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ADHD What is it and how do you know?
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DSM-IV Where does this come in? What it says The menu approach: A. –Either (1) or (2)
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A(1) Inattention –a. Often fails to give close attention to details or makes careless mistakes in schoolwork; –b. Often has difficulty sustaining attention in tasks or play activities; –c. Often does not seem to listen when spoken to directly; –d. Often does not follow through on instructions and fails to finish schoolwork or chores;
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A(1) e. Often has difficulty organizing tasks and activities; f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort; g. Often loses things necessary for tasks and activities h. Is often easily distracted by extraneous stimuli i. Is often forgetful in daily activities.
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A(2) Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that it is maladaptiveand inconsistent with developmental level:
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(2) Hyperactivity a. Often fidgets with hands or feet or squirms in seat; b. Often leaves seat in classroom or in other situations where remaining seated is expected; c. Often runs about or climbs excessively in situations in which it is inappropriate;
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(2) Hyperactivity d. Often has difficulty playing or engaging in leisure activities quietly; e. Is often “on the go” or often acts as if “driven by a motor;” f. Often talks excessively
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(2) Impulsivity g. Often blurts out answers before questions have been completed; h. Often has difficulty awaiting turn; i. Often interrupts or intrudes on others (e.g., butts into conversations or games)
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B. Some hyperactive-impulsive symptoms or inattentive symptoms that caused impairment were present before age 7.
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C. Some impairment from the symptoms is present in two or more settings (e.g., at school and at home).
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D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
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E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder and are not better accounted for by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder).
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ADHD or ADD Different flavors: –1. Attention-deficit/hyperactivity disorder, combined type = Both criteria A1 and A2 are met for the past six month (what most people refer to as AD/HD); –2. Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type = if Criterion A1 is met but Criterion A2 is not met for the past six months;
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AD/HD or ADD –3. Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type = Criterion A2 is met but Criterion A1 is not met for the past six months. –4. A-D/HD, not otherwise specified.
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How then to diagnose AD/HD? Why is diagnosis important? What does AD/HD affect? –School –Home
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How then to diagnose AD/HD? “Co-Morbid conditions” – What does that mean? The importance of history Eye-balling: Is this the best way to diagnose? Ratings: what are they good for? Testing: Is it worth it?
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Ratings: What they measure BRIEF CONNERS BROWN BASC
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Testing: Why bother? What it measures IQ: Does AD/HD affect this? ACADEMICS: Does AD/HD affect this? ATTENTION: How is this assessed? EXECUTIVE FUNCTION: How is this assessed? Language: Why assess this?
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Putting it all together What a psychologist is for The developmental trajectory: Are there differences in how the symptoms appear by age and by gender? Statistics and more statistics
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Treatment Drugs: –Does anything else work? –Side effects –Main effects Supplements Other therapies (behavioral, parenting, talk therapy, etc.)
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Follow-up: What happens down the road The importance of long-term follow-up: –How things can change over time Changing interventions with age Do they grow out of it? What if no one ever noticed it (and now you’re 21)? Test accommodations (SAT’s, LSAT, GRE, PRAXIS)
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Treating a chronic condition The importance of family awareness The importance of family support The importance of psycho-education The importance of self-advocacy
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