). Performance Part
Completing pictures, ordering pictures, drawing with cubes, combining pieces, password, maze
Projective Tests

15. TREATMENT Cognitive-Behavioral Therapy:
The aim is to teach “learning” by giving cues, focusing on the learning and developing learning techniques.
E.g. Commitment Chart
Box-game
The aim is to observe the child’s attention during a task and discover the said and unsaid symptoms.

16. With this treatment what is changed in Ömer’s life?
The child is at his 25th sessions. There is a progress observed by the teachers at school and by the parents at home.
E.g. His grades started to get better and more consistent, he got the 3rd award in a poetry competition, he does his homework and doesn’t forget his stuff as much as he used to.

17. WHAT ELSE CAN BE DONE? Goodness-of-fit
Parent Training (Behaviorally Oriented Treatment)
The aim is to teach the parents “child management techniques”. Sessions include information about the understanding of ADHD, discussion of special and future problems, and the consideration of the child’s school situations.