1. ADHD Fatima Al-Haidar Professor, Child & Adolescent Psychiatrist KSU

2. Development of Normal Attention: Newborn pay attention to certain kinds of stimuli. Moving objects Intermittent tones Pictures of human face Developmental dimensions: Exploration Search Distraction Span of attention Links with other cognitive skills.

3. ADHD Definition: Combination of over activity, poorly modulated behavior with marked inattention, lack of persistent task involvement, restlessness, impulsive tendencies and a high degree of distractibility with an early onset and duration of more than 6 months.

4. Background Information: UK 0.5 – 1.0 % US 3 – 5 % Boys : Girls 3 – 4 : 1 No social class variations KSA !!!

5. Clinical features: Onset Duration Hyperactivity Impulsivity Inattention Sleep School Learning Play Friendship Sociability

6. Comorbidity: Over 50% of ADHD have comorbidity Oppositional/defiant disorder 40% Conduct disorder 25% Depressive disorder 15% Anxiety disorder 25% Learning disability 15-40% Language impairment 15-75% Other ………

7. Etiology: Genetic factors Brain dysfunction Neurochemical factors Diet Lead Temperament Psychological factors Social factors Parental behavior Early childhood experience Interactional effects

8. Assessment: What ? When ? Where ? For how long ? Family issues !!! Chart.

9. Treatment: Counseling of parents Environmental manipulations Formal behavioral modification programs Medication Dietary treatment.

10. Outcome: Mild and pure forms have reasonably good outcome Severe forms show poor scholastic achievement, antisocial Behavior, increased risk for substance abuse, poor work Records, and relationship difficulties. Prolongation of ADHD into adulthood is well described.